Dr. Sharon Malone
Appearances
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
But there is no discussion or apparent connection between the two. Sharon, can you talk a bit about sort of the state of the current state? What's keeping you up at night of the many things that keep you up at night about the state of women's health? Yes, I think that.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
And despite the fact that we grew up in such an open household for that time in life or that stage of our lives, I'm still surprised at how little I know about my own body. uh, you know, and, and how many things we didn't talk about, not because our parents weren't open to it, but they didn't know, you know, so we're going to talk more about this.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Um, uh, but let's introduce, let's get, let's get Sharon in on the, on the conversation.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Well, we're seeing more and more conversations from anti-vaxxers, right? We saw it during COVID, right? What's that about? Why are we all of a sudden, after all these generations now, pushing against vaccines that have saved lives for decades?
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
And we're seeing that with this measles outbreak. So what's going on there? This is in Texas, correct?
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Welcome to IMO, Sharon.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
So if you're a mother that's vaccinated, does that protect your unborn child?
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
I mean, it's just mind-boggling to believe that with all that we know, with all the resources, with the wealth in this nation, that we are going to go backwards in time, that we are walking backwards with our eyes wide open, with sirens blaring. It's just unbelievable to me that in a short period of time, we're here having these kind of conversations.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Thank you for having me. Thank you. Road warrior, because this woman here has been... all over the country promoting grown woman talk. I am so proud of you for so much. But you did the thing, writing this amazing, creative, fun, funny, informative, open, honest book about women's health with a particular focus on women of color, but it's a book for everyone, men, women, women,
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Yeah, and Craig, you know, that piece of advice cannot just be directed to women. You know, this is why I implore the men in the world who have women that they say they care about, daughters that they are raising, that this is their issue too.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
I mean, for men to sit on their hands over this issue and trade out women's health for a tax break or whatever it is, is a sad statement about that man's... level of value of the women in their lives. And there are a lot of men who have big chairs at their tables. There are a lot of women who vote the way their man is going to vote. It happened in this election.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
So just to direct this at women, unfortunately, we've seen is not enough.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
people of all races and all ages, because you cover the spectrum of just some of the things that women go through. Can you talk a bit about why you wanted to write the book and how you're feeling about things? Yes.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
This is a question that we are getting around our kitchen table from the next, because we're in that generation. Our daughters are in that stage in life where it's- Both of us. Yeah, all of us, where they're deciding between pursuing a career, how long do they have to wait, finding a mate, All of those questions feel more existential.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
But even given that, I met a young woman that's a part of our world who just froze her eggs and she's in her 30s. And very enlightened, very educated. She just did it. But she said she only did it because she heard other people doing it. She had never heard in all of her enlightened years on this planet about the importance of freezing eggs.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
That it was even a possibility that she could or even should freeze her eggs. So that in today's young women... She said she had never been in a conversation about the importance or the possibility of freezing her eggs. 30-something, early 30s.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
And just so that we're not assuming things, the difference between egg freezing and embryo freezing is... Okay, so embryo freezing is just a regular IVF.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Surprise!
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
But that's why the research is so unclear about the viability of frozen eggs.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
It's the same procedure. The only thing is there's no fertilization. That's all.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
I'm here for you.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Does it make sense for young women, young men to start getting sort of a sense of their fertility, you know, sort of before all of this? Like, you know, should young women go in and have ultrasounds to see, does that make any sense to have that fertility? on their minds?
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
You didn't show it to me, but it took so many, it's like, okay, Sharon, I know you have a rough draft. I was getting a little insulted for a second there. Well, you know what it is and you can appreciate this, Craig.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
We always get in the short end of something. I'm telling you, isn't it? We get all we have. Sperm after sperm after sperm.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Like smoking.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
We might have to.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Well, speaking of that, I don't want to jump away from the question, but I am curious about what is the connection between aging sperm and birth defects? Or are there any correlations? Because they're going to cut out research in that too. Yeah. It's like, no, I'm 80 and I'm good. I'm still good.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
It's like you're just coming in on the last of everything. Sharon's just squeezing out the last of her brain cells. Who knows?
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
That may be the key behind all the defunding everything. It's just like, let's just blow it up. We can't let them find this stuff. Old men can keep marrying 20-year-olds. Exactly. It's like, I'll give you the baby you want. We don't have to keep that baby.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Yeah, but why would they sit at the inn? It's just weird. Just sit up by your wife's head. I know. Be where she is.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Go to the head of the table. All right.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
This is educational for men. Yeah.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Don't need that. No, you don't need that. Yeah, that sounds about right. Yeah.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Hey, Mish. Hey, Craig Robinson. Today's topic is one that's near and dear to me. Now, one of the reasons why I'm excited about, one of the many reasons I'm excited about our platform IMO is that we really get to talk about whole array of issues that we both care about. But this topic today is particularly of note for me because we're going to be talking about women's health.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Why?
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
And I want the men out there, be involved. It doesn't have to be your partner. If you've got any women in your life who are willing and open to help educate you, seek it out. Sharon? Thank you for the book. And we have to talk about your podcast that's coming up.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
But well, to give some folks some context, I mean, Sharon and I, we've known each other since that day at the, that evening at the Black Caucus when we first, actually our eyes first met. Because this was a time where, what was, Sharon's husband happens to be former Attorney General Eric Holder. He's a non-factor. He is not a non-factor. He's a non-factor in our relationship.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Because we're going to be able to hear from Sharon a whole lot more and dig deeper into a whole range of issues because you are working on your podcast. your own podcast. Tell us all about it.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
So exciting. And I would be remiss to say that TSO is a part of the Higher Ground Audio family. And as proud as I am of all the work you put into Grown Women Talk, I know that TSO is going to have the same level of candor, humor. Are you going to have some good music to your podcast?
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Because we didn't mention that sharing the book, Grown Woman Talk, comes with a playlist because my girl loves her music. And sprinkled throughout every story, she has a song that
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
That goes with it, you know. And it is a fun, it's a fun playlist.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
I wasn't even thinking about it. I wasn't even thinking about it. What I was thinking about is that I am looking forward to having Sharon back on IMO. I am looking forward to having some great conversations with you, more candid, more focused on TSO. Because this issue, if... anyone couldn't tell is near and dear to my heart.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Health and women's health has been at core of my advocacy since I've been in the public eye. I believe strongly that we as women have to take ownership over our health. I live my life by that motto and I've been better off. I mean, my physical health is directly linked to my mental health. And what got me through so many
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
of the tough times over the last decade was the fact that, you know, I felt good inside. And I think it's incumbent upon us to share that good news with other women because it's something we can do. You know, we don't have to be athletes climbing up a mountain. We just have to get up and move a little bit, eat better, be advised, believe in science and
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
and have candid conversations with the people that we love, it's doable. I just want us to do it. So I'm grateful, Sharon, that you are going to be the voice of that conversation. So, so excited. And thank you for welcoming me to the family. Yeah. Yeah, absolutely.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Well, I think you need to be in, or more guys, I shouldn't say you, but that's going to be a part of it, right? Sharing, having those male voices around the table, people who are educated, but those men who are totally clueless so that the men can feel comfortable in their cluelessness, that it doesn't prevent them from being at the table asking all kinds of questions.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
It's better to ask and be wrong than not ask at all.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Let's contextualize that, please.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Because we were both reluctant spouses attending one of these huge dinners. Okay. And where were they? Was Barack a U.S. senator at the time?
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Well, and the things were, there was a line of people waiting to shake hands with our respective husbands. You know, people like reaching over our heads and spilling water on us, trying to get to these two, you know, illustrious men, you know. And she had the same look on her face as I did. Like, here we go. And I looked over at this beautiful woman. Did we even have a conversation?
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Not until later in that afternoon.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
We hadn't met. But I just saw the look on her face, which expressed the sentiments that I felt, which was...
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
No, it was just kindred spirits. You see this, don't you? You see this. I see you. This is crazy, isn't it, girl? That was the look. And it was like, without words spoken, I was like, I want to get to know this woman. So when Barack got into office and appointed Eric as his attorney general,
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
There were just a couple of women like that, particularly sisters, black women in DC, that I knew I was gonna need my kitchen table there. And I had to do what I've told people to do in my books, which is like, you gotta go out and find your friends. You gotta find your people.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
And I invited you and a couple of other people over to the Hay Adams, because it was before we were even able to get into the White House, just for like a girlfriend's lunch. And, you know, I don't know what that call was like for you, but for me, I was like, I just, you know, before this thing gets started, I need some info. I need to get a sense of where am I? What's this city about?
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Who can I trust? And I instinctively thought of Sharon. She was on the top of my list of people that I wanted to know. Yeah. And we had an amazing, was it lunch or breakfast?
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
And that's when we really started having some really deep conversations about our health as women. how we neglected. Many of us were Black women around the table. We learned from Sharon all that we didn't know. So a lot of times those weekends would turn into Sharon advisory sessions because we'd bring her questions about health, things on our bodies, prescriptions.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
We would use her as a second opinion from our own doctors to make sure that that we were covered. But your book touches on more than just the medical side of things. I mean, your book opens up with something as simple as how do you choose a medical provider?
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
We've got one of our dear friends, Dr. Sharon Malone on. And she's going to talk about her new book, new podcast that we're excited about. And But we want to talk about a whole range of things. And in many ways, to have a guy like yourself on in the midst of this conversation, to some people might seem funny because a lot of men don't feel a connection to women's health.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Well, and we were raised on the doctor's set. I mean, doctors- Doctors, for at least our generation and older, they're revered members of the community. They were second to God. And so the thought that you would question or even have the right or authority to question. So many of us, if in the black community you even ever saw a doctor,
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
But if you did have a doctor, you just fell into the arms of that person and took everything that they said about you as being the truth. And if all these doctors or most of these doctors were men who are not even trained in understanding women's health in that same way. And I want you to talk a little bit about how that happens.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
And this is the frustrating thing about the fight to protect women's reproductive health. Sadly, it has been reduced to choice, the question of choice. Right. And it's as if that's all of what women's health is. That's the only thing. And as I attempted to make the argument on the campaign trail this past election was that there's just so much more at stake.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
Because quite frankly, oftentimes we as women don't understand our own issues. And we're going to talk a little bit about that. But I think you are... in a unique position because we grew up in a household where women had voices.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
And because so many men have no idea about about what women go through, right? We haven't been researched, we haven't been considered, and it still affects the way a lot of male lawmakers, a lot of male politicians, a lot of male religious leaders think about the issue of choice as if it's just about the fetus, the baby. But women's reproductive health is about our life.
IMO with Michelle Obama and Craig Robinson
Take Back Control of Your Health with Dr. Sharon Malone
And it's about this whole complicated reproductive system that does the least of what it does is produce life. It's a very important thing that it does. But you only produce life if the machine that's producing it, if you want to whittle us down to a machine, if the machine is functioning in a healthy, streamlined kind of way. Right.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
No, you can be treated with menopausal hormone therapy.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
There is this study of women across the nation where they looked at women, different ethnic groups, and they found that Black women tend to go through menopause earlier, their symptoms are more severe, and they last longer. So obviously, if you're going to go through menopause earlier, that means that parents
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
Perimenopause starts earlier because back that up 10 years, if you're going to be menopausal at 45, then you were perimenopausal at 35. Yes. One of the things that I always tell young women, particularly when they're concerned about what does this mean in terms of childbearing and will I be able to have a baby or not?
