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0:14

Well, welcome, welcome to armchair expert,

0:16

experts on expert. We are joined

0:19

today by Dr. Mary Claire Haver.

0:21

Wow. This is a long time

0:23

coming. Big time. Armchairy's demanded it.

0:26

And we have produced it. We

0:28

actually leaned on arm cherries to

0:31

tell us who their favorite menopause

0:33

expert was. And by unanimous, popular.

0:35

Dr. Mary Claire. She popped up

0:38

and she fucking delivered. I love

0:40

her. I thought she was so

0:42

great. This is so informative and

0:45

helpful and needed. And I've brought

0:47

this up obviously to a lot

0:50

of my female friends. What was

0:52

the main thing you said? I

0:54

brought it up to some people

0:57

too. Oh, I'm just like... Guys,

0:59

we had a Perry Menopause, Menopause

1:02

expert on this really intense. It's

1:04

very positive. It's like the most

1:06

hopeful. It is, it is, I

1:09

was overwhelmed. Okay. In a good,

1:11

in a way that I needed

1:14

to be overwhelmed. We're like, there's

1:16

a lot. Everything coming slash here.

1:18

Yeah. And, and there are real

1:21

things to do. And so I

1:23

got to do them. I've been

1:25

telling people about the topical vaginal

1:28

rub. Sure. That's what I was

1:30

most interested. Yeah, we learned a

1:33

lot. We learned a lot. Okay,

1:35

so Dr. Mary is a certified

1:37

menopause practitioner from the menopause society.

1:40

She is a board certified in

1:42

obstetric, specialist, and a certified culinary

1:45

medicine specialist, Anna Bestelling author. Two

1:47

of her books the new menopause,

1:49

which is hugely successful and the

1:52

Galveston diet I urge everyone to

1:54

follow her on Instagram She has

1:57

really really great videos that will

1:59

be addressing all these little things

2:01

that and also you could go

2:04

to her website, the pauselife.com, which

2:06

is a comprehensive approach to menopause

2:08

education and support. This is awesome.

2:11

She was rad. Yeah. All right,

2:15

We are supported by Allstate! Some people

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to check your trunk for reusable shopping

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bags first before you get to the

2:40

grocery store check outline and need to

2:43

buy paper bags again. Longua

3:36

Franca, what is it? Lingua

3:38

Franca. So they hosted my

3:40

book launch, so my big

3:43

New York, one of the

3:45

deals, and she made this

3:48

for me. Will you wait

3:50

39 seconds? Absolutely. This is

3:52

so nice. I feel left

3:55

out because I don't. Hydromagic.

3:57

I love it. I'm told

4:00

it's a wicked reference.

4:02

It is. Yeah. And the colors are

4:04

wicked. Yeah. I'm going to a Mardi

4:06

Gras ball that is Wizard

4:09

of Us wicked themed. In

4:11

New Orleans? In Galveston. I

4:13

love Galveston. You've been there? I

4:15

have. There's like three people and he's one of

4:17

them. Yeah. I used to work for General Motors

4:19

and we had a car show there and our

4:21

ride route ended there and we stayed at a

4:23

very cool hotel and each room was like kind

4:25

of unique you know the one I'm talking about?

4:28

So that's gonna be the Galvez more than

4:30

likely. Okay, very very nice. On the water,

4:32

old? Yeah very old. I felt

4:34

like vampires would stay there. That's

4:36

it. And you guys moved there.

4:39

You're from Louisiana. Yeah, I

4:41

grew up in Louisiana, went

4:43

to undergrad. I was a

4:45

raging Cajun. So what? U.S.L.

4:47

I'm dating myself. It's now

4:49

ULL. They're fancy. They're fancy.

4:51

And then I'm dating myself.

4:53

It's now ULL. They're fancy.

4:55

I've kind of had a

4:57

change of heart. going to

4:59

do this PhD I need

5:01

to do something cool and

5:03

big let me just take

5:05

the MCAT and see what

5:07

happens so then LSU from at

5:09

school which was in Shreveport North Louisiana

5:11

and then I did residency in Galveston

5:13

and we've stayed in the Houston Galveston

5:16

area pretty much since then do people

5:18

tell you look like Courtney Cox yes

5:20

especially back in the day yes win

5:22

She was on friends, I was a

5:24

resident, and we would have friends watch

5:27

parties. And now it's kind of Tina

5:29

Faye. Anyone with black hair and big

5:31

glasses is me. Well, both are compliments.

5:33

Yeah. And we love them both. Yeah, we do.

5:35

You're one of eight. Yeah. What did mom and

5:38

dad do? A lot of sex. Well, clearly,

5:40

yeah. Good for them. Yeah, yeah. They weren't

5:42

shy about it. I would walk into

5:44

the parents making out in the corner.

5:46

Really? Stop! So mom and dad were

5:49

restauranteurs. Oh, yes. They owned a Cajun

5:51

restaurant. Yeah. We just called it food.

5:53

You would call it Cajun. And it

5:55

was a little more upscale. It was

5:57

steaked and seafood. And I grew up

5:59

in a big. restaurant family. My grandparents,

6:01

my aunts, and uncles, most of my

6:03

siblings. That's why they couldn't keep their

6:05

hands off themselves because restaurant people are

6:07

party a lot and they're horny. That's

6:10

a whole lifestyle. Lots of naps, work

6:12

the lunch shift, come home naps. How

6:14

do you choose? Oblivion? Yeah, I want

6:16

to say obstetric, it's obstetrician, but obstetrics.

6:18

Obstetrics, that is tricky. Obstetrics and gynecology.

6:20

So in your third year in in

6:22

classroom and you get a little taste

6:24

of different things, but you're mostly just

6:26

getting the basics down. Your last two

6:29

years are out in the wards, where

6:31

you're in the hospital rotating and figuring

6:33

out what you want to do. I

6:35

remember I thought I wanted to be

6:37

a pediatrician, I was president of the

6:39

PEED's interest group, but they called Pig,

6:41

and I did PEED's first, and I

6:43

realized quickly, I love babies, but I

6:45

don't love their parents. The whole dynamic,

6:47

this is not my niche. So then

6:50

you rotate through surgery, you rotate through

6:52

surgery, I really like surgery, I really

6:54

like aspects of surgery, but I didn't

6:56

like surgeons. They were a barrier. Yeah.

6:58

EMT was cool, but super competitive. I

7:00

had the grades, turns out, but my

7:02

last block was Obie Jen, and that

7:04

first night I caught a baby. The

7:06

block I happened to have first was

7:08

Labor and Delivery. Yeah. I have some

7:11

awesome upper-level resin who's like, we got

7:13

this, come on, you know, get in

7:15

there. And I was like, ugh. And

7:17

I remember calling my mom, like, I

7:19

finally figured out what I want to

7:21

do. I want to deliver babies. I

7:23

didn't want to have anything to do

7:25

with menopause. What part do you think

7:27

was so rewarding? I still could cry.

7:30

It never gets old being there for

7:32

a birth. Well, I want to dial

7:34

in on it because two of my

7:36

favorite experiences on earth are the second

7:38

both of my daughters were born holding

7:40

them, looking in their face and going,

7:42

welcome to earth. Like there's something so

7:44

crazy. And I get to see them

7:46

before you. Yeah. And I'm just like,

7:48

hi not, you know, it's never gets

7:51

a miracle. I make a big production.

7:53

We lay the baby on mom's tummy

7:55

and I let the daddy cut the,

7:57

I let, you know, he gets to

7:59

cut the cord and everyone's crying through

8:01

the whole birth labor process. I'm hanging

8:03

out. Where'd y' y'all meet? Let's talk,

8:05

because you don't get that connection in

8:07

a 15 minute a visit. through the

8:09

OB stuff, so I'm there for delivery.

8:12

I'm not just rolling in to catch

8:14

the baby, I'm there for the whole

8:16

labor. You're also getting to be a

8:18

part of the most intimate thing that

8:20

a couple will share. or one of

8:22

them for us for sure. Like, oh

8:24

my God, we made a thing and

8:26

it's here? As opposed to a meter

8:28

maid who has to give people bad

8:31

news all day? This is like the

8:33

opposite. Yeah. There's occasional bad outcomes and

8:35

tragedies and I'm trained for all the

8:37

crazy stuff that could happen. But most

8:39

of the time, I just get to

8:41

be there and it's just such a

8:43

cool experience. So that's what I fell

8:45

in love with and I'm like, and

8:47

I have to do surgery. And I

8:49

have to do this menopause thing and

8:52

do gynecology, but it's a necessary evil

8:54

to do this baby thing. Yeah, yeah.

8:56

So this menopause thing was a sector

8:58

of it? Yeah. But not even. Not

9:00

even. Medical school, right? We do four

9:02

years, two years on the books, two

9:04

years in the wards. And we had

9:06

one, one hour lecture. in that first

9:08

two years. This is Minneapolis. It's a

9:11

basic overview. One, one hour lecture. Okay.

9:13

I'm not shocked. I know almost nothing.

9:15

That's why I'm here. I got you.

9:17

Exactly. And you pointed out this isn't

9:19

my realization, but we're going to do

9:21

one hour to address a third of

9:23

a woman's life. That 100% of women.

9:25

Yes, we'll go through. It's not optional.

9:27

And it's not a couple weeks or

9:29

a couple months. It's a third of

9:32

their life we're going to just not

9:34

worry about. Yeah, but you know, it

9:36

wasn't put to me that way. This

9:38

is just a transition and estrogen declines

9:40

and off you go. And she might

9:42

have some hot flashes. We've got medicine

9:44

for that. Okay. Then in OBGIN residency,

9:46

which is women's health, probably 55 60%

9:48

of what we did was to do

9:50

with OB, getting people with OB, getting

9:53

people pregnant. staying pregnant, unpregnating them. All

9:55

the trials and tribulations, important stuff. So

9:57

proud of everything I learned. And then

9:59

everything else gets shoved in the box

10:01

of gynecology. And we have reproductive endocrinology,

10:03

which is basically endocrine stuff that happens,

10:05

weird chromosomal things, and. getting people pregnant

10:07

for fertility issues. We have pediatric oncologies,

10:09

how to take care of smaller people

10:12

with the same organs who have issues

10:14

and need help. We have general gycologies,

10:16

well woman exams, so menopause was part

10:18

of our REI block. reproductive endocrinology, which

10:20

we only did second year for six

10:22

weeks. We had a one hour lecture

10:24

each week. So I got six hours.

10:26

So in eight years of medical training

10:28

and education, I had seven hours of

10:30

menopause. We had no menopause clinics. And

10:33

then I was leashed onto the world,

10:35

go be free and practice. I didn't

10:37

know anything, yeah. Yeah, you've come to

10:39

regret how many women were basically asking

10:41

for your help and in that paradigm,

10:43

you pretty much were just turning people

10:45

over to different specialists. I didn't know

10:47

enough at the time to know that

10:49

her palpitations, her frozen shoulder, her, you

10:51

know, myriad. Oh, girl, wait, we're gonna

10:54

get that. Oh no! I'm a laundry

10:56

list of complaints. I'm the well woman

10:58

examiner and I got 15 minutes to

11:00

get through this. So I'm like, we're

11:02

going to send you to cardiology for

11:04

your palpitations, we're going to go to

11:06

the orto for your shoulder. So I'm

11:08

giving her six referrals. I'm going to

11:10

sleep specialists for your insomnia. Yeah, and

11:13

a nutritionist for your weight gain. Yeah.

11:15

And a nutritionist for your weight gain.

11:17

I had an endocrine condition, I didn't

11:19

ovulate regularly, why I had fertility treatments

11:21

for my kids. You'd PCOS? PCOS. I

11:23

had the two pay kids, finally got

11:25

that done. I don't want to go

11:27

through another miscarriage. We're done. So I

11:29

go on birth control pills to manage

11:31

my condition, which I did great on.

11:34

That was fine for me. And then

11:36

I get to about 48 and I'm

11:38

like, okay, I think we're getting close

11:40

to where we're going to be. And

11:42

I'm totally suppressing my period. So I'm

11:44

not taking the inactive pills. So I'm

11:46

totally replaced all my hormones and shut

11:48

it down. I felt better that way

11:50

than PCOS. I felt better that way

11:53

than PCOS. I was like, probably time

11:55

that get off the nurse practitioner who

11:57

took care of me. I was like,

11:59

I'm going to get off the pill.

12:01

We're going to get some blood work

12:03

in a month. died when I was

12:05

nine from leukemia, so I was a

12:07

kid when that happened. And then my

12:09

next brother Bob had HIV and hepatitis.

12:11

The HIV is actually really under control,

12:14

but it was his liver, just tanking,

12:16

tanking, tanking. So I've stopped the pill,

12:18

see where Mary Claire is at, in

12:20

the O.R. The phone's ringing, ring, ring,

12:22

ring. like get the phone and they

12:24

put it to my ear and they're

12:26

like Bob's in a coma you probably

12:28

should start heading home. Did you know

12:30

that was coming? Eventually I had sat

12:32

the kids down and said you know

12:35

Uncle Bob's getting sicker but not like

12:37

today. It kind of was abrupt despite

12:39

knowing it was coming. Yeah I thought

12:41

we had a year two years. Anyway

12:43

my partner comes down we get to

12:45

a good part in the case scrubs

12:47

me out and I go and prepare

12:49

to go home and figure all this

12:51

out. So here I am grieving this

12:54

horrible thing. I am in full on

12:56

menopause, but I don't know it. I'm

12:58

gaslighting myself. I'm attributing all the things

13:00

to grief, and certainly grief was a

13:02

part of it. But after like month

13:04

six, I realize the grief is lifting,

13:06

I'm not crying all the time on

13:08

the way home. I'm like, when was

13:10

your last period? Shh. It must be

13:12

so comforting to hear an OB, be

13:15

out to lunch on their own health.

