Menopause, Unscripted.

Perimenopause, Decoded: Breaking Down The Perimenopause Survival Guide || Episode 25

• Heidi Gastler X Stray Kat Studio • Season 1 • Episode 25

Share episode

Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.

0:00 | 1:03:36

Read The Perimenopause Survival Guide: A Feel-Like-Yourself-Again Roadmap for Every Woman Over 35: https://www.amazon.com/dp/B0F4T7H61F/ref=cm_sw_r_as_gl_api_gl_i_N407V9GANWM6AE8EN0D3?linkCode=ml1&tag=mtn2seapt-20&linkId=a29761d4638108a1a280f1bc02bc11c7

Follow Menopause Unscripted:
Instagram: https://www.instagram.com/menopause.unscripted
TikTok: https://www.tiktok.com/@menopause.unscripted

Connect with @HeyDrHeidi:
Website: https://www.heydrheidi.com
Instagram: https://www.instagram.com/heydrheidi
TikTok: https://www.tiktok.com/@heydrheidi
Facebook: https://www.facebook.com/people/Hey-Dr-Heidi/61568353334042/?utm_campaign=social_link_list&utm_medium=referral&utm_source=later-linkinbio

Menopause Unscripted is a women’s health podcast hosted by Dr. Heidi, the creator of Hey Dr. Heidi. Each episode delivers expert insights, real-life stories, and evidence-based information to help women navigate perimenopause, menopause, and post-menopause with confidence.
This podcast covers topics such as menopause symptoms, hormone replacement therapy, pelvic health, sleep changes, intimacy and relationships, osteoporosis prevention, brain fog, mood shifts, and healthy aging. With a focus on science-backed advice and approachable conversation, Menopause Unscripted offers clarity, support, and practical tips for every stage of midlife.

Whether you are experiencing early menopause symptoms or seeking resources for post-menopausal health, Menopause Unscripted is your trusted source for reliable information and open conversation.

Want to be on the show?
Think you’d be a great guest or know someone with an important story to share? Email us at connect@heydrheidi.com.

-----
Produced By Stray Kat Studio & Katherine Donovan
straykatstudio.com
https://www.youtube.com/@stray.kat.studio

Support the show

SPEAKER_00

Thanks for joining me on menopause unscripted. Remember, the change is just another beginning. Welcome back to another week of Menopause Unscripted. I am back with one of my favorites, Dr. Tara Noakdar. She is a DO and she is one of my favorite people to work with when I'm dealing with patients who need HRT. And I'm not a prescriber, so when I have a patient come in who needs or could potentially benefit from hormone replacement, she is one of my favorite people to work with. Well, thank you for coming back with me. Thank you for having me.

SPEAKER_02

I'm so excited to be here. Um obviously, I think so highly of you and your practice and what you do, and I think it's so amazing that you decided to go ahead and get menopause certified because you can recognize when and how hormones or or the discussion of hormones or the discussion of menopause and perimenopause will be beneficial to your patients and you know who to refer to, and I think that's super important.

SPEAKER_00

That having people that I can work with in a team environment just it's so helpful for a patient, especially, yeah, because we can have trusted providers, patients can understand more about this, and they can understand the physicality from me, and then they can understand a lot of the other implications from you.

SPEAKER_01

Yeah.

SPEAKER_00

So thank you. It's a great combo. Yes, definitely. It definitely like this is not something that you can do in like an isolated environment or siloed for women's health.

SPEAKER_02

Yeah, like nothing in perimenopause and menopause exists in a vacuum, like everything uh has another layer. So it's important to have a team.

SPEAKER_00

And that is a perfect segue into our book from today because this explains so many of the layers. So we are book clubbing the Perimenopause Survival Guide, written by Dr. Heather Hirsch. And we are both menopause society certified and went through a lot of Heather's education. Could you tell us a little bit more? Because you are definitely deeper into it than I am.

SPEAKER_02

Yeah, so um I think I touched on this last time I um podcasted with you, but when I started to realize that like I didn't know enough about perimenopause and menopause to treat it, I was kind of like reaching through all of the material on my own and figuring it out on my own, which was fine for a little while. Um, and then eventually I thought to myself, okay, there are these resources out there like Heather Hirsch's um courses or Rachel Rubin's courses, and so I decided to take the plunge and just do her course. Um I specifically did the um the hormone, like getting comfortable with hormones for practitioners. Um I don't think that's what it's called, but it's something like that. Close enough.

unknown

Close enough. Yeah.

SPEAKER_02

Um, so I decided to do that one, and it was a great um like line by line, she really delves into the stuff that we're always questioning, you know, the things that patients are questioning, that patients are worried about, and she has a way with words, I'm not gonna lie. Like she just knows how to explain things really well so that we can explain it to patients. Um, so I I think that aspect of that course was really helpful for me. And just getting more and more comfortable with talking about it and talking about hormones and hormone replacement or non-hormonal medications. I mean, the the course is like very um involved. It's not just like these are hormones, this is how you use them. Bye. Yeah, it's pretty involved.

SPEAKER_00

And there's a lot of the things, like you already said, that are the non-hormonal options as well. I'm currently enrolled in the botanical medicine. Oh, you're you're doing that one. Yeah, I Dr. Suzanne, I love her, and I really wanted to like learn from her more and definitely like hear more about the botanical side of things. But I also love that she has a lay people course and is writing these books and other resources for people who are patient side versus a practitioner side. And this is a very complex book, but I feel like it lays things out really well.

SPEAKER_02

Yeah, the it organizes things so easily and just relatable, you know. It's like people see themselves in these words, and I think that's super important.

SPEAKER_00

Oh, I definitely, I definitely did. Yeah. Well, so we kind of talked about a way to break this down for an audience because there is a lot of information here. And one of the things that we kind of both agreed on is that her four pillars of health that she explains are a kind of a good starting point because then she breaks everything into uh symptom, what does she call it? Symptom sets. Symptom sets, symptom blocks, but they all tie back into these four pillars of health. And the four pillars I've opened to this page sleep, diet, exercise, and mental health. So it's really like the base of where you need to be before considering anything else, especially hormone replacement or other things, these are not in order, and you don't have like your house cleaned up in this area. It's really hard to know like, do you need anything else? Yeah. Do you talk to your patients about kind of these similar things in your clinical practice?

SPEAKER_02

Always. And I think um almost to the point of being annoying about it. I think I think if any of my patients are listening, I'm sorry.

unknown

Right.

SPEAKER_00

Same. I I mean people come in all the time, and I'm like, you you gotta clean house before anything else, and everyone wants a magic cure, they want a magic pixel. Yeah, but in reality, none of these things even work if these are not in order.

