Redefining Menopause: Why We Need A New Narrative with Dr. Suzanne Gilberg-Lenz

Hey, J.J. here. Can you believe how fast the holidays are knocking at the door this year? One minute it's pumpkin spice season, the next you're getting your guest room ready and wondering where their wrapping paper went. And that's when I turned to Wayfair. From bedding and towels to holiday decor and last minute stocking stuffers, Wayfair has everything you need to get your home and holidays together fast. And for way less. With Wayfair, I know I can refresh my guest room in no time. Maybe I'll add a soft new comforter or a few holiday throw pillows. With Wayfair, it's so easy and everything arrives super fast. Plus, there's free shipping for any order over $35 easy and total peace of mind. So whether you're hosting, gifting, or just adding those final festive touches, Wayfair has your back. And when the holidays wind down, Wayfair has everything you need to tuck it all neatly away. Smart storage solutions for every room from the kitchen to the closet. Get organized, refreshed and ready for the holidays. For way less head to Wayfair.com right now to shop all things home. Wayfair Every style, every home. That's W-A-Y-F-A-I R.com hey, it's JJ here. You know, I've been talking about environmental toxins forever, and laundry detergent is a sneaky one. A lot of them contain harsh chemicals like dyes, preservatives, and even UV brighteners. Those brighteners don't actually clean anything. They just coat fabric so your eyes think things look whiter or brighter. That's more chemicals I don't want on my family's sheets or skin. And if you've got sensitive skin or allergies around the house, this can be a big problem. That's what got my attention about Earth Breeze. It looks like a dryer sheet, but it's actually laundry detergent. You toss one in the washer and that's it. No pouring, no mess, and no heavy plastic jug. Their packaging is lightweight cardboard, which helps reduce plastic waste. And if you choose the fragrance free option, it's gentle, hypoallergenic, non irritating and non sensitizing. I really like how simple it is and how fresh and clean everything comes out without those unnecessary chemicals. Right now you can try Earth Breeze for up to 40% off with free gifts@earthbreeze.com virgin that's earthbreeze.com virgin for up to 40% off plus free gifts on.

Your first order hello listeners, this is Anne Boeckle, author, blogger, and creator of the podcast what Should I Read next? Since 2016, I've been helping readers bring more joy and delight into their reading lives. Every week, I take all things books and reading with a guest and guide them in discovering their next reading. They share three books they love, one book they don't, and what they've been reading lately. And I recommend three titles they may enjoy reading next. Guests have said our conversations are like therapy, troubleshooting issues that have plagued their reading lives for years and possibly the rest of their lives as well. And of course, recommending books that meet the moment. Whether they are looking for deep introspection to spur or encourage a life change or a frothy page turner to help them escape the stresses of work, school, everything, you'll learn something about yourself as a reader and you'll definitely walk away confident to choose your next read with a whole list of new books and authors to try. So join us each Tuesday for what Should I Read Next? Subscribe now wherever you're listening to this podcast and Visit our website whatshouldireadnextpodcast.com to find out more.

Hey, this is JJ Virgin. Welcome and thanks so much for joining me. This is Ask the Health Expert. Here I put the power of health in your hands and give you access to the top people in health and wellness. In each episode, I share safe ways to get healthy, lose weight, heal your gut, detox, and lots more. So if you want to get healthy and get off the dieting for life merry go round, I'll give you strategies that will help you look health and feel better fast. All right, I get asked this all the time, so I am just going to share with you what I do since I always get asked and it's so in line with what we're going to be talking about today. So I have my new pal, Dr. Suzanne Gilberg with me. She literally I was like, how have I never met you? This is so weird. We have so many of the new of the same friends and she is, we are like soul sisters in the way we think she's a little bit smarter than me and that's how I was like my friends, smarter than me. So let me tell you a little bit about Dr. Suzanne and then I'm gonna pull back the kimono since you asked. You didn't ask, but I know you will, so I'm gonna tell you anyway. So Dr. Suzanne Gilberg is a diplomat of the American College of Obstetrics and and Gynecology. She got her medical degree from the USC School of Medicine. We will not hold that against you, Dr. Suzanne, since I graduated from UCLA, because I did do my grad work at USC, so I forgive you. Anyway, she also did her residency in obstructics and gynecology at Cedars Sinai. So, like, really strong credentialed background. And she has done a load of media, everything from Steve Harvey, Dr. Oz, the Today Show, CNN. And she is really out there now redefining menopause. So she's got this super cool background where she had, you know, this really credentialed, huge medical school residency, all that. Then she did integrative medicine, studied that, Then she went and studied Ayurveda. So. So, I mean, a really cool background that has all come together to change the way that she looks at and treats menopause. And so I think that is really exciting. She's got a book out now. It's called Menopause Boot Camp. You're gonna want to get this for sure. And we have such a great conversation about everything from ageism, you know, how amazing it is once you go through menopause, like how it changes your life and. And for the better, and what you can do to really protect yourself from the most scary things that happen as we age that really are what take women down, what happens with your heart, your bones, your brain. So I'm going to share with you. When I went through menopause, and it really hit me hard when my son got hit and nearly died. And I spent four and a half months in the ICU and it was right when I was 49. So, like, boof. I get hit and I start going through this. And one of the first things that happened is I went on hormones and they saved me. I do have Hashimoto's. It is completely controlled. And I use. I use thyroid medication through my buddy, Dr. Alan Christiansen. And I also do estrogen, progesterone, and testosterone. And I will tell you that I still remember. You know, the first thing that I did was thyroid. Noticed a huge difference. And I could tell I needed thyroid because I started to lose the outer third of my eyebrows. I was cold, and I'm usually running hot. I was cold and I started getting a little tingy yellow on my hands, and I got constipated. Who wants that? So I knew something was up. That was when I first started on thyroid. Then the next thing that happened is my hormones started to go down. One of the things that I noticed as I was Doing hormone replacement therapy that helped me kind of go, you know, I need to dose this differently was I couldn't recover well from the gym. And that's when I knew I needed a little bit more estrogen. And then my gums started to bleed a little bit. Same thing. So I now do estradiol patches and then I do testosterone injections and then I cycle oral progesterone. So that's what I do. I get asked all the time. So if you were wondering, that's what I do. Along with a special WP throid that I get from Dr. Alan Christensen. There it is. I pulled back the kimono. But again, you're going to hear in this, we talk about exercise, how you need to shift that, what you need to do for mindfulness, all sorts of good stuff. So you are going to want to.

