The Jamie Kern Lima Show

The #1 Menopause Doctor Masterclass: How to Lose Belly Fat, Sleep Better & Stop Suffering Now! Dr. Mary Claire Haver

72 min
Jan 1, 20265 months ago
Listen to Episode
Summary

Dr. Mary Claire Haver, a board-certified menopause specialist, discusses the widespread lack of medical training on menopause, revealing that most doctors receive fewer than 7 hours of menopause education despite it affecting 100% of women who live long enough. The episode covers the three stages of menopause, 77+ symptoms often misdiagnosed as other conditions, and how hormone replacement therapy is safer and more beneficial than previously taught.

Insights
  • Medical education systematically fails women: doctors receive only 1 hour in medical school and 6 hours in residency on menopause despite it affecting all women in their final third of life
  • Perimenopause symptoms in women's 30s-40s are frequently misdiagnosed as anxiety, depression, or ADHD when the root cause is hormonal fluctuation that goes undetected
  • Estrogen decline affects multiple organ systems simultaneously (cardiovascular, neurological, musculoskeletal, gastrointestinal) but doctors treat symptoms in isolation rather than addressing root hormonal cause
  • 1 in 5 women quit their jobs due to untreated menopause symptoms, and cognitive changes during perimenopause are often worse than in menopause itself
  • Hormone replacement therapy is significantly under-prescribed due to outdated 2014 ACOG guidelines, while the Menopause Society updated guidelines in 2022 to reflect safety and preventative benefits
Trends
Growing disconnect between outdated medical school curricula and emerging menopause research, creating knowledge gaps in clinical practiceIncreasing patient self-education and advocacy driving demand for menopause-informed care, with women sharing information across generationsShift from symptom-based treatment to root-cause hormonal analysis in progressive menopause medicineRecognition of menopause as a systemic health issue affecting career performance, relationships, and economic productivityExpansion of menopause research revealing previously unknown connections between estrogen decline and conditions like frozen shoulder, fibromyalgia, and recurrent UTIsPolicy advocacy emerging for mandatory menopause education in medical school curriculaGut microbiome research showing menopause-related dysbiosis and loss of protective bacterial diversity in womenUnderinvestment in menopause research relative to pregnancy (98,000 articles vs 1.1M for pregnancy on PubMed)Racial and ethnic disparities in menopause age being recognized (African-American women 1.5 years earlier, Southeast Asian women at 46-48)Mental health bias in medicine: women's menopause symptoms historically dismissed as psychological rather than biological
Topics
Perimenopause symptoms and early detection in women's 30s-40sThree stages of menopause: perimenopause, menopause, postmenopause77+ menopause symptoms across organ systemsHormone replacement therapy safety, efficacy, and guidelinesEstrogen's protective effects on cardiovascular, neurological, and musculoskeletal systemsCognitive changes and brain fog in perimenopauseMenopause-related weight gain and belly fatMusculoskeletal syndrome of menopause and frozen shoulderGut microbiome changes during menopause transitionVaginal atrophy and recurrent UTI treatment with vaginal estrogenMental health disorders (anxiety, depression, ADHD) in menopauseMedical education gaps in menopause trainingDiagnostic testing and hormone level assessmentFertility and egg decline by ageWomen's Health Initiative study impact on hormone therapy prescription
Companies
The Menopause Society
Updated menopause hormone therapy guidelines in 2022 away from conservative approach, contrasting with outdated ACOG ...
American College of Obstetricians and Gynecologists (ACOG)
Professional organization whose 2014 menopause guidelines remain unchanged and are more conservative than current Men...
Mary Claire Wellness Clinic
Dr. Haver's clinical practice where she implements evidence-based menopause treatment and education
Tulane University
Institution offering certified culinary medicine specialist credential that Dr. Haver obtained
People
Dr. Mary Claire Haver
Board-certified OBGYN and menopause specialist; author of 'The New Menopause'; founder of Mary Claire Wellness Clinic...
Jamie Kern Lima
Podcast host; founder of IT Cosmetics; interviewer conducting menopause masterclass with Dr. Haver
Dr. Vonda Wright
Clinician and researcher who wrote 'The Musculoskeletal Syndrome of Menopause' paper connecting frozen shoulder to es...
Dr. Natalie Crawford
Fertility expert and author providing education on egg freezing and reproductive health decisions for women in their ...
Dr. Carol Tavris
Expert on menopause hormone therapy safety who presented at menopause conference challenging Women's Health Initiativ...
Dr. Averin Blooming
Menopause expert who presented research on hormone replacement therapy safety at menopause conference
Dr. Sharon Malone
Menopause expert who presented research on hormone replacement therapy safety at menopause conference
Jennifer Weisswell
NYU lawyer specializing in women's health policy; co-authored Citizens Guide to Menopause Advocacy with Dr. Haver
Dr. Rachel Rubin
Researcher who conducted study showing vaginal estrogen could prevent 50% of urosepsis hospital admissions in nursing...
Zoe Research Team (UK)
Researchers who studied gut microbiome changes across menopause transition, finding loss of bacterial diversity and p...
Quotes
"I promise you, you walk into nine out of 10 doctors offices today, good, well certified, well-meaning, loving, caring, incredible doctors, and they have it totally wrong on menopause and hormone therapy. Nine out of 10."
Dr. Mary Claire Haver
"We maybe got a one-hour lecture. One hour on menopause. This is affecting 100% of women who live long enough for the last third of their lives that blows my mind."
Dr. Mary Claire Haver
"I couldn't even diagnose myself, Jamie. You know, like I was the expert and rushing to Dora, my nurse practitioner, and we get blood work and yeah, my levels were all fully menopausal."
Dr. Mary Claire Haver
"Hormone therapy, not only is safe, but preventative and beneficial. And why aren't we talking about, why isn't the world shouting this from the rooftops?"
Dr. Mary Claire Haver
"You must be the CEO of your own healthcare. You must advocate for yourself. It is not enough to depend on the people in charge to do the right thing."