SPEAKER_02

Yeah, and I mean, sure, if you take estrogen and you're that's all you're doing, things are gonna improve, right? Your hot flashes are gonna improve, your night sweats are probably gonna improve, but if you're not doing the work to make sure you're maintaining your muscle mass and like strengthening your bones, and um, you know, eating a good diet that keeps you satiated and healthy and gets all of your micro and macronutrients, then at the end of the day, you're there's so much missing and you're not gonna optimize. Like, I like to talk about optimizing everything because nothing's ever perfect, nothing is gonna do everything, not one thing is gonna do everything for you. So hitting each thing independently, each topic independently is gonna really make you whole in the future, right? Like, where I always like to talk about the future with my patients because like right now, yeah, hot flashes are really hard. So it's a really hard we're gonna work on that and that's gonna get better. But if we don't hit all the other things, we're not going to be independent and healthy and strong in 20 years.

SPEAKER_00

And stay out of nursing home, stay out of nursing home, stay in your house, not having falls, osteoporosis. Yeah, and that's a lot of things I talk about people with people too is they come in and they are deconditioned, they are in pain, they are falling, we have a big falls risk issue, right? Or we're dealing with a fracture we already had, and that's like with my you know population of women that are mostly postmenopausal. But but then I have like the women who are not even in perimenopausal, they're normally menstruating, and people who are perimenopausal, it's like, how can we get ahead of this? So then that way you are setting yourself for success later in life and not having these issues, you can maintain a healthy active lifestyle and age well.

SPEAKER_02

Yeah, and she definitely touches on that. She's like really Heather Hurst, she she I think she's really passionate about getting ahead of it, right? I think it's so important to think about your future in terms of how can I improve my future now? How can I get myself to a point where I won't be worried about falling and breaking my hip or you know, having spine fractures, or um, you know, working on your balance, working on your flexibility, working on your strength, but eating really healthy and and you know, I I I'm also pretty passionate about it. My patients are so over me.

SPEAKER_00

And everyone is so sick of hearing like protein, fiber, lift weights, drink more water, sleep. Everyone hates the word sleep hygiene. No, but it's true. I mean, these are accurate things we need to work on.

SPEAKER_02

Yeah, it's important. And I think especially, I think the part of all of this stuff that I think is the most difficult is like developing habits. And I was doing a little um Googling to see like how long does it really take to develop a habit? And the average is 66 days. Yeah, it takes 66 days of doing something regularly to make it something that becomes second nature, which is a really long time.

SPEAKER_00

It is, and it's frustrating, especially when you're symptomatic and you want it to be fixed yesterday. Yeah, and this is something we talk about here a lot is that a standard physical therapy order says come into PT for two to three times a week for four to six weeks. And everyone's like, Why is that the standard order? And the standard order of that is because it takes that long to create the habits. Yeah. And I'm not generally seeing patients longer than that. Some I do, but it's because we're trying to form these new neuromuscular pathways where people can then actually carry on on their own. I tell people, after six weeks, you aren't done. Hopefully, we've created new habits so you can carry on on your own. Yeah, exactly. So let's talk about these things that are annoying habits. And let's start with sleep since that's the top of the list, and then we can talk about our own things. So I'd love to hear about your own sleep hygiene and what you do for sleeping.

SPEAKER_02

Okay, so I never watch TV before I sleep. So my routine starts by I put my pajamas on, I brush my teeth, uh, well, I floss my teeth, I brush my teeth, I wash my face, um, and then I get into bed and I read. I'm not gonna lie. Kindle. Okay. But I put it on dark mode and it's like the least bright ever. It's a paper white, I think. But um, but sometimes I feel like my eyes are getting old and I need it to be a little bit brighter. I'm getting there, it's okay. Um, but I refuse to have the so we have a TV in our bedroom, and that was not my doing. I don't like a TV in a bedroom because I don't want that to be a part of like our bedroom is meant to just be for very specific things, right? We're sleeping in there, sex, and like reading, relaxing, but it's not for TV. TV is excitement, entertainment, and that's for the living room. Yeah.

SPEAKER_00

We have a TV in our bedroom too, but the reason we put it in was for sick days. Okay. You know, so it's never on. We're not watching TV in the bedroom, but if you have a sick day, it's a sick day TV. It's really the only thing. It's like it's there, it's a pretty crappy old TV, it's fine, but it's literally there for the sick day. Yeah, I'm sick that often. No, but every once in a while you have that sick day and you're home with your partner and you want to just like lay in bed, because we only we have a pretty small apartment. It's like that's that's the TV purpose in there. Definitely not watching TV before bed, but it does live there too. Yeah, yeah. What's on your nightstand?

SPEAKER_02

Oh god. Um I'm gonna take a picture and send it to you. Okay, it's a shit show. Am I allowed to say that? It's a nightmare. You can say anything you want. Um, I have about like seven menopause books that they look really pretty, and I'm just gonna leave them there. And I've read maybe a couple of them. Okay. Is this the pre-bedtime reading? Or no, no. I so like my menopause books are not bedtime books. Yeah. My bedtime books are like fun, exciting, entertaining, or like romanticies, or dragons, you know, Sarah J.

SPEAKER_00

Mass and Do you see she has two new books coming out?

SPEAKER_02

No, I've been not paying attention to any of them.

SPEAKER_00

Just was announced she's got two more books coming out, like one in the fall and one in the early winter. Like part of her previous series? Oh my god. Oh, that's so exciting. I know. There's like, you know, I will take like small wins in this very scary uncertain world. We need it. That was a definitely a win this week. I was like, something to look forward to.

SPEAKER_02

Yay, that's really fun, actually. Now I'm like gonna go home and find out what there's not a lot yet.

SPEAKER_00

There's not a lot of info, just announced that they're coming. Okay, that's really fun.

SPEAKER_02

We could speculate, but okay, great. Well, that's gonna be on my nightstand also. Yes. Or in my Kindle. Um, and then I have my like random like random things that I sometimes need. My nail file. Yep. Super weird. Um, my I have this like foot balm, this prequel foot balm that I put on sometimes before bed. Sure. Sometimes. Um, nail clipper? I don't know why. Clipping your nails in bed. It's always like I think when my if one of my nails like snags on my foot or something, I'm like, oh, I need to immediately address this. So and without getting out of bed because I don't want to get out of bed.

SPEAKER_00

No, you're you're there, you're in it. What else? I have a flashlight just in case. That's smart. Yeah. Especially like last night with the wind. Never know. Yeah. I think that's it.

