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The 'Pause
The menopause podcast with unfiltered conversations about the symptoms you hate, the changes you didn’t see coming, and the hilarious moments midlife can bring. You've got questions and we've got the experts to answer them.
The 'Pause
Navigating HRT: A Woman's Guide to Finding the Right Fit
Tired of keeping a towel by the bed for night sweats? Fed up with anxiety that won't quit? You're not alone, and you don't have to suffer through menopause symptoms.
When Val finally reached her breaking point with perimenopause symptoms, she took the leap into hormone replacement therapy (HRT) despite decades of scary headlines about cancer risks. The result? Life-changing relief—but also questions about which options work best and why. That's why we've brought in women's health advocate and certified menopause provider Nisha McKenzie to break down everything you need to know about HRT.
Together, they untangle the web of confusion surrounding hormone therapy, exploring the truth behind that infamous 2002 study that scared a generation of women away from effective treatment. You'll discover the differences between patches, pills, rings, pellets, and other delivery methods—and why your insurance might steer you toward certain options. Nisha explains why the question "Do you still have your uterus?" matters so much (hint: it determines whether you need progesterone with your estrogen) and shares candid advice about side effects like breast tenderness that might occur during the initial adjustment period.
Perhaps most importantly, you'll learn that "estrogen causes cancer" is a dangerous oversimplification that has prevented countless women from getting relief. With only one trained menopause specialist for every 25,000 menopausal women, this episode arms you with the knowledge to advocate for yourself in a healthcare system that often dismisses women's symptoms.
Ready to take control of your menopause journey? Listen now and join our private Facebook group, The Pause Diaries, for more resources and community support as you navigate this transformative time of life.
Welcome to the Pause, the menopause podcast, with unfiltered conversations about the symptoms you hate, the changes you didn't see coming and the hilarious moments midlife can bring. I'm your host, val Leggo, and I've been a dedicated health reporter for 25 years and I wanted to normalize something that every woman goes through menopause. So together we're going to talk about it the Perry, the Menno and the Post. Welcome to the Pause.
Speaker 1:So about four or five months ago, I got really tired of my perimenopause symptoms.
Speaker 1:I mean, I was keeping a towel by the side of the bed, so in the middle of the night when I got my night sweats, I could get up, wipe myself off like I just got out of the shower and then crawl back into bed. So in the middle of the night when I got my night sweats, I could get up, wipe myself off like I just got out of the shower and then crawl back into bed on like wet sheets, of course, because you also sweat on the back of yourself. So I was over it and I was cranky. My anxiety was through the roof and I just started doing my research about hormone replacement therapy and said I'm going to try it and, like many of you out there, I was a little nervous because there was so much research that talked about breast cancer and scared women against the hormone replacement therapy.
Speaker 1:But I went to my doctor and I tried it and I'm going to tell you life changing but there are so many different kinds out there to choose from. What's right for you? Do you still have your uterus? Do you not have your uterus? All of the things. So that is what we are going to be talking about today, and I am joined by my friend and certified menopause provider and women's health advocate, nisha McKenzie. She is going to help us sort through all the things that are hormone replacement therapy, because there's a lot to it.
Speaker 2:There is a lot to it, hey, val, hey. So yeah, I guess I'm going to let you kind of lead with what questions you think you would go in to your provider with.
Speaker 1:So I went in and I told her. I said I was a little scared because the research out there is, you know, for 20 years, ooh, should stay away from hormone replacement therapy. I'm like, is this for me, how do I get into it and what can I expect from it? And she was really great and I said, you know, you can start on like microdosing and see where that goes from there. And so that's what we chose I still have my uterus. It was so such a weird question, you know, when the nurse practitioner was going through everything with me and she's doing the questions and she's like, ok, do you have this? Do you still have your uterus? Ok, do you have this? And she was just, it was like she was asking if I want a cream in my coffee.
Speaker 2:I'm like, yeah, I didn't lose it. I think I brought it with me today.
Speaker 1:Let me check real quick. I'm not sure. So, like it's just those weird questions that like for them you know they run through it because they do it every day and it's like, oh my gosh, yeah, that was bizarre, but yes, I do. So just kind of like understanding what was about to happen to me and what was you know what could be good. Of course you rattled off the symptoms, like it could be this, this, this and this, but the benefits so much better to the benefits. So let's just kind of like talk about what hormone replacement therapy is and why it got such a bad rap.
