Menopause and Andropause

Hormones can change your body so fast you feel like a stranger to yourself, or so slowly you do not notice until your relationships start taking the hit. We sit down with nurse Taneeesha Roberts to get clear on menopause, perimenopause, and postmenopause, plus the often-ignored conversation about andropause and gradual testosterone decline in men. If you have ever wondered whether hot flashes, vaginal dryness, fatigue, low libido, brain fog, or mood swings are “just stress,” we give you language that actually fits what may be happening.

We also dig into why these transitions are still surrounded by silence and confusion. Menopause is a universal stage for women, but it is still frequently misunderstood and sometimes misread in clinical settings, with symptoms like palpitations or cognitive fog getting treated as isolated problems instead of part of a bigger hormonal shift. And because andropause can be subtle, men may not connect irritability, depression, belly fat, or sexual performance changes to hormones at all, especially when masculinity is tied so tightly to identity.

The most powerful part of the conversation is what this does to intimacy and partnership. Pain with sex, erectile dysfunction, anxiety, and shame can turn into accusations and distance if couples cannot talk about it. We share a better approach: listen, validate, and treat hormone changes as a “we” problem, not a personal failure.

If this resonated, subscribe, share this with someone navigating midlife health, and leave a review so more people can find it. What symptom or relationship challenge do you wish someone had warned you about sooner?

Transcript

Welcome And Why This Matters

SPEAKER_01 0:00

Hello everyone, I'm Dr. Beatrice Ippolid, and this is Your World. Hello everyone, welcome to another episode of our podcast, Your World, where we educate, empower, and inspire two meaningful conversations that improve our health and overall well-being. Today we are discussing a topic that refers to millions worldwide, but is still surrounded by mate, confusion, and silence. Menopause and anthropause. Menopause is a natural transition every woman experiences, while anthropose refers to the gradual decline in the testosterone that many men experience as they age. Although these life stages are normal, they can significantly affect physical health, emotional well-being, relationship, intimacy, and quality of life. Today, we will separate meats from facts, discuss treatment options, explore life changes, and answer the questions that many people are afraid to ask. And to do so, we have the privilege to welcome one more time in our studio nurse Attenisha Roberts. Welcome.

SPEAKER_00 1:40

Thank you for having me.

SPEAKER_01 1:43

So, what you have for us.

The Three Stages Of Menopause

SPEAKER_00 1:45

So, as you already said, um menopause is something that is a natural occurrence. It happens with women. So there's three different stages of the whole thing. It's not just menopause, it's perimenopause, menopause, and then postmenopause. Perimenopause starts happening in women. Um, it can happen usually between the the 30s and the 40s, you know. And sometimes it can happen like as young as 35, but it can go, you can start having it like in 45, you know, between 35 and 45. That's usually around the time that women are starting to feel perimenopause. And that is the part of menopause that people associate with the hot flashes. That's when you have the onset of those kinds of things. The hot flashes, the vaginal dryness, the fatigue, the brain fog. And then menopause is um specifically when a woman hasn't had a menstrual cycle in 12 months. So that's when the actual act of menopause, that's when you're actually menopausal, when you haven't had a menstrual cycle over the course of 12 months. So 12 consecutive months, no period, menopausal. So then it's official. Then it's official, right? It's official. And then post-menopausal is the end of it, and that's from the time that you experience menopause until the end of your life, right?

Andropause And Testosterone Decline

SPEAKER_00 3:11

For angropose, which is a similar natural transition that happens in men, around the ages of 30, 40, men's their testosterone starts decreasing about 1% a year, right? All men don't actually experience it. It have it's it's more um, it's not that all men don't because some men don't have it, but the majority of men experience that decreasing in testosterone 1% a year from the ages of 30 and and on. That's when it usually starts, between sometimes between 30 and um 40.

SPEAKER_01 3:49

So it is interesting that you say that it does not happen in Hormain, while it is inevitable that women at some stage in our life we all will go through the process of menopause.