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
First thing is know your family history because I think you should talk to your mother because at 35, if you talk to your, you say, mom, when did you go through menopause?
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
If she remembers and she shares that information, if she tells you you were menopausal, she was menopausal at 42, well, then that has some bearing for you because at 35, you are more likely to be perimenopausal and to maybe have some fertility challenges more than someone whose mother had menopause at 55. Do you see what I mean?
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
So yes, it has a direct implication on when your symptoms start, but what to do about it. And let me say, we have more options now than we have ever had, because this is a situation if you say, I'm not ready to have a baby right now at 35. I may not have even identified a partner at 35. then this is where we can use technology.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
Egg freezing might be something that you would do because it at least preserves that possibility for you that if you just wait, then time will make that decision for you rather than you making that decision for yourself.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
You know, I'm not really sure what to make of the fact that women are starting to experience symptoms earlier, but I think that stress is certainly a factor. I think that how we live, you know, the... environment that we're in. You know, who knows? Maybe it is some of the endocrine disrupting chemicals that women are exposed to that are causing this.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
Oh my, where to begin with that one? You're on at least three different medications, right? You've got progesterone, you've got something for anxiety, something for sleep. If we know that it's all perimenopause, then why don't we treat the perimenopause, which is with hormones? Estrogen is the common denominator of all the symptoms that you have there.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And this is not uncommon during perimenopause where women will say, okay, well, I need something for sleep and then I'm depressed and I need something for this. And by the time you look at it, you're on five different medications for your five different symptoms and still haven't adequately solved the problem. And I think that the first go-to ought to be able to say, it's perimenopause.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
Let's go to the most effective treatment for the symptoms of menopause and perimenopause, which is estrogen therapy. And don't be afraid of that unless there is a reason that I don't know why you should not.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
Well, let me say that there is a different way that we give estrogen for women who are perimenopausal. I've said all the time that in perimenopause, your estrogen levels aren't consistently low. Sometimes they're too high. Sometimes they're too low and everything in between and in no particular order.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
So what works well for women who don't, you know, who are having these persistently high estrogens? You know what you do?
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
You use a low-dose birth control pill, just a plain old oral contraceptive, because what it does is that it shuts down all that extraneous estrogen production in your ovaries, and it will give you back what you need to quiet your ovaries and give you enough estrogen and progestin
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
So what you're doing is that you're tamping down all that background noise and just giving back the estrogen as you need it. And you can take birth control pills every day. And when I say every day, you don't even have to stop them to have your period. You can just go straight through.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
So it is a very interesting area that needs to be explored further because we are aging ourselves faster than I think that we should be given this day and time.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
You're like, I would prefer not to be off the pill for a week, a month, because your symptoms will come back when you're off your estrogen. Birth control pills is a very easy way that we use commonly for women in perimenopause, particularly when one of the other symptoms in perimenopause tends to be irregular bleeding or sometimes the bleeding is too heavy or you need birth control.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
In those instances, a birth control pill, a low-dose birth control pill works better because you are getting cycle control and you're also controlling your symptoms and you get birth control. So very commonly to stay on that.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And then once you're finally menopausal, which who knows, maybe five, six years from now, then that's when we make the transition from birth control pills to menopausal hormone therapy. But I don't want you to think that those are two things that are separate and apart. Birth control pills have estrogen and progestin in them.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
It's a different estrogen than what we take in menopause, and it's in different amounts. There's more of it when you're perimenopausal.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
I'm going to say, Dr. Malone told me. Do that, do that. There's a whole section in there on that. It is true. But that is, again... Oprah, we get back to our same access problem, finding doctors who understand the subtleties of how to treat. Because yes, can you take the levels of menopausal hormone therapy when you're perimenopausal?
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
Yes, you can, but not if you need birth control, not if you have bleeding problems because there's not enough menopausal. estrogen in the menopausal hormone therapy to control those other symptoms. It may take care of your hot flashes, but it's not going to take care of the other things. So don't be afraid of using the type of estrogen that is appropriate for what your symptoms are.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And once you get to cross that line in your menopausal, then we can switch it up and go back to menopausal hormone therapy.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
Why the weight gain? You know, that is one of the most common complaints that women come in with when the perimenopausal phase, when they start gaining the weight. And they're like, what is going on? I'm eating the same thing. I'm exercising the same way. And I've gained 10 pounds just for breathing. And I believe you because, you know, I've been through that myself.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
I, too, no longer weigh what I weighed 20 years ago. But the key to this is to understand what is happening to your metabolism and what is happening as your estrogen levels fall. Well, whether you have symptoms or not, and now you're having hot flashes, but let me just sort of walk you through the cascade of events that happens. Your estrogen levels fall.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
One thing that happens is that your body composition changes. So even when you don't gain a pound, and most people do, but even when you don't gain weight, you tend to lose muscle and you put on fat. And so that weight gets redistributed. Yeah. And now it's like, why do I have this belly fat? Why are my boobs bigger?
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
That's also happening because that's just deposition of body fat. That's a response to the lack of estrogen. So that's one. You have hot flashes, night sweats. You can't sleep. Sleeplessness and hot flashes lead to fatigue. It increases your blood pressure. Women who are estrogen, when their estrogen level is low.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
Oh, absolutely. And it also increases insulin resistance so more people will start to develop type 2 diabetes after menopause. So guess what happens when you're irritable, you're tired? Guess what you're not going to do the next day? exercise. Now you're fatigued. Now you've got more fat and less muscle. So everything that you eat, you don't have... Muscle is more metabolically active than fat.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
So it just continues to make more fat. And then the more depressed you are, and guess what happens when you are depressed and you're tired? You make bad choices the next day. You're not going to exercise. You're like, I know exactly what this feels like because as a resident, when I would be up all night... Yeah, I'd be up all night.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And you make bad choices about what you eat, what you drink, what your behaviors are. So it's a really complicated system, but it all goes together. And it happens to women, I would say, nine times out of 10. This is the complaint.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
Well, knowing what you know now, I can say this. The better health you are in leading into this perimenopause and menopausal phase, the better you are going to be able to endure it. It won't say that you won't eliminate the need for medications, but the healthier you are coming into it, the better you're going to weather this process.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
But I would say as a young woman who is watching her mother go through this, the one thing you can do is give her a little grace and understand that, you know, your mother's not maybe, she's not snapping at you because of something you did. It may be the day and you just have to sometimes maybe go up to your mom and give her a hug and say, hey, mom, I understand this may be a bad day for you today.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And sometimes it may be something you did now, so I'm going to let you distinguish between the two. But just understand that your mom has a whole lot less tolerance for the stuff that you do now than she may have had 10 years ago.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
That's exactly right. You know, I was thinking, Oprah, when I got to the end of my career after practicing for 30 years, and when I decided it was time to stop doing that, I had no idea what the next chapter was going to be, but I knew I was done with that. And... I created a whole new life for myself after 60. I mean, I wrote my book when I was 62 years old.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
I'm going to say this, and this will surprise no one. I don't know how you are, but I know how I am. But I can tell you from personal experience that sex at 60 is not sex at 25. It's different. And you just accept that different does not mean worse. Now, I didn't say this. So there are two things that you need to understand that are happening hormonally.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
What's happening with your estrogen and the lack of estrogen after menopause is really responsible for things like vaginal pain. dryness, the discomfort. Now, it stands to reason that if sex is painful, you don't want to have it. You know, we are all sort of, you know, we're programmed to avoid pain and go towards pleasure, right?
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
So the first part of what we need to do is to eliminate those barriers that are causing the discomfort. And vaginal estrogen is a great place to go at vaginal estradiol. And the estrogen in the vaginal estrogen is so low, it doesn't get absorbed systemically such that you don't need to take a progestin if you are just using vaginal estrogen. Sometimes that's enough.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And you can say, well, look at that. I'm not in pain. You know, this isn't difficult. I'm not getting a urinary tract infection every time I have sex. I'm not avoiding it the way that I would. There is also the issue of testosterone.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And testosterone has been, you know, we talk about it a lot, but it's not readily accessible for most people because there is no FDA-approved version of testosterone that women can take. There is one for men, but not for women. So that would involve, you know, after you have taken care of the pain and discomfort issues and you say, it's still not where I want it. Pain, discomfort, dryness.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And, you know, you need a good lube. And then you say, well, okay, well, then maybe testosterone might be appropriate for you for treating just what we call the hypoactive sexual disorder, okay? That's one.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
I'm not thinking about sex. I don't want it. But here's another. I want to give you another frame for how to think about sex after 50 or sex after 60. Most women, once you eliminate their discomfort. OK, so we've taken that off. You're treated and you're fine.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
I have, you know, a new career really taking the message of menopause and women's health outside of just the office when you're just talking to people one-on-one. There are only so many people you can get to. That's right. But to be able to take that message and to amplify it and to get out. Doesn't it feel like your life kind of blew up? Oh, absolutely. Absolutely.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
most women will find that there's a difference in your desire, where there's a difference between spontaneous desire, where I'm just sitting here and, oh, I can't wait to go for my husband to come home or my partner to come home and have sex. But there is what changes as we age, it's more responsive desire. And by that, I mean, I called it the build it, they will come theory.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And that is, I wasn't thinking about sex, but if you bring it up, and I'm going to say this to you, Husband Remember when you used to date your wife before you were obligated? Raymond, remember those days?
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
Then you create the scenario by which your wife would be responsive to you. And most women will find under that circumstance is like, well, I wasn't thinking about it, but look at that. You put the dishes in the dishwasher and you came over and you were nice to me. All of those things that will make her more receptive. when you initiate.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
So there is a lot, it's more complicated and that is also, that will get you in the right space. Novelty is important. You can't do the same things over and over and over again and expect anybody to get excited. That's just, it doesn't matter what you're talking about. Once you've done it a million times, you're not going to get the same response.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
So novelty, role-playing, sometimes you need a sexual therapist. But let me say this, what's really important, and I go back to for women, There's also a problem with arousal. And there is also the problem with inability to have an orgasm just because, you know, things are just less responsive. And to that, I would say, be playful. Invest. If you don't have one, get yourself a good vibrator.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
There are lots of good lubes you can use. At Alloy, we have a cream called Omazing, which is actually a cream that's topical sildenafil, which is the same thing as topical Viagra, but it's for women. It's the same. So it's a cream that you use externally and it increases arousal. So, you know, you realize it's, yeah, it's going to require some potions. It's called O-mazing.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
I should have branded that. O-mazing. Exactly.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
You know what? You're absolutely right. You can be our spokesperson. O-mazing.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And that's what I want to tell young women. Don't think that you need to know everything that's going to happen to you and to your life when you're 30 years old. You will have many chapters. And I want them to be encouraged by looking at people like you and Gail and Michelle and all these wonderful women who are out there recreating a life that they want to live. And we're doing it on our terms.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
The one message that I really want women to have is this, is that menopause is inevitable, suffering is not. And I think that every woman has a line drawn somewhere in the sand between what's tolerable and what's not. You don't let someone else tell you how you feel or how you're supposed to feel. If you are bothered...
