103 | Learning To Trust Your Body Again After Surgical Menopause With Julie Parana

What happens when a healthcare professional goes through surgical menopause at 42 and is handed nothing but a message in her patient portal that says "you are post-menopausal"? No education. No discussion. No next steps. Just a diagnosis and silence.

That is exactly what happened to Julie Parana. And even as an occupational therapist who spent her days supporting patients through major health challenges, she found herself doing what so many women do — minimizing her symptoms, pushing through the pain, and waiting far too long to ask for help.

Julie Parana, MS, OTR/L, CWHS, is an Occupational Therapist, Certified Women’s Health Specialist, Menopause Coach, and founder of The Menopause OT - Menopause Coaching, a virtual practice empowering women to feel informed, supported, and in control through perimenopause and menopause. She works with women at every stage of this transition, including early, surgical, or treatment-induced changes

Together, we talk about: 

✨ What adenomyosis is and why it goes undiagnosed for so long

✨ How surgical menopause differs from natural menopause

✨ The five lifestyle pillars that help women feel like themselves again

✨ Why affirmations feel awkward at first and why they work anyway 

✨ How to start small, build slowly, and actually stick to midlife wellness habits

Julie spent years dismissing her own symptoms because she was too busy caring for everyone else. What she learned on the other side of that is something every woman in this community needs to hear: menopause does not have to mean years of needless suffering. There is so much available to you. But you have to prioritize yourself first. No one is coming to do that for you. 

If you're seeking to reclaim your pleasure and vitality, join Gabriella at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

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The information shared on Pleasure in the Pause is for educational and informational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or Pleasure in the Pause.

Transcript

Introduction and Return to Her series overview

Gabriella Espinosa 0:27

Welcome to Pleasure in the Pause, a podcast dedicated to empowering midlife women to connect with their bodies, pleasure, and power in Perimenopause, Menopause, and beyond. I am your host, Gabriela Espinoza. Each week I sit down with leading medical experts, thought leaders, and trailblazers for bold, thought-provoking conversations that educate, inspire, and challenge the myths we've been taught about our bodies, aging, and sexuality. I also share solo episodes with evidence-based insights and real talk to help you feel informed, supported, and in charge of your health and pleasure in this season of life. Because your pleasure matters in and out of the bedroom. So take a deep breath, settle into your body, and let's begin. Hello, beautiful listeners. Welcome back to Pleasure and the Pause. Today I'm sharing another intimate installment of Return to Her, a series where I sit down with women I admire to explore what it means to come home to themselves in this season of life. Through the challenges, the shifts, the wisdom, and the practices that help them feel like themselves again. My guest today is Julie Perana, occupational therapist, menopause coach, women's health specialist, and founder of the menopause OT. At the age of 42, after a hysterectomy, Julie went through early menopause. And even as a healthcare professional, she initially brushed aside many of her own symptoms. What followed is something so many women will recognize being told fatigue, brain fog, sleep struggles, and feeling unlike yourself is just something to push through. In this conversation, we talk about the normalized suffering so many women experience. What happens when we finally stop minimizing our symptoms and how powerful it can be to advocate for ourselves and seek support. What I love about Julie's story is that it's ultimately one of trust, learning to trust her body, trust what she was feeling and trust that she deserved to feel better. Now she's helping other women do the same. This conversation is practical, validating, and incredibly hopeful. Let's welcome Julie Peranna to the show. Julie, welcome to Pleasure and the Pause. I'm so glad you're here.

SPEAKER_01 3:03

Thank you so much for having me. I am a huge fan of the show and also so appreciative of all you do with Manipause advocacy and awareness. So I'm very grateful to be here. Thank you.

Gabriella Espinosa 3:14

Oh gosh, likewise, you are an important voice in this space as well. And thank you so much for being part of this new series that I've launched called Return to Her. It's it's really about one thing: women sharing their stories and going through something challenging and finding their way back to themselves. And your story, I just knew it needed to be here. So let's start at the very beginning before any of this made sense, before you had answers. What was actually going on in your life? What was going on in your body? And what were you telling yourself about it?

