9. Perimenopause and Menopause: Signs, Symptoms, Tests and what you can do about it.

Are you navigating the waves of menopause or perimenopause and struggling to decipher the changes within your body?

Let's emerge from the fog together as we journey into the heart of weight loss and belly fat reduction during these transformative times.

This episode will leave you equipped with a fresh understanding of the challenges and opportunities that menopause presents, going beyond the symptoms to uncover the true essence of this life stage.

Let's chart a course through the sea of hormone testing and blood work interpretation, while we define the tools that we can use to recognize and embrace the changes in our bodies. From tracking menstrual cycles to understanding the pivotal roles of FSH, estradiol, and TSH, you'll gain invaluable insights into managing menopause with a blend of science and compassion. Discover the potential of hormone replacement therapy and how it might address sexual dysfunction as we consider the delicate balance of hormones within the female body.

Concluding our voyage, we anchor in the harbor of holistic health, emphasizing the importance of not attributing every new symptom to menopause alone. You'll learn how to document your symptoms meticulously, identify key health indicators, and make nutrition and lifestyle changes that cater to your well-being. This episode is not just about enduring menopause but flourishing through it, with a community of support and a treasury of actionable advice. By the end, you'll see menopause not as a storm to weather but as a chance for rejuvenation and empowerment.

Join us, and let's turn this chapter into a celebration of health and self-discovery.

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Transcript

Speaker 1: 0:00

Hello my friends, happy holidays and welcome to my podcast. This podcast is actually a live Instagram replay on the topic, so listen in.

Speaker 2: 0:13

Welcome to the Thriving Through Menopause podcast. Dr Inaka Yembe, your host, is dedicated to helping you navigate the transformative journey of menopause and perimenopause, particularly focused on achieving menopausal weight loss and reducing belly fat. As a post-menopausal physician herself who has helped thousands of women experiencing the significant life stage, she understands the unique challenges you face. Listen in as we explore a wide range of topics aimed at supporting you in your health and wellness journey. Hopefully, the practical tips and strategies offered potentially help you adopt an empowering approach towards menopausal weight loss and belly fat reduction. And now here's your host, Dr Inaka Yembe.

Speaker 1: 0:59

Hello my friends, happy holidays and welcome welcome to my channel. Happy holidays everyone. I have my show notes here because I will be going over a very important topic today. I have received so many questions about blood tests and how do I know if I'm in menopause or perimenopause, or I'm having several different symptoms, and what can I do about these symptoms? So tell me where you're watching from and share this video with your friends and anyone who you think can benefit. So now, today, I will speak generally. Every female's condition is different from another, so everybody's blood work is going to be different. Everybody's signs and symptoms will be different as well. The purpose of today's video is to educate you, so this is not really medical advice pertaining to you specifically, but it's just general information that can help you know what's what, because, if you're like me, when I was growing up, nobody told me what to expect when.

Speaker 1: 2:10

I hit menopause. Okay, so I hit menopause and I was in a dilemma. I'm almost 56 now, so menopause is full blown. In addition to that, I am a medical care provider, so our medical education is not really geared as to don't really teach doctors on what to do when menopausal females sit down in front of you and they ask you specific questions. For example, why is this belly fat here and what can I do about it? So if you've been to your doctor, you've had some blood work done and you don't know what's happening and you're not really getting any straight answers, I want you to listen very carefully. Again, these views are general discussion and not specifically clinical advice for you.

Speaker 1: 2:56

Alright, so first things, first definitions. What is menopause? Menopause is a retrospective diagnosis and what it simply means is that I have not had any menstrual cycles for 12 months Very important for you to know that. So it's a clinical diagnosis. However, if you have surgery, obviously, and your ovaries both of them were removed, then you go through a surgical menopause. Or if you had some medicines like chemotherapy, that can put you into menopause as well. So again, remember menopause, you must have a clinical history to go with your blood test.

Speaker 2: 3:37

So let's talk about symptoms.

Speaker 1: 3:39

First, when I did my research, I found about 100 signs and symptoms of menopause and perimenopause. They're almost similar, so I can be experiencing different things in perimenopause and that really continues for the next 15-20 years. So it could be long or short, but there's so many symptoms. I'm going to touch on some of the common ones and some that are not so common. All right, we have changing periods when you get into perimenopause. Periods could be longer, shorter, heavier, lighter. They just change.

