Episode 2: Hot Flashes and Insulin? What Your Metabolism May Be Telling You

Most women are told that hot flashes are simply the result of declining estrogen.

But new research suggests the story may be more complex.

In this episode, we break down a recent study published in the Journal of Clinical Endocrinology & Metabolism that found higher fasting insulin levels early in perimenopause were associated with:

• Earlier onset of hot flashes
• Longer duration of vasomotor symptoms
• Greater overall symptom burden across the menopausal transition

Importantly, insulin predicted symptom trajectory independent of BMI.

This means metabolic health — not just body weight — may influence how perimenopause unfolds.

Who tends to have higher insulin levels?

Women with:

• Abdominal weight gain
• History of PCOS
• Prediabetes or gestational diabetes
• Family history of type 2 diabetes
• Sedentary lifestyle
• Chronic stress and poor sleep
• Diets high in refined carbohydrates

Many of these women are told their labs are “normal” because glucose and A1c may still fall within standard ranges — but insulin can be elevated years before diabetes develops.

What We Discuss in This Episode

• What the study actually showed
• Why insulin may affect hormone dynamics (including SHBG and androgens)
• The relationship between metabolism, inflammation, and vasomotor symptoms
• Why perimenopause isn’t “just an estrogen problem”
• How early metabolic health may influence long-term symptom patterns

We also answer social media questions about weight gain, “normal labs,” insulin resistance, and whether women should request fasting insulin testing.

Why This Matters

Perimenopause is not just something that happens to you.

Emerging evidence suggests there may be modifiable risk factors that influence symptom severity and duration. That opens the door to earlier intervention, prevention, and more individualized care.

If you’re in your late 30s or 40s and noticing changes, this conversation is for you.

www.menopauselouisiana.com

Transcript

SPEAKER_01 0:00

So in menopause, labs can confirm menopause. So like if I'm someone, say, say I've had a hysterectomy or an ablation or I have an IUD that I don't want to take out, but I do want to know if I'm in menopause. Labs can confirm menopause. And every situation is different, but that's one reason to look at labs. But in perimenopause, that's a whole different thing. Estrogen's going up and down. I can have, let's just say hypothetically, I have my labstrom at 8 a.m. and my estrogen is 150. At noon, if I were to have labs again, which we don't do, but if I did, my estrogen might have gone from 150 to 50, and both of those levels are normal. Anywhere from 10 to something like 600 estrogen in perimetopause is normal. But I don't feel the same as I feel if I go from 150 to 50. When I'm dropped at my child, I don't feel normal. So laps don't tell us much. You are listening to Perimetopause Explain.

SPEAKER_02 0:57

This show is about Perimetopause. Here before menopause.

SPEAKER_03 1:01

When things start changing, often before anyone calls it menopause.

SPEAKER_00 1:06

Each episode is real talk from real questions to explain what's going on in your body. No hype, no minimizing, just straight answers and honest conversation.

SPEAKER_02 1:15

If something feels off and you haven't gotten clear explanations yet.

SPEAKER_00 1:19

This podcast is for you. Welcome back to your show.

SPEAKER_01 1:23

Hi, Steven.

SPEAKER_00 1:25

I'm Steven Youngblood, medical director, internist, and co-founder of the menopause clinic. And this is Crystal. Crystal, introduce yourself.

SPEAKER_01 1:34

Hi, I'm Crystal Burke. I am a nurse practitioner and menopause specialist and co-founder of the Menopause Clinic.

SPEAKER_00 1:41

And this is Perimenopause Explained.

unknown 1:45

Right.

SPEAKER_00 1:45

So quick reminder: this podcast is about science, symptoms, and solutions for perimenopause and menopause. We are not diagnosing or treating. And Crystal, I thought we'd start today with an article I came across. It was at the Journal of Clinical Endronology and Metabolism. You know, it's you see those magazines hanging out everywhere now.

SPEAKER_01 2:06

Real fancy scientific stuff stuff, right? Yeah.

SPEAKER_00 2:09

And this was a very scientific article with lots of statistics. So, you know, only the uh the science geeks and us would would, you know, would have gone through the article. But I did want to talk about it a little bit.

SPEAKER_03 2:22

You're gonna explain it.