SPEAKER_00 4:03

So the thing is this is that what andhropose is is the decrease of that testosterone, like you said, right? So it's a decrease of testosterone, and testosterone is one of those things that is with when you have in your blood a therapeutic range. So you peak in your 20s and you may have a really elevated testosterone, and then you get your 30s and you gradually start declining, but it doesn't mean that that gradual decline is gonna immediately put you in a state of hypogonadism or of risk of being the testosterone going too low. You still may be within that range. Do you see what I'm saying? The process continues and your testosterone continues to deplete itself, but it's not doesn't necessarily fall into a range where it's testable. Now, in women, they don't really have a lot of tests because, as we know, medicine primarily is revolved around men, right? The the idea of women's studies and how the woman's body works and all that stuff, that was almost kind of like an afterthought. You know what I'm saying? But when women begin to have um menopause, it's an abrupt drop. When men begin to start losing their testosterone, is a much more gradual kind of occurrence.

SPEAKER_01 5:28

But in society in general, it you know, onto pause is not something that people talk about. No, it's not true. So you always uh hear men talk about uh menopause for women and sometimes in a jokely manner.

SPEAKER_00 5:42

Right.

SPEAKER_01 5:43

Uh but which isn't appropriate, but yeah, because at the end of the day, let me say this. Many men may say, Oh, it's not a subject for me. Yes, it is a subject for you because you do have a mother, you have a wife, a partner, a a daughter, you know, so you have a lot of women around you. Right. So the better you understand menopause, the better you can support. The people in your family, yeah,

Why These Changes Stay Unspoken

SPEAKER_01 6:08

you know, or the women in your life. So it's very important for men to understand that. But to come back to the lack of knowledge that society, you know, at large, right, you know, does not have uh about uh anthropos. So it's it's should I say it's sad in a way because it's sad that's supposed the same way that we talk about menopause, you know, so it's uh it should have been a subject of conversation to talk about anthropoults. And I assume, and correct me if I'm wrong, I assume one of the reasons why they probably don't talk that much about anthropoules, it's because so, like you just mentioned earlier. So, in order for somebody to say, you know what, hey, you know what, I am in that area, you know, so now I'm officially dealing with menopause, right? You have to have not seen your period for a whole year, which is which is 12 months. So, and after that period, getting pregnant, it's will be a no-no for you. While men, while they're going through their phases, so they don't have to experience that. With menopause, you won't be able to conceive afterward. Right. But men, you know, so they still have productive health.

SPEAKER_00 7:26

Absolutely. And the thing too is, I think a lot of times the whole idea of it is overlooked because it's such a gradual thing for men. For women, we abruptly stop, you know, our estrogen and our progesterone levels, they stop very quickly. It's a rapid thing that happens. We have a lot of those symptoms, the hot flashes that are noticeable. You'll see the you know, the fanning. But for men, it's something that happens so gradually, it can almost be undetected. And so that's why I don't think it's part of the conversation. You know what I mean? I I think that a lot of times because it's not something that we can see with our eyes, it's not something that we can say, oh, this person looks like they're extra moody or whatever the case, because it's such a gradual thing, one percent a year, it's harder, I think, for us to be able to identify and pinpoint what though the symptomatology is in men, and they certainly may not, you know, want to acknowledge that there's a you know that they're losing their testosterone, because heaven knows, they don't know there's no man on the planet who wants to hear my the testosterone is declining, you know, annually as as the time goes.

SPEAKER_01 8:38

But for women, it's a much more abrupt thing, and and I think you know, so that's just one personal opinion because we know how men tend to, you know, the idea of not losing their menhood, it's so significant to them, which becomes a psychosocial thing as well. Absolutely, absolutely anything around that anything that can bring a subject that may people believe that hey, that may happen.

SPEAKER_00 9:07

Yes, so they don't they're not gonna have that conversation, and even when you bring that up, even when you say it like that, what we're talking about also is like I said before, the medical congregation has really focused itself on men and the changes in the way the body works with men. That's why there's a test. There is a test for testosterone. You can go and get tested for testosterone to see where you are. Are you in that therapeutic range? There are some tests that you have for uh menopause and women, but generally a lot of the symptoms, the

Testing Gaps And Missed Diagnoses

SPEAKER_00 9:40

primary care doctor will send you, or even the OBGYN will send you to other um disciplines of medicine. Oh, you're having brain fog, they send you to a neurologist. Oh, you're having palpitations, they send you to cardiology. Meanwhile, these are core symptoms of things that happen to women when they're experiencing menopause. So they could be having these symptoms, and the diagnosis of these symptoms is kind of redirected to not, you know, to the ball over there when the ball is right here in front of your face because they're trying to deal with the symptoms and not globally what the the weight estrogen has changed the way your body is functioning. Because that decrease in estrogen, it literally affects every body system that the woman has.