Speaker 1: 4:13

You can get anxious mood swings that's a big one. That comes in the clinic. Mood swings, poor sleep, hot flashes, hair loss doesn't pertain to me, my own hair, anyway. Low self-esteem that's a big one. We start to get some mental problems there, things like brain fog, depression, anxiety. Some women actually get palpitations, memory loss. Some women start to have urinary problems, not only vaginal dryness, but some women actually have frequent urination and frequent urinary tract infections. Some people have decreased libido, joint pain, breast pain, changes in your skin dry skin, itchy skin, dry mouth. Now belly fat that's really common. I have lost over 150 pounds in about the past 15 years, but I still struggle with the belly fat. Sometimes my belly is here, sometimes it's not, it's just a temperamental thing and towards the end of this video, stay with me because I'll tell you what you can do, specifically when it comes to belly fat. Weight gain is very common in perimenopause and menopause.

Speaker 1: 5:26

Increased numbers, clinical numbers like cholesterol, blood sugar, blood pressure that also can happen during menopause and terimenopause. Some women have headaches for no reason. So if you have new onset headaches, all these symptoms, the very first thing that you want to do is get a medical checkup. Don't second guess, don't try to diagnose yourself. See your doctor so they can put your clinical history together and maybe do some blood tests if you are actually in menopause. So let's start with perimenopause. Peremenopause is a natural process that a female goes through before she gets into menopause proper. Now in the United States and generally in the world per se, the age where a woman gets into menopause ranges between 47 and 52, but on average it's really around 51 and 52. The time before that is called perimenopause. For some women it is the two years before that, but it can be up to 10 years prior, and this is why I say in my program if you are 35 and above, you most likely could be in perimenopause. What really are the characteristics of menopause?

Speaker 1: 6:43

Number one your body starts going through some changes. You begin to produce less estrogen and I tell you, when that estrogen level starts to decline, it declines slowly. Then you start getting their symptoms. So you could have cycles, menstrual cycles, and still have a lower estrogen level, which puts you at risk of developing belly fat and other major medical problems. So just because you're having menstrual cycles, it doesn't mean that you may not be in perimenopause. You also produce fewer eggs. That's why your cycles are also irregular. You become less fertile and, of course, you have irregular menoses. But remember, perimenopause is a natural process. The hormonal changes vary from one woman to the next and even in the same female, they vary from day to day to day, and this is why I'm going to tell you there is no specific one test that you can run that will tell you yes, you are in perimenopause. There's none. There's none. Please don't waste your money Now.

Speaker 1: 7:55

This is just my own personal opinion here my personal opinion please Do not waste your money doing saliva tests, blood tests and different things to diagnose perimenopause because the result, whatever result you get, is not going to help you in your management or in your treatment or in taking care of yourself. Some of the symptoms that you have, yes, they can be controlled by your lifestyle. They can be controlled, some of them, with hormones, even when you are in perimenopause.

Speaker 1: 8:30

Now, if you went, into the doctor and you had your blood run today your estrogen level or your FSH level we'll talk about that here shortly. Those could be one number. You go back tomorrow. That could be another number. So now, what do you do? You've had two blood tests. Don't know which way to go. So perimenopause is a clinical diagnosis. That said, you could be experiencing some concerning symptoms in addition to what I've told you. Again, there are 100 of them. So if somebody comes to me in clinic and she's having palpitations, that makes me worried, together with her history, that she may have a cardiac problem, yes, I will be doing some tests to rule out major medical complications, not to diagnose perimenopause per se.

Speaker 1: 9:17

So again, if you're having experience in these symptoms, please seek the advice of your medical provider. And yes, some tests could be done to rule out major medical complications, but not to diagnose perimenopause. So here's the biggest thing to remember during perimenopause Number one get checked.

Speaker 1: 9:39

Number two you can take control of how your body changes with changing hormonal levels, because when you get into perimenopause, the very first thing like I talked about that happens is estrogen levels start to decline. When the estrogen declines, it causes so many problems. Estrogen is the parahormone, is the metabolic hormone. It's the one that determines how your body fat is stored.

Speaker 1: 10:06

It's the one that determines whether or not your insulin is sensitive or resistant. So when you start having these symptoms and hormones are fluctuating yes, you went to your doctor, they're doing some tests. There are some things that you can do. Big one, big one, is nutrition. Nutrition is so big. Imagine.

