Menopause, Hormones and Real Answers With Dr. Vanessa Soviero

Menopause can feel like your body changed the rules without telling you. In this episode of The Anthony Amen Show, Anthony sits down with Dr. Vanessa Soviero, an OB GYN and certified menopause specialist, to cut through the confusion around hormones, weight gain, energy loss, and what actually works for women navigating menopause today. 

They discuss symptoms many people do not immediately connect to hormones such as joint pain, brain fog, skin changes, and stubborn belly fat, and why being told it will pass often leaves women struggling longer than necessary. Dr. Soviero breaks down common misconceptions from the WHI study, explains when hormone therapy may be appropriate, and explores evidence based nonhormonal options for women looking for real relief. 

The conversation also gets practical. Anthony and Dr. Soviero talk about strength training for bone density and metabolism, nutrition shifts that help manage cravings when sleep and hormones are disrupted, and how visceral fat and insulin resistance can change during midlife. You will also hear about creatine monohydrate, sleep strategies that can make a real difference, and why an individualized realistic plan matters more than chasing quick fixes.

Beyond the science, they discuss real world challenges women face including limited time with providers, overwhelming supplement advice, and navigating health information online. If you have felt dismissed, confused, or unsure where to start, this episode offers a grounded honest conversation designed to help you move forward with clarity.

Subscribe to The Anthony Amen Show for more conversations on fitness, health, and real world lifestyle change, and share this episode with someone who needs it.

This episode is for women going through menopause and anyone who wants to better understand hormones, health, and how to support women during this stage of life.

Transcript

Meet Vanessa And The Mission

SPEAKER_00 0:00

Hello and welcome to the Anthony Amon Show. And today we have another great episode for all of you today. Really excited to do this. Without further ado, welcome to the show. Vanessa, it's pushed to have you on today.

SPEAKER_01 0:09

Thank you so much. I'm so excited that we're even talking about this topic. So thank you.

SPEAKER_00 0:13

Yeah, I always like to preface. I know more about menopause than most men my age or even men in general. So this is gonna be a lot of fun to talk about.

SPEAKER_01 0:20

Love it. I'm ready for the challenge.

SPEAKER_00 0:22

Before we hop into that, just give a little backstory about what got you into the menopause world and what got you leading the initiative for Northwell.

SPEAKER_01 0:29

Okay. So originally I am an OB, I'm a trained OBGYN, and up until 2015, I was delivering babies, needed a spine surgery. Two years later, needed another, and then my surgeon told me it was career-related, positional, delivering babies. So I had to stop and do GYN only. And I started getting a lot of women, menopause complaints, perimenopause complaints. And like most doctors, almost all doctors, we were not trained for menopause. We did not learn about menopause. We blow off patients because we don't know about it. So I was that doctor until patient after patient after patient I realized I was really missing something in my training. So I seek training myself. I went to the Menopause Society, I became menopause certified, and that's what I do now.

SPEAKER_00 1:14

That's amazing.

Symptoms Few Link To Hormones

SPEAKER_01 1:15

That's awesome. It was a blessing in disguise.

SPEAKER_00 1:17

To start off with you seeing patients in menopause, what was the what's the most common complaints you get from women that start going through perimetopause eventually into menopause?

SPEAKER_01 1:26

Well, there's a lot. Most common symptoms, hot flashes, night sweats, sleep, waking, body composition changes. Everyone all of a sudden has a belly. They didn't have that. Very common symptoms that most people don't associate with menopause, joint pains, brain fog, skin symptoms. So there's really symptoms from head to toe. And most people don't necessarily associate that with their hormones because they're just the entire body.

Why Most Doctors Miss Menopause

SPEAKER_00 1:54

So yeah, I totally get that. So what was the initial approach you had with that before you ended up learning about menopause? Tied into what's still the approach of most physicians if I'm walking into the office saying, hey, I'm going through this.

SPEAKER_01 2:06

Well, the truth is, unfortunately, I hate to admit it, but the reaction from most doctors is it'll pass. Give it some time. It's gonna go away on its own. And for some women, unfortunately, and doctors don't tell patients, symptoms can last seven to ten years. So when you're telling a woman to just give it time, it's gonna pass, they are basically living a different life for many, many years. So unfortunately, that's what most doctors will say. It's not their fault. It just wasn't part of their training. But now women need to know that there are treatment options because it affects every single aspect of their life. It affects their sexual relationships with their partners, it affects their work, it affects their um friend relationships, it affects them physically. And a lot of women, it also changes how they feel about themselves because of the body changes, the weight gain. It really changes how they feel about themselves. And it's really awful.

SPEAKER_00 2:58

Yeah, I mean, I would just talk about someone that was going to menopause and I went with my doctor and he told me that it will pass get over it. It's not a good feeling that you sit with.

