Episode #39 Navigating Relationships During Menopause

Many people may think that menopause only affects the women who are going through it, but the truth is, it also impacts the people around them, especially their partners. Symptoms, such as those related to mood and intimacy, can affect emotional connection and fuel misunderstandings, often straining relationships.

In this episode, licensed marriage and family therapist Stephanie Clavenna joins Dr. Cat Brown in exploring what it really looks like to navigate relationships during perimenopause and menopause.

This episode covers how hormonal shifts can impact mental health, self-esteem, and intimacy, and what both women and their partners can do to better understand and support each other through these changes. The conversation also dives deeper into the importance of open communication and why this stage of life, while challenging, can also be a powerful opportunity to strengthen relationships.

Have more questions you'd like to ask our experts? Join our next live Q&A: bywinona.com/liveqa-spotify.

Learn more about Winona's treatments here: bywinona.com/treatments-spotify

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Transcript

SPEAKER_01 0:00

Welcome to the Menopause Hour, your go-to source for answers to your burning menopause questions, the ones you won't get from your OBGYN. Brought to you by Winona, where menopause care is made easy. Download our free Winona community app where thousands of women connect and access exclusive content, expert-led courses, exciting events, and more. It's time to take the guesswork out of your hormonal journey.

SPEAKER_00 0:25

Hello, hello everyone, and welcome to another one of our Dr. Dialogues. Um, today we are going to be talking about navigating relationships during menopause. And then afterwards, we are going to have a live QA session. So start prepping your questions. Um, but just want to say again, we're so glad that you took the time out of your evening or your afternoon, whatever time it is where you're at, to be here tonight. That just says a lot about what your priorities are and really trying to make the best out of your health journey. So so excited you are here. Um, a couple things. If you've never been to one of these before, um, I'm Maddie. I am Winona's community manager. So I have probably seen your face somewhere in the community. So really glad that you are here tonight. Um, and I love seeing some old faces, I love seeing some new faces. Um, but if you've never been to one of these before, at the bottom of your screen, you're gonna find a little chat button. Um, it's kind of in the middle of all the buttons. So if you can click on that, you can go ahead and start typing any questions that you have in that chat box. Um, these can be like really anything that you might have on your mind. It could be about some symptoms you're having. We are talking about relationships today. So you could have some questions about relationships, what a relationship looks in menopause. Um, there's a whole wide range of questions. We're also about to get into a conversation. So if you have any questions that come up, feel free to drop those in the box as well. I know sometimes you need to hear a little bit of conversation before those questions are prompted as well. Um, but again, we're so glad you're here. Um, and as you can see, we have two very special guests with us today. Um, we have Dr. Kat Brown and we also have Stephanie Clavenna, is that correct? With us. Perfect. Tonight, um, I'm gonna go ahead and hand it off to them to introduce themselves. Um, but then we'll get into our conversation and then we will have our questions afterwards. So um, Dr. Kat, I will pass it to you first, and then Stephanie, I'll let you follow up on that one.

SPEAKER_03 2:26

Sure. Well, if those of you who haven't seen me, I am Dr. Kat Brown. I'm the medical director here at Winona. And so um I help to curate some of our medical information for patients and a lot of the stuff on our journal page. But also, I'm one of our prescribing physicians as well. So I take care of patients in the state of Pennsylvania, Michigan, Hawaii, and Florida. Um, and I am a board-certified OBGYN who's dedicated my life to women's health, and I am a woman in midlife, also in the thick of it. So this has become a very um important topic of interest for me. Um, and I became menopause society certified last year, um, just because this is something I feel like is not really, you know, um focused on for women. And this is really the best part of our life, I think, because I'm in it. So we have to think positive moving forward. Um, but we're here to answer all of your questions. Um, and we're so lucky to have Stephanie here as well. Um, so it's it's nice to have someone in the therapy world, especially when we're going to talk about relationships. So tell us all about yourself, Stephanie.

