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A bi-monthly podcast where we share the stories of our Caregivers, patients and community.
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Women's Health Through the Decades
"Your periods shouldn't be unbearably painful. Most women in their 50s will experience dryness. Muscle mass matters more than being thin." These are just some of the straightforward truths nurse midwife Claire McStacy shares in this comprehensive conversation about women's health through the decades.
From establishing care in your twenties to navigating the changes of menopause, this episode cuts through the noise of trending TikTok videos to deliver practical guidance on what's actually happening in your body and what you can do about it. McStacy brings 23 years of experience to address questions many women have but don't know who to ask: When should cervical cancer screening begin? (Age 21.) What does perimenopause actually feel like? (Brain fog, irregular periods, and possibly up to ten years of symptoms.) How do hormones affect your heart health after menopause? (Significantly, women lose estrogen's protective effects, making heart attack risk similar to men's, though symptoms present differently.)
The conversation tackles critical but often overlooked topics, including PCOS (affecting 8% of women), the importance of preconception health, managing fibroids (particularly common among African American women) and the benefits and risks of hormone replacement therapy. Throughout, McStacy emphasizes the importance of establishing and maintaining a relationship with your healthcare provider for personalized guidance.
Perhaps most powerfully, this episode challenges listeners to prioritize self-care at every stage of life. As McStacy notes, "When you have time for yourself, you have time for everybody else." Whether you're concerned about fertility in your twenties, managing work-life balance in your thirties, noticing perimenopausal symptoms in your forties or navigating post-menopausal changes in your fifties, this comprehensive guide helps you understand what's normal, when to seek help and how to advocate for your health.
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Hi and welcome to, and so Much More.
Speaker 1:I am your host, cammie Smith, and I am sitting here with Claire McStacy, who is a nurse midwife at our Central Medical Group Forest Women's Center, and we are in the midst of I'm sure everyone is seeing all of the videos being pushed to our Instagram and Facebook feeds on all things women's health, whether it's perimenopause or menopause, and all of the all things women's health, whether it's paramenopause or menopause, and all of the many things that have to come with that.
Speaker 1:Um, but it really depends on your age, and so, as we're talking about we talked a little bit about men's health this month and we wanted to kind of branch into women's health as well. We want to talk about what is normal, because normal is so fluid, like there is not going to be like this one, two, three step for every single person who's out there, um, even by age group, and so I'm going to throw some questions at you, but I want everyone listening. Obviously, we're going to preface with have a relationship with your primary care provider and you can have a nurse midwife as your primary care provider.
Speaker 1:You can, and so we'll touch on that a little bit but have a relationship with your primary care provider, because maybe these are questions you want to go and have with them, or maybe something that we talk about today is going to pique your interest in asking these questions directly in a different way. So, before we jump in, thank you for coming and um, and we haven't had the pleasure of meeting before now.
Speaker 2:So why don't you tell?
Speaker 1:me a little bit about yourself and then what you do at the forest women's center.
Speaker 2:Thank you, cammie. Um, I am Claire McStacy. I was born in Virginia. I lived in Bedford my whole life, um. I did move away briefly to work in New York and in Nashville, um, but I came back. I love it. So you're local, I'm local, my whole family lives here.
Speaker 1:I love it. I love it. You're back and providing service where you grew up.
Speaker 2:Yes, I have been a midwife now for 23 years and um, I love it. I love it.
Speaker 1:I love that so much. So do you get bombarded with questions about like, what are some things we have on here Paramenopause, obviously, irregular periods, mood fluctuations, and then the big screenings question of like who, when, where, why with screenings. So do you just get a ton of questions?
Speaker 2:Yes, yes, as you should, as we should. Um, because women's health is very important. Um, we do have a lot of screenings available. We don't have as much health research in women's health as we could have. Yes, and so hopefully hopefully in the future we'll have more women's health studies. Some things that you know I hear a lot are help me with HRT, help me with my heavy periods why can't I get pregnant and also just pregnancy itself. We care for a lot of women in pregnancy.
