Dr. Jane Oh on Women’s Health, Menopause, Body Image & Connection

Speaker 1: 0:00

What does a hot flush really feel like? It tends to happen right in the face. You get really flushed. There's literal sweat dripping down your face. We never really learn how to keep people healthy, which is really a big deficiency in medical training.

Speaker 2: 0:17

Have we changed work culture so that it is conducive for women versus not?

Speaker 1: 0:22

People don't talk about it, and that's what's so great about this and to share our experiences in a community of other women.

Speaker 2: 0:31

We're going through menopause. It changes our body beyond not having a period right. Does it change our metabolism and stuff too. Does it change other things about our bodies?

Speaker 1: 0:40

Oh, a lot of other things.

Speaker 2: 0:43

Do tell. That's why we're here. What's going to happen to my boobs? Well, um, welcome to the Whole Shebang. I'm Jen Briggs, your host. Let me tell you what you're in for here.

Speaker 2: 1:01

Many of us have been running at breakneck speed, functioning mostly in our heads, and we've suffered from disconnection, burnout and lost passions. I believe it's because we functioned in part and not in whole. So we're exploring a new path, embracing intuition, creativity, playfulness and connection in all of life. It's vibrant, powerful and magnetic. So come on with me and buckle up buttercups. We're diving in. Listen for just a few seconds. What do you hear? Let me tell you what I hear. I hear the sound of women, warrior women, wild women, women sharing stories, laughing, opening hearts. What I hear and what I saw in those moments is also a desire to create a sense of village, multi-generational, rich, wise, strong, voluminous. There are so many soundbites from this conversation that I could have started with, but a chorus of connection felt the most fitting.

Speaker 2: 2:04

This episode was recorded with a live audience at my friend Lindsay Ronning's house, where I had the pleasure of interviewing Dr Jane oh, and while our primary intention was focusing on perimenopause and menopause, how to create resilience before it begins and ways to reimagine the workplace so that it can hold space for women in this transformative phase.

Speaker 2: 2:24

We also took many bends and turns in the conversation, talked about how Western and Eastern medicine practices could benefit from one another, we covered ways that we can focus on staying healthy rather than just reacting to sickness, and in the end, we opened it up for our questions and had a really powerful conversation with the women in the room, which I thought I was going to have to cut out, but the sound quality managed to come through and I think it's such a beautiful raw conversation that you get to hear, where women share about their feeling invisible at times, their libido later in life, the power of connection and community, and I'm really happy that you get to be a fly on the wall for it Now, men, if you're still listening and you're here right now, thank you.

Speaker 2: 3:07

So thank you in advance for your empathy, for your desire to understand the different phases that we, as women, evolve through in our lifetime, and remember that this is for all the women in your life, for your coworkers, mothers, sisters, daughters, partners. Thank you for your support and for also seeing this phase of our lives as one that continues to show us as full, wild, resilient, intuitive, wise warrior women. This is our design. It's a gift, and just as your design is a gift, so thank you for helping us to see it as that, especially on the days when we're cursing it in the midst of a hot flash, without further ado let's get started.

Speaker 2: 3:48

I was going to just take a minute and introduce myself to you guys. I have the pleasure of knowing Lindsay through real estate and have been the general manager of a few of the franchises that Lindsay's a part of over the last year, and I'm just moving out of that into launching my own business for coaching, consulting, training. Um, that's not really how I identify who I am. I've really been working on who am I outside of what I do, how you know and you guys in the yoga community. It's like it's about being right and so who am I being? Who am I becoming? How am I being present? And it's a lot of what this podcast has been about for me. It's not me showing up as an expert on a topic. I actually wasn't going to do the podcast because it was like I'm not an expert on anything, Then it was a huge aha to go.

Speaker 2: 4:36

oh a host doesn't the expert, they're the one that wants to learn and.

Speaker 2: 4:40

I love to learn, so this is really about a journey for me to to learn the things I'm interested in and share that with other people, and I think the other part of that is it is building a community, which is really fun. And then I think the third thing that I'm hearing is that it's presenting a mirror for people. So when we hear each other's stories, we see ourself in people and we realize we are never alone in what we're going through. Our human experience is just so human.

Speaker 2: 5:10

It's so real. So, um, that's kind of my aim in this is to keep it pretty real and to explore together. So a little bit. I've got three daughters, so this is good for me to learn about menopause. But also I'm raising three women. They are about to be 18, 16 and 13. So we've got a house full of periods, lots of periods.

Speaker 8: 5:33

Yes, yes.

Speaker 2: 5:35

My daughter goes mom, did you, did you get your period today? I'm like, well, I don't really get a period, cause I have an idea, except I did start spotting today. She's like you know, it's the clips. You know what that means? I'm like I don't know what that means.

Speaker 4: 5:46

What does it mean?

Speaker 2: 5:47

She said you're a white witch.

Speaker 9: 5:48

I was like okay all right, I'll take that.

Speaker 2: 5:55

So all right, Jane, you ready to dive in Sure?

Speaker 1: 5:58

Okay, we're going to talk all about periods today, or lack of periods.

Speaker 2: 6:05

I think we're going to go to the lack of Okay, well, welcome to the whole shebang, Jane.

Speaker 1: 6:10

Thank you for having me.

Speaker 2: 6:11

It is a pleasure to be here speaking with you and to be learning from you. So we're going to talk about menopause and lack of periods. That's right. Before we do that, can you just introduce a little bit about yourself and what your journey has been to get to this work?

Speaker 1: 6:27

Sure, absolutely.

Speaker 1: 6:29

Well, I'm an internist, internal medicine physician and I practiced primary care for many years and in the last two and a half years I've moved to working in hospice medicine.