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
If you are having any one of those 34 symptoms in any particular order or if you're not having those symptoms and you're at risk for things like cardiovascular disease or osteoporosis, you need to educate yourself and advocate for yourself because that's a big message that I want women to get is that don't be passive. sort of participants in your own life, in your own health.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
You have way more power than you think. You just don't know how to exercise it. And so my book and my message and my mission is to make sure that women have all the information they need to be able to make good decisions for themselves and for their families.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
I think this is something that should reassure you because only about 1% of women will actually go through menopause before age 40. So that's very uncommon. So it has to be some other circumstances. Sometimes, though, we're seeing a lot of young women who are diagnosed with cancer. We're seeing a lot more breast cancers in young women. in their 20s and 30s even.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And so sometimes it's a result of chemotherapy. But I think that you should take some comfort from the fact that it's unlikely. And if you are having problems with either with your menstrual cycle or with mood or rage, sometimes you have to take a step back and go, Well, sometimes you're mad and you have a reason to be mad. You know, you have to look at what was your day.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
But what happens when you're perimenopausal, the symptoms are more persistent and pervasive when there's no reason why you should be having those symptoms. You see, you know what I mean?
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
hot flashes, depression, anxiety, vaginal dryness, changes in libido, frequent urinary tract infections. There's a lot of overlap between things that young women can experience and things that perimenopausal women experience. But I think so you could take a look at it and say how much of this is due to the situation.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And how much am I sitting here and I'm depressed or I'm having these issues when there's no apparent reason? It should at least raise a flag for you. But for younger women, you really, before you jump to just this might be perimenopausal, I think you should look at things like there are other things such as what's called PMDD, which is premenstrual dysfunction, which is basically PMS.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And that's not, so young women can have all those symptoms, but they only happen.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
But that is the natural fall in your hormones that happens with a normal menstrual cycle that happens. But if you say, is this consistently happening the week before my period? yes or no, then that's probably more likely to be PMDD.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
There are other situations, what's called polycystic ovarian syndrome, which is PCOS, where women can start to have, again, irregular periods that, you know, that you can have periods twice a year and you think, oh my God, am I going through menopause? Well, these are things that can be easily ruled out. So as younger women, yes, can you have some of those symptoms? Is it an overlap?
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
But I think one of the things that young women tend to show up with sometimes, and that is infertility. That's the thing about... perimenopause and this menopausal transition. And again, as I said, you don't know when your ovaries are going to expire. Every person has a different end date on that. And sometimes it's the delay in getting pregnant that is the first sign that things are going wrong.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
Yeah.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
You don't know when your ovaries are going to expire. Every person has a different end date on that.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
Endometriosis can be a very debilitating condition for women where normally the endometrial tissue or the tissue that lines your uterus, that is what gets stimulated every month and then you slough it if you don't get pregnant. That's what your period really comes from, the stimulation and actually elimination of that tissue. Well, that works fine if that tissue is in the lining of your uterus.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
It has a way out. But if that tissue is on your ovaries or it's on your bowel or it's in other places that has no exit, then that can be very painful because the same process, it gets stimulated every month with your cycle, but it has nowhere to go. Got it. So it actually, it can be on your bladder, your bowel, and it causes pain. It can cause infertility.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
If it's on your ovaries, it causes scarring. And women who have endometriosis often...
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
have suffered for years before they get an adequate diagnosis about what's going on because pain is a hard thing to you can't see it all the time and you know they'll go get a scan or a sonogram and they go well it looks normal and you have no idea but they say i'm in pain i'm in pain the average woman with endometriosis has gone to the ER five to seven times for relief of their pain.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And this gets back to not believing women. And there's also this trope that we have been taught is that endometriosis is a disease of thin white women. So again, when you are complaining of the, I have pain, I have pain with sex, I have pain when I'm having a bowel movement or urinary issues, they're not thinking about that because their image of who they think has endometriosis may not be you.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And that's why there's often a delay in diagnosis with endometriosis. Yeah, it took three years. Yeah, it took three years. And that is... Typical, to be quite honest with you.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
But endometriosis in and of itself... We don't know that that is going to alter the course of menopause for you. Not necessarily. It may not come earlier. It's going to come when it comes. But what happens for a lot of women with endometriosis, they end up going through menopause prematurely because once your symptoms have gotten to be so severe... And you've tried medication for it.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
Sometimes we try birth control pills. Actually, one of the medications that we use to sort of keep endometriosis at bay is actually a medication that puts you in menopause. Which is? Lupron. It's a Lupron, it's a shot, and now there's a newer pill that you can do. But basically what it does, it shuts your ovaries down.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
So that cycling and all that stuff that's going on in your body, it just goes away. Well, it's great. It helps with your endometriosis, but it gives you menopausal symptoms.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
That's where menopause and the endometriosis connection comes in. And also for young women who have endometriosis, once the symptoms get to be so bad and you've tried all those medical management things, and you may even try surgery to go in and remove some of the endometrial tissue, but if it comes back, often the definitive treatment for endometriosis is... A hysterectomy.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And it's a hysterectomy with removal of the ovaries. Which means now you're going into menopause. Now you're in menopause forever. So that's sort of the endometriosis, you know, menopause connection. Either some of the medications that you're on will throw you in menopause temporarily. And or if that's not working, then you're having a surgical menopause. And this can happen again for young women.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
They may be in their 30s and 40s. And that's devastating from a lot of different standpoints.
The Oprah Podcast
Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
And just symptom relief. But... The one thing I want you to understand is because once you get to menopause, if that is the route that ultimately you're on and it ends up with the hysterectomy, you can be treated with menopausal hormone therapy. That does not mean that, oh, I'm 35 years old, I've had a hysterectomy and my overs are out, so I just must endure.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
You know, it used to be. And let me say, because, you know, I'm in the old group of people. And, you know, the study that really changed everything in 2002, the Women's Health Initiative, really did an about face on the conversation about menopause. Because let me just say, women have been going through menopause for as long as we've been alive. Yes.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
The only thing that's changed historically is that more of us are living long enough to get to this phase of life. But women have complained about menopause forever. But it was thought to be, you know, women just being hysterical with the symptoms or you're losing your mind. Women would go to sanitariums at that point because of the mental illness and the mental distress that it caused women.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
But we have known how to treat the symptoms of menopause since 1942. That was when the first estrogen product was introduced. That was Primarin. And so women have been using hormones since 1942, those who had access and the awareness of it. But it really changed everything. In 2002. In 2002. Okay. I was taught about menopause and what to do about it.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
And then from 2002 on, doctors who were trained didn't really get that information.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Right. You know, even for the women who are out there who are currently going through menopause, they haven't heard this conversation. And there's another 6,000 women every day going into menopause. And so the backfill is constant because there are people that just haven't had this conversation, not with their doctors, not with their mothers, and not even with their friends.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Exactly. In a nutshell, you know, as I told you, 1942, we've been treating women who were symptomatic during menopause, typically the hot flashes and the mood swings, with an estrogen product. It worked. So as we sort of got more women who were taking hormones, we found that there were some tweaks that need to be made along the way and added the progestin component to it.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Because remember, estrogen and progestin go together.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
So we knew that it treated the symptoms of menopause. That wasn't new news. But what we found was that there was a nurse's study where they just looked at a group of healthy nurses, young women, and watched them through menopause. And what they found is that the women who took estrogen therapy or HRT had half the risk of heart disease than women who didn't, the nurses who didn't take hormones.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
So imagine now the thought was, okay, we're not only relieving the symptoms, but we are actually decreasing the risk of cardiovascular disease by 50%. Well, that would be a blockbuster, right? But you couldn't prove it because it was just an observational study. So the Women's Health Initiative that was really initiated in 1991, the purpose of it was to sort of solidify that finding.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Does hormone therapy really reduce the risk of cardiovascular disease by 50%? That was the central question. So we do a study, largest study ever in the history of NIH, specifically for women. So they recruited women in that study that were anywhere from 50 to 79 years old. The majority of the women, 90% of the women were over age 55.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
So it's not surprising that when they looked at the women, they said, well, there's really no difference here. We don't see any improvement in the cardiovascular. It was like the same whether you took it or not because they were starting it on women who were too old. So that was problem number one with the study design.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
The second part was that when they were looking, they said, well, let's have some safety stops. Let's make sure that women aren't having an increase in breast cancer because of this estrogen, because that was a thought.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
So when they got to about five years in the study and they looked into the data to see how is this coming, there was this dramatic press conference that they held because not only did they not see the expected decrease in cardiovascular disease, but they saw a slight increased risk in breast cancer. From these 60 to 79-year-old women.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
From these women who were on average 63 years old, more than 10 years after menopause. So when you hold a press conference, and it's dramatic, and they stop the study, hold the presses, and they say... Not only does hormone therapy not improve your cardiac profile, it increases the risk of breast cancer. And when they said that, I mean, women who were taking hormones happily... Abandoned them.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
It was a very much misinterpreted study because if you had said, I don't disagree, okay, your data is your data. If you start women on hormone therapy later in life, you're not going to prevent their heart disease. I think that's probably true. The problem is that they generalize that data to everybody. Well, what about a 50-year-old?
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Well, what about if I start it when I'm 45, whenever I'm menopausal? Because that's when we clinically would start it. Yes, yes, yes. That's a very different outcome. And that was the misinterpretation of taking very limited findings and applying it to everyone.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
It has been, when you say the words breast cancer... to women, I think that is their number one fear, is breast cancer, despite the fact that the number one cause of deaths in women is cardiovascular disease. It is more than all cancers combined and all accidental causes of death for women.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
There is everything. When you take that same data, the largest study ever done, and you exclude the women who are older and only apply it to the women who are under 60? Yes. And within 10 years of menopause, guess what they find?
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
The same findings that we had from the observational study that the cumulative data says that if you start hormone therapy within 10 years of your last period or before age 60, you decrease the risk of cardiovascular disease by anywhere from 30 to 50%. Wow. Yeah, wow.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
I would love to. The first stage that we're all familiar with is your premenopausal phase, and that really starts at puberty. And that encompasses your reproductive life, the peak reproductive years, which starts somewhere at 12, 13, and it goes to women when they're early 30s. That's premenopause. So when we're talking about that, that's the concern. Yes.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
That is an excellent question because, as I said, that perimenopausal period is the part that is most confusing for women. Yes. But I would say this as a rule of thumb. If you are between the ages of 35 and 45 and you are having any one or any combination of those 34 symptoms that we associate with menopause, hot flashes, mood swings, sleeplessness, painful sex, irregular heavy periods, bloating,
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Brain fog. If you have any of those things in no particular order.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Yes. Then you are perimenopausal. Now, the question then becomes, well, I'm still having my period. And this is the part that really makes my head explode because there are still doctors out there who are saying, well, you're not menopausal yet because it hasn't been 12 months since your last period. Right. That's ridiculous. You should be treated when you are symptomatic.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
And no one can tell you when your symptoms are intolerable, but you know. And that's the point at which you should engage and ask someone to please fix this for me. And to be honest with you, we do know what the answer is. It's not like we're waiting to figure out for someone to discover something. It's hormone therapy in some form or fashion.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Then when you become perimenopausal, that is that amorphous phase between being your peak reproductive years and the end of your reproductive years. And the end of reproduction really starts at menopause. So there's this great space in between the perimenopausal years where you start to have some of the symptoms of menopause.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
And we may use different types and different dosages for women who are perimenopausal than when they are after when they've had their 12 months of no period. The doses may change, the types may change, but the concept is still the same. You treat a hormonal issue. with hormones. And that's why we say hormone replacement.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Some people don't like that phase, but I'm old, so I still say hormone replacement.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
I've been on hormones for 15 years. And I knew exactly what was happening. And I was like, okay, well, that's enough of that. And just go right on. And I have no intention of stopping unless and until there's a reason, a medical reason why I should stop hormone therapy. But...