SPEAKER_01 3:55

My story begins with years and years of struggling with symptoms of adenomyasis, but I didn't know that's what it was at the time. I was having horrible period cramps. I felt like I was getting my period all the time, even if I wasn't. Sometimes I was bleeding for 35 days consecutively. I had awful floating. I was just experiencing a host of very uncomfortable symptoms. And I think like many women, I initially dismissed myself. I told myself, this is normal. This is just what periods are like for women. We normalize suffering, unfortunately, as women. And so for a while, very long while I just lived with all of these symptoms. And I'm a healthcare professional. I know better, but it's different when it's yourself. And so I ignored a lot of these symptoms for a while. But then when they really started to impair the quality of my life, I decided to look for some answers.

Gabriella Espinosa 4:55

And can you take us back to those days? Can you tell us a little bit about what you were doing around that time and all the things that you were juggling in the midst of these heavy, heavy periods?

Why Julie elected to have a hysterectomy

SPEAKER_01 5:06

Yeah, so I'm an abbotational therapist. I work in acute inpatient rehab. So I'm taking care of others all day. It's a very physically demanding job. I'm helping patients that are recovering from strokes and spinal cord injuries and amputations. I'm getting them up out of bed. I'm helping them stand and walk. And so it's a very physically demanding job. And sometimes I was trying to do that while I was in a significant amount of pain myself. I was trying to, you know, race to the bathroom in between every client so that I could change my feminine hygiene products. I even had an awful experience where I was doing caregiver training. I was trying to help a family learn how to take care of their loved one. And I could feel blood dripping down my leg, which was mortifying to me. And I had to excuse myself and find a coworker who had an extra pair of scrubs I could swap with. And it was definitely not easy. That is why I decided to get a hysterectomy because it was really impairing the quality of my life at that point.

Gabriella Espinosa 6:06

Yeah. And what strikes me about your story is that you were so busy taking care of others that you dismissed yourself first. Did you try going to a doctor and asking them about your symptoms?

What adenomyosis actually is

SPEAKER_01 6:19

I did many years before I ended up ultimately getting the diagnosis. I had a uterine biopsy and they did do an ultrasound to look for things and they weren't very conclusive. Those tests weren't conclusive. By the way, the uterine biopsy was excruciatingly painful, and I was not prepared for that either. I wasn't offered any pain medication or anything, which I think is pretty barbaric. Women need to be prepared for the pain of that procedure and to be medicated for it. And so it did take, I think adenomyiosis is one of those conditions that does take a while to find and diagnose correctly. So I had sought some help. I didn't really get a lot of answers. And then I just kind of pushed it to the bottom of the list and didn't really address it again until it got to the point where it was really affecting my day-to-day life. It wasn't just something that I was dealing with a few days out of the month. It was more days than not that it was affecting me.

Gabriella Espinosa 7:14

And can you explain to us what exactly is adenomyiosis? I actually heard that term for the first time when I was in my 50s because I was experiencing a similar situation to you, excessive bleeding. And my doctor has said, oh, you you may have adenomyosis. I'm like, what is that? And you didn't even do a good job of explaining it. She just said excessive bleeding. I'm like, okay, why? I've had this before when I had periods normally that this was happening to me post-menopause, but this was happening to you in the midst of you having a regular cycle.

SPEAKER_01 7:50

Yes. And adenomyosis is, I describe it as endometriosis' evil stepsister because it's very similar, but in adenomyosis, the uterine tissue grows into the muscle wall of the uterus where it's not supposed to be. So it doesn't grow externally to the uterus like endometriosis does, where uterine tissue can end up all over your body, but it does grow into the muscle wall where it's not supposed to be. And then that leads to all of these symptoms. Pain, heavy bleeding for very prolonged periods of time, a lot of bloating, it can lead to digestive issues as well.

