#80 Pause Perimenopause

Read the full episode transcript

 Hey, this is Melissa Parsons, and you are listening to the Your Favorite You Podcast. I'm a certified life coach with an advanced certification in deep dive coaching. The purpose of this podcast is to help brilliant women like you with beautiful brains create the life you've been dreaming of with intentions. My goal is to help you find your favorite version of you by teaching you how to treat yourself as your own best friend.

If this sounds incredible to you and you want practical tips on changing up how you treat yourself, then you're in the right place. Just so you know, I'm a huge fan of using all of the words available to me in the English language, so please proceed with caution if young ears are around.

Well hi there, welcome back to Your Favorite You!

I am still your host, Melissa Parsons. Today I am bringing you a topic that I am fired up about.

I am friends with a lot of amazing physicians, and you may or may not know this, but there is a growing cohort of physician coaches in the world! These people are my favorite people because we have chosen to go into a healing profession not once, but twice! We became physicians because we wanted to help people heal, and we became coaches because we realized that traditional Western medicine doesn’t have all the tools in the toolbox for healing, so we took it upon ourselves to add to our ability to help humans heal in different ways! … so in my opinion these are very special people, I want you to know all about them. And yes, I am completely biased!

Anyhow, one of these physician coaches that I love and admire is named Kelly Casperson. Dr. Casperson is a rare breed - she is a female urologist who has taken it upon herself to educate herself to help women with their sexual health and with their hormones. Kelly has agreed to be on the podcast, but this badass is so busy that we have to wait until summer to hear from her… This is going to work out perfectly - going along with my thought that the schedule always works out, because she is going to get to talk to a very different Melissa Parsons in a few short months. You may be thinking, what??? A different Melissa Parsons? I will share with you what I mean later in the podcast. Though if you have been following me on IG, my recent reel on this went somewhat viral, with several thousand views, so you may already know what I am talking about.

Back to Kelly! Kelly has a very active profile on Instagram - she just surpassed 100k followers, which is amazing because she’s reaching so many amazing women…, she has an incredible Ted Talk, which we will link in the show notes, and she has written a book for women called “You are Not Broken”... she has a podcast of the same name, you can find it wherever you listen to this podcast. Kelly does not dabble… she goes all in when she is passionate about something. I love her and I know if you start to follow her or you read her book or listen to her podcast or you watch her Ted Talk, you will love her too!

I have been following Kelly and have been her friend for a few years now. She has been talking about perimenopause and hormone replacement therapy all this time, and I have just started really paying attention because my periods have been wonky, and I have been achy in my joints, I have noticed irritability (a few others may have noticed, too - lol), I have noticed fogginess in my thinking, and I just haven’t been feeling myself… so, time to pay attention.

I have also been following Dr. Mary Claire Haver, and Dr. Corinne Menn, who are actually two ob/gyn physicians, after hearing Kelly talk to them, talk about them, and refer to them. They are all saying very similar things, they’re talking to each other, they always have lives speaking to each other when new things come out, and I’ve been paying attention, and I am frankly pissed off.

So, why am I mad?

Back in 2002, there was a landmark study called the Women's Health Initiative. The results were released in 2002, and this study had a huge impact on medical practice and public health for women specifically.

The results of this study were misinterpreted at the time and this led us to believe that hormone therapy for women with estrogen was causing breast cancer rates to rise in women if they were on estrogen. This effectively and profoundly scared physicians away from offering women in perimenopause and menopause the hormones that we so badly need to replace in order to feel human.

Prior to this study, whose results have now been disproven, estrogen was actually the third most prescribed medication for women in the United States! After the study results were released, less than 10% (actually more like only 5-6% of women) were offered hormone therapy and were taking it. Thankfully, this number is on the rise again with education - mostly by female ob's and urologists on Instagram and TikTok, believe it or not!