Jamie Kern Lima
Full Transcript
That is a big breakthrough. That right there. I'm going to jump out of my seat, Dr. Mary Claire Haver, because the number of people listening right now that are going to be like, holy sh- Wait a minute. Yeah. Maybe I need to go in and ask for these tests and understand what's really going on with my body. I went through the endoparion menopause and menopause and was absolutely blindsided. And started digging into the science and the literature. I was just kind of shocked. It was a little bit of rage, you know, of what are we doing? What am I supposed to be helping these women and these women are suffering? Right now, 1.2 billion women are in perimenopause or menopause and whether or not you're experiencing this personally in your life right now, I guarantee you someone in your life is. It's not just weight. This is heart disease, dementia, diabetes, and stroke, and musculoskeletal pain, or entire quality of life. Your libido takes a hit, sense of worth, 1 in 5 women are quitting their jobs. A lot of marriages break up. We're ignoring this. So you're a doctor, physician, and you are realizing, wait a minute, how I was taught to treat my patients going through menopause or even to handle yourself going through menopause and menopause. This isn't working. No. Across the menopause transition, a woman can expect to have a 40% increase risk of a new mental health disorder, either anxiety or depression or even ADHD symptoms. But we're just telling her, oh, you're depressed, and here's an antidepressant. Oh, you're not sleeping. Here's a sleep aid. And no one's knowing to connect the dots. So many women are going to connect with this, whether they're in perimenopause or about to be. And how do you know if you are? What are the three stages? What are so many of the symptoms? Oh my gosh, they go. Ignore, they go. Miss Diagnosis. We think it's something else. And I'm so excited. I'm going to jump out of my chair. Hormone therapy, not only a safe, but preventative and beneficial. Why are we talking about? Why isn't the world shop this from the rooftops? I promise you, you walk into nine out of 10 doctors offices today. Good, well certified, well-meaning, loving, caring, incredible doctors, and they have it totally wrong on menopause and hormone therapy. Nine out of 10. I've talked to now thousands of clinicians. How much menopause training did you get in medical school? We maybe got a one-hour lecture. One hour on menopause. This is affecting 100% of women who live long enough for the last third of their lives that blows my mind. So if you're 36, you're 41, you might be having anxiety, depression, all of these other things happening. So you go in for that. Right. And you're not checking your hormones. You're not thinking in my impairment appauses. So you go in for that. You're thinking, I'm anxious. I'm thinking for that. But nothing's changed in my environment. And all these different things are happening to us. And we're going into doctors who aren't, for the most part, training menopause. So we're not getting our hormones checked. Probably not getting the correct tests. Are they think, oh, you're in your 30s, you're 40s, you're too young. And you're getting treatment for a symptom. Right. Whereas what we could be doing and why your work is having such a profound impact on so many people is in our 30s. And our four, we're going to talk about this, but understanding the underlying thing. Where are all of our hormones at? Where is our estrogen at? Could that be causing these other things that we think and so many women are taking it to an identity level of, oh, I have this, I have that. I'm diagnosed with this, I'm diagnosed with that. But never actually the underlying thing that could impact whether you have any of those other things or not. Right. There are so many girls and women of all generations listening to the show. When we look at the data, it's all generations. And one of the things I, one of the things that moves me to tears is when a woman will share with her daughter and then she'll share with her grandma and then she shares it with her girlfriends. Whether you're a man or a woman, menopause is going to affect you because it's going to affect 54% of our society. Right now, whether you or someone you love is experiencing parry menopause, which can start at 30 or even younger or menopause, which can typically start in your 40s, 50s or 60s. There is so much conflicting information about the subject. So few doctors are well trained. And there are so many things our mothers didn't tell us or even know about it. And it's time that you feel informed about what's going on with your body, your brain, and your hormones. Today is your menopause master class. And you're going to leave this episode with your own menopause toolkit equipped with the info and tools you need that I know are going to impact your life today, whether it's how to sleep better, understand what's at menopause myth and what's the truth, lose belly fat or stop suffering finally. My guest today, many call her the top menopause doctor on the planet. Dr. Mary Claire Haver is going to take us from feeling powerless to powerful on everything your doctor forgot to mention on topics, including the exact tests you need to ask your doctor for during your next visit, the three stages of menopause. And what's actually happening in your body on your changing hormones, on hormone replacement therapy, including the risks versus the benefits, should you do it? How and when on belly fat and weight gain linked to menopause and what you can do about it right now and on the surprising symptoms happening to so many women that go untreated and overlooked by the majority of doctors who just aren't as well informed as they could be. Today is a master class from the master of menopause herself. Dr. Mary Claire Haver is a board certified obstetrics and gynecology specialist and certified menopause practitioner from the menopause society. She's also a certified culinary medicine specialist from Tulane University, a best-selling author of multiple books, including her brand new book, The New Menopause. She's also the founder of the Mary Claire Wellness Clinic. She's a mom of two, a wife and a woman on a mission who says that while menopause is inevitable, suffering doesn't have to be. And she is here to help you and me today. I love a truly life-changing episode. I am so excited for this one today, whether you're listening for yourself or because someone that you love shared this episode with you, I want to welcome you to the Gene Kermey Mishau Podcast family. And today we are shedding light on everything your doctor forgot to mention to you about menopause. And for everybody new to this episode, can you do me a favor? If you like the show and the guests that I bring you, please hit the subscribe or follow button on the app you're listening or watching on. It truly means the world to me and thank you. And I want to remind you, this episode is not just for you and me. Please share this with every single woman that you know because what you are about to hear will change your life and hers. Welcome to the Jamie Kermey Mishau. Oprah, how have you defied the odds? Her shift is unlike any I've ever done. A revelation. When you listen, it feels like a hug, but your brain and your spirit and your heart is like, wow, Melinda French gates. When I look into Jamie's eyes, I feel like I am on some other cosmic level with her. I could see the light around her. She's infused with light. Imagine overcoming self-doubt, learning to believe in yourself and trust yourself and know you are enough. Welcome to the Jamie Kermey Mishau. Jamie Kermey Mishau's for names. Everybody needs Jamie Kermey Mishau in their life. Jamie Kermey Mishau. Jamie, you're so inspiring. Jamie Kermey Mishau. Jamie Kermey Mishau. Dr. Mary Claire Heaver, welcome to the Jamie Kermey Mishau. Thank you for having me. I am so excited you're here. You are impacting millions and millions and millions of women as we speak. And it is just an honor to have you here. I am so excited for this episode. We are not wasting a second. And I just want to open with asking you your mission and the work that you are doing to help so many women who are, in so many ways, either feeling lost or powerless or just suffering or trying to figure out what's going on with their bodies. Can you share for you personally? Like I know that this is really personal work. I will. And a passion of yours. I didn't realize what I didn't know. And I was the expert, right? I was the board certified OBGYN. I blew the top off of my boards. I was a straightaway student. I checked every box. And when I went through the end of Perry, I met a pause and met a pause and was absolutely blindsided. And started digging into the science and the literature that had not been taught to me. I was just kind of shocked. It was a little bit of rage, you know, of what are we doing? I'm supposed to be helping these women. And I don't have the tools to do it. And these women are suffering. So my mission began. I started like you with zero social media followers. We all start with nothing, right? No one inherits a social media following. And so I just kind of tentatively started talking about it. Really