High Sensitivity, Hormonal Changes, and Your Aging Body

Whether you’re perimenopausal, menopausal or postmenopausal, listen in on this episode of the Awaken Your Wise Woman podcast. as host Elizabeth Cush and Dr. Betsy Greenleaf, a premier women’s health expert, talk about high sensitivity, hormones and pelvic health at mid-life.

“I do believe that the women who tend to be highly sensitive tend to also feel things a lot more. I've seen this not just with hormone changes, but also with aches and pains.” 
 — Dr. Betsy Greenleaf

Are hot flashes burning you up? Do frequent bladder leaks leave you too embarrassed to leave the house? Oh, and how’s your sex life? For too long, women didn’t talk about menopause and other issues they experience at mid-life. Instead, we suffered in silence. Fortunately, we don’t have to. In this episode of Awaken Your Wise Woman, host Elizabeth “Biz” Cush, LCPC, a licensed professional therapist, founder of Progression Counseling in Maryland and Delaware, and soul-support for highly sensitive women, welcomes Dr. Betsy A.B. Greenleaf, founder of the International Pause Institute and CEO of the Pelvic Floor Store. They talk about pelvic health, perimenopause and menopause, hormones and other therapies, vaginal prolapse, incontinence, and other health and wellness issues of importance to mid-life women.

You can find the full show notes and resources here.

Transcript

Besty Greenleaf Interview

SUMMARY KEYWORDS

Menopause, hormone therapy, pelvic health, urogynecology, integrative medicine, perimenopause, andropause, stress management, gut microbiome, environmental toxins, bioidentical hormones, pelvic floor therapy, menopause symptoms, highly sensitive women, 

SPEAKERS

Betsy Greenleaf, Elizabeth Cush

Elizabeth Cush  00:04

Hi Betsy, and welcome to The Awaken Your wise woman podcast.

Betsy Greenleaf  00:09

Thank you so much biz for having me. I'm so excited to be talking with you today.

Elizabeth Cush  00:13

I'm excited to talk to you too. I feel like, I don't know if it's every season of the podcast, but I feel like it's been important to bring on guests who really validate the experience for women who are menopausal, perimenopausal, postmenopausal, like just, it's just that it's a thing that we don't doesn't get talked about a lot, although I do feel like it's more there is more focus happening now, but with further out, further ado, if you could just introduce yourself and share a little bit about you and the work that you do.

Betsy Greenleaf  00:50

Sure. I am officially the first board certified female urogynecologist in the United States, and I'm double boarded in obstetrics and gynecology, urogynecology and the third in esthetics, and I'm actually currently working on my fourth board certification right now in integrative medicine under Dr Andrew Weil. So I practiced for 17 years doing pelvic reconstructive surgery. And then I've been saying that I'm retired, because it sounds nice, but the truth of the matter is, I'm medically retired after a car accident. I don't have in a neck injury. I don't have the hand strength to do surgery anymore. But it's the truth is, I kind of think I manifested that because I was working for a hospital at the time that was incredibly abusive to their their doctors, and lo and behold, I was, like, one month into this contract, and I knew that it was not a place I wanted to be. And I literally, I would be so exhausted, like, I would say things in my head, like, Man, I wish I could just get a have a car accident, like, just enough so that I could get some rest, but not to be, like, incredibly injured. And I wasn't serious about that. But one day, I was driving to work, and somebody couldn't get to Walmart fast enough, and pulled across three lanes of traffic into the back of my car, and I ended up having a Yeah, I ended up having a little car accident. Herniated some discs, and interesting enough. That was the only clause in my contract that could get me off of working for that hospital. Was there was a disability clause. It was the one and only time I got fired, and the one and only time I was very happy no longer be at that job. So and I think I honestly believe that it was the universe kind of coming in, because I don't think I would have stopped on my own. And the you know, you said, you put it out there, and all of a sudden that go, the universe goes, Okay, great, we'll take care of that for you, right?

