A Mother’s Day Guide to Women’s Health at Every Stage

Two little voices kick off a Mother’s Day special, and that warm family moment quickly opens into bigger questions about women’s health that too often get ignored until they’re urgent. Speaking of Women's Health Podcast host Holly Thacker, MD shares what every woman should understand earlier: fertility has a biological clock that doesn’t match how healthy you can feel in your 30s and 40s, and ovarian aging is a major driver of infertility. She talks about when to seek an infertility evaluation, why conditions like endometriosis and celiac disease can be behind unexplained infertility, and how the real-world costs of IVF shape people’s choices. She also shares a hopeful story about stress reduction and acupuncture as a supportive option for some patients who are experiencing fertility issues. 

Next, she gets practical about varicose veins and spider veins, especially during pregnancy and with weight changes. 

Because May is Osteoporosis Awareness Month, she ends with a focus on bone health, menopause, and prevention. Bone loss can speed up dramatically in the early years after menopause, and osteoporosis can stay silent until a fracture.  She also touches on under-recognized factors like celiac disease, persistent nutrient deficiencies, and why biotin supplements can disrupt thyroid, cardiac, and hormone lab tests. 

Transcript

Mother’s Day Welcome And Guests

Dr. \ 0:10

Welcome to the Speaking of Women's Health podcast. I'm your host, Dr. Holly Thacker, the Executive Director of Speaking of Women's Health. I'm also known as Mimi. And on today's special Mother's Day podcast, I have a couple of special guests. My oldest granddaughter, Artemis, and my next oldest granddaughter, Beatrice. And whose birthday is it in May? My birthday. How old are you? Going to be three. Three. And how old are you, Artemis? Five. And do you know that your dad, Dr. Schnetz and Thacker, has been on this podcast? Yeah. Yeah. And uh we just got uh done with the Derby party, the Kentucky Derby party, and you guys are wearing your fascinator hats, right? So, do you want to say anything for Mother's Day to your mommy? Do you want to say anything to your mom? Happy Mother's Day. Happy Mother's Day. Yeah, it's a very special day. And do you think you're Happy Mother's Day? Are you girls gonna be moms someday? Yes. And how many babies do you think you're gonna have? Four. Sounds good. Well, on today's podcast, we are going to talk about a lot of things related to women. We're going to talk about infertility, which is a big problem. We actually have some of the lowest birth rates that we've had in the United States in decades. Uh, we have a great infertility treatment guidebook. I want to touch on varicose veins because uh that's something that women get more than men. Uh and pregnancy and weight gain, and certainly genetics and female hormones can all play a role. And then we'll end uh talking about osteoporosis because May is osteoporosis awareness month. Yes. May is also nurse appreciation month, and uh we have a lot of information on osteoporosis. Well, my little helpers are now off playing with their sir, and we're gonna get back to the topics uh that are important to women. Right before Artemis left, she said, Mimi, be sure and tell them to eat their vegetables. And certainly healthy eating and exercise go a long