SPEAKER_00 2:23

So we're gonna explain it a little bit and just kind of keep it at simple levels, but I thought it was a good, it was an interesting series of talking points. The article showed that women with insulin resistance had worse vasomotor symptoms during perimenopause and menopause. So worse hot flashes and all the in night sweats and the other symptoms that come along with it. Um and it kind of suggested that higher insulin levels was an instigator of these worsening symptoms. Okay. Um now it also correlated well with body mass index. So high, you know, when we know higher body mass index generally will lead to more insulin resistance. So and more insulin resistance generally leads to higher resting or fasting blood glucose sugars.

SPEAKER_03 3:18

Yeah.

SPEAKER_00 3:19

Okay. So give me your take on it.

SPEAKER_01 3:22

Like so tell me what this means to any woman. Like, what does this mean in English?

SPEAKER_00 3:29

In in English, yes. Yes. So in English, it would suggest that if you're pre-diabetes, overweight, um, you're at higher risk for having worse perimenopausal and menopausal symptoms, specifically the vasomotor, which will be the hot flashes.

SPEAKER_01 3:48

So that makes sense. Okay, so that makes sense. So the thing is, though, is that even just going into perimenopause puts you more at risk for insulin resistance and higher BMI. So this is all a big circle that's a mess that is perimenopause.

SPEAKER_03 4:04

Is what it means to me.

SPEAKER_00 4:05

So are there any other endocrine disorders that could worsen the symptoms of perimenopause?

SPEAKER_01 4:11

Um well, I mean, basically, the basically perimenopause, it there's a circle. The other conditions haven't been known. Like there's there's not anything that says if you have this condition, perimenopause will be worse. However, perimenopause can get can worsen any condition you have. So it is kind of like a circle. But yeah, I mean, I can see how, you know, if we're because I think the study, what did the study look at? Do you remember the specifics of the study?

SPEAKER_00 4:46

A little bit of the specifics, yes.

SPEAKER_01 4:48

Yeah. What were they were they looking what were they looking at specifically?

SPEAKER_00 4:52

So I think they were mostly looking at body BMI. Yeah. And um they did some serum insulin levels, which is something clinically we would never do. Yeah. Um, and they were also looking at serum serum glucose levels.

SPEAKER_01 5:05

Yeah. So I mean, it basically the thing is that perimenopause can affect other things, and other things can affect perimenopause, is what is what I'm taking from that, right? So so yeah, I mean, we know I feel like like we know that, but it's good that they have these studies that are saying that so that it's clear.

SPEAKER_00 5:25

Yep.

SPEAKER_01 5:26

But yeah, it's really interesting.

SPEAKER_00 5:27

It is, absolutely. So in theory, if a person or excuse me, a person, a woman was to start having, was able to exercise and diet, which we know is incredibly hard for weight loss, but if they were able to lose some weight, in theory, it could potentially lessen their symptoms. But in the setting of perimenopause and menopause, that's really hard to do.

SPEAKER_01 5:49

Yes. So, well, so yeah, so basically, I guess what I'm taking from that is if you're if you're at a good or a BMI that is within within a certain range, you what it's saying is that your likelihood of perimenopause symptoms being less is likely. But the thing is, is going into perimenopause, you can have an a a normal BMI, but your BMI can go up despite exercise in the spiding diet. Diet, right. So I mean, that's the thing, is it's just a big circle.

SPEAKER_00 6:31

Absolutely. So I looked up some of the risk factors for higher insulin resistance. And one of the ones that came up was chronic stress with poor sleep.

unknown 6:45

Right.

SPEAKER_00 6:45

Which pretty much describes standard American condition, right?

SPEAKER_01 6:49

Right, especially perimenopause, though.

SPEAKER_00 6:52

Right. Absolutely. How many, I mean, like, is poor sleep habits whether something you see often in perimenopause?

SPEAKER_01 7:00

That is one of the most common things, but it's not but that's the thing is it's not always poor sleep habits. It's poor sleep.

SPEAKER_00 7:07

Poor sleep.

SPEAKER_01 7:08

But not always because you because again, you can do everything right. You can go to bed on time and and you can even sometimes fall asleep fine, but you wake up in the middle of the night because of biology and because of what's happening to your hormones, not because of anything you are doing. Like, like what happened with me, I could not sleep. I was doing everything mostly right, but I mean, I was trying.

SPEAKER_00 7:31

Minus six cokes a day.