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Right. When you are bothered, when you are either you find out that it's either affecting the quality of your life, the quality of your work, the quality of your relationships. When you reach that level, then that is the time that you should seek care. Right.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
But here's the reality is, as we said, I say it over and over again, there are not enough doctors who are out there who know how to treat menopause and perimenopause. So what's a woman to do when you have read everything that you need to read and you are clear and you know exactly what's happening to you? And it's not uncommon for you to go to a doctor's office and the doctor will tell you,
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
No, or I don't believe in hormones, which is not an uncommon thing.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
And that is really why when I left my private practice that I, you know, joined the women that I work with at Alloy Women's Health. Alloy, yes. Because what it is, is really giving women access who don't have access to doctors who know what they're doing.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Or it's too expensive to go to those doctors because, you know, everyone should have access, in my mind, to the same quality care, whether you live in New York City or whether you live in New Mexico. It shouldn't matter. Or in Dyma. Absolutely. Exactly.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
And, you know, and here's the other thing is that for people who are just sort of getting into this hormone therapy game, a lot of them don't have the experience of knowing what to do. So they give you the answer based on, okay, well, this is what it's supposed to do, but every person's different. Yes.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
But you're still having your periods, sometimes regularly, sometimes not.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Yes, because sometimes for women, that's the... You're not in menopause until it has stopped. You are not in menopause officially until you have had your last period. And how do you know when you've had your last period? Well, you know you're in menopause when you've gone 12 full months and you've not had another period. Then it's official. You are menopausal.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Thank you.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Thank you. Thank you. Thank you. Thank you. Thank you.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Thank you. Thank you.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
But what's confusing for women is that in-between state because it can start as early as your mid-30s. And it can go on until you've had your last period. And that can go on from anywhere from four to 10 years for women. And that's where I think a lot of the confusion comes in.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Because if you're having your period and having hot flashes, well, then you go to your doctor or you're having sleeplessness or... mood disturbances and you go to your doctor and the first question they ask you is, well, when was your last period? And if it was last month, they immediately get off the conversation of perimenopause or menopause.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
,,,,, It's not just annoying and they're not funny. They actually are harbingers sometimes of long-term health implications of menopause, such as increased risk for cardiovascular disease, such as increased risk for weight gain, for hypertension.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
So all of the symptoms that we typically associate with menopause that people are familiar with, like hot flashes, mood swings, sleeplessness, painful sex can start in perimenopause. And women think of menopause as something that happens to old ladies. The average age is 51. But a 35-year-old having these symptoms is very much in that menopausal transition, that in-between state.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
All of these long-term things that we talk about, a hot flash is sometimes the first signal to saying, hey, maybe you're at risk for these things, which again will affect not just the quality of your life in the short term, but in the long term. So that's why I say if you have them, treat them. And you don't get any bonus points for having endured them.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
I think that is very important when we talk about Alzheimer's, what we know and what we think we know. And what we do know is that women are twice as likely to be diagnosed with Alzheimer's in their lifetime than men are. And the women who are more likely are women who have a female relative with Alzheimer's. It's not to mean that you will because it's very much a multifactorial process.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
What we also know is that the same things that we tell you to do that decrease your risk of cardiovascular disease decrease your risk of Alzheimer's. So regular exercise, good night's sleep, cutting back on alcohol, don't smoke. And for goodness sake, watch your diet. Weight is important.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
All of these things, just lifestyle, whether we're talking about heart disease prevention or Alzheimer's prevention, or whether we're talking about just the rules that you need to observe for healthy living and aging. So all of that.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
But what we do know, and I'll tell you what we know and what I think, there's a brilliant neuroscientist by the name of Dr. Lisa Moscone who has written a book called The Menopause Brain.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
And what we know is that for women who have an early menopause, and early means you have had your last period before age 45, or it's a premature menopause if you've had your last period before 40, those women who do not get hormone replacement, because they are so young, are at increased risk for cardiovascular disease and Alzheimer's.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
That could go on for another 10, 15 years. It can go on for another 10 years. And I think what is also confusing is that when women say, all right, so we've got premenopause, perimenopause, menopause, and postmenopause. And I don't really like the term postmenopause because it implies that at some point you're over it.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Now, do we know for a fact that estrogen therapy is a preventative measure for Alzheimer's? Maybe. That's where we need a lot more data on that.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
It certainly does.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
No, ma'am. No, ma'am. That is not a contraindication to HRT. It is not. And as a matter of fact, not only is it not a contraindication to HRT, to estrogen therapy, I should say, because you've had a hysterectomy. Remember I said you don't need the progestin. All you need is the estrogen. So, yes, you can have estrogen.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
The only reasons, the only contraindications that we have for HRT are if you personally have breast cancer or an estrogen-dependent cancer such as endometrial cancer, if you have undiagnosed vaginal bleeding, if you currently have a heart attack, you, not a family history of a heart attack or stroke. or you have active liver disease.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
And the issue about blood clots is debatable, but we'll leave that aside for now. But that's it. Those are the only contraindications. So you might go back to your doctor and say, well... Or go to another doctor.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
I honestly don't think that doctors are trying to do a bad job. I really don't, because I worked for... I don't think that they're trying to do a bad job.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
They don't know and they don't even know what they don't know. And they don't know what they don't know. And that's the problem is that you've got to keep current. And that's why I really would advocate that menopausal care and care of women in midlife should be separate and apart. from all the other things that OBGYNs have to do. It's a lot to keep up with.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
You know, you've got to do surgery and you've got to deliver babies and you've got to, you know, get birth control. But this phase of our life that we will spend anywhere from 30 to 40% of the rest of our lives in this menopausal phase deserves its own area of inquiry. We need more research. We meet more doctors who are knowledgeable about it because that's what they do. We deserve...
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
As women in midlife.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
We deserve better and we deserve to have the attention paid to the issues that have historically not been paid attention to.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Because it is a celebration of a time of life where I think we should all look forward to. And I do say this in my book, Oprah. I said when people have a different vision of what that time of life is like, people think of it as, oh, I'm getting old or dread. But I mean this sincerely.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
I mean, for people like Michelle Obama, Naomi Watts, you, Halle Berry, all the people, Gayle, who are out here showing young women what this phase of life looks like, it should be something that we look forward to because I don't know about you, but I am happier now At 66. For sure. Then I was at 46. So I look at people sometimes like, oh, don't feel sorry for me.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
You're not over it.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
You're never over it. And people think that because your hot flashes stopped or you didn't have hot flashes that you didn't have menopause. And I'm saying, yes, you did.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
We deserve a celebration.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Yes, you did.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
But there are other ways that women can go through menopause other than just the natural process that happens.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Absolutely no longer fertile. And sometimes it's not just the complete loss of eggs, it's the loss of function of your eggs. Because the other thing that happens that people don't talk enough about during perimenopause is that there's a change in your fertility.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Because when you're perimenopausal, when you're 40, you still have eggs, you're still having your period, but your fertility is not what it was at 20. It's not what it was at 25. Because you've already lost eggs. It's not because you've lost them. It's because they are less responsive. Oh, they're less functional. They're less functional. And I'll give you an example.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
I like to say, you're born with all the eggs you're ever going to have. You don't get any more, you don't make any more. And then over time, you ovulate some, but you're not losing them because you've run out of them. You only ovulate about 500 times in your lifetime, but you had a million when you were born. Those eggs become less functional.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
And every woman has a different expiration date stamped on your eggs. So you don't know, are my eggs going to last until I'm 45? Or are they going to expire when I'm 35? And that's why we start to see the fertility changes. And for each individual, when you reach the end of that road, it's going to be different from person to person.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Yes, hormone replacement therapy, typically it is comprised of estrogen, which is the secret sauce in hormone replacement therapy, and a progestin, which is the second hormone that you take when you have an intact uterus. Now, for women who've had hysterectomies and don't need to have the progestin, you can just take estrogen alone.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
But most of what we associate with the symptomatic relief really comes from the estrogen component.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Yes, they are. But all of the studies that have been done really basically are with estrogen and progestin. We are sort of behind the curve. We're finding out a lot more about testosterone because women make testosterone too. And I think that that's sort of the misconception is that, well... Estrogen is a female hormone and testosterone is a male hormone. And that is not true.
The Oprah Podcast
Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Women make almost as much testosterone in the course of our reproductive lives as we make estrogen. That's really responsible for that sex drive that you get right around mid-cycle. So we're coming back around to understanding that maybe there should be more to hormone replacement therapy than just estrogen and progestin. But we need a lot more studies about that.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Das ist wirklich ein Gesundheitsproblem, das wir beantworten müssen. Und ob oder nicht Sie systemische Hormone auswählen, von denen wir geredet haben, kann jede Frau vaginale Estrogen benutzen. Sie behält die Integrität der Vagina, schlägt auf Urinär-Traktinfektionen und all diese anderen unbedeutenden Dinge, die mit dem Alter passieren.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
So, I want to make it clear, because I still use the old term. I say hormone replacement therapy. I don't think replacement is a bad word, but obviously someone objected to it. Sharon tells it like it is, and that's what I love about it. I'm like, what's wrong with that? I don't have a problem. But hormone replacement therapy, menopausal hormone therapy, same, same.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und all it means is that when you reach either perimenopause or menopause, then you are using hormones to treat hormonal problems. And, you know, because we know in menopause, it is really defined by a persistently low lack of estrogen and lack of ovulation in the fertility forever or not.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
So you are just giving back, not at the same levels that you had when you were ovulating and you were premenstrual, but you are giving back just enough to take care of the symptoms, all those gnarly symptoms that come up with menopause. Hot flashes, mood swings, night sweats, sleeplessness, brain fog, the list goes on and on and you know it.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
So you are giving back a smaller dose of estrogen and progestin for women who have a uterus. And if you've had a hysterectomy, then you can be treated with estrogen only. Because estrogen is really the secret in the secret sauce that controls the symptoms that women have during menopause. So that simply is all menopausal hormone therapy is.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
But to give you an idea, women are so afraid of menopausal hormone therapy. Women are afraid of menopausal hormone therapy who've been on birth control pills for 20 years. And I just look at them and I'm like, girl, you've been on estrogen and progestin since you were 25. And you're going to be taking far less of it. in Menopause than you did before.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And somehow, you know, again, it's a perception problem. Of course it is. It's a branding problem. Menopausal hormone therapy is anywhere from a third to a quarter of the dose of what's in a standard birth control pill. It is? Yes.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Die gleichen Komponenten, die Komponenten sind anders, weil sie verschiedene Missionen haben, aber sie sind immer noch Estrogen und ein Progestogen, Estrogen und ein Progestogen. Einfach unterschiedliche Typen in unterschiedlichen kleineren Mengen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Es gab eine ganz andere Konversation über Menopausen, als ich in der Privatpraktik angefangen habe. Ich habe in den 80ern in der Medizin studiert und in 1992 angefangen. Es gab wirklich viele Konversationen über Menopausen und wir haben uns mehr von den langfristigen Gesundheitsbedürfnissen angesehen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Das war, als die Daten über kardiovaskuläre Krankheiten kamen, und es sah sehr favorabel aus für Frauen, die Hormone nehmen. Aber um euch eine Idee zu geben, also das Arschloch der Estrogen-Therapie. Premarin wurde von der FDA im Jahr 1942 verabschiedet. Also hatten wir 50 Jahre, als ich angefangen habe, zumindest mit dem Konzept, dass man Estrogen für das Behandeln von Symptomen benutzt.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und es ist interessant, was passiert ist, dass sich die Perspektive verändert hat. Primerin war da draußen, die Frauen wussten es, aber sehr wenige Frauen hatten damit Zugang. Denn es gab noch nicht viele Ärzte, die wussten, wie man sie präsentieren und behandeln kann, auch damals. Und dann ist etwas in den 1960er-Jahren passiert.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Ich glaube, es war 1965, als Gynäkologe Dr. Robert Wilson dieses Buch »Feminine Forever« geschrieben hat. Die Menopause wurde diskutiert, wirklich nicht aus der Sicht der Frauen, sondern aus der Sicht der Männer. Menopause. Er hat ein Buch geschrieben, alle Gynäkologen waren Männer damals, aber er hat ein Buch geschrieben und er hat diese Art von Ode zu...