SPEAKER_01 10:23

And and I think you know the symptoms are different for women. So it's like some women some of them mimic each other, a lot of them mimic each other, though. Yeah, so it's like uh like myself, so it's like I haven't though I am I already have the age, but I haven't experienced any of those symptoms. Right. And me on the other hand, I be half-flashed like a crazy woman. You know, I just call myself privileged that way. But you know, it's very important that you mention that there are not too many tests you know that they do for women. And I think you know it's very important to have because sometimes there are some situations women may be dealing with. So while you may think, oh, it has to, it may be a case of this or a case of that, but to come to realize it could be a case of menopause. Right. Or pair with menopause. Exactly. So I remember, you know, it was sometimes last year I was watching a TV show where Ali Berry was the guest at the show, and she mentioned something that she was going to phases, and one morning she went to the bathroom, she was dealing with so much pain, she could not even move. When her partner at that time took her to the hospital, and there was like a heavy discharge that was part of uh the reality that she was dealing with. To make a long story short, she said that the doctor conducted some examination and to come to realize, you know, the minute that the doctor saw the discharge and the corner, so it's like, oh uh, I may be wrong, but it seemed that it's a sign of airpiece. And she said that she went crazy. Of course. She

When Symptoms Get Misread

SPEAKER_01 12:09

went crazy, and so why did she was asking, you know, they're blaming the game studied between the two of them. Now she was wondering whether he gave it to her, or he was wondering whether she gave it. So it was a whole story until the doctor called two days later and said, you know what, we were able to do some further test. And whatever that you experience, right? It's due to peri monopoles. So it was Aliberry who had the money, the resources, and everything. Not everybody had that money and resources. And push her doctor to go to do further exactly. What about the average people love us?

SPEAKER_00 12:47

Yep, yep. And not everybody has access to a physician who is gonna go into depth and say, you know what, let me broaden my idea of possible outcomes or possible diagnoses and see what other differential diagnoses are available based on the things that I'm looking at. And like I said, women's health has always kind of been like at the low end of the totem pole because, you know, that's the society we live in.

SPEAKER_01 13:15

Okay, so I've heard, you know, a couple years ago, a girl who had just turned 30 and uh claimed that since she was 29, she was praising God for the fact that when she got pregnant at the age of 19 or 20, she kept the child. Otherwise, she probably will never be able to have a child because by the time she turned 20, she never seen a sign of her period. Wow. So can menopause occur earlier than

Early Menopause And Egg Supply

SPEAKER_01 13:45

expected?

SPEAKER_00 13:47

Um, yeah, it could because what brings menopause, perimenopause, and all that stuff on is a decreased production of estrogen and progesterone. Now, each woman, when she's born, she's got about a million eggs, you know, and every month she drops an egg or two, and that signifies that's that's the menstrual cycle, right? That's the menstrual cycle. The egg drops, and the menstrual cycle occurs. And as you go on, you are depleting the number of eggs that you have in your ovaries. You're born with a sedimental, you know what I mean? And every menstrual cycle you have, you're shedding. And so the older you get, the less viable those eggs that you have are, right? But when you're young, if you have, for whatever reason, any decreases in the estrogen and decreases in the progesterone that your body is producing, then you will experience those perimenopausal symptoms. And then, like we said, you hit menopause once there's been no cycle for 12 months. And there, and then, and then that's it. That's it, that's where you are for the rest of your life. You're pretty consistent, pretty stable. But uh as far as your estrogen and progesterone.

SPEAKER_01 14:59

So I know this is not your hour of expect it. So you're not you know you're not a midwife, you're not a GIN doctor. Right. But you know, I'm grateful that you were able to educate yourself, read about the subject, and to have uh to make today happen. So thank you so much. I've heard somebody mention it was sometime this week we were talking, and I was excited to, you know, talking about, you know, hey, you know, in my podcast this week, this is the subject that we we're gonna talk about. And she mentioned something that was very important, and she said to me, Dr. H, uh, you know, the one of the reasons that I never had kids, it's because I was heavy on birth control. And by the time I was 39, I never seen

Birth Control And Hormone Disruption

SPEAKER_01 15:46

my period again.