SPEAKER_02

A l a a light thingy. Oh, my lip gloss. Um, and my water bottle that is right there. But that just lives next to me at all times.

SPEAKER_00

So you said mentioned pajamas. Okay. So going into some of the things in the book here, do you or underwear to bed? Um, only when I'm on my period. Okay. Because one of the things in here that they're talking about and I talk about a lot in clinic, is letting your undercarriage, your vagina, your vulgar tissues, having room to breathe. Yeah. And she mentioned several times sleeping in a long nightgown, and I immediately pictured my grandma and I was like, Do people even make nightgowns anywhere? They do. I have several.

SPEAKER_02

I was like, do they?

SPEAKER_00

But I was just thinking, because I like really like loose, flowy pants, and like I I get really hot at night, but I also like to be cozy and I like that like feeling. So I turn on my chili pad and like get it make it really cold, and the room is cold, so then I can like wear pajamas. But one of the things my patients is, and I am guilty of this too, is like they're wearing like leggings all day that are tight, and then they go to bed and they're wearing tight underwear, and then we see things like bacterial vaginosis, increased yeast infections. We see a lot more like vulvo vaginal issues, especially when our hormones start changing.

SPEAKER_02

Yeah, and you're becoming more sensitive, your pH is changing, and it's like all out of whack. And yeah, I I I don't like underwear to bed.

SPEAKER_00

Do you tell patients that often? Okay. You need a little healthy breeze.

SPEAKER_02

Yeah, just like let it air out. I mean, not air out. I hate to say it like that, but like as if it needs to like I don't know, like that. I feel like air out has a negative connotation. I don't want to put a negative connotation on it, but it just needs to not be enclosed.

SPEAKER_00

Yeah, maybe more oxygen, not have that like dark, like anaerobic state down there, right? So just get some air down there so it can actually the pH and bacteria and stuff can kind of normalize. Yeah, especially when you're wearing yoga pants all day long. Yeah, you don't really get that. So other sleep tips, like are there other things that you tell your patients to work on for their sleep hygiene, uh, for like just being more comfortable and avoiding some of these symptoms at nighttime? Like, what what do you also see in the sleep pillar?

SPEAKER_02

Yeah, I think making sure the temperature in your room is low ish, like 65. I think she mentioned 65 is ideal.

SPEAKER_00

Yeah, I think she says either 65 or 68, but something like that. In the 60s.

SPEAKER_02

Yeah. Um, which for me in the winter, like even in the winter, I hate having hot air blasting at night. So I just get more cozy, like you said, rather than have the heat on. Um so keeping the room cool, um, not drinking a lot of water immediately before bed. I feel like people like chug a glass of water before they go to bed and they're like, I'm up peeing all night.

SPEAKER_00

Yeah, get that nocturne. Yeah. I would be too. For sure. I'm a little guilty of that. Like, I will sometimes right before bed just chug and because it's like I'm just thirsty at night. Sometimes patients have the same thing, and they try to cut it off like two hours beforehand. And I just had a conversation about this on Wednesday about all the different things you can do to have less disrupted sleep just because of you know, the urination in the middle of the night. And as my patient gets older, that's one of the times I see falls too, is that they're getting up in the middle of the night. Maybe they sit up, they get a little dizzy, and they try to rush the bathroom because they have that feeling of urgency. Yeah.

SPEAKER_02

Or they're tripping over things on the way there. Yeah. It's dark.

SPEAKER_00

I know. I try to keep my pathway clear. Me too. Best I can. And like with the sleep, I mean, this kind of falls into the hot flashes and night sweats and other things. If we can keep it cold, we can have it our sleep hygiene, so we're more relaxed and our nervous systems are a little bit more downregulated. Yeah. You know, avoiding some things at night. Like everyone hates when I'm like the red wine, trying to get rid of it at night. I'm so sorry. I know you want it, but the alcohol and especially things that are creating that vasodilation that you kind of ramp us up.

SPEAKER_02

Yeah, and it, I mean, like, it is palpable how different I sleep if I have a glass of wine or a drink and if I don't. I mean, it is, it's almost gotten to the point where I'm like, oh, it's the weekend, I might have a drink, but then I'm like, I maybe would rather not have a drink because then I'm gonna sleep badly. And this is I always think about like the weekend as my time to catch up on sleep because during the week I'm like so in my head about everything ruminating, yeah. It's harder to like sleep well, so I'm you know more relaxed on the weekends, but then drinking alcohol really just like gets in the way of that too. So I think avoiding is a really, really good tip.

SPEAKER_00

Yeah, and everyone hates it. And I love coffee, I love my caffeine, and my biggest guilty thing because I had to stop drinking several years ago because of my health issues, but I'm guilty of the like 3 p.m. caffeine blast, and or you know, you go to dinner and I'm like, oh, like I'll have an espresso shot as my like dessert, and then you know, my sleep is so disrupted that night because the half-life of caffeine is so long, and then it's you know, waking me up in the middle of the night because yeah, of course, and I um I mean as a rule, I will not drink coffee or anything caffeinated after like noon because I'm very sensitive to it.

SPEAKER_02

Forgot that stuff. Do you touch the fuzzy bunny?

SPEAKER_01

Sure.

SPEAKER_02

Um, but like I'm really sensitive to caffeine, like even just having a couple sips of that, like I feel it. Yeah, which is kind of crazy, but I'm just sensitive to it. So I know if I have caffeine after 12 o'clock, I'm screwed. I can't sleep. Um, and the same thing with drinking water before bed. I stopped drinking by 8 p.m.

SPEAKER_00

What time is your usually by your usual bedtime?

SPEAKER_02

I like to think that I'm gonna get into bed by 10. You've been smelling a kind of two hours. Yeah, it's usually like more like 10:30 or 11, but yeah, I try to I try to start to wind down at 10. Yeah. The next pillar that we're gonna talk about is nutrition or diet, right? And I think this one is so important and it's something that I harp on my patients about aggressively because if you're eating foods that aren't serving you the nutrients that you need, and not only that, but they're kind of doing the opposite, then you're doing it wrong, right? I I've most recently myself have really started to try and pay more attention to what I'm eating. Not that I ever ate super unhealthy or I don't know, I I generally have a decent diet, but in the last couple of years I've just been trying to make sure that what I'm eating is giving me some kind of nutrition or or nutrients, right? Serving you impossible. Positively and making me feel good, I think, more than anything. Um not to say that I don't have the occasional ice cream or Taco Bell because that's my weakness, but um there's also one really close to me when I'm working, so it's like a little dangerous, but um, but I can also make decent decisions at Taco Bell, or I can also decide that my dessert is gonna be one mochi ice cream, not like a bowl of ice cream, not a pint of Ben and Jerry's. So um what she talks about, what Heather talks about in I'm gonna call her Dr.