SPEAKER_01 7:33

Well, yeah, but I've done that my whole life. True, true. But that's the thing is you you can you can have bad habits your whole life, but all of a sudden they're affecting you in a different way. There's something different, something else different going on there. So, so yeah, you sleep is a very common problem. It's one of the most common problems. So, yeah, but we do see insulin resistance and cholesterol go up in perimenopause. But that's the thing, it's it's an inverse relationship. So estrogen goes down, insulin resistance and cholesterol go up.

SPEAKER_00 8:07

Well, cholesterol is something you know easier to measure than insulin resistance. So have you seen patients where like their their cholesterol was out of whack, quote unquote? Because it's really not just, we don't look just at total cholesterol, right? We're looking at ratios of the bad to the good and all that. So have you seen a situation where someone got on HRT therapy and all of a sudden their cholesterol levels right-sized and came back to a good level?

SPEAKER_01 8:34

Yes. What do those mean?

SPEAKER_00 8:36

That's why I asked the question.

SPEAKER_01 8:37

Yes, what do those mean?

SPEAKER_00 8:38

So tell me about that. Like, give me some some your experiences on that and just how it made you feel.

SPEAKER_01 8:44

Yeah, so I um I had always had low cholesterol.

SPEAKER_00 8:50

Better than mine, much better than mine.

SPEAKER_01 8:51

Which is weird because mine must be hereditary. I must have good cholesterol hereditarily because my eating habits were never as and my and definitely master's habits, not as good as yours. But I always had really good cholesterol until I was about 38. And then it went straight up. With the graph, it went straight up, and then it kept going up, and although nothing else changed. I was gaining weight, which was probably also insulin resistance that we didn't we don't check for.

SPEAKER_00 9:23

Right, right.

SPEAKER_01 9:24

But you know what? My A1C was going up too.

SPEAKER_00 9:27

Um how high do you remember how high it got?

SPEAKER_01 9:30

5.6. It's always been around five, but I was almost pre-diabetic.

SPEAKER_00 9:35

Yeah, 5.6 is borderline for pre-diabetes, right?

SPEAKER_01 9:38

Yeah, I was almost pre-diabetic, and then but although nothing had changed in what I was doing, and then it went right back down. Absolutely. Both of them now. My and now it's like my A1C is like 4.8.

unknown 9:53

It's clear.

SPEAKER_00 9:54

Super therapeutic. All righty. So uh from this point, we're gonna move on into some questions that we've commonly hear, commonly pick up on social media. Yes, um, message real questions, real questions that people ask us all the time.

SPEAKER_01 10:09

Yeah.

SPEAKER_00 10:09

Um, some of them sometimes the questions are asked in the middle of the street.

SPEAKER_01 10:13

Which happened recently.

SPEAKER_00 10:14

Which happened recently. Um, so first question uh why doesn't my OBGen bring up perimenopause or HRT?

SPEAKER_01 10:24

Yeah, that is that is a good that's a great question.

SPEAKER_00 10:27

And then was that the one that she asked us in the middle of the street? Okay, yeah, yeah.

SPEAKER_01 10:31

Yeah, that was, that was. Um well, because just like me, and just like you, your OBGYN PCP were not trained in menopause. Perimenopause is a whole different physiological condition that was never mentioned in nurse practitioner school for me and never mentioned in medical school for you, right?

SPEAKER_00 10:56

Right, right, right.

SPEAKER_01 10:57

So obs the studies show that 30% of them, only 30% of them, even had menopause training for three hours. So the rest of them had no menopause training, and that even those three hours were on menopause, not perimenopause, which is a whole different physiological condition. In menopause, estrogen is declining steadily, and the symptoms are are different because it's just a different part of the process, but physiologically and perimenopause, it's up and down, up and down, it's treated differently, it is a different process. So your OBGYN and PCP haven't been taught that, and so that's hard for them to bring up because it would be like your dermatologist talking you about cardiology, right? It's not it's not a fair expectation, especially when you consider all the things that go into parimenabolics. So one of one of the worst things for me was brain fog. So your g your OBGYN isn't trained on brain fog and and attention and focus and sleep. So that that's that's why women get sent to multiple different specialists, but that's your OBGYN is is trained mostly on fertility, like birth control, fertility issues, and um like menstrual irregularities, hysterectomies. There, I mean, there's surgery involved in that. Um parametabols isn't taught to them. The people that I know like I got additional, like I looked for and went for special training, it just wasn't taught in school. So that that's why an OBG by N and a PCP, it's going to be difficult for them to do because they weren't taught it, and they're doing other things.