Finding Qualified Menopause Care

SPEAKER_01 3:07

No, and that is why it's important that people like you are doing podcasts like this because women need to know your doctor will most likely not address your symptoms, but there are places, doctors, practices, nurses that will. And it's a matter of empowering ourselves to know. Maybe my doctor didn't do that for me, but I can find someone who will.

SPEAKER_00 3:29

Well, how would you know?

SPEAKER_01 3:31

Well, so basically, what I tell a lot of women, well, women that are coming to me already know this is my specialty. But for women out there, if you don't get simp, you know, your doctor doesn't give you the information. If you go to the Menopause Society and you put in your zip code, you can find menopause certified practitioners within your area. There are also a lot of online um health places that do online consults and treatments. So I always say, as long as you get somewhere, get started, then you could find maybe someone close to your house and then something like that. But just get started, get acknowledged, get validated.

Supplements Hype Vs Reality

SPEAKER_00 4:07

Yeah, I think it's great to sort of look for avenues like that. I want to start just in general. If I'm a patient, I'm coming to you, right? What's the first avenue that people are saying they're trying before they either walk into your door or be that you're giving them for advice? So, what is something I'm doing on my own to try to get over this, or that I think is common knowledge based upon a friend told me or learned from a doctor or someone else that is wrong, or maybe it's right, I'm just not doing it right.

SPEAKER_01 4:33

It's a complicated question because it all depends on what their symptoms are. Everyone's menopause or perimenopausal symptoms are unique and different. So it really all depends on what's most bothersome to that person. If someone's having hot flashes, night sweats, problems sleeping, most of them, their friends told them to try this supplement, try this supplement. Um, so they've already tried that kind of stuff. For women that have had weight gain, body composition changes, they're going to the gym, they're trying to change their diet. But for some women, that's just not enough. So it really all depends specifically what their symptoms are. Most people are tried every supplement. They've gone to vitamin shop and they've bought in hundreds and hundreds and hundreds of dollars worth of products that are not going to help.

SPEAKER_00 5:14

Like what?

SPEAKER_01 5:16

Very commonly for hot flashes, women are trying black kohosh. Uh, there's other supplements. The problem with the supplement industry is that it's not FDA regulated, so you don't know what you're actually getting. Does actual black kohosh, for example, help reduce hot flashes? Yes. But when you're buying supplements, is there actually black kohosh in that product? How much is actually in it? Um, probably minimal to none. So the problem is all these different supplements. So I'm hearing all different things. I have people coming to me telling me that they've tried this supplement that I've personally never even heard of. So this is part of the problem with social media, is there's people out there that don't really have medical backgrounds that are recommending these things that I've never even heard of. So I don't I don't know where this information is actually coming from.

SPEAKER_00 6:00

No, I totally agree. A lot of it's farce and like you said, it's not regulated. So it's understanding what supplement companies are regulated.

SPEAKER_01 6:05

Yes.

SPEAKER_00 6:06

And you can figure that out by looking things for like NSF certified or specific things to that nature. Are there specific medications though that maybe if I'm going to a doctor that they're prescribing me to help with symptoms?

Nonhormonal And Hormone Therapies

SPEAKER_01 6:17

Okay. Again, it depends on the symptoms. If we're talking about hot flashes, night sweats, sleep, the most effective um gold standard of treatment is actually hormone therapy. Not everyone can take hormone therapy, not everyone wants hormone therapy. So there are non-hormonal treatment options. For some women, if you take anti- a certain antidepressants, not all of them, they can help reduce hot flashes. Problem though, common side effect, weight gain, decreased libido. And women at this age group are already struggling with weight gain libido issues. Um, there are other non-hormonal medications that can help with hot flashes. Um, so it really depends on their symptoms. If they have symptoms of joint pains, a lot of women are going to their primary doctor, they don't have Lyme disease, and their doctor's saying, well, have a good day. For some of these women, off-label hormones can improve their joint pains and muscle pains and stuff like that.

WHI Study Myths And The Facts

SPEAKER_00 7:08

So start with hormone therapy. What exactly does that entail for someone going to menopause? And what are the results shown to help people with it?

Estrogen, Progesterone, And Delivery

SPEAKER_01 7:16

Well, I think the most important thing to know about hormone therapy is the reason why doctors don't know about it, why doctors didn't learn, and the reason why most people are afraid of it is because in 2002 there was a study called the WHI, and the results of that study were reported prematurely. And basically, the results came out that women were getting breast cancer, having heart attacks, strokes, blood clots. So basically, that was worldwide information. Everyone stopped prescribing hormones. Women who were on hormones and doing very well were told to stop their hormones, they were gonna die. What happened was is when they looked at that study and they pulled out the women less than 60 years old within 10 years of menopause, they actually saw that the risks were actually rare. Very rare case, uh increased risk of breast cancer, heart attack, stroke, rare. So in healthy women, um, without certain medical issues, hormones are the most effective treatment. And it means you need estrogen. Estrogen is the hormone responsible for the symptoms. If a woman still has their uterus, they also need progesterone to protect your uterus. And off-label, we use it for other symptoms. But what the indication is hot flashes, night sweats, and also osteopenia. You know, in your industry, you probably do see a lot of women coming in for bone health. You know, they already have osteopenia, they're going to the gym, which is great, important for their bones, but may not be enough to prevent them from getting osteoporosis. So estrogen is also very important for bone health.