SPEAKER_02 3:28

Yeah, thanks, Dr. Kat. Um, my name is Stephanie Clement. As Maddie said, I am a licensed marriage and family therapist. I live in Dallas, um, but I practice here and California. My practice is virtual, so I see clients in both states. Um, I've worked in the field for over 20 years. And in the last probably three to four years, I've started to see a significant increase in women in our demographic coming to me because they were experiencing some emotional things that they were unfamiliar with. Um, and it started to dawn on me that a lot of these women were in the perimenopause, last menopause timeline of their life, which might explain why now all of a sudden they were having this amplification of anxiety and depression and struggles in their relationship and um difficulties with their self-esteem. And so my practice kind of shifted naturally towards working with women, and that's what I specialize in now. Um, I have a lot of experience working with children, families, people who've experienced trauma, grief. So that stuff still comes up in the work that I'm doing. But like you, Dr. Kat, I am a woman in midlife. I'm having this experience as well. And I want to talk about the mental health impact of being in perimenopause and menopause and what that does to us personally, what it does to our relationships. So that's how I found myself here. Um, and I'm just so thrilled to be able to participate and have this conversation. So thank you so much for including me.

SPEAKER_03 4:56

And it's so apropos because May is mental health awareness month. So you'll see lots of stuff in the media this month and people speaking up. And, you know, I think the hardest part is mental health and behavioral health has such a stigma. Um, and a lot of people are afraid to seek help, you know, because they're afraid to, you know, be labeled or, you know, be judged. But part of Mental Health Awareness Month is like, let's get this out in the open. Let's talk about it. Let's make this part of normal communication and everyday, you know, conversation so that it's not so taboo and it's not stigmatized and so that more people will get the help they need.

SPEAKER_02 5:31

Yeah.

SPEAKER_03 5:32

Yeah.

SPEAKER_02 5:32

Absolutely. I'm so glad to be having that conversation, kind of like what you're talking about. There is more of the um, you know, in what you're seeing on your side of the aisle with respect to medical care and a conversation happening around that and better access for women and better education around that. I want the same on the mental health side. Right. Um, because there are so many factors that are happening for us now that maybe it's the first opportunity we might have to even consider going to therapy. Um, and taking that leap, there's a there's an element of bravery and courage that I think that requires. And it's such a gift in my experience to be invited into an opportunity to have conversations with women and their loved ones about this, you know, time in life. Um, and I want to do, you know, a service, if you will, in that way for them to help that process be, you know, to navigate it more smoothly.

unknown 6:22

Yeah.

SPEAKER_03 6:22

And I think, you know, we can start off probably talking about how, you know, for anybody that has a history of anxiety or depression, and you mentioned that, you know, it can get exacerbated during this time. But often so many of my patients come in and um, you know, come to us just saying, I just don't feel like myself. And so when we don't feel like ourselves and we don't feel like our best self, it affects all those people around us and every relationship that we're in, whether it be a romantic relationship, a professional relationship, whether it's friends, kids, dealing with parents. Um, and you know, with women in midlife, you know, we're kind of in this position where we're taking care of children, but also maybe caring for aging parents. And there's a lot of stressors and a lot of demands on women in this time frame, too. So it's just like this perfect storm, this tornado of things that are happening. Um, and when you're internally having so many changes and so many symptoms that it's hard to deal with, it makes it very difficult to stay resilient and to to kind of roll with those punches and to be flexible when it comes to your relationships. I don't know if you can talk about that a little bit more.