Speaker 1: 10:25

Estrogen causes you to become more insulin resistant. So even if you didn't change anything and you're eating just about the same like you did for the past 20 years, guess what you notice is that you start gaining weight. Why is that? Declining estrogen levels. So once you get older, 35 and above, the first thing that you want to do is portion control. Start eating a little bit less. Eat two slices of bread every single morning, like you did. You want to back it up and eat just one slice. Next thing that you want to do, even if you do nothing else, is to clean out the diet. Why is that? Estrogen? Once the start declining, once you start having the fluctuations, it's going to make you more insulin resistant. When you are insulin resistant, that hormone insulin levels will be higher. So, by default, whatever you do, you will be storing fat easier. This is why the struggle is real. My sisters, the struggle is so real.

Speaker 1: 11:32

Do one thing for yourself. Clean out the diet. Stop drinking all the sodas. You can drink maybe one soda a week, maybe not 10. I say so because I'm just being realistic. I used to be over 300 pounds. I cannot honestly sit here and tell you cut out this for 100% or 100% of that it doesn't exist. We just need to back things up so that our bodies can thrive. So cut back on the sodas.

Speaker 1: 11:59

If you're somebody who drinks sodas every single day regular sodas then you want to maybe switch first to a diet soda, less sugar and eventually cut back on the amount. Cut back on processed foods. What are processed foods? The manufacturer takes out all the good stuff and they add things to the food that make it more tasty for us, but it causes so much damage to our bodies. They add sugar, salt and oils. We're back to the same thing. Remember, you cannot control your estrogen, maybe, but what you can do is control the fact that you're consuming this much sugar. So even though you're more insulin resistant, your body may not be storing fat as much. I hope that makes sense.

Speaker 1: 12:45

I will talk about some more lifestyle changes when I talk about menopause, because it's really about the same things that you want to do for menopause and perimenopause. Alright, moving on to menopause, menopause is also a retrospective clinical diagnosis. This is a big one. It just means to say that. How do I know you're in menopause when you come to me and you tell me you have not had any menstrual cycles for 12 months? So let's say your last menstrual cycle was six months ago and you're having hot flashes, you're having night sweats, all these mood swings, the belly fat is coming in, but your last cycle was six months ago. Oh no, ma'am, you're not in menopause yet. I can't tell you that. I'm going to say go home. What do you do when you go home? Please pick up the journal and journal things your cycles, what are they doing, what are your cycles doing? It's good for you to journal it so you don't miss that last cycle, because sometimes we may forget. I ask you when was the last cycle?

Speaker 2: 13:49

and you're thinking hmm, hmm.

Speaker 1: 13:51

Well, maybe it was seven, eight, nine, ten, I'm not sure. Well, if you're not sure, I'm not sure either. So I want you to make if your cycles start changing and we are at the age of 35, 40, 45, just pick up your notebook or put it in your phone notes. Just document what are your cycles doing? Is it every month, Is it twice a month? What is it doing? Just journal that. That's going to really help with your diagnosis of menopause. Menopause is actually easier to diagnose by lab work because at that point modern nature says always you are in retirement. Goodbye, bye, bye. 12 months have passed, no cycles. So the blood tests that you get, they are a little bit more, definitely more accurate in diagnosing menopause and not perimenopause. So again, your clinical symptoms, the hot flashes, night sweats and all these things put together with your blood work, can diagnose menopause. And without any blood work, just the fact that you have not had any cycles for 12 months, that diagnosis you with menopause.

Speaker 1: 15:02

But anyway, just a few labs are important. I see so many labs done Again my friends who are natural parts. I'm going to get some bad, bad feedback with this one. Some people do survivor tests. Don't do it. Don't do the survivor test. It's costly, it's not going to give you too much information. They're just really very few tests that are pertinent for you who is in menopause now?

Speaker 1: 15:30

Number one FSH follicles stimulating hormone. That's a hormone that's produced by the brain. It talks to the ovaries and says you need to ovulate. You need to ovulate. So guess what happens? Modern nature puts the ovaries in retirement. Your brain goes into overdrive. It produces more follicles stimulating hormone. It's trying to talk to the ovaries. Ovaries are asleep, so by default that hormone gets higher and higher in Efforts to stimulate the ovaries and that's not happening.