Gabriella Espinosa 8:25

And I think it can just go undiagnosed for so long unless you really have the doctor diagnose it and take treatment for it. Because I suspect that, as my doctor said to me, you must have had adenomiosis when you were cycling. And this is why now you're probably having these same issues post-menopausal, even with HRT. I mean, my story is a little bit different, but again, it's just like all these questions that come up that surface with these medical terms and with doctors who may not explain to you what you're actually going through. And I think that's why getting a diagnosis is so important. Even if you're experiencing something like you were, like that was not normal, right? Excessive bleeding in that scenario that you painted of, you know, being with patients while you're experiencing these extreme, uncomfortable, embarrassing symptoms. You were minimizing your own experience. And that's something that we're so conditioned to do. And you have a clinical background, so you know that's not something normal. So, what was that voice telling you? And where do you think that was coming from?

SPEAKER_01 9:35

I think some of it too is because of my clinical background, and because I spend so much time every day with people who have gone through major, horrifying sometimes life transformations. They've had their leg amputated, they have a spinal corn injury and they're never going to walk again. They've had a massive stroke and they can't use half of their body. And almost in a way, I feel like I tell myself, like, oh, well, what I'm dealing with is not nearly that bad. You just put it to the side because you think, oh, this isn't suffering enough. And then we do that to ourselves. And thankfully, I don't have that mindset anymore. But it was something that I carried with me for a while, just dismissing it because it didn't seem like it was bad enough to do something about it. Until it no longer was. And then I did elect to have the hysterectomy, which was great. I started to feel better almost right away. But then, even though my ovaries were left intact and I was told that it wouldn't impact timing of menopause, that's not what happened. I initially felt great after recovering from surgery, but very soon after I started to experience a whole host of symptoms that I didn't initially connect to menopause because I didn't know anything about menopause other than hot flashes and night sweats. And those were not my initial symptoms.

Gabriella Espinosa 10:54

I want to get to that for sure. I think so many women are going to recognize that this sense of just pushing through, don't be too dramatic. It can't be that bad. This is just part of being a woman. And I'm curious, did you learn that at a very early age? Do you think it was your family of origin conditioning or cultural conditioning? And looking back now, what do you think that narrative might have cost you?

SPEAKER_01 11:22

I think cultural conditioning for sure, because I think that's just something we do as women. We expect our periods to be bothersome to us. I haven't had children. Women normalize the pregnancy and the childbirth and delivery and all of the pain and discomfort that come with those things. I definitely saw this sort of attitude in my mother as well. My mother is amazing. She was a single parent. She worked full-time job while raising three children and also navigated cancer during that. When I was pretty young, my mom had breast cancer, and she did not miss a single day of work while she was going through her chemotherapy. And she also went into menopause as a result of her chemotherapy. I never once heard her complain about any of those symptoms. And I think that just toughness was just something that was kind of ingrained in us, even if it wasn't outwardly spoken about. It was just something that I saw modeled. And, you know, I just think that kind of led to this tough exterior that I had that was like, I'm just gonna have to deal with this. And it does come at a huge cost. Like you said, it comes at a huge cost. I probably spent years suffering with something that could have been treatable had I taken action sooner.

Gabriella Espinosa 12:39

I just want to stress for our listeners that attitude of just toughing it out, not complaining, that attitude, yeah, that was our mother's metabolism. That belonged to that generation. My mother, it was exactly that way. She still is, minimizing everything. We take that narrative on. And I'm so glad that you took action and put an end to that legacy of suffering that we inherit. And I'm seeing that with so many women now, our generation, you're, I consider you an a millennial, an elder millennial, not quite generation X, I'm Generation X. Because you're young. You were experiencing this at a younger age.