SPEAKER_00 13:04

Right, right. So how much how long did that additional training take you?

SPEAKER_01 13:10

Um, so I it took me a while to find someone.

SPEAKER_00 13:16

Okay.

SPEAKER_01 13:16

It took me a while to find someone. The training, I mean about it was because I have the other trained, it was about six months for the training for that. But I also attend meetings every month so that I keep up on everything. Because the thing is, is is like a lot of people will think, oh well, it's just prescribing a patch. No, it's it's a there's a lot involved in this. There's the patch has to match the progesterone, but what if what if someone has progesterone intolerance? What if this doesn't work for them? There's a lot involved. So so there's ongoing education. So that's the thing, and that's gonna be hard for someone who that's not their primary focus.

SPEAKER_00 14:01

And yeah, and like I guess from the standpoint of an OBGEN or any physician, nurse practitioner, you know, seeing a patient that with a medicine that requires multiple titration steps over weeks, months? So weeks to months, yeah. Weeks to months, but yeah.

SPEAKER_01 14:24

And and then the pair of minimum walls, it can you can have it can take you weeks to months to get really good at where you are, and then six months later be at a completely point because your body's changing.

SPEAKER_00 14:34

And even in the field of like cardiology with their heart failure clinics, a lot of these medications have to be titrated fairly frequently. And so they've developed entire clinics where that is just their one job is to go out and make sure that you know, are you weighing yourself? Okay, yeah. Medicine, click up one level, see you back in a week or two, click up another level. And and you know, and again, even in that field, it's you know, three, four, five medicines that they're trying to adjust to find the right thing.

SPEAKER_03 15:05

Yeah, yeah.

SPEAKER_00 15:07

All right. Second question that we often hear is around blood work. Okay. And the question usually goes something like this Um, I feel awful, but I'm told my labs are fine.

SPEAKER_03 15:19

Yeah.

SPEAKER_00 15:20

So give me some information around that. Like, how do you use labs in the process of pregnanopause versus menopause versus all the other types?

SPEAKER_01 15:31

Yeah. So I'm glad you said that because that is different. So in menopause, labs can confirm menopause. So, like if I'm if I'm someone, say, say I've had an hysterectomy or an ablation or I have an IUD that I don't want to take out, but I do want to know if I'm in menopause. Labs can confirm menopause. Um especially for and every situation is different, but that's one reason to look at labs. Um, but in perimenopause, that's a whole different thing. Estrogen's going up and down. I can have, let's just say hypothetically, I have my labs drawn at 8 a.m. and my estrogen is 150. At noon, if I were to have labs again, which we don't do, but if I did, my estrogen might have gone from 150 to 50. And both of those levels are normal. Anywhere from anywhere from 10 to something like 600 estrogen in perimetopolis is normal. But I don't feel the same as I feel if I go from 150 to 50, when I've dropped that much, I don't I don't feel normal. So labs don't tell as much.

SPEAKER_00 16:49

Okay. So when would you use lab work in anywhere in in your treatment protocol? Like, because I've I've I've heard of a saliva test and and a few other tests where I can't think of an example when I would ever test anyone's saliva, but yeah.

SPEAKER_01 17:08

So so we uh there's so many different types of perimenopause care, right? So there's functional, there's integrative, there's evidence-based, there's different kinds. So we we do evidence-based. So we go by the menopause society guidelines, a American College of Gynecology guidelines, we go by very specific guidelines that say that the best way to test for estrogen is by blood. So we don't, we don't, we don't use saliva tests. So what would what would we look at blood war for? So say I talk to somebody who is having paramenopause symptoms, understands that that lab isn't going to tell her whether her symptoms are related to perimenopause, but she wants to know her baseline. Like I want, you know, maybe I just want to know what my estrogen is now. If I want to know that, then yeah, I I think having having labs are are worth it. For you, if you have information you want to know about your body, yeah. But is it gonna help guide treatment? Not necessarily, because your symptoms matter more than the number on the paper. And it can be very discouraging to know that something's wrong. Like, I know I can't sleep, I have brain fog, I have a little libido, like I have all these symptoms. Something's wrong, but I look at a piece of paper and the numbers normal. That's very discouraging, and that's not the whole picture. So that's why labs can be harmful in some situations, but if a woman wants to know what her baseline is, then yes, she should have it. Also, a lot of times, not a lot of times, but sometimes symptoms can look like thyroid. Um, it can look like other problems like thyroid or or other conditions. So if we can test before to kind of see is it related to the thyroid? Um, could it be both? Could there be overlap? So sometimes that could be very helpful.

