Menopause, Perimenopause & Hormone Therapy: What Women Need to Know

Menopause is having a moment—and for good reason. But what many women don’t realize is that the journey often starts years earlier with perimenopause.

In this episode of Baptist Health Talk, we break down what’s really happening in your body, the early signs to watch for, and why so many women feel confused or dismissed when symptoms begin. From mood changes and brain fog to sleep issues and weight shifts, the conversation goes beyond the basics.

Our experts also tackle one of the most talked-about (and misunderstood) topics: hormone replacement therapy (HRT). Why did it become so controversial? What’s changed? And how do you know if it’s right for you?

We also explore:

• The connection between menopause, breast cancer risk, and heart health
• Why lifestyle factors play a critical role
• How symptoms are diagnosed (and why labs don’t always tell the full story)
• What options exist for women who can’t or choose not to use hormone therapy
• The importance of advocating for yourself and finding the right provider

Most importantly, this episode is about empowerment—understanding your body, knowing your options, and realizing you’re not alone in this stage of life.

Host:
Johanna Gomez
Award-Winning Host & Journalist

Guests:
Anastasia Tousimis, M.D.
Chief of Breast Surgery
Baptist Health Miami Cancer Institute

Jila Senemar, M.D.
OB-GYN & Menopause Specialist

Tamsen Fadal
NY Times Best Seller, Emmy Award Winning Journalist, Podcast Host and co-producer of MFactor2

If you found this episode helpful, you may also enjoy:

Menopause Unplugged: How a New Generation is Owning Menopause

Perimenopause and Menopause: What's Happening to Me?

Hormones and Menopause

Transcript

SPEAKER_06 0:00

I think uh I was, you know, at an event earlier this morning, and a 37-year-old woman came up to me and she goes, I hear all about perimenopause. I don't know if I'm near it or close to it or should be thinking about it, but what should I know to get ready? And that's what I want women to do.

SPEAKER_01 0:14

Welcome to Baptist Health Talk, a podcast on all things healthcare, powered by Baptist Health South Florida, your trusted source for healthcare prevention and wellness.

SPEAKER_02 0:24

Hey everyone, I'm your host, Joanna Gomez. Welcome back to a new episode of Baptist Health Talk, where we answer your most search questions on trending health topics. In today's episode, we're diving into menopause, what's really happening in your body, why the conversation has changed so dramatically in recent years, and what women should know about their options. If you've ever felt confused, dismissed, or overwhelmed by conflicting information, this is the honest empowering discussion you've been waiting for. We are joined by Dr. Anastasia Toussi Miss, Chief of Breast Surgery at Baptist Health Miami Cancer Institute. Tamson Fidel, New York Times bestselling author and podcast host. And we also have Dr. Gila Senemar, OBGYN and menopause specialist. Thank you, ladies, for being here. The conversation is going and there is a lot to unpack. We're gonna first start off with there is perimenopause and then there's menopause. Two differences that people that women go through. Why is it though? Let's start off with just perimenopause just kind of flying under the radar.

SPEAKER_05 1:28

You know, um, I'm glad that you were we're starting with this because I think for so long now we have been now finally talking about menopause and what that is and the transition and not having the period for 12 months and then, you know, kind of being, okay, this is peri this is menopause. Now I'm postmenopausal. But I think um perimenopause is really where it's at. And that's where we need to tune in and have women understand that transition phase because it can last anywhere between five to ten years. And it can start in our late 30s and early 40s.

SPEAKER_04 1:59

Yeah.

SPEAKER_05 1:59

So we need to bring that conversation to light. And that's what you know, a lot of new documentaries are talking about is like the M factor 2, is all about perimenopause. What it is, when does it start, and what are the symptoms that we should be looking out for? So, what are the first signs that we should be looking out for? And it's it's not very um, you know, consistent in every individual. I think each woman's journey is a little bit different, but the things I want women to kind of pay attention to are with perimenopause, it's more mood-based, sleep disturbances. Okay. Uh that little brain fog that everybody talks about, where you know they can't remember things, they're not as sharp as they used to be. And um, just different things like itchy ears, itchy skin, hair changes, things that they weren't used to, and that weight change that starts happening. And they're like, I don't know what's happening in my body, and I don't recognize this.