SPEAKER_00 8:39

Yeah, you're pretty much on point with that, which is helpful.

SPEAKER_01 8:43

Yes.

SPEAKER_00 8:43

Uh note on the estrogen side of it, yes, there was a study around the same exact time with birth control, how it could cause clots, strokes.

SPEAKER_01 8:53

Yes. And the a lot of people don't know the difference. So there is a big difference between birth control and menopausal hormones. So birth control is a different type of estrogen and progesterone, and it is about four to five times more potent than menopausal doses. So menopausal doses have much lower risk. So if you ever saw, if someone ever saw a doctor and they said you can't take birth control, you have migraines, you can't take birth control because you had blood clots, very different when we're talking about menopausal hormones, um, because the doses are different and we give it in different ways. Meaning you could take hormones orally. Most menopause specialists prescribe what we call transdermal estrogen, meaning through the skin. And when you're taking hormones through the skin, it's avoiding the breakdown in the liver. So significantly reducing risks of developing blood clots. So much safer, very different than birth control.

SPEAKER_00 9:44

Yeah, I actually have a friend that had a stroke from birth control.

SPEAKER_01 9:47

Yes. And a lot of times people who have had a stroke may also have some underlying blood clotting disorder. Um, but different for hormones. So for women out there who think they, oh, my doctor told me I can't take birth control, therefore I cannot take hormones. That is not necessarily true. And that's why they should specially see a specialist because it's very nuanced.

Fitness Fears And Strength Training

SPEAKER_00 10:08

Yeah, I want to branch into because we were talking about this pre-show, and I just think it's great. You talked about how women seek fitness as a form to dive, like come here and do that. And that's not the case of what I've seen over the last few years.

SPEAKER_01 10:25

Okay.

SPEAKER_00 10:26

There's a subsect of women who do their own research, who reach out, come here, get help, and actually see improve it. Then there's a subsect of women, and it's a meme going on on Instagram, and it literally shows them doing this weird little exercise in a group, and it's like things women would do to avoid strength training. And then there's a subsect of people that go to the doctor, and the doctor doesn't even tell them to work out or says they can't work out in four, and actually pushes them away from the gym because maybe they're afraid of some underlying issue whatever down the road. So you have these three sects of women going through menopause, and the information then gets skewed because one's talking to the other, one talking to the other one. So I want to just set hard ground rules from your knowledge of them, from where I'm at, is what's the right avenue when it comes to fitness? Because fitness in general.

SPEAKER_01 11:19

Yes.

SPEAKER_00 11:19

So how do you get specific?

Visceral Fat, Sleep, And Weight Cycles

SPEAKER_01 11:20

Well, like you said, fitness is in general for is important for overall health, cardiovascular health, bone health, everything. You know, um, brain health, it's important for everything. When it comes specifically to menopause and weight gain, exercise alone may not be enough for a woman to lose weight because for a couple of reasons. One, there's metabolic changes that happen once we hit midlife that make it very, very hard for us to lose weight. In addition, the weight gain we have when we're perimetopausal is in really the bad areas. It's the belly fat, it's the what we call visceral fat. And it's that type of fat that increases our insulin resistance. So now you have this huge cycle, right? You're insulin resistant, you're gaining weight, you get more insulin resistant. It's this cycle. Much harder for a woman to lose weight. Now, tackle on symptoms, hot flashes, night sweats, not sleeping, all those things increase someone's weight gain. So it makes it very hard for a woman to lose weight. So a lot of women might talk to their friend and they may say, I went to the gym, I didn't lose weight. So that woman may not think it's gonna be important. So I do tell women if weight loss alone is your goal, number one, hormones are weight neutral. Hormones are not gonna help you lose weight. You're not gonna gain weight from hormones, you're not gonna lose weight from hormones. I always say, unless part of your weight gain is because you're not sleeping, um, you're having hot flashes, night sweats, you have such bad fatigue because you're not sleeping that you don't have the energy to go to the gym. I hear a lot of women say, I want to go to the gym, I can't, my joints hurt, my muscles hurt. So if we fix those symptoms, those women may be more motivated to go to the gym. But I think the gym can't be the only answer, no offense. I think it has to be part of the treatment. And a lot of doctors probably, it's not that they don't recommend it. I think part of the problem is we're just so time restrained in a visit. And unfortunately, I think we there's so much we need to talk about. And unfortunately, what gets pushed away is something easy, like should be easy talking about working out, talking about the gym. And I think we just don't have time for all of that, which is why it really has to be a multidisciplinary approach.