Speaker 2:Well, it got a bad rap back in July of 2002 when the Women's Health Initiative came out and I think we're going to probably do another show about that because it deserves its whole own show. But it came out, it was poorly reported. It came out in such a way that it scared people off hormones and they basically said in the media hormones cause cancer. Everybody's gendered hormones. And they went oh, it must be estrogen. So now everybody thinks estrogen causes cancer. But that is not at all what the data showed then or what 20 plus years of data have shown since then. So if you're able to find a menopause expert, a hormone expert that can walk you through the data, give you good articles, show you back up what they of 2002, we've put out pumped out 20 plus years of medical providers that have been scared of hormones because they haven't been taught anything other than the myths that were perpetuated back in 2002.
Speaker 1:So you had women for all of those years who were just suffering through it, just like I got it. I have to either find natural remedies or I just have to suck it up and get through it. And it's so sad to me, it really is, and there's this other, this like proposed 10-year window that people talk about.
Speaker 2:So then, those people that went through menopause the boomers, right, those people that went through menopause during that time they're past that 10-year window and I think that's probably another one that we can spend almost a whole podcast on. Is that 10-year window? But for the most part, that 10-year window is a suggestion. It's based on data showing that by the time you're 10 years post-menopause, you're more likely to have plaques laid down on your arteries and then hormones might cause more problems certain types of hormones, certain delivery of hormones. So if you're 10 years, if you're 11 years post-menopause and you go in, it's still worth a conversation. Do I have the cardiovascular health that is going to make this helpful for me, or is it harmful for me? It's not a 10-year dead cutoff, like you just fall off a cliff after 10 years and we cannot help you anymore, but 20 years post-menopause, right? Like the people that were in the baby boomers, right? The people that were in that at the moment that that study dropped. They've missed out.
Speaker 1:Yeah, and that's so sad. And you see the increase in many things, like the heart disease in women and the dementia and Alzheimer's, and you wonder if there's a correlation. Of course, we keep saying another episode, we're coming up with all kinds of ideas here, but right now let's get into the nitty gritty of, like you know HRT, which you know because we've got to have initials for everything. So HRT hormone replacement therapy and so when I got on it, one of the things that I wasn't quite prepared for were some of the side effects. So I gained some weight. This does not happen to everybody. I want to put that out there. Some people have no problems.
Speaker 1:I'm a weight gainer, that's me, that's my superhero power. And so I gained some weight and my boobs were huge. My husband's like oh, my God, it's like you got a boob job. I'm like I'm glad you like them. You cannot touch them. They are so sore. I can't even lay on my stomach and sleep. Like do not. Like, three feet around me is where you need to stay. And that went on for a little while. You know what's a little while? I'm going to say a month, about a month-ish or so, but yeah, I was like whoa, this is like oh, this is a lot. I've now come on the other side of that and I feel much better when traded. I mean, that was a really uncomfortable good month to six weeks that I was like no picture, please don't take pictures of me Like I don't want to go out of the house. I'm just going to sit here in my yoga pants and a big sweatshirt and that's all I'm going to do.
Speaker 2:Don't take my picture, don't touch my boobs.
Speaker 1:Yep, nope, but I feel great, and so I don't want to scare anybody from getting through that and it doesn't happen to everyone, but you can have those kinds of symptoms too, and I had a little bit of bleeding. That was concerning.
Speaker 2:But as a certified menopause provider, you know, sometimes it's your body thinking that you're pregnant. Yeah, it's the change again. Right, it's the change in hormones. So what I always tell people when I start on hormones is a couple of things, both of those things, actually. So you're going to find symptoms that are due to the fact that you've been without hormones and now I'm giving you hormones. So it's not necessarily an adverse event of the hormone that you'll always have. Right, like it's not like statins can cause muscle or joint or muscle aches. Right, it's not like that, it's like PMS. When you have those peaks and valleys and you get hormone symptoms, you get breast tenderness, bloating, headaches, mood swings, constipation, nausea, whatever PMS symptoms you have. That's essentially what's going to happen again, because I'm changing your hormone level and giving you some hormones.