Speaker 1: 16:01

So when you're in menopause you're going to have a high FSH level. That's a good diagnosis. You get blood test is higher than 3535 Together, with no cycles for 12 months, then you are in menopause. This is really important for some of the women who go through menopause early. So you come into my office and you are safe 42. You haven't had cycles for about 12 months. 12 months, I would go. An FSH level at that point? Because I want to know, you want to know, am I menopause now? Use somebody like me. I'm 56 and we got no cycles and I already know by myself that I'm in menopause. Please don't do any blood test of me. It's not gonna change anything.

Speaker 2: 16:44

I already know where.

Speaker 1: 16:45

I am with everything based on my symptoms and based on the fact that I have not had the cycles for years. Okay, so FSH is a good one to do to diagnose menopause. The second hormone that's important is the free estradiol. This is your estrogen level, of course. So if you're in menopause, remember, estrogen levels decline in perimenopause. You get two menopause. They take a nose dive and they are low. So women in menopause will have an estrogen level between 0 and 20. Some menopausal females have a Higher estrogen level and that's really because of adipose tissue could be producing some estrogen or the adrenal glands could be producing some Estrogen. But generally, remember how we talked about. You got to put the clinical picture together With the blood test results to know that you're in menopause. So estrogen, estradiol, that's a good one to test. The next one, though that's a very good one to test is CSH. So your thyroid function. Some of the symptoms of menopause and perimenopause, like Papatations, anxiety, mood swings some of those really could be of fatigue could be because of thyroid dysfunction.

Speaker 2: 18:02

Which is really very common in women.

Speaker 1: 18:05

So, if anything, I will definitely be doing a thyroid function test at CSH, which is checking the brain hormone first, just for screening purposes. I will be doing that on you once a year night. That's abnormal. We'll do some additional thyroid function test, probably the whole panel there. So that's one that doesn't diagnose perimenopause or menopause, but it definitely gives you some good information or whether or not you have any thyroid disease, which is very common during this time of life. All right, the next hormone is the male hormone, believe it or not? Yes, ma'am, we women, we have a small amount of the male hormone called testosterone. So I'll be checking the total and free testosterone, especially if a female is not really to diagnose menopause.

Speaker 1: 18:49

But you know, some women do Wants to be on Hormonal replacement treatment and some women specifically who complain about sexual dysfunction, decrease libido and things like that. I do want to check a testosterone level. Why is that? Because sometimes a testosterone level is too, too low. We don't want to correct it, to bring it up too high no, we don't want to do that. But we want to bring it up to physiologic level so that you may feel better and you may have a better sexual function. However, we don't check testosterone levels, say diagnosed menopause per se. It's not just we need to help treat or alleviate a certain condition and another hormone that sometimes checked. That really can depend on some symptoms that you present. So, like we said, menopause causes headaches. That's a big one. So I don't always want to say you're having a headache because of menopause, especially if you have visual problems, especially if you have some nausea with it, some GI problems.

Speaker 1: 19:51

Yes, you could have GI problems because of all the foods that you're eating, but then again you may have a pituitary, so a brain mass or a brain tumor that could be causing headaches, vision problems and things like that they do, more common in females. So we do check that hormone called prolactin. It is also another one when its levels are high, especially in the younger women. If its levels are high, it causes your menstrual cycles to go away. So I can't say that you're in menopause now without checking a prolactin level just to make sure you don't have that hormone that's causing cessation of cycles, because obviously you have a brain mass. The treatment is completely different. So again, ladies, if you're experiencing all these symptoms number one, journal them. Number two, just don't chop them off to perimenopause and menopause. I'm a big, big fan of women taking care of their bodies. Just like we take care of our family's bodies, take care of your bodies. Write down all your symptoms, because sometimes we get in front of the doctor's office or we get to the doctor's office and we forget even all the things that we meant to discuss. Write down your symptoms, go to the doctor and discuss all the symptoms. Sometimes it's just menopause, but sometimes it could be something else. Another something else that it could be is diabetes. Diabetes is notorious and you could even be pre-diabetic. We could find out from a blood test. You could have fatigue, dry skin, frequent urination, just feeling overall blood feeling bad. You could have all these symptoms and maybe it's just not menopause or perimenopause. It could be pre-diabetes. And guess what? Pre-diabetes or insulin resistance is more common in those of us females who are older and in those of us females who are in perimenopause. Remember that when I talk to you about lifestyle changes that you can implement right now for your better health.