SPEAKER_00 13:30

I would argue that it should be the opposite.

SPEAKER_01 13:33

Okay.

SPEAKER_00 13:33

So it's not that I should wait for these symptoms to relieve themselves to then go start working out. It should be I start start working out so those symptoms can relieve themselves.

Bone Loss Starts Earlier Than You Think

SPEAKER_01 13:44

Or even better, I think we, as physicians, as the medical field, need to do a better job and preparing women. Okay, when you're in your mid-30s, you may have started having perimetapausal symptoms. Encouraging healthy lifestyles earlier. Maybe that'll reduce their symptoms later on. Maybe that will reduce, maybe not get rid of their weight gain, but reduce it. So I think we need to do a better job talking about these things before they happen. So it's part of their routine. It's much different to go to the gym when it's your routine. When you go to the gym, if you know you're gonna do X, Y, and Z, much easier. When you have never gone to the gym and now you're 49, you gain 20 pounds, you have belly fat, you hate the way you look, you didn't sleep the night before, it's much harder to go. It's really much harder.

SPEAKER_00 14:29

Definitely much harder, but it's always even more important to understand that you're doing the right thing.

SPEAKER_01 14:32

Absolutely. But we it's also, you know, have it's also easier if we have places we could tell women to go. It is very intimidating when a woman says, Well, I tried to go to, I don't know, world gym or something like that. And you go in, and it's a lot of people that are at much higher levels of you than fitness, and then they're already embarrassed of themselves. Unfortunately, they already don't like how they look, they don't like how they feel. It's very hard for a lot of women to take that jump.

SPEAKER_00 14:54

So it's less of telling them where to go, it's more telling them the type of thing training they should be doing. So, more specifically, strength training when it comes to building muscle. Women tend to avoid that. It's it's getting better, but there's still that nuanced like, I'm not gonna weight train, I don't want to bulk up, et cetera, et cetera. But that's really the key that's gonna unlock a lot of issues that are gonna come later from menopause. You mentioned osteopenia osteoporosis. What helps more than the leading medication of the market? Strength training.

SPEAKER_01 15:19

Yes.

SPEAKER_00 15:20

Bar none.

SPEAKER_01 15:21

Yes.

SPEAKER_00 15:22

And still all these other auxiliary fun classes are good to get your heart rate up and good for cardiovascular, but aren't really gonna be there for the long term.

Dementia Risk, SWAN Data, And Sleep

SPEAKER_01 15:31

I think a lot of that's fear, though. A lot of women, you hear weight training, you hear weights, and what you picture is like lifting these giant weights. They're afraid to get hurt. Now, because they feel not like themselves, they feel weaker, their joints hurt. I think they're really, from what I get in my daily experiences, I think women are also just afraid. They're afraid they're gonna do it wrong. So, unless women know it's not gonna be that hard, you're not gonna be lifting 300 pounds, you know, you're not gonna be dropping this barbell from, you know, onto the floor. Like, I think, I think it's it's overwhelming if you've never done it. But you're right, for bone health, and especially once we have osteopenia, it's much harder to uh to stop that process, even with weight training, unless you're doing significant weight training. So it's very important that we maintain our bone before we lose most of it. And we lose a major amount of our bone. Most rapid bone loss is two years before we even stop our periods. Women aren't even in menopause yet. So you're still getting your period. You still think your bones are great. When if you you don't know, you can't predict in two years you're gonna stop. So you're already in the rapid bone loss phase. And this is where we really need to be specially be doing all this stuff.

SPEAKER_00 16:40

All right, now take that a step further.

SPEAKER_01 16:42

Yes.

SPEAKER_00 16:42

So now you have strength training, which is symptomatic from osteopenia osteoporosis, could help with osteoarthritis as well for joint health. Yes. You mentioned symptoms start in your body without you knowing 10 years before you even hit menopause, which is true, which is why it's important to start things earlier. Even as of more recently, with something I'd spent a good hour episode on, which I definitely recommend people to go back and look, on Alzheimer's. And women are 70% more likely to get Alzheimer's than men are, comboed into these reasons of menopause. And whether menopause is a causation or a correlation, it's still related in there because now they're not sleeping. Absolutely. All these risks are beforehand.

Creatine’s Emerging Brain Role

SPEAKER_01 17:25

Yep. The other thing we know from one of the studies that is still being done, really, it's called the Swan study, is women who have moderate to severe vasomotor symptoms, meaning hot flashes, night sweats, not sleeping, in and of itself, those put you at increased risk for heart disease, osteoporosis, and brain disease, meaning dementia, Alzheimer's. So these symptoms alone can be devastating. And then add on top of it, if you're not working out. So we have to do everything we can to mitigate those risks. Because you're right, Alzheimer's dementia, we don't really have a good treatment out there. It's really questionable in the literature if estrogen treatment really does prevent. We don't know. Right now, it's really we don't know what really.