Infertility And Ovarian Aging

Dr. \ 2:50

way. In terms of infertility, which is the first topic that I really wanted to touch on, a lot of it has to do, not necessarily with not having a healthy enough lifestyle, it has to do with ovarian aging. And that's one thing I don't think that's emphasized enough to women. Um, you may look great and feel great in your 30s and 40s and beyond, but the eggs age and peak fertility for females is around age 24. And if you have premature menopause or early menopause in the family, uh peak fertility might even be a little bit earlier. And I think that we see uh these prominent people in the news and movie stars and um people that are on social media having children at older ages. And a lot of times that's because of egg donation. So uh even though a lot of our listeners may not be in the uh age of childbearing, certainly you know women who are, and we just see a lot of pain and heartbreak. We've had a lot of advances in infertility. We have a great infertility-free treatment book uh on speaking of women's health.com. Uh, endometriosis is a cause of infertility, and we did a podcast on endometriosis and treatment of endometriosis, celiac disease, uh uh, autoimmune conditions, undiagnosed medical conditions, anything that stresses the body can reduce fertility. I had a uh friend talk to me about his son's wife's infertility, and they basically had spended all the money that they had available to pay for IVF, because of course that's a relatively expensive treatment. Now, certainly some of the medications that are used have somewhat come down in price. And on my recent podcast on how to reduce the cost of medicines, I talked about the government website, trumbrx.com, that links up to medications and certainly some of the infertility medications, which are so expensive, uh, have some reduced price. But most people, of course, would prefer not to have to undergo that. And so uh to this family who said, look, we don't have any more money to undergo IVF and we really want to have our uh our family, I suggested reducing the stress level and going for acupuncture. And sure enough, they did that, and they had a healthy baby. And we're so happy about that. And uh acupuncture is a very interesting uh treatment, and we uh did a podcast with an acupuncturist on all the different indications for that. And so certainly people who don't want to undergo medication intervention, uh, that might be something to look into. We usually say that you need to seek a medical obstetrical women's health evaluation for infertility if you're under age 30 and you have tried to become pregnant with unprotected uh intercourse for 12 months. But if you're over 30, because again, after age 30, 35, there's just such a big drop-off. We say six months of trying. And as much as you can do to reduce the stress in your life, improve your nutrition and fitness, the better.

Varicose Veins Versus Spider Veins

Dr. \ 6:42

Now I'd like to move on to uh another topic: varicose veins. Uh, because they are certainly a vexing problem during my um pregnancy with the girl's father, uh, Stetson. He was actually initially a twin. Uh, and it was after having a pregnancy loss, so I had kind of had back-to-back pregnancies. And that's the first time that I personally experienced any varicose veins. They're common in women. Um, there's a genetic predisposition. Certainly, pregnancy and weight gain can make it worse. Women will also often ask me what's the difference between varicose veins and spider veins. Um, varicose veins are larger and they're treated with support hose, compression, exercise, or even surgery or even laser ablation. They're usually large blood vessels, uh, and they're most commonly in the legs, but they can be uh in the pelvic area, in the vulvar area, whereas spider veins are much, much smaller, and they're tiny, tiny dilated vessels that might be reddish or purplish or blue in hue. And they're just underneath the skin. Um, they're commonly on the legs and thighs, kind of like a roadmap, the kind of roadmap you really don't want. So, what causes varicose veins and spider veins? Well, there's a number of factors that predispose a person to varicose veins and spider veins. Heredity. So if it runs in your family history, certainly occupations that involve lots of standing, like nursing, hairstyling, teaching, working in a factory, weight gain. Ah, weight gain. That's women's biggest, biggest concern. And we've got about a dozen podcasts on what you can do about weight gain and how to treat obesity. The hormonal influences during pregnancy also increase varicose veins. And certain hormonal contraceptives, high estrogen uh doses may having a history of blood clots or uh conditions that uh increase blood clots. Anything that would increase intra-abdominal pressure, like pregnancy, a tumor, constipation, externally worn garments like girdles, and other reported causes are topical steroids, trauma to the skin, previous vein surgery, and exposure to ultraviolet light. So who is affected by varicose veins and spider veins? Well, they develop a lot more often in women than men, as I said, in part because of hormonal issues. And they do increase with frequency with age. So 30 to 60 percent of adults have varicose veins and or spider veins. And the symptoms that people complain about can be pain, aching, cramping in the legs. Other symptoms might include tiredness, restlessness, even a burning or throbbing sensation, tingling, heaviness in the legs, and pain caused from varicose veins is usually relieved by elevating the legs and wearing support hose. I wish I would have known about pregnancy Sigvaris support hose. And I'm sure there's other brands. Jop's is a brand. Um, you could order them online. They have medical grade compression, they can be kind of difficult to put on. Um, and the pregnancy ones, of course, have lots of extra space for the expanding belly, but that's a lot of support. And of course, in non-pregnant people, women, um, there are uh compression stockings that can be worn. There's compression, compression socks uh for men that go all the way up to the knee, because of course men uh can have varicose veins as well. Some women notice that the symptoms are worse during their menstrual cycle. Um swelling. If swelling persists and is not treated, there can be ulcer formation. Uh, also, there can be an increased pigmentation or color of the skin, especially in the ankle region, because of this pooling blood. Occasionally, varicose veins may develop what we call superficial phlebitis or inflammation of the vein, which can cause pain and redness along the vein.