The results of this study were so misinterpreted, in fact, that scientists now purport that taking estrogen in perimenopause and throughout the rest of our lives is actually preventing breast cancer - AND colon cancer, and osteoporosis and the resultant deadly hip fractures that we see in grandmas all over the world… taking hormone therapy is also linked to a decrease in dementia AND Alzheimers… Women taking estrogen also have a 60% reduction in risk of developing heart disease! How is that possible? If this was about men and there was a drug that was touted to decrease the risk of developing heart disease by 60%, every man would be on it! There is even evidence that it may be safe to take even if you have a history of certain types of breast cancer… I want to add a caveat that you need to discuss all of this with your doctor, someone who knows your past medical history and your family history - before making any decisions about whether or not to utilize hormone therapy! That is my disclaimer! And remember, that although I am a doctor, I am not YOUR doctor while you are listening to this podcast!

All of this to say that I have been down the hormone therapy rabbit hole. In defense of my ob/gyn, whom I love - she delivered both of my babies and continues to be my gyn… I have not brought this up with her, because when I saw her 6 months ago, I was not having these issues. My doctor is part of the North American Menopause Society - called NAMS for short. If your doctor is part of NAMS, this means that they are up to date on these newest study findings, and are likely very amenable to prescribing hormone therapy for you.

If you want to know if your doctor is part of NAMS, all you have to do is go to menopause.org and there is a place where you can look in the “For Women” section: “Find a Menopause Practitioner.” You put your doctor's name in, and if your doctor is a part of NAMS, his or her name will come up there.

If you go to your doctor with symptoms of perimenopause – The most common symptoms women in their 40s notice are changes in periods and the onset of hot flashes. Menopause is defined as 12 months without a menstrual period, in the absence of other conditions. Other symptoms you may notice besides the hot flashes and wonky periods are mood swings, disturbed sleep, and vaginal dryness… if you go to your doctor with these symptoms and he or she tells you it is ‘natural’ and just a sign of aging, and that maybe you’re depressed and tries to put you on an antidepressant, please find a new doctor, one that participates in NAMS.

Typically, there is no need to have blood work done in perimenopause, as your hormone levels will likely be all over the place throughout your cycle, and ‘normal’ levels of hormones don’t mean you are not in perimenopause. The only time your estrogen really tanks and goes low is after you are already in menopause, and you don’t have to suffer through the years of perimenopause, waiting for your estrogen to be down at a low level enough for your doctor for your doctor to feel comfortable.

I was listening to Kelly’s podcast, You Are Not Broken, where she was discussing Midlife Transformation: The Power of Education, Empowerment, and Hormone Therapy and she was talking about a company that she endorses, called My Alloy. This company was borne out of the need for women to be able to be under the care of a physician trained in the use of hormone therapy. Now that we women are getting wise and educated about the benefits of hormone therapy - remembering, again, that there are some risks that you will want to discuss with your doctor, and very few, but real contraindications… it is very hard to get in to a doctor who has the knowledge and the comfort level to prescribe these medicines. Remember, they have all been scared since 2002 with the Women Health Initiative. So My Alloy, and other companies like it, who I will not discuss here, as I do not have personal experience with these companies, but My Alloy offers an online consultation with a physician expert. It is so simple to use. You go to their website, you put in your past medical history. You enter the medications you are taking. You let them know when your last mammogram was and you give them all the pertinent medical history, pertinent surgical history, pertinent family history, and it goes to physician review.