SPEAKER_00 15:47

Can that play a role into well, birth control tricks the body into not ovulating the way that it normally did? So it's it's hormones that you're taking on a regular basis. And if you taking those hormones for an extended period of time decreases your body's ability to create, you've become deep, your body is saying now, wait, we've been you've been drinking down the hormones. What now do you want me to do? I haven't been making it. You understand what I'm saying? So it's still again, once that decrease in estrogen and progesterone happen, that's when the symptoms of menopause and perimenopause, that's that's that's when they that initiate them. So anything that happens that's gonna decrease those hormones, that's where you are.

SPEAKER_01 16:36

Interesting, very interesting. Okay, so now since we go, you know, we explain to everybody what is menopause, what in what is androuse, and uh the symptoms. So can you give at least one or two symptoms? I know you give the hot flashes for, you know, can you have uh can you uh add one or two more and as well as for men?

Symptoms That Overlap For Both

SPEAKER_00 16:58

Yes. So I think what I'm gonna do first is I'll give um one or two for women, one or two for men, and then some of the ones that they have in common. Because there are some of those same symptoms that they experience the same symptoms. Although, like I said, a woman's gonna it's gonna happen quickly, and a man it'll be a gradual thing over time. So for women, like we said, the hot flashes, um, the decreased libido, right? Those are things that happen to women specifically. For men, it's kind of the it can be kind of the same thing. Sometimes they lose the morning erection, sometimes they have erectile dysfunction, and those are things that are very specific to men. Both of them experience brain fog, both of them experience belly fat, both of them experience decreased muscle mass, mass, both of them ex right, right. So there's a lot of things that happen that that mimic each other, that kind of mirror each other in the symptomatology between men and women and menopause and andropause. But we do have things that are very specific to us. Like a man, he's not gonna experience vaginal dryness, right?

SPEAKER_01 18:12

But women will.

SPEAKER_00 18:13

But women will. He may have a problem with erectile dysfunction. Do you see what I'm saying? Which is why things like VR, Viagra and Cialis, these things are so important, you know, they're they're very popular because men are truly experiencing these things, and they are able to go to their doctors and say, listen, I'm having a problem with this, and that becomes a top priority. They don't say go to the cardiologist, they don't say go to the endocrinologist, they don't say go to the neurologist, they say let's get your testosterone levels tested so you can do the thing. You understand what I'm saying? Right.

SPEAKER_01 18:45

You have to women, you know, we you cannot lose that manhood. But you know, it's very important that you mention that because oftentimes we we hear people complaining about their partners in regard to sexual activity. So you mentioned where women will have a decrease of beating? Exactly. But women experiencing that may have a partner who will be complaining about oh, you know what? She's uh she always refusing to, you know, to have an adult moment.

SPEAKER_00 19:15

Right.

SPEAKER_01 19:15

And then the the thing too is this is that it's like for women, you know, who have men dealing with their own experiences, they may say, oh no, oh, let me, who you who, who else you sleeping with?

SPEAKER_00 19:26

Right, but they have they have a pill for the their fix. You understand what I'm saying? They can take a pill and they can make it happen. Right. Do you see?

SPEAKER_01 19:33

So but before before before they go to the doctor to check, you know, this is the reality that's been going on. Because when that first happened, you don't know what it is. Right. And especially for men who were never educated, because women, we know the minute that you know we feel, we know, oh, you know what, especially if you're 40, 45, or you know what, you know, it's menopause. But men, they don't know about anthropause.

SPEAKER_00 19:59

No, they don't. No, they don't. So that puts in their mind, I'm sure, a lot of um uh problems with self-confidence because a lot of men, they are, you know, their pride is their virility. Their pride is, you know, is there be um can satisfy a woman and I can, you know, that's something that's really tied to their masculinity. For women, on the other hand, not only may she have a decreased libido, but she also may experience pain with intercourse because of that vaginal dryness. You see what I'm saying? And so now

Intimacy Pain And Relationship Friction

SPEAKER_00 20:33

for her, it's not only just a matter of I don't necessarily want to, but also I don't want to subject myself to the pain that's associated with it, which sometimes can create conflict in relationship because I'm sure the partner is saying, Well, we've been for 20 years, we've been just fine. Now all of a sudden it hurts. You understand what I'm saying? And so that creates, you know, more rift within I think relationships where they aren't able to uh discuss the different transitions for the man and for the women and not have it be out in the open so that they can have some kind of a uh uh educated conversation where they can both support each other. Exactly. That's what I don't think.