13:17

I didn't like menopause. I was like,

13:19

eww, I was like Samantha on Sex

13:21

in the City, not the menopause. And

13:23

so I was like, Dora, I'm going

13:25

to come get the blood work now.

13:27

And so we did everything. And sure

13:29

enough, I was fully, fully menopausal. And

13:31

that's detectable. Yeah, check your estrogen, check

13:34

something called F. One's high, one's low.

13:36

That's low. That's it. So it. Perry

13:38

Menopause, no, we don't have one. Okay,

13:40

that's what I was gonna ask, because

13:42

I think I'm in it. I know,

13:44

everyone your age does. I've looked up

13:46

all the stats for Southeast Asia. Oh,

13:48

you did. Yes, I did. Thank you.

13:50

Yeah, so we'll go over that. But

13:52

I reluctantly go on hormone therapy, because

13:55

I'm like, I cannot live like this.

13:57

I was still in the impression I

13:59

would get breast cancer and died. It

14:01

was gonna kill me. Well, let's address

14:03

that right now because I happen to

14:05

dress that right now, I happen to

14:07

know way more about this right now,

14:09

I'm going on this right now, I

14:11

think, I'm in, I'm in, I'm going

14:13

on, I'm in, I'm in, I'm going

14:16

on, I'm going on, I'm going on,

14:18

I'm going on, I'm going on, I'm

14:20

going on, I'm going on, I'm going

14:22

on, I'm going on, I'm going on,

14:24

I'm going Well, I do love one.

14:26

But a doctor at Tia, I love

14:28

Peter at Tia, and he's been such

14:30

a vocal supporter of this. But so

14:32

all of this, the hysteria that you

14:35

probably received was based on the work

14:37

of two people virtually. So the WHOI

14:39

study was a large, multi-centered trial. It

14:41

was one of the biggest projects the

14:43

NIH had ever taken on, and for

14:45

the first time, they were studying women.

14:47

We were so fucking happy. We knew

14:49

from anecdotal. evidence that women who were

14:51

on HRT before the WHO before the

14:53

WHOI, hormone replacement therapy, yeah, hormone replacement

14:56

therapy, 40% of women were utilizing HRT

14:58

and menopause. So that was kind of

15:00

the baseline where it was recommended by

15:02

the American College of Physicians. I mean

15:04

it was like everybody should consider this.

15:06

We knew that women who chose it

15:08

had lower heart disease, had lower certain

15:10

risks, but that's not proof. That's an

15:12

observational study. blinded. So NIH billion dollar

15:14

study, let's study women, they got 37,000

15:17

women recruited, half were placebo versus estrogen

15:19

or estrogen or progesterone if they had

15:21

a uterus. Which is a huge issue

15:23

already right there if you're not combining

15:25

the two. Particular estrogen that they were

15:27

on was primerin, which we don't use

15:29

today very often, and then a very

15:31

specific progesterone. It wasn't using modern HRT

15:33

formulations, it was just looking at this

15:36

one, but at the time in the

15:38

two thousands that was the most common

15:40

formulations used. we're there. Because they were

15:42

looking for heart disease as the outcome,

15:44

is this really protective for heart disease

15:46

or are just wealthier, healthier women on

15:48

HRT and we're getting an artifact, the

15:50

average age was 63 in the study.

15:52

Little late, we know it works for

15:54

hot flashes, we know it works for

15:57

hot flashes, we know it'll take care

15:59

of menopause symptoms, but it doesn't really

16:01

help with heart disease. So they wanted

16:03

to start later because it's expensive to

16:05

go with the... trial, the women on

16:07

estrogen only had a 30% decrease risk

16:09

of breast cancer. And that was statistically

16:11

significant. The women on the combo saw

16:13

a slight increase risk, but it never

16:16

reached statistical significance. Really quick. The reason

16:18

it was kind of irrelevant statistically is

16:20

that the control group. had an abnormally

16:22

low rate. That's it. Which was not

16:24

even considered. So when you compare the

16:26

two groups, whoa, this is really causing.

16:28

It was four guys. Flabowski, Aragoski. I

16:30

can't even pronounce their names. And they

16:32

still stand by. It's crazy. Just recently,

16:34

they're back at it. There were 17

16:37

centers involved in this. study, there were

16:39

multiple PIs primary investigators, and these two

16:41

or three guys wrote this paper and

16:43

said, estrogen causes breast cancer, HRT causes

16:45

breast cancer, and they called everybody in

16:47

a room and said, take a look

16:49

at it, you have one hour to

16:51

make changes, they rejected all the changes,

16:53

and then they went to the breath.

16:55

Yeah, yeah, they just did it, and

16:58

it was like letting a genie out

17:00

of a bottle. Flawed interpretation and... Hysteria.

17:02

There was no viral for internet back

17:04

then, but it was the number one

17:06

medical news story of 2002. It was

17:08

on the cover of every magazine. Nancy

17:10

Snyderman is on ABC saying don't give

17:12

anyone estrogen. I was a chief resident.

17:14

I remember the day it came out

17:17

and we were like, what? I was

17:19

terrified to give people HRT. What I

17:21

didn't know in the ensue in 20

17:23

years, being board certified, getting my recertification

17:25

every year, reading every article they put

17:27

in front of me, I was the

17:29

straight-day student. They never walked it back

17:31

to the OBJENs. And the guidelines have

17:33

not been changed in American College of

17:35

OBJEN since 2014, and they still say.

17:38

Only for severe symptoms smallest amount for

17:40

the shortest time possible Wow and a

17:42

tree study it was at 40% which

17:44

he said and then last year in

17:46

2023 we just got this published in

17:48

the Menopause Society it was 4% 4%

17:50

Wow 4% of women who are eligible

17:52

are receiving FDA approved now. There's probably

17:54

more with compound it. It's hard to

17:56

track that because they don't report so

17:59

maybe 7 but still There's a great

18:01

bit of context around this. So you

18:03

start having the symptoms, you decide you

18:05

want to do some investigation in this.

18:07

In your investigation, you quickly find out,

18:09

if you were to search medical peer-reviewed

18:11

articles in journal entries about pregnancy, almost

18:13

1.2 million. And if you look at

18:15

menopause at that same period, 94,000 articles

18:18

written. Do you know much brain power

18:20

we're talking about, how much NIH funding,

18:22

how much private funding, how many labs?

18:24

That's 10 to 1. And more women

18:26

will go through menopause than bare children.

18:28

and the bearing children process will last

18:30

them. However long you want to say

18:32

that window is. Average of two kids,

18:34

nine months each. 30 years? No. So

18:36

pretty nuts. And maybe now's a fun

18:39

time. Because I actually want you to

18:41

explain my post, but I think now

18:43

would be a fun time to just

18:45

talk about men versus women here. Yeah.

18:47

Because my father, at the same time

18:49

that's being published about HRT for women,

18:51

my dad is being advised to be

18:53

on testosterone. It improves his level's low

18:55

and it improves his life. He goes

18:58

off of anti-depressant. It's fine. So men

19:00

have a slow decline from like 18

19:02

or 19 down till they die. But

19:04

for most, it's still detectable. It's still

19:06

detectable. As if your testicles shriveled up

19:08

and died at the average age of

19:10

51 and your empty ball sack is

19:12

flapping in the breeze for the next

19:14

30 years. And we're not going to

19:16

do anything about that. Yes, and good

19:19

luck to you, dude. Yeah, exactly. We're

19:21

never horny again. Here's a sleeping pill.

19:23

Here's something to improve your libido. Maybe.

19:25

Here's a palpitation medicine. Here's an antidepressant.

19:27

Bitch. Yeah. I'm giving her six drugs

19:29

or I can wipe the whole thing

19:31

out with just replacing her estrogen that's

19:33

gone missing. Right. And it'll actually increase

19:35

her bone density. You'll actually have real

19:37

results. Yeah. It is the longevity drug

19:40

for females. Nothing's going to work better

19:42

than that. Yeah. So I mean there's

19:44

a lot in there. Now you can

19:46

draw a dog minibus. You know what's

19:48

making you go on it. You can't

19:50

underestimate the layers of sexism that exists

19:52

within the fact that it would take

19:54

however many years before we would acknowledge.

19:56

Oh yeah, women are really suffering from

19:59

this and they have a bunch of

20:01

symptoms from a bunch of different... issues

20:03

arising from this and better to treat

20:05

those than to get to the core

20:07

of what's going on. When you look

20:09

at why menoposs hormone therapy was developed

20:11

it was to treat a hot flash

20:13

and forever the pathinemonic the poster child

20:15

symptom was hot flashes. What we call

20:17

medicine, vasomotor symptoms. What was never taught

20:20

to me ever and I learned like

20:22

three years ago was we have estrogen

20:24

receptors in every single organ system in

20:26

this body and what I also was

20:28

taught is in perry menopause. That's all

20:30

I learned once in it. decline until

20:32

full menopause when you lose function. It

20:34

is a rocking roller coaster and your

20:36

worst symptoms tend to beat the mental

20:38

challenges, the brain fog, the cognitive disorders,

20:41

the frozen shoulder, all of it is

20:43

peri and late, peri and early men

20:45

parts. That's when you're accelerating your loss

20:47

of bone and muscle. And the eggs,

20:49

right? We were born with all of

20:51

our eggs. A million though, that was

20:53

a shocker to me. One to two

20:55

million at birth. One to two million

20:57

eggs. your grandma's eggs or your eggs?

21:00

Yes, when your... Grandmother was pregnant with

21:02

your mother the egg that made you

21:04

was inside of your mother inside of

21:06

your grandmother in some ways women have

21:08

always existed always knowledge wisdom and trauma

21:10

that they think that this imprinting that

21:12

goes on through a traumatic that goes

21:14

on through a traumatic that goes on

21:16

through a traumatic that goes on through

21:18

a traumatic pregnancy yeah through a traumatic

21:21

pregnancy okay a million a month we

21:23

lose eggs two ways one and from

21:25

the minute they form we start losing

21:27

it through a treasure which is like

21:29

an aging the healthy ones behind to

21:31

catch this sperm. So a treasure is

21:33

happening boom boom and it accelerates at

21:35

35. We see a big drop-off and

21:37

then just from ovulating we lose about

21:40

10,000 to get one to like pop

21:42

up. Every ovulation is every ovulation. Is

21:44

that every ovulation? Is that every ovulation?

21:46

Is that in your menstrual discharge? Where

21:48

all those eggs? They just kind of

21:50

dissolve. So when the one egg pops

21:52

out the fallopian tube picks it up

21:54

and it gets swept like a... you

21:56

know when they've done studies but sometimes

21:58

it just kind of dissolves but it's

22:01

tiny tiny microscopic yeah I wrote it

22:03

down by the time you're 30 you're

22:05

down to 10% down to 10% how

22:07

do you now 37 okay so at

22:09

40 most women and this is different

22:11

for you and this is different for

22:13

you and I'm an explain way don't

22:15

shoot the messenger are down to 3%

22:17

this is for people who look like

22:19

me this is the average American white

22:22

girl are you Indian or Southeast Asian?

22:24

So that's average. The window, 41 is

22:26

still normal for an Indian descent. And

22:28

then that goes up to 51. You

22:30

start younger. And then Perry Menopause back

22:32

it up seven to ten years before

22:34

that. Am I in it? Maybe. I

22:36

bet you have a mix of emotions,

22:38

validation and depression. No, I don't want,

22:41

yeah, this one is not good to

22:43

be validated. I don't, oh God, okay,

22:45

well, how would I know? That's a

22:47

great question. Certainly if your cycles were

22:49

starting to become irregular and if you

22:51

had hot flashes, if you had hot

22:53

flashes, if you had hot flashes, if

22:55

you had hot flashes, if you had

22:57

hot flashes, if you had the kind

22:59

of cliche symptoms, and they are doing.

23:02

all these quizzes and things you can

23:04

take, fatigue out of the ordinary. Nothing

23:06

has changed. Your diet hasn't changed, your

23:08

stresses haven't changed. You want to set

23:10

mental health changes. We have a 40%

23:12

increase in depression and anxiety across the

23:14

menoposs transition with no real environmental changes.