Speaker 1: 21:53

The second blood test these are other blood tests that we're talking about just for good health, just to find out if you are healthy, because when you can't start talking about menopause or perimenopause specifically menopause we are prone to other major medical complications like heart disease, diabetes We've just talked about that and we're also prone to strokes and cancers. So number one, the very first test I will do, is an A1C. A1c is justa blood test that gives me an average of your blood sugars for the past three months. It tells me about your metabolic health. It tells me about whether or not you are pre-diabetic or even diabetes. If you pre-diabetic or diabetic, you may not even have any symptoms, but we can diagnose that from a blood test.

Speaker 1: 22:44

Second test that I will do to check your metabolic health will be an LDL low density lipoprotein. That really tells me whether or not your cholesterol fat that's circulating in your blood, your cholesterol numbers. It tells me where they are, and high cholesterol can be common or more common at this age. Remember, metabolism is dropping because when now in menopause we're declining estrogen levels, we become more insulin resistant, cholesterol tends to go up.

Speaker 1: 23:18

It's just all the things. All the things are happening and you hear you've done everything that you could do and you continue to eat the same amount of food and you're exercising and you're working really hard and you go to the doctor and they tell you your cholesterol is high. Listen, there are a few things that we want to do, starting very early in perimenopause. All right, other blood tests that I'll do just to check on your general health vitamin D vitamin D, that's a big one. Low vitamin D levels can cause depression, can actually cause it more difficult for us to lose weight and for some people it can cause them to gain with low vitamin D levels. Other two blood tests that we do at this time.

Speaker 1: 24:00

When you come in with all these symptoms, I just check a blood count to make sure you're not anemic. It would not diagnose you with perimenopause or menopause, but you can be complaining of tiredness and things like that. Sometimes you could be anemic and some women are severely anemic, which triggers different kinds of testing now. So please get tested. The last one is the comprehensive metabolic panel to check your kidney and your liver. That's also important. Liver disease, fatty liver disease, is very common at this age because, again, the biggest cause of fatty liver disease is what we eat. So let's move on to lifestyle changes. I have all my show notes here, so I'm looking at these lifestyle changes. What can you do to alleviate all these symptoms, especially the metabolic changes that are occurring in your body that you may not see at this time, until you have an event, and we don't want you to have an event, we want you to be healthy. So, moving on into 2024, I wish this is your best and your healthiest life ever. So, number one, number one, the biggest one is nutrition. What you eat really is so important. Clean out the diet. Just remove processed foods as much as possible If you're somebody who likes one thing. Whatever you like, don't do the one ever you like. Every single day I'll take it and I'll box it into one meal. So let's say I like to eat I don't know chocolate cake. I can't realistically say I would never, ever, ever eat a chocolate cake. That's an existing real life. So what I'll do is I'll tell myself well, sunday lunch time is the day we go out with family to have that Sunday lunch after the long church service. All right, so on that Sunday I'm going to have my one little slice of chocolate in the restaurant and that's not something I'm going to be making at home. Whatever you do, just one time, once in a while, is not going to change anything.

Speaker 1: 26:06

So, in addition to removing the processed foods and removing added sugars from your nutrition, you want to prioritize protein. This is a big deal. Why? Because estrogen levels are declining. We can see that from your blood tests. With declining estrogen levels come a decline in your muscle mass. Your muscle mass, when it reduces your metabolism, your base and metabolic rate will decline. So now you're gaining weight, eating the same foods and exercising even more, and things are not working out. What you want to do is eat more protein one gram of protein in the food per pound of your ideal body weight. I talked about that last Friday. So if you miss last Friday, go back on this Instagram page or on my YouTube channel, go back and listen to that video. What I talked about last time on how to increase proteins in your nutrition.

Speaker 1: 27:05

Next thing you want to do is reduce processed foods as much as possible, cut back on sodium, cut back on fats and things you can add to your diet. Number one vitamin D. Number two is a probiotic. Number three lots of water. Stay hydrated. That would help you. And also sleep is important. If you're struggling with belly fat, then you want to sleep enough, because why your hunger hormones? Those are regulated while you are asleep.