SPEAKER_02 7:28

Yeah, I think that, you know, what I discover whether it's, you know, just I'll be honest, whether it's people I see professionally or even my girlfriends, because right, I'm having this conversation with my girlfriends, which is a blessing, right? I'm glad that we're having this discussion, is you know, an opportunity to really start to uncover who you are. And that involves maybe deciding that there are things that you have had as part of your background that no longer serve you, and things that you have now that you really want to pursue. That doesn't necessarily mean a shattering of everything you know, um, although I I do acknowledge that that sometimes is the path that ends up, you know, being what we walk. But I think um you mentioned this is sort of the better, the best time of your life, right? Because it's your it's midlife for you and it's the start of this next amazing chapter. And I think if we frame it that way from a mental health perspective as well, right? That it isn't a crisis in a way that there's no opportunity for improvement or growth, then I think we uh go into the conversation about mental health with the expectation of a positive outcome. Yes. Um and yes, absolutely. If you have had a history of depression or anxiety or attention-related concerns, that's another one that I have a lot of, you know, people that are concerned about. This time of life will magnify that. But you can get a lot of really good support from your physician, from a therapeutic practitioner to kind of help navigate that process and um end up in a place at the end of this where you feel much better about where you're going than when you started. But it is a process, it doesn't happen overnight, um, right? Kind of like starting HRT. Like it's not, it's not anonymatic, you're gonna start it, it's gonna be effective. You're gonna maybe have to change the dosage. And then, right, there's a lot of things that are happening in that space. The same thing happens in our relationship. Like we have to give it some time. And I know that that can feel a little bit challenging because we're not maybe very patient. And there's expectations that are being placed on us, and sort of we get looked at sometimes in a negative light by the people around us. Um, because some folks don't necessarily understand what's happening. Um, but some of that is because I don't necessarily know what's happening. Like I'm trying to figure it out for myself. So one of the things that I like encourage people to do is be candid and open with the people that you're close to about what's happening for you. Understanding maybe that I don't really know, but I'm trying to figure it out, and recognizing that you can have a lot of willingness to work on something, and then you have to match that with information and um kind of a commitment to that, and that you know, the the combination of those two allows you to kind of move forward in some way that is many times better than where you started.

SPEAKER_03 10:17

Yeah. And and true growth doesn't happen easy, right? I mean, so sometimes you have to go through a little bit of growing pains and turmoil before you come out on the other side. But generally, you know, when you go through that and you're working through it, there's always something better at the other end, usually. We don't always see it when we're in the thick of it, right?

SPEAKER_02 10:37

No, but it's interesting. I I tell this story often that the the Japanese word for um crisis is made up of two distinct characters uh in the Japanese alphabet, one of which is the if the if the character stands alone, it is the word for crisis. And opportunities is a crisis. Or crisis is an opportunity. Sorry. The the the kanji word for um crisis includes the word opportunity. My apologies for mesameta. It's an opportunity. That's what I tell people, right? Yeah, um you may be at a place in your life where you are willing to look at some things for the very first time, right? A lot of women come to me and say, I don't have a BS filter anymore. Like I am over it, right? I want to be honest about who I am, I want to live my life authentically. That really matters to me, right? And so how can I how can I have this conversation with the people that I care about in a way that they learn and understand like who I am showing up as now is the very best version of myself. Right. And some of that is this the process of uncovering it.

SPEAKER_03 11:46

So yeah. And there's beauty in that growth too, because you know, once you figure out your own journey, then you know, it's only better and best things after that, I think. Yeah, yeah.

SPEAKER_02 12:00

So I think the other thing, oh, sorry, go ahead. No, sorry to say I think the other challenge, right, is just like the variation in the physical menopause symptoms, your mental health journey through this period will look different than that of the people around you. Right. And I think we do sort of this comparison thing, right? Much like we might do when I have symptoms and my girlfriend has something different, right? Your mental health journey might look different. That doesn't necessarily mean there's something wrong, but right. It's it's unique and individual to you. Um, and those things are still navigatable. So um I really encourage people not to like compare yourself too much to the woman next to you in that regard because that's a unique experience for you, um, as much as it is for them. Um and that just like in the medical side, your treatment strategy may look a little bit different depending on the woman's presentation. The same is true for what we do on our side of things in terms of where do we need to spend time and focus.

SPEAKER_03 12:58

So yeah. Yeah. It has to be individualized, really. Yeah. Okay. Yeah.

unknown 13:06

Yeah.

SPEAKER_03 13:06

I'm sure a lot of the women listening, um, you know, if you have questions about certain things that you're navigating in your own relationships and how that is applied to your experience and some of the struggles that you've had, you know, we we have this great resource on the call tonight. So utilize her. Um ask away. Yes, ask away. But anything goes, any questions related at all to midlife, perimenopause, menopause, relationships, mental health, but also physical health, you know, anything goes. So any questions you have and that you're wondering an answer to, or if you just want to share information, you can put them in the chat. Um for someone to ask questions. And and this is hard because I think that this is sometimes the mental health aspect too. Like, you know, you're putting something in the chat, your name is next to that in the chat. So it's fighting that stigma again that we talk about. So, you know, raising your hand and recognizing, like, hey, I have an issue that might be mental health related is hard to do. I think it's really hard to do. Um, but I'll tell you, I think therapy should be integral to everybody's health care. I don't think it should be like when you look at health plans and you look at medical insurance things. We don't have to go to the call. I really think you have it shouldn't be an ancillary add-on, right? It shouldn't be this separate thing. Um, and especially in women's health. I mean, we go through so many physical hormonal changes that affect our mental health throughout our lifespan as women, you know, whether it be um, you know, in puberty and then in pregnancy and postpartum and then in midlife and going through perimenopause and menopause. So many changes and ups and downs. And and our mental health is very linked to our estrogen levels and then our hormone levels overall.