Speaker 1: 6:42

But I also have a huge interest in healthy lifestyle and that really started with my yoga practice over 20 years ago and because it was such a transformative experience for me to have the experience of doing a form of movement that helped me with anxiety and a lot of other issues that I was having. So I went on to explore what is that connection between the mind and body and I wanted to learn more about that. So I took a course in mind-body medicine, became certified in stress management and resiliency training, and that led me to learning more about healthy lifestyle. So I got board certified in lifestyle medicine. So as I was learning this, it really made sense to me. It was like aha now I understand why yoga is so powerful and why it's such a healing, transformative practice. So I began incorporating that into my primary care practice because people were asking questions you know what is a healthy diet, what kind of exercise, what about stress management? And in my medical training I really didn't have the answers because that's not part of our formal medical training.

Speaker 2: 8:12

Okay, hold please. This is where I'm like back the bus up. Okay, I am fascinated by so much of what you just said, as I'm sure a lot of the women are here. I want to talk, I want to go back, we can rewind a little bit and if you can just dive into yoga and the mind-body connection and you said it was a transformative experience for you so you've got people that are coming to you in a clinic and they're looking for help and you recommend yoga, why?

Speaker 1: 8:56

What does it do Like? What does it really do? Response so the relaxation response is a physiologic response in your body that happens when you get out of the fight or flight response. So the stress response is one cascade of hormones that takes place and then the relaxation response is on the opposite side. And there are lots of ways to induce the relaxation response um, meditation, yoga, other practices where you can get into the relaxation response, and that helps with so many symptoms of like anxiety, but also hypertension, high blood pressure, elevated blood sugars, all of those things which were pertinent for me in my medical practice.

Speaker 2: 9:55

Okay, I know that this episode is not about, like, all of that necessarily and we're going to connect this to periods and lack thereof? Okay, going to connect this to periods and lack thereof? Okay, I've like screeched the bus to a halt when you talked about how this isn't we don't talk about this in Western medicine. Really, why? Why do you? Well?

Speaker 1: 10:15

because the focus of what we learn in medical school is really about pathology, really about pathology, so learning to recognize when people are sick. So you learn about illness, you learn about the signs and symptoms of sickness, but we never really learned how to keep people healthy, which is really a big deficiency in medical training, at least when I was doing it. I think there is more of a movement to move into more prevention and healthy lifestyle because because people want to know about that and we recognize that it's more to let there's more to medicine than just treating people after they're already sick.

Speaker 2: 11:07

Yeah, yeah, and I know you know we chatted previously. A lot of what we're going to talk about isn't we can't prevent menopause, but we can set ourselves up to be more resilient for it. Yes, yes, yeah. And so when we chatted, I shared a story and I'll share with you, ladies and the people, people listening here. This was like a month ago, and I think I was telling you about this, lindsay, that I just lost my train of thought. This is my menopause story.

Speaker 1: 11:40

Is this a symptom of menopause? You were asking a question to a doctor. I think oh yeah, I went to do a doc.

Speaker 2: 11:48

I was like thank you, I don't think I'm going to edit that out actually.

Speaker 1: 11:56

I remember this conversation yeah.

Speaker 2: 11:57

So I went into an. I was like I think I need to go into OB. I hadn't been into OB like prior to COVID. I was like I should probably take care of myself I'm 42, but I had been having some night sweats and I just was like this has got to be married perimenopause, or maybe it's not. I don't know what's happening. Maybe they can give me something for it, maybe not. So I went in and she's she told me that perimenopause was like the Instagram word of the year, and then it kind of wasn't like a real thing. I was like what? So I went home. So I went home and Googled like perimenopause symptoms and one of them is night sweats. But I'm like, well, if perimenopause isn't a thing, what are these night sweats then? So the first thing was like number one how many blankets do you have on your bed? And I was like whatever I have, whatever. Number two you could have lupus or you could be dying you know, I'm like am I, am I?

Speaker 2: 12:51

I literally had a moment of like am I dying? Oh my gosh my girls are too young for this and go down this path of what's wrong with me? I did have too many blankets on the bed, so there's, but also I'm pretty sure I'm having symptoms of perimenopause at 42.

Speaker 1: 13:07

And I thought I think it's time Most people have symptoms for four years prior to at least four years prior to their final menstrual period. So, menopause is not a moment in time. It is a gradual process that occurs over several years, and oftentimes the symptoms begin at your age and, you know, for several years beforehand before you stop having regular menstrual cycles. So I'm sorry you had that experience. That's pretty awful.

Speaker 2: 13:43

Yeah, I feel like there's been more conversations lately with women who are feeling sort of gaslit, you know like oh, that's not what you're experiencing and you're like, but this feels like what I'm experiencing, you know so it's encouraging to speak with people and have these conversations with women so that we can talk about what's really happening in a really real way. Yeah, so can we break down the science a little bit on what menopause is and when it starts and some of the things that may be common sense that maybe I don't know.

Speaker 1: 14:13

Sure. So menopause occurs because the follicles in the ovaries and the ovaries, there's aging of the follicles and ovaries and they're no longer active and then there's a drop in estrogen levels. And after menopause technically is 12 months, is urine menopause, 12 months after your final menstrual period. However, you know before that you can go for many, many years where you're having hot flashes, where your periods are becoming more irregular. They could get lighter, they could get heavier, because you know sometimes you'll have anovulatory cycles and then there's a buildup of endometrium and then you get a really, really heavy period.

Speaker 1: 15:10

Um, you can have shortened cycles, you can have longer cycles, so pretty much runs the gamut. And and so no woman experiences it exactly the same way. However, we have many common experiences and most women will have hot flashes. About 80% of women will have hot flashes as they go through menopause. The average age of cessation of menses is 51.4 years, but but having said that, a lot of people will go through menopause at 42. Some people go through menopause at 60. So again, there's a range of what happens in women, but this is just the average.