SPEAKER_02 2:52

Yeah, uh it's I feel like I've checked everything on the box of everything you just mentioned. Should I though go back and think it and talk to my mom and say, one, did you go through perimenopause or menopause? And I know that my mom is probably gonna tell me, I have no idea because the conversations didn't exist back then like it is now, but is that a like a look guide, a little guide, I should say?

SPEAKER_05 3:13

It could absolutely help. It's not going, you know, it'll give you more data, it'll give you more information so you kind of can tune in and listen to what your body's telling you, and then, you know, decide, okay, where am I on this journey?

SPEAKER_02 3:25

Okay, Dr. Tusimus, let's talk about breast health. It's always been front and center. What should we be aware of when it comes to risk and going through perimenopause?

SPEAKER_00 3:35

So all of us know that breast cancer is very common and it affects one in eight women. And the risk factors for developing breast cancer are family history, genetic predisposition for getting breast cancer, such as the brachogene, which is also associated with ovarian cancer. But there's also other risk factors such as early menses and late menopause. Because the thought is the longer you're exposed to the hormones, the higher your risk is. Those are things that we cannot control. But there's other lifestyle risk factors that you can control, such as activity, obesity, alcohol consumption, smoking.

unknown 4:13

Okay.

SPEAKER_00 4:14

So, you know, when I'm counseling patients, you know, we talk to them about their inherited risks, but we also talk about their lifestyle risks. And it's very important to individualize the breast cancer or the patients, because most of the patients I see have breast cancer, but the patients' individual risk for developing breast cancer in the first place and working on adjusting the risk factors that they can control.

SPEAKER_02 4:36

Yeah, there's a lot of young women that are being diagnosed with breast cancer. And sometimes you get your period back, sometimes you don't. I mean, it just right it just changes. But if right now someone was diagnosed or is going through it, should they automatically think that they're going to go into perimenopause mode?

SPEAKER_00 4:53

So that's a great question. It really depends on the age of diagnosis, and it also depends on the type of treatment that they receive. So a lot of the medications that we give patients cause them to go into menopause. Like some of the chemotherapies, they cause immediate menopause. And actually, some of the endocrine treatments also cause the patients to go into menopause. So it really depends on the type of tumor, the stage, and the treatments that they receive. But as you can imagine, it's really debilitating. You're facing a cancer diagnosis, you're facing chemotherapy, you're facing, you know, very significant surgeries that alter body image, and now you have menopausal symptoms on top of everything.

SPEAKER_02 5:29

Yeah, there's a lot that's going on. Tamson, you talk to so many women. You have uh, I think I'm safe to say you've been like the pioneer of starting this conversation on social media. At least you're one of the first women that I have seen that actually you've been so open about it. You're like, this is what I've gone through, and now I'm gonna open this and help other women. You've heard so much, you've seen so much. Hormone replacement therapy is like the big tucker, right? You've heard so much, you've seen so much. What do you want us to know about HRT?

SPEAKER_06 5:58

Yeah, you know, it's interesting. Um, talking about breast cancer, I lost my mother to breast cancer, and she was diagnosed at 44 years old. And at the time, I I didn't even, I know, didn't know the word menopause or perimenopause. And she would go around, you know, sweating, hot flashes. I don't even know if she really knew what if she had gone into menopause or not. She had gone through chemo and radiation. And when I look back at that and I look where we are today, uh, I say, I don't know that hormone therapy would have been an option for her or would have been offered or she was even aware of it. But I know today to be able to have those conversations, have women be able to ask questions, um, wonder what their options are, and then have those questions answered, that's what's so important. I think uh it was, you know, at an event earlier this morning, and a 37-year-old woman came up to me and she goes, I hear all about perimenopause. I don't know if I'm near it or close to it or should be thinking about it, but what should I know to get ready? And that's what I want women to do. When we think of that baseline of moving into this next transition in our lives, and we're thinking about this at 35 and 37 and 40 years old, I just feel like this next generation is gonna be so beautifully prepared. But I think I want all women to know that there are options for them, no matter whether or not they can or want to take hormone therapy. And then I think I also want them to know they're not alone in the journey and that there's actually really help.