23:16

We have weight gain. So it's a

23:18

steady state weight gain, but what's happening

23:20

in the background with body composition is

23:23

we have this acceleration of muscle mass

23:25

loss and an acceleration of body fat

23:27

gain. typically in the vistra. So the

23:29

introbdominal fat. So my patients used to

23:31

come in and grab their tummies and

23:33

their little paper gowns and be like,

23:35

what the fuck is this? Mary Claire,

23:37

I worked in a small town and

23:39

we all went to church together. What

23:42

is this? I knew her, I worked

23:44

out with her, we ran together. I

23:46

know this woman, I know what she

23:48

eats. That's when I was like, I

23:50

are all my friends and now me

23:52

gaining weight and weird places. is another

23:54

key thing. So we're seeing acceleration of

23:56

bone loss. And so I'm telling my

23:58

patients, let's get early bone densities. Let's

24:00

not wait till 65, especially if you're

24:03

programmed to go through younger than what's

24:05

expected. Okay, can you get pregnant? You

24:07

absolutely can get pregnant during period of

24:09

time. It's just a little harder. Because

24:11

your supply and the quality of the

24:13

egg goes down. Well, that, you know,

24:15

the older you are. She's frozen some

24:17

eggs. I have. I've done two rounds

24:19

but it Wasn't great. There's already been

24:22

some telling. But it is still regular

24:24

periods. But as you said, maybe that's

24:26

the later end of it. Towards the

24:28

end of Perry, meaning you're getting close

24:30

to exhausting the whole deal. Combativeness with

24:32

co-workers? That's mental health and physics. Who

24:34

are working with? Brain fog, you know,

24:36

you suddenly you lose your words. We

24:38

all do it from time to time,

24:40

but this is consistent. I'm gonna make

24:43

you do it now. We're unique. as

24:45

an animal. There's a pot of certain

24:47

whales that do it and elephants are

24:49

very matriarchal, but when you look at

24:51

like the anthropologists and they're like, why

24:53

do women go through menopause? So from

24:55

a survival standpoint, it behoves a woman

24:57

to not keep being pregnant over and

24:59

over again. You kind of have your

25:01

batch of children and then you have

25:04

better survival rates if you stop. The

25:06

anthropologists also think that women served as

25:08

the source of wisdom for the tribe.

25:10

They were the passersers on of knowledge,

25:12

the dudes tended to die younger because

25:14

they're getting killed by saber, The grandma

25:16

stayed back. And I remember these people

25:18

were still very young compared to what

25:20

we think of a grandmother now. We

25:23

also died a lot sooner. Things that

25:25

don't take people out now like vaccines

25:27

and childhood diseases. We have a reason

25:29

why we live longer. You're right. There

25:31

was a very... predictable role for the

25:33

grandma. She was passing on all this

25:35

wisdom, helping with children. Now we have

25:37

all these things. We have child care

25:39

and we farm things out to strangers

25:41

and this whole role that once served

25:44

our genetic fitness. We've industrialized our way

25:46

out of it. We've evolved past our

25:48

genetics. Yes. So we're saying the reason

25:50

that human women didn't die is because

25:52

of their... and being killed by accidents.

25:54

If they survive, they seem to take

25:56

on these very wisdom creating, teaching the

25:58

next generation. You know, if you look

26:00

at whales, they're teaching the babies to

26:02

hunt while the moms are hunting gathering

26:05

with the dads. Or grandma elephants, they're

26:07

very. involved in the hand system. And

26:09

I guess too, would I be wrong

26:11

to say this? I'm assuming childbirth gets

26:13

more dangerous as you're older? Yeah, it's

26:15

harder to do and it's harder to

26:17

stay healthy doing it. In general, we

26:19

would lose more women to cardiovascular issues,

26:21

hypertension, pre-clampsia, that kind of stuff. Before

26:24

modern medicine, we had medications to help

26:26

manage those conditions, diabetes. So that's how

26:28

we got there. We're kind of unique,

26:30

as you say, there are a couple

26:32

of other people, but let's. What physically

26:34

happens during menopause? Let's talk about the

26:36

endocrine system. What is it? What does

26:38

it do and how does it change?

26:40

So let's talk about what you're going

26:42

through right now. A healthy woman who

26:45

has a regular menstrual cycle. Nothing is

26:47

ever steady state. It's an EKG-like ebb

26:49

and flow of some key hormones. And

26:51

ovulation starts in the brain, not in

26:53

the ovary. In order to ovate, the

26:55

brain registers that are estrogen level is

26:57

low. The brain gets that signal, whoa,

26:59

we're low. The hypithalmus is testing. It

27:01

says, all right. It's time. It sends

27:04

a signal to the pituitary, next bland

27:06

underneath. And pituitary is like, all right

27:08

boss, I got it. The pituitary then

27:10

sends L-H and F-H. So if you've

27:12

done any fertility treatments or you know

27:14

these words or had the shots, you

27:16

know, I did all that too. So

27:18

those two hormones go down and bind

27:20

to the ovaries to stimulate the ovulation.

27:22

Around each egg are a set of

27:25

cells, follicular and granules, and that cycle.

27:27

is unbelievable and goes month after month

27:29

after month in perfection unless you're ill

27:31

or you're pregnant. Crazy athlete. There are

27:33

things that we can do to mess

27:35

it up, but for the average woman,

27:37

the cave woman, this worked very well

27:39

month after month after month after month.

27:41

And is testosterone going up in preparation?

27:43

That's the one steady state that we

27:46

have. It might mildly fluctuate, but really,

27:48

testosterone starts high in our 20s and

27:50

30s and then just like a man.

27:52

It seems it would be... evolutionarily advantageous

27:54

if it upped your testosterone when you

27:56

were fertile. but we just don't really

27:58

see that. Female male drives are a

28:00

little bit different. So then what happens

28:02

in peri menopause, in the background we're

28:05

losing eggs, losing eggs, losing eggs. We

28:07

reach a critical egg threshold level, which

28:09

is different for every human, where the

28:11

signals coming from the brain no longer

28:13

work. We become resistant because the quality

28:15

and the quantity of the cells around

28:17

the eggs available are declining. So the

28:19

brain's like, where is my estrogen? The

28:21

pituitary is like, boss, I sent the

28:23

signal, he's like, send more. You start

28:26

pounding the ovary with the gonerage, the

28:28

pituitary, pituitary is like, fuck, all right,

28:30

shoots out FSH and LH. We see

28:32

the stimulating hormones start to rise, much

28:34

higher, the stimulating hormones start to rise,

28:36

the stimulating, so the period starts to

28:38

become irregular. And then because you were

28:40

just pounding that egg, we end up

28:42

with higher estrodial levels than we ever

28:45

had before. That's why twins are a

28:47

little bit more common towards the end

28:49

of your fertility. Oh, interesting. Yeah, then

28:51

they were when you were younger because

28:53

you're getting your self-made fertility drugs basically.

28:55

Right, right, right. To push that egg

28:57

out and then progesterone never quite gets

28:59

to where it was before. So what

29:01

used to look like this gorgeous EKG

29:03

each month now is literally a zone

29:06

of chaos. Interesting. So you have estrogen

29:08

doing this progesterones like I'm trying to

29:10

keep up F.SH and L.H. or all

29:12

over the place. And that's why we

29:14

don't have a great blood test. For

29:16

Perry menopause, I can't do a one-time

29:18

blood test and say, obviously. Now for

29:20

post, when you run out of eggs,

29:22

F.S.H. and L.H. the brain is always

29:24

looking, always pushing, always trying. And now

29:27

we know. We have F.S.H. receptors in

29:29

other areas of our body. We think

29:31

the bone, we know the liver. So

29:33

sometimes it's not just the loss of

29:35

estrogen, but it's these high F.S.H. levels

29:37

that are leading to the cholesterol changes

29:39

that we see. A new study just,

29:41

just came out two weeks ago that

29:43

was looking at using a specific cholesterol

29:46

marker, L.D.L. marker, called Super Dense L.D.

29:48

As a marker for Perry Menopause. But

29:50

would AMH be helpful, which is one

29:52

of fertility? things that we check, which

29:54

is a ovarian reserve hormone. Do you

29:56

have needed a baseline test prior to

29:58

any of this? So that's a great

30:00

question. People ask me all the time.

30:02

Okay, so if I'm going to replace

30:04

my hormones in my menopausal journey, would

30:07

it have been good for me to

30:09

know my 30s, where they were? I'm

30:11

like, where in the month would you

30:13

like me to check? Probably not the

30:15

high, because that's when we have the

30:17

breast internness, we worry too much. differently

30:19

and not everyone's therapeutic on our transdermal

30:21

doses so in my clinic we're starting

30:23

to check three months out what are

30:25

her levels how was she absorbing we

30:28

know that women who start HRT in

30:30

the first 10 years have a 50%

30:32

per year lower risk of new heart

30:34

attack cardiovascular disease out there's grosses it's

30:36

very protective of the endothelium what we

30:38

don't know is what were those levels

30:40

we just know she was on it

30:42

or she wasn't right yeah so should

30:44

we be taking estrogen during perimenipose I

30:47

think so Yeah, there's quite a big

30:49

group of data for that. We can

30:51

decrease your risk, but it's just how.

30:53

Do we suppress and replace, like what's

30:55

in a birth control pill? Or do

30:57

we just support? Give you just enough

30:59

to calm the brain down and make

31:01

your symptoms better, but allow the process

31:03

to proceed in the background. Right. There's

31:05

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31:08

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33:01

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24 I lost my narrative, or

33:31

rather it was stolen from me,

33:34

and the Monica Lewinsky that my

33:36

friends and family knew was usurped

33:38

by false narratives, callous jokes, and

33:40

politics. I would define reclaiming as

33:42

to take back what was yours,

33:44

something you possess is lost or

33:46

stolen, and ultimately you triumph in

33:49

finding it again. So I think

33:51

listeners can expect me to be

33:53

chatting with folks both recognizable and

33:55

unrecognizable names about the way that...

33:57

have navigated roads to triumph. My

33:59

hope is that people will finish

34:02

an episode of reclaiming and feel

34:04

like they filled their tank up.

34:06

They connected with the people that

34:08

I'm talking to and leave with

34:10

maybe some nuggets that help them

34:12

feel a little more hopeful. Follow

34:15

Reclaiming with Monica Lewinsky on the

34:17

Wundery app or wherever you get

34:19

your podcasts. You can listen to

34:21

reclaiming early and ad-free right now

34:23

by joining Wundery Plus in the

34:25

Wundery app or on Apple podcasts.

34:32

Okay, so it's 6,000 women reach menopause

34:35

every single day in the United States

34:37

and there are only 2,300 providers certified

34:39

in menopause medicine. So once this occurs

34:41

you and you're going through it and

34:43

you start. getting serious about your own

34:45

reluctance to go through this, which is

34:47

a great motivator. How do you approach

34:49

it? What do you start looking at?

34:51

How do you even begin assembling what

34:53

becomes the toolkit? I wish that I

34:56

could tell you you could confidently walk

34:58

into your OBGY and your family medicine,

35:00

your internal medicine, your internal medicine doctor,

35:02

and have a reasonable logical conversation about

35:04

your plan of care in period menopause

35:06

and menopause. That is not possible right

35:08

now. It is not the fault of

35:10

the individual doctor. excellent in your birth

35:12

and your pregnancy, every aspect. But because

35:15

of this six hours, so right now

35:17

they surveyed residents coming out three years

35:19

ago. Only 30% felt barely adequately trained

35:21

to treat menopause. It's awful. So at

35:23

least they're honest. Call ahead. Look on

35:25

the Menopause Society website, which is menopause.org

35:27

and see who has passed the test

35:29

and is certified there. It's not perfect.

35:31

There's always people out there who aren't

35:33

great doctors who took the test, but

35:36

it's somewhere to start. We crowdsourced with

35:38

my followers. I've got thousands of testimonials

35:40

and we organized them by country, city,

35:42

city, city, and state, to help people,

35:44

they don't pay me. And right now,

35:46

it's pretty slick. There's some great telemedicine

35:48

companies that have been developed, mostly female

35:50

founded, who saw a gap in care

35:52

and they saw. a need and they

35:54

develop these telemedicine companies. I have women

35:57

calling me from New York, LA, London,

35:59

the most well-connected, you would think, who

36:01

have the same basic questions and the

36:03

same worries and the same fears and

36:05

cannot find help as the woman sitting

36:07

on the couch in Iowa. Yeah. Okay,

36:09

so as you start. focusing on it

36:11

and kind of pledging to get competent

36:13

in it and start treating women. Are

36:16

you yourself even shocked with the amount

36:18

of symptoms? Because I wrote down symptoms

36:20

and it's about the longest lips of

36:22

symptoms I've ever written. I was shocked

36:24

and most of that was driven by

36:26

questions I got in social. As my

36:28

little social media platform was exploding, when

36:30

10,000 women ask you about frozen shoulder

36:32

or palpitations or vertigo, you're like, they

36:34

can't all be lying. Then I'm digging

36:37

and I'm like, somebody who did the

36:39

study, there's clear data here. So I

36:41

go online and I make a little

36:43

video talking about the correlation between menopause

36:45

and furze and menopause and validations and

36:47

the world goes crazy. Wow. I get

36:49

10,000 comments. Why didn't my doctor know

36:51

again? We're doing a terrible job of

36:53

teaching, but I was literally learning alongside

36:55

my followers. As I learned, I'd make

36:58

a video and teach. And that's what

37:00

inspired me to write the book. And

37:02

they were like, please write a book.

37:04

I don't want to chase you all

37:06

over social media. It's too complicated. Just

37:08

put it all in one place. Frozen

37:10

Children. That is scaring me. My mom

37:12

had it. My grandmother had it. One

37:14

of my mother-in-laws has been dealing with

37:17

it for the last six months. So

37:19

this is a great story. And I

37:21

hope I get the lore right. And

37:23

it was the head of OBJEN and

37:25

the head of orthopedics who both happened

37:27

to be women. And it was something

37:29

like they were sitting in the doctor's

37:31

lounge or in the cafeteria and just

37:33

shooting the breeze over, can you believe

37:35

all these women with frozen shoulders? You

37:38

think there's a correlation? I don't know.