SPEAKER_00

Hirsch, I feel is Heather feeling a little too like it feels like um we're besties.

SPEAKER_02

I I do, I do. Um, I mean we did meet and she's just the sweetest woman and she's so smart and kind. Um but Dr. Hirsch um talks a lot about uh plant based diet, which I basically mostly am also trying to do. And my for me it's more because like I don't really like touching meat. It's icky. And so I, when I cook at home, I'm mostly cooking with vegetables. Okay. And um, you know, finding protein sources in vegetables is not difficult, especially because vegetable-based proteins are often also high in fiber, which is amazing. Double dipping. Yeah, double dipping. And so um, you know, when you're trying to hit all your nutrients via um vegetables, it be it can get a little bit complicated, right? Because a lot of vegetarians or vegans are um deficient in B vitamins. Um but there are ways around that, right? I think like nutritional yeast has B B vitamins, and she mentions that in the book. Um, there are ways around it. There are ways to get everything you need in a reasonable way, and it's also like more cost-effective, right? Supplements are expensive. Supplements are expensive, and meat is expensive. Um, tofu's pretty cheap. And beans.

unknown

Yeah.

SPEAKER_00

And for me, like I guess I can't do soy or legumes, so it's really, really hard for me to do a plant-based diet and really get in protein. So I do eat more meat, but then I have to be really careful that I'm getting enough fiber as well, not just kind of falling into all only protein. Yeah. And so I I'm a big griller, like I have a barbecue outside, and I meal prep generally on Sundays. And so when I'm grilling my proteins, I'm gonna mix into other things for the week. I might also like grill a bunch of like vegetables as well to make sure I've kind of got both sides. But the legumes and soy unfortunately really upset my system. So I've really and I can't do gluten at all, so that kind of cuts out that and vegetable protein. Man, you just can't eat anything. I can eat I can eat animal stuff, any animals I'm fine with, which I hate saying that, but like any animals I'm fine with. Not you, Doc. No, Docie, you're you're not on that, you're not on my menu, baby. He also benefits from the grilling. I have a little sous chef over there for sure. But also, like, it's uh you know, it's one of those things I have to be really mindful about what I'm consuming, yeah, and making sure that I'm getting enough fiber and getting enough vegetables. And I don't think that that's hard for me, but I do have to be very, very mindful what I eat. I also love Taco Bell. But I love Chipotle, Chipotle is like my sick food, it's like a burrito bowl, it's my my comfort go-to. It's hard. It's just I have to make sure I'm not eating too much of it because it's really good. And they keep like spamming me with coupons for like a free guac doesn't help because I'm like, oh, I have a free guac by Sunday. I guess I'm fibering guac. What? Fiber. It's not you know, avocados are great for you. Like good fat, so you know the chips are the part that you know maybe not as good. Okay, fine. But but I digress. The but it it is something, and I harp on my patients about this all the time. And I think people are so sick of hearing about you have to have so much protein, you have to have so much fiber, but they're forgetting that like we used to eat a lot more whole foods, and like that just isn't happening as much anymore, or we're being marketed with so many commodity foods and things that are really hitting that this like bliss point of like just that perfect sweet, salty fat where it becomes almost an addict an addiction. Absolutely. I sent you an article, I don't know if you've read it yet, but it is an old article, and I will link it in the show notes. But it is this New York Times article from like 2013, but it literally talks about the addictive science of junk food, and even though it's old, it's one that I tell I re give that resource to patients all the time so they really understand why they're craving these things that really aren't very good for us because it was designed that way.

SPEAKER_02

Yeah, it was by design, it was on purpose to make us want it more and more and again and again.

SPEAKER_00

And you can eat an entire bag of Cheetos and they don't make you full because they dissolve. And this article talks about how they are like the most perfectly engineered junk food because they're cravable and you can eat in a whole bag and not be full, which just it just hurts my heart knowing that this was done to us. Yeah. So it is kind of sad and disappointing. It is.

SPEAKER_02

Um, I wanted to pull in the symptom sets on this nutrition part because I think there are so many of the symptom sets that are involved with nutrition or that nutrition is involved with, right?

SPEAKER_00

So which ones did you really hone in on?

SPEAKER_02

So I think sleep and anxiety. Um, when I eat better, I sleep better. When I eat better, I feel better, and my anxiety level is definitely improved. And I think also because I'm sleeping better, right?

SPEAKER_00

Absolutely. Those things tie dramatically mental health and sleep.

SPEAKER_02

Yeah, yeah. And when I'm eating better, I'm more regular, I'm not constipated, I'm less gassy. And so, like, that also contributes to like feeling better when I'm sleeping. And I like again, sleep hygiene and like getting good sleep is so important to the rest of our bodily functions and the rest of our mental health, also. And so that is a big one for me. Um and then obviously the the weight gain part, right? So when and and I I don't sometimes I think that like am I so concerned with having a nutrient-dense diet that it's like kind of becoming a problem? Like, do I have yeah, or or is it like disordered eating, right? I don't think so because I think I'm too lazy for disordered eating, to be honest, but um, but I do think that there is like a slippery slope. Definitely. But when you're eating well, it makes it easier to maintain a normal weight. And that includes like not drinking a lot of alcohol and like setting um what's the word I'm looking for? Boundaries, boundaries, yeah, right? Boundaries and limits for yourself. So like during the week I don't drink alcohol. Friday doesn't count as a weekday. So like I did have a drink last night, right? And it doesn't have to be so restricted, yeah. Yeah, yeah. And like I do it that way because I sleep better that way, and so I'm trying to avoid waking up super groggy the next day, so back on sleep, but then nutrient-wise or nutrition-wise, I like trying really hard to meal prep on Sundays so that my week isn't all thinking about what do I eat tomorrow, what do I eat for lunch, what do I eat for dinner, because I have it all planned out, right? And that allows me to not have not have to have the brain space for all these annoying things that I would otherwise have to think about. Um I think that's a really big deal too, right? So that ties into weight, but also the um mood changes and that kind of thing. I don't know, I think everything is so tied together, and she does such a good job of breaking it up into um like approachable sets, right? But they're all tied in to each other.