Elizabeth Cush  02:55

It's working. Yeah?

Betsy Greenleaf  02:57

Fast Yeah. Fast forward. I was at that that time, then I was teaching and speaking, and, you know, traveling all the time, and I was speaking a lot on menopause, and somebody asked me a menopause question at one of the conferences. I don't know what happened. I don't know why I said this, but I blurted out that I was opening a menopause clinic, and, like, after it came out of my mouth, I went, Oh, why did I say that? And then I was like, okay, that's terrifying, because I wasn't planning on going back into clinical medicine. But at the same time, I'm like, You know what? It makes perfect sense, because I was getting really frustrated. And to your point, I agree that, like, menopause has not been spoken about enough in the past. Like right now it's trending for whatever reason. But what was starting to happen? I was seeing people on social media who are not qualified to be talking about it or giving advice, and I was getting really frustrated. So I think it was like this combination of something spoke through me combined with frustration that I blurted this out because I knew that I could do it better than what I was seeing being done. So fast forward. That's what I just did. I opened a menopause and actually andropause. So the men don't have it easy, like they actually have their own change that they go through. So and I was finding as as I was working with women, they would be like, Hey, can you work with my husband or my boyfriend, or like, they're having problems too. And so we were like, Sure, let's add that into the mix. So yeah,

Elizabeth Cush  04:28

boy, boy, well, it's amazing how much our bodies go through as we enter this phase and how much is changing, but also how it impacts us emotionally. Yeah, yeah.

Betsy Greenleaf  04:43

One other thing is, I'm finding is actually a messaging issue, because I find some of my older patients that, like, maybe are like, 70s or 80s, and I say, like, I have a menopause clinic, their first response is, Oh, honey. I've been through that a long time ago. And so this is i. Don't know where that message isn't coming is coming from, and I'm trying to figure that out, and trying to get the message out better, that this is a phase that you go through that's like, from the time you stop getting your periods, the rest of your life. Is that menopausal phase, or post menopausal or like, I guess our language doesn't fit what it is, right? But you have the same health concerns. You might not be suffering through that perimenopause with the crazy ups and downs of the hormones, but you still have the same health concerns as the like that early menopause for the rest of your life. So it's still this continuum, I kind of like to explain it to people like a butterfly in that like your reproductive years, you're kind of like that caterpillar phase. And then perimenopause is the cocoon. And if you've ever seen or or read about what happens to butterflies in a cocoon is fascinatingly enough, they completely dissolve, which is great, easy that this happens in nature. They completely dissolve and cellularly reorganize. And for those women that are going through men, that perimenopausal period, they probably feel like they're completely dissolving. You know, that's a very tumultuous time, you know, for some people. And then, you know, on the other side, you're butterfly, and your butterfly the rest of your life, like this, is that new phase. So, yeah, that's

Elizabeth Cush  06:22

a lovely way to look at it. I know a lot of people well, don't necessarily see it as beautifully as that, right, as this recreation of who we are, but, but I do think that there is this assumption of, like, okay, perimenopause is like the hard stuff, then you hit menopause, and then it's just like, Okay, I'm done like, I just kind of move on from there. But I also want to address like, there are people that I know when I I guess when I was first starting perimenopausal symptoms, and at that time, I think there was still this feeling that, like hormones were bad, we should not be doing anything other than, you know, suffering through the symptoms that potentially are out there, right? And that has all changed, right? That dialog around, yeah, how we can get help and relief from some of the more difficult symptoms?