SPEAKER_02 14:59

Yeah. Yeah, I I sometimes am uh so pleasantly surprised to see new research related to the hormone connection to mental health. It it sheds um a light on things for myself in just personally, but also professionally, um, that there is a lot of connection being made around that. And I'm so glad that the conversation is happening about that. Um But I think, you know, the one thing I want to say is a lot of women have this concern like it's you know, it's something wrong with me. It's the language that I hear a lot of the time, right? It's something wrong with my relationship because I feel like there's this level of struggle. And I think that being really attuned to that language is is really important. Um and if we think about this more as like this is a time of transition, not unlike other times that we might have gone through a transition in our lives, we look at that as you know, short term, right? Now the length of that transition might look different again for you and you know, your friend or the person next to you, but it's still just a period of time that we are working through to navigate, right? Like the parametal pause timeline is different for every woman. The mental health journey as part of that is also different. But if you're feeling for the first time in your life, this sort of intense, almost unrecognizable level of like challenge with your emotions, please don't hesitate to reach out to find somebody to talk to about that. Start with your physician, do some research about who's available, interview multiple therapists. If I can say anything about that, just like I would encourage people with respect to their medical provider, don't feel obligated if you talk to a therapist and it's not a good fit. That is a really important part of the work that we do. I don't want to be a bad fit for someone. And I tell every client that I work with if at any point you feel like this is not working for you, please let me know. I am more than happy to work to get you connected to somebody else. And I think that women are finding themselves in a really vulnerable position at this time, right? The women that I talked to who went to see a physician and were totally dismissed. And I'm like, you need to go see somebody else. I would say the same thing about being in a position where you're looking for a therapist that's a good fit. And if you're going to therapy with your partner, same thing, right? The therapist that you would see one-on-one might not be the best fit for the for working together between you and your partner. Um and so it's okay to say, like, this isn't it for me. I want to consider something else. Um, but I understand that that's that's a that's a big vulnerability. Um, but I want to I want to put that out there because I think that that it's really important.

SPEAKER_03 17:40

Yeah, well, I think that's true. I mean, we we talk about that on these webinars a lot that you know, women shouldn't take no for an answer. And I think that so much we feel we we have this sense of obligation once you've kind of made a commitment, but that's it, it doesn't mean like you have to stay with that person and and don't take no for an answer. It's okay to shop around, it's okay to keep going until you get someone you feel you know heard by and you feel listened to. Um, I think it's so very important.

SPEAKER_00 18:09

Absolutely. And we we do actually have a question from Cindy real quick. I just want to to jump in and see if there's yes, some answers on this one. Um, Cindy says, I've been trying to get my boyfriend to read a bit about what I'm going through, but with no result. Do you have any suggestions for me?

SPEAKER_03 18:27

I think it's really hard to hand a man a book or a magazine or something, you know, a handout about a medical thing and expect them to want to read it. But um, my suggestion would actually be to try to find um like maybe one of the documentaries, the docuseries that have been out. There's been several different ones on menopause really recently. Last year, I think the M Factor came out. I was actually in one um that you can stream online um called Four Days, um, and it's about five episodes of menopause and perimenopause. There was another one too, the um that was another, but I I didn't get to watch that one. It was made um recently and released, I forget what it was called, but that might be better. It might be better to like sit in front of the TV and like watch something for entertainment that might spark a conversation and might be educational too, while as well as visually appealing. I think that that might that might be a good way, but I don't know if you have other suggestions, definitely.