SPEAKER_00

And you know, with like the stress level, you know, it's like if you I you know, it's for like this last week, I didn't get a chance to meal prep on Sunday, and I've ended up door dashing so many meals this week. And looking at my food budget this week, it was like literally stressing me out and creating more stress because I was like holy crying, I'm paying like$35 to have a salad door dashed when I could make that thing at home for seven dollars. Yeah, and that was creating anxiety and stress for me this week because I was literally door dashing so many meals and looking at how that was like affecting my food budget for the week. Yeah, and that was a really big stressor for me this week of like it was 11, you know, 11 a.m. What am I gonna have for lunch at noon? And having to make that decision and decide which thing I was gonna buy because like what's gonna be satisfying me the afternoon, I'll get have to get through an afternoon of clinic, but also what is like wallet-friendly, and that was a very big stressor in this last week. And I Dora Dash occasionally, like is like a treat sometimes, or like I just didn't get a chance to like have that food, but every day this week felt incredibly excessive, yeah, you know, and it's prepared food, which is not necessarily as clean, or it's probably gonna be like having a lot more, you know, unhealthy fats and stuff in it, which I'm recognizing, but also that was this week, yeah. But the disordered eating I think is really important because people, especially when we're kind of getting to perimenopause and menopause, we might be having a more difficult time managing our weight all of a sudden. And some people get so neurotic. And I have patients who are literally weighing themselves a couple of times a day, and they're so stressed about that that I think that it can become neurotic, and trying to educate people, you know, about eating, but then also like the next pillar of exercise, I think is really important. So people I'm seeing in here that this is an issue, most of them have some sort of orthopedic pain, and their weight management, healthy weight management definitely has part to do with that, but then also my patients who are maybe incontinent in realizing that that extra weight is like pushing down on their pelvic floor, yeah, and that this can be part of their continence issue. And over the last year, I experienced some of that myself where I was a little heavier like last winter after the fire and we stressed and everything, and my incontinence actually got uh markedly worse. I was having some overactive bladder things, I was definitely having some urge incontinence, and after losing just a few pounds, it actually improved dramatically, which I honestly didn't think that like that little bit of weight that I had to lose would make it so different, but it it did, and it was really a thing that I noticed and have talked to patients about too.

SPEAKER_02

Yeah, and I think that's a hard one to talk to patients about, especially when they're already feeling like self-conscious about their weight and what's um changing. Um, but it is a good point, right? So if you're having these new onset urinary symptoms, it may be because of the weight that you've put on, but it's not the only thing, and I hate, I really hate just focusing in on weight as the problem. Um, I like talking more about like feeling good in your skin and feeling more comfortable rather than like losing weight because I think especially for me, I um I don't know, over the last like six years have gained a lot of weight. Um and I used to be like 132 pounds soaking wet, right? And now I'm like 139, 140, 142. But I've also in the last two years have been working really hard to put muscle on, and um, so now I feel more like stable. I'm like probably 138, 136, um, but I'm more muscle than I used to be, which I feel like helps me feel good about myself. And like my clothes from whenever ago aren't fitting, um, and so I'm like getting rid of them slowly, but I don't feel like I don't look at myself and think like, oh well, my clothes don't fit, or this is too tight, and like I'm fat. It's more like that's just not who I am anymore, and I've put on a lot of muscle and I'm very strong, and I'm stronger than I was before, and I'm trying to think about it that way, and I'm trying to express to my patients that like maybe that's the goal. Maybe we're trying to be stronger and more more physically fit but physically balanced and flexible, and you know, our bones are healthier, and I don't I don't like to harp on weight.

SPEAKER_00

No, and same. Like, I don't recommend people get a scale. And I'm like the scale number doesn't matter. It's like more the body composition that matters, and having more lean muscle mass is gonna help your metabolism, which is only gonna help everything. Having more muscle, and that's gonna be and doing exercises that are loading your body are gonna help with that bone health over time. Avoid sarcopenia as you get older, which is like that muscle wasting, which the minute I hit menopause, it was like I that sarcopenia happened to me really fast, where all of a sudden I was like, I swear to god, I don't have triceps anymore, and my quads felt like they're gone. Yeah, just like those two areas in specific for me, I had to work really hard and I I continually have to work really hard at making sure that the diet stuff I'm working on, like my nutrition, is then doing something for me with exercise. Exactly. And also, like a couple weeks ago, I was in Florida or shelling. I'm that total nerd who like shells like crazy, and I was telling myself while I was shelling with like the mobility stuff, if I can't get my ass to the ground to pick up a shell, like I don't deserve to do this. And I know that some people like they can't bend down, they can't do it, and that's like something that is with that person, but my mobility is really important to me. So even just working on the strength, my ability to squat down, get up and down from the ground. And I see this a lot with patients where they no longer can get to the ground and back up. Yeah, and so something we work on because it can be part of their balance, their mobility, their strength. And I'm like, if you fall and you can't get up, we got a problem. And I don't want you having to get the button, yeah, right. I want you to be able to get yourself off the floor. So I think the mobility part's a big part of the you know, the exercise and that as well. And that's we kind of morphed into that topic, right? We didn't even talk about like the fact that this is another pillar, but it is really like the next one.

SPEAKER_02

It is so I think it's a super important one, and I was just thinking as you were talking about the shelling, which that's a new is that a verb?

SPEAKER_00

Yeah, shelling. They literally have shelling tours. Oh my god. And it's like a I have this dream of a retirement job of like being a part-time like shelling guide. I know this is so nerdy, but I have always been like a rock collector. I'm that person who hiking, I'm like picking up rocks and like. I think I want to go shelling with you. Do it. There's shelling tours. Yay! Wouldn't it be so fun? Honestly, it sounds kind of um whimsical. Yeah, it's really whimsical, it's very relaxing. And I never really understood the like endorphins people get from social media, but shelling, if I find something cool, the endorphins kick in and I am just a maniac. Just a maniac. It's my my girlfriends know I like when the ones I'm doing this with, like, I it's like once I stop, it's like can't stop, won't stop. Just you have to like physically remove me from the beach. From the shells. I you do, and like it's hard like because I'm constantly like looking back, being like, but there's more.

SPEAKER_02

Um what I was thinking was when you were saying you're bending down to get the shells, my mom. Um, she's she had me when she was 37. So she's a and I'm 41 now, so do the math. Um, don't tell her, I told you. Um she I was starting to notice a few years ago that when she would get up, she would throw her weight forward to get up off of a chair. And I was like, that that needs to change. Right. Like, why are you throwing yourself? First of all, that's a slippery slope. You're gonna end up face first in your coffee table if you keep doing that. But also, like, try to use your muscles to get yourself up. Don't use your momentum because if you keep doing that, eventually you're not gonna be able to, because eventually you're gonna be frail and you won't be able to throw yourself forward like that.