SPEAKER_00 18:09

Do you know what does help? Alzheimer's can eat every isn't has even been starting to show to help menopausal symptoms and it's a supplement.

SPEAKER_01 18:17

What's that?

SPEAKER_00 18:18

Yes.

SPEAKER_01 18:20

Oh, I don't even know.

SPEAKER_00 18:22

Creatine.

SPEAKER_01 18:23

Really? You know, it's funny. A lot of women keep coming in asking about creatine, creatine, creatine. And my answer to them, maybe I'm wrong, is if you're not working out, taking creatine is not really gonna help you. So because now a lot of women are on this creatine thing, then they're all popping, you're doing their creatine, but if they're not going to the gym.

SPEAKER_00 18:40

Doesn't matter.

SPEAKER_01 18:41

Really? See, I didn't know that.

SPEAKER_00 18:42

When we produce creatine naturally, well our life, I would imagine. When we're sleeping.

SPEAKER_01 18:48

Yeah, okay.

SPEAKER_00 18:50

What happens with menopause? Like you just said, you're not sleeping.

SPEAKER_01 18:53

Yes, okay.

Food Choices, Hunger Hormones, And Reality

SPEAKER_00 18:53

So your creatine loads are dropping. Creatine flushes into your brain, helps vasodilate the uh veins in your brain. So supplementing creatine helps that. And it's but beyond the increasing your ATP, which everyone knows it does, right? Right. When specifically tie that into research with dementia and Alzheimer's, it's showing that you can actually stop the how much progress you're going. It's not gonna reverse, but it can help prevent the symptoms from increasing more than medication.

SPEAKER_01 19:24

No, well, medications really aren't great at all.

SPEAKER_00 19:26

Yeah, right. Supplementing up to where most people would see creatine monohydrate and say, okay, five grams a day as a baseline. They're showing up to 20 grams a day. Which is even more wild. That came out is 20 grams a day for taking creatine has been helped with memory recall, even to the point, like if you only slept four hours a night and you take it, your memory recall is just as good as if you slept eight.

SPEAKER_01 19:48

That's awesome. Which is because another very common symptom, brain fog for women. So women are already suffering with that. So I definitely have to look into that more because I didn't really I don't really know much about creatine. So I'm walking away with something from here, too, you know.

SPEAKER_00 19:59

There you go. Side effects, nil. That's awesome. Lots of drinking water, but right.

SPEAKER_01 20:04

Well, that's the other thing, too. We really need to hydrate. I mean, I I carry a water bottle around. By the end of the day, I go home, it still has water in it. That's I mean, that's really bad.

SPEAKER_00 20:13

Yeah, definitely.

SPEAKER_01 20:14

I know.

SPEAKER_00 20:15

I want to talk about the other side of it, which I think a lot of people screw up, and that's food. So, what do you typically recommend to people when it comes to what they eat as they're going through menopause? And what are some common mistakes people make?

Protein Targets And Simple Habits

SPEAKER_01 20:29

Well, obviously, as healthy of a diet as possible. Once we're What does that mean? Meaning green leafy vegetables, vegetables, produce reducing um processed food. You know, by I always say, you know, when you hear on TV, like, oh, just, you know, you're supposed to like shop around the periphery of the store where, you know, all the healthier stuff is. Yeah. But the other thing is, it's not always everyone's fault when we're reaching for the bad stuff, because when we're not sleeping, I'm always gonna claim the menopause symptoms, we're not sleeping, we don't feel well. It increases our hormones, the leptin and the ghrelin. One of them is supposed to make us feel full. And one of us, one of the hormones is supposed to make you know when you're, you know, it's excessive hungriness. The problem is when we're not sleeping, our hormones are off. So what happens is there's studies that show when people don't sleep and their leptin and ghrhrin hormones are off, they are reaching for the worst food. You're reaching for the processed foods because that's what your body is making you reach for. Yeah. And a lot of things, the other thing, too, is what's really hard with food is that a lot of women are suffering mood symptoms in perimenopause, menopause, depression, anxiety. Those symptoms, in and of themselves, are making people turn to the comfort foods. So it's so easy for us to say, eat your vegetables, you know, eat your healthy, lean protein. But the reality is sometimes it's really out of someone's control hormonally. You know, it's not just willpower. So I think it's very important.

SPEAKER_00 21:56

I disagree.

SPEAKER_01 21:56

Do you? 100%. Because I feel the opposite. It only because I have so many patients that are personal trainers. I have someone who owns a gym and suffering with the weight gain, the belly fat, and no one eats better or works out more than those people. So it just goes to show you that there is something else going on.

