WORST Menopause Myths Women Should Never Fall For! with Wise and Well

When it comes to menopause, there are a lot of myths, a lot of misunderstandings, a lot of myths and a lot of different opinions. What I want to address today are the most common myths, the most common ones. We're going to be debunking a lot of this and we're going to be getting into a big discussion around hormones because I get how confusing this could be. So many different opinions, so many different experts. It gets very overwhelming and very confusing. So thank you so much for being here today. I've got the wise and well, girls, Maria and Kristen. Thank you. I always love chatting with you. Thank you.

We love it with you.

I want to dive right in to menopause and what's happening and what the changes are and what these common myths are. And I'm going to start with just one that I have that is every time I brought on an expert about hormones, this continually comes up. And that myth is that I. If I do hormones, it's going to cause cancer. Can we start with that?

Sure. The elephant in. Yeah. No, and it's. It's a great one because it's unfortunately been kind of, you know, propagated amongst all the talking heads and everything. So essentially where this comes from is from a really bad study. Most women are familiar with the WHI Women's Health Initiative. You know, unfortunately, that study used drugs that were called hormones that weren't exactly hormones. They were synthetic molecules that did not even come close to replicating what our hormones look like in our body. They altered the receptor. Essentially, what was given to women were endocrine disruptors. If we're just really blunt. And when endocrine disruptors go in, particularly MPA or medroxy acetate. Progesterone. Progesterone, which is a progestin, a synthetic, they essentially they harm the receptor, they create a bad signal, and we develop what's called folded proteins, which can essentially cause DNA damage, which then can lead to, you know, cancer processes. Did women in the WHI get cancer? Yes. However, they were. It was isolated to the women who were given progestins. I believe it was only an additional six cases of cancer if you looked at the whole study. So this is not like everyone was getting cancer, even some of those who took the progestins. And unfortunately, many of these women were well, well, well beyond the age of menopause. They were in their 60s, they were metabolically unhealthy, they were obese, they had diabetes, and they were smokers. So if we took hormones completely out of the equation. And we said, what are some of the highest risks for cancer in a woman's life? It's being female and getting older for one. And then it is essentially obesity because we know inflammation in the breast, you know, blood sugar, dysregulation and any sort of metabolic derangement. So unfortunately, these women probably already had cancer processes. That's another thing a lot of people don't know. They were not pre screened for cancer. Right. So you know, it was bad hormones in the wrong bodies, I shouldn't even call them hormones. Bad drugs in the wrong bodies at a time of life that unfortunately some stuff had already started to happen. So that's where the, the gist of the fear came from. What we know in reality is that the estrogen only arm, even of that study using crappy estrogens did not develop cancer. In fact, their risk of cancer was lower. We do know now using true bioidentical hormones, those that molecularly mimic the hormones that we make, women diagnosed with breast cancer at the time of using HRT have better outcomes for mortality, less aggressive tumors and less chance of recurrence. So in reality, hormones are actually cancer protective. They were protecting us our entire life. And we can get into kind of how that worked in the cycle. But we seem to not be able to shake this connection of cancer and hormones because of this bad study.

One of the things that you said to me months ago when I interviewed that always stood out to me. You said if estrogen caused cancer, then every pregnant woman would have had it.

Right.

Because you've got such high doses during pregnancy.

Yeah, I mean thousandfold levels of what we normally have during our premenopausal years. So cancer isn't caused by hormones. Can hormones be a catalyst for cancer that already exists? Yes, because all cancer tumors, they're either active or inactive in that they have a fuel source. And so can we essentially increase cancer growth because estrogen is a pro growth hormone? Sure. If we have an estrogen receptor positive cancer and it's exposed to estrogen, it doesn't mean it's going to grow. And I think that's really, really important for women to know. Is there the risk? Yes, but it doesn't mean it's going to grow. So the cancer already has to exist. There is more evidence for keeping a woman on her HRT even after a breast cancer diagnosis, simply because the cancer's growth, progression, profile and biology are actually improved and stabilized with estrogen.