SPEAKER_00

That's actually a rule in here that you're not using momentum to get people up and you're not plopping when you go down. Yeah. And again, things people get so sick of hearing me do you. I'm like, no, no, we're gonna use our muscles to get out of the chair. And I see people doing that. Like, I will physically modify their seating surface to make it so that they can train that before they're sitting out something lower and softer because it's harder. Yeah. But like getting off the toilet, you know, getting off a low couch, you go to your daughter's house or her couch is squishy, yeah, you know, whatever it is, like that is really a good thing.

SPEAKER_02

It's super important. And then um also being able to do my trainer actually um really, really, I mean, I hate it when she makes me do this, but she makes me do like sit down and stand up on one leg until I can't do it anymore. And she started with like it was like a you know, the box thingy. Yep. At the highest one, we started there, and then slowly she was taking it to the lower one, and I was like, I hate this, but I know it's gonna be good for my future, and I'm gonna have the balance and the flexibility, and I'm gonna be, I'm not gonna be the one who can't get up.

SPEAKER_00

Absolutely, right? It's so important. It is, especially like when you have sustained injuries, which I know you have, you start really appreciating the fact of like I've had this disability and I had to work past it, yeah, and we're younger, but what if I had that disability as an older person? Yeah, I don't I don't want to have that either.

SPEAKER_02

Honestly, and it's it's um especially so I what she's referring to is that I broke both of my elbows last almost exactly a year ago. Um, and so for about I would say for six weeks, I basically couldn't do a lot of things that I was so used to doing because I couldn't flex all the way and I couldn't extend all the way, which now look at me. I know that's great progress. Like that. Um it took a long time, but um, but I couldn't do all the things I was used to doing, but I was still going to the trainer, and she, um, my trainer Krista, she was like, It's okay, we're just gonna pretend your arms don't exist right now because I was doing physical therapy at home, but we really were focusing on my lower body at that time and my core because I really needed them when I couldn't use my arms. And it was um a really challenging time, I'm not gonna lie, but um both mentally and physically, but like the fact that I had been exercising very regularly made it less of an issue for me, right? Like I first of all had a decent amount of muscle there already, and so building it back up once I was allowed to start using weights again. I mean, I started back at one pound and um I built up really quickly, and I'm I'm back at like 15-pound um bicep curls now. I honestly think there might be more than I can do. Right? I mean, it's not easy, and I can only do like my I get to exhaustion pretty quick, but um but yeah, I mean it took a really long time to get there, but I think because I had that stable background of I've been exercising at least twice, three times a week, very regularly for the last year and a half or so, I was able to recover so much quicker. So, I mean that's so important. And like one thing she one thing Dr. Hirsch talks about in this book is like prepare yourself, right? Get your body where you want it to be now. Don't wait until you're unable to function. Right. You can't go back very easily. It's so hard, it's so hard to fix what's not working rather than prevent that from being broken.

SPEAKER_00

Absolutely. Does that make sense? 100%. And like this is something I talk to people about a lot is that you know, I could not have prevented myself from getting cancer. There's no way, but I got through it with more grace and ease than I think a lot of counterparts because I was so healthy and fit that when I started losing that, I started from here, so I had a like a lot more that I didn't get so far down, yeah. And again, having that stable base and like having that higher baseline, I didn't get as low, and also it just allowed me to have that mentality of like I can get this back, and I've been still working on getting it back at this point, but one of the you know, other things that was in the symptom sets was really talking about depression, anxiety, mental health, and I think exercise and this go really well together because for me, my exercise is part of my mental health management and stress and anxiety. I go and exercise in whatever form that is, and my current forms are powerlifting and hiking, and also daily walking of doc because that is a mental health walk for me as much as for him. Yeah, but you know, when we're having more of these potential, like you know, increased anxiety with hormone changes, and we're maybe having like some pre-existing things that maybe are feeling a little worse, you know, then I think it's really important to have tools. And for me, exercise is one of those tools.

SPEAKER_02

Yeah, I think you're totally right, and um that ties in as well, like if you're if you have an injury and your you know, mental health is definitely gonna suffer. Um you know, when I couldn't use my arms, I wasn't working for like three months, I I was sitting at home in excruciating pain. I was sleeping like 14 hours a day because I was in too much I mean, I my body was recovering, right? Um if I'd I didn't have my like twice a week workouts planned with my trainer, Krista. I I think I would have, I mean, I already was like probably situational depression, right? I wasn't in a full-blown depression because I had things to look forward to and I had that physical activity. I was walking a lot more. Once I was, once I got over the fear of like, what if I trip over something and fall in a can't catch myself because I have broken arms? Um, I started walking more, and so I was walking more, I was outside more, I was exercising regularly, and it I think it really prevented me from falling into like a I can't do anything depression.

SPEAKER_00

So it's more fan to our like the last of the pillars here.

SPEAKER_02

Okay, so the last pillar is the mental health pillar, which ties into every single symptom set and every single like person who is experiencing perimenopause and menopause. Because um, like let's go through the sets, right? Bleeding, uh, not being able to predict when your period's coming, being worried about you know, if you're prepared, it showing up out of the blue, unsuspecting, and then you have to worry about oh my gosh, am I bleeding through my pants at work? Um bleeding heavier than usual, not bleeding at all. Like this is all, I mean, all of that is so anxiety-inducing. Absolutely. Right? And and um, so that's the first symptom set, right? Sleep changes and anxiety, obviously, right? You're head to head. Yeah. If you're not sleeping well, um, you're not recovering well, your anxiety is increased, your depression is increased, your mood changes increase, um, right? And so that that almost seems like duh.

SPEAKER_00

Yeah, duh. But then a lot of people are then struggling with like low libido or like not having interest in sex, and like you're tired, right? And so that ties in. And then if you're having low libido, then you have more anxiety, more mental health issues because I might have a disappointed my partner, you know, there's the relationship ties, and that's anxiety-producing for a lot of people.

SPEAKER_02

And what's wrong with me? Why don't I feel the way I used to? What's you know, like that's a big deal. Um, and then it the next symptom set, fatigue energy, right? If you're fatigued all the time, if you're like just the this idea that you're not feeling like yourself, that is so anxiety-inducing, and that makes you some people spiral, right? Hello, yeah, for sure. And then on top of that, obviously the mood changes and brain fog, mood changes, mental health, right? If you're blowing up at your partner every time they like, I don't know, wash the dishes wrong. I'm guilty of that. Um, wrong. Like, what why why do I care? Just they're clean, but you did it weird, yeah, and I absolutely lose my mind.