SPEAKER_00 19:21

Okay. So the next question evolves around age. And and this is something that I think in our in our first episode we we had a long conversation about when we were talking about you. And um, so often hear someone mid-thirties say, Well, I'm too young. And then you can ask them something like, Well, how are you sleeping? Oh, I sleep terrible. When did it start? Like six months ago. Right. Right, right. So what is too young for perimenopause? And you know, when should on average we ex women should expect something to start happening?

unknown 20:03

Yeah.

SPEAKER_01 20:04

So this is the hard part because if if there was a certain, like if we were talking about menopause, then yeah, we'd be looking at 51 is the average age, so 40 between 45 and 50 five. Perimenopause is 10 years before that. So on average, it can it can it can be between 35 and 45, most commonly in the early 40s, but studies show it can happen as early as 34. So there's a lot of answers in there, but basically 34 and up. Although, does that mean that someone can't go into perimenopause or menopause much earlier than that? They can. Yeah.

unknown 20:55

Okay.

SPEAKER_00 20:56

And like what's the ballpark like the latest a woman should expect for, I guess, really probably more like menopause. So again, remembering menopause is 12 months without a period. So we're talking about menopauses, the ovaries aren't doing nothing. Right. Right. So what would be the like the latest? Like, you know, would it be 70?

SPEAKER_01 21:17

I mean could that have ever happened? Maybe. But it's not likely. So average, average would be average menopause is 45 to 55. Could you be, you know, after 60? Yeah. But typically, typically it's going to be in that range or just after it, if that's the case. But yeah. Yeah, that will be something.

SPEAKER_00 21:50

All right. This is this is a topic that I think we've heard a lot of women mention. And so here the question is why. Why do I, as a woman, feel dismissed when I bring up hormones?

SPEAKER_01 22:06

Well, because most of the time you are. Sadly, you are. Because most of the time, I mean, again, we weren't taught this. I wasn't taught it. You weren't taught it. And so you when you're talking to a provider, a physician, a nurse practitioner, a PA, most of the time they weren't taught this, so they don't know. So without knowing, then there's not really an answer that you're going to get, which then you feel understandably so you feel dismissed. Because there's not an answer. But I mean, we've talked about this before. Like for you, you you've seen women that that had complaints, joint pain and and insomnia, and and you didn't know how to help them, right?

SPEAKER_00 22:57

Right, right, right. So yeah, I mean, you know, when a person comes in with a complaint, it doesn't really matter the complaint. They have a complaint. You do what you do, you know, you do an exam, you ask questions, probably gonna do some blood work at some point, or an x-ray, pinning what the complaint is. And at the end of the day, if nothing comes back, it's I can't fix this. Um, this is an unfixable thing for me. Um and I think that's the way it gets complicated when you have a diagnosis that is purely a clinical diagnosis.

unknown 23:32

Yeah.

SPEAKER_00 23:33

Right? Like there's no one lab you can hang your hat on. There's no X-ray test, ultrasound, EKG, EEG. You know, we can test a lot of cool things, but there's a lot of things that are still, at the end of the day, a clinical diagnosis. Like you just have to ask the right questions, and that whatever it is has to pop into your head. And I think for a long time, when we don't know what it is, you know, the follow-up question is do you feel depressed? Are you do you feel anxious?

SPEAKER_01 24:10

Yeah. What's going on in your life? What's going on in your life that it's made that is making this in your head? Right, right. Right. And stress, it's stress anxiety. You have kids, you have parents, you have stress in your life, manage to stress better.

unknown 24:26

Yeah.

SPEAKER_00 24:26

And, you know, not to belittle anxiety, depression, you know, those problems. They're very real. And for some people, they're just you know debilitating. But I think we do have a tendency to go to those when we don't know what else to do.

SPEAKER_01 24:42

Right, right. So, so that that rightly so can feel this like you're being dismissed. But it it's a it there's a very clear and known lack of training around all of this. And even then, like some uh when I'm talking to people, I I can't tell you all the time for sure, is this perimenopause? I can tell you that you're in the right age range, as long as we don't we know that you don't have other things that this could be, sometimes it is it is a therapeutic and diagnostic trial to do HRT if someone wants it. Because if somebody wants HRT, like they say, and I've had women that say, you know what, I don't care. Let's try anything, whatever. Okay, so we can try it. And if if say we adjust and it hasn't worked and it hasn't done anything with adjustments, sometimes you need adjustments, even within that period, right? So if if it's been three months and we've adjusted and we've done the things that we can do with that and it's not helping you, then no, it's definitely time to check everything else, even if you've already had things checked before. Because if you've if that doesn't help you, then it likely isn't hormonal. But very typically in that age range, that is not the case. Right. That is not the case.