Get your pen and paper out, take.

Notes on this and also grab her Dr. Suzanne's menopause boot camp. Now I'm going to also have a really cool surprise for you as well@jjvirgin.com so make sure you go there, grab that, and I will be right back with Dr. Suzanne. Stay with me.

Hey, jj, Virgin here. Okay, real talk. So often the holidays sneak up on me. Travel, gifts, hosting, you know, all the things. And suddenly it's like, wait, who spent what and where? And I know I'm not the only one who's looked at a bill in January and thought, wow, that escalated quickly. If you want to keep your finances under control this holiday season, you need to be using Monarch. It's rated the Wall Street Journal's best budgeting app of 2025. Monarch is the all in one personal finance tool that brings your entire financial life together in one clean on your laptop or on your phone. Monarch lets you link everything and gives you real time visibility so you're not shocked later. Right now, I've been checking the holiday spending category so I don't accidentally start the new year with that dreaded debt hangover. And honestly, just seeing everything laid out is already helping me stay more aware. This season, Monarch does the heavy lifting. It links your accounts in minutes, gives you smart categorization and super clear visuals. Yes, that end of year reset could.

Be a real goal.

This time, don't let financial opportunities slip through the cracks. Use the code virgin@monimal.com in your browser for half off your first year. That's 50% off your first year@monarch.com with the code Virgin.

Welcome to Walgreens.

What can I help you with today?

Hi, I need A last minute gift for a secret Santa. Something thoughtful, impressive. Not a fruitcake.

We've got Ferrero chocolates, artisan coffees, even a spa kit. Any vibe you're going for, Whatever says.

Wow, this guy's great at giving gifts.

How about this premium skincare gift set?

Just needs a bow. Will look like you planned it weeks ago.

Well, happy holidays gifts, holiday decor, and more. The holiday road is long. We're with you all the way, walgreens. All right, Dr. Suzanne, we have to start this interview because we've been having so much fun offline. I know we're let everybody into the conversation.

Exactly.

And I don't, first of all, I don't understand how I've never met you before today. I don't know how that happened, but.

You know, the universe wasn't ready for us to know each other yet. Jj, apparently, now that you have your.

Book out and it's a topic that my audience is always starving for, we're going to be digging into menopause. You have menopause boot camp out. Let's start with the obvious question because I'd really love to understand what, why you got into this. I have a friend who does a lot of menopause and she's like, she's like, I don't know if I want to stay here. Everyone's so angry and hormonal. I know. So, you know what, the obvious first, like, how did you decide you were going to tackle menopause?

You know, it's, it's like a lot of things in life, it wasn't something like I decided that I was going to tackle. It just sort of evolved over time. And I think some of it was that as my patients were aging with me, I've been very privileged. I'm in a private practice that I've been in for 22 years. So I have. I saw someone yesterday who I am now caring for because I'm that age, who I delivered. You know, it's like one of those practices where I really. Yeah, yeah. Put an IUD in a 16 year old that I delivered. I was like, wow, full circle. So I think as I evolved and my patients evolved and their needs evolved, I was seeing more and more people entering into that phase of their lives, life and really being flummoxed, having no preparation, no idea what to do. And to be perfectly honest, I had to learn too, because I came out of a prestigious medical school and residency program, Cedarsina Medical Center. You know, I don't think there's anybody on the planet that does not know that name and really didn't have hardly any education on, you know, women's health and aging. And it's not to disparage the medical education system, which has plenty of things that we could improve on, but there's only so many things you can squeeze into a four year residency. And it just was missing completely. And so I had to start going and looking for the information myself. And the more I dug in, the more interesting I found it. And what your, your audience may not know about me is that I have a background not only in conventional OB gyn, I'm board certified, but I'm also board certified and integrative and holistic medicine and had been a student and practitioner of Ayurveda of Indian medicine. So I really felt like I had a different perspective on the aging process, the importance of destigmatizing and normalizing it. And I had this toolkit that was a lot wider and deeper. And I think that is when I did decide, like, okay, I really, this is what I want to do. I want to create a space that is safe and effective for people to experience a normal life transition, but also to have the support and the validated, legitimate, you know, ways to handle this that I was able to offer. I just, you know, it's a big, it's a big, big, big topic and it's, yet it's very simple.