Speaker 1:And that is like I mean, your body and your mind are just going through a roller coaster, Absolutely, and so that, yeah, like you said, brings all questions all of its own. What would you say is probably the number, maybe not the number one. I was going to say the number one question you get, but the most popular question you get.
Speaker 2:Right now, the most popular question I get is can you check my hormone levels?
Speaker 1:Yes, I identify with that on such a deep level.
Speaker 2:I will. I will tell you, the current research does not support testing random hormone levels. Yeah, at any age. Yeah, what we do recommend is, if you are in menopause or think you're in menopause, we can test for that with hormone levels. We can test for certain abnormalities with hormone levels, especially if you have abnormal periods. Yeah, but just getting a hormone level because you have, um, some mood changes doesn't really help.
Speaker 1:Yeah, yeah, nailing, I'm sure just needing answers, maybe to understand what is happening in my body as we age. Yes, yes, blood panels are great, yeah.
Speaker 1:And and I think that's why it's important to have that relationship over time with your provider, because then they know what you're talking about, they know your blood work, they know your moods. When you're like this is different, they can say, yeah, this really is different, whereas if you wait until the problem arises, sometimes you know not only say it's too late, but then there's a lot more digging that has to be done.
Speaker 2:I like to establish um care with women in their twenties Um and I've had lots of people now in my career that I've known from their GYN um care, or women's health care, all the way through pregnancy and now heading into perimenopause.
Speaker 1:Oh, wow, so they've established relationships, yes, yes, so I'm going to jump into these questions and and we don't have to hit all of them, but we did reach out to women in their twenties, thirties, forties and fifties, and and we asked what are some of the most pressing questions that you have for we want to say general women's health, but the things that are rising to the top, the concerns that are just kind of repetitive in your life, and so we're going to go through these. Are you ready? I'm ready, okay, question number one we're gonna start with women in their twenties. What are the most important preventative screenings and health habits women should adopt in their 20s to support long-term reproductive but also overall health?
Speaker 2:So by the 20s, our periods generally are normalized, like they're going to be fairly regular. If your periods are irregular or very heavy or painful, please come and see us. Yes, screening tests for women in their twenties. At age 21, we start testing for cervical cancer. Cervical cancer is a cancer on the cervix, on the skin of the cervix, and the screening test is called a pap smear or pap. Yes, we test for the cells to see if they're normal skin cells. If they're abnormal, we need to do more work. Okay, we also will test at age 25 for hpv. Okay, hpv is the virus that turns on cervical cancer. There is a vaccine for cervical cancer which we recommend that women get in their teens, but you can get it up to age 45.
Speaker 1:Oh, okay. So I don't know how many people are watching, are thinking like, wait a minute? 21,. What, like cervical cancer, 21. But, yes, oh my gosh, absolutely. I think that knowing these things ahead of time and knowing that, um, you know, it's not just those of us who are up in their forties who suddenly have to worry about screenings. There's so much available to you right now, um, so that's fantastic, um sorry.
Speaker 2:women under age 25 need to be screened every year for STDs. Yes, If they're sexually active.
Speaker 1:Yes, and please have that conversation. We had a conversation with a provider who talked about how important it is to be honest with your primary care provider, because these can be awkward conversations, but not having them is just so much more detrimental.
Speaker 2:And being honest with yourself is very important. We are here to provide information and referral, but you're the healthcare provider for yourself.
Speaker 1:You make the decisions. Okay. Next question and this kind of is a little bit about what you've talked about, but it branches out how can young women manage irregular periods or painful menstruation, and when should they seek further evaluation for conditions like PCOS or endometriosis?
Speaker 2:Okay, so irregular periods? The danger irregular periods would be bleeding for longer than 10 days, bleeding to the point where you hemorrhage and have a low hemoglobin or having a lot of pain. Yes, the pain with periods can be endometriosis. It can just be dysmenorrhea, which is painful periods. Those can be fixed, we can help.
