Perimenopause Symptoms No One Talks About: Dr. Mari Mitrani | Ep 68

You're not broken — and it isn't your fault. If you're a woman over 35 who doesn't quite feel like herself, this is the perimenopause conversation no one had with you.

In this episode, Aimee Rickabus talks with Dr. Mari Mitrani, physician-scientist and regenerative medicine researcher, about perimenopause, hormones, and women's health — far beyond hot flashes.

Dr. Mari shares:
- The overlooked symptoms women are told to ignore
- Why women were left out of medical research until 1993
- What the Women's Health Initiative estrogen study actually got wrong
- How to advocate for yourself and find a provider who's trained
- Why endometriosis takes 7 to 10 years to diagnose — and the science behind it

Whether you're deep in the transition or just starting to wonder what's happening to you, this conversation will leave you more informed and far less alone.

Educational only, not medical advice. Hormones and regenerative therapies are decisions for you and a qualified, licensed provider.

🔗 CONNECT WITH DR. MARI MITRANI:
Instagram: @marimitrani
Website: https://dr-mari.com/

———

The Manage Her® Podcast — hosted by Aimee Rickabus. Honest conversations on leadership, financial empowerment, motherhood, wellness, and career reinvention for ambitious women.

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Transcript

0:00

You're not broken. It's not the end of your story. This is where the story becomes beautiful. This is where the butterfly, and I see you have butterflies in the back of you. I do, and you're making me cry. It's beautiful. But this is where metamorphosis happens, right? I don't know if you've seen the cocoon stage. The worm has to liquefy to then become a butterfly. And this is the moment where we are right now. Hi, I'm Amy Riccobus, and welcome to The Manager. As women, we're managing families, careers, businesses, communities, relationships, and often everyone else's needs before our own. But what if the invisible work is actually leadership? Every week, we will explore the skills, stories, and strategies helping women lead with greater confidence, purpose, health, and impact. Because women have been leading all along. Today's conversation begins with a question that completely stopped me in my tracks. While preparing for this episode, I learned that humans are one of the very few species on earth where females continue living for decades after fertility ends. A few species of whales do this too. But among mammals, it's remarkably rare, which raises a fascinating question. If evolution is primarily concerned with reproduction, why would women spend nearly a third of their lives beyond their reproductive years? Why would nature design women to continue living, leading, mentoring, creating, and contributing long after childbearing ends? And if that's true, why do we spend so much time talking about what women lose during menstruation and so little time talking about what they gain. The question felt especially personal because today's guest and I are both navigating perimenopause ourselves. During our conversation, we found ourselves talking about something deeper than hormones. We talked about the perspective shift, the clarity, the changing priorities, the growing willingness to stop living for everyone else and start paying attention to ourselves. And as I reflected on this season of my life, I kept coming back to a metaphor I've been exploring in my own work, I've come to believe that human potential is less like a ladder we climb and more like a garden we grow. And it makes me wonder if the same thing isn't When we're younger, so much of our energy goes into creating, creating families, creating careers, creating businesses, creating homes, creating identities, creating stability. But what if perimenopause and menopause represent a shift from creator to cultivator? Not the end of our contribution, but a different expression of it. A gardener isn't constantly planting new seeds. A gardener is nurturing what already exists, helping it grow, helping it thrive, helping it bear fruit. And I wonder if that's part of what makes this season of life so powerful. Not because women become less important, but because our roles evolve from creating the garden to cultivating it. So the question we're managing today is... What if perimenopause isn't the end of a woman's story, but the beginning of her transition from creator to cultivator? To help us answer that question, I'm joined by Dr. Mari Mitrani. Dr. Mari is a physician, scientist, entrepreneur, regenerative medicine pioneer, and one of the leading voices in stem cell research and women's health innovation. For more than two decades, she has worked at the forefront of biotechnology, fertility research, regenerative medicine, longevity science, and future healthcare technologies. She is also passionately committed to advancing women's health research and helping answer some of the biggest unanswered questions in medicine surrounding hormones, aging, menopause, and women's long-term health. Today, we're discussing perimenopause, menopause, hormones, stem cells, longevity, women's health research, and what science is beginning to reveal about one of the most transformative seasons in a woman's life. Let's dive in. Hi. Dr. Mari, it is so nice to have you here on The Manager today. Thank you so much. Hi, Amy. Thank you so much for the invitation. I think I've been counting the seconds to be in your podcast. I met you and I think it was love at first sight, the electricity, the connection, the sisterhood was right there from the very first hello. Oh, I felt the same way. I know you're just brilliant. And anytime I meet a beautiful, brilliant woman, I'm like, let's be friends and You are just the whole package, girlfriend. You really are. Thank you. I feel the same. I've learned to thrive with my powerful women and it's the only way I want to live from now on. Oh, I'm right there with you, sister. So before we get into the science, I'd love to start with something personal. where you're also navigating perimenopause right now. What has surprised you most about this season of your life? Yeah, you know what? What has surprised me the most? The lack of education that me as a physician scientist that has been always advocating for women's health, preventative medicine, regenerative medicine. I mean, I with so much background of science and education, and I always love to dummy down all of the difficult science. And for me to step into this world knowing nothing and then not being able to even recognize that I was going through the transition, even though I was pushing the agenda of education for two years, and I was in the midst of it. So that's what has surprised me the most is that I think From now on, and I am the loudest, women from 35 years plus should be carrying a diary of symptoms. If you don't feel like yourself, if you have itchy ears, itchy skin, gum disease, like you've lost a tooth, like the weirdest things that are like not normally associated because everybody's like, oh, hot flashes. No, bro. Hot flashes, no. are like at the end of the story. But I think it's the lack of education. But clearly, we're going to talk about why, right? We've got to this point, but me personally going through my journey and not being able to recognize that I was fully immersed in because I'm way older than 35 and a Latina, which our backgrounds do determine the length of of our perimenopause, like how many years we go through perimenopause. I mean, I'm ready to dive in. See, I know nothing. I'm the same here, you know, and that has been the thing that all of my girlfriends, as we sort of crashed into the wall of perimenopause with zero sex ed or education on such things. You know, it was one of the things that we all went, wait, what the heck? In fact, a lot of my friends have said, Amy, please do an episode, find an expert, help us navigate this, like find somebody that can help us walk through this because it's one of the most common things that we we really don't know how to handle it. And a lot of times our doctors don't even know how to handle it. So it's Tracy. So I'm so happy you're here. I am so happy we get to talk about these things today. Oh my gosh. So one of the things we connected over was the perspective shift that seems to happen during this transition. Yeah, of course you've experienced this. All of a sudden, as estrogen drops, what happens? Yeah, we call it, and again, I just want to make this point clear. I am not a physician that sees patients. I am not seeing your patients in perimenopause, menopause. I don't treat the patients. But I am surrounded by so many physicians. I know how to read. I know how to interpret data. And I am so fortunate to come, again, surrounded with so many physicians that are making this change. So I am going to put in your notes all of the physician that really I want you to go and read and listen to podcasts, listen to their audiobooks and things like that. But if I can be your first window to your own advocacy, let's do that