Speaker 1: 27:38

The next thing to think about is self-care. Remember, when we go into menopause, or even perimenopause, we start to have quite a few mental problems, mental-like symptoms, anxiety, depression, stress, all those things and if we keep going and going, sometimes those symptoms can just become overwhelming and we get trapped over there. I want you to come back, carve out some time, even just an hour in the week or two hours, where you can take care of yourself. Women are caregivers who are so used to taking care of other people, but when you take care of yourself, your body thrives, you thrive, and everyone around you your family, your children, grandchildren they thrive as well. So we've talked about those lifestyle changes and things that you can do in addition to sleeping seven to nine hours.

Speaker 1: 28:31

Let's talk about hormones that I generally do not test. Again, this is my opinion, and these are hormones that we don't test generally because they're of no help in your treatment or in your management of menopause, even if you go in for menopause. Our hormone replacement treatment, which some women do qualify for. I will bring that video here shortly. So hormones which we do not check is number one progesterone. Progesterone is low in menopause. Of course we know it's low. Why is it low? Because its function is to sustain a pregnancy, so obviously we're not pregnant in menopause. It also protects the uterus from estrogen, so obviously our estrogen level is low. So if I check your progesterone level, all I've done now is cost you some money and it's going to be low, and now that I know it's low, then it's just not helpful to check it.

Speaker 1: 29:30

Another one is luteinizing hormone. It's a hormone that is produced just before ovulation. It is high and after ovulation it goes back down. So why am I checking it when you are in menopause? Another one that's checked is DHEA. This is a precursor, so it's a hormone that comes before your androgen hormones, before testosterone and cortisol and things like that. So if I check it, what will I do with it? So that's just testing for no reason. In medicine we have an oath to first do no harm. I think that by default that also comes with first don't cost the patient too much money. I'm going to get shot, but anyway, some of these tests really are just unnecessary. No need for them to be done. So let's summarize here If you're really struggling with menopause, belly fat or overall weight loss, I have an online weight loss program.

Speaker 1: 30:27

It runs every 21 days. Next one starts on January 2nd, just on time right after the new year. So go to the link or type in link after this video uploads. Go ahead and type link and I will send you the link to join, or go to my profile and join. I am a female in menopause. I'm also a medical care provider. I'm a physician. I work full time in the emergency room. I also have a part time outpatient weight loss clinic in the hospital. I see patients from the age of seven all the way through to the 70s, several menopausal females. In addition to that, in my online program I have several women who have successfully lost the weight just with guidance. My personal history I was born obese, been obese all my life until when I got to menopause towards the age of 50. I thought it was really important for me to change things, and I did. It's not easy, but it's doable if you're consistent and if you use all the little tricks that I use. I share them on my Instagram page.

Speaker 1: 31:34

So just to summarize here, we've talked about the signs and the symptoms of menopause and perimenopause. Perimenopause is that transitional period, two to ten years before you actually get into full blown menopause. Menopause is diagnosed after you have had no cycles for a whole 12 months, or if you had a surgical menopause where your ovaries were removed or you had some treatment. There are some tests which we've discussed. The important ones are FSH it is higher than 35 if you are in menopause. Estradiol is between 0 and 20 if you are in menopause. And then we do some other tests to roll out chronic medical diseases. I really hope this helps you. Well, that said, there are no blood tests or saliva tests to diagnose perimenopause. So I hope this information really helps you in your journey and, if it did, go ahead and follow me on Instagram.

Speaker 1: 32:35

I am on YouTube and on TikTok as well. I'm also on threads I'm not sure what thread is, but I'm on there, so follow me and ask me questions. If you want me to address any other topic that's really pertinent to you, type that in one of the charts or send me a direct message and I will be very willing to discuss the topic. I'm very, very big specifically on menopausal belly fat loss and weight loss. If you're struggling, send me a message, thank you. Thank you and have a happy new year, everyone. I will see you next Friday.

Speaker 2: 33:12

Bye. Thank you for tuning in to this episode of Thriving Through Menopause. We hope you found valuable insights and practical advice to support your journey. If you enjoyed today's episode, be sure to subscribe to the podcast, share it and review. Your feedback is greatly appreciated. Remember, menopause doesn't have to be a challenge. It can be an opportunity for growth, renewal and self-care. Connect with us on social media, where we share additional resources, tips and advice to help you along your path. Once again, thanks for listening in and we hope you 'll join us again on the next episode of Thriving Through Menopause. Until then,