SPEAKER_00 22:15

I think you're going to gain weight, but I think to the extreme that people take it is the issue. And this is the example I even use for the general population as a whole. Right? It's okay. I had I have two kids under two. If someone like me is gonna gain 15 pounds through the next six months because I'm not sleeping, I'm up all the time, and I have to balance out that stress, that's fine. I'm gaining it over a slow period of time, right? And then they can easily dock it up. It's when you get to the 40, to the 50. Yes, to the 60. And now you're really looking at somebody and saying, all right, this is something structurally you're doing wrong. You mentioned reaching for food at night. And this is it's actually kind of funny because I thought for years, time of day eating would make you gain weight. It's not true. It's just what you go grab at night. Right, right. So my argument would be don't have it in your house.

SPEAKER_01 23:01

That's true.

The Time Crunch In Healthcare

SPEAKER_00 23:02

So if it's not there, how can you go grab and eat it? Oh, I do for my kids. Well, do you want your kids eating shit too?

SPEAKER_01 23:08

Yeah. I mean, that's true.

SPEAKER_00 23:09

Right? So don't have it in general. And then on top of that, make those things a tree. So I I'm a big fan of my wife and I go for walks to go get ice cream. But we're walking to go get ice cream. I like that. And then we're getting a kitty size. We're not getting the large, we're not getting the extra large. Yeah. So you can actually satiate those hormones by having just a small spoonful. You don't need the whole pint. That's self-control.

SPEAKER_01 23:33

That is true. Except I feel like when women are suffering with symptoms, it's very hard to make the right decisions. It's very hard to motivate the physical. Well, life is hard. Life is hard. Absolutely. But that's why I think it's also very important that women just seek treatment because it's very hard to make the right decision. It's very hard to motivate yourself to get up and to get up and go to the gym when you didn't sleep for three nights, or when your joints hurt. Or, I mean, I could go on and on about the symptoms. Or a lot of women have palpitations as a symptom. They don't know what if they what if they think they're gonna have a heart attack? They might not want to get on the treadmill and feel their heart racing more. So it really is very important that we really get to the bottom of what is holding you back from doing all the healthy things. Because if it's symptoms, most of them, not all, most of the symptoms are treatable. So I think it's it's easier said than done. And I I know this more now than I did years ago because this is what I'm seeing every day. And my patients are suffering, suffering, suffering, but they are also some of the most motivated people to make the changes. But they have all these other symptoms that are really just holding them back and in their way.

Payment Models, Med Spas, And Ethics

SPEAKER_00 24:39

I get it. It gets you, beats you down, tears you up. Yes. And you have to keep fighting and you have to keep going. And it's I think there's like I said, there's a percentage that's okay, but then it's the opposite side of it that's not okay. And that's when it really comes to a conversation of what do you really want?

SPEAKER_01 24:56

Yes.

SPEAKER_00 24:56

Do you really want to fix this or is it something you just want to complain about? And you can get a 10% loss, it's fine, but 20, 30, 40, 50%, it's a different conversation. You talk about food. And I think that has to do with not knowledge of what to eat. So you mentioned dark green leaf vegetables, which yes are great, but I wouldn't even prioritize that. I don't even think it's something you need to worry about. You want to be full and eat right, increase your fats and your proteins.

SPEAKER_01 25:22

Say right.

SPEAKER_00 25:22

Screw everything else.

SPEAKER_01 25:23

Right. And this is the thing. We all learned about diets years ago. We all think we're we're doing the right thing, but that's the other thing too. Like you said, maybe we're not. Maybe we don't know. And as a doctor, I could tell you, unfortunately, the reality is I'm not having those conversations every day. Not because I don't want to, because there's just no time.

SPEAKER_00 25:40

I have a full, we're gonna have a full episode on that with my brother who's a doctor about the timing. I know it's insurance company knocking in.

SPEAKER_01 25:47

It is, but we what we also is just make it easier. Like here, I'm sitting here as we're talking, I'm thinking, well, how great would it be? Like I'm director of the Metapood Center here in Stony Brook now. How great would it be if we made it easy for outpatients and had like a session, like, okay, on, I don't know, make up a day. You're gonna go. You can you can learn about nutrition. This and if we make it easy, easier, I think that's so important.

SPEAKER_00 26:07

So we make it easier for people. If they want simple take-home advice and tell me if I'm wrong, but this is what I would go eat more unsaturated fats, start there. If you can't change anything else, specifically for menopause to help regulate hormones, hormonal regulation a little bit, and to feel full, unsaturated fats. Next step, proteins. You can't protein will never make you fat.

SPEAKER_01 26:28

Right.

SPEAKER_00 26:28

Eat as much protein, lean protein. I'm gonna specify and not frying your chicken and saying it's protein.

SPEAKER_01 26:35

So much better that way.

SPEAKER_00 26:36

Yeah, agree. But just understanding if I just eat that and constantly focus on that, 90% of my symptoms are gonna disappear. Supplements, creatine. That's and protein powder if you can't eat meat because you're disgusted by it.

SPEAKER_01 26:50

A lot of people I do find a lot of women coming in saying they're doing protein, they're doing protein bars, protein drinks.