It's kind of interesting though, you know, you're an OB GYN and they didn't really go deep in women's health.

Well, we did go deep in women's health, but when you're learning how to do pelvic surgery and manage high risk pregnancies, there's a lot of focus on procedures, you're right. And not on normal, normal events of life. And I do think that, look, there's a lot of issues that we are trying to address and need to be addressed in health care and in medicine specifically. But when you look at inequity and bias, you know, there's misogyny and ageism. I'm not even going to talk about like white supremacy and racism in medicine. We're going to leave that for another conversation.

Yeah, that's a heartbreaking.

It's a situation. It's a huge thing. It's a huge thing. And I don't think people are doing it on purpose, but it's baked into the system and misogyny and ageism are just part of our culture. So a lot of what happened is I started, as I mentioned, like well, look, my patients needed this stuff and weren't getting the answers they needed. So I dug in and I started learning and educating myself. But also I started seeing the big picture here, which was as an individual living in this culture, in this body, I really wanted to see change on a larger structural, cultural level in terms of how women treat ourselves, what we expect, and what narrative we're willing to participate in. And that has been one of the most wonderful and gratifying aspects of the work that I'm doing. Because there's something about midlife. You know, sure, it's really, really discombobulating. That transition is rough. But once you get through it, you have got you. You have resilience, you have wisdom, and you understand what your own value is, and you have a lot to offer. And we really. We. And I'm talking about me and you and the people listening to this podcast, we can continue to choose to accept this narrative that as we age, we're not viable, we're not legitimate, we're invisible, we don't matter, blah, blah, blah, blah, blah. Or we can say, that is not my story. That's your story. Go have fun with your story. My story is xyz.

I gotta tell you so a couple. I mean, you're bringing up so much stuff. I love this so much. It is interesting. I'm 59, which still is amazing to me. And if someone had told me that whatever happens at 50, that flip switch that gets flipped, I was like, why couldn't I? I wish I could have been 50 at 30. You know, it's like, I keep trying to explain this to my friends who are in their 20s, 30s, 40s. I'm like, oh, no, this is so fantastic. Like, this is the greatest. And, you know, I was with a group of friends. We got to go to the Grammys, and we were at the Grammys, and we were watching. And it was the year that Dolly Parton was heading the whole thing up, and Diana Ross had her 70th birthday there, and all these amazing, powerful women were there. But, you know, they had. They had JLo, they had some other younger gal, but it was really about, like, you know, Dolly, who was belting it out at what, she's 70 something, and Diana Ross. And I'm like, holy smokes. So, you know, I. I wonder, like, did it help you? Why did you go do ayurvedic practice, learn Ayurvedic? And was some of that, you know, help with this ageism stuff? Like, it seems like some of these other cultures like you at the blue zones and this longevity. And I always go, is it because people are celebrated as elders and we realize their importance?

That's a huge thing in pretty much every indigenous culture. Ayurveda, I didn't necessarily get that, but what I did get was a toolkit that validated my personal life view, which is more mind, body, spirit oriented. Look, I'm a surgeon. I believe in Western medicine. I prescribe medications and I have participated in Western medicine, which is a miracle, but it does not address everything. And we look at normal developmental processes, of which menopause is one. I think sometimes the indigenous cultures and the more holistic traditional medicines have something to offer. Let's put it this way, my interest in Ayurveda grew partly because I'm just a seeker. And when I. I had a lot of experiences during my medical training where I realized that the encounter between the patient and myself was not just what it looked like on the face of it. Like, you have a problem, I have a solution, and I'm going to help you and you're going to go on your merry way. I mean, sure, that happens sometimes, but there was something else going on that wasn't being addressed, whether it was, you want to call it energy, healing, love, whatever that was. And I actually had a patient who had a big influence on me. And it's. The story is in the book. And she introduced me. I was doing yoga and meditation really to just sort of like take care of myself. Right. I was a busy resident and a young mother. I had both my pregnancies during my OBGYN residency. So it was kind of crazy. And I was coming out into practice and trying to just take care of myself. Found yoga and meditation and from there found Ayurveda. Ayurveda is like Chinese medicine. Grew up around the same time, five, six thousand years ago. Yoga is actually a branch of Ayurveda. And I really started looking at it from my own. I was curious and I started seeing the benefits very quickly for my patients because I had specific spiritual practices that were not invasive. Or I started really getting interested in herbalism and in botanical medicine, which is super powerful. And of course maybe 30% of pharmaceuticals are actually plant derived. And I just had an interest in other ways to do things. And I'm here in Los Angeles where, you know, people tend to be pretty open minded. And it rapidly. I developed a reputation in the community for being open minded, for being like, look, she can attend your birth and, you know, keep you safe and she can do surgery but she's also not afraid to talk about herbs or meditation. And it just kind of grew from there. And I got more and more interested and just started incorporating those things.