SPEAKER_02 7:13

Yeah. And can we also just highlight the fact that by the time you're like in your 30s and your late 30s, you're busy like raising your family, you're in your career, whatever it is that you're doing. And like the last thing that you're doing is thinking, okay, what making yourself the priority because you're probably trying so hard to make other things a priority that you kind of just things just slip through the cracks, as they say. But I would love your both of your perspectives on HRT. And I know that it's depends, right? Every patient is different. We're gonna start off with you, Dr. Senomar.

SPEAKER_05 7:43

So um I think in those 30, 40-year-olds, it's nice for them to now know what's going on in their bodies and so they can decide what they need to do for themselves. And a lot of it does start with lifestyle modification, especially at that age range. Um, that way they can kind of prepare themselves so they have an easier transition when they hit menopause. Um, and I I really want them to have that conversation and we talk about these things all the time, every time they come in. And if it does start where these symptoms are affecting their quality of life, where they're just not able to manage anymore, and multitask and you know, take care of the kids and the family and elderly parents, that's when we start talking about hormones. And now, you know, we're the formulations we're using today are similar to what the ovary naturally makes, or what people like to call bioidentical. This is what we're using. It's FDA approved, it's been around, it's been tested. And we have a variety of formulations that we can use in terms of the estradiol and the progesterone and the testosterone, because we can't leave that out. That is part of the conversation for a lot of women.

SPEAKER_02 8:52

But why is it that if it's such a big conversation now and it's been around for so long, why is it that none of the women that came before us had this opportunity? What is that missing link?

SPEAKER_00 9:03

So, from the cancer perspective, about 25 years ago, there was a very large study that was published that showed that there was a strong link between hormone replacement therapy and breast cancer. And it caused a lot of fear. And literally throughout the country, they stopped prescribing hormone replacement therapy to women. Even though there's so many known benefits of hormone replacement therapy, the breast cancer risk was outweighing that. Now the conversation has completely changed. And now we're not so black and white about this. And we really work closely with our OBGYN partners when we have mutual patients to talk about what is the breast cancer patients' individualized risk. These are for patients who have already been diagnosed. Right.

SPEAKER_02 9:43

Like someone like myself.

SPEAKER_00 9:44

Exactly.

SPEAKER_02 9:45

Okay.

SPEAKER_00 9:45

Exactly. Because we've been very black and white that once you're diagnosed, you're off hormones for good. But there are some combinations and there are some lower dosage and um lower dosages and shorter durations, which are safe for these patients if patients need it for quality of life. Because some patients' menopausal symptoms are so severe that they can't function. And it's always a risk uh benefit ratio of what are we gonna do here to treat their symptoms while mitigating the risk?

SPEAKER_06 10:14

Okay. I think I do want to say this. Um, you know, we talk about it a lot, but still just about 5%, not even 5% of women in this country are on hormone therapy. So that's how much work we have to do because that study changed to so much. And women at that point, which almost 25 years ago, we're at 44% of the women were taking hormone therapy, it dropped down to what, like 4%? And now we're just creeping back up, not even hitting 5% yet. So we have a lot of work to do so in terms of education.

SPEAKER_02 10:41

I could tell you what as a breast cancer survivor, it's scary to think about getting on HRT. And I'm in that, I'm in that window where I should start talking about it. And there's a lot of hesitation from my oncologists, from my doctors of well, should you or should you just ride the wave? And I think that's where the uncertainty comes from women. Is that there's they kind of still feel like there's still so much to learn from. Is that even correct for me to say?