37:40

Let's look into it. They started pulling,

37:42

I don't know. Let's look into it.

37:44

They started pulling charts, I don't know.

37:46

Let's look into it, they started pulling

37:48

journals first. No. Nobody would touch it.

37:50

Nope, this can't be right. Nope, this

37:52

is an artifact. Nope, no, no, no.

37:54

So one of the menopause journals published

37:56

it. And so then. I have a

37:59

friend, Vonda Wright, she's an orthopedic surgeon,

38:01

she does a ton of teaching, and

38:03

she wrote the paper on the musculoskeletal

38:05

syndrome of menopause. How's that all work?

38:07

Astrogen receptors and probably progesterone here as

38:09

well are all over the musculoskeletal system.

38:11

We know bones, we got bones down.

38:13

We've known about osteoporosis since I was

38:15

resident. I know that one really well.

38:18

But what wasn't understood was tendons, muscles,

38:20

muscles, and the connections between bones and

38:22

muscles and how that all works together.

38:24

Frozen shoulder is adhesive capsulitis. There's a

38:26

capsule around the ball joint and the

38:28

shoulder that gets absolutely adhesed and frozen

38:30

and it's an inflammatory condition. You can't

38:32

put your arm behind. Like, you go

38:34

to take a picture. Yeah. And it's

38:36

very, very painful. You need early intervention.

38:39

You need physical therapy. There's needling. They

38:41

have to break it up. And that

38:43

we can delay the onset. and the

38:45

duration and probably prevent several cases for

38:47

women on HRT. Because estrogen is protective,

38:49

so it's an anti-inflammatory. But my mom,

38:51

I've never heard her once say she

38:53

had that because of menopause. Well, no,

38:55

most women don't know. Most orthopedic surgeons

38:57

don't know. We're working to change that.

39:00

That paper was written a year and

39:02

a half ago. Oh, wow. Because it

39:04

was ringing in the ears? Yeah. Tenitis,

39:06

I still don't know how to say

39:08

it correctly. Yeah. I've had it once

39:10

and man. People kill themselves from it.

39:12

Madening. So again, this is an estrogen

39:14

receptor problem. The vertigo is that the

39:16

crystals break off. quicker is basically osteoporosis

39:19

in the ear. And the crystals break

39:21

off and then float around and then

39:23

you're dizzy, but the tenetists, the inflammation

39:25

around the nerve and around some of

39:27

the aricular bones that they feel like

39:29

is leading to and that all these

39:31

studies say age match women, premenopausal women

39:33

definitely have it less than post and

39:35

women in HRT are less likely to

39:37

get it. Yeah, wow. What are some

39:40

other dry skin? Yeah, in the skin

39:42

and tegmentary, skin and the pair of

39:44

follicles and yeah, that word. That's a

39:46

fancy. All the follicles and oil and

39:48

sweat glands, it's a whole. system. Largest

39:50

organ in the body. It is most

39:52

absorbent. So we lose 30% of our

39:54

collagen, you don't have to tell a

39:56

woman that she knows. In the first

39:58

five years of menopause we can attenuate

40:01

that with topical or systemic hormone therapy.

40:03

Topical works better actually which is why

40:05

I'm on my vanity cream. Is that

40:07

a retinal? No, it's estrogen for the

40:09

face. Wow. So it's compounded. Some people

40:11

take the vaginal product and we'll mix

40:13

it in their moisturizer and put some

40:15

on their face. But you should talk

40:17

to a doctor before you do it.

40:20

You shouldn't do that on your own.

40:22

Do any compounding at home. So yeah.

40:24

Makes it a little mortar and pestle.

40:26

You lose oil production and the skin,

40:28

you lose thinness and the transapodermal water

40:30

loss is much greater. So you're just...

40:32

losing all your barrier, your protection. So

40:34

the skin is less healthy. Dry mouth,

40:36

that's the same. Dry mouth, same thing.

40:38

So mucus production, the salivary glands dry

40:41

up, we have tremendous dry mouth and

40:43

dry eyes, dry mouth. This is the

40:45

same. Guys, I don't want menopause, this

40:47

is fucking miserable. Body odor, what's creating

40:49

body odor? Early in menopause, as the

40:51

estrogen levels decline. something that's made in

40:53

the liver called steroid hormone binding globulin,

40:55

SHBG, which binds our sex hormones and

40:57

carries them around the blood and renders

40:59

them inactive until they let loose and

41:02

then they bind to go do things.

41:04

When we lose the binding hormone the

41:06

activity of our androgens increases even though

41:08

your total testosterone may not be different

41:10

but the free is higher. So when

41:12

I first got a panel for testosterone

41:14

My overall numbers were like fine not

41:16

alarming. My free was super low. Yeah,

41:18

I had the binding globulin. Yeah, so

41:20

you had some, but they were bound.

41:23

That's right. It's a balance because you

41:25

can eat certain things, take certain things

41:27

to certain supplements to increase, decrease, but

41:29

then sometimes you're Robin Peter to pay

41:31

Paul. And so in women, when the

41:33

activity of their angers increases, we see

41:35

male pattern baldness, they start grading chin

41:37

hair, and their odor changes. They smell

41:39

like onions and it's a really kind

41:42

of weird, yeah, I hear the onion

41:44

thing a lot. Monica, I am living

41:46

my best. You just stick with me.

41:48

Okay, so I like to hear that

41:50

because my mom actually said the same

41:52

thing. I don't think she did any

41:54

hormone therapy, but I was like, when

41:56

did you hit menopause? She said 50.

41:58

And I was like, oh man, well,

42:00

I'm nervous. I'm in Perry menopause after

42:03

I read this book. And she was

42:05

like, well, I like it. So many

42:07

women just go blindly into the night

42:09

and they have no idea. And so

42:11

one of my critics have said, you're

42:13

just fear-mongering, you want to scare people,

42:15

whatever. I'm like, no, I'm like, critics

42:17

have said, you're just fear-mongering, you want

42:19

to scare people, whatever. I'm like, no,

42:21

I want to educate, you're not blindsided.

42:24

You know, imagine the quarter's all levels

42:26

that will come down, and they're like,

42:28

oh. The suicide rates are all... right

42:30

in there at this age. They kind

42:32

of peek there. Peak suicide rates are

42:34

45 to 55 in women. Wow, and

42:36

that should be the kind of transition

42:38

in life where you're like, oh, I

42:40

made it. I'm needed, I'm going to

42:43

lean into work, we're going to go

42:45

off in the sunset here. No. Oh,

42:47

wow. That's heartbreaking. And is that hormonal

42:49

to? The neurotransmitters in the brain are

42:51

heavily influenced by estrogen progression levels and

42:53

the brain doesn't like the chaos. So

42:55

the real mental health. that we see

42:57

the big big problems are in Perry.

42:59

Post things tend to calm down both

43:01

cognitively and mental health. You still may

43:04

need your assor, you know, whatever, but

43:06

we see this wild uptick in Perry.

43:08

So decreased sex drive. I think this

43:10

is also something that. people have just

43:12

taken for granted? I learned this much

43:14

about sex drive. She's holding up a

43:16

zero for the listener. Holding up a

43:18

zero, sorry. I get my little diploma

43:20

and I graduate and I'm at the

43:22

top of my class. I win lots

43:25

of awards and off we go. I'm

43:27

gonna go be the best OBJIN. So

43:29

the pregnant people come and then these

43:31

other people come. I'm like, ew. So

43:33

like as you're walking out from the

43:35

well woman exam, I'm like, okay, we'll

43:37

see you next year. was just like

43:39

dear in the headlights. You're like, I

43:41

don't know. So I'm like, oh, okay.

43:44

This is probably what you're thinking like.

43:46

So I go out in the hallway

43:48

and I find my boss, who's our

43:50

mentors when we first get out, keep

43:52

us out of trouble in those first

43:54

couple years. I'm like, hey, so Miss

43:56

Smith, you know, everything's fine, she's healthy,

43:58

but you're sexy. I can't even say

44:00

it. You know, I'm deep south and

44:02

taboo and he's like, and he's like,

44:05

he's like, he's like, he's like, he's

44:07

like, he's like, he's like, he's like,

44:09

he's like, he's like, he's like, he's

44:11

like, he's like, he's like, he's like,

44:13

he's like, he's like, he's like, he's

44:15

like, he's like, he's like, he's like,

44:17

he's like, he's like, he's like, he's

44:19

like, he's like And yeah, that'll be

44:21

fine. Just pat on the knee, but

44:23

she's going to be okay. Tell her

44:26

to anesthetize herself so she can get

44:28

through it. Exactly. Women just go through

44:30

this at the stage. So many people

44:32

were complaining over and over again. I

44:34

started looking for resources and I read

44:36

Venus and Mars in the bedroom. Like

44:38

that was my Bible. That was the

44:40

only thing I knew how to do.

44:42

No one taught me. I was going

44:45

back in the expert. going. I'll be

44:47

right back. Let me see what I

44:49

can find. So I ended up making

44:51

little handouts for my patients on what

44:53

I could dig up on desire and

44:55

herbs. And I didn't know about, well,

44:57

they came out later, but Addie and

44:59

Vilecy and testosterone and all these things

45:01

that might be helpful to a woman

45:03

and counseling and therapy and looking for

45:06

orgasmic disorders and arousal disorders and pain

45:08

disorders and pelvic disorders. It's common for

45:10

sex that get more painful, right? the

45:12

bladder, that whole, we now call the

45:14

genital urinary system, pubic bone all the

45:16

way back, and up to the bladder.

45:18

We lose elasticity, we lose the ability

45:20

to produce mucus. So if you biopsy

45:22

to pre and postmenopausal vagina, premenopausal, it's

45:24

this thick velvety full of mucus glands,

45:27

very resilient, it'll take a beating and

45:29

be fine. Baby comes through there, it's

45:31

traumatic, but they'll make it. And then,

45:33

postmenopausal looks like a desert. You went

45:35

from this gorgeous, gorgeous thick, multi-layerd. tissue

45:37

to six cells laying on top of

45:39

each other with no mucus, no nothing

45:41

like a desert. All we have to

45:43

do for those women is give them

45:46

back estrogen and the vagina and all

45:48

that tissue will grow back even at

45:50

70. You can absolutely prevent and reverse

45:52

this condition. So I recommend lubricants for

45:54

all of my patients on every sexual

45:56

encounter. Just get used to it, do

45:58

it proactively, normalize this. And then I'm

46:00

advising not to wait until you start

46:02

having symptoms to use vaginal estrogen. It's

46:04

very safe. It's like skin care. It's

46:07

like skin care. There's very much risk

46:09

free. If you have active breast free,

46:11

if you have active breast cancer, you

46:13

can still use it. for recurrent UTIs

46:15

for a menopausal person is vaginal estrogen

46:17

not recurrent antibiotics. It's just topical. Yeah,

46:19

they have creams, gels, they have a

46:21

spository, they have a ring, there's multiple

46:23

ways, but generic and cheap, the cream

46:25

works for most people. Yeah. Wow. Where's

46:28

testosterone in the drive part? So we

46:30

look at female sexual function, we have

46:32

five buckets where she may not be

46:34

happy. First of all, it has to

46:36

bother her. Some women are like, I

46:38

don't care. Then you're going to do

46:40

you. Other women are like, I used

46:42

to have it, I miss it. So

46:44

you have to make sure she's not

46:47

having pain. There's a pain disorder. She's

46:49

not having a relationship disorder because no

46:51

amount of testosterone is going to fix

46:53

a bad relationship. Can she have an

46:55

orgasm? Or is the plumbing still working?

46:57

If she puts her mind to it?

46:59

Does that drop off? You see arousal

47:01

disorders, it's more of a blood flow

47:03

issue. I kind of had that. I

47:05

was having delayed work as I'm like,

47:08

hello, everything's working, I'm ready. I was

47:10

like, okay, fine, I need vaginal estrogen

47:12

now. And it took about eight years

47:14

in menopause because I was on systemic,

47:16

but I wasn't quite getting enough and

47:18

everything's fixed. Labido, which is desire, and

47:20

medical, we say, hypoactive, sexual desire disorder,

47:22

HSDD. That is a mood. It's totally

47:24

in the brain. It's totally in the

47:26

brain. It's totally in the brain. Everything's

47:29

working down here, but it's the thought

47:31

of it. And most women will come

47:33

to say, once we get going, I'm

47:35

fine. So if a female has an

47:37

arousal disorder, vaginal Viagra might work for

47:39

her. What does that do? Increases blood

47:41

flow. Basil dilator. Specific to the corpus

47:43

spongyosum. So that's the squishy part that

47:45

gets erect. We have exactly the same

47:48

tissue in the clitoris. Well your clitoris

47:50

becomes my penis. Same. anatomy, except ours

47:52

looks like Gumbie, and yours is like

47:54

a little rocket. So we've ruled out

47:56

all the things and she's like, I

47:58

love him, I'm not going anywhere, I

48:00

miss it, please help me. So we

48:02

have two classes of meds that we

48:04

talk about. One is testosterone, it works

48:06

great for these women. If it doesn't

48:09

help her in three months, that's not

48:11

the answer. And the options for testosterone

48:13

are. So we don't have FDA approved

48:15

option for women. So we're either having

48:17

someone cook it up in a lab

48:19

and get a compounded cream generally. Right

48:21

there. Red flag. Ridiculous. Ridiculous. We have

48:23

studies that prove the safety and efficacy

48:25

and all the things. And she's so

48:27

much happier. There is anecdotal evidence that

48:30

also her stamina is better, her mood

48:32

is better, her mood is better. say

48:34

it's a chandelier. So I have low

48:36

muscle mass genetically and I'm doing the

48:38

things eating the protein, working out a

48:40

full-time job, wearing my weighted vest, and

48:42

I was like, what if I tried

48:44

some testosterone off label for myself? Did

48:46

not have a libido issue and no

48:49

one was complaining. And then start some

48:51

testosterone and I see an uptick in

48:53

the area. A little more interested. He's

48:55

not cuter. He's not my poor husband.