Speaker 2:So I always tell people if it's tolerable, yet annoying, try to go with it for a couple of weeks. If it's intolerable in any way and you get to decide what intolerable is not me then stop it first, then call. You don't have to ask me, can I stop and wait for me to call you back. You can just stop it and then call me and be like Mayday, mayday, he's final Don't ever do that to me again and then we'll find a workaround. But for the most part we start with the lowest dose and we slowly titrate up to get you to therapeutic effect, because if we start with too high of a dose, it's too big of a delta, it's too big of a change, and then it's like PMS, like big time right. So it's just hormone related changes. Your body will acclimate to having that hormone back again, but in the meantime it's just kind of miserable for a minute, or it can be, like you said, it's not everybody.
Speaker 2:And then the second thing I tell people is if you bleed within these first few months I don't always say this, it depends on how well I know people, but like, don't call me no, like it's write it down, let me know. But don't panic Again. It's the change, right? Your uterine lining isn't used to having any hormonal stimulation and we've got to find the balance, the balance that happens through your 20s and 30s when you're having estrogen in the first couple of weeks, progesterone. In the second couple of weeks it's build up shed, build up shed. And there's a balance there for the most part, for most people, right? We're trying to find that balance again and we may not find it right away at least the balance your uterus wants in the first couple of months. So keep a log of it, let your provider know. But don't panic. If you bleed in the first couple of months, the other thing.
Speaker 1:once I was all in on it. I had my conversation with my doctor. She runs down like okay, do you want the ring? Do you want the pills? Do you want this, do you want that? And I was like I just want hormones. Like I don't know, like which one should I have? Which one's better? And it does depend on your insurance. So I kind of decided based on that. But there's a lot out there. So I wanted to get to all of those different types and we have our wonderful private Facebook group, the Pause Diaries, and we had some women asking about what are the different types? What's better? Some have higher doses than others, and so forth. So let's just dive in. So what are the different types? What are the better? What's better? What's the? You know, some have higher doses than others and so forth. So let's just dive in. So what are you? What do you? You've got the pills which are maybe the most common. Do you think? Oh, that's a good?
Speaker 2:that's a good question. In my practice the patches are most common Worldwide. The pills are the cheapest They've been. This is what. When people ask me, is estrogen safe? I'll be like, oh, sit down. I mean, the best example I think I could give is if you do have a uterus. This is why they ask that question Did you bring your uterus today?
Speaker 2:If you have a uterus and you take estrogen and you do not take progesterone when you're menopausal, then we're mimicking the first half of the menstrual cycle, which is building up the lining inside your uterus so that it can prepare for a period. The second half of the menstrual cycle is when the progesterone comes in and sheds that lining. So again, it's that balance. If I give you just estrogen unopposed by progesterone, it will just continue to build up that lining and as that lining continues to build, then those cells can start to stack up, lack differentiation and become precancerous or cancerous. So in that sense, if I use estrogen in the wrong way, without a progesterone, if you have a uterus, then yes, you'll have a higher risk of developing uterine cancer.
Speaker 2:So is estrogen safe in the eye of the beholder in the right hands, right Like when used properly in the eye of the beholder, in the right hands, right Like when used properly, yes, it can be safe, but used improperly it can cause cancer. So, yeah, we have to know what we're doing, but what can't happen is we can't say with a blanket statement estrogen causes cancer. We cannot say that Right, Right, anymore, no, no, we cannot say that.
Speaker 1:We should not say that in the first dang place. We are not saying that anymore.
Speaker 2:So pills, patches, rings, pellets, trochies, injections, all of these I mean. There's so gels, there's so many ways sprays that you can get your estrogen. Generally, insurance is one of the first dictators or cost right. So even if you're cash paying, if you don't have insurance, you still want something that's lower cost. So you want to use a generic and generally most of us will start with something through the skin versus something orally implanted under the skin like an injection or a pellet, because if we use it through the skin, the predominance of data tells us there's less likelihood of a blood clot or stroke. But I want to be really clear about that, because the likelihood of blood clots people are always kind of panicking about this is still lower even if you're taking an oral estrogen than it is when you're pregnant. Well, they tell you that.
Speaker 2:about birth control pills too, or than it is with birth control pills. Birth control pills have a still higher likelihood of blood clots than does hormonal replacement therapy or menopausal hormone therapy, because it's a different dose and a different type of estrogen. So while it's a risk with oral estrogen, that's a little bit higher than the risk with the transdermal. It's not so high that it precludes everybody from using it and it's just, it's a low risk, it's a possibility. And we have the transdermal, which means going through the skin, which is even a lower risk. So let's just try it right, like why not try something that we know is a lower risk?