SPEAKER_01 13:22

Yes, I'm 45 now, but I was 42 when I had my hysterectomy. And then, you know, as a result of that, found out that I was post-menopausal. So I did go through the transition about a decade earlier than I should have.

Gabriella Espinosa 13:36

When you made the decision to have that hysterectomy, that's not a small thing, right? Physically, emotionally. I hear women throwing around the term, oh, I just had a hysterectomy. It's a big decision in terms of your body going forward. How did you arrive at that decision? And were you told anything about what to expect afterwards?

SPEAKER_01 13:56

It actually wasn't truthfully that big of a decision for me. I had my tubes removed when I was like 34-ish. So I felt like I didn't have any use for this uterus anymore that was destroying the quality of my life. And then I've had a few other surgeries for other issues in my life. So I wasn't super concerned about the procedure itself. But the only education I got was about what to expect with the procedure and a little bit of information about the recovery. I was not prepared that it could impact the timing of menopause. And I was told, in fact, the total opposite of that, that because my ovaries were left in, that it wouldn't affect my hormones. And that made sense to me. So I just assumed that would be the case. And then later found out that for a lot of women, that's not the case and that it can impact the timing of menopause. And so I wish I had been prepared for that. And I wish I would have known what the symptoms of menopause are, so that when I started to experience them, I didn't waste less time bouncing from specialist to specialist trying to figure out what was wrong with me. I would have known that those symptoms were related to the decline in my hormones and I could have acted sooner.

Gabriella Espinosa 15:03

And did they mention the word menopause to you at that time?

The cascade of symptoms nobody connected to menopause

SPEAKER_01 15:07

Not at the time of the surgery. No. I had asked, will this affect menopause timing? And I was told no. And that was the end of the discussion. So it wasn't until afterwards when I started experiencing significant brain fog and word-finding problems, memory lapses and allergies and rashes. I was constantly breaking out into hives and I had to take a few rounds of steroids to treat that. I had plantar fasciitis, I had dizziness and vertigo, I had ringing in my ears, my weight was creeping up. So I just was bouncing around to all these different specialists, and none of them tied it to menopause either. And then it wasn't until I started having hot flashes that all of a sudden the light bulb went off and I realized, oh my gosh, this is probably hormonal. And all of these symptoms started after my hysterectomy. And then initially I'd asked for blood work and I was told, oh no, you're too young to be in menopause. And I said, I understand, but I did have it, I did have a hysterectomy. So maybe we should check. And then we did check. And it turned out I was making almost no estrogen. And so no wonder I felt so weird. And all I got was a message in my patient portal that said, You are post-menopausal that explains your symptoms. But that was it. No education, no discussion on next steps, no offer of hormone therapy, even though I had gone through this a decade early, and early menopause significantly increases risks of cardiovascular disease, of osteoporosis, of diabetes, of dementia. None of that was explained to me at all.

Gabriella Espinosa 16:36

Just a message in your portal. What did that moment mean to you? And what happened next?

SPEAKER_01 16:44

Well, I read the message and I thought that can't be good. I'm too young for that. So I just started reading everything I could about menopause because I did not intend to spend the next half of my life feeling this way. I just felt I am too young to feel like this. I felt like I had aged a decade in a few months' time, and I did not want to continue feeling that way. And I figured there must be something I can do about this. My doctor might not know, but there must be something I can do about it. And so I started reading everything that I could about menopause. I started following experts on social media. I started listening to podcasts like yours. I really just started to educate myself about menopause, about hormone therapy. And I learned a lot of what I thought I knew about it was incorrect and based on misinformation from a decades-old study. And so I started reading studies. I really just dove into it. It became like my passion to learn about it. And then I found another doctor to help me. I started replacing my hormones and then I started making lifestyle changes. And then I felt really good again. And I just wanted to help other women navigate this. I felt if I'm a healthcare professional and I didn't know any of this, the average woman isn't going to know all of this either. And the average woman is probably not going to spend countless hours reading and researching everything the way I did. And so I didn't want to keep all this information to myself. I wanted to use it to help other women navigate it.