together, right? So estrogen, first of all, is not until recent that women were included in clinical trials. there was a big disadvantage that we, all of us, 51% of the population, we were not included up to 1993. And this happened like almost a hundred years because women during pregnancy were given a specific drug. And when women were advertised for this during pregnancy for morning sickness, and this was like, again, a hundred years ago, they did not account for the fact that it could affect the baby, and then a lot of birth defects happen. And from this situation in Europe, now, you said we're not counting any women into this. And that's how we were kind of like, that's kind of the history of why were we negated entering into actual research, right? And so much research has been done, and we are like, we're little men in research. So that's like the concept. And we are not. We, as the 51% of the population, carry receptors for estrogen, progesterone, and testosterone in every single cell in larger amounts. Our life, when we are getting into puberty in our reproductive years, where we are like, we have to have a little child once, twice, three, seven times grow inside of us. They really depend, like our whole system, our whole universe depends on these hormones to sustain us. a different life, right? And that's why every single organ of our body has that many receptors of these hormones. So when we go through this transition, and it's the same transition that we understand in adolescence, teenage years, that they go through this roller coaster, that's what we're experiencing right now. A roller coaster shift of hormones as we go out. When we were trained in med school, they said, oh, it's going to happen. It's menopause. You're in perimenopause, menopause, and you're done. There was no research. Nobody taught us in med school. Nobody told any of my colleagues in OBGYN specialty. Even they don't have all the training, right, of what it is to go through this transition. Now, little by little, we're educating ourselves. We're understanding the menopause society is training physicians. So menopause society is actually certifying physicians that want to train. And not only OBGYNs, I have a gamut of family medicine practitioners, integrative medicine, like you name the physician that is touching women in some kind of way, I hope they get educated. I hope dentists get educated to recognize the symptoms, right? When these shifts start happening, estrogen drops, right? And especially in the brain, the brain has a lot of receptors for estrogen. And when There's no much estrogen. You know, those receptors are like Marco, Marco, Marco. There's no polo coming back, you know, and that is the transition that we go. And sometimes it's like really high and sometimes it's really, really low. And the symptoms go through there. Why is this? And we call it is like if we take the veil of. always trying to please everybody and always trying to say yes to everything. As women, that's what we want to try to do. We're nurturers. We're like, that is our nature, right? Because we are trying to sustain life and to mother our babies, right? And therefore also our baby, our older babies, which are the husbands or the partners, right? If you ask every single woman, they will consider their husband, their baby as well. This veil lifts up. The drop of estrogen kind of has this condition of like, oh, I don't have to start pleasing anybody else. Like, I'm on my own. This is it. I had it. Like, why do I have to go the extra mile, 10 miles, 100 miles? Most of the time, our kids are already going in through teenage years. There's a lot of birch right now where a lot of women that are in their early 40s, mid 40s are now trying to conceive. So they are like entering a different stage. And it's these two co-founding things that we're seeing, right? But even for us that have the kids on teenage years, it's like they're going through their hormones, moms are going through their hormones, and we are like at it, right? Or we have the little toddlers with their tantrums and moms are going through it. That's you. I have both. I go from 17 to 3, so I really get to do both, which is so fun. So you're understanding the reality of both sets of mothers right now. And that is the reality, right? But there is that shift of when estrogen comes down, we start giving an F about a bunch of things that before we cared for. We were like, oh no, I'll do it. No, mommy will take care of it. Mommy ain't taking care of things right now. No, I feel it. I feel it. So I think that was like kind of the first, my first awareness that something was up was was sort of this like perspective shift that happened. It was the sleep, a little of the insomnia, you know, that was a weird one because I've always slept really well. But when I kind of was like, you know, before if my kids were like, I'm hungry, mommy, I need a quesadilla, like stat. I would be like, okay, baby, I'm on it, you know? And now I'm like, you can make a quesadilla. You've got this. So, yeah. Or dad, go do it. Or your oldest- Siblings, got it. I have plenty of older kids who are so capable. And I think that making that shift, I don't know, maybe that's a biological function too. Like maybe us always doing everything for everybody isn't actually great. Maybe they do actually need to learn how to do things for themselves. I don't know. There's got to be some sort of evolution happening in this message, you know? Burnout? Burnt. Yes. For sure. But it's very interesting to tie it down and understand biologically and physiologically why are we going through this change that is mentally we're like, yeah, no, I ain't making that quesadilla anymore. Right. Unless you're dying, right? Unless it's like survival, right? Yeah, yeah. Oh, for sure. Mom will always be there. five or three, of course, mommy's going to feed you. But if you're like 12, 14, 16, 17, you can make your own food. It's going to be, you got this, you know how to make things. We've gone over this. I've taught you how to do these things. So, you know, I definitely, it's so very interesting to me just how it's shifting me, you know, at 45, that's when I started writing the manager, my book. And I felt this like shift in me, this like pursuit of legacy. Yeah. Leaving something behind for my kids, leaving something behind that tells my story for my grandchildren. You know, all of a sudden I felt like, hey, I'm not always going to be here. And I feel like that might have been some hormonal shift, too. But do you think perimenopause is changing more than hormones? Absolutely. Like the attitude towards life is 100 percent. It comes from that. And it is the fact that we are going to live a third of our life, more than a third of our life, three thirds. of our life, almost like, right? Outside of this scope, because women are living longer nowadays, right? Longer than men and longer than we ever lived, right? So it's like, what are we there to do? We are not here just for our reproductive years, right? And it is this shift on who are we? And you used a word that is specifically what we should use moving forward is our legacy. What are we going to carry from everything we've learned up to this point? There's other species in other animals, right, that go through menopause. Not too many go through it. There's five identified. And they're all matriarchal, matriarchal, matriarchal societies, right? And it is when those elder women or females take over They don't compete with other women anymore or with other females, right? They just take over the survival of the species, of their species, and they start telling the stories. And as elephants, they guide where they're going to eat, where they're going to be the safest. They protect the youngest. They always protect the youngest and the female in the group. So it is beautiful to understand, even though humans in 2026, we are not a matriarchal society anymore. That is where the shift should be in you from now on. Biologically, this is our shift. This is our fulfillment at this point. You're not broken. It's not the end of your story. This is where the story becomes beautiful. This is where the butterfly, and I see you have butterflies in the back of you. I do, and you're making me cry. It's beautiful. But this is where... metamorphosis happens, right? I don't know if you've seen the cocoon stage. The worm has to liquefy to then become a butterfly. And this is the moment where we are right now. It's time to shine. It's time to lift that veil. And really, how do we share our stories? How do we carry our legacy as matriarchs that we are and move forward, caring for everybody? And this is something that I think it's wrong in society right now where male think that we are here to attack them when we know all along we have different roles, but us being dismissed is not for debate anymore. You know, it's like we're here to stay. We're here to change things because we care about our communities. We care about our children. We care about compassion. And we can do this correctly, either in business, either in whatever it