SPEAKER_05 11:07

So let me just go back to the WHI and why that study, you know, changed so much and now we're changing back. A lot of the information there was actually misinterpreted. Right? Let's start with that. Um, the average age of women in that study was 63, a decade after menopause. Right. And the hormones that they used were synthetics, not the formulations we're using today. And they didn't take risk assessment into play in terms of those women who did have those outcomes. Okay. And the risk, the breast cancer risk was actually blown out of proportion. It was not statistically significant. Put that all behind us. So they've actually walked all of those back in this past 23 years, and that's why we are where we are and having this conversation again.

SPEAKER_02 11:49

Okay, so I'm just gonna give a little bit of a pushback, right? Just for the sake of doing it. It's been 23 years. Is that even long enough? Do we would we say to kind of take a risk? And I'm just talking as a breast cancer survivor because I don't want to go through what I went through in 2017 ever. So if you tell me right now that I have to run, you know, a mile and never, I'll be like, whatever, I'll do whatever you want me to do.

SPEAKER_05 12:10

Do not. So that's my question. Do we even know? Yeah, we do. So here's let me let's go. I'm just gonna kind of you know explain why we're thinking the way we are. We have the information, even from that study, right? The estrogen-only arm showed a reduction in breast cancer risk. We don't talk about that. None of that, but all of these have been published. So there is published data on what we're saying. Okay, it's not just because I think so. This is published. And the other side of it is for somebody who is a breast cancer survivor, right? And now you're at that juncture. Do I want to consider this or not? You have to think about your long-term health. We're talking longevity. You're gonna live longer. That is, we know women live longer than men, but we live in poorer health because of that last that lack of estrogen does affect the vasculature around the heart and predisposes us. So our risk of heart disease actually matches and suppresses men at menopause. Okay. So we have that, and you have your osteoporosis risk.

unknown 13:17

Okay.

SPEAKER_05 13:18

Okay.

SPEAKER_02 13:18

So Tamson, what should women know about HRT while they're going through perimenopause? What would you like them to know?

SPEAKER_06 13:26

Yeah, well, I think I think I want to do one thing. You know, I feel like I've been a member of the media for a really long time, and I feel like the media did a real disservice during that time, um, 25 plus years ago, because those headlines in that study being so misinterpreted and then blown, you know, across the headlines. If you go back and we did this in the first documentary, and went back and found all these headlines that were so scary. And so I understand why doctors were afraid, why women were calling doctors' offices screaming, women were flushing their hormones down the toilet. Um, so I do, you know, part of being a journalist and saying, okay, well, what can we do to kind of rectify what those headlines said and understand what could make women feel uh safe or at least understand their options, even if they decide hormone therapy is not for them or they can't take it. I think I want women to know that we all go through this individually. I think that's really important. So when somebody says to you, I didn't have any, I didn't have any symptoms, I believe. Oh, I've heard that's like I'm like having a conflict right now. I'm looking for them. I'm like, good for you. That's amazing. So that's one thing. Um I think that the other big thing is to be aware that there are options. If you decide you're not going to do hormone therapy, you know, there are options for you out there, whether you're talking about lifestyle changes, whether you're talking about paying attention to supplementation, how you're talking about nutrition, um, how you're talking about exercising differently. And then I I think the the final thing would be that you're never too young to have this conversation. And I think that's really important because you don't have to wait until you're 12 months without a period or hit menopause to if you decide to start hormone therapy, and you certainly don't have to wait that long to implement lifestyle changes.

SPEAKER_02 15:00

Well, what does life look like after I start taking HRT?