Speaker 1:All right. So I use the patch and then I take the progesterone pill and I keep telling my girlfriends I'm like, oh my gosh, the patch, and I'm like it's not like a big giant nicotine patch Like it is, so it's like the size of a Tic Tac and you don't have to put it on your forehead Right, right, like.
Speaker 2:you can put it in your bikini, like, even if you wear bikini, still, mad props if you're menopausal and wearing bikinis. Exactly so, even if you're wearing bikinis, still it goes under your swimsuit, like under your underwear line, and it's clear and it blends in with your skin, so it does sometimes, sometimes tend to leave this little like ring of gray lint or whatever right, like sticking around.
Speaker 1:Yeah, my husband, he has seen that before. He was just like um, there's lots of things going on there.
Speaker 2:There's lots of things you can do to kind of get rid of that. So you can talk to your practitioner about it, google it, but but. Or you can put it on the backside, like you really can put that patch just about anywhere. It is going to absorb differently in different parts of your body, like through different layers of skin. But most people, I would say, put it on their lower abdomen and just alternate it a couple times a week. Some people put it on their back, like the upper part of their buttocks. As long as you just put it in the same area each time, then you're going to have steady absorption.
Speaker 2:Now what about the vaginal rings? So there's two different vaginal rings, and this is really important. Are you ready? Everybody listening. You have to know that there's a difference. One of them is systemically absorbed and will help your hot flashes and night sweats, or should? The other one stays just in your vagina. Obviously, the rings always stay just in your vagina, but the hormones stay just in your vagina, and so it's only for vaginal dryness, what's called genitourinary syndrome of menopause Another podcast.
Speaker 1:And also a really long description for saying dry vagina Dry vagina.
Speaker 2:It's GSM. So if you're intending to use something like the, femring is the brand version and we are not supported by FemRing, but it's the brand version of the vaginal ring that's systemically absorbed. Some people erroneously use that in the vagina, thinking it's going to just stay in the vagina, because the E-string stays in the vagina, the hormones do so. There's a big difference. We have to make sure we know the difference between the two, because there are some people who systemic throughout your whole body. Hormone therapy is not appropriate for and then the femoring would not be appropriate.
Speaker 1:It's based on the dosing and so who would those people that should not have systemic um estrogen?
Speaker 2:at this point in time and side note, I think this will change. I don't know if it'll change during our lifetimes, but at this point in time it's people who have had breast cancer, who have active breast cancer, endometrial or uterine cancer, ovarian cancer, and they're probably people who have had a blood clot or a stroke. At least they have to have a really intense, in-depth, I should say, discussion with their medical provider to see if it's appropriate.
Speaker 1:And when you? Just because we've talked about this in another podcast. But for people who don't know systemic, you know estrogen, what that's doing, all of the protection that it's giving you, your heart, your brain your bones, your colon, diabetes risks right, it can protect estrogen.
Speaker 2:Progesterone, testosterone receptors are literally everywhere you talked about when you started estrogen and you're a weight gainer, right? Apparently, I'm a fingernail grower. That is my superpower. I was like I have had to cut. I mean, I'm in gynecology. Everybody wants my fingernail shorts. I had to cut my fingernails like twice a week. But you saw our hair skin nails. There's estrogen receptors there. They're all over.
Speaker 1:And they protect us.
Speaker 2:I think we should get t-shirts. We should. I'm a fingernail grower. I'm a weight gainer.
Speaker 1:Okay, a couple of questions that we had from our Paws Diaries gals and just a side note if you're interested in joining our private Facebook group which those ladies are amazing and they talk about all the things and it's a really supportive group just go. Are amazing and they talk about all the things and it's a really supportive group. Just go to Facebook type in the Paws Diaries and send a request and we'll let you in. A lot of them were asking whether or not they can use the rings with an IUD Absolutely.