is that we're going to do. We're here to do this in our own way. I love it. Yeah, this was this theory came from the grandmother hypothesis. There was actually a science, a researcher who came who has now there's been a few books written about it. I had no idea prior to researching this episode. But my gosh, it's so interesting that we, from an evolutionary perspective, that there is now evidence that humanity is missing out on one of its most important facets, which is the leadership of the wise woman. Up until this point, I feel like women of a certain age are just completely dismissed. They become invisible. Your hair goes gray and you can't see you anymore. I think it's time. The Apaches have given a prophecy and they talk about the time of the grandmothers leading the way. And I always I always am like, when will that time come where the grandmothers are leading the way? That's us, baby. It looks like us. Yeah, I am a grandmother. I have two grandbabies from my step from my stepdaughter, my oldest. You know, I'm ready to, you know, absolutely. Right. It's we are the grandmothers. We are leading the way. Yeah. And this is what 2026 grandmothers or step grandmothers are doing. are coming and showing up in our unapologetic way of doing things. I'm grateful for our previous generations that allow us to be these disruptors in women's health. We're not taking shit anymore. And pardon my French, but it's like, you know, and you see it. Hailey Berry was very, very loud in Hollywood, right? That started that revolution. Tamsyn Fadal as a reporter has changed everything. The way that we approach perimenopause, not saying that we're in perimenopause or menopause, we're not saying it like this anymore. We're being loud as AF. We are proud to say this. We're in the transition. We're able to communicate what's happening. And I think that that is what we are achieving with this conversations, right? It's like, if we didn't know it was coming, how would we know, right? But we saw it. More anxiety attacks, more panic attacks, more suicide actually happening, more women leaving very high executive, like all types of jobs. Women just like giving up on themselves because obviously, even medically, there were terms that they were used against us in this period. Oh, be careful. There comes the woman in her 40s. Just beware. Medically, internally, there was a huge bias. It's like, watch out, here comes the middle life crisis lady. Biologically, we are not going crazy. We're just going through a shift of hormones, and it is time to address it. And this does not mean only being in hormone replacement therapy. It's a whole combination of things that we have to start addressing. approaching and seeing it differently. I love that. What else do you recommend? What are you doing? Yeah, so again, I am surrounded by incredible physicians, researchers that have done the previous work. Dr. Jessica Shepard, an OBGYN that is specialized only in women's health. Her book is called Generation M. I mentioned Tamsyn Fadal. She's a journalist, a reporter. She has a beautiful podcast that is like she'd interview everybody in the realm of this. One of my personal favorites, Dr. Vonda Wright, she is an orthopedic surgeon. And you'll say, what does an orthopedic surgeon have to do with perimenopause and menopause? Well, women have fractures, bone fractures at older age, right? And a bone fracture... and can determine how fast you're going to die. And the quality of life is horrible. The faster we get lifting weights, like actual lifting weights, not the cardio bodies, we are going to strengthen our muscle and the muscle is going to protect the bones. And this is probably one of the biggest things if we're going to do something is starting from there, being active. Stop being afraid of lifting weights. You're not going to get bulky. There's nobody going to, believe me, people try their hardest to get bulky. You by yourself starting lifting weight are not going to get bulky. So either with a personal trainer or there's so many things online or even her book, Unbreakable, also an audio book, has a guide of how you can just by jumping 10 jumps a day, morning and night. two times a day can increase your bone density. So getting a DEXA scan, seeing where is your bone density early on, where's your bone density, your muscle density, your visceral fat, because all of these things change throughout this transition. More fiber. And this is good for everybody, not only for women, but especially for our changes, including more fiber. And fiber doesn't come from the powder fiber. It comes from actually eating your whole foods, which are plants. And where are the plants? Like the plants are the only ones that carry fiber. Which are the plants? Vegetables, fruits, nuts, seeds, whole grains. Like these are the things that actually have vitamins, minerals, antioxidants, phytonutrients, and fiber. So these are the things that we have to start. Now it's now or never because you really want to ensure your quality of life for a future era. And better you, right? You said you have babies that are three years old and 17. You want to be and show up for the three-year-old the same way that you're showing up for your 17-year-old. This is, we can do it. It's never too late to start doing these changes. It's never too late to take a hold of your own, you know, faith on the future. I love that. It's so true. And little changes add up. And you're right. You know, we course correct now and then we end up with a more health, you know, because you live a long time. But do you want to if you're in poor health and you're living in a nursing home? You know, you know, thank you. Like, I want to live a long time, but I want to be healthy the whole time. The difference between lifespan and health span, which is now being studied so much more by physicians like you, research scientists and, you know, all the anti-aging people. It's very interesting stuff, you know, how we age. Taking a handle on our muscles and our bones, it is one of the biggest priorities because we have the most amount of fractures. They're accidents, right? It's like you were not intending on slipping and falling or tripping and falling, and now you're in a fracture. And a hip fracture is one of the deadliest. Like in a year, you are kind of like statistically, if you don't have that much muscle and bone density, That's it. Right. And it's like it's awful because you would have had a longer lifespan if you would have tackled early on. So getting a DEXA scan, which is simple. You don't need to wait till you're 65 and over, which is when insurance will cover. Right. So get those. And this is one of the most interesting things also that I learned. A friend of mine at 35 was diagnosed with osteopenia. Osteopenia is the low amount of density of bones. So you don't have to even be over 40 to know that that is where you're at. Get a hold of it. And that's what I'm like. I'm like 35 and over. Who has their notebook? Who's taking notes of your symptoms? Because they're happening. What I said before, right? Your ethnicity has a different time frame of perimetopause symptoms, right? Wow. So I'm mixed. So we'll have to see what happens with me. My mom's white. My dad's Hispanic. So I'm always I feel like I'm like a tester pancake a lot of times. I'm like, oh, who's which which whose genes am I going to express on this one? But for the Latinas community, for example, is eight point six years of perimenopause. Black women are 10 years and Asian women have the shortest on four years. But also the symptoms are very different. Not who are alike. Yes, now we are more mixed and there's different genetic components that are doing. Our epigenetics are shooting the shots, even though we're the same age and maybe we're raising the same and maybe we have different parents that are the same. You still have different ways of how the symptoms are presenting. Taking those notes, having your own little... And now with the apps, it's so much easier to track those, like... The aura ring now has a way to track him, right? Or just your notes app. You just have to dictate. How am I feeling these days? Like, right? Periods are going to start shifting in different ways, either longer or shorter. And so many, so many things. Heavier. Oh, my goodness. That's what I was surprised with, the heavier periods. Like very, very, very different than anything I've ever seen before. So what symptoms are most commonly overlooked or dismissed in perimenopause? So now there's a list of 150 symptoms. What? 150? Where can we find that? I guess we could just add chat. I think now they'll be more described in the common literature. But again, I really invite you to go look for either Tamsyn Fadal. She just posted today. So that's why she's fresh in my list. But there's cardiologists right now that are so into making sure that we are aware that heart attacks are killing the most amount of women. Women always think, oh, breast cancer, right? But a heart attack, you would never think That because you enter perimenopause, you have a higher risk now because your