SPEAKER_06 15:04

I'll tell I'll speak from experience for me. So I decided because uh being a daughter of you know a mother who uh was no longer around and I saw her struggle with breast cancer, and um, she had a double mastectomy. Um it, you know, it eventually progressed. So that was watching that, and I know that you know better than anybody, um, being a young woman watching that was something I thought, like, I I don't I don't even want to have that conversation. And I was one of the women that walked in uh when I found out that I was in menopause, and um the doctor said, Well, yeah, I mean, let me look. And they pulled out a calculator, like a calculator with little jewels on it, to type up, like, well, let me see what your risk is. And I went, if that's how you're figuring out my risk, no, thank you. And and I know that that is there's actually an assessment in, but but I just was not in a place where I could think that that was how we were gonna figure out whether it was good or bad for me. And I left the office and I said, I'm not doing hormone therapy. It's just like I'm too afraid. And I went for several years like that as a journalist. Uncomfortable. Uncomfortable, trying to read a teleprompter, looking at a word, not being able to remember it, not functioning like I did before when I was supposed to be at the top of my game in my career. Um, and you know, really miserable for a long time. Um, not sleeping, gaining weight, you know, you name it. I went back and looked at one of my um doctor's reports, you know, that I still were on paper for some reason. It said, you know, patient complaining of weight gain and moodiness. And I was like, oh my gosh, nobody told me. Um but it's so it's so funny to go back and look at those two words, like annoying woman complaining of wicked of that. Um so anyway, I I think that for me, on the other side of it, when I finally did say, okay, this is what I'm gonna do, brain fog for me has been, you know, very very lifted. Um I am able to sleep. I do feel like I've just got more control in the hot flashes that I had that were out of control really have subsided. And so that's really nice. And I know those are not all the things database that we say that hormone therapy is for, but I've certainly felt a difference in my own life.

SPEAKER_02 17:03

I just saw you. I'm a little jealous. Dr. Sennamar, should we first check our homework our hormones before we actually take sleep aids and medications to help us? Sleeping, uh anxiety, you know, all these things that we feel that make us just check us off as an annoying woman going through perimenopause.

SPEAKER_05 17:24

You know, I have a lot of women walking into the office asking for hormone labs to be checked. I want to know where am I? And to be honest with you, it's more symptom-based, especially in the perimenopause age range, because those hormones fluctuate from day to day. But I will still run labs because there are other things that can mimic some of these perimenopausal symptoms. So we need to confirm it's not an iron deficiency anemia. We have to check the thyroid function because any of those can kind of mimic the fatigue, not feeling well, just being under the weather, moody. It can mimic all of that. And so I will run panels, but I can assure you, pretty much nine out of 10 times, the hormones are fine because I found them on the day that we did them. They were all normal.

SPEAKER_02 18:10

I was just gonna say, I did one. Yeah. And one year they were like, oh, you're great. Goodbye, spring chicken. I'm like, okay. Then the next year they're like, oh, you are in perimetapology the following year. And then the following year, it was completely different. I was back to being a young, uh-huh, young times felt great. My hormones were. So I was like, I'm all over the map. So how do you determine?

SPEAKER_05 18:31

It's the clinical picture, is really where it's at. So as soon as I can confirm it's not a thyroid or an iron issue, and based on the symptomatology of the patient, then I'm like, and the age, it makes sense. I'm like, okay, more than likely you're in perimenopause. This is what's happening. And then I really hone in on what the symptoms are that's affecting them the most. If it's a sleep problem, how about a mood problem? Mood and sleep is progesterone. There you go. Remember, progesterone is our calming hormone. Women will tell me they start developing anxiety out of nowhere in their 30s and 40s. They're like, I've never had this before. What's wrong with me?

SPEAKER_02 19:08

Right. It's funny, I actually chopped it up to cancer, is what I thought, because I was like, I'm ghost going through soup so much that it has to be, let's blame it on the cancer that this is why. And it probably could be true at that point, but now at later, like a couple years later, okay, I'm still going through it. Right, right, right. It looks different, obviously, because there's sleep, the fog, remembering the energy, all that that's plays into it. Now that we know so much and the conversation is so much around our heart, breast cancer. Is there a link to that?

SPEAKER_00 19:41

There actually is, because the same risk factors that can lead to breast cancer, which are the lifestyle associated ones that I mentioned before, are also associated with cardiac disease. So obesity, inactivity, alcohol, smoking.