Speaker 2:So the IUD? I know most people come in and it's just like the down there area and like it's all kind of one mesh of things. But the IUD is inside your uterus like where a baby would go. There's strings like fishing line that hang out in the vagina but they soften and they curl up around the cervix so they're not just like sitting there like a spear just in case you've got anybody going in there. They don't have to worry. But the vaginal rings, they stay in the vagina far away from the uterus. It's relatively far right, like it's not going to disturb that. And they have different mechanisms of action. So the IUD is preventing pregnancy, if that's what you should be needing, and helping control your bleeding. The vaginal ring is either preventing vaginal dryness, recurrent urinary tract infections, vaginal infections and or also, if it's the fem ring, helping with hot flashes and night sweats. So they're doing different things and they're sitting in different I don't know area codes.
Speaker 1:I like that, yeah Well, and I also like the fact that you mentioned, like you know, iud if you still need to be protected from getting pregnant, you know. Then also being able to use the ring for estrogen because another conversation that we need to have later but like really encouraging women at younger ages to get on hormone replacement therapy. You know, like you've often said, if you're 40, you're in it, and so you could never really start too soon if you're having the symptoms, and it's all about being in tune with your body, which is really hard at that point in time because you're doing so many things. So if you're wondering, like what I shouldn't be worried about getting pregnant if I'm using hormone replacement therapy, well, yes, you do have to potentially worry about getting pregnant if you still have your uterus.
Speaker 2:I'm just going to giggle about that every time. If you still have your uterus and if you're having sex with someone who produces sperm like, there's a potential for pregnancy. It's lower than your potential for pregnancy was when you were 20. For me, I didn't even know they existed.
Speaker 1:So if you are, a member of the menopause society they're strong advocates that we should not use pellets.
Speaker 2:Many of us out there doing the work and seeing people in real life are saying listen, if it's working for you with and you've done it. So I have a couple of people that see me that have done it for 20 years. It's worked for them, they have no problems. We check levels and it's fine and I'm not going to take them off of it. But it's not what I start with. One thing is it's cash, usually cash pay, and they're expensive, but I would say I don't know from my perspective. More notably, it can be dangerous.
Speaker 2:So when you use pellets, they're first not FDA approved, which you know my opinion on the FDA. They're not all the end, all be all for me on everything. They don't always get it right, but it is something. It is some regulation right. There's something to fall back on. They're not FDA approved. In other words, you get a little pellet and they say it's 25 milligrams. It can be any variation around there. There's nobody saying it has to be 25 or 25.5 or 24.5. That's the only variation you can get. It could be a 15 milligram, it could be a 50 milligram.
Speaker 1:Oh geez.
Speaker 2:You don't know. And then when it's sitting in there, you've got three months, it's in there, there's no anecdote for it. So if you don't like it, it's in there. And also we can get what we see we call supraphysiologic doses. So when we treat with hormones, we try to keep your hormone level within physiologic range, which is the quote unquote normal range. Right, with pellets it's like a bolus, it's a, a burst of hormone and you do it about every three months and then by the time, like two and a half months comes, you're, you're, you're going down the, the valley again, right? So it's peaks and valleys and it doesn't. Those peaks and valleys are what we're trying to avoid. And perimenopause and menopause, that's what feels like crap, right, that's what makes you sweat, right.
Speaker 2:So here's my, my personal shtick on this is women, understandably, are frustrated because information has been withheld and it's been misrepresented and we in Western medicine have done a disservice. And I'm sorry, like all the women listening, I'm sorry, it was bad, it is bad. So they're rightfully frustrated. So then there are people out there preying on those frustrations and going come over here, I'm going to do it naturally and in people's heads. Natural equals healthy and safe. And that is not always the case and so they'll say we're going to do it naturally. We're going to give you this bioidentical pellet and it's safer and it's more like what your body did, and then they're going to charge you cash for it. They do your saliva tests. Not everybody's doing this, but there are bad players in this that are just really preying on people's frustrations and sucking in their money, and we can give you bioidentical or as natural as possible hormones through your insurance that are proven to be safer. So pellets may be okay for a small subset of people. They're not my first choice.
Speaker 1:They're worth a conversation if you're interested in them, right, because I think the pellets probably came in some way or shape or form by women not wanting to wear the patch, right, or just like not wanting to have to be seen, or they don't want to have to remember to do it, because then they're, you know, it's like one and done, kind of like the injection which I didn't know existed.