Compression And Procedure Options

Dr. \ 12:08

So you might ask, what are some of the treatment options for varicose and spider veins? Uh, the first and most important and conservative approach is to wear properly fitting medical-grade support hose, particularly when the veins are causing painful or uncomfortable symptoms. And you can get them at any surgical supply store, at some pharmacies, also online, uh, depending on your insurance. Your insurance may or may not cover the cost of the stockings. And they come in different compression uh strengths, varying from 15 to 20, all the way up to 40 to 50. The 40 to 50 ones are really hard to put on. Weight loss, if needed, along with exercise, keeping the muscles strong, can help improve varicose veins. Now, sclerotherapy, that's been available since the 1930s. It's another treatment option. And it uses a highly concentrated salt water solution or a specially made detergent that's injected directly into the vein, causing the vein to disappear gradually over three to six weeks. It's pretty simple, relatively inexpensive, and can be performed in the outpatient setting. I've certainly had it done on my legs because I looked at my aunts, who are all uh strong, healthy, beautiful, uh wonderful women in their uh 80s now. And a few of them had significant spider veins, and they would joke that it was like a roadmap on their legs. So I thought, ah, I just get a little bit ahead of it. And um, I can say it it stings, it's not the most comfortable, but it's not that big a deal. But you really have to follow the instructions and not take any aspirin or non-steroidals or anti-inflammatory agents a couple weeks beforehand. And you must wear your compression stockings afterwards. Now, complications are minimal, but can include pigment staining, blisters, or rarely the formation of a skin ulcer. Patients are encouraged to be physically active after the injections, uh, and they can drive themselves home after the procedure because no sedation is needed for this relatively painless procedure. Now, lasers, and we've had a podcast on laser therapy with Dr. Taryn uh Murray, uh, who is a dermatologist and has special expertise with lasers. And this device uses heat energy from laser light to selectively damage or destroy abnormal veins. And the advantage of this method is that no needles or sclerosing solution is needed, and there might be some minor discomfort. And side effects can occur, including discoloration, staining, or blister formation. Now, I tried the laser as well, and I just didn't think that it worked as well for me personally. Whereas other patients uh prefer the laser to the sclerotherapy. Not all people need treatment for varicose veins or spider veins. Uh, some people have no pain or any symptoms. And for these individuals, no um treatments necessarily needed, particularly if it's just cosmetic and doesn't bother the person. And I have told many a patient who just don't like spider veins, but don't want any interventions done and don't want to pay out of pocket to just get some leg makeup, you know, or self-tanning bronze bronzer uh to cover them up. That can certainly be done. Now, there are special laser ablations and medical ablations uh for symptomatic varicose veins that is medically necessary and it's not cosmetic. Now, people who should not get sclerotherapy are pregnant women, uh, as well as people who are not able to walk or move around very well. A very common question is will my insurance cover the cost of support hose, sclerotherapy, or surgery? And really depends on your insurance company. And generally speaking, symptomatic varicose veins are covered. Um, and I've had to have treatment for a symptomatic vein that was covered, but for the superficial cosmetic spider veins, no, that was self-pay. So check with your insurance company before considering treatment options. In general, most laser uh treatments, if they're cosmetic or not covered, although we did learn uh from Dr. Murray that some insurances will cover laser for hairsuitism from medical conditions where there's excess hair growth. Now, on our speaking of women's health.com site, we have a bunch of free treatment guidebooks, and we do have one specifically on sclerotherapy.