Betsy Greenleaf  07:26

Yeah, I unfortunately went through training. Was just finishing my training. When that all happened, it was literally like, one day we were like, hormones for everyone, and then the next day we're like, no hormones cause cancer and heart disease, and they're terrible. And that was back early 2000 so 2001 time when the Women's Health Initiative study came out. And what happened, unfortunately with that study is it got reported in New York Times and, like, it got blown up. So it's, I just imagine, like, what would happen today if the same thing happened, but not in the newspaper. It happened over social media, like it would have made people crazy. I mean, still it did, unfortunately, like literally, as doctors, our thing is do no harm, so we were pulling people off of their hormones left and right. So there was a lot of hot, flashing, pissed off women that were miserable at this time. And you know, people were getting the point where they're like, I don't care if it causes heart disease or cancer, like, give me my hormones back. And then at the same time, there's a whole generation of women that missed out on hormones because they were going, oh my god, hormones are bad. I'm going to get cancer. Now they're looking back at that study, there's so many factors we realized it really got blown up in the it really got blown up in the media, more so than it needed to be. And more of the issue is the type of hormones that were used in that study, and they're what I like to refer to, is non natural hormones, so they're not the hormones that naturally occur in our bodies. And the explanation of, well, why do these hormones even exist? It's purely for business purposes, because you can't patent anything that's naturally occurring. So how does a pharmaceutical company make something that works in the body, like a hormone that they can patent and protect their intellectual property and make money off of. It is they take something that's naturally occurring and they tweak that molecule. They add a couple more carbon and oxygen bonds on there, and now it's this new, novel compound that happened to work in the body, somewhat like hormones. However, what we realize now it was even even in that study, it was the type of progesterone that was used was more of an issue than the non natural estrogen. In fact, in the the estrogen only arm of that study, even though they were using non natural estrogens, those patients did not have. Have the heart disease risk, they did not have the breast cancer risk, and in fact, they had improvement in osteoporosis and lower rates of colon cancer. So it was specifically the estrogen progesterone arm that they found out. And we now know that type of progesterone is incredibly inflammatory. It happens to be processed in the body down a pathway that makes toxic, toxic metabolites. And those toxic metabolites can, I'm not saying it does, but can damage DNA. And when DNA is damaged, it can cause cancer. Doesn't mean it will, but it can. So there, you know. And unfortunately, those, those hormones, are still on the market today. And I personally think it's criminal that those are still being sold on the market, even though we know, you know, the issues. So I'm a big proponent of the by well, they we refer to as bioidentical. I think the word bioidentical has been a little overused. I kind of like called Bio equivalent, or natural hormones. It's what our body recognizes as natural, because we're finding out in research that those hormones are actually protective. And there was a big study that was done in France, and this is completely, you know, has flipped my my training too, for many years as a traditional doctor was like, oh, hormones are bad. And I was scared to put people on hormones. I was scared to take hormones. And now we're finding, actually, there was a study and it was like, I think it was about 50 ish 1000 women in France, where they took women with breast cancer and wins without, and they put them on hormones, and they followed them over time, and they found even the women with the history of breast cancer didn't have any adverse outcomes compared to the the other group. So now they're actually starting to see it may be protective in certain cases, but that's something you know. Make sure you're, let's say you know, blanket statement is safe for everybody. Make sure you you know, in your specific instance, you go over your doctor, you know, with your doctor, but we're finding new things, and we're like, wow, you know what this might be? You know this is a valid treatment option for people.

Elizabeth Cush  12:11

I know. I have friends who have had incredibly extreme hot flashes to the point where I don't know, it made life almost unbearable. And I know hormones really, really help them. They're a little bit younger than me, but yeah, yeah.

Betsy Greenleaf  12:27

And it's interesting because I also, you know, you see these trends on social media now, and the one thing that I'm finding is you get people on both ends of the spectrum who are very militant about their opinions, and you can be very militant about your opinions on social media, and kind of get away kind of get away with it. You have the people that are like, everybody needs to be on hormones. And then you have the people are like, No, I'm going to be all natural. I'm just going to go through my life and do things natural. What I say is, guess what? There are so many options. I think it's personal choice. It's, you know, there's no right or wrong. It's what you feel comfortable with. And in conversations with a doctor who is trained in how to manage these hormones,