48:57

a little more often or maybe I'm

48:59

even initiating, which had not happened in

49:01

a long time. And we've just reached

49:03

a different level now, and I think

49:05

I would miss it if it was

49:07

gone. Of course. So I'm like telling

49:10

my patients this. Certainly if you're distressed,

49:12

let's go for it, let's go for

49:14

it. Certainly if you're distressed, let's go

49:16

for it. But here's my experience. Certainly

49:18

if you're distressed, let's go for it.

49:20

But here's an Australia, and I can

49:22

duck and know it, I know it.

49:24

What we're doing in our clinic is

49:26

either T-stem gel or Andrew gel. So

49:28

we're doing the FDA approved gels for

49:31

men. We're just using them off label

49:33

for women. Interesting. You can also get

49:35

a capsule? So there's trokeys that dissolve

49:37

that or submucosals. So you put them

49:39

under your tongue. Oh, you mean the

49:41

pellets. The pellets are commercially available. They're

49:43

not... approved. There's a problem with pellets

49:45

that we see kind of in the

49:47

ethical realm. Two problems with pellets. If

49:50

you go to a doctor and they

49:52

are trying to talk you into pellets

49:54

and they won't discuss any other form

49:56

of hormone therapy, that is an ethical

49:58

red box. They're financially benefiting from the

50:00

sale of the pellets. And I just

50:02

think you can do better because pellets

50:04

are very hard to manage. You have

50:06

this rapid rise and I've seen females

50:08

with testosterone levels in the four and

50:11

five hundred and I am not kidding.

50:13

They never made a female level pellet.

50:15

They just give females the low level

50:17

and say, you're running 200, you're fine.

50:19

You're not going to die. They don't

50:21

slowly dissolve at a predictable rate. Suppose

50:23

you. I've never seen a decay curve.

50:25

Have you? They don't publish them. They're

50:27

not FDA approved. They're not FDA approved,

50:29

so they don't have the FDA approved,

50:32

so they don't have the FDA approved,

50:34

so they don't have the FDA approved,

50:36

so they don't have the FDA approved,

50:38

so they don't have you're not FDA

50:40

approved. doctor is really railroading you if

50:42

they say I only do pellets I

50:44

would probably be interesting okay good tip

50:46

okay so back to so we can

50:48

do an injectable injectable you can do

50:51

a cream you just rub it's really

50:53

hairy wherever you rub it but that's

50:55

fine you could so I'll tell patients

50:57

to put it here so I'll tell

50:59

patients to put it here so the

51:01

an air follicles here I was studied

51:03

on the shoulders okay we want to

51:05

monitor them to see how they're absorbing

51:07

to see how they're doing. I'll say

51:09

I started on a cream. The only

51:12

thing I didn't love about the cream

51:14

is you have this dispensary for it

51:16

and you click. The amount that comes

51:18

out per click per day did not

51:20

seem very consistent to me. It seemed

51:22

a little all over the map. I

51:24

much prefer just an all over the

51:26

map. I much prefer just an injection

51:28

you know exactly what you're getting. so

51:30

they can see the pea and then

51:33

you just rub it in. Wow. Okay

51:35

so you're doing testosterone on your... your

51:37

arm, estrogen on your vulva. What else?

51:39

I think I replaced my hormones like

51:41

five way, you know. Yeah. For estrogen,

51:43

there's oral and non-oral. And in non-oral

51:45

patches are what we usually prescribe in

51:47

my claim. On your Instagram, you're a

51:49

fan of those, right? They're very inexpensive.

51:52

We have multiple strains. We have a

51:54

lot of options for patients, but sometimes

51:56

people have a reaction to the adhesive,

51:58

tape allergies. So we have gels, so

52:00

we have a reaction to the adhesive,

52:02

tape allergies. So we have gels and

52:04

creams, it's just the expense goes up.

52:06

The vaginal ring is great because you

52:08

get too for everyone. Even like the

52:10

Diva Cup, it's not... for me having

52:13

something in there. Yeah, I don't. You

52:15

have an outsized fear of toxic shocks.

52:17

I wouldn't say outsized. I have a

52:19

real fear of it. Yeah, as you

52:21

should. Yeah, scary, right. It's scary. And

52:23

you die. And then there's local estrogen

52:25

options for the face and or the

52:27

vagina. and then you're progesterone. So progesterone

52:29

is typically given in the menopossi. We're

52:31

giving oral, micronized progesterone. It's the safest.

52:34

I believe I understand a lot about

52:36

testosterone and estrogen and esterdile, but I

52:38

don't know that I know a ton

52:40

about progesterone, estrogen, esterdile, but I don't

52:42

know that I know a ton about

52:44

progesterone about progesterone, esterone, but I don't

52:46

know that I know a ton about

52:48

progesterone, potentially malignant. This is where some

52:50

of those studies were misleading because that

52:53

was an early early days of hormone

52:55

therapy and the like get your wife

52:57

back sexy movement with estrogen. They were

52:59

doing just estrogen and women were getting

53:01

into metrial cancer. So we learned that

53:03

lesson. You give her a progestogen, you

53:05

will negate that. So if she has

53:07

a uterus without the marina IUD which

53:09

has progesterone in it, you must give

53:11

progesterone to not potentially give her cancer.

53:14

Turns out progesterone is amazing for sleep.

53:16

our sleep, sleep hormone. So when patients

53:18

are coming in an early periomena pause,

53:20

still having regular cycles, but they can't

53:22

sleep. in the morning, progesterone might be

53:24

your new best friend. It's fine to

53:26

start with progesterone without estrogen. We do

53:28

not know a lot of cases. I

53:30

have so many things to take it.

53:32

No, I do, I do, I do,

53:35

I do, I do, anxiety thoughts, it's

53:37

great for that 2 a.m. wake up,

53:39

I'll just take an extra one if

53:41

I still have. I mainly have a

53:43

hard time just falling asleep. I mean,

53:45

it's worth a trial, it's not going

53:47

to hurt you, it's not going to

53:49

hurt you, it's not going to hurt

53:51

you, it's a natural problem. And none

53:54

of this is a problem. and menopause

53:56

hormone therapy really was not high enough

53:58

to suppress ovulation. So the biggest difference

54:00

between birth control pills and menopause hormone

54:02

therapy. You think about why they were

54:04

created. Birth control was formed for contraception.

54:06

We need a high enough dose to

54:08

shut the signal down from the hypithalmus

54:10

to tell the hypithalmus, we're cool, we

54:12

got enough estrogen, no signals. No signals,

54:15

no ovulation. Menopolos hormone therapy was developed

54:17

to simply stop a hot flash. You

54:19

don't need nearly as much. Got it.

54:21

So it's lower. Formulation, though, is different

54:23

because a big pharma. Formulation tends to

54:25

be ethanol estrodiol, which is cheap and

54:27

easy to make, and it's 100 times

54:29

as potent as estrodiol. And that's why

54:31

you have those little tiny birth control

54:33

pills. Whereas... Estridial in its natural form,

54:36

which is body identical, it's much less

54:38

potent than its cousin ethanol, Estridial, but

54:40

it's got a great safety profile and

54:42

you don't need much to stop the

54:44

hot flash. Now, how much do we

54:46

need to prevent cardiovascular disease? You don't

54:48

need much to help your bones. They

54:50

did study those numbers. So we're all

54:52

kind of debating, if we're going to

54:55

check levels, what's therapeutic? We really covered

54:57

HRT, hormone replacement therapy. I'm so glad

54:59

you're an advocate for it. I think

55:01

it's insane that women have been just

55:03

left out of this. What I have

55:05

experienced being on hormone therapy, which has

55:07

made me want to work again, made

55:09

me want to do my hobbies again,

55:11

made me mentally, and then my fitness,

55:13

everything, right? I remember Kristen going like,

55:16

this is bullshit, but you're right, it

55:18

is. This is insane. How many doctors

55:20

did you go to before they could

55:22

be disaster? I have to police them.

55:24

A woman on average has to go

55:26

to six to eight doctors before her

55:28

menopause is diagnosed. This is how bad

55:30

the problem is. Well, I'll be clear.

55:32

The general practitioners tend to still be

55:34

pretty... adverse across the board in my

55:37

experience, but we have hormone clinics on

55:39

every 10 feet for men. Most of

55:41

them don't see women. So all one

55:43

needs to do is go there. You

55:45

actually need to police them, I think

55:47

is my tip. Yeah, and that's kind

55:49

of the pellet, it's the biote really,

55:51

that got into, whoa, let's put these

55:53

in women and see what happens, you

55:56

know. And you don't need to be

55:58

at 1100. Yeah, no, I mean these

56:00

women are coming, they're coming, they're coming,

56:02

they're coming, they're coming, they're coming, they're

56:04

coming, they're coming, they're coming, they're coming,

56:06

they're coming, they're coming, they're coming, they're

56:08

coming, they're coming, they're coming, they're coming,

56:10

they're coming, like, like, like, like, like,

56:12

like, like, like, like, like, like, like,

56:14

like, like, like, like, like, like, like,

56:17

like, like, like, like I might have

56:19

a clue. Because women, what naturally in

56:21

their 30s would hover around? So about

56:23

40 to 70. Yeah, so that's a

56:25

good 8x. So you know, most of

56:27

them come in and menopause 12, 15.

56:29

Oh, wow. Let's get you up. So

56:31

I'm trying to titrate my patient 60

56:33

to 70. Let's overshoot just a little

56:35

bit and see if this is going

56:38

to help with your libido. But there

56:40

are two FDA approved medications for libido

56:42

that are not testosterone. One is by

56:44

lesi and it is an injection you

56:46

give yourself 45 minutes before and it

56:48

causes a massive dump of melanocortin that

56:50

then stimulates dopamine. And when our dopamine

56:52

levels are higher it makes us want

56:54

to do things. Yeah. So we want

56:56

the other. Most of my patients don't.

56:59

Choose that because they're like there's a

57:01

praying mantis on the other end of

57:03

this waiting the 45 minutes going is

57:05

working. Well, additionally, it's almost the wrong

57:07

medicine for the arousal type that women

57:09

are which is like that's great for

57:11

a man because a man's sitting around

57:13

thinking about wanting to fuck in an

57:15

hour and he's like, oh yeah, I'll

57:18

do this. Whereas a woman needs to

57:20

be brought into a romantic. Exactly. Yeah.

57:22

So it's almost like a counterintuitive solution.

57:24

base dopamine, like don't give it to

57:26

an addict. I've not seen those studies.

57:28

I've not had a patient yet who

57:30

was like. Yes, please. Addie is another.

57:32

So Addie was studied and moved and

57:34

they saw an uptick. Tells how Addie

57:36

works. Is there a sponsor? Addie works

57:39

the same thing. It's going to increase

57:41

your dopamine levels. And it's something you

57:43

take every day. With Studied and moot,

57:45

it works by increasing happy sexual encounters

57:47

a couple of more times a month

57:49

or however they measure it. So the

57:51

detractors of Addie are like, well, that's

57:53

not enough. And the women are okay

57:55

with it. let the patients decide. Most

57:57

of my patients choose testosterone purely because

58:00

of cost and potentially the other benefits

58:02

for bone and muscle even though we

58:04

don't have great studies yet but the

58:06

anecdotal data is looking very positive in

58:08

that area. Right, so if you just

58:10

kind of reverse engineer, as I understand

58:12

it, or if you believe Attia and

58:14

I do, the best way to combat

58:16

osteoporosis is to not get osteoporosis. Well,

58:19

yeah, that'd be great. It's to not

58:21

get it. But your bones respond immediately

58:23

to muscle and strain. So if you

58:25

can work out heavy, you're putting a

58:27

lot of strain on your bones and

58:29

they will react. They will make themselves

58:31

stronger. They will make themselves stronger. And

58:33

for you to do a lot of

58:35

strenuous and high intensity heavy lifting. you're

58:37

going to benefit from testosterone with your

58:40

muscles. They're all related. The muscular skeletal

58:42

unit works together. It's not like it

58:44

works in isolation. So testosterone will help

58:46

a little bit. We looked at one

58:48

of the things from WHO H.I. when

58:50

the Women's in a health initiative is

58:52

they followed these women forever and they

58:54

followed them into nursing homes and they

58:56

looked at protein intake and frailty scores.