So let's look at how you approach menopause then. Like someone's coming in to the office because now they have the opportunity with the menopause boot camp book. And I think you do retreats too, don't you?

Yeah, yeah.

So you know, like someone walking in. So how would you help someone who's maybe just kind of starting to have like irregular periods, mood swings, etc. You know, what's the process process you take them through so that this isn't such a chaotic time of life?

Yeah, I mean, a lot of what I do honestly is just allow them some time and space to talk about what's going on. Because what's frequently unfortunately happened by the time they get to me is that they've been dismissed. Either they had labs done, which are really not meaningful largely in this context, and oh, they're normal, sorry, nothing to do, or oh yeah, that's a normal part of aging. Bye, good luck. I mean a lot of. So a lot of times I really have to unwind that because people feel really invalidated, which is why your, your friend was saying like people can be angry when they, when they finally get to someone because their gut instinct is like, I don't feel right. That, that can't be right. So part of it is just hearing the story and validating. Yeah, you're right, it is really uncomfortable. And then helping them prioritize what is it that they want to get out of this. Because I remind them you don't have a disease. But also I don't want you to get diseases because it's going to lead to something that I think is very, you know, we share. How do we prevent those long term health issues? I mean, obviously what you do before you get to menopause is incredibly important. But even if you start doing things at menopause or around perimenopause, the time leading up to menopause, you can have a big impact. So I'm talking about heart disease, brain health and bone health. These are the big three that women face as we age. So as we get to perimenopause and menopause, I want to help you live through that experience so you don't hurt anybody and let you know that there are things you can do. So is it the hot flashes, Is it the sleep? Is it your sex life? What's the main issue for you today over time, what are the issues evolving for you? How can we address those via pharmaceuticals, botanicals, lifestyle support and community, which is a huge part of what the boot camp really provides. Honestly, people talking to each other and then moving forward. I'm there to sort of guide you through the process while building those healthy habits to decrease those long term health consequences over time. I think the message is not, it's not getting out there enough that we can mitigate these long term health issues and that women have heart disease. That the number one killer of women is heart disease. This makes me crazy.

I'm so with you on like, I love that you said bones, brain and heart. And I'm like, why is there so much emphasis on breast cancer? And we don't talk about heart disease.

Totally. Because it's scary. So let me just say this. I feel like I'm. Look, I'm a breast cancer survivor. I had breast cancer in my 40s, so I feel like I can say what I want. All right? So I'm going to say I feel the same way. And I do feel like it's a little bit of a third rail topic. Like you can't say anything about breast cancer. I mean, breast cancer is a thing. I don't want anybody to get breast cancer. It sucked. Although in some ways it changed my life for the better. That's more of my journey. But the reality is that most women who are diagnosed with breast cancer are going to be diagnosed in early stages. And it's a big wake up call. But guess what the number one killer of those women is? Well, I mean, I know, you know, it's heart disease. I'm more likely as a breast cancer survivor to die of heart disease than breast cancer. And I think it's the kind of, the fear mongering that's out there. I want people to get their breast screening and colon, you know, screening and all that. But like, let's be real. Let's be real about what the things are that are really facing us. And of course these are things that we can do something about. I mean, you know, we can have an impact on our genetics by what we're thinking, doing, eating, how we're sleeping, what we're filling our time with, what our senses are coming into contact with. Not just what, you know, eating is obviously so important, but how we eat, when we eat, why we eat, who we're evolving ourselves with, what energy is near us, blah, blah, blah.

Well, let's dig into that. You know, I just did a summit the what to Eat, when to eat and why Summit. Oh, my God. Because I was like, no one talks about food. Come on. It's the place we start. We start with what's at the end of your fork. And I want to dig into all of these things. I will tell you. I used to work at a clinic in Palm Springs where I would see clients and it was incredible to see people's lab work when their estrogen dropped and to see the difference between someone who was doing a biodentic clinical and someone who wasn't. And what was going on with all their cardiovascular factors, who was like, zoom, you know? Yeah. Like, no, it's wild.

I mean, cholesterol goes up. Listen, I personally had that experience in the last 18 months where I was a person whose cholesterol was super low genetically, probably. And estrogen wise, I'm not actually through with menopause, which is insane. I don't understand it. But my. I think part of it was the stress and the change in lifestyle with the pandemic, especially as a physician. But my cholesterol went up like 80 points. I was. And I, you know, listen, I'm just being honest here. Like, I know everything you're supposed to do.

Yeah.

So it was in. A lot of. It's hormonal. A lot of it is.

It's. Well, here's the thing. And you know, the thing I love to say is your body's not a bank account, it's a chemistry lab. I know there's a huge argument between the bank account model and the hormone model for weight. And they both matter.