May Awareness And Bone Health

Dr. \ 17:39

You have been listening to the Speaking of Women's Health podcast, and I am your host, Dr. Holly Thacker, in the Sunflower House for the month of May. Uh, at the beginning, you saw two of my three granddaughters. I'm expecting my fourth one in the fall. We just uh got back from the Kentucky Derby party. They had their fascinator hats on, and we were talking about how May is Mother's Day month. So happy Mother's Day to all of you mothers uh and all of you women who um are supportive to your families and your communities. You're greatly appreciated. It's also Nurse Appreciation Month, and we have some of the most fabulous nurses in the Center for Specialized Women's Health. Many of them have been guests on our podcast. Um May is also osteoporosis awareness month. And every May that we have been doing this uh podcast, and we are in season four. Uh, we've had several podcasts on bone health. In fact, we have uh won some awards uh for our podcast on bone health. Back in March, we had osteoporoporosis expert, Dr. Christy Tuff DeSapri of Bone and Body Health. She is in Chicago. She is fellowship trained, went through my specialized women's health fellowship over a decade ago, and uh is in private practice and is an osteoporosis expert. So if you missed that one back in March of 2026, that's a good one to go back to. In fact, we have several great podcasts. Um in October of 2025, uh, we had information about boosting your bone health and how your bones can be silently changing beneath the surface. And when you enter menopause, that change could accelerate at an alarming rate. You could lose up to 30% of your bone mass in just the first five years of menopause. And I've even seen some bone loss start right around perimenopause when the hormone levels are fluctuating and going down. It's a silent thief and it works without symptoms until you break a bone. And once you break a bone and have clinical osteoporosis, well, the cat's out of the bag, you've got osteoporosis. I have also podcasted my one of my books, The Clipid Clinic Guide to Menopause, and chapter 12 of my book offers a lot of insights and tips. And it's not just about preventing fracture, we want women to maintain independence and quality of life, and we want to expand the health span. Breaking a hip after age 65 carries a 40% mortality rate in the first year. And this risk is preventable with proper screening and treatment. So whether you're approaching menopause or you're recently diagnosed with bone loss, or you're simply planning to keep your skeleton healthy and you want your teeth and gums to be um in good shape, your bone health is very, very important. In May of 2024, I answered people's most frequently asked questions about osteoporosis and osteoporosis treatment.