Speaker 1:I didn't know that.
Speaker 2:Yes, that's amazing. Pcos is an endocrine disorder called polycystic ovary syndrome, where there's lots of little immature cells around your ovaries. It's not only related to your reproductive system, but it works on your endocrine system as well. Okay, so it's a whole body condition which we can help with.
Speaker 1:Yeah, so how common is PCOS?
Speaker 2:So PCOS affects 8% of the population, but it has been rising as our population increases in size.
Speaker 1:Yeah, okay. I just feel like I'm hearing more about PCOS.
Speaker 2:Is it?
Speaker 1:more common in older age groups.
Speaker 2:No, it's actually more common in twenties and thirties and then, as people are getting larger, in their teens and twenties, it's more common.
Speaker 1:So start that conversation. Okay, what should women in their twenties know about fertility preservation, especially if they are not planning to start a family soon, but want to understand their options for the future?
Speaker 2:I think this is a really interesting question because it gets at what is fertility, what is the best time to have a baby, what is good health? Because as we get older, our eggs do start to degrade and some providers will say that after age 28, there is an increased chance of having more degradation. There is an increased chance of having more degradation. Okay, and so you brought up egg sparing technology.
Speaker 1:Yes, yes, or freezing Egg, freezing ovarian reserve, which I'm not sure.
Speaker 2:Ovarian reserve is another thing. If you're not having periods, we need to check and make sure that your ovaries are working.
Speaker 1:So would you say most 20 year olds are asking these questions? No, because this is fascinating to me. Yes, and I feel like most 20 year olds should be asking these questions, but do they even know to ask these questions?
Speaker 2:I think the old wisdom was you know, you come every year to your gynecologist or your women's health provider, you get a pap smear. People weren't sure what that was about and then you just did it, and then you get your birth control. Ok, I think having these health screenings and having these questions in your 20s helps to set you up for being a healthy 30, 40, 50 year old.
Speaker 1:Yeah, yeah, and that's so important for those who are listening. Um, I have a daughter. She's 11. She's not necessarily in any of these age groups yet, um, but I just know that I want to have very intentional conversations with her. I want her to know what options she has. I want her to be protected as much as she can possibly be, um, and so, uh, yeah, I just think there's a different level of intentionality now, yeah, and more information.
Speaker 1:Yes, advocating for yourself, but then, I think, also parents knowing how to set their daughters up for success and their sons, when we talk about men's health, okay, we're going to jump to women in their 30s, all right. All right, and here comes the big hormone wave. How do changing hormone levels in your 30s impact your mood, your weight and fertility, and what strategies can women use to navigate these shifts proactively, okay.
Speaker 2:So by the time we reach 35, our hormones have shifted and our ovarian reserve has shifted and the risk of having a baby with a genetic defect has increased to 1 in 250. That's the same risk of having a miscarriage from having an amniocentesis which is a test for genetic defects. Oh wow, so the risk and the benefit kind of cross match at 35, which is why we often say that after 35, you have an elderly pregnancy.
Speaker 1:That's fun, Thank you. I do have friends who have had children in their forties. Yes, Um, and they are healthy and they are they're doing great, Um, but I do feel that, that fear of you know what? Is this safe? Is this in the term elderly pregnancy? No, thank you, but I don't want to minimize something that is what somebody has for themselves Now. Okay, this brings up a good question If you've frozen your eggs in your 20s, can your body healthily sustain a pregnancy after 35?
Speaker 2:So the egg is going to be age 28. Okay, your body depends on how healthy you are. Okay, if you come to pregnancy with medical conditions, yeah, then you have a more chance of having medical, medicalized pregnancy. Yeah, um, for yourself or for your baby? Both, well, both. People who have obesity do tend to have a higher chance of gestational diabetes and gestational hypertension, which is high blood pressure. Okay, so having a healthy body before pregnancy increases your chances of having a healthy pregnancy.