SPEAKER_01 21:15

As holding this conversation is important. Exactly. Because we have to understand each other's body.

SPEAKER_00 21:21

That's it.

SPEAKER_01 21:22

They then transition all the you know changes that is going on in our bodies for my husband to understand, for me to understand, you know, and for for in order for us to have it, you know, to keep on living a decent life. That's correct.

SPEAKER_00 21:36

That's right.

SPEAKER_01 21:37

Oh, okay. So I know this is not the end of the show, but if you were to educate a men on this in terms of like try to understand their women's body more, so what

Listen And Validate Your Partner

SPEAKER_01 21:49

would what what that would be? If you were to say something.

SPEAKER_00 21:53

This is a tough ask, okay? Trying to educate a bunch of men on. Something sometimes can be a tough ask. I think that um within a relationship the core has to be respectful, and once you are able to be respectful, when your partner is saying something to you that is affecting their body, that's affecting their mood, that's affecting maybe their desires, you have to be able to respectfully listen and validate. That's that's the listen. Those are the key words. Listen and validate. Say, you know what, I understand. And although my needs are XYZ, what I'm getting from what you're communicating to me is that hormonally, you are not you are not prepared to maintain the sex drive that you've had for years. Physically, you are not prepared to maintain the sex life that you've had for years because it may be painful. It may be something that it's very dry. Do you see what I'm saying? It's it's the the tissue there, it dries, it's not, you know, in when you're young, it's everything is supple and lush, and you know. Now the situation is not that. You are not producing the hormones that are gonna provide what it is that you've been experiencing for all those years. You just don't have it. And a lot of times you you you don't, you're not in the mood.

SPEAKER_01 23:37

It's right, it's a time to have a lot of understanding, right? To be considerate and not to go to validate others' feelings and understand what they are going through, and not to say, you know what, oh, you don't want to do it, right? I'll go elsewhere. Right, exactly.

SPEAKER_00 23:54

And and it's not a time to be selfish. Definitely not a time to be selfish, definitely not a time because, as we know, while our change happens rapidly, their change happens gradually. And they have to think about down the road, if I do experience erectile dysfunction, if I do experience um, you know, losing that morning erection, if if if I do, you know, any of these things, would I want my partner to be respectful and to validate my situation as it currently is? Exactly. So there has to be a there has to be an exchange. And without the education, that exchange can never happen because you're just going by what your perceived situation is. You're not seeing the whole picture, what your partner is experiencing at the time, and helping support them get through those times.

SPEAKER_01 24:48

Yeah, so it basically has to be, you know, a we thing. Don't make it like you know, something personal, like you should be the only person in the picture. So it cannot be that way.

Anxiety Depression And Character

SPEAKER_01 25:01

Right. It cannot be that way. So I'm just looking for one more symptom: anxiety, depression. People you know will have difficulty sleeping, dread pain.

SPEAKER_00 25:15

All that stuff is are things that both men and women can experience. So we talked a little bit about the physical health and the mental health. We also have to discuss that because, like you said, anxiety, depression sometimes, because you know, the fear maybe they're they're they can't perform. For both men and women, you know, a lot of a lot of women are, you know, they feel bad. Do you know what I'm saying? And they put a sense of guilt, they put weight on their shoulders that really has no business being there because they want to be able to please their spouse. And the same thing with the man, the he wants to be able to please his spouse, but the current condition is not allowing that. And so that can cause great anxiety, that can cause great depression, that can cause all kinds of things. But definitely there are physical effects and there are mental health effects that go Especially when you know that you are dealing with a health situation.

SPEAKER_01 26:10

This is a this is a major health concern. But instead of having a partner who won't understand and deal with the situation with you, but will choose instead to go out there and deal with a younger one. Yeah, that can be painful.

SPEAKER_00 26:26

Of course, that can be painful.

SPEAKER_01 26:27

And that's you know, that's a full and considerate and selfish.

SPEAKER_00 26:30

I'm repeating that word again and again. That that's a character thing. And and and anthropause or not, if that's in your character, if that's if that's something that's in you to do, then that's what you're gonna do. Regardless of whether or not your testosterone is really. Right, you're gonna use that as an excuse. There's no, there's a that's a character flaw. That has nothing to do with the actual decreasing of the testosterone. That's who you are. If that's the case. You see what I'm saying? If if it's your that's just who you are. It's it's I don't think that that's something that says, oh, my testosterone is decreasing and my partner is doing this. If it's in you to do it, you are going to do it.