Elizabeth Cush  13:09

absolutely, yeah, I feel like that's very good advice for all medicine, right? You have to find what works for you, and working with your doctor to make sure they're listening to you and yeah, and helping you through that. And as you know, like our my podcast really is focusing on highly sensitive women. And I'm curious, like, I'm wondering if for highly sensitive women, there is a because our sensory experience is a little more intensified that if potentially menopause could be or perimenopause could be more difficult for women who are highly sensitive. And I don't know if that's something you can answer, or what anything you've seen in your

Betsy Greenleaf  13:59

you know, I will say, from a medical standpoint, I can't answer it, but from a personal standpoint, I can having myself being an empath, and also really, you know, having a lot of friends who are into energy medicine, and really kind of finding my own woo, woo aspect of life over The years, and kind of admitting that I have some of these, you know, sensitivities, and what I've seen over the years, I do believe that the women who tend to be highly sensitive tend to also feel things a lot more than, let's Say, somebody who is not. And so I've seen this not just with hormone changes, but also with like aches and pains in the body. And so I think that when you are highly sensitive, you're also more in tune to what's going on in the body, and are able to pick that up at the same time, I think the energies around us. Also influence that and and I think if someone's already going through menopause, and they have some in, you know, in their in the presence of somebody who may not have the best energy, I think that energy will rub off on them and will can potentially make their their menopausal symptoms worse. So I think if you're a highly sensitive person, I think you got to look at a number of things, like, what is going on with you internally, and then also what is going on in and around your environment, and which things can you change? So, yeah,

Elizabeth Cush  15:34

yeah, yeah. That makes so much sense, yeah, because we Yeah, well, and I think energetically, we're all picking up on energies from other people, but I think highly sensitive people tend to be more attuned to other people's energies on the whole and that makes so much sense to me. Yeah. And so what? What was it that pushed you to really focus on this area for women, just sort of pelvic health, and yeah,

Betsy Greenleaf  16:06

all that, yeah. You know, it's definitely one of those things where, I think Steve Jobs said, you can't connect the dots looking forward. You can only connect them looking backwards. And so, you know, everyone, a lot of times, I get asked, like, what made you become a gynecologist who wants to look at vaginas all day long. And that's definitely not my was not my career goal as a young child, let alone medicine. I mean, I grew up and I just happened to have an interest in medicine. But connecting the dots, looking back, it all makes sense, even from like, a young age, at the age of four, I remember there was, like, four or five, there was a TV show that was on the TV back then, this was probably like mid 70s, called emergency, and it was about an ambulance team at a out of California. And I remember loving that show as a kid. Like, looking back, you kind of like, I was like, Oh God, I can't believe my mom actually let me watch that as a child. It probably wasn't that appropriate, but I remember really being interested in that same thing when my mom was pregnant with my sister. I was about five, five and a half. I remember like, being obsessed with the book. She had these books that, like, had pictures of the baby inside the uterus and with the uterus. And I remember, like, Well, looking at that book and like, being, like, really interested in it still, you know, when I said it's, it all makes sense looking back. And then, even when I went to college, I knew I was interested in medicine. I didn't know which way I wanted to go. In fact, actually, I studied biology, but I thought I wanted to go into veterinary medicine, and being a New Jersey resident, there's no veterinary school, so I applied to veterinary school, and medical school was my backup plan. And did not get into veterinary school because I usually take people from their own state first. So I was told, I was told, we'll move to another state, set up a residency and then reapply. But in the meantime, I got into medical school, and then I really just loved it. I thought I wanted to do pediatrics, because that's kind of close to veterinary medicine.

Betsy Greenleaf  18:11

You know, I mean to let the babies can't tell you what's going on, you know?