Speaker 1:Okay, this is such good information. I love it. What are the key considerations and potential risks for women who are planning pregnancy in their thirties, including how to optimize preconception health? So how do you take care? I mean I, I all I knew was take this prenatal vitamin.
Speaker 2:Prenatal vitamins are very important because of folic acid. Most of us do not get enough folic acid in our diets, which come from vegetables and fruits. Folic acid helps to form the baby, to reduce the risk of miscarriage Okay, okay, wow. And also to reduce the risk of cleft lip, cleft palate or spina bifida Okay, the risk of cleft lip, cleft palate or spina bifida? Okay, if we have preconception, you can start to take prenatal vitamins before you even try. So that helps to get your eggs ready. Okay, gotcha. The other thing for preconception is we can look out for things that can cause medical problems like diabetes, high blood pressure, increased weight. If you have preconception, you can also test for viruses that we know cause problems with pregnancy.
Speaker 1:This is so smart. I mean, think about it. If you're going to run a marathon, you are not going to wake up on a Tuesday that when you've never run before and expect your body to deliver on that attempt. And so when you're coming up to something like pregnancy, it does catch some of us by surprise and that's a whole nother conversation. But I think, preparing your body and really training it sounds silly now that I'm saying it out loud, but it's so true, like you just have to be prepared and there's so much you can do. Pregnancy is a long-term yes, commitment. There's prep involved.
Speaker 2:There's prep involved and labor is a marathon you are not kidding.
Speaker 1:You are not kidding. I don't know if we have that question. We don't have have that question.
Speaker 2:We just have women's health. That's probably a whole nother podcast.
Speaker 1:Okay, next question how can women in their thirties best manage work life balance? I don't have a healthy view of that term, but we'll come back to that. How can women in their thirties best manage work life balance and mental health, especially when juggling career, family planning and caregiving roles and we're thinking about like anxiety, burnout and mental health and care of yourself, mentally anyway.
Speaker 1:But so the reason work life balance is such a trigger for so many people and this is my opinion I have for myself, so I'm not going to push this on anyone else, but I just think it's forever going to be a push and pull. I don't know anyone in my life who has a perfect work life balance and and maybe the balance is the push and pull, I don't know Like it's. It's a lot to dig on there, but I just think that, um, I have so much of myself and at work I'm going to give my a hundred percent and at home I'm going to give my a hundred percent, and sometimes it pulls in either direction, right? So do you have women who come in and who have this overwhelming like help?
Speaker 2:me. Most of the time, what they're saying is I, I am tired. Yeah, I am stressed, and my husband says that we don't have sex anymore. And that happens in the thirties, forties, fifties not so much in the twenties, yeah, but 40s, 50s, not so much in the 20s, yeah, but most of the people will have more stress in their lives and not be able to have time for themselves. It's hard, and when you have time for yourselves, you have time for everybody else. Yeah, so it's important to do self-care.
Speaker 1:Yes, yes, and that's where you learn the, the ways to approach work-life balance. Um, in a way that's going to be good for you, cause it is going to look different for everybody.
Speaker 2:And so.
Speaker 1:So I love what you said about taking care of yourself first, and that is such a theme I see in so many health conversations, as as individuals, whether you're parents, whether you're more empathetic, it does. I don't think there's a key set person who takes care of others first. I just think that it happens, it happens. You care about the people you love, you want to take care of the people you love, um, and so take, take a minute and take care of yourself, um, so that you can better take care of everyone else around you. And everyone always brings up this example, but it's so good when you're on an airplane and those little orange things come down, put the oxygen mask on yourself first.
Speaker 1:Put it on yourself first. Your first inclination is going to be to take care of your child. Take care of your parent, take care of someone else. Take care of yourself first. That's probably across the board. Um okay, women in their 40s. What early signs of perimenopause should women be aware of in their 40s, and how can they distinguish those from other health issues or maybe even other like mental health issues?