At that stage, a physician reviews all of this information, along with the symptoms you are having and the concerns that you have, and recommends a treatment protocol. To use myself as an example, I put my info in on a Wednesday, and had my recommended protocol by Thursday evening. This may be TMI, but I will be using topical estrogen (in the form of a mist that I will spray on my forearms once a day in the morning), a daily progesterone pill that I take at bedtime, and I also requested the estrogen face cream to help with increasing collagen production in my face and increasing elasticity. I am also going to be taking My Alloy's Panbiotic - this is a combination probiotic and prebiotic to help with my gut health and my microbiome. This is definitely TMI, but I have had such a positive response to my sharing about all of this, that I will share this here. I don’t need the vaginal estrogen yet, but as soon as I notice ANY HINT of dryness to my vulva or vagina, you better be sure that I am going to add that to my regimen! If you end up checking this out, you can use my code to get $25 off your first purchase - the initial medical consultation is only $49, which is a total bargain. My meds ended up being about $125/month… it would have been about $73/month if I had not added the face cream… so that’s the price of vanity! So, if you want my code, please reach out and I will send it to you!

I should probably mention that I also use Dr. Mary Claire Haver’s Pause Nutritional Supplements -I have been using these for the past 2 months or so, and like the way I feel on them. The products I currently use from Pause nutrition are a daily fiber supplement, which actually tastes pretty good and dissolves well, just in water… I’m also using their daily collagen powder that I mix in with my electrolytes in water once a day. I’m taking daily turmeric supplements, and daily combination Omega3s, VitD and VitK - that adds about another $130 per month… I am getting pricey in my old age… LOL, I don’t have a coupon code for you to use for these!

The reason I decided to share this on the podcast is that I messaged my friends Maggie, Sara, and Lindsay about this, and it turns out they were searching and they have been suffering too, but we have all been suffering alone in our own corners of the world… so each and everyone of us had been researching hormone therapy without the other knowing… I am the only MD in this bunch and they thanked me for my transparency and for being willing to share all this info with them. I figured if it was helpful for them, it would likely be helpful for all of you too!

Of course, I have been keeping sweet Kelly abreast of my findings and interactions with my doctor from My Alloy, who happens to be Corinne Menn, one of the other physicians I have been following for some time now on IG. I thanked Dr. Menn in our messages back and forth after she reviewed my case. That is the other thing I forgot to mention. As part of using my alloy to get your meds, you get unlimited messaging back and forth with your doctor. So, if issues come up or if I need to increase or decrease my dose, I will have a relationship with Dr. Menn where I can message her. And these medicines auto refill, so I’m going to have the ability to keep ordering these meds for the next year. These are medicines that I am likely going to be taking for the rest of my life.

It takes about 2 months to see the full effects of the hormones on your body, so my plan is to have Kelly on the podcast after my meds have taken full effect, and to discuss all of this with her. The bottom line is that we are living longer than ever. Although it is natural for our bodies to go through menopause, that does not mean we have to live with it. I know for sure that I don’t want to live the next 30-40 years without the hormones that my youthful body used to make in abundance! Kelly and I will surely be talking about the discrepancies in the care of women as compared to men’s health in our society when I have her on the podcast. The data will shock you and enrage you if you have two XX chromosomes!

So, the bottom line is this: Start with your regular gynecologist. If it takes too long to get in, or if he or she tries to put you off with this is normal, something to live with, you’re just getting older, or maybe you’re depressed, find a NAMS provider or consider using My Alloy or something similar like I did. There is relief out there for you. You don’t have to live the next 40 years without estrogen!

I would love to hear from you if you found this podcast helpful! Please feel free to reach out at any time…

Here I thought that coaching would be the only thing I refused to live the second half of my life without… it turns out estrogen gets her place, as well!

OK - see you all next week!

Hey, everybody, don't go quite yet. I want to let you know all the ways that you can work with me.

If you've been listening to this podcast and maybe especially you have listened to episodes where I interview my clients, and you are thinking like the older woman in the diner in the classic Meg Ryan, Billy Crystal film, When Harry Met Sally... In the film, Sally is proving a point to Harry by faking an orgasm while in public at a diner. Sally finishes, so to speak, and then takes a bite of her food. The older woman in the next booth says, "I'll have what she's having." If you've been thinking, "I'll have what she's having," this is your sign from the universe to schedule a consult with me.

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