SPEAKER_00

Right? You I feel like I have to apologize to my partner all the time for being a problem. All the time.

SPEAKER_02

All the time. I'm like, like mid-argument. I'm like, I realize this is unreasonable, and I'm probably just hormonal right now, but it feels really urgent to me.

SPEAKER_00

Yeah. A couple weeks ago, he's like, So is this what we're gonna be anxious about today? And I was like, Yes, it is, and like I probably sounded just like a gremlin. It's like, it is, this is the anxiety.

SPEAKER_02

Yeah, I mean, like, we're all guilty of it, but it's you know, it's part of these hormonal changes, and unfortunately, you know, it's a given, but luckily we both have partners that understand and are helpful, right, and not and then don't react. I think that's a big deal because if they were reacting, it would just spiral. Yeah.

SPEAKER_00

Well, and the perimenopause, like, I mean, uh, we were talking about earlier about how you can have these like loop events where you're essentially ovulating twice in a month and the bleeding that can come with it, and the PMS that can come with it, and like all of the like rage feelings and this mental health stuff that can happen, and people don't understand like why is this happening to me? Like, why am I essentially having PMS twice in a month? Yeah, you know, versus like I used to have it once, or like kind of the PMDD stuff as well. But and a lot of this is because that unpredictability of the estrogen. Yeah. Oh, and with that, you know, if someone goes on estrogen, does it help to like level them out from your perspective as a provider who is prescribing?

SPEAKER_02

So, yeah, so I think the benefit of going on estradiol is that you're not crashing as much as you were before. Your baseline is slightly higher, so you have this baseline that's kind of keeping you even keeled, so that when you do have those big drops, you're not dropping all the way to zero, right? So that's why it helps with hot flashes and night sweats, etc. Um, but also why it helps with anxiety because you're not having those, those, you're not bottoming out, yeah, right? Um, so yeah, it helps a lot with I mean, for my patients at least, um, a lot of their anxiety issues and even depression um and just overall mood. I mean, one of my patients actually I'm I just um remembered, I she came to me, she is a menopause provider, okay, and she came to me saying, like, I just noticed that I've been so much moodier and I've just been really down, and she's this bubbly, positive, happy, like everything is great woman all the time. So it was really strange to like see this change in her. Sure. Um, and I know her socially, so you know, she expressed to me like, I don't know what this is, but I think I'm perimenopausal. Her periods are still the same, they haven't changed yet. Not a lot of other things have really changed, but this one thing, um, and at first she thought it was situational, you know, like going through some things with her partner, with her family. But we put her on estrogen, and the next time I spoke with her, she was palpably a different person. She was like, I feel normal. I feel back to who I was six months ago. And it was such a relief for her because she was trying to figure out like what's going on. Right. It's such a scary thing to like suddenly have all these like thoughts and um you know, thought processes going on that you had never really experienced before.

SPEAKER_00

That's that's a lot. It's a lot, and that is really anxiety-producing and feeds into this mental health. I'd like to ask you, and I've got a couple questions about this. The role of progesterone for people with mental in mental health and also with sleep, what is your general thoughts on that?

SPEAKER_02

So I think progesterone can be so helpful for the people that tolerate it well for anxiety and sleep. Okay. So it um increases your GABA, right? It basically increases your calming neurotransmitters. Um and so taking it at night before bedtime helps kind of like bring you down, get you calm, get you ready to sleep, get you sleep, right? But then also overall, it's keeping you calmer, it's keeping your um uh like preventing you from going into these anxiety spirals. Um, but some a lot of people don't tolerate it.

SPEAKER_00

So let's talk about that because I got some questions about lack of tolerance and depression related to poor tolerance to progesterone in the last week. So, with those people, is it that they just don't tolerate progesterone? Did they need to change the form? Did they need to finish change the delivery system? Like, what is your recommendation for somebody who isn't tolerating it well?

SPEAKER_02

So when you're not what I do when someone's not tolerating it orally is I say put it in vaginally. Okay. Okay, so the same capsule, you just put it right up there.

SPEAKER_00

Then how does that change it, like in terms of like delivery that might be better?

SPEAKER_02

Well, it's bypassing the GI tract, right? So it's you're hopefully bypassing the nausea and like the upset stomach that a lot of people get, and is why they're not tolerating it. But it tends to lose that GABA activity when you're using it vaginally and you're not using it orally. So um, for some people, using it vaginally still helps with sleep. Okay. I have like a couple of patients that it still works fine for. Um, I have one patient actually who the capsule itself is really irritating to her, so she like takes it out of the capsule and puts it in. Um, and that she actually is sleeping really well, despite, you know, previously not. So um I think it's hit or miss, but when you change the formulation or when you change the route, you're technically not supposed to be getting the um the sleep and the anxiety relief that comes with oral mycronized progesterone. So, in that context, like what what do you do if you're also not tolerating it vaginally? Because some people still don't tolerate it vaginally either, is then you're thinking, okay, we we need to do a formulation change. We need to maybe try uh synthetic progesterone, which if the goal is protecting your endometrial lining, which most of the time it is, then fine. Like the other progestines do fine.

SPEAKER_00

And how are those formulated and how are they delivered?

SPEAKER_02

Okay, so uh there are a few different kinds, right? There's my favorite one, which um helps with bleeding also, which is the IUD. Okay, the Levonogester IUD somarina. Um, you can use it for five years and you don't, it's like a set it and forget it. Okay. What was that infomercial?

SPEAKER_00

Ronco Peel. It was my verse history chicken. I know exactly, I can literally see that commercial when you say that.

SPEAKER_02

Yep, set it and forget it. Um so that's really nice. Uh helps with bleeding, you know, helps with cramping if you're having more painful, more heavy periods. The other oral synthetics would be things like um uh agestin. Okay. Uh you could do northendrone acetate. Wait, is agestinorndrone acetate?

SPEAKER_00

I think yes. Remember how I told you there were like so many medications on my version of the menopause society test? Yeah. I I can't remember.

SPEAKER_02

I'm I'm pretty sure. And now I'm doubting myself. But there's also vera. Yeah. There's Provera, which is mandroxy progesterone acetate. Um, these also have some side effects, so it just depends on what your side effect profile or what your symptom profile is, too, right? So there's also SLIND, which is a Drosperinone oral contraceptive pill, which is helpful if you're also trying not to be pregnant, then you're perimetapausal. Um, but it does a really great job of blocking the androgens. So if you also have low libido, that might not be my first choice. So there's a lot of moving parts in this, right? So you have to think about what other symptoms the patient is having, what their goal is, why they need the progestin um in order to decide which one would work best for them.