started in the nutrition space. Talking about weight gain and menopause, nutrition and menopause. Because that was kind of my biggest shock. Was someone who always had been privileged. All of a sudden had this. I was dealing with weight gain in new places that I had never experienced before. And all the tricks that had worked before stopped working. And all the advice I had given to patients wasn't working for them and also wasn't working for me. So that kind of took me down all these rabbit holes. And now's the conversation around weight gain and menopause, the more I learn, the more I realize it's not just weight. This is heart disease and dementia, diabetes and stroke and musculoskeletal pain and her entire quality of life. And what I realize is that the vast majority of women have this pivot at menopause where they have this loss of resilience, this loss of them, this loss of self, this loss of, you know, their libido takes a hit, their sense of worth, their one in five women are quitting their jobs, you know, through the menopause transition. A lot of marriages break up through this point. And I thought, we're ignoring this. And we're treating it. It is a natural phase of life. But it is one that needs to be really understood. And I thought, this is, I'm stealing the quote. But if not me, who, and if not, and when, now, let's do it now. Let's just start talking about it. So you're a doctor physician. And you are realizing, wait a minute, how I was taught to treat my patients going through menopause or even to handle yourself going through menopause. You're going to pass, this isn't working. Can you, can you take us through that moment? Because I think what you're going to share, so many people can relate to because it's been their experience going to the doctor, they go in and then they get a prescription for something that has nothing to do with what they're going through. Right. And then they're still, they're still suffering. And can you, kind of, this is just so insightful for you to shed light on your experience. As a doctor, realizing, wait a minute, how I was trained and what I know so far isn't working for my patients. It's not working for myself. So I was taught that menopause caused three things. Hot flashes, some general urinary symptoms, dry, and recurrent bladder infections, et cetera. And, met your bones got weak. You lose bone mass as you age. And that was it. And if you wanted to treat those things, you treated them almost in isolation. We didn't look at the root cause as the estrogen decline. I learned nothing about estrogen's effect on the cardiovascular system, on the brain, on the musculoskeletal system, on the lungs, on the kidneys, on the gut. And when I realized it's all tied together, and really in OB-GYN, we mostly focus on just vasomotor symptoms, which are hot flashes, basically. And if you just treat, just hot flashes, you only consider hot flashes to be the pinnacle of treatment of menopause, we're really doing it to service to women. And the more I talk about it, the more women are like, oh my god. And so really, when I was researching for the new menopause, women would reach out to me on DM social media and my clinic. Could my frozen shoulder be related to menopause? Could my exema be related to menopause? Could my recurrent UTIs be related to menopause? Could my loss of libido be related to menopause? And I would say instead of saying no, no, no, I'd say, let me get back with you. And really, as a clinician, what shocked me was the data is there and very, very clear. But no one's talking about it or sharing it on a larger platform. And I thought women are suffering needlessly and we're not addressing really what's happening. So for the mental health changes, for example, which 40% of us have across the menopause transition, a woman can expect to have a 40% increase risk of a new mental health disorder, either anxiety or depression or even ADHD symptoms. So we have the psychological impact and the cognitive impact. And but we're just telling her, oh, you're depressed. And here's an antidepressant. Oh, you're not sleeping. Here's a sleep aid. Oh, you're having musculoskeletal pain take some non-steroidols. And no one's knowing to connect the dots because we're not training them. So she's walking out with six, seven prescriptions to treat each of the symptoms of her menopause. And it's a whole paradigm shift to think, let stabilize or replace her hormone levels and see what gets better. And then we'll address the rest after. To have this sort of epiphany as a doctor and then looking at the industry and also just your own experience, can you share? Because I know so many women are going to connect with this, whether they're in paramedic paws or about to be or don't even know if they are yet. We're going to dive in, by the way. And how do you know if you are? What are the three stages? What are so many of the symptoms that, oh my gosh, they go missed, they go, they go, ignored, they go, misdiagnosed, we think it's something else. And I'm so excited, I'm going to jump out of my chair. Okay, but before I get into that, can you share just a little bit about your own experience of paramedic paws, you personally, and then also menopause. And how was it, how was it, how was your experience with your own doctors, you were going to at the time? So I was on continuous birth control pills, meaning I skipped the placebo week and just suppressed my periods. For my entire reproductive life, I've suffered from polycystic ovarian syndrome and I had the thin kind that doesn't respond to dietary changes as well. And I did great with it. I felt great, I felt much better than I did when I was off of them. Of course, I had fertility issues, both my kids were fertility babies. And thank God they're here and, you know, I've had miscarriages and all the things, you know, but I have two healthy, beautiful, perfect children and thank God. So when I was about 48, I was making the decision with my practitioner. So my nurse practitioner, who I'd work closely with, was my doctor, right? And so I said, I think I'm going to get off the pill and see where I'm at. Let's get some blood work and see where I am in my menopause journey, you know, get in, you know, because I was thinking about bone density and hip fracture risks, you know, moving forward, not thinking about cardiovascular disease and mental health and all that. So at the same time, my second oldest brother, my oldest brother died when I was nine from leukemia. My second oldest brother was very ill from hepatitis and HIV. And there was a lot of back and forth for his end of, he was kind of, I didn't really think it was end of life, it was, but, you know, multiple hospitalizations for this complication and not complication. And I get a call when I'm, so I just stopped the pill and my body's trying to figure out where it's at. And I get a call in the OR, so I'm operating and they call three, four or five times. So the scrub, whoever was circulating, picked up my phone, put it to my ear and they said, your brother's in a coma and you should come home. And I remember, and I just repeated what they set out out loud to the OR team. And they called one of my colleagues to come down because I was like really struggling, you know, I had to finish the surgery, I'm not gonna let the patient die. But I was, you know, you tell my brain was like distracted and they're like, okay, we're gonna call in Dr. X and so one of my colleagues came in, we got to like where we need the patient was gonna be fine. I got through the critical part of the surgery and he's like, I'll close, scrub out, go home. And I rush home and home is four hours away. So to my hometown and he had had a stroke and he was, they were gonna move him home for hospice. And that was really hard. So I called my husband and the kids, they start coming towards Louisiana because we were in Texas. And I'm also in menopause or very late perimenopause. I don't realize it, okay. So I'm going through this incredible grief process, this man that I just worshipped and loved but had to love him through some poor health choices. You know, despite his choices, I still had to love him and then now deal with his death. And we had this beautiful death three days, all the family and friends at the bedside singing. Of course, he's in a complete coma and my sister and I are doing all the like physical care for him, she's a hospice nurse. And then just the devastation, you know, when he passed and I didn't realize it, but I was also having hot flashes and nights, wets, depression. You know, like my brain wasn't functioning the way it should, but I was so overwhelmed with grief, I couldn't realize it in myself. So, you know, we get through the funeral, we go home and a couple, three months go by and I'm struggling, struggling, struggling, with weight, all of a sudden. Like I'm starting to put on weight in my midsection. I'm not sleeping, I'm getting up in the middle of the night and I'm like, okay, you're just depressed. You know, Bob died, everything's fine. And certainly the grief was a part of it. You know, we get to about month six. I'm still really struggling with weight and really sleep disruption and snapping at my kids and just being really short and just don't feel like