estrogens dropped, your progesterone dropped. You are in a higher risk for a heart attack. Did you know that? No, I didn't. And women are not aware that those are the things that can happen. GI symptoms, right? Itchy ears are one of the... Itchy ears. Why? Those ears are... So why? Because estrogen drops in the skin by itself, not only the inside of the ears, but all over the skin becomes more flaky. So it's thinner. So it starts flaking. And those are like the weird, let's say, like the weird ones, right? But you name the organ, you will find a symptom. Gum disease, losing teeth. Wow. Who would have thought? And then you start looking back and then you ask your mom, ask your grandma, ask your aunties. Do you ever experience that? The higher anxiety, you know, brain fog. And right now, Menopause Society just recognized last year that this feeling is included in the symptoms. I don't feel like myself. If that is your symptom, let me tell you, baby girl, we've entered the chat. Yeah, I think that that's a really common one. Why don't they feel like themselves? Is our brain chemistry changing? Is this changing our brain like pregnancy changed our brain? Yes. Yes. It's the hormonal impact of why you don't feel yourself. Yeah. Right. Because the shifts on estrogen and progesterone are doing different peaks trying to adjust because estrogen is coming from your ovaries. So your ovaries is like your ovaries are not producing the amount of eggs that Those eggs are the ones that will produce the amount of... It's like a little circle, right? So the brain says, oh, I didn't get enough today. Hey, guys, is anybody doing anything out down there? And then why your wall in your endometrium and your uterus starts growing thicker or bigger because it's like trying to signal, hey, nobody hurt me. What's happening? So you're seeing... thicker periods or more blood clots in your period because the wall got thicker because your brain was signaling down. And it was not until it happened to me, I was freaking out. I did not know what was happening with me. I've been like a little perfect book. You know, every 28 days after I delivered my baby, it was every 23 days. But it's like, it's like a harmony. My hormones always being like so perfect and pretty. I know I come from a privileged place because I know so many women are not like that. But when I got to see those blood clots, I was like, did I have a baby? And I just did not know. Like, I don't think so. Like, there was no possibility. Like, it's like, what is actually happened with my body? And I'm such a content creator. One day I will be posting what I, it was the wildest blood clot. It was probably like this long. It was thick. And I had already wiped. I stood up and I was like going to pull up my pants when I just felt the blop. And I was like, I had to stay like for five minutes of staring at this. And then I grabbed my phone. I was like, I have to document this because I have to send this to my friends. I am lucky again that I have so many friends that are in the perimenopause menopause space. They're my physicians and I had to send it to her. I'm like, is it normal? Like, is this part of what people are saying and talking about? Like the changes? Like, is it me? Am I bad? completely broken? Do I have to run to the emergency? A few friends like sat me down and really explain what I just explained, right? Is this crazy interchange of hormones going up and down, the brain not getting it, the ovaries are like dying down, like, you know, like the live of those eggs are coming down. So they're not producing as much. And therefore, all of the symptoms change, including the brain chemistry, as we were saying, right? But in the gut as well, like we're Start losing hair, frail nails, itchy skin all over, not only itchy ears, right? Right. Whoa. So what should every woman know about perimenopause before she gets there? First, that I think what we have to and what we're normalizing is that it's a transition process. It's the same transition that happened with us as when we were teenagers. We have accepted that. We are training our kids that are going through it to recognize that, oh, you're in rage right now. It is not you. It is your hormone change. So always take a second back to understand that biologically you're being impacted and this rage that you're experiencing, right? Listening to your husband eat Cheerios and wanting to kill him because he's just eating or because he's just breathing. It's not you. You're not broken. He didn't do anything to you. It is the transition of the hormones bringing your family into this reality and telling them, hey, guys, I just learned today. I heard this podcast. I just learned today that if I am over 35 years old, I think I'm broken. I think think I just screamed at you or all of this is not me. It's what's happening to me. We recognize it in the teenagers. We recognize it through pregnancy too. The mommy brain, right? We do understand. We talk about it. We, you know, it's explained. It happens to us too. So it is, I think having more of these conversations is normalizing the fact of where we are and listen to a podcast, a physician friend. family medicine. Like she's not an OBGYN, but she was going through it. And she said that she sat her kid, the teenage kid, the husband and the whole family and said, hey, let's use a word for when mommy is acting a little bit weird so I can recognize because I cannot see it. Right. So they use the word pineapple. So now gently the husband or the kids say, mom, I think you're in a pineapple time right now. So, you know, creative ways of us bringing that conversation to who are around us because we will fail. We're humans, right? We don't know what's going on. And as you were saying, like they see our gray hairs and we're dismissed in work. We, you know, we're not valuable anymore when we are the most valuable at this age. Yeah. I mean, this is when we come into all of our wisdom and our knowledge. We have the best stories. Collectively, at this point in our lives, we've gathered tremendous amounts of experience. And in traditional matriarchal culture, we would have been revered. And this would have been a very important time for women. And instead, it's really sad what I've seen through the 80s and the 90s and the early 2000s with how women are treated as soon as they get old. You know, it's like in our, I live in California, you can't get old in California. Like our policy on aging is don't do it, you know? So it's, you know, to be able to kind of come into a time where we could actually recognize each other as women first, we're going to have to do it with each other first. And then the men will follow our lead. I think, you know, if we can recognize that this is just like going through puberty, but what's actually biological happening to us is that we're coming into this time of cultivation, where we're coming into this time of legacy, of teaching, of stewarding, of now we're stewards of humanity, we're keepers and gatherers, and we are the wise ones now. How beautiful. Right? Now it's a beautiful thing. Now I understand what it is because I have been struggling with this. Like, And it's like an emotional kind of way, you know, realizing that my last baby was my last baby because being a mother, I get that. I owned that. I felt that like that phase of my life that, you know, maiden was so fun. Mother was so fun. But this whole crone phase of life, the mother maiden crone, you know, it's the trifecta for women and not really coming from this patriarchal perspective that the crone was kind of like, discarded she wasn't necessary for society you know and to be able to come back from a biological place with you and say ah no this phase of our life is actually super vital to stewarding and guiding humanity and maybe that's what we've been missing all along maybe that's how we got to this place where humanity is on the verge of breaking it's because we haven't been listening to our elders yeah our our elder mothers, our elder grandmothers, you know, we were burning them at one point because we were going crazy because we were telling the facts because the veil of estrogen left. And we're like, oh, hell no. Right. And that's where we are right now. And I think it's very powerful because now we're fully educated and now we are having this conversation. So now we know now we're going to be fully empowered. And thank God for our generation to open up our mouth the way that we are, because I'm like, How did my mom do it? How did my aunties, great-grandaunties, grandmas do it? How? How did they do it? And yeah, you're going to be going through shit for 10, 12 years. And then now we know that it's more than that, right? Like forever, you will be in menopause. Forever, you will be postmenopausal, right? And forever, if you can... receive a little bit of those hormones to stabilize, you don't need to be dry all the time. You don't need to be itching and going through UTI and VVs like in a cycle. And that's another very big symptom, right? If you are constantly in UTIs or constantly going from fungal