Speaker 2: 15:56

Okay, that's great, that's really helpful. Um, so you you've talked about sort of the lifestyle piece of it that we can set ourselves up for some resiliency going into menopause. Can you speak to what we can do, to? There are things we can do to help with the symptoms.

Speaker 1: 16:14

Part of the lifestyle medicine is healthy diet, exercise, sleep, stress management and um avoidance of risky substances. So I'm just going to talk a little bit about alcohol. Just because alcohol is so much a part of our society and we're we've normalized so much of just like drinking and um, I would say that that's something to look at in terms of healthy lifestyle. Stress management is something else that is really helpful. So any practice like meditation or yoga or things that help get you into that relaxation response when you're having a moment where you know you've just had your hot flash in the middle of the meeting and then you start to go into that fight or flight response and panic and worry oh no, you know what's my boss going to think of this? And just taking a moment and doing some deep breathing and maybe a short meditation. So all that, I think, really does help make us more resilient as we're going through these really massive bodily changes.

Speaker 2: 17:34

I feel like these are all things that most people know, right? It's like yeah, get sleep, eat well, exercise done. Great, I'm going to ask you kind of what seems like a basic question but why don't, why don't we? I'm going to just say we do those things. Can you answer for all of humanity?

Speaker 1: 17:58

I think that's a very complicated question, um, but I think it's because we want the easy way to do things, um, so, in terms of like diet, a healthy lifestyle management diet would be mostly a plant-based diet. So, um, um, you know, and that's just not how we, as Americans, eat, um, and so it's very hard for people to and I talked about alcohol and to cut back on their drinking, cause it's just such a normal part of what we do. Every event, every book club, you know, drink the wine, maybe talk about the book.

Speaker 2: 18:46

Yeah, what can we get specific on that? What would be like a healthy amount of alcohol to have or not have is oh, that's a good question.

Speaker 1: 18:58

No, actually for women. Women should have no more than seven drinks in a week and no more than two drinks at a time or in an evening. It's different for men because men are bigger usually and they metabolize alcohol differently. When I was in primary care, I talked to people about that, because people were drinking a lot more than that Well, and I feel like a lot of people don't.

Speaker 2: 19:27

Actually, I'll just speak for myself. After I had kids, I was drinking wine every night and feeling like it was pretty normal, and when I'd go into the doctor I would definitely put a lower amount.

Speaker 4: 19:37

Because I was like I don't want to be judged.

Speaker 2: 19:39

I know that I probably shouldn't be having two or three glasses every night, you know. Right, yeah, that's real. I probably shouldn't be having two or three glasses every night, you know just right yeah, right yeah.

Speaker 1: 19:45

And yeah, so learning about the specifics has really helped me kind of look at my own life more closely and make some changes, um, that have helped me feel better.

Speaker 2: 20:01

So one of the things that's coming to mind as you're speaking about this is that I don't I think I just heard this, probably on some other podcasts but this idea that we're we're often obviously thinking short-term versus long-term, and so it may seem a little morbid, but can we normalize also talking about if we're, if we're near the end of the life hopefully we have a long life, we're going to be able to look back and if we could look back and change what we're doing now and gain another, however many years by healthy lifestyle, would we do it? Would we make those changes? And I think if we had perspective, maybe it'd be easier. I think that's maybe one of the reasons, cause we're just like well, this feels good right now, I'll do it, I'll change it later, but not really pausing to think what the long-term compounding impacts are of change or lack thereof.

Speaker 1: 20:50

Yeah, and part of the healthy lifestyle is exactly what we're doing here, which is connection. So social connection is so, so important to us as humans and we got a really hard lesson in that during COVID, when we were so isolated, Gathering people together to talk about things, doing a yoga class I mean, I did so many Zoom yoga classes in front of my Peloton bike but there's a different experience when you're in a class with other people and it's because you're experiencing that connection and you're also um. There's this term called positivity resonance, where you resonate, where you actually um have you should have this shared experience, and there are these mirror neurons that turn on and so you start mirroring each other's experiences and that helps you feel connected and that also helps you get into a relaxation response. So it's all so good for your mind and body and that relaxation response helps decrease inflammation and all the things that cause disease and illness and sickness.

Speaker 2: 22:20

I love that so much. I mean, we're speaking to a room full of women who know how to be connected that this live recording right now. You guys all met in a lot of you in yoga classes. I've, and maybe you all have too. I've had a lot of conversations with women and a lot of men who are not connected.

Speaker 2: 22:38

They're not connected in meaningful relationships, they're not connected in community, and I think again, that's a part of our, our American sort of society, that we focused on so many other things and haven't made time for village.

Speaker 1: 22:52

Right.

Speaker 2: 22:52

And that's been something I've been sort of passionate about, but not exactly sure how to go about it other than these kinds of things and people like Lindsay that are just pulling people together. Yes, so I mean hats off to all of you. And so I mean hats off to all of you and I think, if we can continue in that vein of just like we're going to show up and just I did this actually at the tail end of COVID, when we could gather distance wise, we got women together and I did a 30 day sisterhood experiment and I said, all right, I literally am going to have you guys sign a contract that anything we say in here stays in here, and can we just agree to go really deep right away, so that we can like be connected and they were like yes, because we all want that.

Speaker 5: 23:33

Like.

Speaker 2: 23:33

I think we human. You said we're. I don't know exactly what the science is behind it, but we see it in all of nature most of nature that we are designed to be connected and what happens when we're not.

Speaker 1: 23:46

Right, but it's even those moments, those micro moments of connection, that are valuable too. So when you go to the grocery store and you see the same checkout person and you find out their name and you say something to them, even those micro moments of connection are valuable for both you, the person and the person receiving. So you're both receiving. So doing everything we can to make those micro moments and then also a more conscious group gatherings. So there are lots of lifestyle things, but I will say that if you are having symptoms that are interfering with your life like you can't go to work, you're not sleeping at all because you're getting woken up multiple times a night with hot flashes you're just not functioning well.