myself, okay, and I realize my grief is lifting. This is not grief anymore. You know, this is something else going on. And I was like, wait, when was my last period? It was six months ago. Like I couldn't even diagnose myself, Jamie. You know, like I was the expert and rushing to my, you know, to Dora, my nurse practitioner, and we get blood work and yeah, my levels were all fully menopausal. And I was like, we need to pause for a super brief break and while we do, take a moment to share this episode with every single woman that you know because this information can truly change your life and hers. In life, you don't sort the level of your hopes and dreams. You stay stuck at the level of your self-worth. When you build your self-worth, you change your entire life. And that's exactly why I wrote my new book, Worthy, how to believe you are enough and transform your life for you. If you have some self-doubt to destroy and a destiny to fulfill, Worthy is for you. In Worthy, you'll learn proven tools and it's simple steps that bring life-changing results. Like how to get unstuck from the things holding you back. Build unshakable self-love. Unlearn the lies that lead to self-doubt and embrace the truths that wake up worthiness. Overcome limiting beliefs and imposter syndrome. Achieve your hopes and dreams by believing you are worthy of them and so much more. Are you ready to unleash your greatness and step into the person you were born to be? Imagine a life with zero self-doubt and unshakable self-worth. Get your copy of Worthy plus some amazing thank you bonus gifts for you at Worthybook.com or the link in the show notes below. Imagine what you do if you fully believed in you. It's time to find out with Worthy. Who you spend time around is so important as energy is contagious and so is self-belief. And I love to hang out with you even more, especially if you could use an extra dose of inspiration, which is exactly why I've created my free weekly newsletter that's also a love letter. To you, deliver straight to your inbox each and every Tuesday morning from me. If you haven't signed up to make sure that you get it each week, just go to jameycurnleamah.com to make sure you're on the list and you'll get your one-on-one with Jamie Weekly newsletter and get ready to believe in you. If you're tired of hearing the bad news every single day and need some inspiration, some tips, tools, joy and love hitting your inbox, I'm your girl. Subscribe at jameycurnleamah.com or in the link in the show notes. Do you struggle with negative self-talk? Living with a constant mental narrative that you're not good enough is exhausting? I know because I spent most of my life in that habit. The words you say to yourself about yourself are so powerful. And when you learn to take control over your self-talk, it's life-changing. And I wanted to give you a free resource that I created for you if this is something that could benefit your life. It's called five ways to overcome negative self-talk and build self-love. And it's a free how-to guide to overcome that negative self-talk to build confidence and develop unshakeable self-love so that you can dream big and keep going in the pursuit of your goals. Don't let self-sabotaging thoughts hinder your progress any longer. It's time to rewrite the script of your life when filled with self-love, resilience and unwavering belief. If you're ready to take charge of your narrative, build unwavering confidence and empower yourself to persevere on the path to your dreams, you can grab your free guide to stop overthinking and learn to trust yourself at jameycarnleema.com slash resources or click the link in the show notes below. And now more of this incredible conversation together. I couldn't even diagnose myself, Jamie. Like I was the expert and rushing to Dora, my nurse practitioner, and we get blood work. And yeah, my levels were all fully menopausal. And I was like, what? I'm too young, I'm 48. I'm what's happening. And no, I was absolutely fully menopausal. I didn't even know the normal age range of menopause. That's how little education I had. I knew the average age was 51, and I thought I had till 51. I take care of women like this, my entire career. And I realized I was a terrible menopause doctor. What do I not know? OK? And that took me down the rabbit hole. The change of my mind on, so I went on HRT extremely reluctantly because I thought it would increase my risk of breast cancer. Or a motor placement therapy. Yeah, hormone replacement therapy. And I was terrified to do it because there's so much cancer in my family. But I was like, I can't live like this. So if it takes a couple years off my life, it's a gamble, but I'd rather have a better quality. I cannot live like this. Something's got to go. Go on hormone replacement therapy. Immediately. The world calms down. I'm sleeping again. I'm the weight was another story. That's a whole other book. But I felt like I got my resilience back, my ability to cope with what was in front of me. Then I went to my first kind of menopause conference. And it was in New York. Or actually, it was in Santa Monica. And I was going to present about nutrition and menopause. It was lots of experts there. Women had never met who I was starting to follow. This was the beginning of the menopause. And I see Averin Blooming and Sharon Malone and Dr. Carol Tavras on stage talking about the safety of hormone replacement therapy and how wrong the women's health initiative was and how many of those things had been walked back. I was tears. My daughter was with me. She was applying to medical school. Tears falling down my eyes. And she's like, mom, are you OK? I'm like, yeah, they're not in no. I didn't know. I didn't know. This is my job. I am the expert. I did not know that for the vast majority of women, especially at this age, hormone therapy, not only is safe, but preventative and beneficial. And why aren't we talking about, why isn't the world shop this from the rooftops? And that was really like, that was the moment, the light bulb, where I was like, this is my mission. This is my mission to share this as far and more as I can. Because you had the aha moment that you're this incredible doctor. And you're like, I didn't even know these things. And then you're watching three other doctors talking about their research on hormone replacement therapy. You're seeing how it impacts you. And you're like, why isn't this being talked about? Why don't people know about this? No, how safe it is. I promise you, you walk into nine out of 10 doctors offices today, good, well certified, well-meaning, loving, caring, incredible doctors. And they have it totally wrong on their nipause and hormone therapy. Nine out of 10. Why do you think there's so little information out there? And nine out of 10 doctors, you say, have got it wrong. Why do you think there's just so little information? So when I look back and I've talked to now thousands of clinicians, how much menopause training did you get in medical school? Because in the US, we do a four-year medical school curriculum. Then we go off and do our specialty training, which is three to 10 years, depending on what you do. How much did you get? We maybe got a one-hour lecture, one hour on menopause. This is affecting 100% of women who live long enough for the last third of their lives. This is not a niche boutique. This is all of us. And I got one hour of the most basic, basic, basic information in medical school. Then I go into my OB-GYN residency, a four-year curriculum. And over 50% of the time is spent in obstetrics. Very important, super proud of what I learned. I spent four years learning how to deliver babies safely and all the complications and how to shepherd someone through a healthy pregnancy and deliver in the postpartum and everything. And then everything else gets shoved in the gynecology box. And that includes pediatric gynecology. That includes reproductive intercronology, getting people pregnant, saying people with having chromosomal disorders and how we manage that, down syndrome, how that all affects females. Menopause got shoved into a tiny, the smallest little sliver in a tiny box. We got six hours of lectures in four years of curriculum. We had no menopause clinics, no clinically relevant menopause training. And then in my last year, we had the Women's Health Initiative being released. And basically, anything clinically, like, hormone therapy was taken off the table as an option, unless in the most severe cases. And you really tried to do everything else before you give her hormones, because we were all terrified that we would give her breast cancer. And it was never true. Never true. We're going to dive into hormone replacement therapy into the myths, into the truths, into every option that exists, into what you do right now, day to day, all the applications, who's it for? Who's it not for? When do you start? How long do you do it? I'm excited about this. But I want to just tap into something you just said that blows my mind. So your four year medical degree, one hour of menopause training, and then your four year specialty in OBGYN, six hours. Six hours. Six hours. Six hours. So seven hours total in eight years. How common is that? What is the average would you say