Speaker 2:so women in their 40s do tend to have a change in their hormones. It's called perimenopause. Perimenopause can be up to 10 years before you actually go through menopause. That's awesome menopause is considered a year after you've stopped having periods.
Speaker 1:Okay.
Speaker 2:Most people will have irregular periods first, where their periods either go longer or shorter, or heavier or lighter. It's just wonky, yeah, and that's a medical term, I love it. But in terms of perimenopause symptoms, other symptoms, it includes brain fog, it includes stress, it includes anxiety, it includes heart palpitations and what else? Brain fog, heart palpitations brain fog.
Speaker 1:Oh um hot flashes, hot flashes.
Speaker 2:That's, that's the one.
Speaker 1:Yep, Yep, so um. I have heard that perimenopause can start as early as 30 or 35. Is that true?
Speaker 2:30 would be pushing at 35. Probably, the average age of menopause in the United States is 51.
Speaker 1:Oh, wow, and so hormone changes in your body is not necessarily perimenopause, right See? And I think that's where there's some confusion because, like you said earlier, there's there's going to be throughout your life, changes in the hormones in your body, for whatever reason, um, and so I think there's so much focus on HRT that I think the really labeling paramenopause, what it is, um, it, I don't know it's it's almost like the diagnosis circle just keeps getting bigger and bigger and bigger, and everyone's like that's just me, um, but it's that, it's that um, desperate for answers, you know, like sometimes, you just feel so good when you have a reason for what's happening to you, right, and I think?
Speaker 2:self-care. It's hard to put yourself first, it's hard to say I need time, I need space, and if you have a diagnosis, then you can say well, I have to do this because of my perimenopause, or I have to do this because of my perimenopause, yes, or I have to do this because of my anxiety.
Speaker 1:We should do it, because that's what's right for your body. All right. Next question how can women in their 40s maintain muscle mass, manage weight gain and protect bone density as metabolism slows and estrogen begins to decline?
Speaker 2:So this is a really important question. I think that it's good for women in their 20s, 30s, 40s and 50s to really work on strengths, because muscle mass is what keeps us sane and helps to prevent hip fracture later on in life, and being strong is more important than being thin 100%.
Speaker 1:Yes, yes, um. So I'm going to do a little plug here, because I think that so many women think this is out of their reach. Like, where do I begin? I don't even have the right tools to know, like, what my baseline is Right. And so we have a strong relationship with the YMCA, and um center provides some incredible services over there.
Speaker 1:Um, I don't want to say we provide services, we have a great partnership with them, and so they have this full body scan where you can go in and it will break down for you what your muscle mass is versus what your fat percentage is, and and one of the biggest takeaways is, the combination of the two will raise that number on the scale.
Speaker 1:And so when people think weight gain, they think it's negative. Oh my gosh, the number's going up. But if your muscle mass is going up, that number's going up as well, and and that's good. And so I think that talking with um, either a health coach or a functional fitness coach, someone who can do some level of personal training with you, is going to really help you get that body scan to understand what your body is currently doing. And if you don't want to get that granular, then then step into a functional fitness class. I think as we age, those, those functional fitness classes, are great because they mimic moves that you are going to be doing in real life Um, push and pull, and picking up and um and building muscles to continue doing those things or just keep moving.
Speaker 2:Yes, people who get older, the people who keep moving live longer, healthier lives.
Speaker 1:Yes, people who sit oh yeah, don't do well. Your body wasn't created to just sit all day long every day. Um, this wasn't a direct question on here, but we did mention it briefly in here. How do you approach nutrition with your patients?
Speaker 2:So nutrition is a very important part of life. Um, for pregnancy, we really rely on guidelines from CDC and the USDA. Nutrition builds babies, yeah, and nutrition builds bodies, and so we encourage people to eat lean proteins, complex carbohydrates, fruits and vegetables.
Speaker 1:Yeah, for that folic acid. For that folic acid, for that folic acid. All right, what are the implications of fibroids, abnormal bleeding or changes in menstrual patterns in your 40s, and how are these typically evaluated and treated?