Gabriella Espinosa 18:11

I love that you stopped waiting for someone else to give you answers and that you took action to find those answers for yourself. And really, that's what self-advocacy is all about. And I know some women get upset and think, why do I have to do all of this work? Why can't the doctors provide more guidance in terms of the symptoms and side effects that I might experience after a hysterectomy? But as you've pointed out, and as we all know, a lot of them are not trained in menopause care. They just don't know. So we have to advocate for ourselves. We have to empower ourselves with that knowledge. You got certified in women's health and menopause coaching and built your practice around everything you've been through and learned. When a woman comes to work with you, what does she actually get? Not just the clinical picture, but the experience of really truly being supported through this. What does that look like?

SPEAKER_01 19:12

She gets someone who listens to her, who validates her experience and what she's going through and the kind of education that you can't get in a 10 to 15 minute doctor's visit because our healthcare system, unfortunately, is simply just not designed for that. I wish it were, but it's not. And so, you know, I'm offering a little bit of a way to bridge that gap to really give you the time to talk about this and how menopause is impacting your day-to-day lives. My background as an OT kind of helps me look at that picture, how what you're going through is affecting your roles, your routines, your relationships, your work life, your just your day-to-day life. And then we figure out ways to help build new healthy habits and practices into your daily routine that will help you feel more like yourself again, but in a way that makes it realistic and attainable because we can't change 15 things about our lifestyle at once and expect to stick to it. It can be very overwhelming if you are on social media and you hear all these things that we should be doing at this stage. That's information overload. And then women don't know where to start. This just gives you a way to do it in a realistic and sustainable way and give you a roadmap to follow. And everybody's plan looks different based on their lifestyle, what's actually realistic for them to achieve?

Gabriella Espinosa 20:34

I know you support women who have been similar experiences like you who have gone into early menopause or surgical menopause. How is that different than, say, the woman who is the average age of menopause, say 51, and is just starting to experience those symptoms? How does the support differ, do you think?

The long-term health risks of early menopause

SPEAKER_01 20:57

Well, in surgical menopause, the symptoms come on very suddenly. Your body doesn't have that, like, not that natural menopause is a kickwonk either, but there's a bit of an on-ramp to it. Your hormones gradually fluctuate and decline until you're no longer making them. But in surgical menopause, you go from making them to not making them instantly. And so the symptoms can often be much more severe and abrupt. And they can have long-term health consequences, like I talked about, with increasing your risk of cardiovascular disease and osteoporosis and diabetes and menopause itself causes an increased risk for all of those, no matter the timing. But when they happen before the natural age of menopause, if you're younger than 45, it significantly increases those risks. And so we really need to double down on the lifestyle pillars to help minimize those risks. Replacing our hormones is great. And I highly encourage all women to learn about that and to consider it. But in addition to that, we really have to live the lifestyle pillars as well to reduce all of those risks.

Gabriella Espinosa 22:02

Yeah. And can you remind us about those lifestyle pillars? I talked about that a lot with doctors and experts here on the podcast, but I think we have to be constantly reminding women about these because I am in shock sometimes of how I talk to women who okay, I got educated on the hormones and I feel great, but I spend time with them and I see that. They're not eating, that they're drinking excessively, that they're saying they're going to start strength training later. And I'm like, oh my God, the clock is ticking. I'm sorry to scare people, but the clock is ticking. Tell us. Share with us what are your lifestyle pillars that you encourage women to follow.