across every doctor? It's very common. If menopause, so in an OBGYN residency, if menopause is included, it's an elective. So like a menopause clinic. There are menopause, it's getting better, but we have a very long way to go. And tell me if this perception is accurate or not. But when I think about doctors, because there are so many just rockstar, amazing, good-hearted, hardworking, incredible doctors who are day and and day out treating their patients, they don't have time. Exactly. You go be doing a whole bunch of other. So to get, you have to step outside of the box of your training. So I am board certified. I have a main board certified by reading 114 articles a year and taking a quiz on each one to make sure I understand. So the American board of OBGYN puts out a beautiful set of articles on the latest and new updates and everything. And probably less than 3% have anything to do with menopause. And a lot of them are elective, because we subspecialize in OBGYN. So a lot of people do just surgery or just obstetrics or hybrids go be or whatever. And so you can even opt out of the few menopause articles that are out there. So the American College of OBGYN, the American board of OBGYN, I mean, I hate to call them out for this, really have not prioritized it. So the menopause society, which I did not know existed until three years ago, was kind of a rogue group of clinicians who said, hey, no one's focusing on menopause. And they started their own society and started making their own guidelines. And their own, so the American College of OBGYN and the menopause society are not connected. So in 2022, the menopause society updated their menopause hormone therapy guidelines away from the old, it's probably going to be dangerous. Give her the smallest amount for the shortest time possible to probably beneficial for most women. We've got a window of opportunity for cardiovascular disease, probably. There's no age at which you have to stop. But ACOG's guidelines have not been updated since 2014. They still say the exact same thing. So most OBGYNs don't even know about the menopause society. They think they're doing a good job because that's what they were taught and they passed. That was me. But all of a sudden you realize, wait, you know, I maybe don't know what I'm doing. Your patients are coming in with questions or God forbid a video of me or, you know, a medical article I tell them to print out and hand to the clinician. But they are so busy. I mean, things in medicine with the corporatization and administrative burden have just gotten to the point where the burnout is terrible in multiple areas of medicine. And you cannot lay the fault. This is a systemic problem. And these are good doctors working really hard doing what they were trained to do and they just don't have the time. They just don't have the time. We're going to link to the menopause society and every other resource, by the way. And we're also going to dive into in this conversation. How do you prepare for your appointments? How do you know the questions to ask? What test did you ask your doctor for? We are going there today, which I'm so excited about. But I just want to call this out because, you know, we already have a challenge in our country. And I would say every country around the world, but we have a challenge where, you know, if we are fortunate enough to have what we consider a great doctor that our insurance actually covers, there's still a very high probability. They've had little to no training. Clinically relevant as menopause training. For everyone listening right now, a lot of people start experiencing paramedicost symptoms in their 30s, or it could be younger, it could be, you know, and then menopause, I want to break this down for everyone because, you know, again, as a woman going into a doctor we're not learning these things. I also think sometimes there's now so much information online, so much of it's not vetted, that in a single Google, we can all read all about the wrong info and not know if that's right. And we go to our doctor who maybe if we're blessed is amazing, but they don't have time or they actually don't have the experience. So I want you to break this down, and I'm so grateful to have you here today doing this for each one of us, but can you break down the three stages, your paramedicost, menopause, postmenopause, what are they? How do we know if we're in them? All right, let's start with menopause, and then we're gonna work our way backwards and forward. Okay, so menopause, guess what? Is one day in your life, one day. Everything after is postmenopause till the end of your life, and then the 1710 years ish prior to that is perimenopause. So menopause is medically defined, and this is a problem, as one year after the final menstrual period, but it represents something much bigger than that. It represents the end of the production of hormones from your ovaries. So what most women don't understand, and what I love to teach is that we're very, females are different than males in multiple ways, but let's talk about endocrinology. Females are born with all of their eggs. So you were born with a set amount of egg supply, and your maximum egg supply was when your mother was pregnant with you at five months gestation. And then they start going through a process of atreisure, which is an aging process, so that the healthiest egg survived, right? And then when we start ovulating at 11, 12, 13, 14, however old, to get that one egg to ovulate, we lose about 10,000 in the process. So Jamie was born with one to two million eggs, and by the time you were 30, you were down to 10% of that, about 120,000 on average. By the time you were 40, you were down to 3% of your originals, you're right. 3% of your eggs left by 40, yes, on average. Okay. And then menopause represents no more eggs. And how do we ovulate? What is that process? Actually ovulation begins in the brain. So our brains are, there's a gland in our brain called the hypothalamus, and it is constantly checking the blood every day for estrogen levels. And when the estrogen levels get low as in a normal cycle, so most women have seen the normal menstrual cycle, hormones where we have a surge of estrogen, that cycle, and then for just a round surges on the second half. And that is like a very EKG-like ebb and flow that goes month after month after month, no problem in a healthy woman. When you get to parimenopause, we reach that critical egg threshold. We're just down to enough where the signal's coming from the brain, saying, hey, give me the estrogen. Stop working as well. So the ovaries can't respond, they don't have enough of the eggs, because around each egg are something called follicular cells and granulose cells, and that's where the hormones are produced. So we're running out of those units. So the hormones go down from the brain, saying, give me, give me eggs, give me estrogen. And the eggs are like, I don't have enough, sorry. And then the brain goes, wait, I need my estrogen, so it makes higher hormone levels coming from the brain. That's when we get into the chaos. So what you used to look like this beautiful EKG every month now becomes chaos. Estrogen levels surge higher than we've ever seen in your whole life, and then they crash. And progesterone never gets where it used to be. So what used to look beautiful is now spaghetti. I literally take a pile of spaghetti and throw it out the wall. And that is what your hormones are doing for seven to 10 year process, until you just run out of all the eggs then everything flat lines for estrogen and progesterone. So many questions here. I know you've been mentioning heart disease, all these different diabetes, all these different conditions. And what so many people don't know is that when you don't have your hormones balanced and when you go through menopause and you may be deficient in hormones, it can impact and potentially cause so many other things. Multiple organ systems. It accelerates the aging process. So our ovaries age twice as fast as most other organs in our body. And when we lose the benefit, so estrogen turns out as insanely protective of our liver, of our joints, of our brains. Kidneys got all of it. We work better as humans, female humans, with estrogen on board. It's just the way it is. That gets taken away, goes chaotic and gets taken away. Let's go organ system by organ system. And then this is starting in parimenopause. This is starting in parimenopause. And really for a lot of women, the symptoms are worse, especially mental health and cognition in parimenopause. Our brains hate chaos. Our brains love to know there's a system. Everything's working. This is coming, that's coming. And we're it's gonna go over and over and over again. In parimenopause is when we see the most rapid, expansive bone loss, the most rapid, expansive muscle loss, and the most rapid increase in mental health changes in the forms of anxiety and depression, and where we see the worst brain fog. All of that tends to stabilize, stays, you know, we get this rapid expansion and then stabilization in postmenopause. Still not great. And then we go back onto normal aging. And when you're estrogen, your brain's saying, when you're estrogen, then it's surging, that it's plummeting. So guess what? Estrogen and progesterone, and as well as testosterone, actually directly affect our neurotransmitters, dopamine, serotonin, or epinephrine. You know, GABA, all these important chemicals, signals in our brain that keep us functioning. And so there's this fascinating study that just got released, and I'm researching for the new book right now. And it's called, I just don't feel like myself in parimenopause. And they actually quantified it. And it stopped me in my tracks. We need to pause for a super brief break. And while we do, take a moment to share this episode with every single woman that you know, because this information can truly change your life and hers. Who you spend time around is so important as energy is contagious, and so is self-belief. And I love to hang out with you even more, especially, if you could use an extra dose of inspiration, which is exactly why I've created my free weekly newsletter, that's also a love letter to you, delivered straight to your inbox, each and every Tuesday morning from me. If you haven't signed up to make sure that you get it each week, just go to jameycurnlema.com to make sure you're on the list, and you'll get your one-on-one with Jamie Weekly newsletter, and get ready to believe in you. 