SPEAKER_01 27:11

Okay, there is one of the last symptoms that I wanna talk uh about is uh memo problems. Yeah, brain fog. Something that both both yeah, both have them. I didn't do any research about it to know exactly who experienced it more between men and and female.

SPEAKER_00 27:30

Well, so I wouldn't say one more than the other, but like I said, the difference is is it's a immediate something that happens very, it's a rapid onset when it comes to women. So it makes it very noticeable. For men, it's a gradual onset. Do you see what I'm saying? So year after year, you may find the symptoms are becoming more and more strong, but as for women, it's like that's it. Here, here it comes, and then it fluctuates until the time that you are postmenopausal, and then wherever you are at that time, that's generally where you stay. So um it's noticeable in women who are experiencing perimenopause and postmenopause. Whereas in men, a lot of times it's it's such a gradual onset that it it's like under the radar. And I think like again, that's why I think that so many people are not very well versed in angropose because it's such a slow, gradual thing. It starts in their 30s and it can go up until their 80s. And by the time they're 80, they could still have a therapeutic testosterone level.

SPEAKER_01 28:41

But what you right, so you know, among all those symptoms that men tend to experience, depression is one of them too. And but they tend to

Masculinity Pressure And Mood Changes

SPEAKER_01 28:52

get irritated more often than women do.

SPEAKER_00 28:55

And you you see that, you know where you hear that trope kind of in that grope grumpy old man thing, the grumpy old man, you know what I mean? Who he had the the grouch. There's nothing positive to say about anything at any time. Any conversation had is a complaint, it's a gripe, it's a whatever the case. And that could be certainly tied to that lowered testosterone and that moodiness, that that depression, those that symptomatology that goes along with that the continued and consistent decrease in testosterone over the course of decades.

SPEAKER_01 29:28

But you know one thing, uh nurse Wabras, so I've you know I've been around men all the time. And it's a subject that is really hard, not anthropous, but for them to lose their menhood, it's a it's a subject many of them don't want to talk about. They don't want that to go anywhere. Even if they were to be 90 or 80, they still wanna be men. Right. So it's like when they get to a point where hey, it's going down, I can see the the tension, the irritation.

SPEAKER_00 30:04

And that's unfortunately that's that's really a societal thing. That's a societal issue because we put so much pressure on men, even as they start with little boys, don't cry, you know, don't hit the ball like a girl. The idea of everything being so hyper-masculinated. You know what I mean? This this idea, and then once they've they've identified themselves as masculine, then there are certain characteristics and traits that they're gonna attach to how they've identified. And they have to go through life saying, Well, I identify as this, I identify, you know, that you know, I'm masculine because I can bench press, you know, 250 pounds, or I'm masculine because I can um, you know, get the touchdown. I'm masculine because I'm attractive to a lot of women, I'm masculine because, and those things, that's part of their core personality then. So as they go through life and they see that these things may or may not be faltering, they have a problem with that because their whole identity and masculinity is associated with those characteristics and traits. A mouthful.

SPEAKER_01 31:19

It is very important, and it is a sad reality, but it

Hot Flashes Turning Into Panic

SPEAKER_01 31:23

is a reality for way too many of them. Hormone can change a lot of things in the body, like you mentioned earlier. Born fog, difficulty concentrating, uh panic attack, but we didn't mention about panic attack. So that's my question.

SPEAKER_00 31:39

Yeah, so sometimes a hot flash can turn into panic, the palpitations, all the things. So I was I was watching a program, some programming, and there was a woman who was talking about how they did a study, and what they found was is that estrogen in the woman's body is all over the place, and so with that slow decline of estrogen, that's when you get all the symptoms the palpitations, the dizziness, the brain fog. And sometimes, if you are, let's say you're having hot flash and palpitation at the same time, that may throw you into a panic attack, just like that, because you're you're meeting, you're you're not feeling safe within your body, you're feeling ill, you know, and it's not anything that you can clearly control at any one given time. You can go fan yourself, you can, but if you're having palpitations, it may be more difficult to be able to control that. So that kind of thing, in it in addition with the anxiety, can absolutely turn someone into panic. Absolutely.

SPEAKER_01 32:54

Okay, I know we broadly uh mention you know some uh impact on relationship and things like that, but to uh probably ask the question how can menopause affect marriage, dating, or family relationships.