SPEAKER_01 22:44

Yes. So my framework, the pillars that I'm focusing on, the first one is mindset. So your brain believes what you tell it. And so why wouldn't you tell it what you want it to believe? We often really have to start with how we think of aging and how we think of the menopause transition and knowing that we have control over this and that there's so much that we can do. And so just having a positive mindset about it is step number one. And then step number two, we work on nervous system regulation and stress management. And truthfully, before I went through menopause, I would have rolled my eyes at suggestions about nervous system regulation. I was not a meditator or a journaler or someone who really intentionally thought about how am I going to regulate my nervous system today? I didn't do that. But our hormones quietly do that in the background for us. And then when we're not making them anymore or we're not producing them to the level that we used to, you are going to realize that your body needs that intentional support now. And simple practices, 20 minutes a day, can really make a huge, huge difference. I just did a session with a breathwork coach a couple of days ago. And the data from my aura ring was very telling about how powerful just that one breathwork session was. It was so beneficial for my brain, for my body, for everything. And so we need to intentionally do things like that to support ourselves. Then we also focus on nutrition, to your point. We're prioritizing protein. We are prioritizing fiber, and blood sugar stability is really huge. That's something that we need to pay very close attention to in the menopause transition, is eating in a way that regulates our blood sugar. So it's not necessarily to be heavily restrictive. Most of my clients are not weighing and measuring their food and counting every calorie they put in their mouth, but we're more focusing on what we're adding. We're adding more protein, we're adding more fiber, we're adding more whole nutrient-dense foods. And then sleep is another pillar that we focus on. Basic sleep hygiene practices. I think most of us, if we're truly honest with ourselves, are not regularly following those. And that's the first place to start. A lot of us are zoom scrolling on our phone late at night. We're just jumping right into bed, but we're not doing anything to wind our body down and have a routine that helps our body know that it's time for bed. Well, at first, we just work on the sleep hygiene. Now, sleep hygiene alone is often not enough for everybody. And so if you have a really good sleep hygiene routine, but that's still not moving the needle, then there are things like cognitive behavioral therapy for insomnia. There are other strategies with medications that you can talk to your doctor about. So some women do truly need more than just sleep hygiene, but that is the first place to start just to see if that is going to impact your sleep. And then movement. Movement, of course, is a very important pillar. Adequately strength training to your point. We need to put muscle on our bodies at this age, this stage of life, to reduce all of these issues that can come up later in life. We lose our muscle mass, we lose our bone density, our blood sugar stability is directly related to how much muscle you have on your body. And so thankfully, I fell in love with strength training many years before I went through menopause. And that's something I love to help women learn how to do is to strength train. And it always makes me feel good when someone falls in love with weightlifting after they work with me.

Gabriella Espinosa 26:11

Those are a lot of pillars, and I know that it's always best to start with one of them. So I'm sure you don't throw all of that into it. I know it is doable to address all those pillars. I try my best to stick to them. Sometimes you get off track, especially if you're traveling. I'm traveling right now and I'm not getting the sleep or eating all the food that I normally eat or hydrating, and I feel it. What suggestions do you have to our listeners who are trying to do all the things and yet they find themselves getting off track? How do you get back on track and stay there?

SPEAKER_01 26:50

You do have to start small. You cannot try to tackle every single pillar. And I think that's where a lot of women get stuck is they try to change too many things at once, and then it becomes very hard to stick to. And then they feel like failures because they weren't able to do that. So pick one thing that you think is really going to move the needle the most for you. And often with my clients, we start with the sleep and the nervous system regulation pieces. Because if you're in fight or flight and you have a million things going on in your life, you are not going to meal prep and you are not going to start strength training. You're not ready for that yet. And adding more of that onto your plate is not going to be helpful. Often, what I'm helping clients do in the beginning, we do a little life load audit where we look at where all of your energy is going, the different buckets of energy cost in your life. And we try to find ways to reduce that load, reduce the mental load, set boundaries, delegate some tasks, take some things off your plate first so that we can find time where you can start to build in some of these healthy practices that are going to help you in the long run. And to your point, once you start doing them little by little and you see how much better you feel, it makes it so much easier to stick to. And then when you do get off course a little bit, like you said, you feel it right away. And then your body is reminding you, okay, actually doing all of these things really helps me. And that's what helps me stick to it too, because I feel good and I want to keep feeling good. So I keep doing these things. And it doesn't necessarily feel like work anymore. It just feels like this is how I live my life. I am a person who eats whole foods, nutrient-dense foods, and feeds my body. I am a person who prioritizes exercise. I am a person who makes sure that I'm regulating my nervous system and you become the identity of the person who does all of those things. And then it does get easier to stick to. It does take effort. It does take work. And that's why sometimes having someone to help you through that is very beneficial because trying to implement it all on your own can be challenging.