SPEAKER_00 26:05

So you so you bring up an interesting point of the therapeutic trial, right? So we give you some medicines and we see how you do, which can be very complex because you're the patient then has to realize whether they're getting better or not. How are what are some tools you're using to help patients realize that they're getting better? Because you know, I if and I saw this a lot when treating depression or um uh fibromyalgia, where I do an intervention, and then I always tell them, look, you're gonna have to do some journaling. You're gonna have to go and write down what you're feeling at some point on some papers. And that way we know if you're getting better or not. Because if three months or you know, four weeks in, I say, How are you feeling? He goes, I feel no better. Well, maybe you do, maybe you don't. And we have some tests that we some some some tests. We ask questions, it's it's a scoring mechanism, right? To see how they're doing. So can you ex talk into that a little bit? Because I think it's a it's an interesting point.

SPEAKER_01 27:10

Yeah. So I mean, and it happens differently for every woman. Um, but like if you take, if you take a one of our good friends that's served on HRT, at first she's she was like, Yeah, I don't think it's helping me. And in one conversation, she this is she's like, I don't think it's helping me. Well, wait, you know what? I didn't take it, I didn't take a nap. I haven't taken a nap in two weeks. Maybe it is helping me. Wait, maybe I do feel better. So so that's the thing is is sometimes you know, our mind thinks, no, nothing has changed. But then as we really think about it, so one of the things, and uh life is life, and so it's not always easy, but but I'm trying to develop this app to make it a little easier on people, but to track your symptoms, whether you track them twice a week, once a week, once a month, whatever time we have to compare, just track them. It takes less than two minutes so we can kind of see, did this work for you? Um, and so you don't have to, when I say, How are you feeling? It's not like I'm putting pressure on you, tell me right now.

SPEAKER_00 28:18

Right, right.

SPEAKER_01 28:19

You know, a yes or no, I'm determining the way that we're gonna proceed from here. No, like I'll look back and go from there and we'll talk about it. It's not like because sometimes when when it's me and somebody says, How do you feel to that help? I don't know. No, maybe I'm hard.

SPEAKER_00 28:38

And how are you feeling is and and and providers we're all really guilty of this. How are you feeling is such a vague, open-ended question. And we get to ask, okay, let's get down to your sleep. Let's get down to hot flashes. How many did you have this day? Like, is it going up, going down? You know, all the other things. Yeah, um, it can become a little more, you know, it can clue you into like, oh, I am getting better.

unknown 29:04

Yeah.

SPEAKER_00 29:05

Absolutely. Absolutely. Well, we're reaching end of time of this second episode. We've talked about a lot. We talked about insulin resistance and hot flashes, we've talked about uh labs, why it's hard to get treatment with from just OBGENs and general physicians and whatnot. Um, we discuss being dismissed. Well, you have any take-home points, anything you just really like to, you know, some key fact you would like our people to remember.

SPEAKER_01 29:35

So, yes. So if you're 34 and above and you feel different, one of the most common things is I don't recognize myself. But if you feel different at all, then it's worth it to consider perimenopause. That's one. Number two is yeah, even if your lives are normal and you feel like something's off, it's probably off.

SPEAKER_00 30:01

I don't think I think those are two good points. Two good points. Absolutely. All right, that's the end of this episode, Crystal.

SPEAKER_01 30:08

Thank you for listening.

SPEAKER_00 30:09

And if you have any questions, please send them in below or email us that are menopause louisiana.com.

SPEAKER_01 30:16

Our email address is on there. Send us your questions.

SPEAKER_00 30:19

Absolutely. Thank you so much.

SPEAKER_01 30:21

Thank you.

SPEAKER_00 30:22

This podcast is for education only and doesn't replace individualized medical care. Our goal is to give you clear information, not to rush you, scare you, or brush things off.

SPEAKER_02 30:31

We'll keep answering real questions and talking honestly about what Harry Menopaulis really looks like, feels like, and what you can do about it. Thanks for listening.