58:58

And the women who ate the most

59:01

protein, like 1.6 grams for a kilogram

59:03

of lean body mass, had much lower

59:05

frailty frailty scores. I'm drilling down. We're

59:07

going to prevent your osteoporosis. We're going

59:09

to consider hormone therapy and estrogen. We

59:11

know we'll prevent 50% of fractures. So

59:13

she's on HRT. We're going to work

59:15

out heavy, we're going to lift heavy,

59:17

and we're going to eat the protein,

59:20

we're going to get some creatine on

59:22

board, so all of that works, synergistically.

59:24

I call it my nursing home prevention

59:26

program. Because once I put out the

59:28

fire for menopos and she's functional, she's

59:30

functional, she's your mom, she's your mom,

59:32

and she's your mom, and she's your

59:34

mom, and she's your mom, and she's

59:36

your mom, and me, and me, and

59:38

me, and she's your mom, and me,

59:41

and she's your mom, and she's your

59:43

mom, and she's your mom, and she's

59:45

your mom, and she's your mom, and

59:47

me, and she's your mom, and she's

59:49

your mom, and she's your mom, and

59:51

she's your mom, in a nursing home

59:53

with Alzheimer's and a broken hip. She

59:55

just got a rehab. She's not doing

59:57

well. Right. It's going to take a

59:59

long time. And all of these four

1:00:02

horsemen are metabolic disorders. Alzheimer's is not

1:00:04

the natural course of aging brain. There's

1:00:06

14 risk factors. So of course, so

1:00:08

of risk factors. Of course, the easy

1:00:10

stuff. Don't smoke. Eat a balanced diet.

1:00:12

Don't get insulin resistance. All of that.

1:00:14

But then it's social connection. Keep your

1:00:16

brain. Bob in 2015, one of my

1:00:18

brothers, my second birth of a esophageal

1:00:21

cancer, the third one, they lost the

1:00:23

one when he was 18, when I

1:00:25

was nine, she'd lost two kids and

1:00:27

a husband in five years. And she

1:00:29

was like, I'm out. She locked herself

1:00:31

in the house and started drinking, which

1:00:33

I can't blame her. What I've seen

1:00:35

it due to her, relationships with her

1:00:37

kids and this long protracted course she's

1:00:39

going to have until she goes and

1:00:42

all the talking of the children on

1:00:44

how to manage and how to manage

1:00:46

and who's doing what, who's doing what,

1:00:48

who's doing what, I don't, I don't

1:00:50

want that. Exactly. You know, I want

1:00:52

to die like my dad. He was

1:00:54

great until like the last month and

1:00:56

then he kind of slowed down and

1:00:58

then we all gathered around and we

1:01:00

sang songs and told stories and were

1:01:03

there and sang to him and he

1:01:05

slipped into a coma and then it

1:01:07

was over. Yeah, that sounds great. That's

1:01:09

not what happens to women. We have

1:01:11

this nursing home. She's frail and she

1:01:13

breaks and yeah. Yeah. Yeah. That's so

1:01:15

true for my grandparents. The men just...

1:01:17

collapse. Yeah. And the women just struggled

1:01:19

for five years. I got drank a

1:01:22

bunch here and more miserable. My patients

1:01:24

are not interested in option B. Yeah.

1:01:26

Okay. So we have diet and I'm

1:01:28

glad you're slightly protein. Top nutrition tips

1:01:30

for aging and longevity for women and

1:01:32

menopause. Is she limiting added sugars? So

1:01:34

the whole keto movement sugars got demonized.

1:01:36

But turns out that sugars added to

1:01:38

stuff are much worse than found naturally

1:01:40

in fruits and vegetables because the sugar

1:01:43

in a fruit which has fiber. and

1:01:45

vitamins and minerals. This is a doctor

1:01:47

who sells supplements, but I think everyone

1:01:49

should be able to get everything they

1:01:51

need from food. That just doesn't happen.

1:01:53

That would be amazing if it happened.

1:01:55

So I'm here to help you fill

1:01:57

in the gaps. you need it. Fiber,

1:01:59

vitamin D. 80% of my patients are

1:02:01

deficient in vitamin D. We're checking everyone's

1:02:04

levels. We're telling them to supplement. I'm

1:02:06

giving prescription doses if they're super low.

1:02:08

We're trying to give them loading doses.

1:02:10

Magnesium is really great for a lot

1:02:12

of patients. I have a specific college

1:02:14

and product that was studied in metabolic

1:02:16

osteoporosis that seems to have some benefit.

1:02:18

So we're talking about most of my

1:02:20

patients are walking minimum. You have to

1:02:23

meet her where she is. Did she

1:02:25

sedentary? Just walking 30 minutes a day will decrease

1:02:27

her risk of diabetes by 50%. Yeah, wow. That's it.

1:02:29

If she's walking, let's put on a weight of vest.

1:02:31

If she's doing that, let's get in the gym. You

1:02:33

have to meet them where they are. All the fluencers,

1:02:35

they're lifting and all that. That scares, they're lifting and

1:02:37

all that. I'm like, that scares the, that scares, they're

1:02:39

lifting and all that. I'm like, that scares the, that

1:02:41

scares the, they're lifting, they're lifting, and all that, and

1:02:43

they're lifting, and they're lifting, and all that, and all

1:02:45

that, and all that, and all that, and all that,

1:02:47

and all that, and all that, and all that, and

1:02:49

all of, and all of, and all of, and all of,

1:02:51

and all of, and all of, and all of, and all of,

1:02:54

I'm, I'm, I'm, I'm, I'm, I'm, I'm, I'm, I'm

1:02:56

hire someone to come in and show my followers

1:02:58

how to do a squat you say yeah you

1:03:00

don't have to do a lot of different exercises

1:03:02

just the really basic push-pull there's some real

1:03:04

key ones that are super

1:03:06

beneficial particularly for osteoporosis squats

1:03:08

lunges for osteoporosis for osteoporosis good

1:03:10

studies with walking with a weighted

1:03:13

vest doing yoga with a weighted

1:03:15

vest balanced training with a way

1:03:17

to vest is super helpful vibratory

1:03:19

plates again you're stimulating that muskelus

1:03:22

skill a muscular you're be decreasing

1:03:24

your risk of fall with balance

1:03:26

training. And then lifting, they were

1:03:28

putting 80 year old ladies in

1:03:30

the gym from nursing homes and

1:03:33

they were seeing all these gains.

1:03:35

And grip strength is a proxy for

1:03:37

the rest of your body. Right. If

1:03:39

you do deadlifts, fuel inadvertently. Yeah,

1:03:41

so it's not the grip strength.

1:03:44

That's an easy thing to measure.

1:03:46

It's an indicator. Stay tuned for

1:03:48

more armchair expert if you dare.

1:03:51

At 24 I lost my narrative, or

1:03:53

rather it was stolen from me,

1:03:55

and the Monica Lewinsky that my

1:03:57

friends and family knew was usurped.

1:03:59

by false narratives, callous jokes, and

1:04:02

politics, I would define reclaiming as

1:04:04

to take back what was yours,

1:04:06

something you possess is lost or

1:04:08

stolen, and ultimately you triumph in

1:04:11

finding it again. So I think

1:04:13

listeners can expect me to be

1:04:15

chatting with folks both recognizable and

1:04:17

unrecognizable names about the way that

1:04:20

people have navigated roads to triumph.

1:04:22

My hope is that people will

1:04:24

finish an episode of reclaiming and

1:04:26

feel like they filled their tank

1:04:29

up. They connected with the people

1:04:31

that I'm talking to and leave

1:04:33

with maybe some nuggets that help

1:04:35

them feel a little more hopeful.

1:04:38

Follow Reclaiming with Monica Lewinsky on

1:04:40

the Wundery app or wherever you

1:04:42

get your podcasts. You can listen

1:04:44

to reclaiming early and ad-free right

1:04:47

now by joining Wundery Plus in

1:04:49

the Wundery app or on Apple

1:04:51

podcasts. So

1:04:56

that's exercise diet. Now where do

1:04:58

G.L.P.1's fit into this? We do

1:05:00

use them in our clinic and

1:05:03

probably 20% of our patients end

1:05:05

up on them. When they come

1:05:07

to us, it's usually, hi, I'm

1:05:09

in menopause, help me, I'm dying.

1:05:11

Probably 50 to 60% of them

1:05:13

now have a weight problem. I

1:05:15

have either always had it or

1:05:17

they have new weight gain. So

1:05:19

the first thing we do is

1:05:21

breakdown. where their fat is, if

1:05:23

they have it, because some patients

1:05:26

come in, they're just muscular and

1:05:28

they've been told they're obese their

1:05:30

whole life and they're crying their

1:05:32

eyes out because, oh my god,

1:05:34

I'm healthy, what? If they have

1:05:36

a visceral fat problem, I really

1:05:38

don't care about subcutaneous fat, it's

1:05:40

not. metabolically that active. It's just

1:05:42

storage. It's the intra-abdominal fat that

1:05:44

will kill you. And so we

1:05:47

are working on that number. And

1:05:49

what do we know works for

1:05:51

that? Starvation, but that's not why

1:05:53

they're there. High-fiber diets, low-added sugar,

1:05:55

diets, virgin probiotics, or probiotic supplement,

1:05:57

zone 2 training, all of that

1:05:59

works. So we're focusing on that

1:06:01

and we get her in HRT.

1:06:03

Across the menoposs transition, a woman

1:06:05

will go from 8% of her

1:06:08

total body fat being visceral to

1:06:10

23, on average. Just from becoming

1:06:12

menopausal. No changes in diet nexus.

1:06:14

I have the unusual circumstance of

1:06:16

most of these people following. and

1:06:18

me have read the book, it's

1:06:20

an investment to come and see

1:06:22

me because I'm outside of the

1:06:24

insurance model. So they've done their

1:06:26

homework. They're dedicated. Yeah. So they're

1:06:28

like, okay, let's do this. We

1:06:31

start HRT, we bring them back

1:06:33

in three months. If for cardiomatabolic

1:06:35

risk factors are still there. And

1:06:37

she's like, I want to give

1:06:39

it a try. I'm like, let's

1:06:41

go for it. So there's Timaglutide

1:06:43

which had just the G.L.P.1 and

1:06:45

then terzepotide which is what we

1:06:47

usually start with now, which has

1:06:49

the G.L.P.1 and the glucagon agonist

1:06:52

and then this new one has,

1:06:54

I forget what the third ingredient

1:06:56

is, but I'm excited to see

1:06:58

when it comes out. Yeah, it's

1:07:00

supposed to reduce the loss of

1:07:02

muscle mass. And they are able

1:07:04

to maintain and then it's like

1:07:06

that first three months, if they

1:07:08

lose 20. 20 pounds maybe five

1:07:10

is muscle maybe 20% but then

1:07:12

that just levels out and it's

1:07:15

all fat loss after that is

1:07:17

absolutely the coolest thing to watch

1:07:19

because we bring them back every

1:07:21

six weeks to check their muscle

1:07:23

mass we stay on top of

1:07:25

it we're checking in with them

1:07:27

they're doing this not to look

1:07:29

great in a bikini I mean

1:07:31

maybe that'll happen and that'll be

1:07:33

great but they're doing this to

1:07:36

decrease their risk of all these

1:07:38

diseases they don't want to die

1:07:40

from. Or play their children with.

1:07:42

Protect the last 15 years of

1:07:44

their life or 10 years of

1:07:46

their life. And be happy during

1:07:48

those. They're so motivated to avoid

1:07:50

the diseases that plagued their elders.

1:07:52

As you might expect, my wife

1:07:54

knowing that I was interviewing you

1:07:56

had some specific questions. Are there

1:07:59

any ways to predict when onset

1:08:01

will be? Kristen Hurd, your mother's

1:08:03

sister can be a guide. There

1:08:05

is a genetic component. So there's

1:08:07

an ethnic genetic component. So I

1:08:09

was telling Monica, for me it's

1:08:11

51, is average. For her it's

1:08:13

46.7. African Americans is about 18

1:08:15

months behind Caucasian. Asians get a

1:08:17

little bit longer. Okay. Does sexual

1:08:20

activity impact that? Trauma does. So

1:08:22

we know lots of things that

1:08:24

speed it up. You were born.

1:08:26

with X amount of eggs and

1:08:28

they're going to go before you

1:08:30

die if you live a normal

1:08:32

life span. But what do we

1:08:34

know speeds up the process of

1:08:36

egg loss? Smoking, chemotherapy, radiation, abdominal

1:08:38

surgery, you have a hysterectomy, leave

1:08:40

the ovaries behind but we've cut

1:08:43

a significant bloods behind but we've

1:08:45

cut a significant blood splotid of

1:08:47

ovary, but we've cut a significant

1:08:49

blood splotid of ovary, but we've

1:08:51

cut a significant blood splothed, but

1:08:53

we've cut a significant bloods, had

1:08:55

one when she was 30. My

1:08:57

mom had one after baby number

1:08:59

eight. They were like this is

1:09:01

your Catholic birth control. Time for

1:09:04

that uterus to come out. So

1:09:06

does it instigate menopause? It cuts

1:09:08

the blood flow so you lose

1:09:10

the shelf life of the ovary

1:09:12

where you may have gone through

1:09:14

a 51 now you back that

1:09:16

up four years on average okay

1:09:18

but it's not like you have

1:09:20

the hysterectomy and then no unless

1:09:22

they remove the ovary right exactly

1:09:24

which they didn't but yeah premature

1:09:27

menopause and early menopause so those

1:09:29

are a little bit different animals

1:09:31

premature ovarian insufficiency is usually with

1:09:33

an autoimmune condition so it has

1:09:35

its own set of risks and

1:09:37

then surgical menopause you don't get

1:09:39

a trial period it's like boom

1:09:41

So whenever I had to take

1:09:43

out ovaries for medical reasons, I

1:09:45

was putting a patch on them

1:09:48

in the OR. Yeah, that makes

1:09:50

sense. Okay, so ethnic is a

1:09:52

predictor, ethnicity. And then family history.