Betsy Greenleaf  18:17

So, and I actually, I found myself very frustrated with dealing with parents, especially in some of the inner cities where they were being given free formula and they were watering down the formula because, for whatever reason, they didn't want to go pick it up from the the WIC program that we have in New Jersey for Free. And I was like, like, how? Like, you're getting this for free. Like, why wouldn't you take care of your child? Yeah, we know there's a lot of social issues there, but like, I found myself very frustrated, and then I kind of just was drawn to some of the surgical sub specialties and found my way into gynecology and really like dealing with, with women I was actually started out in general surgery, and halfway through general surgery, I kind of realized it wasn't for me, because general surgeons are amazing. You want them when your appendix has ruptured, but they, I find them to be very like, much like body mechanics, like, let's get in there and fix it and get out there wasn't this warm, fuzzy relationship,

Elizabeth Cush  19:23

relationship building. 

19:25

I would go around, this was actually really funny. I would go around on my on my rounds in the hospital, and I really wanted to know about people's feelings. And I'd be like, so how do you feel now that your gallbladder is out? Like, how do you feel now that your appendix it just wasn't that warm,

Betsy Greenleaf  19:42

fuzzy type. 

Elizabeth Cush  19:43

Wasn't the same,

Betsy Greenleaf  19:45

but I can get that and the relationships in the women's health. So I switched it into gynecology and then, and then urogynecology. I didn't even know that was a field. Into my senior year,

Elizabeth Cush  19:58

I was gonna say, you have to choose. What that is? Because I'm not, yeah, sure.

Betsy Greenleaf  20:01

And in fact, there's only 1500 euro gynecologists the United States. And I remember when I told my mom that I was going to do the fellowship in that and she was like, What is euro gynecology? Is it like European gynecology? Like fancy gynecology, extra special, Euro Disney, you know? And it's really a combination of urology and gynecology. So it has to deal with the bladder. And in fact, actually, it's really everything from everything in the pelvis, but more like bladder, bowel, reproductive organs, the muscles, the nerves. Traditionally, most urogynecologists end up dealing with things like prolapse, where the organs can droop and drop from ligament damage from childbirth or lifting heavy objects. They deal with incontinence issues, recurrent urinary tract infections, pelvic pain. So that's kind of we're like a super sub specialty,

Elizabeth Cush  20:57

yeah, but it feels as if, well, I appreciate that more there has been more attention to that whole success specialty, right? That pelvic health is really important to our overall health, but also to our sexual health, like, if we're I don't know if we're in pain when we're having sex, or if we're incontinent, and so sex feels icky because we know or prolapse even right, like, I don't know, it feels important that we're addressing these things with compassion and care and actually talking about them as because we know so many women suffer from these things.

Betsy Greenleaf  21:41

Yeah, it's crazy. Like I remember, you know, in my office, I would have women come in and talk to me about the incontinence or the prolapse, and they'd be like, am I the only person that you've ever seen that has this? And I'm like, nope, pretty much, this is what I do all day long. And I mean, from a prolapse standpoint, 50% of women will have a prolapse at some point in their lives, and that is definitely forget about menopause. Not being talked about pelvic health is even more like, you know, kind of quieted and hush, hushed and, you know, and it is really, I would love to, like my goal in life would be number one to, let's talk about, you know, be able to get to get to the point where you could talk about these things and people don't blush or get embarrassed. And there was a study actually in it was actually done in Europe, but I'm sure it applies here, that 61% of women are uncomfortable saying the word vagina. But the fact is, 83% of us will have a problem down their vagina point in our in our lives. So if we can't say the words, how do we ask for help? So yeah, it's really and I unfortunately, like, I think I say the word vagina so much like, I'm desensitized to it. So, like, sometimes I have to watch when the company I'm with just start talking about vaginas, and my poor teenage girls, like, are just like, mom, and I'm like, oh, yeah, but really, I mean, it's no big deal. It's just another body part. I'm old. I'm always in trouble on Facebook because I'll put something about vaginas, and then they'll tell me this word goes against community standards. I'm like, What do you want me to call it?

Elizabeth Cush  23:20

Like, really? Right? Right? It. Make up some, yeah, ridiculous.