Of course, we're individuals.

It was really interesting during the pandemic. I stepped on the scale and my weight had gone up five pounds. And I'm like, okay. Huh, what's up? And I thought, okay, well, this is just stress started going up a pound a day. I had a stress triggering autoimmune thing happen. So it is. These are like so critical for us to look at. You know, what can stress do? What can stress do to an autoimmune disease, to, you know, to cholesterol, to how sticky your blood is. It's crazy, but it was really interesting. It's when I first started to really become aware of. This was, first of all, one of my biggest frustrations is we start bone. Like, I don't know when they actually ever prescribe bone density tests. I actually did one at 30. Like, I don't know why this is.

Well, the U.S. preventative Services Task Force in all its glory, does not recommend bone density until well past 60, which.

Is what are you supposed to do at that point?

Right. I know so well. But the bone density is also, also like not the greatest test. It's just that we have. It's the test we have. So, yeah, there. There's so many. But this is another reason why, you know, algorithm and cookbook medicine is problematic when you're looking at something that is not a disease. I don't know how many times I say this a day. This is not a disease. This is a stage of life. It's a normal stage of life. And it's an honor and a pleasure and a privilege to get to this stage of life, because if you don't, that means you're not here anymore. The other thing to remember is that the average age of menopause is 51 to 52. The average lifespan of a North American woman is 80ish. So we are spending at least a third of our lives in this time. So you're right. When you start looking and questioning the screening tests that are involved and when we try to like, put a normal life phase into the disease model, I think this is part of the problem we're having here because again, with all due respect to Western medicine, I'm very, very careful to not disparage the privilege that I've had to be a physician. But we have a lot of problems in our perspective there. It's a disease model. It is not a prevention or a wellness model. I think that's part of the failure to address menopause, because menopause is not a disease.

Ray Ban Meta glasses come with open ear audio so you can listen to.

Your favorite music without blocking out the world around you.

Hey, Meta, play Gorgeous.

Here's Gorgeous by Doja Cat.

You can also ask Meta AI questions.

Hey, Meta, when's Doja Cat's next concert?

Doja Cat is playing at the Los Angeles theater next Tuesday. Sweet Ray Ban Meta glasses available at.

Ray Ban stores and other authorized retailers. And I think this is so important. Like, hey, I had a son who was hit by a car when he was 16. Literally left for dead in the street. Western medicine saved him. And then all of the alternative stuff brought him back, right? We needed all of it. I think you used all the tools in your toolbox. But I think the kind of through line here is this is how do we feel the best for that last third of life? What do you do? What do you do during that time? And especially for women, you know, we have. It's very different during childbearing years. And how you treat yourself versus now. So looking at someone now who's, you know, peri or in menopause post, like what. What are the shifts that they need to make to now feel their best and to lower that risk of heart disease, to be able to not start to have dementia and to keep their bones healthy and strong? What do they need to do?

I mean, I want to start with hormones because I think that hormones have become so fraught. And by hormones, I mean using menopausal hormone therapy. So I am trained conventionally. I am a member of the North American Menopause Society. I believe in science. I believe in evidence. I think think they are a little too conservative. I will say that I think the use of what we call bioidentical hormones, which your audience should know, is not a medical term. Yeah, sure. It's a marketing term. I don't care. I'm trying to speak the same language here. If I'm trying to communicate and educate, I'm not here to shame you about the words you're using. I'm here to talk to you. So, yeah, I use the term bioidentical. I really don't care that I have colleagues that don't want to use that term because they're mad at it. That's silly. It means that these hormones are biologically identical to what your body was making in larger quantities prior to menopause. All right. The thing people should know is that pharma makes these. There are FDA approved bioidentical hormones, and they are safe, effective, and vetted. If those particular formats or dosages don't work for you, I think if you're working with a trusted professional and a trusted compounding pharmacy to find a way to get those hormones into your body safely and effectively, I don't have a problem with that. I disagree that compounding overall is bad. I think that's really throwing the baby out with the bathwater. But I do think that people get very nervous. I feel like there's two camps. There's like, hormones for everything. Everything is hormones. Everybody should be on every hormone. They should be on every precursor hormone. There's, by the way, no data to support any of that. And then there's people who are like, my great grandmother had breast cancer or my mom had breast cancer. I can't use hormones. Okay? So I'm the middle path. I'm pretty much the middle path about most things. Neither of those is true. Hormones are not for everybody. Hormones are safe for almost everybody. Not everybody. And I will say vaginal hormones are safe for everybody. Cancer survivors, stroke survivors, any of that. So looking at hormones to help optimize your health, to decrease your risk of osteoporosis, that data is very clear to probably decrease your risk of dementia and Alzheimer's because women face two to three times the risk of Alzheimer's and dementia as their male cohorts. Super important to understand that. And heart disease. The data is there from the 90s. There's large studies that indicate that heart health is definitely improved by using hormones. Let's say you can't or don't want to use hormones. I have all sorts of information in the book on botanicals, herbs, supplements that I think have robust data to support their use. Are you going to do, are you going to put a head to head study of an herbal preparation and a pharma? Of course not. They're not the same.