1:09:54

If you look at the women

1:09:56

in your family, when did they

1:09:58

go through? But on your mom's

1:10:00

side, is she? But on your

1:10:02

mom's side, is she right? But

1:10:04

on your mom's side, is she

1:10:06

right about? But on your mom's

1:10:09

side, is she right about? going

1:10:11

to go? Certain tribes in Africa

1:10:13

have a lot of twins or

1:10:15

certain cultures are more prone to

1:10:17

twins. That's more of a general

1:10:19

than a chromosome. There's a couple

1:10:21

things happening. A. It was completely

1:10:23

understudied as you pointed out. It's

1:10:25

beginning to get studied, but also

1:10:27

we're seeing an art. What do

1:10:29

you think about the impact of

1:10:32

all fours? I just flipped the

1:10:34

switch for me. I read for

1:10:36

entertainment. I read about fairies and

1:10:38

dragons and lots of sex. My

1:10:40

daughter reads all the dystopian novels,

1:10:42

so I read to read with

1:10:44

her and talk about stuff. And

1:10:46

then I read medical journal articles.

1:10:48

So to pick up a book

1:10:50

that is outside of my usual

1:10:53

and not have a 15-year-old little

1:10:55

girl who turns into a princess

1:10:57

with magical powers was like hard.

1:10:59

I'm trying to identify this. She

1:11:01

just stopped trying to identify, read

1:11:03

it, and figure out why the

1:11:05

hell the world is resonating. And

1:11:07

then I'm like, oh! So then

1:11:09

the doctor in me is like,

1:11:11

she's having palpitations. That's a panic

1:11:13

attack. That's menopause. That's menopause. That's

1:11:16

menopause. Now, have an affair and

1:11:18

redo this room in this weird

1:11:20

hotel. That's a whole another thing.

1:11:22

But I'm getting it now. It

1:11:24

is so hard resonating. Movie rights.

1:11:26

Oh yeah. All my friends read

1:11:28

it. Did you love it? I

1:11:30

loved it. I haven't read it.

1:11:32

I've been told what it's about

1:11:34

from Monicaica. it, and now I

1:11:37

want to decide. That's so perfectly

1:11:39

parallel to, hey, guess what, I

1:11:41

don't want to live a third

1:11:43

of my life in discomfort. So

1:11:45

what I'm finding, and I think

1:11:47

why the divorce rate is so

1:11:49

high, is that women and myself

1:11:51

included, and thank God my relationship

1:11:53

is better than it's ever been,

1:11:55

and we're working together, we have

1:11:57

a small business through the supplement

1:12:00

company and he's now running it,

1:12:02

but women are... circling the wagons

1:12:04

around themselves. Menopause is fucking them

1:12:06

so hard. They are giving themselves

1:12:08

permission to put themselves first. Yes,

1:12:10

exactly. To me it's I've had

1:12:12

enough on all the levels. And

1:12:14

now it's a survival thing. If

1:12:16

I don't do this, for me

1:12:18

my journey was... quit a job

1:12:21

that didn't serve me, stop serving

1:12:23

a system that was broken, absolutely

1:12:25

get the hell out of Dodge,

1:12:27

figure out what the fuck I

1:12:29

wanted to do with my life,

1:12:31

put my own oxygen mask on

1:12:33

first. It's time for you. And

1:12:35

I really didn't give a shit

1:12:37

if the kids or my husband

1:12:39

cared. But I had to do

1:12:41

this, thank God it all worked

1:12:44

out. And look where I am

1:12:46

now. But that's what it is.

1:12:48

It's I'm making choices. I get

1:12:50

to make the choices and my

1:12:52

body is disintegrating. That's the part

1:12:54

that I think everyone was like,

1:12:56

oh my God, we have to

1:12:58

wait till then and it's coinciding

1:13:00

with that. What do we do?

1:13:02

How do we prevent ourselves from

1:13:05

getting to the too late? Exactly.

1:13:07

Too late to celebrate. Well, educate

1:13:09

yourself as soon as possible. Yeah.

1:13:11

That's part of my mission is

1:13:13

just vomiting all over social media.

1:13:15

I think a lot of people

1:13:17

think of HRT as being what

1:13:19

you do after you of all

1:13:21

the symptoms. Right. some of the

1:13:23

hardcore old school menopause people are

1:13:25

like don't say prevent they come

1:13:28

after me every time I talk

1:13:30

look FDA approved for the prevention

1:13:32

of osteoporosis and that is enough

1:13:34

for me but let me tell

1:13:36

you the US Preventative Services Tax

1:13:38

Force needs to get their shit

1:13:40

together because you have a window

1:13:42

of opportunity for cardiovascular disease prevention

1:13:44

and the data coming out clearly

1:13:46

for mental health. We can prevent

1:13:49

the suicides, the job loss, the

1:13:51

brain fog, unless you're on the

1:13:53

dementia spectrum, with early and judicious

1:13:55

hormone therapy, not allowing your body

1:13:57

to withdraw and go through that

1:13:59

chaos. Why wait till you have

1:14:01

all the symptoms? Why wait till

1:14:03

your vagina is broken? But there's

1:14:05

no other condition that we don't

1:14:07

think early detection and treatment is

1:14:10

beneficial. It's never been thought of

1:14:12

like that. It's way to your

1:14:14

miserable. And then it was severe

1:14:16

symptoms only. A doctor is going

1:14:18

to tell me if my symptoms

1:14:20

are severe enough. Is that even

1:14:22

mean? What does that even mean?

1:14:24

Yeah. Why? It's like some old

1:14:26

vestigil protestant suffering. Some things. Women

1:14:28

have been taught to minimalize. Did

1:14:30

you read the WW story? Oh

1:14:33

yeah. The whiny woman. The whiny

1:14:35

woman. This is just what women

1:14:37

go through. They tend to win

1:14:39

a lot. Early in her residency,

1:14:41

they'd come during say we got

1:14:43

a WW in room 305. The

1:14:45

woman with a laundry list of

1:14:47

complaints. Very vague, brain fog, low

1:14:49

libido. And they're like, check her

1:14:51

thyroid, get these tests, make sure

1:14:54

you're not missing anything, but you're

1:14:56

not going to be able to

1:14:58

help her. It's just a whiny

1:15:00

woman. It's just one of those

1:15:02

whiny women. So I talked to

1:15:04

other doctors across the country. And

1:15:06

in California, they called it whiny

1:15:08

guineas. Oh, nice. And on the

1:15:10

East Coast, around New York, it

1:15:12

was. T.B.D. Total Body Delore and

1:15:14

in Miami it was Madame Delores.

1:15:17

Oh my God. What is that?

1:15:19

Pain. Like she's got a lot

1:15:21

of pain. Women who come in

1:15:23

and complain a lot, kind of

1:15:25

vague, libido, go have some wine.

1:15:27

You'll be okay. Yeah, yeah, yeah.

1:15:29

Oh my God. This is wild.

1:15:31

I don't want to scare people,

1:15:33

but when it's good to know,

1:15:35

we don't know anything. Anything. And

1:15:38

your doctor, not their fault, may

1:15:40

not know. anything. None of us

1:15:42

know, even the smart people who

1:15:44

are educated. I do these girls

1:15:46

dinners and we just had one

1:15:48

recently and we were talking about

1:15:50

something random. We were like... Why

1:15:52

don't we know the answers to

1:15:54

any of these questions that keep

1:15:56

popping up about our own bodies?

1:15:58

Yeah, because it was never studied.

1:16:01

Women in medicine have been treated

1:16:03

as small men, so excluded from

1:16:05

studies till 94 because of thalidomide

1:16:07

and what happened. If there's a

1:16:09

chance in hell she might be

1:16:11

pregnant, we need to exclude her

1:16:13

and oh, we probably shouldn't study

1:16:15

them anyway because hormones are hard.

1:16:17

Yeah. They didn't even study female

1:16:19

rats in the love. Oh really?

1:16:22

Because they have Estr. They too.

1:16:24

So they too will fuck up

1:16:26

your shot. It'll be confusing. The

1:16:28

cardiovascular data is awful for women.

1:16:30

You go into the ER with

1:16:32

a heart attack if you're a

1:16:34

woman, you have a 50% higher

1:16:36

chance of dying than if you're

1:16:38

a man. Because we have atypical

1:16:40

chest pain. So men have the

1:16:42

classic clutching their chest, going up

1:16:45

their neck, sliding down their arm,

1:16:47

you're an actor, and they're like,

1:16:49

you're having a heart attack. I

1:16:51

know exactly what you're going to

1:16:53

do. A woman has fatigue. Abdominal

1:16:55

pain. It's very vague. Because men

1:16:57

have the LAD, the widow maker,

1:16:59

the very large vessels that immediately

1:17:01

come out of the A order

1:17:03

to dive into the heart muscle,

1:17:06

to feed that heart, that's where

1:17:08

the plaques happen. Women, it's way

1:17:10

down below that. It's the diffuse

1:17:12

microvascular disease. You're always shoving it

1:17:14

down. Oh, another way to speed

1:17:16

up your menopause is trauma. So

1:17:18

there was a study that looked

1:17:20

at women who were sexually abused,

1:17:22

who then had kids who went

1:17:24

on to be sexually abused, and

1:17:26

they went through menopause nine years

1:17:29

sooner. Wow. My mom must have

1:17:31

hit menopause at like 35, because

1:17:33

she had a hysterectomy. She got

1:17:35

the trauma. The kids with trauma.

1:17:37

Her libido is okay. That somehow

1:17:39

is, well, I think it's trauma

1:17:41

related, but yeah. That's true. There's

1:17:43

a million factors. Your book's a

1:17:45

bestseller, the new menopause. You have

1:17:47

the Mary Claire wellness clinic. It's

1:17:50

my little baby clinic in Galveston.

1:17:52

You have. Many millions of followers

1:17:54

that are interested in this subject.

1:17:56

You were the person people wanted

1:17:58

to come on the most. Yeah,

1:18:00

we turned it over to Americans.

1:18:02

Who's your favorite menopausal expert? And

1:18:04

you were voted on. You were

1:18:06

elected. And we were like, who

1:18:08

do you want to come on

1:18:11

experts? And your name came up

1:18:13

over and over and over. It's

1:18:15

a different audience. But is it?

1:18:17

It's all women. Yeah. Two daughters,

1:18:19

21 and 24. Okay, cool. Are

1:18:21

they on? Oh, that's a question.

1:18:23

How early can someone get on

1:18:25

these things? Well, it's a little

1:18:27

early for them. So, Catherine's in

1:18:29

med school. She's tough, man. She

1:18:31

has guaranteed me she's not doing

1:18:34

OBGYN. But talk about having someone

1:18:36

hold a mirror up to you

1:18:38

and keep you in line and

1:18:40

double check your facts behind your

1:18:42

back. Yeah. So I'm like sitting

1:18:44

out studies and she is literally.

1:18:46

to make sure I am toe

1:18:48

in the line. She's talked about

1:18:50

it. She's a little freaked out

1:18:52

and wants to freeze her eggs

1:18:55

now for the highest quality. I

1:18:57

think that's the move. I kind

1:18:59

of do too. So I did

1:19:01

a talk, I was at Reese's

1:19:03

event, Hell of Sunshine. I was

1:19:05

the MC for the first time,

1:19:07

that was fun. Of a panel,

1:19:09

and one of the panelists started

1:19:11

this where you go and you

1:19:13

donate your eggs, but you get

1:19:15

to keep a few for herself.

1:19:18

I didn't even know about this.

1:19:20

I didn't even know about this.

1:19:22

I didn't. even know about egg

1:19:24

freezing really like you kind of

1:19:26

hear about it and then my

1:19:28

best friend works at Netflix they

1:19:30

pay for that and so she

1:19:32

was like oh I'm getting this

1:19:34

done that's a covered benefit that's

1:19:36

amazing I'm smart for them too

1:19:39

yeah someone in the prime of

1:19:41

their career who doesn't want to

1:19:43

necessarily take the time at that

1:19:45

moment it's so smart but I

1:19:47

was like why are you doing

1:19:49

that she was like well they're

1:19:51

paying for it and you might

1:19:53

as well and I was like

1:19:55

interesting so then that's when I

1:19:57

started thinking about thinking about thinking

1:19:59

about thinking about it age person

1:20:02

did not think about it at

1:20:04

all. Did you just do it?

1:20:06

I did it at 35 and

1:20:08

then 30s. Six. It's ubiquitous and

1:20:10

common knowledge to go like at

1:20:12

35 you're officially in a geriatric.