SPEAKER_02 19:24

Yeah, so I actually find a lot of really great information on Substack. I don't know how many people here are reading Substack. There's a lot of really good conversation happening um related to menopause, paramenopause, relationship issues. There was a wonderful article in the USA today that my girlfriend, my neighbor, actually sent me talking about um I'd have to, I can I can get the resource for you, Maddie, and send it if it's something that we're allowed to share. Um yeah, send it my way and we'll see. And but I think it was talking about like the dynamic and the shift of like communicating with your partner or how men are kind of finding themselves um like at a bit of a loss and not really knowing like what to do or what to navigate. Um, but there are some amazing resources on Substack uh practitioners, people in midlife who are writing this both for us as women and for our partners. Um so I would encourage maybe that if if if it's something that you were resonate for you and you know your partner better, um, that might serve as another really good way to kind of have a small introduction into the conversation, along with what Dr. Todd is talking about in terms of some of the um amazing you know programs that have been out there, like she said in the last year related to this conversation. So um I wish I had a great book. Like there isn't, I I don't know of a book yet that's not geared for men. Most of everything is wonderfully geared for us, which is such an amazing experience, but we're not not that I'm aware of at least, not there yet on this the side of how to help men feel more open and understanding about this process.

SPEAKER_03 20:55

The other thing, Cindy, if if you guys are ever on long car rides, um, our episodes of these webinars, we we actually have a podcast um called the menopause hour um that's made by Winona that would be you know short and sweet episodes kind of going over some key topics, that might be a good option, like in the car. He might be like, What did you put on, babe? Like, what's going on? Um, but at least maybe if you can get through part of one, you know, maybe that could help to stem some conversation and maybe maybe then he'd be interested in learning more after you get a little bit of a taste, you know, that kind of thing.

SPEAKER_00 21:30

Yeah, absolutely. And well, I I also think it would be really helpful. I mean, I'm sure Cindy, please let us know if that kind of also answered your question or if you have any uh any other follow-up questions about that. Um, but I I'm guessing that there's probably a few people, and I know that I'm always very interested in this as well, and I think this is a great call to do this in and ask about is kind of what the overlap or how it looks like to kind of manage, especially when you're in midlife, going to paramedics. Going through menopause, like what it looks like to manage medication and also kind of going through like the emotional side. And like how do those two kind of work together? Is there like a push-pull? Or how would you both kind of um approach that kind of approach to perimenopause and menopause?

SPEAKER_03 22:19

I mean, I think that you know, taking care of yourself, it's it's kind of like a you have to take a holistic approach and it's about trying to fit in, you know, what works in your schedule during the day, not trying to make big, huge wholesale changes all at once because it's hard as human beings with, you know, set in our ways and with schedules and with certain habits to change things, you know, whole like whole circle, you know, around. Um, and so I think, you know, when you're trying to navigate starting medication, you want to stick to simple things. I always encourage patients to kind of focus on sleep hygiene, making sure they're getting plenty of good sleep, focus on their nutrition, go back to basics and try to focus on those as they're incorporating changes like a medication into their into their day-to-day routine. Um, and then I think, you know, when you're navigating relationships too and you're and you're dealing with all of that, like don't expect you're gonna fix everything overnight and that everything is just gonna be instantly better when you start taking hormone therapy. Um, you know, it's gonna take some time, it's gonna take some adjustment, that kind of thing. You know, so it's like a juggling act rather than a push-pull, I would say, Maddie. Um, you know, and it's about trying to kind of keep all the balls in the air, you know, and juggling those, um, but try trying to find the best way that works for you as an individual, and that's the hardest thing. Um, but then when you come out the other side and the wisdom that you have as a woman and you know, how you navigate that is your own journey. And and many women come out of it so gracefully and you know, really have crafted a great life for themselves. And menopause is that time period, it shouldn't be so negative. It's like a, you know, really that causes you to pause to reevaluate your life. My daughter's sneaking behind me now. We can see you on the camera. We love real life. Real life. She's, I think she thought she was out of breath. She didn't so cute. Um, yeah. So, you know, and I lost my train of thought, obviously. Um, but yeah, it's it's a lot to to navigate, but I think that um everybody has their own journey. Oh, what I was saying is that the pause, you know, make this be your impetus to kind of pause and reevaluate your life, you know. You get to redesign how you want your life to be from this point forward, you know, because and we can redefine ourselves all the time as human beings if we're brave enough to, you know. Yeah.