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Femininität und, oh Mädchen, ihr wollt doch nicht ein trockener kleiner Schwanz sein, oder? Und das war das Ding. Seid für euren Mann erstaunlich. Das war, wie Hormontherapie wirklich in den 60ern verkauft wurde. Und es gab einen riesigen Ausstieg in Preskripten, nicht weil jemand wusste, wie es dir gefällt, aber wer will nicht erstaunlich und sexuell verfügbar sein? Das war der große Druck.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
It was really about making sure that women were able to remain alluring to their partners. That was the whole, that was the thrust of it. And who wanted to, you wanted to be young, you wanted to be feminine forever. Because otherwise, why would anybody, what's your value?
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Who's going to want you? You know, you're done having children and you're not available for sex, so what's the point? Das war wirklich die Perspektive. Und es wurde verkauft. Und das war der erste echte Ausstieg in der Anwendung von Estrogen. Das war in den 60ern. Ein kleiner Tipp, den die Leute nicht wussten, ist, dass der Mann, der es geschrieben hat, Robert Wilson, ein Gynäkologe war.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Jedoch wurde das Buch von den Machern von Primarin bezahlt. Und das war die erste Marketing-Ploye für Frauen, und wirklich von der Perspektive eines Männern und von dem, was wir als Männer von einer mittleren Frau wünschen würden. Das war also die erste Stufe. Ich wünschte, dass ich überrascht werden könnte. Aber wenn wir uns fragen, wie wir hierher gekommen sind? Weißt du was?
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Die Franzosen sagen, plus ça change, was bedeutet, je mehr Dinge verändern, desto mehr bleiben sie gleich. Und wir gehen immer noch zurück und forth mit diesem Pendulum von Estrogen ist gut, Estrogen ist schlecht, Estrogen ist gut.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und so nach dem 60er, die eine Sache, die wir herausgefunden haben, war, dass Frauen, die Primarin oder Estrogen alleine benutzen, wir wussten nicht wirklich, dass man ein Progestin dazwischen geben musste. Und so gab es einen Aufprall in den Fällen des Endometrialen-Kanzers oder des Uterin-Kanzers für Frauen, die Estrogen alleine benutzen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Stell dir vor, dass es viele Frauen in den 60ern gab, die Hysterektomien hatten, weil es schwer war, über die Menopause mit einem intacten Uterus in diesen Tagen zu kommen. Aber für die Frauen, die einen Uterus hatten, okay, also das war das erste schwarze Auge für Estrogen, war, oh, es wird Endometrialkanzer verursachen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Das Problem wurde irgendwo, ich würde sagen, in den späten 70ern geschlossen. Und sie sagten, oh, wir brauchen eine Progestin, um den Uterus zu schützen, wir sind alle gut wieder. Und jetzt starten wir, Daten zu akkumulieren. auf Frauen, die Estrogen genutzt haben.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und sie haben herausgefunden, und wahrscheinlich der größte, der kam, war das Studium der Ärzte, das Framingham-Ärzte-Studium, wo sie nur Frauen folgten. Sie wissen, Ärzte, die generell gesund waren, Estrogen, kein Estrogen. Und sie haben herausgefunden, dass die Frauen, die Estrogen genutzt haben, eine niedrigere Anzahl an kardiovaskularen Krankheiten hatten. Now we're on the upswing again.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And this is when? This is probably in the 80s. In the 80s, okay. And so now we're using estrogen not just for the relief of symptoms, which it has always done. That's been the one consistent thing about estrogen. For women who are symptomatic, it's the thing that works the best. And those symptoms are? Hot flashes, mood swings, vaginal dryness.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
We didn't really talk about brain fog then because I think the notion was that all women were ditzy. Right. You know? Right. I mean, there's that Edith Bunker thing.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
That's just how women were. Wir haben also nicht wirklich den Kopfschmerzen als Symptom des Menopausen erkannt. Aber all die anderen Dinge, wie die rote Haut, die Schmerzen, die Irritation, die Stimmung, waren wirklich das, was den Nutzung des Estrogens geführt hat. Es hat immer dafür gearbeitet.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Aber als wir Progestin zusammengenommen haben, sagten wir jetzt, okay, wir haben nicht nur Estrogen für die Erlösung von Symptomen, sondern wir haben diese großartige Beweise, die sagt, selbst wenn es nicht eine randomisierte Studie war, es war tatsächlich beobachtbar und sagte, die Frauen, die es benutzt haben, hatten weniger Herzschmerzen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Das war, als wir begonnen haben, nicht nur die Erlösung von Symptomen zu sehen, sondern auch den langfristigen Vorteil von Herzschmerzen. Und das ist so, als ich in die Geschichte hinein kam. Weil in den letzten 80ern und den frühen 90ern I actually was taught about menopause. And I was taught about the use of estrogen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Because again, we were coming at it from a health point of view, not just the relief of symptoms, because we knew that already. Right.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And not only that, but I joined a practice that had been in existence for 30 years before I got there. So I still had that initial wave of women who had started estrogen in the 60s. Right. You know, because the Und sie waren immer noch da, diese kleinen 80-jährigen Mädchen mit ihrem Estrogen. Und sie waren so, nein, nehmt es weg. Und ich so, okay, aber ihr braucht ein bisschen Progestin.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und es gab viele Frauen, die an dieser Stelle dabei waren, als ich in die Geschichte eingestiegen bin. Für 30 Jahre. Und sie waren glücklich, sie waren gut, sie sahen gut aus. Und dann? Also von 1992 bis 2002, weißt du, das war das, das war das, was wir bei der Preskription und beim Denken über Hormontherapie gemacht hatten.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Nicht nur für Symptomatische Erlösung, sondern für die Daten, die über Osteoporose kamen, und die Daten, die über kardiovaskuläre Krankheiten kamen, beide waren favorabel. And, you know, the makers of Primarin, I said, I have to give it to them because they came back at it and they're like, okay, well, we can't pay someone to write a book about it. So we will start with the spokesmodel.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And believe it or not, the first spokesmodel for estrogen was Lauren Hutton, the beautiful Lauren Hutton. And she was out there. And, you know, so now, again, we're getting back to that same sort of, you know, Ja, wenn du Estrogen benutzt hättest, hättest du Lauren Hutton aussehen können.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Versus die Gesundheitsbedürfnisse davon. Und wir auf der Doktorfront versuchen wirklich die Gesundheitsbedürfnisse zu beurteilen. Und so gab es viel. Also, du weißt, das Pendulum schwingt wieder und jetzt ist es in Bezug auf Estrogen. Ja. Dr. Bernadine Healy, may her soul rest in peace, was the first female director of NIH. And she was a cardiologist and a woman of a certain age.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
So she was very much interested in doing a study Das betrifft Frauen, postmenopausalische Frauen. Und vor ihr, hatte es noch nie eine large-scale Studie betroffen, die Frauen betrifft, postmenopausalische Frauen. Nun, das ist schwer zu glauben, aber das Studium wurde in 1991, 1992 begonnen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And it was her urging that really got the focus, you know, on women in midlife. And so she started the study. Unfortunately, she was not there as the study progressed. But, you know, we said, oh, great, now we're going to prove that.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Once and for all, this little observational data that we have about cardiovascular disease, we're going to prove it, because we are going to do a gold standard, randomized, double-blind, placebo-controlled study, and we're going to manipulate it such that we're going to prove once and for all that it does decrease the risk of cardiovascular disease. That was the point of the study.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Nicht, ob es Hot Flashes beherrscht, nicht, ob die Frauen ihre Leben durch Hormone verbessert haben. Das war nie der Punkt, denn das wurde damals erstellt.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Das war es. Genau. Es wurde als Präventionstudie gestaltet. Es ging darum, die Frage zu stellen, ob der Nutzung von Hormontherapie den Risiko für kardiovaskuläre Krankheiten reduziert, welches wir wissen, ist die Nummer eins cause of death für Frauen in diesem Land und weltweit.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Schau dir mal an, was das tun würde und wie das jeder Behandlung verändern würde, wenn du wüsstest, dass ich eine Medikation geben könnte, die für 50 Jahre vorhanden war und wir den Risiko einer Kardiovaskularen Krankheit bei 50% reduzieren könnten. Das wäre großartig.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And that's the good news and bad news, I think, really about the public education effort about breast cancer. Because we're in a very different place now than we were 50 years ago in terms of awareness and screening. That's success. But it is so sort of elevated that in women's minds that we think that that is the only and most important thing that women are dying from. And it is not.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
It is still, was then and is now, still cardiovascular disease.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Oh, I do, I do, I remember it. Because remember, at this point, I've been practicing for 10 years. Yes. All right, so 10 years, I've been telling patients one-on-one every day, oh, you've got to take this hormone, it's great. Und die Investoren bei NIH haben eine Pressekonferenz im Nationalen Presseclub gegründet. Sie haben alle eingeladen, zuhören.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und sie haben gesagt, übrigens, du weißt, dass alles, was wir dir über Hormone erzählt haben und wie groß es ist, es ist nicht. Es reduziert nicht nur den Risiko für kardiovaskuläre Krankheiten, es erhöht den Risiko für Brustkanzer. Und als sie die Worte gesagt haben, dass es den Risiko des Brustkanzers erhöht hat, wollte ich dir sagen, was für einen seismischen Effekt es war.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Denn das flog wirklich in die Füße, was wir über Estrogen im Zeitmemorial gesagt haben. Und dann, poof, ging es weg. Frauen waren wütend, sie waren überrascht. Es wurde auf jeden großen News-Outlet aufgenommen. In this country and around the world. And it cemented this idea that doctors had been doing something really to the detriment of women's health, not to the benefit.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And that if you took these awful hormones, you were going to get breast cancer. And women abandoned hormone therapy in droves. From a large percent, right? From about 38% of women who were eligible to take HRT. It went from about 38% to less than 6% and it has persisted. It is still in about the 5% range even today. 22 Jahre nachdem das Studium herausgekommen ist.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und du weißt, das ist nie das Ende der Geschichte, weil, du weißt, es ist schwer für Menschen zu verstehen, aber es gab ein Zeitpunkt vor dem Internet und bevor wir instantan Zugang zu Informationen hatten. Und als sie diese Pressekonferenz gehalten haben,
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Even the investigators who were participating in 40 centers around the country had no say in the stoppage of that study, in the article that came out that made these claims about increased risk of breast cancer. It's sort of a small group of regulators at NIH came up with this.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
They put it out and immediately, it wasn't like it was years later, the doctors who were involved in the clinical trials protested. Weil sie dachten, warte, warte, warte, das ist nicht wirklich das, was es gesagt hat. Aber wiederum, 22 Jahre später versuchen wir immer noch, das Genie zurück in den Bottle zu legen. Und es war schwierig.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Wir haben ein paar Dinge von der Women's Health Initiative gelernt. Es war ein großes Studium. Aber hier ist, was der grundlegende Fehler war, oder die grundlegende Missinterpretation der Daten.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Wenn du ein Studium konstruierst und sagst, wir versuchen, zu beweisen, dass es den Risiko für kardiovaskuläre Krankheiten reduziert, und wir werden es mit heiligen Frauen tun, und wir werden dich über Jahre folgen, um herauszufinden.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Nun, der Grund, einer der Gründe, warum sie in dem Studium jüngere Frauen nicht wählten, war, weil Frauen nicht, wir sehen nicht den Aufprall in kardiovaskulären Krankheiten bis etwa zehn Jahre nach der Menopause. So they can't start a study and say, all right, we're going to start at 50 and I'll come back and check you out when you're 70.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
So they skewed it such that the women were much older at the start of the study. So the average age of the woman entering the Women's Health Initiative was 63. And you could be anywhere from 50 to 79 and still be in the study. Well, that may have sounded, you know, I understand their reasoning. However, that was not typical of who we normally prescribed hormones for.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