1:20:14

They act like you fall off

1:20:16

the cliff and all that, but

1:20:18

it is a steady state. But

1:20:20

I did better the second time

1:20:23

weirdly. Amazing. But I wish I

1:20:25

had known so much earlier and

1:20:27

just done it and felt insurance.

1:20:29

My 21 year old is not

1:20:31

on the radar. She's just trying

1:20:33

not to be pregnant. I'm like

1:20:35

go to the party. How fun!

1:20:37

Come on, I'm like so worried

1:20:39

about her social life. My second

1:20:41

one has rolled with 20 kids

1:20:43

her whole life. She gets there

1:20:46

within October, she's like, I'm out

1:20:48

of money. Like she went with

1:20:50

her summer money and her graduation

1:20:52

money. I'm like, what? I check

1:20:54

her account. I'm like, I check

1:20:56

her account. I'm like, I check

1:20:58

her account. I'm like, bars, clothes.

1:21:00

That's about right. That is so

1:21:02

cute. These Baton Rouge moms. You

1:21:04

know, that will definitely not get

1:21:07

her to freezer eggs nanny. I

1:21:09

will say that. She's not at

1:21:11

all worried. Yeah. To any young

1:21:13

people, I just really encourage it.

1:21:15

I think a lot of people

1:21:17

get a ton on your book.

1:21:19

It's wonderful. The new menopause book.

1:21:21

And please follow you. What's your

1:21:23

handle on Instagram? Dr. Mary Claire.

1:21:25

DR. M-A-R-R-Y, C-C-A-A-A-A-R-R-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I-I snow makeup. She's

1:21:27

in her weight test all the

1:21:30

time. And I'm like, no one's

1:21:32

gonna recognize. Yeah. Oh my God,

1:21:34

that's so great. And you're doing

1:21:36

all these fun things. You mentioned

1:21:38

Reese. I know you're doing something

1:21:40

tomorrow that's very cool. Love it.

1:21:42

Or grateful for you. Yeah. The

1:21:44

women I know are so grateful

1:21:46

for you. Big time. Yeah. So

1:21:48

everybody, read the book, follow you

1:21:51

on Instagram. This was awesome. Thank

1:21:53

you. Thank you so much. Stay

1:21:55

tuned for the fact check. It's

1:21:57

rather party, Zach. Hi. Hello. Cute

1:21:59

jacket. Thank you. Instagram Impulse by.

1:22:01

Really? Got one in this color

1:22:03

and one in blue. From where?

1:22:05

Marine Layer? We like Marine Layer.

1:22:07

Right? Yeah. That's a place. Mm-hmm.

1:22:09

That's a thing. We are sweats

1:22:11

were from marine layer for a

1:22:14

little while. Yeah, I like this

1:22:16

quilted thing. Yeah, quilted is nice.

1:22:18

That's what we call. Well, what

1:22:20

one's quilted for comfort? The toilet

1:22:22

tissue. Oh, Charmin? Charmin? The quilted

1:22:24

quicker. Well, that's a paper towel.

1:22:26

The quicker picker. This is Mandella

1:22:28

effect. Do you think there's a

1:22:30

product called Charmons quilted the quicker

1:22:32

picker upper? People would say yes,

1:22:35

definitely. Because it's bounty. Bounty, the

1:22:37

quicker picker upper. But the bounty

1:22:39

doesn't have the same alliteration as

1:22:41

shaman and quicker. Charmin quicker picker.

1:22:43

How's your morning? My morning was

1:22:45

good. Every two weeks I get

1:22:47

a flower delivery on Friday from

1:22:49

Flamingo Estate. Okay. And it's really

1:22:51

exciting. It is. You've signed up

1:22:53

for a bi-weekly annual sitch. Yeah.

1:22:56

Do they spice it up? Is

1:22:58

it a different bouquet every time?

1:23:00

Yes, so you don't know what

1:23:02

you're going to get. So you

1:23:04

have anticipation, what will it look

1:23:06

like? Yes. And it's always from

1:23:08

a cool, like, farm. They find

1:23:10

a guy who just has one

1:23:12

flower bed in his backyard. Very

1:23:14

limited dish. Very, extra, extra small

1:23:16

micro business. Today it was renunculas

1:23:19

and their orange. Oh, that's the

1:23:21

name of something. Flower. and they're

1:23:23

orange and they're so pretty. I

1:23:25

did lose a little track of

1:23:27

time because I was cutting the

1:23:29

ends and I was, you know,

1:23:31

cleaning up the stems. Yeah. And,

1:23:33

uh... East right, we just learned

1:23:35

a fascinating fact from somebody. It's

1:23:37

a rule in sketch comedy. Uh-huh.

1:23:40

It's not our rule. Yeah. But

1:23:42

if a man comes in to

1:23:44

pick a woman up on a

1:23:46

date and a sketch, yes. Have

1:23:48

him bring chocolates, not flowers. If

1:23:50

you bring flowers, the audience starts

1:23:52

getting very distracted. Well, they got

1:23:54

to put him in a vase.

1:23:56

Oh my gosh, she's got to

1:23:58

get those in a vase, got

1:24:00

to give him in a water,

1:24:03

and you can't even pay attention.

1:24:05

Yeah. Unfortunately, I did try to

1:24:07

gift this exact thing today. Oh,

1:24:09

to just today. Today's Callie's birthday.

1:24:11

Oh, happy birthday, Callie. Happy birthday,

1:24:13

Callie. And I was gonna get

1:24:15

her this weekly bloom bundle. Right.

1:24:17

The gift that keeps on giving.

1:24:19

Yeah, but it's sold out. Oh,

1:24:21

sorry. So I can't. That's the

1:24:24

problem when you go with these

1:24:26

micro growers that only have one

1:24:28

flower bed in their backyard. Yeah,

1:24:30

it's really great idea, but then

1:24:32

in practice. Part of the fun.

1:24:34

It's part of the limited dish

1:24:36

element. Okay, so I don't want

1:24:38

to say this, and I just

1:24:40

really can't control myself to not

1:24:42

say it. Okay. Because I got

1:24:44

to get out of the habit

1:24:47

of addressing... Commenters. Yeah, I would

1:24:49

prefer not. I know. I know.

1:24:51

I don't look at them. Yeah.

1:24:53

Yeah. But I just want to

1:24:55

make this simple point because. People,

1:24:57

you know, they'll, Jonathan, he'll be

1:24:59

on. So people will be like,

1:25:01

you know, he's so anti-technology and

1:25:03

he doesn't know and it brought

1:25:05

people together. But great, great, great,

1:25:08

great. But I was just thinking,

1:25:10

you know, what I like about

1:25:12

our show is we have Reed

1:25:14

Hoffman on. He's a techno optimist.

1:25:16

Yeah. You get to hear the

1:25:18

full sales pitch for Why Technology's

1:25:20

great. And then we have Jonathan

1:25:22

height on it and you get

1:25:24

to hear the full sales pitch

1:25:26

on why it's bad. And instead

1:25:28

of being like angry at these

1:25:31

guests who have a different point

1:25:33

of view, I would really wish

1:25:35

people would be grateful that they

1:25:37

got to hear the counterpoint to

1:25:39

what they believe. I mean that's

1:25:41

that's what I so enjoy about

1:25:43

the show. And guess what? I

1:25:45

don't know which one I think.

1:25:47

Yeah. It's like I half believe

1:25:49

what Reed's saying and I have

1:25:52

believe what Jonathan's saying. I don't

1:25:54

agree with Jonathan. So grateful to

1:25:56

hear a very smart person. We

1:25:58

got to hear the opposite point

1:26:00

of view that I have. And

1:26:02

I just wish people could click

1:26:04

into like, yeah, that's a gift

1:26:06

to hear someone with a different

1:26:08

point of view. Tell you what

1:26:10

the opposite side thinks. It's not

1:26:12

shut that person down and get

1:26:15

them out of here and I

1:26:17

don't like what they're saying. Yeah,

1:26:19

I agree. I was burning the

1:26:21

hole in my. Go ahead. You

1:26:23

know what I'm gonna say. Yeah,

1:26:25

I wanna hear it. It might

1:26:27

sound disrespectful to the audience, what

1:26:29

I'm about to say. Yeah. And

1:26:31

I don't mean that. I love

1:26:33

our audience so much. I love

1:26:36

the arm cherries. I'm so grateful

1:26:38

that people listen to us, but

1:26:40

I don't care. Right. That's healthy.

1:26:42

If they don't like... an episode.

1:26:44

I also personally, I don't believe

1:26:46

it. I don't believe that what

1:26:48

you're reading is indicative of what

1:26:50

people think and that it bums

1:26:52

me that you get you get

1:26:54

like yeah in snare well some

1:26:57

woman told me I need to

1:26:59

apologize for saying young men are

1:27:01

disenfranchised and I said apologize to

1:27:03

who but who am I apologize

1:27:05

I know but this is the

1:27:07

I know I know it's really

1:27:09

tricky now I'd say the good

1:27:11

news is like, I'm not going

1:27:13

to change at all what I'm

1:27:15

doing. So it's not like I'm

1:27:17

subject to altering how I'm going

1:27:20

to invite Jonathan on and invite

1:27:22

read Hoffman on. This is going

1:27:24

to have no impact on how

1:27:26

I do the show. I think

1:27:28

I have a, I do have

1:27:30

maybe an arrogant delusional belief I

1:27:32

could explain the value of hearing

1:27:34

this and people might lock into

1:27:36

it and go like, oh, you

1:27:38

know what? You know, I just

1:27:41

stop blasting everyone I disagree with.

1:27:43

It's okay to disagree with people.

1:27:45

You don't have to hate them.

1:27:47

Jonathan's a great guy. I totally

1:27:49

disagree with a lot of what

1:27:51

you say. You know? So I

1:27:53

have this stupid belief I can

1:27:55

encourage people to embrace this. And

1:27:57

that's my own delusion. It's a

1:27:59

delusion, but you're only seeing like

1:28:01

one piece of the whole puzzle.

1:28:04

You're so right. You don't know

1:28:06

who you're even talking to. No,

1:28:08

you're absolutely right. And I do

1:28:10

think about that. So like naturally,

1:28:12

you're a nice debate about men

1:28:14

and women. Obviously. Yeah, it was

1:28:16

very polarizing. I expected that. And

1:28:18

that's totally fine. It's like 50

1:28:20

people. You know, on either side,

1:28:22

out of millions of people, it

1:28:25

could literally be one person. This

1:28:27

is what I'm saying. Oh, that's

1:28:29

got 30. Yes, this is my

1:28:31

point. Like to get wrapped up

1:28:33

in it, your strongest trigger is

1:28:35

getting taken advantage of. But when

1:28:37

you react like this, I think

1:28:39

you. you've been taken advantage of.

1:28:41

Because I got wound up about

1:28:43

it. And you don't even know.

1:28:45

But what's perfect about it is

1:28:48

it is a facet. of this

1:28:50

thing I obsess about without the

1:28:52

comments. Yeah. Right? So I, your

1:28:54

big concern is women's reproductive rights,

1:28:56

which makes total sense. It's a

1:28:58

concern. Yeah, but it's like a

1:29:00

very paramount concern and rightly so.

1:29:02

Yeah. And you'll think about that

1:29:04

a lot, you know? If it

1:29:06

feels threatened. I don't know right.

1:29:09

Okay. But if it's, if it's

1:29:11

threatened, yes, of course. And I'm

1:29:13

regularly so scared about the inability

1:29:15

to listen to one another. Yeah.

1:29:17

I'd like think about it too

1:29:19

much. And it really frustrates me

1:29:21

and it scares me. I'm scared

1:29:23

of the future where there's two

1:29:25

camps on the planet and they

1:29:27

don't talk to each other. Can

1:29:29

we deep dive? Yeah. Why is

1:29:32

that so scary to you? Like,

1:29:34

of course it sounds, it's bad,

1:29:36

right? Like, I think it's bad

1:29:38

too. I'm like, this is a

1:29:40

huge problem, but I don't have

1:29:42

this reaction that you haven't. And

1:29:44

I wonder. I mean obviously we

1:29:46

know that if anything's like causing

1:29:48

that much of a reaction it's

1:29:50

something else it's something about us

1:29:53

or our past or our like

1:29:55

the fear is about us yeah

1:29:57

I guess probably dysfunction I grew

1:29:59

up in dysfunction I grew up

1:30:01

in two parents that hated each

1:30:03

other till they got divorced like

1:30:05

dysfunction yeah not rising to one's

1:30:07

best self to navigate these things

1:30:09

we have gotten embarrassingly dysfunctional yeah

1:30:11

And I see the total root

1:30:13

of the dysfunction is us against

1:30:16

them. Yeah. And I see that

1:30:18

as such a toxic quality. And

1:30:20

I have children that are entering

1:30:22

a world and I care about

1:30:24

the world for them. So yeah,

1:30:26

it really bothers me really deeply

1:30:28

because my My childhood was plagued

1:30:30

by dysfunction and two people not

1:30:32

communicating and its winter takes all.

1:30:34

And I hate that situation. It

1:30:37

wasn't compromised. It wasn't working together

1:30:39

too. It was, you know, as

1:30:41

I always say, the paradigm everyone

1:30:43

needs to wrap their head around

1:30:45

is, we're married. But left and

1:30:47

the right are married. We all

1:30:49