infection to a bacterial vaginosis infection, That should be the sign. And the fact that the OBGYNs don't pick it up, it's because they were not trained. So it's not their fault. But, and here's the big one, if there's something you're going to take from this one is you have to start advocating for yourself. If you've had this OBGYN that you love, that deliver all your babies, they've done a great job up to that point. But maybe they have not been trained. up to date with the education on perimenopause and menopause. And therefore, it's not their fault. It's not that they don't want to. It's that they were taught to dismiss our symptoms and say, no, go have a bubble bath, have a champagne. It's all good. It's all in your head. Change the doctor. There's so much resources right now. There's two beautiful online resources that we can have. The Menopause Society, if you go to the Menopause Society, to the zip code, physicians, at least all the physicians that have been certified by them. This is in the U.S., obviously, right? And also online, there's two different ones, MediHealth and Alloy, that you'll have telehealth conversations with physicians that are qualified to help you in this and yes just just keep asking just keep advocating for yourself because you are not going crazy it is not your fault you did not lose libido and desire and if you are not getting wet or aroused it is not your fault it's biological it's a biologic response that can be addressed and we don't need to be suffering we need to be enjoying I love that. Yeah, because the sexual symptoms, the sexual symptoms of this perimenopause and menopause can be very detrimental to your relationship. It's so nice to be able to have a continuous, happy sexual relationship with your husband, your partner. And I feel like that's one of the saddest things that I've seen with some of the older women who haven't really been treated or properly by their physicians, who their physicians were uneducated, is the fact that they basically lose their ability to enjoy sex or even have sex. And that's, you know, no thank you. Correct. And interesting that we immediately think about the older women, right? I just got approached by a 36-year-old girl. I mean, in my eyes, she's a girl, right? Yeah. But because she's Latina, she is in this 8.6 years, right? Nobody taught her. And she's like, my husband is telling me, is it my fault? Do you not like me? Imagine the pressure, like on top of all the anxiety and the brain fog and everything, to have your partner think that it is their fault, that you are not attracted to them. When it's like, I don't even know what's happening to me. How can you say, no, I love you. You're my partner. No, I, and then you're in pain. Like women describe having sex as if there's porcupines inside, like because estrogen, estrogen and progesterone dropped, testosterone dropped, and it's dry. The same does happen in your skin. And why is it itchy? The same happened in the mucosa inside of the vagina. So it's like, it's very simple strategy to treat. Again, I'm not a physician. I recognize that I am not treating these women, but the books are there. It's very simple. Like the estrogen topical creams can be accessed by many, many ways. And, you know, it's like, okay, if we normalize the hormones or what it does, if I can explain the HRT that I've learned. from my physician friends. Yes, please explain it to us because it's such a big conversation right now in health. It's one that I've been having all month long with the Manatured Health Series. So please explain. So it is supposed to be a small dose for those, as I said, the hormones are going up and down, up and down. And the problem is that when they go really down, that's when you hit those very hard symptoms, right? But if you can maintain with a standard dose, A very standard dose. So it's not like when you are trying to have birth control, right? Those are really high standard doses. These are lower doses, but will not allow your body to hit all the way to the ground. It is that managing and seeing what the symptoms are. So these physicians that are treating us are so incredible because it is a personalized medicine. What works for me doesn't work for Amy. What's for Amory doesn't work for Paula. You know, it's like the doctors really have to start seeing how much will I increase the micronized progesterone, how much, how many patches. Sometimes, and this works for me, is like, When I am PMSing, I have to use a patch and a half, for example. And so this is like the beauty of how personalized medicine is working with HRT. It is not a large dose of hormones. It's just to maintain so the body doesn't hit rock bottom. And you're just maintained with that. Yeah, I have been using a cream that's an intravaginal cream that I do every night and it's got the progesterone and the estradiol and I'm sleeping better. That was one of my biggest symptoms. One of the things that I was the most, it was really affecting my life because if I can't sleep, I don't think and I love my brain. So my brain likes to sleep. So I am sleeping better and I'm not getting like sweaty when I sleep because I was getting sweaty and that's gross and uncomfortable. Yes. No, and it is very common what you just described, that symptoms, right? And the beauty of HRT right now is that it's not only the patch, it's not only the cream. It's like there's different ways of you, again, speaking to your physician, somebody that can work with you on the different ways of how you can approach getting back to that lower normal level because your hormones are still going to be fluctuating. Like this is going to happen. We're still going through it, but we don't have to suffer constantly so hard on those symptoms. Since I started my cream, I've probably been on it like three months. I've really noticed that my periods are getting less heavy. Like they're not like light, but they're not like scary, like crime scene investigation anymore. Cause I used to be like, don't come in here. Like it was a hot mess. So what same with you? Cause your brain is not sending the signals, right? So you're not thickening that endometrium or whatever it What's it called? It is the endometrium. Yes. Yeah. So so it doesn't thicken as much because it's like that. You know, I haven't seen the block plots that I was seeing that I that is care that shit out of me. Me, too. I was having a miscarriage. I really did. I was like, what is happening? Same girl. And I was like, it's always impossible. I know it's impossible. And then try to pass that blood clot through the cervix. I don't know if we know, but the cervix is usually super, super close like this. When we're giving birth, that's the one that opens up to B10 where the baby passes, right? And during our period, it is slightly open. But if you see those blood clots that are so massive, I was having cramps that I was like, I've never in my life had that massive amount of cramps. So imagine being anxious, depressed. Now you're in pain because you're passing this clots. So again, you're not broken. It is not your fault. All of these are valid things. symptoms that you are feeling you're in pain you're exhausted you're mentally like the hell yeah and at least when we were in school, you know, they prepared us a little bit with sex ed with, you're going to be going through puberty and these are the changes you're going to experience. And it's, you know, someone took us aside, but then for some reason, you know, no one takes you aside at any point in your life and says, okay, girls, okay, we're going to make another change now. We're going to go through cougar puberty and you guys are gonna go through the next well amy is taking us there. Thank you for opening up the podcast to take us through cougar puberty. We can do this. I loved that. I saw it on Instagram when actually one of my girlfriends sent it to me and I was like, hell yeah, girls. I like it because somebody needs to call it something besides menopause because that is not sexy. Correct. Yeah. Perimenopause is not sexy, you know, and we're going to be in menopause forever. So might as well. Let's come up. But it took our generation, the Gen X, the, you know, whatever we are. I don't even know what we are. We're like really, really, really late Gen X. I mean, that's me. I'm the transition between both. Millennials and Gen X. I think there is a term for us, but who cares? But it took us to be... in front of the problem to be able to recognize, verbalize it. And now we're so educated that we're really pushing. Melinda Gates today came out with, I don't know if you heard, but she came out with, she's going to put $2 billion into research for women transitioning in perimenopausal menopause. So it's like we are starting, but it takes women of power to make these changes. It's a women physician position. friends of mine, to stand up to FDA and say, we got to take that black box out of our HRT, which it happened. But it's taken us, the educated women, to speak up and to change and reform. And I think it's going to happen for our next generation, right? Our