SPEAKER_00

So even someone who might be experiencing negative mood changes in related relation to this, they could potentially try different forms and it might give them a better result.

SPEAKER_02

Yeah, I mean the mood, the mood changes part, I feel like estrogen does a better job with that. Um the anxiety often is a progesterone um or like a progesterone uh fact symptom, a low progesterone symptom. Um, but can be improved with estrogen. Also, it just depends on the person. And the the synthetic um progestins are generally not found to be helpful for the anxiety.

SPEAKER_00

Okay. And yeah, because that was the big question for me is like, what if it makes my depression worse? And I was like, honestly, I don't have a great I find that it's not super common to make your depression worse.

SPEAKER_02

And if it does, like, there are so many other options. And there's even if you're if the main reason you're on a progesterone or progestin is for your endometrial lining, you could also try duo-ovy, right? Dewey is also a really amazing option where you it you don't even need the progestin.

SPEAKER_00

Yeah, it just gives you a different option altogether. Oh, so back to like the symptoms. I'm sorry we did digress, but I wanted to kind of touch on that because that was a big question that was this last week. Of course. Let's go back to the other symptom sets where this is really impossible. That's what we were doing. That's what we were doing is how I die we made you digress.

SPEAKER_02

Well, I think the only one that's left is the weight gain, right?

SPEAKER_00

Yeah. And obviously, if you're struggling with body composition or body image, it's gonna affect your mental health. Yeah. Or if you're starting to get super neurotic, they keep, you know, and having neuroses about it, definitely gonna increase some anxiety and mental health.

SPEAKER_02

Yeah. So, you know, our mental health is related to every single thing that we do all day long. Or alternatively, everything that we do affects our mental health. Um, and one thing that I actually love that Dr. Hirsch talks about a lot in this book is CBT. Yeah, she talks about CBT a lot. She really does. And I have a lot of patients who have benefited a lot from CBTI and CBT A. So CBTI is for insomnia, okay, and CBT A is for anxiety, and um it it's really, really amazing how helpful CBT can be for patients who their primary issue is their mental block. Sure. Right? Um, and that's something that they had never experienced before, right? And it's like very tied into their perimenopausal mood changes and hormone changes, and so it's like a new experience, they don't know what to do, but CBT really helps you pinpoint what is putting that block in place and helps you find out how to get past it, and that's I think really interesting, and I love that she talks about it so much. Definitely.

SPEAKER_00

Can I ask, what do you do for your own mental health? Like, what are your mental health kind of activities? I mean, what are your things that you do to improve your own mental health?

SPEAKER_02

Um, I exercise is a big one for me. Um, and I and I joke with my trainer about this, but like I see her twice a week, which means I see her more often than I see most people. Um, and she is one of my favorite people, and we've developed this really fun relationship where we just have a great time and we just tell stories and make each other laugh, and so that's like a really uplifting, fun, you know, two hours of my week.

SPEAKER_00

How hard is it to do core work when you're laughing? Really hard. I swear my trainer makes me laugh in order to make my core work harder.

SPEAKER_02

I've like many a time fallen off the big ball. Yesterday was like crazy. Um, but so that's one big thing that I do. I also try to make sure that I eat well, and because when I'm eating well, I like feel so much better about myself, about my body image, about my um uh like overall, you know, well-being, but also um it just feels good, right? Like if I'm digesting well, I'm feeling better. So the third thing that you mentioned that you like to do for your mental health is so the third thing that I do for my mental health is I like to try to keep a gratitude journal, and actually this it's it's in here. I had just started this one fresh. Um and then it turned into, yeah, my friend got it for me. And it turned into like also um things for work, but it's hard not to do that. Yeah, and I try to uh like one page is labeled the my biggest take takeaways from this week, or my biggest takeaways from yesterday, or my biggest takeaways from uh, I don't know, things that stand out to me. So I like to do that at the end of the day, and it does a good job of wrapping up my um day, make it make it easier to um just put things away so I'm not just reeling, and then it's easier to fall asleep.

SPEAKER_00

I love that. One of the things I really liked in the book was her suggestion to do an audio gratitude journal so you could go back and listen to it, and I really might adopt that because she was saying you kind of like listen to yourself talk. It's almost like a little self-self-hypnosis, self-meditation. I thought that was really like a lovely idea.

SPEAKER_02

Yeah, and to hear yourself talk about your high points.

SPEAKER_00

So I feel like this is a really great place to wrap up this conversation. So before we close out for the day, could you just tell us where everyone can find you in your practice?

SPEAKER_02

Absolutely. Um, you can find me at my website, www.drtara now.com. Um and you know, there you can like read a little bit about me, you can click on the FAQs, and you can click to book an appointment if that's what you want to do. There's also my phone number and everything is on the website if you want to reach out to me. Um, I do discovery calls also. So, you know, if you're not sure if I'm the right fit for you, or if you just have some basic questions and you kind of want to get an idea of what I'm like as a clinician, um, that's an easy way to do it too.

SPEAKER_00

So, well, thank you for telling us everywhere we can find you. I think it's wonderful that you do those discovery calls too. And for everyone who's watching, I'd like to thank you for being here for another week of menopause inscripted. If you like this conversation between myself and Dr. Tara this week, please come back next week. You can follow us everywhere you find your podcasts. We really encourage you to like, follow, and subscribe. It really helps us to continue to bring this free educational content for you. After I said all of that, uh Dr. Tara, can you answer one final question for me? Absolutely. I just would like to know what is your daily health non-negotiable okay.

SPEAKER_02

So that one, I mean, I feel like I have a few of them, but let's just go with um movement. I try to at least do some form of movement every day, whether it's like an evening walk after dinner, or um, if I didn't get in a workout that day, which most days I don't, but I probably do about three times a week. But if I don't, I'll do like a set of push-ups or something like that just to make sure I'm doing something, some form of movement to to you know keep me on the move.

SPEAKER_00

I love that. Thank you so much, and thank you for being here another week.

SPEAKER_02

Thank you. I can't wait to come back.

SPEAKER_00

Now I have to end with the boring stuff. While I am a doctor, I am not your doctor. This podcast is for entertainment and educational purposes only. If something in today's episode resonated with you, please bring this to your own healthcare team and self-advocate. We always are promoting that. I cannot wait for you to join me on next week's episode of MetaPause Unscripted for another hot topic.