I'm going to go deeper with hormones with you, but I want to ask A couple other questions first that will tie this back together. A lot of times when I share about being on bioidentical hormones, which I'm a huge fan of, and where I feature anyone that's talking about bioidentical hormones, I'll inevitably have somebody in menopause or post menopause or perimenopause say, I want to do it naturally. What do you say to that?

Kristin's favorite thing. Well, first of all, we have to talk about, like, what their definition of natural is because, you know, they might be all, you know, very aspirational at 50 or 48 or even 55, but talk to us when you're 60, you probably will change your mind. But anyway, let's talk about aspirational still. What's natural about being 70 and being on a statin and a beta blocker and, you know, something for urinary urge or depends or, you know, what's, what's natural about that? Right.

Amazing.

Would these same people, you know, if their eyes were clouding over, you know, and they couldn't see, deny themselves cataract surgery or, you know.

Right.

If God, keep insulin away from the pre diabetes or the diabetics who have type 1 diabetes.

Exactly.

I mean, that's natural. That their pancreas doesn't work doesn't mean it's good.

It's aspirational on their part. I just think we're going to see a lot of those people change.

Okay. Yeah. So it's interesting because to me, I, you know, and my friend Anna Kabeca that I've had on many times, she talks about, she calls it hormone replenishment versus hormone replacement. And I sort of like that idea because you're bringing back up something you had. So when we hear replacement, sometimes I think people look at it as, oh, I'm taking something, a drug or I'm taking something, I'm adding something unnatural, where if we reframe it as like I'm replenishing, it's just something natural that we had and it's just dissipating now.

I mean, I'm synonymous, but. Yeah, I hear you.

Yeah. We call it hormone restoration for that.

I love that.

Right. Is that we're essentially restoring health and we're restoring disease risk protection.

That's great.

Yeah.

Okay. When someone says that they didn't have issues with menopause, they're going to tough it out or everyone should tough it out. What do you want to say to that?

How old are you? First, if you are 50 or you know, if you are, like, we'll just say, like, five years postmenopausal. That's my first question. Like I just said, you know, I'm about 62, 63. We found for a lot of women, the. The bottom falls out. But honestly, even if you are. Say, my son just asked me today, mom, how old is old? And I said, 75 and up.

Okay, Okay.

I had to pick a number. Right? But so. So let's just say, like, you. You hit 70, you're still young.

Right?

Right.

Maybe you don't have palpable, really discernible symptoms, but do you. Do you understand that, you know, the walls of your arteries are changing? They're stiffening. They're stiffening without estrogen.

I was somebody.

Degradation in the bones, stuff like that.

I want to talk about all those things because I feel I'm somewhat fortunate in a way where I had major symptoms of declining estrogen, like hot flashes, you all know, because I messaged you a thousand times, I'm sure when it was happening, I had hot flashes around the clock. So it was very obvious to me I needed to do something because I didn't want to live and function that way. And no supplement was addressing or helping with that.

Right.

Some people don't have that. They don't have the hot flashes. They don't have. Can we. I want to talk. I know you just mentioned bone loss. Like, what are the things that they don't see, see, or feel necessarily that are going on by having that kind of declining estrogen?

Well, it's. It's actually one of our favorite kind of top myths of the book.

Right.

Is that we think that it's either a. About menstruation and fertility, which. Those are actually just byproducts of the hormonal process. They're not actually the point of the hormonal process. Fun fact. Or that it's about symptoms. And those two things, I think, are what get a lot of women distracted. Kind of lull them into thinking they're in the clear, so to speak.

Maria.

And I didn't have hot flashes at all. Not one thing. What did I have? I think now the new acronym is nflm, which is Not Feeling Like Myself. Okay. I simply started to not be able to perform as the person that I had been my entire life. It was, you know, it's kind of like the ground shakes underneath you. You know, for a lot of us, it's all said, like, what is happening to me? Who am I any longer? I couldn't quite do the Things that I used to do. I did not know that my lack of sleep had anything to do with my hormones. I thought that I was just running myself too hard.