SPEAKER_02 19:56

But you know, we also we all do it. We all have to admit it right now. We all have a glass of wine or maybe two or three to help us go to sleep. Don't touch me. We all do it. It's not good.

SPEAKER_00 20:06

Yeah.

SPEAKER_02 20:07

It makes it worse.

SPEAKER_00 20:08

It does. And actually, years ago, you know, five studies would say there was no link between alcohol and breast cancer. Five studies would say there was.

SPEAKER_02 20:16

Oh, it's changed about a hundred times, by the way. We've all done the story on it. Yeah.

SPEAKER_00 20:20

But recently the data is becoming more and more pronounced that the association is very real and that the more you drink, the higher your risk for not just breast cancer, but for multiple cancers. So we're counseling our patients to really decrease the alcohol intake significantly.

SPEAKER_02 20:35

And stay on top of screenings.

SPEAKER_00 20:37

Absolutely.

SPEAKER_02 20:38

How important are those screenings? Mammograms?

SPEAKER_00 20:40

Very important. Because it's the best test that we have for early detection. And we know that early detection saves lives. So it got confusing for a while there with the United States Task Preventive Task Force Services. And now we're back to the American Cancer Society really recommends screening to start at the age of 40. And then every year thereafter, unless you have a strong family history, you would do your baseline mammogram at age 35 or 10 years younger than your first degree relative was diagnosed. So in your case, it would be age 34. That's when I did mine. Yeah.

SPEAKER_02 21:11

Exactly. No history at all of breast cancer in my family. 37 years old, I was I wasn't even going to do a mammogram. I happen to find it myself. Wow.

SPEAKER_00 21:21

Yes. And these are the most challenging because normally you feel it because you're not in a screening program that would would pick it up at a small size. So unfortunately, the recent trend is also that more women at a younger age are being diagnosed with breast cancer. So we actually at Baptist started an early onset breast cancer program for any women diagnosed under the age of 45 in order to offer them all of the services that a young woman who's facing cancer really needs. Such as fertility treatment, psychosocial. You were mentioning before. Most of these women are working. Yeah.

SPEAKER_02 21:53

Raising kids, raising kids, working.

SPEAKER_00 21:56

And now you're facing cancer. That's the biggest disruptor in your life. So how to help them. Support them through this really difficult time.

SPEAKER_02 22:02

If somebody's listening right now and they're like, I went through all that. Uh I'm done with perimenopause. What do I do now? I'm in menopause. Is there anything for them? Or is it you're done?

SPEAKER_05 22:14

No, absolutely there is. And it all depends on where they are on their journey. And so let's say they're a year or two past menopause, which is the average age of menopause, is 51. We would do a full screening and confirm that they are and check the mammogram, the bone density, all of those things. And as long as there is no cardiac risk factor, they're definitely candidates for hormone therapy. And they we should have that conversation because it's only going at that point, that timing hypothesis, which is the first 10 years after menopause, your benefits will outweigh any risk of uh, you know, any cancer or other disease being on hormone therapy. So really it's women have a 10-year window to get on it. And then I have patients coming to me after the 10-year window and they're like, now what do I do? Did I miss out? Did I lose out on hormone therapy? And I'm in my 60s. And again, it is it's a very individualized conversation. If their history is well and they're healthy otherwise, and no medical risk factors, and I do a full cardiac screening and there's nothing there, and they're still symptomatic, or they have signs of osteopenia osteoporosis, it's definitely part of the conversation.

SPEAKER_02 23:24

There's so much online and it all contradicts itself. Sometimes when I'm reading it, I'm like, what? I just I feel bad for us because we don't know who to turn to, what to look for, that has the correct answer. And there's always a Dr. TikTok telling us what we could and should do. But if there's someone right now that has family history of breast cancer, they are in perimenopause, just clear it right now, just for the sake of clearing it. Is what are your risk?