kids. Oh, our daughters will... Hopefully we'll have a whole education. They'll be highly educated. This will be a really common conversation that women have with one another. There won't be the mystery. I mean, it's like you're going off this cliff and no one tells you what's on the other side of it. Because I feel like my best friend, she's five years older than I am. We've been friends since... She was like nine years old when she started going through perimenopause. She's like, Amy, let me tell you, this is real. She's like, and you need to get educated because you are about to go through something super gnarly. And I'm like, really? I was like, you're I was like, wow, you're being kind of like this kind of emotional about this thing. But she was 100 percent right. This is you know, she was like, I can't leave the house. I'm bleeding so heavy like I can't go out today. And I'm like, what are you talking about, girl? Like, is that a thing? And then it happened to you. Yep. That's a thing. But I'm so happy that we're here and we have, you know, we have voices, we have educations, we have platforms, you know, we're, we're visible and we're able to have these conversations in a way that doesn't have any shame around it. I think there was a lot of shame in our, even in our grandmother's generation, for sure. And even our parents, my mother's a PharmD. So of course my mom just did like a low dose birth control pill to transition and during perimenopause. Cause she kind of was like, Oh, I think this will work, you know? And it did. I wouldn't recommend that. No, I wouldn't recommend it. During that time, there really wasn't, there weren't the options available. Um, you know, where you can get no, no. Yeah. I mean, this was 2026. I have so many friends that are like, I, I, I, I asked my OBG and they told me, no, there's nothing approved. And they're just like, no, not there is like, it's just like, you didn't get the further education because now there's society like, like the menopause society that is educating. I mean, there's so many societies right now that are recognizing what is their role in this transition. And I think very soon every single society, As I'm saying, and I'm going to bring in the dentist because I wish I knew. I went to the dentist several times saying, this tooth hurts. That hurts so bad. And they're like, we just run the x-rays. There's no cavity. It can't be just sensitivity. Like, that's the dismissal of that. And now... Me too. I had the same thing. Oh, my gosh. So that's a symptom. I just didn't... Now, every time I'm PMSing, I feel the same pain. So I have like a Lidocaine numbing gel that I use because the pain is real. The pain is paining in the gum, between the gum and the tooth. Yeah, me too. The other day, I recognized it really is. Like as soon as the pain ended, I started bleeding. And I was like, oh, you little fucker. Now I know what it is. Wow. Oh, I know. And you're right. Make a notebook. You know, the more we pay attention to how we're being affected every day and what day of the cycle that we're in, we can really learn a lot about how, what we should be planning for those weeks, what we shouldn't be planning, like even like the heavy workouts. Like I want to work out heavy, a couple weeks out of the month and then work out lighter the rest of the month because I want to honor my body. I want to honor my cycle. I'm having like the biggest personal dilemma ever. in my brain, right? It's like, I know all of this, I understand all of this, but I still, my little brain that wants to train so hard because that's like, I go to the gym is my therapy, right? And lifting really heavy is my therapy. And lately it's been like, you know what? I feel good on just resting and having that dilemma of like, you don't have to beat yourself up because you are honoring what you're, you know, I'm honoring what my brain brain, my whole body is asking me to do, which is rest. And some days I feel like I want to go and train and it's, and I do it, but I'm not, the consistency has dropped down and it's that internal chatter that it has to change because it's okay. It's okay. We're handling a lot. In honoring and kind of knowing where you are in your cycle, I think that there's been a lot more conversations about that, like on social media, when you're in your luteal phase versus what's the other phase. But my nanny and I, she's like my bestie. We talk all the time. We call it the morning debrief. I said I was teasing her that we should have a podcast together because we like talk about everything that I talk about on my show. I love it. And she's like, well, you're in your luteal phase right now. That's why you feel so good. And I'm like, and she's like, and it's really nice that we're not cycling exactly together right now because you're feeling good when I'm not. So we're always kind of filling in for each other. But there's something about the knowledge gap. of your body, of the science, of what's happening to us. It was like, you know, when I got pregnant, I read like a thousand books on pregnancy because I needed to understand what was gonna happen to me, how this baby was developing. I read so many books on birth, like it would blow your mind. Like I read every book about birth that was like available to me. And I felt like with, I haven't done that kind of research on this phase of my life. Yeah, why not? Like a girl like me who reads about everything, if I'm going somewhere, I read all about it. And it's kind of interesting that, yeah, maybe that's something we all just need to grab the reins on and do the research. No one's going to teach us unless maybe, I don't know, we find some girls and we put together a class on it, which would be kind of fun. Yeah. I just, I'm staring at one more book right now, right in front of me. It's called Hormone Habak from Amy Shaw. Like the resources are amazing. so incredible around right now. Like, so it's, this is what we have to do. And, you know, some people don't like to read. Okay. Put it, put the audio book. Listen to the podcast. There are so many incredibly qualified women that are sharing the knowledge, the real knowledge, the real experiences, the real scientific facts around that it is up to us. We have to start educating ourselves to then start advocating for ourselves because, and I'm going to repeat it, I'm going to sound like a broken record. You are not broken. It is not your fault. You're just going through a transition and you're just going to have to adapt the same way that you adapted through it. adolescence and you had your teenage days and years and you were raging and then you came back to your senses, right? And going through for the ones that got pregnancies, right? Just going through the whole pregnancy and postpartum, he adapted. He learned. This is just another stage of those adapting times. But we're coming back stronger. And I think if we can repurpose this as this is where we sit. in power because now we are knowledgeable. Now we can share what has changed. I love that. I love that. And can you tell me how we got with this fear of estrogen that some of these doctors have? What happened? So there was a study, the Women Health Initiative, it's called WHI Initiative. It was early 2000 and the NIH went to study and it was It was a big study. It was a big published study. And the results very early on start coming as, you know, cancers. There was this like, they sat all the media down and said, we're halting the study. This is it. We're not doing this. This is harming women. We're going to stop. And from that point on, the doctors that were training the new generation of doctors said, this is it. We're not touching. We're not. And if you are going to touch women, You come in and then you go out. Like you immediately get out of hormones. Fast forward 20 years. We are seeing the study and we were the ones that know how to review data because now everything is data. Now we know how to interpret all of this type of test. They brought too many women into the study that were past the time of perimenopause. They were like most of the women were 10 years pregnant. past menopause. So they're in their 60s and 70s, 50s, 60s and 70s, mostly 60s, and have pre-existing conditions which were not accounted into the research. So these things were never explained. They just halted and they said, it's the worst thing that can happen. And obviously, I recently, so this weekend, I attended a conference and one of the The physicians that was navigating the panel of women's health said they even fear mongered the physicians saying, if you do not stay away from the hormones, you are going to be considered a witch doctor. The pressure was not only a pressure on get out, but you will be mocked from the medical community. At that point, the universities, the residency programs, and everybody in the community said, okay, we're not going to touch it because it is that dangerous. A small group of people said, wait, let's review this data. And as the years progressed, they're like, look back, let's review the data. The other point was