Speaker 2:So I think the pellets more came with the bioidentical movement after the WHI. When saying like this is safer, but the method of delivery is an option, the injection is an option. That's just like some people do. Testosterone injections we can put hormones can be made into liquid, like in vials. You'll get it and then you just give yourself an injection every however many weeks, or usually once a month. Some people go into their doctor's office and get it administered to them and some people do it at home because they're comfortable giving themselves shots.
Speaker 2:There's the risks with injection, parallel pretty much the risks with pellets and with oral hormones. There's just slightly higher risks with that. So they're not a terrible option. They're just not usually my first option and also there's a lot of people that just don't want to give themselves a shot once a month. Right, so they don't. Injections don't tend to be my first option either. How long have those been around? I haven't even heard of those. I don't know. Since Jesus was a kid Forever Synth hormones have been around. I mean, I think estrogen was kind of discovered and started to be talked about in the 20s and 30s, and so they've been around for a while, but they're not necessarily the most utilized.
Speaker 1:So once you choose your method and again, discussion with your doctor talking about it, figuring out what's right for you, whichever you choose, hopefully will give you the relief that you're looking for, because now that I have settled in, I'm like I love it, but I've settled in. So I'm like one, two, three, four, five-ish almost six months in and I'm kind of feeling like maybe I need an adjustment. So I guess my thoughts are like how do you know when you like need to do that? How do you know what dose is right for you?
Speaker 1:At first, when I first got them, I slept like I was a teenager, like I went to bed and woke up in the morning Like I didn't get up to pee. I'm not sure I even ever rolled over. It was amazing. I was like this is a thing, wow, it's amazing. It's been starting to wane a little bit, where I'm back getting up again at three o'clock in the morning and I'm getting like a little, a little sweaty at night, but not like full on night sweats. Part of me was just like, oh, maybe I have a heater blanket on or oh, maybe maybe I should take that extra blanket off the bed. And you know, just tried those things and I was like, nope, I'm starting to get just just teeny, teeny, teeny tiny bit like ever so slight. That makes me think that it's not that I'm dressed too warm when I go to bed. So now I'm thinking once you're on them, do you adjust them? And if you do, how does that work? Is it more progesterone, is it more estrogen? And how do you figure that?
Speaker 2:out. You don't have to. You trust the people hopefully that are the menopause experts and the hormone experts to help you figure it out. What I tell people is there's not an algorithm for these things. Your body is the algorithm. But what we have been told as women through whole lives is don't listen to your body. So now, when you hit your 40s we've got four decades of learning to undo you can say I'm just kidding. Now this crazy lady right here in front of you, me, I'm going to be saying hey, listen to your body and tell me what it's telling you. You're translating for me. Then we'll take that and say okay, that means you need a little bit more estrogen, a little bit less progesterone, a little bit more of something, a little bit of testosterone.
Speaker 2:What happens is during perimenopause because it's those peaks and valleys what we're really trying to do is narrow the window of opportunity for fluctuation. If we can narrow that fluctuation, great. But then what happens is eventually you go through postmenopause. Now we're at a different hormonal status, and so then it's time to change up the hormones again. Once you're postmenopause, it tends to get a little easier. We just put you on a level and you can kind of stay there, but during peri, if your ovaries kind of take their little siesta and then they're back and then they kick in and party again when they do, that, we have to alter a little bit. So I just tell people don't be afraid to tell me what's happening. It is not nagging, it is not complaining, they are data points. You tell me hey, I mean you even. So I'm going to call you out. Cool, okay, yeah, you even downplayed yours.
Speaker 2:Right, I did, you're like it's just a teeny, teeny, teeny I think you said teeny. Maybe we'll have to listen again, maybe three times, right, you're like it's just. It's like I don't want to be a complainer is what I was hearing. It's probably fine, I can excuse it away. Maybe it's just because it's getting warmer out, right? We reason all of this away. I tell people I want to know all that stuff. This is where I think I probably said it before. But my staff calls me a data whore and I own that. Like, yes, I will be a data whore Because you give me all of that and that's data, and I can just plot it out on this little chart in my head and go, oh, that pattern makes sense. This is what we need to do. So it's not complaining, it's not nagging. Tell us the things. Listen to your body. Ignore the 40 years before that said don't listen to your body and don't tell anybody about it, because you don't want to have a vagina. Complain, right? Ignore that and listen now to it and tell your practitioner.