SPEAKER_00 23:55

So with these patients, I actually work closely with their OBGYN. So we're all on the same team with this. And if they have dense breast tissue, if they have a strong family history, and as Dr. Cinnemar was just pointing out too, if they have the benefits of taking hormone replacement therapy, then I work with the uh GYN and I actually put them in a high-risk screening protocol. So I add ultrasound, breast ultrasound to the mammogram. Okay. Because we all know mammogram is not a perfect test. It actually can miss 10 to 15% of cancers, especially in young women who have dense breast tissue. So by adding a breast ultrasound to their screening protocol while they're on hormone replacement therapy, that can decrease the misrate of mammogram. So these are some individualized screenings that we can add.

SPEAKER_02 24:38

There is hope out there. Absolutely. Everyone. What are some options that you want everyone to know that we have out there? And you mentioned earlier that that's what you would like us to be aware of.

SPEAKER_06 25:02

Yeah, I think it's so important because I think I was one of the ones that did the same thing. I'm like, oh my gosh, I didn't, you know, I'm just getting old. I drank something, I got old. I, you know, I it's all me. Uh I didn't work out enough. And I hear women do that over and over. We spent our whole lives blaming ourselves, you know. So I do think that this is time for a little bit of permission to step back and look at what's going on or or look ahead so you start taking care of yourself early, finding a practitioner. I mean, you know, these are are our two uh doctors that are incredibly educated about these topics and make you feel safe and comfortable about it, and that's what you've got to have because you can't go into a doctor feeling like um you're going in with so much information and don't feel like you're being heard. I think that's one of the most important things that, you know, that that I did for myself. And then I also think taking a little bit of my own time and you know and figuring out what was going to serve me best, how to sleep, how to work out, how to eat, uh, and how to not be stressed all the time. Because that's it's a time in your life when everything's coming together. Yeah.

SPEAKER_02 25:58

Would you like to add to that?

SPEAKER_05 26:00

I think I want women to know that there are providers out there that are going to listen to them and take their symptoms seriously. Because I think a lot for too long, women have been kind of like, you know, it's aging, it's normal. Your hormones are changing. It's changing. It is what it is. You'll be fine. Yeah. And yeah, they're not wrong. We will all go through this. If you're born with ovaries, you will go through this. And it's a natural phase. It is not a decline, which is what a lot of women feel. I'm done. This is it. This, you know, I'm past my prime. Actually, no. We are at our prime. We are in our prime. And this is the next best chapter, in my opinion. You know, and in all of our opinions, I think. And so I want them to know there's more to be done, that there are people out there advocating for them, and that they should be in charge of their own health care. And if that one provider is not listening to you, find another.

SPEAKER_02 26:50

But it's intimidating to walk in and say, I feel all these things. You know, you don't want to feel judged. So it's just a human nature. It's human nature. That's what we don't want to be. What are some of the things that we should walk in with and and understand as we get ready to start that conversation? And Tams, I'm going to start with you, and I want to hear both of your perspectives on this, but I want to hear what you did when they chopped you up as just moody. Oh, yeah. Moody and Moody and going.

SPEAKER_06 27:16

You know, I I really didn't have a good framework around what I was doing at the time. I really didn't. I didn't understand it. I didn't know. But it wasn't there. Yeah, it wasn't there. And it also, I just didn't even feel comfortable. I'd been with my doctor for 20 plus years. Um, it was just, it was very odd for me to even have to change until I started educating myself and like looking into it deeper and deeper. And um, so that's why I actually wound up writing my book, How to Menopause, because I was like, oh my gosh, if I didn't know any of this, like there's so many people I've talked to, and there's so many people that are educating me. If we can, I mean, you know, I talked in sound bites my whole life. I was like, I'm gonna write in a brain fog-proof book to try to help women. But I I think that what I would have liked to have is um, you know, walking into the doctor's office, I wish I had my symptoms all together because I think I said it all different ways. I'd walk in there and be like, oh, and I'm tired all the time. Or, oh, and I gained weight. And I right around here, just right, just here. And so I didn't know to say, like, I have this, this, and this, and this might be what I think is going on. I wish I had had that knowledge to even had that vocabulary. So that's the first thing. And I think that I would have paid attention to the fact that my doctor wrote in my patient portal, in menopause, any questions, and got sent that to me. That's how I found out I was in menopause. So I wish I had changed right away. I eventually did. Um, and then I think the final thing is that I wish I had listened and realized that I did have that optional hormone therapy. Um, but I was so afraid of what, uh, of just fear, you know, and all of the information that was out there that I didn't listen, and so I did suffer a long time.