Speaker 1: 24:54

There really is a time and a place for hormonal therapy. So you know if you're a candidate. So if you're a candidate, some of the things that might exclude you from being a candidate is if you've had breast cancer, if you have a very strong family history of breast cancer, if you've had blood clots in your legs or your lungs, that hormone replacement therapy can put you at increased risk. But I don't think women should be afraid to ask for help from their doctors, um and I think gynecologists are really supposed to be the experts. So if women, if you're having symptoms that are really interfering with your life, I would encourage people to get help from their doctor and get hormone replacement therapy for a limited period of time.

Speaker 2: 25:52

Yeah, we were chatting in the kitchen I overheard some of you talking about this too, and then Lindsay, as we started the podcast, just talking about how that can be such an interference with our careers, and I was imagining you know, the work that I do is often in front of a room too and I've been thinking like what would I do and what does a hot flush really feel like? When I was pregnant I would get nosebleeds and I'd have to run off stage. But now thinking about, well, how do I set myself up for this and what do we do, and you know, part of what I've talked on this podcast is about how can we? Also, can we, can we, can we change work culture? Can we help shape things on the other end of it so that it is conducive for women versus not? So I'm on a rabbit trail a little bit here, but I don't know, I think. I think that that's something that I haven't heard people talking about a lot.

Speaker 1: 26:51

People won't talk about it and that's what's so great about this and to share our experiences in a community of other women. So, one, you don't feel alone. Two, you can find out that you know maybe they are experiencing symptoms, that you are also, and you can talk about what you've done and tried. Um, in terms of the workplace, I I've seen people with little fans at their desks. You know, take taking off their jacket, putting their jacket back on. But the hard thing when you're like when you're sitting in front of a camera, is that it tends to happen right in the face. You get really flushed, there's literal sweat dripping down your face, I mean it's like three to five minutes.

Speaker 2: 27:43

And then could you just say I'm having a hot flash. Excuse me for five. Yes, you could. I'm just like how do we handle this, can we just? What do we do? Yeah, absolutely, is that what we do?

Speaker 1: 27:52

Absolutely All right, okay, and then you get freezing cold because you're sweating and you're shivering. So it is something that is, you know, and I've witnessed a lot of people having hot flashes and I've fortunately I didn't have them that badly, but, um, it is something very visible. It's visible to others.

Speaker 2: 28:16

Well, I imagine that it racks your mind a little bit too, it's pretty hard to stay focused when that's happening physiologically it does. Gosh. I, as we're sitting here chatting, the phrase just keeps running through my mind. Women are such warriors, Absolutely, and I think I'm thinking about. I had an interview with a woman, Stacey St Doan, and we talked about grief and and we talked about what's the book called the red tent, Haven't?

Speaker 5: 28:41

you read it.

Speaker 2: 28:42

It's about when women are in menses, that they they would go into a red tent together and care for each other and just this process of like um community, but also it feels like this uh, I don't know when we talk about it in a really natural way, to me it feels sort of primal and just like yeah, like we're warriors, instead of instead of feeling like oh, I'm having a flash. Like how can we feel really empowered in it?

Speaker 1: 29:11

Right? Well, part of it, I think, is to recognize that it's a natural process, like all the changes that happen in our body as women. We go through menarche, when we're hit puberty, if we have children, I mean our bodies, you know, you can't recognize them anymore, and then the postpartum can't recognize that anymore either. So it's you know, all of these things that we experience as women. It's part of being a woman, and if you live long enough as a woman, you're going to go through menopause and that is a natural process. So I think it's important for us to remember that it's a natural process. It's not something necessarily to be afraid of, but to just embrace in a way, if you can, and there's going to be variation in how everyone experiences it.

Speaker 2: 30:13

One of the things that we had talked about. I'm I'm kind of backstepping a little bit, partially selfishly, because it's a passion of mine, but, um, you talked about weight training and how you wanted to speak to the importance of weight resistance training for women. Can we speak about that a little bit and how those two are linked? Sure.

Speaker 1: 30:30

Sure. So you know, some of the things that happen as your estrogen levels drop after menopause is that there are different things that happen in your body. So accelerated osteoporosis, so you start having bone loss, you lose muscle mass, vaginal dryness, all sorts of things that happen in your body. But weight training, I think, is especially important for women, I think all throughout the lifespan, but especially after menopause, because of osteoporosis and helping to maintain bone mass, because it's the resistance, it's that pull of the muscle against the bone that helps to maintain bone density. So it's one of the things that we can do as women postmenopausally to maintain bone density.

Speaker 2: 31:29

Show of hands. How many of you lift weights in here? Curious yes For those of you listening. Like 90, some percent of them are lifting weights. That's so great. I've had a perception that women are afraid to get in and like lift weights. No, yeah, all right, warriors, yes.

Speaker 1: 31:46

But I also think the other thing about weightlifting for women is that it makes, it builds confidence, and and that confidence is important as we age, because we're aging and our bodies are changing, our, our appearance is changing, but having confidence in your body by having strength, I think, really, really helps.

Speaker 9: 32:10

Yeah.

Speaker 1: 32:11

So just that inner feeling of oh, I'm strong, I can lift my suitcase and put it in the overhead compartment, I can carry my bags through the airport, I can pick up my grandchild those are the things that help us maintain our confidence as we age, which I think is important.

Speaker 2: 32:31

You just mentioned body image. Let's talk about that and how that changes through our life, and what advice do you have for us, as we live in a society where I think there's a lot of pressure with our body image?

Speaker 1: 32:46

That's a tough one, right as women, um, so I would say that staying active, doing the things that you love and, um, trying to ignore some of the messages that you're getting through social media, um, but I think the more active you are in doing things that you love whether it's gardening or biking, or yoga or dancing, whatever it is then you're going to feel better about your body because you can move it. If you can move and be active and do the things that you like to do, you're going to be more confident in your body.