SPEAKER_02 24:54

Yeah, I think, you know, one of the things I talk to people about is the continued conversation about the importance of your relationship in the sense of physical and mental health care at the same time. Right. If a woman comes to me and she has not been to her OBGYN, we have a pretty candid conversation about that because there's a lot of potential benefit for you know having the conversation and starting to look at that, right? There was a recent study that, you know, the typical treatment for women of this time frame for mental health-related issues was some form of antidepressant. Um, that is now no longer the standard of care. It's estrogen, right? And thank God for that. Not to say that there's not room for both. And I am not a medical provider, so I am being really cautious. I'm but there are a lot of women who might have tried um, you know, I work with them who they're seeing a nurse practitioner or a psychiatrist or even their primary care for mental health-related concerns and are getting some support around that, but aren't quite feeling like it's enough.

unknown 25:56

Right.

SPEAKER_02 25:57

And so I say, have you have you consider talking to somebody about perimenopause or menopause as part of you know this conversation? And some of them, depending on their age, are like, oh no, there's no way. Well, maybe. I mean, I think I was in perimenopause long before I actually knew that I was in perimenopause, right? And looking back now, it's very easy for me to be like, oh, is that what was going on? But I didn't know, right? And so, you know, you may not be a great candidate for, you know, hormone replacement therapy. That may not be an option for you, but at least having the conversation um as part of the the work that we do, you know, on the emotional side, because sometimes that can be a very big driver and support for you. So um, so I think I think the relationship is is of the two, mental health and medical side is um is very intertwined.

SPEAKER_03 26:53

Yeah. No, and I would say probably at least 70% of women who end up coming to us for hormone therapy have been given an uh an antidepressant before they they reach us to get hormone therapy. And it may help some symptoms slightly. Absolutely. Um, but it it's not it's not full circle, it doesn't encompass everything. And it really, you know, it's not the standard of care for really treating. So it's it's only gonna put a band-aid on some of the symptoms and not really help, you know, everything. Yeah. But yeah. And I think a lot of women get, you know, kind of offended too, though, when they're going and talking about hot flashes and night sweats and they're talking about all these things happening, and then they're given an antidepressant. And especially if that's done in a 20-minute visit where you don't really feel like you got a word and edge wise, it's really difficult. Yeah. Yeah. Absolutely. Yeah.

SPEAKER_00 27:44

And we do have another question from Cindy as well. Um, if if if we're ready to move on from that question. Um, it's it's kind of it's not quite a second part to her original question, but a little bit of a follow-up. Um, she says, Am I wrong in thinking that my guy is gonna help me make this easier on both of us? So I think just kind of around what the role of um a boyfriend can look like and be within perimenopause, menopause, midlife.

SPEAKER_02 28:17

I don't think that that's the wrong perspective at all. But I I think that there's some element of an understanding like he doesn't know necessarily any more than you do. And you know, you're you're both encountering this in many cases for the first time, right? So, unless you watch a parent or a close person in your life go through that recently, like our recollection of that is minimal. I mean, I remember my mom having hysterectomy, but I don't I don't recall, you know, as a young, you know, I was probably I was a teenager, right, what that looked like in terms of the dynamic between my parents and their relationship. So unless you have something more immediate, I wouldn't expect you or your partner to know um, you know, and have sort of all of the answers there. But I do think that in the uh structure of your relationship, there's a lot of opportunity to learn these things together in a way that can actually enhance the bond in the relationship as opposed to pull it apart. Um the thing I think is struggle, is a struggle for men. If I and I don't want to speak with a stereotypical perspective, but a lot of them want to fix it and they're not able to, right? And some of that's the dynamic of your partnership. If you are in a partnership where your partner is always in this perspective of, I want to fix this, but they're not able to do so, that can be a really difficult and kind of helpless feeling, which can leave them floundering and a little bit uncertain about what to do. Um, if we if we want to talk briefly about like the component of like physical intimacy and relationship, and if I am having a hot flash and you know, night sweats and don't feel good about myself, and what am I gonna do potentially, right? Push my partner away. It has nothing to do with him at all. But is he internalizing that is something he did wrong? Right, and it's not that, right? Your sexual desire has dipped because you have maybe low testosterone, maybe. I mean, there's a number of reasons why that happens, but the discomfort of acknowledging that, right, and feeling like if I'm your partner, like I'm responsible for that, you're not you're not attracted to me. It's not usually what it is at all, right? And so a lot of that is, you know, stuff that you all will again potentially be navigating or having our conversation about for the first time, but that doesn't mean that there isn't an opportunity for resolution, right? There are a lot of women who find themselves on the other side of this in better, more enriching and intimate relationships as a result of this experience, not in spite of it.