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And now more of this incredible conversation together. So there's this fascinating study that just got released. And I'm researching for the new book right now. And it's called, I just don't feel like myself in Perry Menopause. And they actually quantified it. And it stopped me in my tracks because I was like, wait, this is what my patients are telling me. And now they've done a study. And this is a thing. Like, I just don't feel like myself is good enough. Because forever, I mean, besides the lack of education in Menopause, the other systemic problem is that there is a bias that women tend to somatocize. Biological process. So basically what's coming from, they don't recognize that is biology. They think it's psychology. That's causing the problem. I think it's all in my head. It's all in my head. Yeah. Or doctor's thinking, it's all through this. This is the aid when, but no one ever stopped to say, why are all women going through this at this age? I want to call it something really big because I don't want it to be missed at all. So if the average age of Menopause, you're saying it's not 51. 51 for? For us, for Caucasians. So actually, Asians a little bit, tiny bit older, African-American women, a year and a half younger, South-A, Southeast Asian women, 46, 48, is the average age of Menopause. So if Perry, when the brain is like something, I get right, it's seven to 10 years before that. It is completely reasonable for a woman in her 30s to be waving a flag going, I'm not sure what's going on, but I don't feel okay. Here's the big aha I'm having right now that may be a big aha as well for everyone listening. So if you're 36, you're 41, you might be having anxiety, depression, all of these other things happening, so you go in for that. And you're not checking your hormones, you're not thinking in my impairment of pause, or you go in for that. You're thinking, I'm anxious for that. But nothing's changed in my environment. And all these different things are happening to us, and we're going into doctors who aren't, for the most part, trained in Menopause. So we're not getting our hormones checked, probably not getting the correct tests, or they think, oh, you're near 30s, you're 40s, you're too young, and you're getting treatment for a symptom. Where is what we could be doing, and why your work is having such a profound impact on so many people, isn't our 30s? And our four, we're going to talk about this, but getting, you know, understanding, the underlying thing, where are all of our hormones at? Where is our estrogen at? Could that be causing these other things that we think, and so many women are taking it to an identity level of, oh, I have this, I have that. I'm diagnosed with this, I'm diagnosed with that. But never actually the underlying thing, that could impact whether you have any of those other things, or not. That is a big breakthrough. It is a huge breakthrough. That right there. I'm going to jump out of my seat, Dr. Mary Claire Heaver, because the number of people listening right now that are going to be like, holy shit, wait a minute. Yeah. Maybe I need to go in and ask for these tests, and understand what's really going on with my body, because what they think is going on with their body might just be a symptom of something else that's not being treated or even recognized. So in huge. In the new menopause, you know, which was really driven by my followers, people asking me questions, could this be related to my menopause? Instead of saying, nope, I was like, I don't know, let me dig. I couldn't, we have 77 symptoms in this book. And I go through the Y and the path of physiology. These things were, I didn't make this up. These are actual papers written, but there, because menopause is in the word, they tend to be a barried and obscure journals. Let me give you some perspective here from a medical standpoint. When you go to PubMed, which is the database for peer-reviewed medical journal articles, right? So as a physician, as a clinician, as a researcher, this is where I go to find the good stuff, right? And I type in the word pregnancy. We have 1.1 million articles come up. Amazing, important. That is brain power research in IH dollars, like to generate that kind of research takes money, takes investment, takes time, takes commitment. OK, let's type in the word menopause. Knowing more women will go into menopause than have children, then be pregnant, OK? It is right now about 98,000. So more than 10 to 1. Difference. OK, OK. Let's type in the word, Perry menopause. I did this yesterday. 6,800. More women will go through Perry than menopause, because we're going to lose some due to accidents or untimely deaths. That's where women will go through Perry. And if you think about what that represents, focus the wise, the house, the winds, and that is what we're fighting to change. So Dr. Mary Claire Haver's book, The New Menopause, Upcoming Book, The New Perry Menopause, which I am also equally very excited about. I want to ask you, because this is a shocker. You say there's over 70 symptoms, you know? Most of us we think, oh, hot flashes. And that's it. And then, right, that's what the doctor asked. But I was taught, right? That's what you were taught. And then in a few years, your bone density will check bone density at 65. Oh, and then something might happen to your vagina get dry. But we got some cream for that. Yeah. OK, share with us, because so many people are listening are like, I feel like they're lightening bolts are going on. Yeah, share with us some of the symptoms that so many women share with you they have. And they didn't realize, oh, my goodness, this is a symptom of Perry Menopause, or this is a symptom of menopause. It could be. Yeah. So I'm going to go top to bottom. So keep my head straight, because you know menopause. So brain, so our brains, we have psychological changes. And then we have cognitive changes, right? So in the psychological change, we have a 40% increase in mental health problems, usually anxiety and or depression, across the transition through Perry Menopause. And now we know some incredible data coming out of Australia that stabilizing those hormones with hormone therapy is better to treat her than giving her an antidepressant, or the traditional treatment for anxiety and depression. She deserves a trial. And maybe the two can work together. And so if you have a patient who's like, listen, something is wrong. Nothing is changing. Because I'm like death in the face, all the stressors. As you know, I was handling my life. I had it. And now I don't. I've lost my resilience. I'm anxious. I'm snapping. I can't sleep. My mind is racing. I'm getting up in the middle of the night with the roly dex of every bad thing I've ever done in my life. Every mistake I've made, every person who's feelings I hurt. And I can't turn it off. And this is not normal for me. And what we weren't trying to do as clinicians is listen to the woman saying, this is not normal for me. And I was taught to think this is just what women go through. And I think it's absolute bullshit now that I've gone through it. And like it wasn't fair. It wasn't fair. Can you talk about, I know, I want to ask you about a WW in a second. This is a big one. I'm telling you. But really quick, can you share it to you? Because I know frozen shoulder. Yeah, so we'll keep going through the work. Yeah, keep going, because I want everyone to know. I want everybody to have brain fog. Word salad. Forgetting, I just saw a politician being made fun of for Word salad. I'm like, she's a menopause. Give her a break. One in five women in the UK are quitting their jobs because of untreated menopause. We think one to 10 or more in the US. This is a big deal. These women are high functioning, leaning into their jobs, empty nesting. They're ready to give all their knowledge and expertise and wisdom. And then suddenly they're absolutely hamstrung by the cognitive changes associated with menopause. Good