SPEAKER_05 28:45

Um I think you know, we're having more and more of these conversations. And I think women are listening and they are taking it in, but you're not wrong. They're afraid. They have been to multiple providers and and sent home with with no help. Okay. And so I've had women come to me. Their husbands actually brought them to me. And it's I'm their sixth healthcare provider. And she's like, I really didn't want to come today because I figured you're not gonna help me either because no one else has been. And they wrote in her chart psych evaluation. Oh, and this is after five years of struggling with symptoms that have worsened and it's affecting her quality of life. Her husband made her appointment and made her come and drove her. And so once I just spoke with her and I heard her out and I validated what she was feeling, that was half our battle. She was like, I'm happy. I said, Well, no, I haven't treated you yet. She goes, No, I know, but I'm already happy enough. Right. I'm she's being heard. She's being heard. She's being heard. She's like, okay, and I know the next part of it, our treatment plan, is only going to help me.

unknown 29:51

Yeah.

SPEAKER_05 29:51

Okay. This is what it's all about is really finding that team that's going to be there for you and walk you through it. You know what I've heard?

SPEAKER_02 30:01

Call me and let me know when it gets worse. And I'm like, well, how do I know? It's gonna be, I don't want to even go through what I'm going through now. Right. And and I think that there's just a fear because breast cancer. Absolutely.

SPEAKER_00 30:15

Yeah, and we're really excited because I had mentioned earlier that we are building a cancer center that's devoted devoted to women's cancers. And it's gonna be opening in about a year. And the oncologists are so focused on treating the cancer and they're very busy that we don't have time to focus on these other quality of life side effects, menopause. So we're actually starting a menopause program specifically to point out that we want to listen to the patients and address their symptoms. Because to your point earlier, a lot of these women, they don't know if it's from the cancer treatment or if it's just from the natural menopause that they're going through. So we're actually going to set up a brand new program addressing these symptoms. And we're partnering with doctors like Dr. Cinnamar so we can have her expertise and provide that for our community.

SPEAKER_02 30:58

Yeah. And there's books and there's movies out there and a lot of more other conversations just like this. Samson, go ahead and remind everyone about your what you're doing to just continue to push through and help all of us.

SPEAKER_06 31:10

Yeah, thank you. Um, well, I wrote the book How to Menopause because I thought we needed the kind of what to expect, but for this stage in life. And um, I have two films out. One is called The M Factor, Shredding the Silence, and it was really created to open up the conversation as best as possible. And the second one is the M Factor 2 before the pause, and we called the prequel, which is uh what happens right before menopause, which is perimenopause. And um, it's been really encouraging to see um the film uh brought to different communities. Uh just like here in Dr. Dr. Gila said so much to to bring the film here. And um yeah, I'm real excited to see what happens, and um, it just makes a difference to have a community to speak with and talk to and doctors to listen to afterward. So we you usually show the film and then we have a panel of experts that come up afterwards to answer questions within their community.

SPEAKER_02 32:00

I think the beautiful part about it is that's it. You just said that word there, community. And I think that we all have to understand that we're all in this together. We are community, we're women going through it. We need to support each other through this phase and all the different phases of our lives. Ladies, I cannot thank you enough. This has been a wonderful conversation. Thank you so much for sharing your insights with our viewers, and thank you so much for watching. Remember, viewers, be sure to hit that subscribe button on our channel here to keep up with the latest health and wellness information and tips from our experts. Thank you so much for watching and stay healthy.

SPEAKER_01 32:33

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