What returning to herself actually felt like

Gabriella Espinosa 29:03

Yeah, it's the accountability piece, right? Just having someone who is walking by your side, cheering you on, there for you when you've gotten off track, encouraging you to get back on track. And I find that piece is so, so important. You know, your story is one of someone who really found themselves unexpectedly in the menopause transition, thrown into menopause because of your diagnosis of adenomiosis and your hysterectomy without being told anything about it, without giving any warning. You were in that very murky in-between space that I call it, right? You took action, you educated yourself, you advocated for yourself, you got on the hormones and you found your way back to yourself, that return to self. What does that feel like? That sense of, okay, I'm, I feel like myself again. I have returned to who I really am and I've found a purpose in who I am. What does that return to self feel like? And how long did it take for you, that whole transition?

SPEAKER_01 30:17

It took probably a little over a year. And something that I didn't mention as I was also dealing with a breakup at the time that really took a big toll on how I felt about myself, my self-confidence. And so I think one of the reasons I came out from this on the other side, feeling so strong and empowered, was because in order to get myself through that, I did seek help. I did work with a therapist. I did start journaling. I did a lot of inner work on myself that was also happening at the time that I was dealing with all of this. And it really helped me find myself again because I lost it for a little bit there. And it wasn't easy for sure, but it was something that just really helped me not even just feel like myself again. I truthfully feel better than I did before. And so that's why I'm so passionate about helping women see themselves in my story or a similar story, because I just want them to know that menopause doesn't have to be the end. It doesn't have to mean that you need to suffer endlessly for years. Please don't do that because there are so many things that you can do to feel better. But you do have to prioritize yourself and you do have to take action. And no one is going to do that for you. You have to do it for yourself.

Gabriella Espinosa 31:33

Yeah, no one's gonna come to save you. You talk about seeing a therapist, journaling, doing a lot of what we call that inner work in those really dark moments. What were the practices that really moved the needle for you to feel like yourself and return to yourself?

SPEAKER_01 31:51

I think, and it's one that I resisted at first because it felt so silly to me, but affirmations. Affirmations played a huge role in how I dealt with that and got over that really low point of not having self-confidence and self-love for myself. And that was something that my therapist had encouraged me to do. And at the time I felt ridiculous. I was saying these things that I did not believe in to the mirror every morning. And eventually you start to believe it. So when I talked about the mindset piece and your brain believing what you tell it, there's science behind this, and this is very true. And so it's actually something that I have some of my clients doing now too, because I believe affirmations are so powerful. I still do them every morning to this day. What I was saying to myself then is not what I say to myself now because those affirmations are now so ingrained into me, I don't need to hear them anymore. I do truly believe them. So I highly encourage people to start doing that. And even if they feel weird, it felt very cringy. It felt very awkward, but it is very, very powerful. And I love using affirmations.

Gabriella Espinosa 32:59

I don't think I started using affirmations until I was in my 40s. I trained as a yoga teacher, and part of the training and the work of being a yoga teacher is looking at certain affirmations. And I think at the time I didn't think they were affirmations, but then I later learned, yeah, that there is science behind it, that you do get a lot out of repeating these positive thoughts, these positive words to yourself. And I did learn that when you talk about the science behind it, I did hear from a psychiatrist or a psychotherapist that when you put your name in front of the affirmation, so I could say, Gabriella, you have the resilience to get through this difficult moment. Just putting your name in front of the affirmation reinforces it even more. It has just this magnifying effect of really creating this new kind of neural pathway in your system. Because sadly, maybe some of us didn't grow up with those affirmations, with a parent or people in the workplace. Saying, Gabriella, you have the ability to get through this difficult moment, right? And so we have to do it for ourselves.