Same.

And I think apples and oranges. And again, colleagues of mine who want to disparage that I disagree with. I think we have to have a wider and a deeper toolkit and be realistic with what people are using and need and want to use. And then the obvious one, lifestyle. So I have a whole thing I call the six S's of self care, sex, sleep, sustenance, spirituality and social connection. What we're eating, like you talked about what we're eating, when we're eating, how we're eating, we have to change that. I mean, I've seen it in my own body. So you know, I'm not a nutritionist, I'm not a nutrition expert, but we understand that insulin resistance changes are the estrogen influences where our fat is deposited. So even though that large study came out last year, that freaked everybody out. That was like, no, metabolism doesn't change and you don't gain weight. Like, oh my God, what planet are you living on? Dude, for reals, Come on. Now the reality is that the weight distribution absolutely does change. We get thicker in the waist and we don't like it and it's uncomfortable and it also has health consequences. Right. Visceral fat increases your risk for heart disease and cardiometabolic disease, diabetes, inflammatory process. So keeping that in mind, you have to really think about how you're eating when you're eating. Portion control. People don't want to talk about that. I'm very anti diet culture. But the reality is like I'm a small woman. I am five, three on a good day. Like I don't need, my boyfriend is, you know, nearly six feet. I don't need to Eat the same amount as him. Like, I just don't, you know, I mean, I could, but I'm, you know, going to be his size and without the height. So I think we have to talk about some things that are uncomfortable. How we exercise, when we exercise really needs to change. So I was always like, go to the gym directly after work. Since my 20s, first of all. Hell, I mean, I'm not going to the gym at night. That is not happening. Is not working. I also can't go hard the way I used to because I don't. I need recovery time. And I actually, if you are working out too hard and too much, you're going to increase stress, you're going to increase cortisol, you're going to hold on.

To break down muscle.

That's right. So you're not going to, you're so, so we have to shift our mindset about how we balance our care of our body. But we have to continue to move and get that blood flowing. And we have to continue to evolve in our eating and eating for nutrition, but also for joy and for fun. Alcohol is a big problem in general. I'm not a teetotaler, but like, look, if you are using wine to unwind at night, it's not good for you. Sorry. It's just not. If you're a wine connoisseur and you want to enjoy your wine, I think you should do that in moderation. But if you have wine every single night, it's not. You're not going to get away with it the way you did when you were 40 even, or 45. And then the sleep thing, which is just like so, so, so, so, so hard. But we have got to get on restoring our sleep. And really we know what sleep hygiene is. We're not doing it. How many people really are putting their phone and their devices down an hour before they go to bed? A lot of people are not. So I could go on and on, as you can hear, but I think these are some of the adjustments. And then the other thing I sort of touched on, which is, you know, what we're bringing into our world via our senses and relationship and boundaries. And you sort of alluded to that. There is this magic thing that happens in your 50s, the no Fs to give 50s. And I wonder if it's hormonal in some ways. Maybe because we are not cycling anymore. We're not so interested in, like, what's your issue? Like, we care but, like, we need to center ourselves. We need to have boundaries. We need to say no. We need to say yes to ourselves. You know, you can only pour out from that cup for so many decades without getting burnt out, resentful and sick. And if you don't put yourself as a priority, nobody else is going to do it. So that has to change. Just it has to.

So I want to ask a couple questions. We get asked so many questions about hormone. And it's always been my thought process that you want to do all of the things that you possibly can, you know, put in those stress. I hate the word stress management, but do the things that help bring you joy is probably a better way to do it. I will tell you, Suzanne, it took me until during the pandemic, I found Dr. Joe Dispenza and started going to retreats because it's great to go to breathwork retreats during a pandemic. But I was like, here I. We are going to these retreats and no one is getting sick because their vibration's so high. And you know, and then I also started yoga and like the me in my 40s that was burning out everything, you know, in my 50s, I'm like, no, we cannot do this anymore. This is no longer working at all. So I think it's so key to look at like, what needs to shift in terms of our exercise, how we. Like, I can't eat the way I ate in my 40s.

Right.

Like, you know, I just, I'm. I'm not a. Not that hungry, you know.

Right.

It's really interesting. Yeah.

Yeah.

And I have to really be careful with my sleep hygiene in my 50s. And I also cannot have the extra glass of wine. Cannot have it. Cannot. It will completely. I'm up at three and I'm like, I can't believe I did this to myself again. You know, so there's clear things that I think we just have to say this is, this is now. But the trade offs are so worth it of being of the. Of the zero Fs given philosophy. Someone actually made me feel T shirt. I'm like, yes, so I actually do have the T shirt. But. But one question that I've seen come up over and over and over again is this question about bioidenticals. Because it's always been been my feeling and maybe it's because I have the lifestyle hammer. Right. That's what I have as my toolbox is like, let's get you. Let's get your exercise done correctly. Let's get you, you know, and again, like over exercising and creating crazy stress is not going to be helpful here. So let's get your stress hormones dialed. Let's get you exercising correctly, eating correctly, good sleep, good relationships, and then let's see what you need in terms of hormones. I take bioidenticals, like, and. And when this. When I told you about my son getting hit, my son actually got hit and pushed me straight into menopause, as you can imagine, because I was 49 at the time. I was like. It was like foomp. And luckily, I've heard that before, by.