Betsy Greenleaf  23:26

I have to spell it. When I remember, I have to spell like V, at symbol, like G, exclamation point, n, a, like. And I'm like, Really, this is ridiculous.

Elizabeth Cush  23:37

Oh my gosh, that is insane. Well, and I think about too, how many women I know who suffer from incontinence and how it feels as if it's it's pretty common.

Betsy Greenleaf  23:53

It's very, very common. Yeah, and there's tons of different options. Well, I

Elizabeth Cush  23:59

was gonna say, I feel like there are things you can do. And most people, at least the people I have known, they just like, Oh, you just have to deal with it. We just have to suffer through and, you know, manage it however we manage it. But also there's sort of a shame aspect too, like, I should be able to control this, even though it's not within your control, because it's your body that's doing this.

Betsy Greenleaf  24:23

Yeah, yeah. I know it's really a shame, because I think a lot of people just go, Oh, this is just get a natural part of getting older, and they just accept it. I mean, the adult diaper and pad industry is a multi billion dollar industry, and I've had women who don't leave their homes because they are embarrassed and didn't realize that that they can do anything about it. And there's so many different treatments, I mean, anything from like physical therapy, supplements, medications, to the extreme, doing surgery. But there's so many things in between that. So you know, there is definitely, I mean, I'm a big proponent of people saying urogynecologist, because I am one. But like I said, there's only 1500 of us in the United States, so urologist would be the next option. But, like, specifically finding one that does women's health, because sometimes the urologist focus just mainly on men's health, and they kind of, they kind of miss the boat when it comes to things with women's health.

Elizabeth Cush  25:28

So, yeah, yeah. I, I hear that 100% so for you, like, if there were women out there that are listening, who were struggling with some of the stuff we've talked about today, you know, what would you offer to them? What would you like them to know?

Betsy Greenleaf  25:49

You know, I think the biggest thing is there's a misconception that hormones are the answer and hormones are just a tool in our toolbox. And really, and the one thing that's driving me a little bit crazy right now is the number of these online companies that are popping up where you don't even see a practitioner. You're basically just putting in your information, and next thing you know, you're getting a prescription for hormones. Here's the thing, hormones don't work unless the body is prepared for it, and that means, I always say sex and stress can't coexist. So sex meaning sex hormones, fertility and even libido, that has to all happen in work well, in a in a relaxed state, if there's any stressors happening, the body will convert those hormones into cortisol, which is a stress hormone. So even if you're taking hormones, if your body's stressed, and that could be mental stress or physical stress, and I'll go through what the stressors can be like, you can back convert it into cortisol. So that's why the hormones don't work. So the hormones are a tool, but they work better when we are in a relaxed state. So what are the stressors? The stressors can be anything from not getting enough sleep, not drinking enough water, eating inflammatory foods, so anything that's processed sugars. I tell people, I tell my patients, that your food should fall into four categories that your food should have at some point, walked, swam, flew or grew, because Doritos don't grow on trees. There's no free range Twinkies. So if it's into those four categories, those are considered a Whole Foods, and they're healthy. You know, mental stress, physical stress, like of a disease and illness. When the pandemic happened, we saw people's hormones go crazy because of combination the virus and or the stressor of the vaccine. You know, and mental stress comes in so many different it could be like work stress, religion stress, stress, financial stress, so once again, doing the basics and looking at, how can we decrease our level of stress, so that if we choose to do hormones, then it works better. One of the things I like to incorporate into my programming is I actually test everybody their gut microbiome. And that's what a passion of mine is the microbiome, which is the organisms that live on and in our body, and they're finding that they really have a tremendous impact on our health, our wellness, or even our mental health, because if our gut bacteria is off, 90% of our happy hormone is made in our gut. So if our gut is off, we're more prone to depression, anxiety, mental health issues. 80% of our immune system is made in our gut. So if our gut is off, we're more likely to get ill. So I like to I found that over the years, just doing this for people, that same thing when I just gave them hormones, and they didn't work, because that's how we were. I was originally trained like, alright, just give them hormones. I'd be like, why? But if I know that their gut is balanced, and most people do have some gut imbalances, if I can balance their gut and decrease that while working on lifestyle things, and then we add the hormones into everything, everything works so much better.