We prescribed hormones for symptomatic women around the time of menopause. And that's sort of more typical of our population. But when you start it that far out, I don't think it takes a rocket scientist for anyone to see that, how are you going to do a prevention study auf eine 79-jährige. Sie hat entweder Herzschmerzen oder sie hat keine.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und es ist egal, was du ihr an diesem Punkt gibst, du wirst das wahrscheinlich nicht beeinflussen. Das war der erste Fehler. Und ich denke, der zweite Fehler war, dass sie diese Daten genommen haben, von älteren Frauen, die mehr als zehn Jahre alt waren, im Übrigen, nach der Menopause, und generalisierte es für alle.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Also das gleiche Daten, das sie von einem 63-Jährigen erhalten haben, haben sie an einen 50-Jährigen eingesetzt. Und sie haben auch nur eine Medikation geschaut, eine Dose, And nothing else. So all of the other nuance, you know, about dosing and, you know, timing, we didn't know. So it took a very specific finding.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And maybe if they had said, wow, if you give it to women 10 years after menopause and the average age of 63, you don't impact their cardiovascular disease. Right, right, right. If you had said that. But it didn't say that. It said everybody. But that wasn't really the thing that really turned women off. As I said, what really got them was the breast cancer. Of course.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And the breast cancer study... Das Teil davon war auch ein bisschen verwirrend, weil, auch wenn es eine kleine Vergrößerung im Risiko für Breastcancer gab, für Frauen, die Estrogen und Progestin genommen haben, nicht nur für Frauen, die Estrogen genommen haben, auch wenn es eine kleine Vergrößerung gab.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Es gibt dieses Ding bei medizinischen Studien, wenn du ein Studium machst, sind deine Ergebnisse entweder signifikant, Oder sie sind es nicht. Statistisch. Man kann nicht sagen, es ist ein bisschen oder es ist fast. Ein bisschen. Ein bisschen, ein bisschen bedeutend. Ich wette, es ist ein bisschen in der Richtung. Und das ist, was sie gemacht haben. Selbst am Anfang.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Der Verlust des Risikobrechens, selbst in dem ersten Pass, hat nicht den Niveau der statistischen Bedeutung erreicht, dass man das sogar als positive Erfindung nennen könnte.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
All you gotta do is say it. Wow. Und so there was a lot of nuance about the study that didn't really fully get explained. Because no decrease in heart disease and it increases your breast cancer. So why on earth would I...
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
I'll tell you what the real problem was, is that they had the press conference and nobody had read the study. Weil, weißt du, du sitzt da und denkst dir, warte mal, es ist auf der Today Show, aber wo kann ich es eigentlich lesen?
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Es hat fast zwei Wochen gedauert, um uns Zugang zu bekommen, weil das waren die Tage von Schnauze-Mail, wo du auf einen Journal warten musste, um tatsächlich zu kommen und du hattest zu öffnen und es zu lesen. Und auch dann, und das ist der Punkt, den ich wirklich machen möchte, Auch dann, als ich das Artikel gelesen habe, sagte ich, es sagte nicht, was sie gesagt haben. Wow.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Das ist die Partie, die ich in dieser Geschichte verpasst habe, dass es einen sofortigen Rückzug gab. You know, when you talk to Avram Blooming, Avram, you know, said the same thing. How did that get left out of the story?
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Well, you know what? I think what's happening, and I think the reason why we're going to really make some headway, is that there is now a generation of women who never heard that story. Most OBGYNs, whether they will admit it or not, most female OBGYNs take hormone therapy. Of course. The ones who did, I kid you not, I couldn't convince them no matter what I said. I'm like, really? I read it.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
It didn't say that. It didn't say that. I couldn't convince my best friend. that I wasn't telling her something.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And I kept thinking, I was like, you know, come on. I was so convinced that that was not the case, that at the time I was not menopausal. I was only 42 years old. But when the time came, and we were still having this negative... Ich habe gesagt, ich nehme Hormone. Und ich habe nicht einen kurzen Wunsch gegeben, weil ich wusste, dass es das nicht sagt.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und die meisten OBGYNs, ob sie es oder nicht anbieten, die meisten Frauen OBGYNs nehmen Hormontherapie.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Weil wir wissen und wir sind so, nein, ich habe das nicht gesagt.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Ja, ich denke, vieles ist verändert. Und ich meine das ehrlich gesagt. Und vieles hat damit zu tun, dass Leute wie Sie, die wirklich die Botschaft hochladen, weil, Sie wissen, ich habe diese Gespräche gehabt, aber im Büro, eins zu eins. Und es kommt selten außerhalb dieser Raum. Und jetzt haben wir eine größere Phase.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Oh, ich mag das. Okay. Das war ein neuer Internist. Und sie und ich, und ich kannte sie, wir kannten uns von vorher. And she said, you know, she's just taking your history and what medications you take. And I tell her, I said, yes, and I take HRT and I told her what I'm taking. And she looked at me and she said, you know, I'm not a fan. And I was like,
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
You do know what I do for a living, don't you? I didn't ask you that. I need some other advice, but I pretty much got that. And all I could think to myself is that if you would say that to me, then I can imagine how forcefully you would discourage Anybody else who didn't know better. And that would make them go home and say, oh, maybe I shouldn't be on this stuff and throw it away.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And the follow-up to that is, I just saw her not too long ago. And guess what? She said to me, and this is almost a direct quote, I got all my lab work back and everything. And she says, oh my God, I don't know what's going to happen. But she said, one thing you're not going to have is a heart attack. Okay.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
I think the first thing that you need to ask is that whether or not they think that hormone therapy is right for you. Because that's going to tell you a lot. Because you're going to come into that conversation loaded for bear and you're going to know whether or not it's a good idea and whether or not you want it. So the response is important.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Ich denke, die zweite Sache ist, dass du sicher bist, dass du sie kennst, um sie zu fragen und sie bewusst zu machen über all die Dinge in deiner Familiengeschichte, die wichtig sind zu wissen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und wiederum, dass du sicher bist, dass du reingekommen bist, mit dem Wissen, was all diese Dinge sind, und zu fragen, was sind die Dinge, für die ich persönlich beteiligt werden muss, basierend auf dieser Familiengeschichte.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
I say things over and over and again because I think that hopefully they'll sink in. Achtet auf euch selbst, exerciziert euch, achtet auf euer Gewicht, macht sicher, dass ihr eine Diät habt, die nicht voller von, weißt du, unterverpackten Füßen ist. Aber nochmals, es gibt ein bisschen Freude, nicht alles. Aber versucht, besser zu sein.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und wenn du diese Dinge tust, weil ich denke, es ist so wichtig, weil je besser in Form du bist, in diesen Prozess zu kommen, desto besser wirst du am anderen Ende davon herauskommen. Und das andere, was ich dir sagen würde, ist, stopp dich von Gewicht zu besorgen. I want you to pay attention to what is healthy for you.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And you go to your doctor and your doctor will tell you, is my blood pressure good? Is my blood sugar good? Am I not showing any signs of metabolic syndrome? Then that's good. And we've got to leave that sort of impossible image behind.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Also ja, ich denke, dass es viel mehr Frauen gibt, die in dieser Gespräche interessiert sind, jung und alt. And I think that people aren't afraid to utter the word menopause. So yay on that. Lots changed.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Ja. Es gibt eine Studie, die sogenannte Studie der Frauen auf der ganzen Nation, oder die SWAN-Studie. in denen sie schon seit über 25 Jahren eine Gruppe von Frauen folgten, vor der Prämenopause, durch die Perimenopause und so weiter. Und da haben wir viele Informationen dazu, wie lange es dauert, um durch diese Transition zu kommen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und es hat eine sehr repräsentative, eine sehr diverse Gruppe von Frauen, die sie folgten. Und das ist das, was wir gefunden haben, dass die Erfahrung der Menopause anders ist, abhängig von verschiedenen ethnischen Gruppen. African American Women tend to go through menopause earlier, about a year earlier. Hispanics a little bit earlier, but not as much as African American Women.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Their symptoms start earlier, they're more severe, they last longer, they complain about them the least, and they're the least likely to get a prescription for medication, even when they complain about them. So the experience and is it something so different about being, you know, is there something biologically different between African American women and white women in this country?
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Probably not so much. But there are a lot of other things about the lived experience and the other health issues that we come to it with. So it's not menopause per se, it's how you enter menopause. And to know that women who are most at risk
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
für viele der Dinge, über die wir reden, die in der Menopause geschehen und für die Bevölkerung von Frauen, die nicht wissen, dass sie auf Risiko sind, nicht die Möglichkeit zu haben, Ja oder Nein zu sagen, ob sie Hormontherapie machen sollen, weil ich glaube, das ist dort, wo die Missinformation einhergeht. Und ich denke, dass es auch ein Problem mit der medizinischen Gemeinschaft gibt.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Denn das war wirklich das, was ich gelernt habe, dass schwarze Frauen keine Hotflashes hatten, so schlecht wie weiße Frauen. Nun, und lasst mich nur sagen, sie hatten ein Rational dafür. Es war nicht korrekt. Aber der Gedanke war, dass nach der Menopause, weil schwarze Frauen eine höhere Gewalt haben, dass sie das Peripheral-Estrogen in Fasern verwenden werden, sodass sie kein Estrogen brauchen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Das war die Rationale. Das war das, worüber man gelernt wurde? Du hast auch Dinge gelernt wie, dass schwarze Frauen keine Osteoporose bekommen. Das ist nicht wahr. Die Frage, ob du Osteoporose hast, hat nichts mit deiner Race zu tun. Es hat mit deinem Körper zu tun. Also eine dünne, schwarze Frau ist so viel, wenn nicht mehr, auf Risiko für Osteoporose als eine dünne, weiße Frau.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Aber wir schauen auf die Farbe der Haut und nicht auf die Person vor dir.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Aber selbst wenn wir das tun, sind wir wirklich befasst mit der Wahrheit, dass die Grund, weshalb alle Frauen generell keine Gespräche über Menopause haben, Sie sehen, wie lange wir hier über Menopause reden. Es ist eine iterative Gespräche. Es ist kein Ein-und-Dann. Es ist etwas, über das Sie sprechen sollten, dafür vorbereiten, wissen, was zu tun ist, wenn das passiert.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und das ist das eine Ding, das heute in der Medizin in kurzer Verpackung ist, Zeit. Und Ärzte haben keine Zeit, darüber zu sprechen, weil sie eher sagen würden, wenn ich einfach weiterführe, oder es dauert zu lange, oder es dauert zu lange, dir zu erklären, Es ist so viel einfacher, es einfach auszupassen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und ich denke nicht, dass es darum geht, weil die Ärzte versuchen, einen schlechten Job zu machen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Es ist nur so, dass sie keine Zeit haben. Und das ist, wo ich denke, wiederum, die Arbeit, die Sie gemacht haben, die Arbeit, die Mary-Claire Haver gemacht hat, ist, dass wir bemerken müssen, dass wir die Informationen an die Grundlage nehmen müssen. Wir können nicht warten, dass Leute mich hierher führen. Und ich denke, dass die besser beteiligten Frauen sind,
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
the better they're able to advocate for themselves. That is why I joined Alloy Women's Health, simply because it is a digital health company that is doing what I was trying to do in my office one-on-one, because you realize that currently our medical system doesn't support the kind of conversations and the kind of access that we should have.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Yes, but there are a lot of things about medicine that have evolved. And I think that that's the problem. We can't get stuck. Okay, we may have believed one thing, but now we know better, we should do better by our patients.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
I mean, we have to think about, whenever I hear a doctor say something and they're so absolutely resolute about it, I remind them, I was like, there was a time when we thought bloodletting was a good idea. Leaches, how about that? We've done a lot of things that have not turned out to be, didn't work out great. So a little humility is in order. And I think that when you tell patients...