SPEAKER_00 26:56

But how much protein should they be having, do you know?

SPEAKER_01 26:57

Uh, isn't it like 60 grams or something a day? No, I don't know.

SPEAKER_00 27:01

It's that's not it's it's not a general, it's a it's specific. So for women in general that aren't weight training, should have 0.8 grams per pound. So however much you weigh just times by 0.8. And menopause that bumps up to one. So however much you weigh, that's how much protein you should be eating.

SPEAKER_01 27:17

Okay. Well, I'm definitely not eating that much protein.

Final Advice: You Don’t Have To Suffer

SPEAKER_00 27:21

But why? Protein is the building block to muscle. Yeah. How do you lose weight? You build muscle. Why does muscle lose weight? Because it increases your metabolic rate. So you're burning more calories a day at rest. You burn that energy off, now you're sleeping better because your body's learning to regulate. Another quick thing stop watching TV before bed. Easy.

SPEAKER_01 27:39

I actually took the TV out of my room. I don't have a TV in my room anymore, only because that's what I used to do. It used to keep me up, and then you can't fall asleep. And then, yes, you're up, and then you're like, oh, I'm hungry. There's still cookies down there. Yeah.

SPEAKER_00 27:51

But cookies aren't in your house.

SPEAKER_01 27:52

You're right. No, they're not.

SPEAKER_00 27:55

I am a stickler in my life, judging me all the time. But I like there's we have almost nothing bad in that house. And when I do have a craving, because I'll get there, we all not sleeping. Uh well, but the kids, or if I'm going to the metaphors, someone like that, a spoonful. That's it.

SPEAKER_01 28:11

Right.

SPEAKER_00 28:12

Satiate the craving because if you don't, you're gonna go binge later.

SPEAKER_01 28:15

It's worse. Yes. Yeah.

SPEAKER_00 28:16

So satiate.

SPEAKER_01 28:17

You really won't sleep because then you're perseverating on what you're craving. Yes, yes.

SPEAKER_00 28:22

It's those little things that can make a bigger impact on somebody and regulate somebody more. So then the real question is I guess the real problem is you don't have enough time with your patients.

SPEAKER_01 28:34

Yes.

SPEAKER_00 28:35

How do we fix that?

SPEAKER_01 28:36

That time with my patients, that's not gonna change.

SPEAKER_00 28:41

How? Why?

SPEAKER_01 28:42

Why? Because I I don't know. It's just because there's so much else for us to talk about. Like, you know, because as a gynecologist, we're also making sure they're taking care of their general health, their mammo, their bone density, their, you know, um colonoscopies. And then because there's a lot of uh issues with perimenopause and menopause, they're also having some midlife issues that I don't want to ignore, you know?

SPEAKER_00 29:08

Some sometimes No, I get it, but why not have more time?

SPEAKER_01 29:11

Oh, but that'll never happen because you know, you're you get like, I mean, 15, 20 minutes a patient, you have to do all of that.

SPEAKER_00 29:17

Why not get an hour? Why not get it uh even the first console? Like, why can't this is my question?

SPEAKER_01 29:23

Yes.

SPEAKER_00 29:24

You're right. It can't happen. You're stuck, you're in the middle of it, you're not running the company, right?

SPEAKER_01 29:28

Yes.

SPEAKER_00 29:28

But if you were, why can't we change healthcare to not have 15, 20 minutes of someone to have full length, to really dive into what they need?

SPEAKER_01 29:37

Now that in the Metopause Center, we we just opened it in uh second week of January, that was one of the things. I'm like, if I'm gonna do this, I'm gonna do it right. So I do have 40-minute consults. So for the first time, women are coming in for their consults, and even that sometimes is not enough time. But the problem is when you work, now most of us work for systems, you know, there most doctors aren't on your own anymore. And you are required to unfortunately have to see a certain amount of people a day because of the way the insurance reimbursements are. So it's it's not even in our control. Like I, we, most doctors are just employees. So we don't really have a choice. So that's why some of us, sorry, for people wait for me. Sometimes I do have a wait in my office. Sometimes patients are waiting half hour, an hour. I'm always apologetic about it, but sometimes it's because I'm gonna give the patient as much time as they need.

SPEAKER_00 30:23

So now systemize it. How do you change that as a whole? How can how can us as a country change that as a whole?

SPEAKER_01 30:29

I don't see that happening. I don't know. I wish I knew. Um, the only way that can happen is if they really change how insurances pay so that the pressure isn't the way to for the systems to pay their bills that they have to see an exuberant amount of patients in a day. I think that's the problem, is the reimbursement.

SPEAKER_00 30:49

I I mean, I agree. We just need changing. We need someone to step up and change it.

SPEAKER_01 30:53

Yeah.

SPEAKER_00 30:53

I mean, you look at ICB codes as an example, right? The more ICB codes you bill, the more you can get reimbursed back. And it's to an extent.