The way, when people have a major trauma and they're in sort of the transition that. It's like a light switch.

Yeah, it was. It was pretty brutal. I. I don't know. Do you. You must know Dr. Prudence Hall.

Yeah, of course.

So Prudence. Prudence came to the hospital with hormones. I'm like, thank you. You know, I was just like. It was just really rough. But I've heard that you really have to start hormone replacement therapy while you're going through it, that if you wait till afterwards, it doesn't work. What's the lowdown on this?

That's an amazing question. I'm so glad you asked it. I. I think it's. I'm not sure what that even means. And this is. It's excellent to.

It's like your receptor doors closed. I'm like, the receptor doors closed, like, really. Because you can regain your insulin sensitivity, and those are really important receptors.

I don't know. I feel like there's a little bit of a fear tactic involved in some of what goes on, and some of it is marketing, to be honest with you. I don't know that we have that question really resolved. I can tell you this. Here's where the large, robust data does exist. If you initiate hormone therapy within 10 years of your menopause and before the age of 60, you will accrue those lifelong health benefits that we discussed. So the heart disease, the osteoporosis, the brain health, that's actually what the data indicates. Now, I will say this for people who want to preserve the elastin and the collagen in their skin or diminish that slow, or that loss, or slow that loss. Starting earlier is better. And I think the other thing that people need to understand is that the other side of that is that you do not need to wait for menopause to start hormone therapy. You can start whenever you are having symptoms. So if you're suffering and a lot of people in their 40s are starting to, their periods are perfect. But they're having crazy pms, they're having joint pain. They're having hot flashes. They're having sexual complaints. They're having. There's no reason, in an otherwise healthy person who doesn't have a medical reason, they can't use hormones. There's no reason they cannot use hormones unless there's a reason they cannot use hormones. So it's just. It's just not true that you have to wait to start. But also, I don't want people to feel like, okay, I'm 53 and I've been in menopause for four years. There's no reason for me to start now. That is not. That is not true. That is not true. And listen, there's also Genesis. You know, like, we do have genes. Yes. We all know about epigenetics and the ability to sort of turn on and off genes, but there's gene expression. If you look at people in your family older than you, you know, chances are that's probably what you're going to look like. Really? That's the truth. If you look at, like, even body shape and things like that. So some of it is. Or gray hair, you know, some of that is out of your. Out of your control. And here's the other thing, this idea of control, which I have come up against over and over and over in my life and in my career. So it's very interesting. The longer I talk about this and the more I do it, there are so many parallels between pregnancy and childbirth and menopause. They're both life transitions. They're both transformations. You're birthed as a mother, you're birthed as an adult woman later in life again. But one of the biggest struggles I think we face during both of those periods is loss of control and having to surrender to some of the stuff that's going on in our bodies. That doesn't mean you give up, but you fighting it isn't really going to be helpful.

It's going to be hurtful, if anything.

Yes, it is.

Kind of roll with it. Yeah. You couldn't imagine going, you know what? I'm going to be pregnant. I'm not going to gain any weight. You know, I mean, that would just be like.

That would be unhealthy, most likely. Yeah.

And I'm glad you brought up that other thing about testing your hormones, because it's always seemed like to me, as you're going through it, that it's such a moving target.

Yeah.

Shouldn't it be based more on symptoms?

Yes. Well, it is. It is officially. Officially, that is how we treat. We treat clinically based on symptoms. There are time and place for testing. If I have you on testosterone, for instance, I'm going to want to keep an eye on your testosterone levels or, you know, if I'm ruling out that you have a thyroid problem or something else. But I use thyroid a lot for people to understand the differences between hormone testing for menopause and hormone testing for thyroid.

Okay, Right.

And it's a disease. I mean, we're looking for disease process, and we're looking for dysfunction. This is not dysfunction. The other thing is, you nailed it. You know, our hormones are altering all day, every day. We have circadian rhythms. We have, obviously, month, monthly rhythms. And those start getting unpredictable. It's not helpful to look at those numbers. Excuse me. And when people start chasing those numbers, they get very, very stressed. And I do think that there are some people out there that use that to keep you coming in and constantly tweaking and changing. And it's like, it's not like if your estrogen is here and your progesterone is there, you're going to be in a bad mood, but if it's the other way around, you're going to have a hot flash. That's not how it works. So, you know, and the other thing that irks me a little bit is this whole people will sell this idea of like, well, we're individualizing your care, except for that. We're trying to get you into this perfect reference range that is literally the opposite of individualizing care. So buyer beware.

Yeah, that makes so much sense. It always struck me, I was like, I was one of those people. I was very athletic, did not have any curves. I totally did not look like one of those curvy estrogenic. I was like, so why would I go. Hit the same curve, same stats as everybody else. I could tell. And I just worked. I'd read Uzi Reese's book years ago, and I thought, this makes so much sense how you do it based on your symptoms.