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
That I am giving you the best information that I have today. Will that be true forever and on? Maybe not. Will there be something else that will, I hope that we'll be able to refine what we're doing and to have better options for women 20 years from now and we'll know something then that we don't know now. I mean, that's what we do. You know, we learn.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
I mean, women have been overlooked. Für immer, wenn es darum geht, wie wir behandelt werden. Wir waren nicht involviert in Medikamenten-Studien. Wir waren nicht involviert in den Tests für medizinische Geräte. Sie werden an Männern gemacht. Und wir müssen wirklich mit dem Fakt, dass unsere Physiologie anders ist, unsere Hormone uns anders machen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und ich denke, dass die Grund, warum so viele Studien auf Männer gemacht wurden, ist, weil sie ihre Hormone angeschaut haben und sagten, das ist schmutzig und das wird unsere Ergebnisse beschleunigen. Wir brauchen etwas, das in einem stärkeren Zustand ist, wie Männer. Sie haben beinahe die gleiche Anzahl an Testosteron.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und sie wollten nicht, dass all diese hormonalen Dinge ihre Studienresultate beschleunigen. Even the laboratory studies were done mostly with male laboratory rats. Because they just didn't want, you know, unless they were looking something specifically about fertility. We didn't even have rats? No. We had nothing. No.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
They would do, you know, if they were trying to figure out about breast cancer or something like that.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Let me tell you what the FDA has, you know, and we all know. But the FDA has indicated that hormone therapy can be used for... die genitalen Urinärsyndrom der Menopause, die Dinge, über die wir gesprochen haben. Es kann für die Befreiung von Osteoporose genutzt werden. Und es kann und sollte für Frauen genutzt werden, die entweder früh oder prämaturiert sind.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Postmenopause danach. Ich denke, Perimenopause ist die verrückte von diesen Phasen, weil Perimenopause einfach bedeutet, um die Menopause herum. Und es ist auch die Menopausentransition genannt, wo du von deinen peakigen Fertilitätsjahren bis zu keinem Fertilitätsjahr gehst. Und es ist dieser Gap dazwischen. Und für die meisten Frauen kann das von vier bis zehn Jahren dauern.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Early menopause means your menopause will be before age 45. Premature menopause means your menopause will be before the age 40. Those are the four indications for hormone therapy by the FDA. Now, they also give you some guidance on who Oder was sind die Gegenteilindikationen zu Hormontherapie?
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Eine ist eine persönliche Geschichte von Breast-Kranken oder einem estrogenabhängigen Kranken, wie Endometrial-Kranken. Wenn Sie persönlich einen Herzattack oder einen Schmerz haben, wenn Sie Leberkrankheit haben, weil die oralen Medikamente durchgeführt werden und die Leber metabolisiert werden, And the fourth thing is undiagnosed vaginal bleeding. Okay.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Because that's a sign, could be of endometrial cancer. So we need to know what that's about. That's it. Notice what's not on the list of contraindications. Hypertension, obesity, smoking. A lot of things that we use to not give women hormone therapy are not in the contraindications.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And I think that we can all agree that the FDA is amongst the most conservative organizations that will tell you if they knew for a fact that you couldn't do it if you had these other things. But we are denying hormones to women who have a family history of breast cancer. We are denying hormones to women who have hypertension, even though that hypertension may be treated. Oh, Migräne?
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Oh, du kannst es nicht haben. Es ist nicht da.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und ich werde dir sagen, warum. Und ich denke, ein paar davon ist das Extrapolieren von einigen der Kontraindikationen zu Kinderschutzpillen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
zu Hormontherapie. Du solltest nicht atmen und die Behandlungsmittel annehmen, richtig? Richtig. Aber erinnere dich, ich habe dir gesagt, das ist drei bis vier Mal die Anzahl. Nicht wahr für Hormontherapie.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Also sind wir, in Angelegenheit von Frauen, die nicht wirklich aus der Suche nach und der Angst sind, dann ist das, wo diese Art von Aufmerksamkeit mit Physikern kommt, weil Physikern nicht bieten, weil sie denken, dass die gleichen Kontraindikationen für MHT oder HRT are the same ones for birth control pills, and they are not.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
So there are all these women who are out there who are not being treated, and there's no real data to support that. So when you look at the four reasons why they can't... Oh, and the other thing, I forgot, there was one more, and that was about blood clots. You know, if you've had a blood clot in your legs or lungs.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
But even the breast cancer and the blood clot issue, we've come back and we've revisited that because that was all based on Oral-Estrogen nur. Und wir wissen jetzt, dass es andere Modes der Anwendung gibt, wie Transdermal-Estrogen, die man benutzen kann, die nicht den Blutverletzungsfaktoren so stark wie Oral-Estrogen beeinflussen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And you can also look at the issues with women who have had breast cancer and women who are breast cancer survivors who are years out from their diagnosis and are probably cured. Then that is a more nuanced conversation where women get to be involved in that conversation. It shouldn't ever be someone that tells you absolutely no, never.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
It's a matter of your quality of life, what your risk tolerance is and what your treatment goals are.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Wenn du eine afrikanische Frau bist, sind deine Symptome und dieser Zeitraum mehr als zehn Jahre länger als vier. Es ist charakterisiert von vielen Dingen, aber das eine, was es nicht charakterisiert ist, ist eine Verlängerung von Perioden. Und wir denken von Menopause als zu sagen, okay, das ist, wenn mein Perioden aufhört, richtig?
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
It's not. I have two sisters with breast cancer and that gives me not the slightest pause because the other part of that study that never really got out there was that even if you took the Women's Health Initiative at face value, whether it was a fast signifikanten Risiko, du weißt, erhöhter Risiko für Brustkanzer. Es gab keine Unterschiede, keine Unterschiede in der Mordrate.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Also, selbst von den Frauen, die Hormontherapie genommen haben, bist du nicht mehr möglich, davon zu sterben, ob du es genommen hast oder nicht. Aber hier ist die Partie, die nie die echte Depression hatte, die es sollten haben. Und das ist für die Frauen, die nur Estrogen genommen haben, in der Frauen-Health-Initiative.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
The women who took estrogen only in that study not only had a 23% decrease in the incidence of breast cancer, but they had a 40% decrease in the risk of dying if they took estrogen than if they did not, if they got breast cancer. Jetzt, das ist großartig. Es ist großartig. Es ist großartig. Also, du musst sagen, dass egal, was die Beziehung zu Estrogen und Brustkrankheit ist, es ist kompliziert.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Es ist nicht geschnitten und geschnitten. Und hier ist etwas, was ich denke, dass ich vorher gesagt habe und, du weißt, es ist einfach wieder aufgekommen. Und das ist die Beziehung von Alkohol und Brustkrankheit. Talk about that relationship. We make choices. Am I going to go have a glass of wine? Probably.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
But to know, to give you an idea of how small the risk is, the increased risk of you contracting breast cancer on HRT ist weniger, und das ist Estrogen und Progestin, nicht nur Estrogen, ist weniger als der Verlust des Risikos für Breastcancer, wenn man zwei Gläser Wein am Tag trinkt. Es ist weniger als der Risiko, dass man überwältigt wird.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Es ist weniger als der Risiko, dass man physisch inaktiv ist. Also, du kannst... Was ist da los? Du kannst das so machen, wie du willst. Also, du weißt, das ist, wie ich das rationalisiere. Ich nehme meine Hormontherapie. I will exercise. I will make sure I get enough sleep. I will try not to be overweight if I can help it. And then I'm going to have a glass of wine. Okay. So, you know.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
I love you. Come on, there's got to be some joy in the world.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
As long as you like. And let me say this, because there are some people that it really is, that it makes more sense to stay on. Because what we do know about osteoporosis and the prevention of osteoporosis for women who are on hormone therapy is,
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
If you stop your hormone therapy, and I will put myself in this category, that we used to think that, oh, okay, because of that, oh, breast cancer thing, you should probably only be on it in more than five or ten years and then come off of it. Not true. But what you lose by coming off hormone therapy is all that bone density that you preserved while you were on hormone therapy.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
If you stop your hormones when you're 60 or 65 years old, you will start to lose that bone again. And within five years, you will be right back to where you would have been, had you not taken it. So if one of the reasons that you are really taking hormone therapy is that you are concerned about your bone density and not fracturing your hip when you're 80, then you should continue it indefinitely.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Nun, bei Perimenopause, du kannst dein Perioden regelmäßig bekommen, es kann anders sein, es kann schwerer sein, es kann leichter sein, sie können näher zusammen, weiter entfernt sein. Das ist sozusagen das erste Signal, dass wirklich etwas passiert, dass es Veränderungen in der Irregularität gibt.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Nun, und wiederum, das ist Daten, die wir von der Women's Health Initiative erhalten haben. Und von den wenigen Patienten, und es waren nur etwa 10 Prozent oder so, die tatsächlich in der 50-54-Jährigen-Range in der Women's Health Initiative waren, und sie fanden, dass all diese schrecklichen Dinge, die wir gesagt haben, nicht an diese Frauen angehören.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und so haben wir gefunden, dass es für Frauen, wenn man Hormontherapie startet, vor 60 Jahren oder, nicht Anne, oder innerhalb von zehn Jahren natürlicher Menopause, dann sind all diese schlechten Dinge, die wir gesagt haben, nicht wahr, wenn es um Breastcancer geht. Und nicht nur das, sondern es gibt auch einen kardiafischen Vorteil, je früher du angefangen hast.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Ich denke also, dass es keinen Vorteil gibt, und das ist der Grund, warum ich Frauen immer sage, It's not like you're doing yourself a favor. You're like, oh, I'm just going to hold out for as long as possible. And then I'm going to take it because I only have five years to take it. No, you take hormones.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Actually, there's evidence that the earlier you start it, when you are experiencing symptoms, the better. And because there is no age limit on when you can stop. But, you know, you know, why suffer for two or three years and then like, you know, say. And then get started. Why?