news there is that it does tend to stabilize. But it could take a few years and so many walk away from a career because they just don't feel like they can do their jobs. I'm talking surgeons, lawyers, school teachers, and how many marriages are being affected by this. How many relationships with my daughter, my daughter, jumped that I survived mom's period menopause when I was a, you know, you survived my teenage years while I survived your period of pause. So I was like, that really wasn't fair. And you know, like for us to both be going through that at the same time. So then as we move down, the musculoskeletal system, so my dear friend Dr. Vonda Wright, incredible clinician, she's writing a book called Unbreakable right now. She wrote the paper, The Musculoskeletal Syndrome of Menopause. And there were two researchers from Duke University a few years ago, a couple years ago. And it was the head of the OB-GYN department and the head of the orthopedic surgery department. And there's some lore here, but I think they were like at lunch in the cafeteria or something at the hospital. And we're talking about all the frozen shoulder and the ages and they're like, do you think they could be related? So they just pulled charts and did a review study and found, wow, yeah, it's definitely elevated in this menopause situation. And if they're on hormone therapy, they have it less, frequently, less often, they could not get it published in a single orthopedic journal. They got it published in a menopause journal. And it kind of set the world on fire. Then Vonda Wright went in and wrote another paper all about detailing the path of physiology and all the mechanical things and everyone went crazy. Because no one in the orthopedic world could recognize that frozen shoulder is absolutely related to the loss of estrogen. So besides that, our througes, joint pain in my world, in the menopause, we think that probably a significant, maybe 80% of fibromyalgia is actually misdiagnosis and it's really musculoskeletal syndrome of menopause. Wow, yeah. So, and then if we look at the gut, so worked down by Zoe out of the UK, they collected still samples on like a billion, not a billion, but like several thousand women across the menopause transition and looked at the gut microbiome and saw my God. Across the transition, she loses diversity of her gut. She loses the healthy bacteria and her gut now looks like a man's. You know, we had all, we enjoyed all this protection, this better health, this slower track to cardiovascular disease and gut health and brain health and now we, we blow past the men. And get this biosis can impact like every, yeah, every part, how do you metabolize drugs? How are your brain functions? Where are the serotonins made? I mean, it all works together. So, our general urinary system, you know, we, Rachel Rubin did her study, they looked at her chart review and said, if we went into the nursing homes and gave every single woman, vaginal estrogen, prophylactically, you know, we could prevent 50% of Eurosepsis hospital admissions and save these poor women and continents, you know, urgency, frequency and recurrent urinary tract infections, the number one treatment for a woman. If you know when here's anything but this today, for recurrent UTIs in her perimenopause journey is not recurrent antibiotics, it is vaginal estrogen, giving your body back the hormone that kept those tissues healthy, treat the root cause. Besides the cosmetic things, the skin and the hair and we lose 30% of our collagen the first five years of menopause. Wow. And we're gonna dive into hormonal placement therapy as well. Can, just high level, can hormone replacement therapy and getting your hormones back to where they are ideal? Can that, in most cases, resolve most of these things you just listed? Yes, that's what it's looking like. I mean, we are still aging and no one denies that. We're still going to have certain disease processes but all hormone therapy is gonna do is put you back on the track that you were on and just take menopause out of the equation, right? Nothing is, I joke, nothing is better than your 25 year old ovaries and I can't put those back inside of you. Hormonal replacement therapy is good but it's not perfect. Not the same doses work for everyone. We have a lot of trial and error in how we prescribe it but my goodness, in my clinic and all the women who stopped me in the bathroom and every airport in America telling me how it gave them the courage to ask or taught them how to find a clinician who's educated and then they were able to go and determine for them, make a decision for themselves if this was right for them and how many aspects of their life are better that they didn't realize would get better because they didn't know that whatever they were suffering from could have been related to menopause is unbelievable to me. You know, it's such new information also for so many women, I want to just highlight one thing you mentioned earlier as well about our eggs. We're all born, we're all born with the full number of eggs we're ever gonna have in our ovaries and you said by the age of 30, 90% of them are gone. We only have 10% of our eggs, and then you said by the age of 43%, 3% of our eggs are left. I want to call this out because in my journey of, my husband and I try to get pregnant and you know, I had many miscarriages and went through fertility and I'll never forget sitting down and seeing the chart. I had no idea that our eggs declined so quickly and that we lose so many of them and I remember making the decision in my 30s to do agritrival because I'm like, oh my goodness. Like I have at this point, I think at that point I had 5% left and I was like, wow, and then the quality also can be declined. Can you just share, you know, and we're gonna dive in deep into hormonal placement therapy. I wanna talk about how estrogen, you guys, estrogen impacts like literally almost every part of your body in a positive way. Right? Yeah. So I'm excited to dive into that, but there are so many girls and women of all generations listening to the show. When we look at the data, it's all generations and one of the things I, one of the things that moves me to tears is when, you know, a woman will share with her daughter and then she'll share with her grandma and then she shares it with her girlfriends and it's just, it's overwhelming. So I'm just thinking of the number of women who need to know this right now, but your advice, Dr. Merikler Haver, on the optimal age, if a woman is going to do, you know, freeze her eggs or decide to do embryos, whatever she decides is best for her and, you know, when should she do it? When can she still do it? If she's sitting there and going, wait, I'm 40 right now, wait, I have 3% left, should I do it now? What is your advice? The sooner the better and find someone who knows what they're doing. So a reproductive and a chronologist because those are average numbers, right? My sister-in-law got pregnant, spent teniously at 41. My best friend in high school got pregnant spontaneously. It was 42. Yeah, those are pretty rare. You know, and they have healthy children, thank God, and those are my nieces and, you know, I love them. But like, that is really, really rare. So you can't cling to that story and think, oh, that'll happen to me. You know, nature does not care. And, you know, so many things are out of your control. So if you're thinking about it, if you're gonna not decide to have children right now for whatever reason, career, job, education, if you're getting into your mid-30s, you should go and get evaluated. You don't wanna be blindsided by the fact that you're gonna struggle. You wanna know ahead of time because that fertility doctor can do several rounds of tests and be able to tell you, okay, these are your chances, percentage-wise. If I were, you know, and say, if you choose to retrieve now, or maybe wait, you've got a couple of years, you know, if you're gonna try spontaneously to get pregnant. But there, you know, Dr. Natalie Crawford does a tremendous amount of education around this topic. I can't recommend following her enough and she has a new book coming out too. And, you know, went through her own fertility journey. So not only is she like a medical expert, but she really, really, really gets it, because she went through it. I wanna talk about the tests we should ask our doctors and I wanna dive deep into hormone replacement therapy. Sometimes we're people pleasers or we let our doctors give us an answer because they're busy and we don't speak up. Or we get the feeling like what we just shared, even though it was vulnerable, maybe wasn't taken seriously in our appointment. And can you share what WW is? Yeah, okay. And then what do we do about it if we feel like it's happening to us? So there's this actually happened to me when I was a resident. So I was an intern, which is the first year out of medical school. And I was freaking out as an intern, just praying to God, I have all this responsibility now and please don't let me kill anyone. And you're just like kind of really anxious all the time. I was not the overconfident kind of jerk doctor. You know, I was like double triple checking, you know, just so aware of my patients and how