SPEAKER_01 31:05

It's still a matter of uh billing based on time, or sometimes it's a it's a fragment inside of it, but it's an incentive incentivized structure that's just wrong.

SPEAKER_00 31:17

It's incentivized wrong.

SPEAKER_01 31:18

Well, the other thing too is because malpractice rates are so high, um these these businesses, that's what it is, right? These health systems, they're businesses, they have to bring in a certain amount amount of money just to cover the malpractice to let these doctors do their jobs.

SPEAKER_00 31:34

100%. So it's but whose fault is that?

SPEAKER_01 31:36

Medical legal, because of these crazy lawsuits that happen and the amount of money that's spent. It's crazy. And all these things we see we talk about every single day. But there's I don't think there's a solution in sight for that. I don't.

SPEAKER_00 31:51

I I know, but I want there to be change because it needs to be better for the patients, it needs to be better for people. And we have a giant health crisis in the US, and menopause is just a segment of that.

SPEAKER_01 32:01

Exactly.

SPEAKER_00 32:02

You're gonna have more people getting uh getting older now that are now gonna go through menopause, they're not gonna get Alzheimer's, and 5% of the population eats up 90% of the bills.

SPEAKER_01 32:12

Yes.

SPEAKER_00 32:13

So we're gonna keep getting more and more debt and more and more debt and putting more insurance companies gonna play the hospital. The hospital's gonna play patient counts. This is gonna be this negative feedback loop that I just feel like someone needs to come in here and I wish I wished it was possible.

SPEAKER_01 32:30

I'll tell you that I don't see that in my career time because it's just I want you to do.

SPEAKER_00 32:34

I think you can.

SPEAKER_01 32:35

You think I can? Oh my god, I'll try.

SPEAKER_00 32:37

You know, this is my last point, and I really think this is where medicine is heading because I've interviewed people like this. Yeah. They're going, doctors are going private membership. They're going straight, pay me a fee a month.

SPEAKER_01 32:48

Right.

SPEAKER_00 32:49

And I'm your consult.

SPEAKER_01 32:50

And that's what unfortunately, especially for menopause now, a lot of women are getting sucked into going to places now. You know, just because someone is a doctor, um, a lot of these doctors do see money now in menopause care. So they are opening their health spas, their medi spas, and they're doing menopause treatments, and women are paying thousands and thousands of dollars out of pocket, having all this blood work that they don't need. So it's also a problem, though, because for a lot of people it is becoming a business. But then I feel like that's also taking advantage of women. Because now at least their insurance, maybe we can't see as many people, maybe we can't take as much time, but at least it's a copay for them for most people who have insurance.

SPEAKER_00 33:31

Versus it's not just a copay, though, because a lot of people have to pay out of pocket for it. Like my insurance is$1,500 a month.

SPEAKER_01 33:36

True.

SPEAKER_00 33:36

And I did the math. I had surgery last year. If you add that surgery and the amount of times I went to the doctor and I paid out of pocket, it would have been cheaper than paying my health insurance.

SPEAKER_01 33:46

Right.

SPEAKER_00 33:46

And I'm like, why the hell did I have health insurance?

SPEAKER_01 33:49

Right. But having said that, then now there are people who have health insurance, they have it, they're paying their health insurance, but are still finding themselves going to someone and they're paying out of pocket. And they're paying, and and people are taking advantage of that. And they are charging these women when women come to me and I see and they tell me how much they've spent out of pocket for certain supplements that don't work, for certain blood work they don't need, and all the money they're paying out of pocket. And I'm like, well, if you come to a place like this, yes, maybe I can't also talk to you about your diet, but it's a copay for the insurance you're already paying for. And most of the medications we're prescribing, most, should also just be a copay. Most of the medications we're prescribing should are generic, most and really should be affordable.

SPEAKER_00 34:33

So couldn't couldn't agree more. Vanessa, I just want you to give one quick one sentence piece of advice to every woman going through menopause right now. This is my take-home message. Go for it.

SPEAKER_01 34:47

Well, if you're still having periods and you're having symptoms, don't think because you're having symptoms. It's not hormonally related. Unfortunately, women are suffering because someone tells them you're still getting periods. It's not that. When you're in menopause, bottom line is, is any symptoms, even if you quote unquote just don't feel like yourself anymore, find someone who will help you. There are treatment options. It doesn't have to be hormones. Hormones are available. Hormones are safe for most of us. There are non-hormonal treatment options. You don't have to suffer. Your symptoms are not going to go away in a short period of time. They can last on average 10 years. Find someone who can help you. You don't have to suffer.

SPEAKER_00 35:21

Vanessa, thank you so much for coming on. Thank you guys for this week's episode of the Anthony Eamon Show. Like, subscribe, share. It's only with Scroos, and stay tuned for some debate podcasts coming soon live. Till next time.