Celiac Vitamin D Hair And Biotin

Dr. \ 21:31

In May of last year, we did a podcast on celiac disease. And celiac disease can be a hidden culprit behind many health issues, not just gut issues and skin rashes. I've seen women whose only manifestation of celiac has been infertility, which we talked about, uh, is it is a heartbreaking issue for many, many couples. And it's kind of terrifying to look at birth rates in America. I mean, they're so low. We're not at replacement rates. And there's a lot of things that probably certainly weigh into that. That's also seen in other Western countries. But having a family and having grandchildren, you got to see a couple of mine here live, uh, is really the greatest joy in life. And I think uh to gently remind some of the young women around you that um it's there's never a good time to have a baby. Uh, we all would like more time, more money, more resources. Uh, but you can certainly uh make it work. And um it's certainly helpful if you have uh supportive community and family. Uh, but I think very few people are ever unhappy that they decided to have a family. So celiac disease, also, besides infertility, can affect bone health. And I've seen women who were orked up for secondary causes of osteoporosis in my practice, and all we found was celiac, took the gluten out of their diet, and their bone density dramatically improved. So that's worth thinking about. Also, if you've been persistently low in vitamin D and iron, one of my first podcasts back in 2023 was all about iron. I've also done a podcast early on in 2023 about vitamin D. I should do an updated one because there's so many benefits of this posterol vitamin, uh, which is actually a prosterile hormone. It's not a vitamin, actually. And usually not a day goes by that one of my patients who was really low in vitamin D for a long time, who finally got normal, got a high normal level, who then said, Well, you know, my doctor told me to stop my vitamin D because my level was too high. And it was like 83. And so lab ranges are just that. They're based on a range and a population. It doesn't necessarily mean it's optimal. And since vitamin D is not a true vitamin and it's um pretty hard to get toxic on, and lifeguards in the summer have levels of up to 150. Uh, you need a level of 75 for hair growth. And after weight, hair is probably, I think, uh, one of the most common concerns that I hear from women. A lot of times the scalp ages faster even than the skin with menopause. And so nutritional aspects, hormonal aspects, uh, and the health and integrity of your scalp really weigh in on whether your hair follicles are going to grow. Um, and we have about five or six podcasts on hair. Uh, and so that's a good one to go back to listen to if you're interested in that. We, you know, we're talking now about Mother's Day and bone health, and usually in June, which is Father's Day, you know, uh, one of my columns was hair thinning and hair losses, not just for dear old dad. Uh, it is a problem too uh uh for women. That being said, biotin, which is in a lot of expensive hair and nail uh supplements and frequently used by a lot of women at a pretty decent expense, when probably only one in 10,000 causes of hair thinning is due to true biotin deficiency. Uh, and there's lots of foods that you can get biotin in, we list them on the website. Biotin really interferes with lots of blood tests, hormone blood test, uh cardiac blood test, thyroid blood test. And even though we put that warning out to new patients coming in, you know, to stop their biotin if they're on it three days in advance. We've got a big sticker on uh the blue folders we give our patients to put their uh prescriptions or medical information in. And, you know, we put that warning. It amazes me that so many people still don't know that. And these biotin hair vitamins are really targeted to women. And um, even the FDA several years ago came out with a warning about biotin and how it affects blood work. So um going back to celiac disease, we talk about how it's diagnosed and how your you may need to think about this as a condition if you have unexplained infertility, osteoporosis, or persistent nutrient deficiencies. Um, the one thing that I would say about nutrient deficiencies is the more I'm testing women, not just for vitamin D and iron, but zinc and B12 and omega-3 to six ratios, trace minerals like selenium and women with thyroid problems or chromium and those with sugar problems. I'm really shocked to see how many women are deficient, even when they tell me what their diet is, and it sounds like they are trying to get whole foods and eat healthy. So if you've got unexplained symptoms, it might be worthwhile to get a panel that includes uh some of these assessments. And for a lot of these nutrients, if you want to know which foods are rich in zinc, which foods are rich in omega-3, which foods have biotin, how can you naturally increase your creatine through food as opposed to supplement? We've got that covered on speakingwoman's health.com. So if you don't have that bookmarked on your phone or computer, it's it's a good thing to bookmark. Going back to um some of our bone density podcasts since it's osteoporosis month in May of 2024. I also interviewed Dr. DeSapri on tips on preventing it, osteoporosis, and what screenings that you might need.

Osteoporosis Treatments And Nursing Care

Dr. \ 28:32

In February of 2024, our executive producer mom of three, Lee Clecker, interviewed uh one of our former women's health nurses, Rachel Ostermiller, about uh the questions that patients um frequently have when they come in and what they can expect uh when they come in to get osteoporosis therapies that are administered by our excellent nurses. We do bone infusions and um shots of bone-building agents and um antiresorptive agents like denosimab. In fact, now we have biosimilars for ProLEA, which was the brand name of Dinozimab, uh, Jubanti, and a lot of the Medicare and insurance carriers are recommending that we uh they actually they're only covering these other alternatives, which are essentially the same. Umab, which is very effective at reducing bone loss and reducing all types of fractures. And we do have a free treatment guidebook on osteoporosis. Back in May of 2023, I also interviewed um Dr. Christy Tufdesapri of bonebodywh.com. And uh she's got an active Instagram site and is always posting about bone health. Uh, I did a uh podcast in May of 2023 talking about calcium, uh some of the healthiest cheeses to eat, and vitamin D. So midlife is kind of a critical time to deal with and try to prevent chronic diseases. And estrogen is very important in this foundation, also for bone health, and so is nutrition and lifestyle. And thankfully, women have both hormonal and non-hormonal options to uh keep their body systems, including the musculoskeletal system, in good shape. So on this uh Mother's Day special, we thank you for joining us.

Subscribe And Final Takeaway

Dr. \ 31:10

Uh, if you don't already subscribe to our podcast, it's free. We're on Apple Podcasts, Spotify, Podbean, Amazon Music. Um, you can also listen on our website, but an app tracks where you started and stopped. Remember, be strong, be healthy, and be in charge.