SPEAKER_03 30:48

Yeah, I think that's important to think about too. Um, you know, and not only that, not only just the hot flashes and night sweats, but physical intimacy can change just because of the genito-urinary changes of perimenopause and menopause. So, you know, changes in lubrication, changes in the blood flow to those tissues, um, you know, sex can become painful for some women. And that's a huge part of a relationship and you know, a partnership with anybody, whether it be a boyfriend, a partner, you know, anything, or a non-male partner, even if you have a female partner and they're a different age than you and maybe they're not going through it, it can be difficult to navigate that. And so I think that, you know, one of the best things for any relationship at all is just improving communication, you know, having that ability to be frank and honest and be able to let them know like what you're feeling and what's going on and have the conversations like, hey, I love you. It's not you. My body is just not responding the way I want it to, and I don't feel comfortable in my own skin, you know, being able to say that to a partner, um, you know, and finding other ways to to still be intimate, maybe without, you know, sex per se, you know, like other things, you know. Um you have to be creative, um, I think, you know, to make sure. But I think communication is key.

SPEAKER_02 32:09

Yeah, I think there's the component of connection in relationship, right? Um, and that I think is a lot of times what the conversation really is about. So I think that's something else to consider is if the topic, let's say, is intimacy or like a disconnect related to intimacy, is that really the concern? Or is there potentially something else underneath that that is driving that concern? Is it maybe a combination of there's a lack of physical intimacy, but there's some lack of maybe emotional connection that's happening at the same time? Um, because those things happen in tandem often. And, you know, so but I think that the hard part is that vulnerability we talked about a little bit before as it relates to women making a decision to look elsewhere to get it, you know, an answer if they've gone to their physician and gotten a know, or they maybe want to consider starting therapy, but they feel scared about that. Um the openness to you know allow that vulnerability, I think is really important. Um, and that you kind of build up from there to a better version of yourself.

SPEAKER_03 33:15

Yeah. Now you said your practice is all virtual. I think that that's great. I mean, I can I can tell you I have utilized virtual therapy and it's it's it's a godsend for people that are busy and that have scheduled. Um, just in the way that you know Winona has helped to open up treatment options for patients that otherwise don't have access, you know, with telemedicine, you know, we're able to reach people that don't have someone in their neck of the woods to really help them with this. I think that virtual therapy is a great addition to that too.

SPEAKER_04 33:44

Yeah.

SPEAKER_03 33:44

Um yeah. So, and I think that people can be braver doing things through the internet too, um, than actually driving to an office. And and, you know, a lot of people have this um, you know, the stigma of mental health and they think they're gonna be on the couch, you know, like it's Freud, like they're gonna be psychoanalyzed.

SPEAKER_02 34:04

Oh, yes. I've had I've had clients join me from bed, um, you know, their car um on their lunch break, or because that's the only place that they have privacy. Um, you know, I you know, we started doing a lot more mental health care via uh, you know, telehealth during COVID. And it was a wonderful resource. Um, but that is that has not shifted away, right? We have the ability, and I would encourage women if if if local kind of accessibility in terms of what's available around where you are is not the best, consider potentially looking into virtual care. Um, it's not less effective, I found, because we use this medium to communicate. Um, again, there's still some, there's in some ways a little bit more flexibility or a little bit more freedom, um a little bit more comfort. You're in the comfort of your own home, you're not in somebody's office that is maybe a little bit uncomfortable or foreign to you, or right. Um so you know, that I think really is wonderful that we're still having that opportunity to to meet this way. I mean, we're heck, we're doing it now, right? It's a wonderful opportunity for us to have this conversation this way. So um, so yeah, it's it's a it's a great opportunity to find a provider that's a good fit for you.

SPEAKER_03 35:21

I think that's great.