Speaker 2: 33:28

When I think body image, I think. Or if I'm talking to my daughters, I'm like what are you saying to yourself about your body? Right, what's your mind? Focus on your body.

Speaker 1: 33:39

Right, right, yes, and that's where the idea of self-kindness and compassion, self-compassion. And there's a great book by Kristen Neff. I don't know if you've heard of.

Speaker 2: 33:54

Kristen Neff, I just was no kidding this morning, so I'm going to post an episode this coming Monday on self-compassion. And I just stumbled into her.

Speaker 1: 34:04

She is amazing, so she's done a lot of research on self-compassion. She's from the University of Texas in Austin and I would highly recommend her book. But I think one of the things that a message that I got from reading her book is that we really have to have that self-compassion so when we're starting to have negative self-talk, that we recognize what that is. First you recognize what it is and then, once you recognize what it is, you're able to respond with compassion, just like you would with your own daughter. Like when you hear them doing their negative self-talk, how would you respond to them? What messages would you want to give them? That's what we need to do with ourselves.

Speaker 2: 35:02

Yeah, I feel like I mean you mentioned, when we go through these major life shifts, if we have children, after we have them, there's these changes in our body. That is the time right, so there is. Then we're going through menopause. It changes our body beyond not having a period right. Does it change our metabolism and stuff too. I've heard this. I'm like does it change other things about our bodies?

Speaker 1: 35:25

Oh, a lot of other things.

Speaker 2: 35:28

Do tell. That's why we're here. What's going to happen to my boobs?

Speaker 1: 35:38

Well, that's all I want to know it changes a lot of things. Yeah, so you know, all those hormonal changes cause a change in our body composition. I mentioned vaginal dryness. The whole pelvic area changes from lack of estrogen. Sex is more uncomfortable.

Speaker 2: 36:04

Does your libido change too?

Speaker 1: 36:06

It does.

Speaker 2: 36:07

Up or down Down. Yeah, down Down.

Speaker 1: 36:10

I'm looking up, yeah definitely Down, okay, yeah, and you know. And also there's a psychological aspect of going through menopause, of the grief of knowing that you're no longer a young woman, you no longer can have children, even if you wanted them, and so I think there is grief that happens. And so a lot of people will say, you know, depression is a part of menopause. But I would say that's not necessarily true. True, but it's more like it's more the grief of experiencing another change, a major change in your body and who you are as a woman, because so much of who we are as women are having children, you know, being of childbearing age and being I don't know. The society says we should be attractive and all these things, and so things change as we age and there's grief that goes with that.

Speaker 2: 37:17

So I'm going to speak in terms of like heteronormative here, because in a relationship where the other partner is a male we were talking a little bit about this earlier too that I'm assuming there are some men out there that are interested and curious and want to know about menopause and I'm also assuming there are a lot that don't. And, um, if do you speak to men about this, Do you have men ever like in there with their women and they're like tell me about menopause so I can support her? No, Okay, so if there were men listening to this, just curious, I don't know For those of you in here, how many of your, if you have a male partner, how many of them were like curious or like wanted to know what was happening.

Speaker 1: 38:04

Yeah, Okay, good.

Speaker 2: 38:06

That's great. Okay, what would you say? What would you say to men in a partnership Like what advice can we give them or how can they be what they need to be for?

Speaker 1: 38:17

us To understand why, why the bed covers are coming off every single night To know why the temperature needs to be down in the bedroom now, when it used to be used to be cold all the time. And now, suddenly you want the temperature to be 60 to know that sex is more uncomfortable.

Speaker 2: 38:42

Can we make it comfortable? Can you just get like lubrication and it?

Speaker 1: 38:45

can be good, you can. And also Listen to me with all my sex questions.

Speaker 2: 38:52

I hope that's it for the sex questions. Okay, so you're? You're saying you're not a sexpert. I won't put you on the spot anymore. Well, no, no you can actually um.

Speaker 1: 39:05

vaginal estrogen cream is very helpful to help restore some of the kind of natural suppleness of the vaginal tissue, because it does get thinner and dry and it's hard to get lubricated. So there are lots of issues with having sex after menopause.

Speaker 2: 39:31

So empathy, I feel like is really key for partners. And it's easier said than done when they have their own needs and desires, not just sexually, but just in the relationship, right, and so the hormones also. Irritability is another symptom, right? Yes, am I wrong on that? Or is that just because we're getting really hot all the time? I think there.

Speaker 1: 39:52

I think there's a lot. There are a lot of reasons for that, but one is sleep deprivation, because you're not sleeping, because you're getting woken up multiple times a night. So sleep deprivation certainly can contribute to worsening mood. I do think there is a lot of to the grief that women experience as they go through menopause in terms of, you know, I'm no longer that desirable young. You know whatever that we thought we should be, that we thought we should be, and so I would say mood changes can be part of it, but not necessarily so depending on the person. Do people have questions?

Speaker 2: 40:45

Do you have questions? Is there anything called menopause brain? I'm thinking back to when I was pregnant and postpartum and I just was always forgetful, just a hot mess mentally. It's suffered in my work so I'm curious if that's something that will be occurring People do talk about that that there is.

Speaker 1: 41:05

I think they call it brain fog, and again, I think it has to do a lot with the symptoms. You know, if you're getting interrupted during the day multiple times a day with hot flashes, and you're in the middle of doing a meeting and you're working on something and then all of a sudden you're sweating, you're drenched in sweat, no-transcript around you, and then you lose your train of thought and then there's a brain fog, then you're not sleeping at night. So I mean, I hate to paint such a dismal picture, but I think that's a lot of what causes this, similar to, after you know, during pregnancy or postpartum, when you're sleep deprived and you're trying to nurse a baby and you're multitasking, and so it's hard to differentiate. But there is no known physiologic reason why that would happen.