And.

And I still remember, like, being in the gym and not being able to recover. And I go, this is so interesting. Like, this is. And then just using estrogen to the point where I needed to so I could recover. And then. Then the next one that showed up was like, bleedy gums. And I'm like, oh, you know, so it's like kind of learning those symptoms. And really, this is one where you've got to be able to work with your physician and have. And you Know, understand what's going on because, you know, ultimately it's how you're feeling. Right?

Exactly, exactly.

And then looking at, I would think the labs to just see what's going on with your cardiovascular risk factors.

Oh, for sure. I'm not saying no labs at all. But just like checking hormones constantly doesn't make sense.

I mean, there are some other like, sense.

There's some other specific things that again, are not super conventional. But like, for instance, as a breast cancer survivor, I wanted to look at whether or not there are. There are metabolic pathways. I mean, I feel like I should bring this with me. But that huge algorithm that shows you all of the hormone pathways, but there are estrogen. I think people don't understand that estrogen is not one thing. There are multiple forms of estrogens and we have metabolic pathways that will help to clear certain kinds of estrogens via your liver and your gut or accumulate. I was curious, for my own benefit to know what pathway was my genetics favoring and was I accumulating estrogens that might be detrimental to my breast cancer prognosis? I mean, this is like a deep dive academic thing. It's definitely not conventional. And I think that is a very specialized thing. I'm not selling it that everybody should be doing this, but that's a very specific targeted ask. Right. I was taught by old school surgeons at LA County USC General Hospital. And I'll tell you, I never forgot this. If you are doing a test and you have no idea what you're going to do with that result, you have no business doing that test. What are you doing with the results of that test? If you don't know or your doctor can't answer, you really need to rethink if you're going to do that test.

Right. I had my telomeres tested six years ago and I go, and what do I do with this? We don't know. I'm like, great, I'm glad I tested that. Thanks so much. That was a really fun test you.

Went for the team.

I was like, okay, one final question. And it's also back around hormones, because I know all the questions we had asked.

Oh, for sure.

And so it was great to hear that one because it's always been kind of a head scratcher for me on this. Well, wait a minute. So you can't start hormones, you know, it's like, it doesn't make a lot of sense.

No.

What about length of time on hormones?

I love your question so much. Yeah, that's another one that I think has, you know, I think at some point there was a position statement out there either by North American menopause or by one of the organ, maybe American College of obgyn that that got misinterpreted. Everybody kind of held onto it, oh, three years and you should have a conversation or five years and you should revisit and somehow that morphed into you have to come off at four years. I don't know where that came from. It's not really a thing. And in fact, the position has been very clearly stated in the last, I think 18 months by North American Menopause Society, which is the authority in this region. And that is that it should be an ongoing conversation. But there is not a reason why you have to come off your hormones. I mean, sure, if you develop a problem, if you develop a blood clot or you develop a cancer that is estrogen dependent or you have a stroke, God forbid you're going to have to come off of some of your hormones, but otherwise you can stay on them. And usually what I tell people is like, we'll just talk about it, you know, every, every year or every, however often you're coming in and look at it. I do have people that at a certain point in their life say like, you know, it's just one more thing. I'm not really sure what I want to do about this. I want to wean and see if I'm having symptoms. I understand that the benefit, you know, of these things is there, but I'm doing xyz. It's an individualized conversation. But you do not have to come off your hormones if you don't want to.

Yay. Well, and I also think of again thinking of the blue zones, some of the research that came out of there where you hear about these Okinawan women and you wonder if how much of our modern day, crappy, stressful, toxic lifestyle is really depleting our hormones and making have, you know, have way lower estrogen and progesterone testosterone through menopause and after menopause than we would have normally. And so potentially are we just replacing to where we would have been had we not been in this crappy, you know, toxic depleting lifestyle? Maybe so.

Yes.

Awesome. This has been amazing information. I super appreciate your time and I am excited to dig into your menopause boot camp book. Now, I know we were talking offline that you're going to have something super special for everyone listening, but we also are not sure what the super special thing is.

Yes, it's going to be a surprise.

It's a surprise. So I always like to have some great, cool things. So that is even more exciting because when you go to jjvirgin.com forward/, I'm going to make it menopause boot camp. When you go there, there's going to be something amazing that you're going to get as a gift from Dr. Suzanne. So now you got to go over there to see what the gift is.

There you go. I love it. I love it. I personally love a surprise, though.

Who doesn't love surprises? I do, too. So again, jjvirgin.com menopause bootcamp and thank you, Dr. Suzanne. I don't know where you've been all my life, but now you're in my life and I'm keeping you.

Oh, I'm so happy about it. I feel the same way, jj. Thank you for having me.

You are welcome. For more info on this and other health topics I cover or to rate and review, find me on Instagram, Facebook and my website, jjvirgin.com and don't forget to subscribe to my show so you won't miss a single episode. Go to subscribetojay.com thanks again for being with me this week.