they were reporting not the absolute, it's like the risk, right? It's how much risk there is of taking it. So there is a percentage and then the absolute. So they were just reporting a percentage. And that's like the results were like, oh, my God, we are having this illness associated to this. When it was like, no, it's like it's a percentage of it. But the way that it was translated to the public, it was like, this is it. We got to stay away from it. And that still carries very heavily into COVID. those doctors that you're seeing every day, the ones that, you know, you had for all your pap and checks and your daily or yearly checkups, right? The ones that deliver your babies. Most of those doctors, if they're not being up to date with, because there's a lot for doctors to do, but if they're not being up to date with a perimenopause and menopause new research and understanding, they didn't get to hear this, right? And it is a lack of a bulk of specialists that don't have this information. So there was a lot wrong with that study. There's a lot that was not clearly explained to the population, not only to the patients, but also to the physicians that are treating patients. And now that we're seeing, it's like you really did wrong to a generation of women that took away the possibility of these women for 20 years almost of being treated. And here we are. We're right now not accepting bad data, bad interpretation of data, bad interpretation of the population that was included in that research. The intention was good. But if you're not actually looking for all of these things, then how are you interpreting the data like that and the risk? What about the actual hormones that were used? Are they different than the bioidenticals that we're using now? Thanks for pointing that out. That is one of the things also that the type of hormones that were used before is a complete different way of how we're managing hormones right now. That the structure... the ways, the percentages, and the way of administration, right? Or at least totally different than your estradiol patches, the gels or creams that you're using, the micronized progesterone that we have right now. So they cannot be compared. As I said, there's a lot that was wrong with this. Again, the books that I am dropping in the notes and the podcasts that we're suggesting will go really in depth with all of this. That's awesome. If women's health research were fully funded, what questions would you most want answered? I think this past week, which is finally, PCOS was renamed as PMOS, which is a metabolic state. It does not come from the ovaries. It's really metabolically, right? So this is where it is. This is where we're changing. We're changing regulations, legislations. We're changing the way that we're treating. It does take women to lead the research. women to lead legislature to be able to transition this thing. So women don't feel like they're alone, that they think they're crazy. Like endometriosis, for example, is one of the, it takes seven to 10 years to be diagnosed with endometriosis. That means that every single month that you're bleeding, you have a pain times a hundred of what normally we experience in a normal period. Because endometrium that we talked before, that tissue that's inside of the uterus, it should only be inside of the hormones, it grows. And if there's no baby, it drops. But it drops into a canal that has an outside, right? Endometrium, this tissue, can start growing in other parts of the body, like that don't have an exit. And they grow the same way because they're exposed to the hormones, right? They grow the same way and they drop. They shed. And the moment they shed, there's two things happening. One, they're shedding and there's blood And the blood itself is very acidic, very harsh. So where is that blood sitting? In all the tissue that's around. And we found endometrium in the eye, in the lungs, in the pleura, which is between the lungs and the abdomen, in the intestines, in the colon. It is a complex condition. But imagine it takes 7 to 10 years for these young women to be diagnosed and they think they're going crazy. Their doctors think they're going crazy because it can't be that you're in that much pain. Yeah, they are not going to work. They're skipping school. The normal painkillers don't do anything. A hot compress or, you know, they don't do anything. And again, it's just... Thank God for women surgeons that are tackling these things that are also advocating in social media. Right. Absolutely. 100%. So I want to talk a little bit about what you're building, the company that's focused specifically on women's health research. What inspired this mission? And just tell us about it. I'm so excited. This is interesting because I've never done a podcast where we talk about only parametopause and menopause for an hour. Which is not my specialty, right? It's like, as you see, I'm very vocal and very passionate because women's health is so forgotten. But my specialty is regenerative medicine. I've been working for 20 years in the field of stem cells. Again, it's this mix of the passion of women's health with my specialty and what I've learned. learned, published, and educated myself and built the biotech company on this is that I finally want to focus on making sure that we transition this through real science. So I'm building another biotech company right now, not only for women, but Yes, having women's health and women's research at its center is one of the biggest things that we're trying to push now. That's so exciting. What are the biggest unanswered questions that you'd like to answer with your research? I'm fortunate that In the second big biotech company that I built is a fertility company is another big subject that it's that we have not been able to educate the public about. I feel like since we are young, we're taught how not to get pregnant. Right. They're drilling in our heads. Don't you dare to get pregnant. Don't get pregnant. And it's always a female responsibility. Like, yeah, sure. We're the only ones making those babies, but. Nobody taught us the importance of the moment that you're ready to get pregnant. What are the things that you're supposed to be doing, right? So I'm building actually two companies. One is a metabolic health company focused on fertility, making sure that you are metabolically healthy to get to the point of conceiving. That is one beautiful project that I'm working on. Hopefully soon launching. By the time this podcast goes out, hopefully it's out. And then the other one is specifically with the research that I'm doing in regenerative medicine. We have two approved IRBs to study fertility and use in regenerative medicine. It's very complex. So I'm like, I don't get it yet. You got to dumb it down for us just a little. Not too much. I'm sure there's like a lot of intelligent scientific women out there that understand what you're talking about, too. Yes, absolutely. For 20 years of study, the cells, stem cells, stem cells are cells that are undifferentiated cells. This means that every single cell in our body is specialized to do one thing. But stem cells, they have no specialty, right? They can be and become different. any cell in our body. Stem cells have been used for many different things. Right now, the amount of publications and studies through stem cells are as vast as every single cell exists. And every condition and therapeutic condition has been studied with stem cells. And then stem cells, we've learned that stem cells communicate with each other and with the rest of the body through the messengers. So it's like our voice. right? It carries a message. And the way that it communicates, the cells communicate, is through these small vesicles that are carrying the information inside. And those are called exosomes. Exosomes are this really hot word in the aesthetic market. It has become like this very, very hot word. But It's important for you to understand where they're coming from. So exosomes are coming from cells, right? Especially if you are working with stem cells, those messages are coming very regenerative messages, right? So that is my specialty. I've been able to work with FDA on drug approval for specific drugs that are carrying these specific messages. And now focusing, because of the fertility path that I went through, is trying to focus with those exosomes in fertility. So I got two clinical trial IRB, which is a board that approves the trial to go through to study fertility. So very exciting project because it's Very cutting edge and trying to see how much can we advance the world of fertility with the intersection of the specialty that I have, which is regenerative medicine. That's so interesting. I don't think a lot of people, probably not anybody, is really working in that exact intersection of fertility and stem cells. That's quite the specialty, Dr. Mari. Yeah. I always say I'm such a proud nerd. I love what my brain does and the way that my brain works is so unique that I can geek out all day long. You were raised in it. You were raised in it too, right? Like