Speaker 7: 42:04

Can you speak to medically induced menopause? That happened to me when I had my ovary removed and it was real brutal, real fast.

Speaker 1: 42:16

Yes, yes, so medically induced menopause. For someone who has had an oophorectomy, their ovaries removed it's like that's bam. You know I talked about how it's. Menopause is usually a very gradual process. Well, this is, you know it, and that is especially brutal because you haven't had your body, hasn't had the chance to accustomed to some of the symptoms. Um so, in in your case, I think definitely hormone replacement therapy is very, very helpful.

Speaker 5: 42:55

So I'm in the thick of things and I have an appointment with the OBGYN for hormone replacement therapy. I can't get there until a month Meanwhile. I've been suggested everything acupuncture, tiny herbal supplements, and so it's really overwhelming to hear all the different options. So I'm curious about any of those options, what I should be looking out for, what I should think about as well.

Speaker 1: 43:33

That's a great question because I think because these symptoms can be really difficult to manage that people really search you know, and that, um, and I'm going to say this, I'm a Western medicine doctor but I also believe in, you know, yoga and all those things, but from a Western medicine perspective, there is no evidence for a lot of those things, unfortunately, and there isn't a lot in that area that has actually been proven to be effective. I mean, there's always the placebo effect, where people will feel like they're getting better, and maybe they are, but it's very hard to measure. I wish there was more that we could do. Naturally, optimizing our sleep regimen, especially during those years of hot flashes, is, you know, all the things keeping the room dark, keeping the temperature cold, wearing pajamas that you can, that don't that release heat, all sorts of things that you can do in terms of optimizing the sleep environment, because I think sleep is one of the key things for health and if we don't sleep well, then everything else goes to pot Good random thoughts.

Speaker 2: 45:03

I saw a couple other questions. Okay, great.

Speaker 4: 45:07

So I wrote down a handful of things. Part of this happening was talking to people everywhere I go.

Speaker 4: 45:14

I would have thought coming into menopause you're like hair loss, hormone imbalance, dry vaginal weight gain, hormonal harry said that imbalance, that those were things like it's part of it. So you can do yoga to help that, you can eat differently to help that you can have a sisterhood that you can connect to that experience. My period is more irregular now. Before I joked about going through menopause because I think since I was 20 I wanted to go through menopause. This has been something where you know like I'm a period of 12, so now this is um part of it and that is part of this too. There's some sort of and I don't know why, I haven't researched it excitement around the experience of going through menopause and the chapter after yeah, your thoughts made me think of something to say about the menopause, which is it's not all a bad thing you don't have pre PMS anymore.

Speaker 1: 46:28

You can't get pregnant, and if you don't want to get pregnant, that's a nice thing not to have to worry about. You don't have to take birth control pills, you know I mean, and there is a certain freedom that comes from that. So going through menopause is not a terrible thing. I mean, it means you're living. You're living a longer life, right? You are free from the worry of getting pregnant if that was a worry. You're free from having your monthly period, and for some people that can be a real painful ordeal. So there are some good things about it. So it's not all doom and gloom. You know I'm I'm on the other side of it, so I can.

Speaker 5: 47:20

I can safely say that.

Speaker 6: 47:22

Yeah.

Speaker 1: 47:23

Yeah, and my mother? I mean, you know, I never talked to my mother about these things. I, you know she wouldn't tell me anything about anything. So, uh, I just had to figure it out, and and certainly medicine didn't help me with this either, being in medicine.

Speaker 2: 47:43

Wow. Yeah, it's kind of wild, isn't it, and I think things are changing, and I think we've got, obviously, so much information at our fingertips but you're right, Google is not always the best resource at this is this is, though, to just talk to real humans having real experiences and then sharing that. Have any of you read a women who run with the wolves? Yes, and it's uh. It's a book about mythology and how, in a lot of societies, we pass down tradition and lessons through storytelling but, I don't ever have a story told to me, and that's not my mom's fault, but I.

Speaker 2: 48:18

But we didn't, we don't, we don't do that often. But I think even just sharing our own stories like this is so valuable more valuable than me thinking I have lupus when I'm having it, I know.

Speaker 1: 48:31

I'm sorry that you had that experience. That's awful.

Speaker 2: 48:36

Yeah, yeah, and maybe this is a place like some. I saw you nodding along on it.

Speaker 9: 48:41

Do you have other things to add about positive experiences or I had all of the you know sort of negative symptoms, the hot flashes, hot flashes and meetings, but I kind of chose to experience those with humor in that, and I did work with a lot of women so it was a little bit easier to talk about it. Oh my God, there goes my fan again.

Speaker 9: 49:03

Just not really worrying about it, that I was going into a sweat, oh sorry, I got to step outside or laugh about it a little bit. But I did experience a lot of premenstrual every month. I just would kind of go crazy for a couple of days. It was not pleasant every pre-period. So when I went through menopause, all of a sudden I'm just happy all the time oh.

Speaker 9: 49:29

I love that all the time I don't have these ups and downs of my moods, and I think that's a great positive. On vacation, not worry like, oh, if I'm not at the beach, am I going to have to go somewhere?

Speaker 5: 49:44

Am.

Speaker 9: 49:44

I going to bleed all of a sudden.

Speaker 1: 49:46

And do I?

Speaker 9: 49:47

have to be prepared for that, so it is very freeing. I also want to comment a little bit about if I could another observation I have about it. And being a little bit older, there's a lot of things you would hear about women. Oh, she's menopausal. She's menopausal. Her mood is explaining a lot of things about discontent.

Speaker 9: 50:12

Blaming that on menopause, things about discontent, blaming that on menopause. Just from observation, think women in their 50s, their children are grown and they're moving on with their lives and a lot of the feeling that I think that I hear described to menopause is really the mourning of your life is changing in a lot of other ways. This primary caregiver to all of these children. They're maybe off to college and now you've got to redefine your own life a little bit.