Speaker 2:so in your 40s you can develop fibroids. Uterine fibroids are muscle whorls inside the uterus. It's just extra space inside the uterus, and with the muscle whorls inside the uterus there's more surface space for the lining of the uterus to develop, and so you tend to have heavier, heavier periods. Nobody likes that, nobody likes that, nope. And then combine that with the hormones of perimenopause and you could have you could have a flooding.
Speaker 2:So please get evaluated. Wow, pain, uterus up to your belly button and flooding of the of the um of your periods really require, uh, evaluation.
Speaker 1:All right, I had never heard of that before. No, and, and I think I mean that's so helpful fibroids. Even as I was reading it and as you and I, as I was sending these questions over, I was kind of like I have no idea. So I'm curious how many of you are watching are, like I would tell you, a large percentage of African-American women have fibroids in their forties.
Speaker 1:Really, yes, okay, so would that be a strong suggestion for those who are watching? Yes, please come and have that conversation. That's another area that I hope to see. More research is research that is done on different cultural backgrounds, as well as absolutely because it's different, it's just different. I mean, that's again a whole nother podcast. All right, we're going to move on to women in their 50s, like me, all right. So you should answer this from experience, but also from profession. So what are the most important health screenings and preventative care measures for women in their 50s and beyond, especially post-menopause?
Speaker 2:Okay, so interesting things. The PAP testing goes through our lifetime, looking for cervical cancer, even after menopause. Even after menopause up until age 65. Okay, thank you for asking. Yeah, I will tell you that the HPV virus does play a huge part in women's health, and I'm of the generation that came about before the vaccine, and so women in my generation really need to keep up with their screening. Yeah, yeah, yeah. Other things that are really important after menopause, if you have bleeding after intercourse or just regular bleeding, please get that evaluated. That may be a sign of uterine cancer. Time, I mean, yes, unusual bleeding, get it checked out. Ok, screening tests are very important for mammograms mammograms every year or every other year for women age 50 and older. Colonoscopy testing for colorectal cancer, which is the number three cancer in women. Um, you get screening started at age 45 okay, um how long does menopause last it?
Speaker 2:varies. Okay, it varies. People have different symptoms. Some women will do a couple of years of hot flashes and night sweats and some brain fog, and some women it'll be for 15 years Wow.
Speaker 1:So, because I'm thinking post-menopause like how do you know when you are post menopause? So post menopause is considered the year, or considered after you've gone through menopause, gone into menopause, so anything after that year of no bleeding that's very helpful, okay, um, how does menopause affect cardiovascular health, cognition and sexual wellness, and what proactive steps can women take to protect their well-being?
Speaker 2:so cardiovascular health is very important. Women lose their protective effects from the estrogen and progesterone on their heart muscle. Our muscle becomes more like men and our blood vessels become harder, and so our heart attack risk becomes the same as a man's as we get older. So cardiovascular health is very important for women. I will tell you that heart attacks feel different for women than they do for men, but if you have pain moving up your neck, or if you have nausea associated with the pain up your neck or pain down your arm, go see a cardiologist or actually just go to the ER.
Speaker 1:Yeah, just go. That's one of those things we're always like when do you go to urgent care? When do you go to the ER? Um, what about cognition?
Speaker 2:Cognition. Um so brain fog is a real thing, where you feel fuzzy headed and you feel like there's 10 million things that you have to do and you've forgotten all of them but one. And dementia is affecting more and more women these days and may be related to estrogen and progesterone as well this just all feels like bad news.
Speaker 1:I don't know. It's good news. It's good news. It's good news because we're talking about what to do about it. But, man, like there is just a lot to consider when you think about taking care of yourself. Yes, and I wonder how many women just go throughout their day, their week, their month, and they're just busy. They're just so busy that they don't think about these things. And there's just so much to think about, right? Um, what about sexual wellness in your 50s? What does that look like?