SPEAKER_00 35:23

Amazing. Well, it looks like say it again, Dr. Kat. Sorry about that. Cindy's typing, it says. I was gonna say yes. I see Cindy's typing. Well, well, she just stopped. So we'll we'll give it a second and see if she wants to drop anything in there. But it looks like that might be all the questions that we have. We'll give Cindy a second in case she wants to say anything. Cindy, no pressure either way. I know you've already asked a couple questions.

SPEAKER_03 35:50

Well, I kudos to Cindy because she's the brave one of the 14 or so people that are on the call, you know, that have um that has you know asked a question and had something to want to talk about. So that's great. Thanks for being here, Cindy.

SPEAKER_00 36:03

Yeah, Cindy said, I'm 54 in the last three years, menopause has changed everything. Like you said, not comfortable on my own skin, having a hard time building self-esteem, um, which I think is very relatable.

SPEAKER_02 36:15

Yeah, I think there's a thing that starts to happen now is we start to see ourselves differently. Um, and and some of that is a is a challenge, um, sort of the navigation of that. Who am I at this juncture of my life? Right. What am I, what, what's going to be next for me? Right. But I think it's not just menopause that creates that. A lot of other transitions happen in midlife. Your kids maybe are moving out of the house and you're becoming an empty nester. Like Dr. Katz said, you're working on maybe supporting and looking after your parents, right? The transition seems to all happen around this cluster of time, but it isn't always just the menopause components that we're confronting at this particular time. Um, but you might go to therapy at this time in your life because you are dealing with empty nest syndrome and you are dealing maybe with working um to support your family and discover through the process that maybe menopause is having an impact, right? So um I think it's really important to have these conversations around, you know, the intersection of this time in your life and what may also be going on for you. Um, you know, to work to get yourself support and help and to not feel scared or shameful about what you're going through. Yeah.

SPEAKER_00 37:30

Absolutely. Well, thank you so much, Dr. Kat, and thank you so much, Stephanie, for just really giving some of your time tonight. I feel like we were really able to dive a lot into what it does like look like to navigate your relationships during menopause. And I feel like you've both given um some really, some really great points as well. And we did just have uh and Dr. Antonia Alford says, I just started the vegetal estriol cream. I explained to my husband what is going on with me because intimacy is non-existent. So I think kind of what you all were talking about earlier about how that can have like a lot of different sides to it as well, with what's going on. Um, yeah, but thank you both so much for your time. Um, and for everyone who's on the call too, I know that Dr. Kat mentioned a few of these things. I just wanted to also remind everyone um is that if you are if you really enjoyed tonight's session or you're interested in more questions, um, you can find the menopause hour on um Spotify. Um, it's our podcast at Winona, and we have a lot of really great um episodes in there. We have um eventually have like events like this, which are really great. You can listen going to the gym on your work break on your way home, if your boyfriend's in the car, lots of different times that you can listen to that. We also have some really great interviews that we have with our ambassadors, um, which is like kind of some deep dives into what their menopause journey has looked like. Um, also, if you are already a Winona patient, um, you can ask any question that you ever have to your Winona doctor in your patient portal. Um, that is always a great resource to be able to utilize. They are there 24-7, available for you. They want to hear from you. It's a great place to ask questions. Um, another great place is we do have more doctor dialogues like this, and then we also do have live QA's. Um, so we would love you to come to one of those. I would love to see y'all's faces again. I'd love to hear some more questions. Um, but thank you everyone so much for being here tonight. Thanks for tuning in. I know a lot of the time it is just a really big thing to kind of come to an event like this and just take the time to listen and absorb, and like that can be so transformative as well. Um, but so thank you, Dr. Kat. Thank you, Stephanie, for your time. Um, and we will hopefully catch everyone next time. Yeah, thanks for coming out tonight, everyone. Thanks, guys.

SPEAKER_01 39:55

Have a great evening, everybody. Good night. Thanks for spending time with us. We hope today's conversation helped you feel more informed, more supported, and a lot less alone. If you're ready to go deeper, download the Winona app. It's free, it's for you, and it's filled with resources, real stories, expert insights, and a vibrant space to connect with women navigating the same season. Have questions? Join our next live QA. Until next time, take care of yourself. We'll be here when you're ready for more.