Speaker 9: 50:46

So that's not menopause, it's a life change. So I think we have to be careful about putting a lot of blame on menopause. It's natural life changes.

Speaker 2: 50:57

That's so valuable. Thank you for that perspective.

Speaker 6: 51:01

I would just love to add. So my mom was born in the 40s and just my personal perspective is that that generation got so robbed because of the Women's health initiative about the hormones and was so horrible. So I am so grateful to be 51 right now and to have all of this new research about how hormone replacement therapy is a wonderful thing if you meet the criteria, and so I'm just so grateful that I'm going through this rite of passage and have access to this. I feel like our, my mother's generation got completely screwed. You know it's yeah, so we have a lot, aren't the women in this room like we have so much more knowledge and research and information than people in the 40s women in the 40s and so I think I'm always looking for the silver lining, and so yeah, and I've also heard to your point.

Speaker 6: 52:02

It's like it's it's a whole nother. It's a whole nother vibe. When you're not, you know you have, you have crossed the bridge and now you're in this different identity. That's so empowering and like running with the wolves and it's like warriors and you know. It's such a sacred thing and I think that we can change the culture and we do it as this like is amazing props to you having the courage to, to talk about it and own it in a way that's for our good and for our benefit. I just think it's. There's so much juice, yes, yeah.

Speaker 2: 52:39

Agreed. Yeah, yeah, it's juicy, it is.

Speaker 1: 52:43

It is, it is yes.

Speaker 2: 52:47

I mean, we hope it stays that way yeah. Yeah.

Speaker 7: 52:50

Yeah.

Speaker 8: 52:51

Yeah.

Speaker 4: 52:55

I have another question. Yeah, yeah, I have another question, yes, one that I remember about 15 years ago. I can picture the moment a woman told me she had gone through menopause, that she still experiences light monthly cycle symptoms, and now I'm hearing you don't, I mean, I physically don't- produce the chemical that would cause those.

Speaker 1: 53:16

I think it's possible. Okay, yeah, okay yeah, everybody's different. Yeah, not one size fits all. Mm-hmm Right.

Speaker 7: 53:22

I know I wasn't going to say anything, but now I'm going to open my mouth. Thank you, wendy, which is really cool, huh? Certainly it is Just Just piggybacking on everything. What Liz said is true. I'm thrilled I'm through with my period, because it was horrible. It was just horrible. So getting through menopause as hard as that was, but everything helped me. Being on hormone replacement was a godsend for me. In my teaching career I used Vaginocreen and the big thing about sex is I'm just as horny as I always was. Yes, I'm glad to hear that from somebody you know you've got to practice.

Speaker 2: 54:11

Wait, you've got to practice.

Speaker 7: 54:18

I love. I'm just as horny as I always was. Howny it was. I'm just kidding, that's great. What I say is oh, two more things. Weight lifting totally has changed my metabolism. I was slowly gaining weight, little by little, by little by little. I was just so unhappy and it was like I went uh the gym and started actually training with a trainer for a couple of months and totally just, my metabolism has totally changed with that. The last thing is deep breathing when I wake up. Even now I still get hot flashes at night From too many blankets. I do like a breath in for four, hold it for four, and that's huge with some of those yes.

Speaker 3: 54:58

Yeah, okay, going off of what Wendy said about the weightlifting, yes. Can you talk about the changes in the body composition, muscle versus fat, and when you talk about?

Speaker 8: 55:12

weightlifting are you?

Speaker 3: 55:12

saying heavy weights or like yoga, sculpt weights? Okay, that's one part, heavy weightlifting. Are you saying heavyweights or, like yoga, sculpt weights? Okay, that's one part. Heavyweight lifting right, because I know that that's different than the lighter weights that we use at sculpt. And then protein Are we supposed to eat a shit?

Speaker 5: 55:29

ton more protein to get muscles.

Speaker 4: 55:31

Or like what the heck so?

Speaker 3: 55:32

I'm just noticing some specific body.

Speaker 1: 55:34

Yes, yes, yes.

Speaker 3: 55:40

I know that that's a thing you know, whatever, so I'm just curious.

Speaker 1: 55:45

Okay, I'll. I'll talk about the weightlifting um, because, um, so it doesn't have to be really, really heavy weights. What the recommendation is is, at least twice a week that you do resistance training and whatever that means for you. So it could be body weight resistance training like doing push-ups. I think it is helpful to use weights and it does change I do really feel it does change your body composition. Um, we, men and women both lose um a lot of muscle mass. I so, um, we are, unless you do resistance training, that is all going to become just fat. I mean not fat, but just loose skin. You know, and, and it is possible, it really is possible to maintain and actually build muscle mass, even after menopause. And it does change, um, it does change your body composition.

Speaker 1: 57:01

Was there another question? Oh, protein, oh, I'm glad you asked that question. This is because, um, there's a myth about protein and how much protein we actually need. And actually, um, the American college of lifestyle medicine would say a whole foods, plant-based diet is the healthiest diet, Um, and so there are lots of ways to get protein and it doesn't need to come from animals. So, um, need to come from animals. So that's what I'll say about protein. We don't need as much protein as the beef industry would tell us that we need, and we can get adequate amount of protein through a plant-based diet. All interesting things, isn't it?

Speaker 4: 57:59

Is that surprising? No, I'm so happy to hear you. I know you. I don't think you would say plant-based diet lately you would. You have reasons why you're saying that?