Speaker 2:So it depends on when you have menopause and if you have a partner, if you are currently sexually active, if you have new partners, you need to be protective against sexually transmitted infections. Most women in their 50s who go through menopause will lose the estrogen effects on their vulva. Okay, and so on the vulva we have estrogen receptors from the clitoris to the rectum, and during menopause those receptors draw in and so the whole vulva will become smaller and drier. Wow, that is crazy. So what do you do about that?
Speaker 1:So smaller and drier. Wow, that is crazy. So what do you do about that?
Speaker 2:So you can use hormones Okay, hormone replacement therapy, or a cream with hormones in it Okay, that help to rejuvenate the vagina.
Speaker 1:Wow. So there's always something out there, man, this is crazy. All right, this is our last question. Okay, what are the benefits and risks of hormone replacement therapy, which is the big thing that everyone's talking about right now HRT? What are the risks and benefits for women over 50? And how can a woman determine if it is right for her? So HRT is trending now and I have friends who are, you know, between 30 and 35 and they're like I need HRT and and I'm not saying that people don't, because I I believe in it, but I want to hear your perspective on um risks and benefits, and we are talking about women over 50, but maybe we can talk about HRT as it relates back through these age groups.
Speaker 2:So, um, thank you for asking. Yeah, HRT has definitely had a hard life. Back when I was in school, we had the um women's health initiative, which said that HRT was the devil and that it was going to cause everyone to have breast cancer, and so providers stopped providing it. Wow, and then women just suffered. So now we're doing more evidence-based medicine which shows that HRT does have a lot of benefits to women who have gone through menopause.
Speaker 2:Okay, hrt helps prevent the sexual dysfunction, helps prevent some brain fog, is protective for the heart and helps prevent some cancers. Yeah, in terms of hormone replacement in the 40s and the 30s, there are things that we can do. Yeah, but hrt probably is not one of them. Okay, um, the reason I say probably is because we need more research. Yes, um, and right now, if you use hrt in your 30s and 40s, it may not be evidence-based gotcha. There are other things that we can use for symptom relief People who have brain fog. I highly recommend different supplements to help with brain fog, like magnesium and calcium fish oil. And then some people have developed more stress related to their lifestyle and not having self-care, and so they may benefit from mental health medications?
Speaker 1:Yeah, so would you think that in some cases because I do know some women who are referred for more of a mental health approach when they're having symptoms that they believe are related to perimenopause how would you approach that? I?
Speaker 2:would say we need to look at the whole body. Yeah, we need to see what's going on. Okay, the hormones that I check for are definitely thyroid and check for anemia. Check for vitamin D Vitamin D level is huge. Check for vitamin D Vitamin D level is huge. Vitamin D is appropriate for bone growth and keeping us from having osteoporosis. It's for our immunity and it's for our mental health.
Speaker 1:Yeah, so for those of us who are getting blood work once a year, annually, will that fluctuate based on the time you get your blood draw, and how are decisions made in that case?
Speaker 2:So, hormones like estrogen and progesterone will fluctuate throughout the day. Oh great, and so there's not a set time for this. Is what this means. This is what that means. Okay, gotcha.
Speaker 1:Right now. So the need for research is great, absolutely.
Speaker 2:Absolutely. It is very it's vast Um there are people who are becoming certified as menopause practitioners and I hope to become one of them in this next year. I love that, Um. I see people for menopause, perimenopause, for their prenatal care and their teenage care. We see people for the lifetime of the woman and would be happy to see you at our office.
Speaker 1:Yeah, and I do encourage you to check out a relationship with a PCP, have a conversation with a nurse, midwife, because these are the conversations that are going to make the difference in how you are feeling on a day-to-day basis on your whole body and thank you for saying your whole body Um, and I think there are more questions, I think we need to dig into this more, and so maybe we'll do a follow-up um conversation where we can dig into some of these key points that really jumped off at us. But for now, thank you, thank you, this was great and thank you all for joining us on, and so much more.