Elizabeth Cush  29:22

That makes so much sense, though, right? I mean, like our bodies are, they know what to do but, but if we are under distress or under stress all the time, they're going to react to that too, yeah. Wow.

Betsy Greenleaf  29:38

And actually, you know, the thing I forgot to mention is, which is really kind of scary, is the number of chemicals that we're exposed to on a daily basis, and some of these chemicals can actually disrupt our hormones. So there is a wonderful website that I recommend people take a look at. It's called Environmental Working Group, or ewg.org and. You can go look up your beauty products and see if you're using things that are healthy. Because, you know, things that we're putting on our bodies sometimes can be affecting our hormones too.

Elizabeth Cush  30:11

That makes sense, too, yeah. Think about just the impact of I was just reading an article about plastics and how on every level they're entering our bloodstream and our our whole body, is so little terrifying because it, you know, the environment there,

Betsy Greenleaf  30:31

yeah, the environmental toxin is, is that you go down that rabbit hole, it's very frustrating, because there's really, at our level of modern life, there's only, we can only actively try to reduce our exposure. We're not going to get rid of it. It's just, it's, you know, it's around us. It's, you know, it's in our food sources. I mean, this is a better idea. Why eating organic, if you can afford to eat organic, is better because of the insecticides and pesticides and how they can disrupt our hormones. There's only so much we can do. Also on the Environmental Working Group, they have a list. It's called the Dirty Dozen. So it's the 12 foods that tend to be the highest in toxins. And so even if you can just cut those foods out and replace them with organic options, you're better off 

Elizabeth Cush  31:21

check it out. To check it out. Well, if listeners wanted to find out more about you, Betsy, how would they how would they do that?

Betsy Greenleaf  31:31

Yeah, so I am on every platform and social media. If you just look up Dr, Betsy, Greenleaf, B, E, T, S, Y, and then green and leaf, you'll find me someplace. So please follow and you know, I love interacting with people. So on there. Also my practice is called the International pause Institute, and you can find it at pause, like, P, A, U, S, E, like menopause, but without the meadow pause institute.com, they on that website, there's a free hormone quiz, which kind of gives you, just by answering a couple questions, gives you an idea of where you may be. And then also, I have a website called the pelvic floor store, which I started in 2018 because I had a patient who wanted a centralized place to buy all the products that I was recommending instead of going to this website, that website. So it was brilliant. So I started the the pelvic floor store, and actually, if you use the code awaken all upper upper case, you can get 10% off. And I sent you that link.

Elizabeth Cush  32:29

Yeah, you did. I will include that in the show notes. I appreciate that so much. Thank you.

Betsy Greenleaf  32:34

Oh, and last thing I didn't even tell I can't always forget to tell people this. So this past year, I created a menopause rock album that you can find on social you can find on Apple and Spotify. It started off as a joke between me and my friends were like, you know, there's not enough songs out there celebrating like midlife women, like, there should be more songs, because there's more of us. And so it started as a joke, and next thing you know, we ended up kind of writing it, and found people to sing it, and we produced the album, and we're like, it just became, like a fun thing to do. And then we put it out, and it's, it's called menopause memo, and you can find it on, yeah, like I said, you can find it on, on, like, all the platforms. Oh, and one last thing, I am restarting up my podcast. I had one in the past, but I'm starting one in very soon, called 40s forward. And you can find that wherever you listen to podcasts.

Elizabeth Cush  33:31

So awesome, awesome, awesome. Well, I will include all those, yeah, all that information in the show notes, and I hope people will check it out. Thanks so much for coming on the podcast. I really appreciate it. This was a great conversation.

Betsy Greenleaf  33:45

Thank you so much, biz. I really appreciate the opportunity. Thank.