Speaker 1: 58:05

the health benefits are just off the chart. So, um, but it and it's it really has to do with um inflammation in your body, um, and plant-based diet helps to decrease inflammation. Has to do with creating a healthy gut microbiome. Has anyone heard about the microbiome? The microbiome is a bacteria in your intestinal system and when you eat a plant-based diet, your gut microbiome is so much healthier. And when you have a healthy gut microbiome that helps you fight infection, helps decrease inflammation, there are so many benefits. Having said that, I'm not a vegetarian, but I am moving in that direction just because I know all of the evidence. The evidence is overwhelming and we are. There's so much advertising from the meat and dairy industry and the food industry in general about what we should be eating and the old food pyramid. You know, I just toss that out the window.

Speaker 2: 59:32

Yeah, that's wild to think about. Yeah, all right's wild to think about. Yeah, all right, any other questions?

Speaker 8: 59:38

Okay, yes, I'm going to just say add one other perspective on being through menopause. So I'm through menopause and I was one of the very lucky people that had. I mean, I wouldn't say I had no symptoms, but if I had anything they were easy to blow off. So I literally went to my gynecologist. She said let's test you and see if you're going through menopause or if you're perimenopause. She tested my estrogen. She's like nope, you're good to go, and that was the last period I ever had Wow and, but now I've been through menopause for two years and my hair is dry, my skin is dry, I have vaginal dryness, it's thin.

Speaker 8: 1:00:20

You sometimes it tears during sex. So I've had the vaginal creams and stuff. So, but all that stuff is totally manageable. The good thing that I want to say is society, when you're in child rearing, uh, or you're you're, you're still of value to society. Like once you hit menopause, nobody in society cares about you anymore, which is great. They're not micromanaging from you. You totally do. I mean, I feel this huge sense of like. Yeah, my kids kind of need me, they like me and all that. But I feel so free to just like completely be who I want to be, do what I want, because I'm not under the microscope and I'm not expected to be gorgeous anymore because I'm past my prime. I I'm past my prime. I'm withered up and dried up in everybody's eyes, so it's okay, I'm just not scrutinized by everybody anymore.

Speaker 8: 1:01:22

I like have the freedom just to do me and it is so great.

Speaker 2: 1:01:27

What an interesting perspective. I love it. I've never heard anybody say that yeah yeah, I would not have described you as shriveled up and dry. Those are not the descriptors I would have used for you. Juicy, you're a juicy lady.

Speaker 8: 1:01:42

Does anybody follow Paulina Porizkova on Instagram? She's a famous, famous, famous model, one of the top models, and she posts pictures of herself nude and stuff and she gets so much hate. She's so beautiful and she does no botox and no this and that she's just all natural and she's gorgeous and she's so about advocating for women past menopause like I didn't just turn into dust and blow away.

Speaker 8: 1:02:07

But nobody sees me anymore even though she's still unbelievably gorgeous and that's my point about it and creative and inspiring and imaginative, like the list goes on and on and on, Because now we also have the wisdom, the perspective, the experience, a big network of people We've traveled like we have so much, but for some reason we're just dismissed.

Speaker 3: 1:02:30

And I'm okay with that, because I will fly right under the radar. A very wise woman in one of my AA groups that I go to and we call her the OG because nothing comes out of her mouth. That isn't just beautiful. She says I'm invisible, but it's so great because you know how, if you can have a superpower, you're like I wish I could be invisible. And in a really weird way we now get to be Like I'm finding the benefits of when I'm with my daughters and I'm not seen anymore.

Speaker 4: 1:03:09

They are and.

Speaker 3: 1:03:09

I'm like cool, you know what I mean. Or you leave the house in a different way than you used to. So there's some freedom in being invisible, and that's where I'm at. Yeah.

Speaker 4: 1:03:20

Trying to find that one. I'm experiencing some of that invisibility, no.

Speaker 7: 1:03:25

No way, absolutely.

Speaker 4: 1:03:29

No, I completely. Where they're noticing your mother I feel more at a point and I don't maybe this is part of it feels I wouldn't have thought of it that way, except for the point where I feel like I'm at a point where I get to show up and support others versus others being.

Speaker 1: 1:04:04

I hear you.

Speaker 4: 1:04:05

I love it I keep telling David. I'm at this point where I don't want to relive any year past and I appreciate every year lived.

Speaker 4: 1:04:13

It's santosha, the contentment not overly elated about something or underly saddened content with. It is what it is in the most beautiful way yeah, so I mean, and right now, part of this, where the last five years of my life, I chose to shift my amount of time and attention given to physical health, and well-being and I stand by the decisions that I made and I'm so grateful for it, and then, when I turned 41, I was like I don't want to look back at 50 and say at 40, I could have then taken better physical care of my health and well-being and it's not going to take care of itself.

Speaker 4: 1:04:52

It needs more time and attention, so it doesn't get to a point where I can't move the way I want to or do the things I want to do be part of the interest and excitement around getting to menopause but, not rushing, instinctually primal. There's a part where that's where you get to be in the best way, the white witch.

Speaker 2: 1:05:13

Yeah, I want to be a wolf, I want to be a white witch, whatever. Yeah, don't wait for men. No, I'm channeling it right now. Yes, absolutely, I'm here for it.

Speaker 7: 1:05:28

Absolutely, you are yeah.

Speaker 9: 1:05:30

I think also, just we all got through puberty. And I don't know, Jane, I might be wrong, but I don't. I've never heard of anyone dying of menopause.

Speaker 8: 1:05:40

Get through it. I'm approaching 75 and you're my daughter's age and there's a lot, a lot of life after menopause. Enjoy it, you'll get past the stuff.

Speaker 2: 1:05:54

I love this. Do you guys love this? That's amazing. Thank you, Lindsay, for pulling this together. Yeah, thank you. I would like to say thank you, Jane, for sharing your expertise and being open and willing to answer some of the uncomfortable questions that even just hearing you say that your mother didn't talk to you about this and that we're seeking to make a change and to bring more awareness to this, so I really appreciate your desire and willingness to do this.

Speaker 1: 1:06:29

Yeah, it's been a pleasure. Thank you, I'll catch you later, you.