your mom and dad have been doing this kind of research for a long time, right? My dad is a physician. He's been working for over 45 years in preventative medicine. My mom runs the place. So she's the CEO of the clinic. But yeah, they've always seen the lens of medicine through not the little square box. They've always been Outside of that box, seeing it. And it's very interesting to see how today a lot of the techniques that they've been using for 45 years are now becoming a hot thing. Like it's like it's so innovative to do this and that. I'm like, well, I. But they're not here in the U.S., right? And that's so they haven't been limited. No, I am from Ecuador. Yes. Yeah. And my dad has not done research properly, like the way that I am doing, right? He's a clinician. So he sees patients. He's seen, you know, for 45 years, seen all types of patients. But he doesn't run trials and clinical trials. Yeah. Well, it's interesting. Well, we were not able to run clinical trials in the U.S. for quite some time after the Bush administration. The second Bush administration kind of banned stem cell research for quite some time here. So it's nice to see that it's back. We're doing this. It's back. And you're in Florida. Not only that it's back. Yeah. So it's not only that it's back, but Florida became the first place. state to approve stem cell injections, right? So yeah, it's been interesting to navigate 20 years of how this field has transitioned from like, oh, it's experimental. Well, when i stepped in, it was you're right it was like they equated the word stem cell with killing babies. And it was a political move from the administration. And that was it. Like the public just got to hear this debate of if the word stem cells is used, then you're equating with you're killing babies. When We have stem cells as adults. There's stem cells in the pulp of our teeth, in our belly or fat, adipose tissue, in the bone marrow. In our menstrual blood, apparently. In our menstrual blood. One of the most regenerative stem cells are there because it has to every month repair to fully. So now to being able to study to understand that. But it's taking women researchers to... to move the needle on that, which is so fascinating. I cannot wait to get my hands over that type of R&D. The specific field that I got specialized after working with your own adult cells is the field of placental-derived stem cells, which are those cells that are collected only in the O.R., Only after there's a live birth, so mama and baby are okay, mama and baby are perfectly healthy, and they're deemed perfect donors for that tissue. That's when we collect that tissue. It goes through all of the FDA and AATB rules, and we're able to collect those cells, amplify those cells, and then use those, either the cells or the messengers of those cells, to be able to dose them in a drug form. development, you know, manufacturing into drug and specific percentage, quantification, qualification, and then running the clinical trial. So that is the field where I'm in. That is phenomenal. So if we're having this conversation 10 years from now, what do you think would be dramatically different for women? What do we have? I, my women, to not being so much pain or dismissed for so many things. I'm sure there's still so many conditions that we have not realized the impact of just not adding us into research. What has done to those conditions? I can't think of them. But PMOS and endometriosis are the ones that really light up my... It's like, what else can we advance at that point in diagnostic and treatment? Because it's not... one is better, right? It's like, how do we advance the whole field to understand where we're at? Absolutely. Yeah, I know. I have a nurse, Mel, who really wants to meet you, by the way, Melanie Mansell, and she's passionate about getting some women's studies powered also and doing some fundraising for that. So I want to get us all connected to see what we can do to, well, you know, it looks like Melinda may have come to the rescue on that one with the money. On the perimenopause. Oh, yeah. On the perimenopause. Yes. Yes. But there's so many things like we've identified. So right now, a Part of our project is to be able to really collect the funds, but also canalize them to the research that is advancing women's health, but also that is run by women. Right. So I don't think I should point out the research studies, but soon hopefully I can disclose what are those. But just identifying those, identifying the researchers that are like they've said, you over and over, you know, men or VCs, VCs are run by men mostly, VCs are not funding us. And the projects are like, Todd, just imagine if we funded this and in five years we got a drug approval of this. Not only will it impact women, but it will impact so many things. So I think, please connect me with your friend because we're going to be best friends. I'm just excited about the synergy that happens when women start talking about health together. Yes. The manager is all about all the things we manage. And now we're talking about manage your hormones and how to manage your health. But this is, you know, managing your conversations that you're having and that having these kinds of high level conversations, listening to these kinds of high level conversations, continually learning, you know, you're amazing, Dr. Mari. Thank you so much for being on the show today. You are one hour and 20 minutes in and we could just keep going. I know. I love you. It's going to be two episodes. Are we chopping it into? 100% you're coming back so we can talk more about stem cells. But what I loved most about this conversation is that it challenges a story many women have been told for generations that menopause represents decline, that aging means becoming less relevant, that our most important contributions are behind us. But what if the opposite is true? What if perimenopause isn't simply a biological transition? What if it's a leadership transition, a transition into greater wisdom, greater discernment, greater authenticity? Because as both Dr. Mari and I discussed, there is something happening during the season that goes beyond hormones. There's a perspective shift, a clarity, a willingness to stop living by expectations and start living by intention. And perhaps there is a reason women live decades beyond fertility. Perhaps women don't live beyond fertility despite evolution. Perhaps women live beyond fertility because of evolution. Perhaps humanity needs mothers. But perhaps it also needs grandmothers, mentors, teachers, healers, leaders, wisdom keepers. Maybe menopause isn't the closing of a chapter. Maybe it's the beginning of the matriarch. Maybe the season isn't about becoming less. Maybe it's about becoming more fully ourselves. Maybe our role evolves from creator to cultivator. And maybe some of the most important work we'll ever do happens in the garden that we've already planted. And before we go, I want to give you a little preview of what's coming next on The Manager. Over the past month, we've explored what it means to manage your health, from peptides and hormones to functional medicine, regenerative therapies, and the future of women's health care. But one theme kept showing up again and again as women gained clarity. about who they are and what matters most, something begins to shift. They become more willing to use their voice, to share their story, to speak their truth, to step into greater visibility. And that's exactly where we're headed next. Throughout the month of July, we're launching a special series called Podcasting as Thought Leadership. Together, we'll explore how women are using podcasts, media platforms, storytelling and authentic conversations to build influence, create opportunities, expand their businesses and amplify their impact. Because sometimes the most powerful thing you can do isn't start another project. It's start a conversation. And as we've learned throughout this series, leadership isn't just about managing your health. It's about managing your voice. That's all for now. I'm Amy Riccobas, and we'll see you next Monday for our next episode of The Manager. Dr. Mari, before we go, where can everyone find you? Yeah, thank you so much. First, thank you so much for opening the space and for your beautiful words. I can see how much time you spent on actually putting this together. You being and getting emotional just shows me that this was so needed. So thank you. Thank you for opening up your heart and your space. And to everybody that tuned in to listen, I am in Dr. Mari, my website, drdr-mari.com. And you'll find my socials. I'm very active on Instagram and LinkedIn. So please do drop comments. through my DMs. I love to chat. I'm always here if there's anything I can help you or find the resources for you. I like to do that. Nice. And on Insta, you are at Dr-Mari? No, on Insta, on Instagram and LinkedIn is my name, Mari Mitrani, M-A-R-I-M-I-T-R-A-N-I. Just my name, Mari Mitrani on both. Love it. Got it. thank you so much for being here you're just the best we love you