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Let me say this. Yeah. Because, but I'll say one thing too, because this is where it requires a little bit of more conversation because the question comes up. Oh, I missed the window. I'm 62. Can I still take hormones? And again, I would say the answer to that is a qualified maybe. Because again, it depends on whether or not, again, what your treatment goals are.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
If you're 62 years old and you're still having hot flashes and not sleeping, then I would say, provided you don't have any of those other contraindications that we talked about, Why not? You know, make sure that you are healthy enough to do it. But, you know, again, just know, it gets back to like the leeches thing.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Some of the stuff we know and some of the stuff we just kind of think and made up or we've inferred.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und wenn du nicht verstehst, dass die Präsenz oder Absenz von Blut nicht eine definierende Fähigkeit von Perimenopause ist, dann denkst du, oh, es hat nichts mit Menopause zu tun. Aber alle diese Symptome, die wir darüber sprechen, die wir mit Menopause verbinden, können beginnen, during perimenopause.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And we were talking about the onslaught of the baby boomers.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Thank you. And you know what? And Tamsen, thank you for getting the word out and elevating this conversation. Otherwise, I'd still be sitting in my living room talking.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
To my best friend, who I couldn't convince to take hormones.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
You know, the one thing that I want women to understand is that you have more control über das, wie man alt ist und wie man gesund alt ist, als du denkst. Weil ich denke, dass so viele von uns diesen Raum erzeugen, dass entweder jemand uns kümmern wird oder irgendein Ergebnis ist etwas, das unerlässlich ist, weil, oh, ich habe eine Familiengeschichte von dem oder dem.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und ich bin hier, um zu sagen, nein, das ist nicht wahr. Und ich denke, je mehr du weißt, desto besser kannst du dir für dich selbst, für deine Familie, Und ich möchte, dass Frauen nicht für die nächste Phase ihrer Leben Angst haben. Ich werde, wir sind fast an meinem Geburtstag zusammen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Ich werde 66 Jahre alt sein. Ich liebe es. Und, weißt du, in ein paar Wochen. Und ich möchte, dass Frauen wissen, dass, was du gedacht hättest, was Menopause war, oder was du denkst, 65 oder 70, sieht aus wie, mein Gott, Gayle King war auf der Cover von Sports Illustrated, um Gottes willen. Ja. Wir sind hier, und Sie sind hier, positive Rolemodelle.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Also werden junge Frauen nicht in einer Position sein, in der sie denken, oh mein Gott, mein Leben ist vorbei. Nein, wir sind hier, um ihnen zu sagen, Ihr Leben beginnt gerade. All you have to do is stay healthy enough, so that you can take advantage of this great time in life.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And the reason why it's not helpful to get blood work during perimenopause is because your hormones during perimenopause are fluctuating. They may be too high one day, too low the next, and it is that sort of erratic hormone production that that really produces a lot of the symptoms that women have, particularly the brain fog, the irritability. Imagine, it's like having PMS every day.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Wie kann man nur so... Ausgeruht sein? Ganz einfach. Trainiere deinen Schlaf und werde auch du zum Morgenmenschen. Mit der Galaxy Watch 7 oder dem Galaxy Ring und der Samsung Health App.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
That is sort of what perimenopause is like. And for a woman to come in with all those symptoms, Any combination of the symptoms that we talked about, but you're still getting regular periods and you go see your doctor, you're like, what is wrong with me? And your doctor says, well, when was your last period?
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
If that's your first question and you say, two weeks ago, and they've immediately taken anything to do with menopause off the table, that is not correct. And I think that's where there has to be some adjustment with menopause. So they understand that perimenopause and menopause are different things and they occur at different times. And it's not a blood test. You don't need a sonogram.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
You don't need a soothsayer. You don't need anyone to tell you. You know who decides. So all those things are now available, it seems, out there in menopause world. You don't need to pee on a stick. You don't need to do any of that stuff to tell you if you're perimenopausal. Perimenopause is defined by menopause.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Wenn du es sagst, wenn du Symptome hast, und du bist zwischen 35 und 45 Jahre alt, das ist typisch, wenn Perimenopause beginnt, aber weil es keine blaue Linie gibt, die den Anfang signale, ist das, wo ich denke, die Verwirrung ist. Und ich denke, dass es auch dieses Missverständnis gibt, dass man Hormontherapie nicht anfangen kann, bis man ein ganzes Jahr ohne Zeitraum hat.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
You can start hormone therapy in menopause or, and I say or, we get back to you can use low-dose birth control pills. Because remember I told you? Birth Control Pills und Hormontherapie sind einfach nur zwei. Sie sind ähnlich, aber anders.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Weil manchmal braucht man eine Low-Dose Birth Control Pill, weil wenn man perimenopausal ist, wenn man 42 ist und Symptome hat, ist das eine, was man noch nicht hat, infertile. So unless you are actually actively trying for a baby and you need birth control, then a birth control pill will kill two birds with one stone. It will give you birth control, it will control symptoms.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
If your periods are too heavy or too long or too erratic, then a birth control pill may be more appropriate at that particular time, but as you progress through this transition, dann ja, wenn man näher zur Menopause kommt, dann manchmal, wenn man diese anderen Dinge nicht hat, dann ja, man kann die Menopausal-Hormontherapie nutzen. Kann man in der Perimenopause geboren werden? Die Antwort ist ja.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Ja. Ja. Und ich habe dir das gesagt, Tamsen. Ja. Deine wirklich. Nun, ich bin nicht in der Perimenopause geboren, aber ich bin das Produkt eines perimenopausalen... Frau, die wahrscheinlich dachte, dass sie durch Menopause ging, und hier bin ich. Und hier ist Sharon. Und hier bin ich. Und die Antwort ist, ja, du kannst verheiratet werden. Meine Mutter war fast 45, als ich geboren wurde.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Es gab viele Nuancen im Studium, die nicht wirklich erklärt wurden. Frauen waren wütend, verärgert. Es wurde auf jeden großen News-Outlet aufgenommen. Und wenn Sie diese schrecklichen Hormone genommen haben, werden Sie Breastcancer bekommen. Und Frauen verlassen die Hormontherapie.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Genau. Aber weißt du was? Du weißt, dass es bestimmte Dinge gibt, die du kennst, aber du wusst nicht, dass du sie kennst. Aber wenn ich dir sage, dass es in der Zwischenphase ist,
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
That is why, as we have made different lifestyle choices, you know, as women, and we're getting pregnant later and later, that's why there are more fertility challenges, because many of us, unbeknownst to us, have entered that perimenopausal phase, where your fertility is not gone, but it's not what it was when you were 25.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Sie definieren die Menopause als die Zeit, in der man seine letzte Menstruation hatte. Nun, wie weißt du das? Du weißt es nicht, bis du zurückblickst. Es wird nur bestätigt, wenn man ein Jahr verweist und noch keine Zeitung hatte.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Denn selbst wenn du perimenopausal bist, kannst du einen Zeitraum haben, nicht nur einen, denkst dir, oh, ich bin fast fertig, sechs Monate später, und dann hast du noch einen Zeitraum. Das ist nicht ungewöhnlich. Aber du kannst offiziell sagen, ich bin fertig, wenn ich zwölf Monate weg bin. Aber das hat nichts damit zu tun, wie man Therapien verwendet und wann Therapie initiiert wird.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Du initiierst, wenn du symptomatisch bist und wenn du entscheidest, okay, das ist genug. Ich muss für meine Symptome behandelt werden.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Du nicht. Und weißt du was? Ich sage immer, dass Menopause unnötig ist, Schmerzen nicht. Ich denke, dass das etwas ist, was wir als Frauen tun. Wir akzeptieren eine gewisse Basislage von Schmerzen, die nur mit der Frauenheit verbunden ist. Ob wir über Krämpfe oder Kindesgeburt oder Begegnung sprechen oder PMS oder Depression. Das ist das, was wir denken, mit der Frauheit zusammenkommt.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und ich bin hier, um zu sagen, nein, das muss es nicht sein. Also das eine Wort, das ich Frauen mit Tamsin verlassen möchte, ist das folgende. Du musst nicht leiden. Aber auf die gleiche Art und Weise möchte ich nicht, dass du denkst, oh, hier, nimm diese Pille und es wird alles gut sein. Es gibt viel Arbeit, die man an der Vorderseite machen muss.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Und ich habe keine Ahnung, ob du über Menopause sprichst oder ob du über Krebsprävention sprichst oder ob du über die Verringerung des Risikos für kardiovaskuläre Krankheiten sprichst. Healthy lifestyle matters. So yes, this is a both and, not an either or. So do the things that you need to do on the front end.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
And when you've done all those things and you are still suffering, do not feel as if you have failed. You have not. You are going through an experience that all of us, if we live long enough, will. And 80% of us will have some degree of symptoms that may need to be addressed. Whatever those are. Whatever those are.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Well, you know, some of the things, particularly the brain fog, that tends to get better. You're not just on the inevitable slide to dementia from brain fog. Which is so important to say. It is not. Because it feels like that. It feels very confusing. And that's a very scary feeling for a lot of women. But that sort of hormonal tumult...
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
die während der Perimenopause stattfindet, wirklich Schmerzen auf deinem Gehirn verursacht. Und unser Freund Dr. Lisa Mosconi hat uns wirklich Bilder gezeigt, was es mit deinem Gehirn tut, wie es nicht nur die Struktur beeinflusst, sondern auch die Metabolismus in deinem Gehirn verändert. Und dann, ab und zu, Monate, Jahre später, ändert sich dein Gehirn.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Also, egal ob du Hormone nimmst oder nicht, der Gehirnschmerz wird immer besser. Und dann musst du nur mit normaler Erwärmung umgehen. Das Ding. Das haben wir leider noch nicht gefunden, eine Lösung dafür. Aber der Gehirnschmerz wird besser, die Hotflashes werden am Ende besser. Es gibt bestimmte Dinge, die nicht werden. Osteoporose wird weitergehen.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Die Symptome des genitalen Urinärsyndroms, das wird schlimmer. Das ist schmerzhafte Sex, die Frequenz der Urinierung, fremde Urinärinfektionen, Schmerzen. Das wird mit der Zeit schlechter.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Das ist wirklich etwas, was man darauf achten muss, weil es nicht nur die Qualität der Leben ist. Es gibt das. Aber ob du Sex fünfmal pro Woche hast oder niemals. Das genitale Urinärsyndrom des Menopausen beeinflusst dich immer noch. Denn das eine, was wir nicht wirklich darüber nachdenken und nicht genug darüber sprechen, ist der Effekt von Urinärinfektionen in den Älteren.
The Tamsen Show
Hormone Therapy for Menopause: What Every Woman Should Know
Wenn du in eine nursinghafte Bevölkerung gehst, sind die meisten von ihnen Frauen. Und von diesen Frauen ist eine der freundlichsten Gründe für Krankenhäuser Urinärinfektionen. Und wir wissen, was passiert. Urinär-Trakt-Infektionen können zu Sepsis führen. Die Veränderung des mentalen Status in den Älteren. Also es ist nicht nur ein, oh, schön zu haben.