Start small, pick your non-negotiables, and build from there

SPEAKER_01 34:16

Yes, I love that. I listened to them before I fall asleep now, too. Just a meditation track before I fall asleep. Sometimes I do them in the morning to kind of get myself ready for the day. It's a very powerful practice. And so definitely encourage people to try it. If you're not already trying it, give it a shot.

Gabriella Espinosa 34:32

This series is called Return to Her because I believe we spent so much of midlife finding our way back to ourselves. You have talked to us about what that felt like for you, returning back to yourself. What do you do to encourage your clients to really find that path back to feeling like themselves again?

What is giving Julie real pleasure right now

SPEAKER_01 34:57

Start small and pick a few non-negotiables that you can start with every day. Pick a few habits that you feel like you can stick with. And then when you build on that over time, it does become easier to stick with. You do see the changes and then that builds upon it. If you don't pressure yourself to do too much too soon, you just have to start. That's the thing. You know, I think we get stuck in information gathering mode, and we learn everything we can about it, but then it's the application piece that gets stuck, and nothing is going to help you if you don't implement it. And so you have to start implementing. Pull the band-aid off, make one small change, start there, and then build on it. But you do need to prioritize yourself. Please don't put everybody else before yourself. We have been conditioned as women to do that. You have to put yourself first. This is the stage of life where your body is going to tell you that you have to put yourself first.

Gabriella Espinosa 35:57

You know, this podcast is all about really finding and experiencing pleasure in this stage of life, the things that light us up, right? I have a very broad definition of pleasure, things that light you up, that make you feel alive and connected to your body. I'm curious, what is something that is giving you real honest pleasure right now? Something that makes you feel alive and connected to the world around you.

Where to find Julie and work with her

SPEAKER_01 36:24

Part of what is the work that I'm doing now, helping bring more awareness and attention to this stage of life and knowing that too many women are needlessly suffering through it. The work that I'm doing that I'm so passionate about is bringing me a lot of pleasure. And something else that I've recently started doing, I told you, is that breath work practice and some of these nervous system regulation pieces that I've implemented, I get a lot of pleasure from that as well. And just taking time to do something for myself every day. I think that's something I wasn't intentionally doing before. I was going through the motions, I was doing all the things, all the productive things. And I wasn't necessarily making sure that I took time every day to do something that either brought me joy or that was just for me. And that's something I think everybody needs to do.

Gabriella Espinosa 37:18

Yeah, that's so great. Thank you so much, Julie, for your honesty, for sharing your story and for the work that you do for women every single day. Can you share with our listeners where they can find you?

SPEAKER_01 37:34

Sure. My website is themenopauseot.com, and I am the menopause OT on TikTok and YouTube and the Meno OT on Instagram.

Gabriella Espinosa 37:45

I love the educational content. You're on there educating every single day. So please do give Julie a follow. If you're going through something similar, feeling like you're being dismissed by your doctor, not understanding why the symptoms that you're experiencing are affecting you and you need someone walking by your side, definitely reach out to Julie. So thank you so much, Julie, for this conversation. I'm so grateful for the time we spent together. Thank you so much for having me. Thank you for joining me for this episode of Pleasure in the Pause. Want to help me spread more pleasure in the world? Please hit subscribe to the podcast and share this episode with a friend, a sister, or any woman you care about. Because when we share these conversations, we remind each other we are not alone. Together, we create ripples of empowerment and support that reach far beyond ourselves. Your support means the world to me. Thank you. Remember, your pleasure matters. The information shared on this podcast is for educational and informational purposes only, and it's not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or pleasure in the pause.