they felt and always trying to like, feed back on their energy and see, you know, are they understanding me? And so I'm so excited. It's my first like day in gynecology clinics. I just down a block of labor and delivery. So that, you know, you do these little month long rotations that I just left the labor unit where I was delivering babies all night. It was so great, so much fun, so much energy. And then I go into gynecology, which is like very serious. And I have my weight coat on. I pull a chart and I see this woman and she's in her mid 40s and she has a laundry list of complaints. She's not sleeping, her libido's off. She's got some makes and pains, she's gaining weight. She's, you know, has some nausea, you know, her hair's thinning, just kind of a laundry list. And I'm like, wow, why is she in gyneconic, you know, like we're here for the vagina, you know, in the uterus. And cycles are still regular, but she's just not feeling right. So I'm, so my upper level who's in charge of me, right? So they don't just let us loose his interns. We have to check everything out with our, so I have a chief resident come down the hall, happen to be male, happen to be from South Texas in his cowboy boots with his long white coat, really nice guy. Now I want to blame him because this was a systemic problem. He's got what you got. So Miss Smith, she's a 45 year old, you know, with the little, little complaints, he's like, hmm, she ever thyroid checked. And I said, yeah, yeah, she had a couple months ago and it was normal. And he asked about a couple of labs. And I was like, no, while these are normal, and he goes, okay, I think he got a WW. Texas Axel never forget this. And I said, excuse me. And he said, no, don't write this in the chart, but we called out a WW. And I said, what's that? And he said, that's a whiny woman. And I said, okay. And he said, pattern on the knee, get a couple more lab tests. They're probably gonna be normal, but this is just what women go through and they like to complain at this age. And that stuck with me. Like, is this true? Is this the thing? We never wrote in the chart. No faculty ever said this to me. This was a resident kind of information handout. So I kind of forgot about the story. Then when I was writing the new book it like bubbled up in my memory and I thought, oh my God, I need to, like, I need to be honest with the world and like have them realize the mentality behind. And I thought, is this something specific to the cell? Someone taught him that. No one makes this stuff up. So I asked around the country as my, you know, platform has grown. I asked other clinicians. And they're like, oh yeah, Madame Dolores in Miami, TBD, Total Body Dolor in New York, and Winnie Guiney on the West Coast. So this is kind of a thing, this lore of women who just coming in their mid 30s, mid 40s and complaining about a lot of stuff and women just like to win and complain because they're not happy with their lives. And it took me 20 years to realize that woman was in Perry, Menopause. Mm. And to this day, I have to pull myself back from that training. When a woman comes in with a lot of complaints, I have to stop the process in my brain that says, oh, she won't, no, believe her. Your job is to believe her. Why would she come in here with this list? You must believe her. You owe that to her because you were a terrible doctor for 20 years for those menopausal women that you didn't know how to treat. So this is your job. Believe her and get to the bottom of this. I'm just thinking about all the women that get that sense that their doctor is thinking something like that and then they leave not believing themselves. Yeah. Yeah, I mean, I've seen the videos of the women crying in their cars after the doctor's appointment. And I thought, I think I've done that to someone probably more than once. And I'm sorry, but I'm going to do better now. So I know you've shared how part of your mission is when you think of your daughter for her to never have an appointment like that. No. No, I, well, a one's in medical school, so she's calling me, or, you know, I get texts, anytime menopausal is mentioned, she's like keeping me up today and on what they're learning. And I think she knows a little bit more than a couple of her professors just because of osmosis for being around me. But I do think it's getting better. I think it's getting more recognized. But I do think we have a very long way to go. But, you know, we have a whole generation, probably for all time of women who haven't been taken seriously, who the medical establishment has not truly understood everything that menopause can affect. And how it can affect a woman's life. And we deserve better. We are owed centuries of research, centuries. And that is my quest, you know, I wrote a Citizens Guide to Menopause Advocacy with six policy and with Jennifer Weisswell who is incredible. She's an NYU lawyer who does a lot of writing for women's health policy. So we came up with a guide and it's on our website. For the basic woman sitting on the couch in Ohio, if you're out there listening to us, you know, you can do something about this. And policy number one is mandatory menopause education for all medical students. All any clinician who touches a woman needs to know this and how it affects, if you're an orthopedic surgeon, how it affects your specialty. If you're a neurologist, how it affects your specialty? Like, just going into this blindly and assuming women or little men and that our change in hormones don't affect multiple organ system is ridiculous. But the first thing we have to do is change the way we educate. I think so many people listening to us right now are gonna start by sort of changing the way they educate themselves. I've always felt that if we are able, we really have to take charge of our own health care. Especially in this time of your life, you must be the CEO of your own healthcare. You must advocate for yourself. It is not enough to depend on the people in charge to do the right thing. Mm. Right? It can be well intended. Yeah, no. They don't know. I want to dive into hormone replacement therapy and I want to talk about our menopause toolkit. How do we build one? How do we know what test to ask for? So many questions about finding the right doctor. Especially if you kind of feel like yours isn't. Remember this episode is not just for you and me. Please share it with every single woman that you know because it can change her life too. Coming up, this conversation is so incredible. And y'all can't seem to get enough of Dr. Mary Claire Haver and this menopause master class. So we are continuing this conversation and diving even deeper. I am so excited you're not going to want to miss part two of our conversation with Dr. Mary Claire Haver where we are tackling your changing hormones and hormone replacement therapy. That's coming up in the next episode of the Jeannie Curling the Show. And if you loved today's episode, please click the follow or subscribe button for the show on your app and give it a five star rating or review. And again, please share this episode with everyone you believe in. Share it with another person in your life who could benefit from it. Post it and share it with others online or in your community who just might need the words and tools and lessons in this episode today. You never know his life you're meant to change today by sharing this episode. And thank you so much for joining me today. Before you go, I want to share some words with you. Couldn't be more true. You right now exactly as you are are enough and fully worthy. You're worthy of your greatest hopes, your wildest dreams and all the unconditional love in the world. And it is an honor to welcome you to each and every episode of the Jeannie Curling the Show. Here, I hope you'll come as you are and heal where you need blossom, what you choose, journey toward your calling and stay as long as you like because you belong here. You are worthy, you are loved, you are love. And I love you and I can't wait to join you on the next episode of the Jeannie Curling the Show. In life, you don't sort the level of your hopes and dreams. You stay stuck at the level of your self-worth. When you build your self-worth, you change your entire life. And that's exactly why I wrote my new book, Worthy, how to believe you are enough and transform your life for you. If you have some self-doubt to destroy and a destiny to fulfill, Worthy is for you. In Worthy, you'll learn proven tools and it's simple steps that bring life-changing results, like how to get unstuck from the things holding you back. Build unshakable self-love, unlearn the lies that lead to self-doubt and embrace the truths that wake up worthiness, overcome limiting beliefs and imposter syndrome, achieve your hopes and dreams by believing you are worthy of them and so much more. Are you ready to unleash your greatness and step into the person you are born to be? Imagine a life with zero self-doubt and unshakable self-worth. Get your copy of Worthy plus some amazing thank you bonus gifts for you at Worthybook.com or the link in the show notes below. Imagine what you do if you fully believed in you. It's time to find out with Worthy. 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