Speaker 1:I think it's wonderful to have a great relationship with your doctor, like you have with your patients, but we have a lot of women who are on the struggle bus where they are talking and the doctor, you know, know I've got seven minutes for you. Tell me what's wrong. You know they're not listening, and so that's a little bit of a struggle too, and so finding that person in this part of your life that you are really like, connected to and like is listening and wants to help you through it is such a big deal that was very entitled of me to say just go tell your provider.
Speaker 2:No, no, no, I didn't mean it that way. No, but it was what it did.
Speaker 1:Do was like point out the fact that there are providers out there that you can go find.
Speaker 2:They are, but they are few and far between. I keep hearing the statistic around that for every menopausal woman there is for, I'm sorry, I keep saying it wrong too For every 25,000 menopausal women there's one trained provider. Right, and so we're getting more trained providers, but then but then they're they're new, right they're they've been doing it a year or two or three or four, and so experience is helpful as well. So even if you get a certified provider a menopause certified provider sometimes they're not giving you the answers that are helpful, or they're not listening, or they're in systems that don't allow them to spend the time right. So that's when it's important to find groups like the Pause Diaries, right, like those Facebook groups, and coordinate with other people. Make sure that you feel comfortable, like you can be your own advocate. We'll start posting some articles in that. Grab those articles, follow people on social media that have resources for you and then go in very prepared and say look, here's these resources. Be prepared to make another appointment If you go in during your annual exam, which is supposed to be just preventative.
Speaker 2:Don't shoot the messenger. This is the insurance. Like, they won't let you have what they call a problem visit at the same time or they won't pay for it often, right? So, but also, you're going to do yourself a disservice if you just try to tack it on the end of your physical Right, because that's a preventative exam I spend with new menopause appointments. I want to spend at least 40 minutes with everybody. If they're a brand new patient to me, I want to spend 60. Like there's time that needs to be spent to go through all of these things. But if you can go in armed with here's what I want to talk about next visit, can I make an appointment with that? Then you're going to cut down on time and you're going to give them also, as a practitioner, some time to kind of look into that and come to you with some better answers when you do have your appointment.
Speaker 1:Advocating for yourself is going to be something you'll never stop doing, and I'm going to tell you, having an older father who's in an assisted living facility, it never ends. The older you get, the more you have to advocate. So, even though you might be hearing this and thinking like, oh, I just want them to know, like yep, sorry to have the be the bearer of bad news, but like the, advocating for yourself just gets more as you get older. And that brings me back to a point that I do want to underscore is like with this whole hormonal replacement therapy, like knowing your body, like you said to me come on, is it really just a little bit of sweat, or just is it? Is that? I mean, is that really the way you want to look at it?
Speaker 1:Knowing where you're at, like really being in tune, because there's no blood test to be like, oh, you're on the right hormone dose, we nailed it. It's still about you saying I've got these symptoms, I've got that and that's just the way it works, because you are special and you are unique in the way that you're built and so your hormones are going to be different with what you're going to be taking. Maybe you do need the testosterone. Maybe you don't. Maybe, however, that works. But you have to be like super in tune with what's going on and like block out the world and say nope. In my gut. I know it's this.
Speaker 2:So, yeah, and the T-shirt we can all wear as women yeah, that's our superpower Is what, as women, yeah, that's our superpower is what is I'm a soldier? Right, I do love that. We're going to soldier through just about anything, yes, so, but you don't have to. We have resources.
Speaker 1:Yes, we've got great resources which we're going to put in our pause diaries facebook group. It is a private facebook group. We'd love to help you, have you join. It keeps growing and growing and we love the women that are in there, and so all resources, information. We will post podcast episodes if, for some reason, you can't find this one again, but we absolutely love having everybody as part of our community and continuing to talk about this and normalizing menopause and everything that we've talked about today and going forward.
Speaker 1:But I do want to just give you a heads up that this podcast is for informational purposes only. It is not a substitute for professional medical advice. Even though Nisha is really awesome, we are not your doctors in this setting. So always, always, always, check with your own healthcare provider for personal medical concerns. That is a must. All right, until next time. Join our Facebook group, the Paws Diaries, to get links to the experts and contents on the podcast and share your Paws journey with us, because we want to hear all about it. And remember this isn't the end of anything. It is the beginning of the rest of your life and we are going to talk about it.