Right.

I didn't know that my UTIs were actually a symptom of my. My menopausal transition. I was going to kidney stone doctors and, you know, looking at all these different things because I thought something had to be wrong with me. You know, women don't. We'll gaslight ourselves, to be perfectly frank. You know, even if I had dry vaginal tissues. Absolutely. Did you know what I thought? I thought I wasn't in the mood, right? Literally, that's what I thought, and that's what my husband thought, too. And that's really, you know, degrading to a relationship because it's like, why aren't you in the mood? You've been on the moon the last 30 years. You know, what's going on. So there were little things like that that I think we overlook as possible symptoms related to. But then there are those who, God bless them for genetics or metabolic status or whatever, we don't really know, literally can claim they had no symptoms. They aren't going to feel bone mineral density changing. They aren't going to feel, as Maria said, the arterial walls changing in terms of inflammation and stiffening. They aren't going to see that their liver is stopping processing and clearing cholesterol at the same rate. They'll find it out later once they get blood tests or have a disease process.

Right?

They aren't. No. None of us feel the cognition changes, truly, of tau proteins building up in the brain, Right. So there's these really, really important things that we say. You know, you can't feel your microbiome shifting, right?

That's right.

And how many of us are going to sit there and say, well, gosh, all of a sudden I have a little bit of bloat and I'm not pooping as often, and that must be menopause. No, the mass. Majority of her like, gosh, what did I eat the last couple days? Or, you know, what's kind of going on with my, you know, am I hydrating enough? Or whatever?

Is it stress?

So there's so many things that women aren't understanding that are happening under the hood. They are not going to feel them in the moment. They're going to become aware of them. And unfortunately, it's going to be hard to repair arterial walls.

Right.

So even if you are not feeling things, you're thinking, I've got this, I'm 52, whatever it is you're, you're feeling, I don't need this. You need to be looking at the data and the research around this because you could in a decade. And I watch this with some of my friends, by the way. I've got many friends in their 60s that did not do hormone replacement and they're now having these issues and they're trying to play catch up now with this, which is not so easy all the time. So I, I literally witnessed this going on with my friends. What about the people that have all the things going on and they're, they're going to the doctor, they have all the symptoms, they go to their doctor and they say, I don't like how I feel, I don't feel like myself. I've got these problems, my hair is thinning my skin. All the things are listening and their doctors are telling them it's just age, it's just menopause accepted.

Well, they wouldn't be saying that to these women if they were say 32 years old and are com. And, and they came to find out that say the 32 year old had all of these symptoms and issues going on in the body because she was severely like ovarian deficient. Her hormones were in steady decline. That would be like red alert. Why? Because of the bones, because of the brain, because of her heart, Just so many different because of the cardiovascular system. So pray tell, why when A woman is 55 and has these issues and it's due to deficient hormones, do we not take the same concern for those women?

Well, and we'll say too, just aging, it's like, well, and there is a element of estrogen loss accelerates aging. Estrogen is highly influential on our mitochondria and our cells. We know that aging is essentially mitochondrial. Mitochondrial decline.

Right?

I mean, that's, at the end of the day, that's what's happening. Our kind of energy factories and these wonderful ATP generators and, you know, cellular membranes and everything else starts to kind of fail totally. How many women are told that estrogen actually makes that work? Losing estrogen actually makes that worse.

Right?

Losing estrogen, we lose an enzyme, sod that is highly relevant for mitochondrial function. So is it aging or is it women? You know, because if you look at men and women, we don't physically age at the same rates. And that's kind of a brutal and sad reality. So knowing that, you know, what are we going to really say? That women just age faster? Or is it women lose their hormones earlier and quicker than men do. And therefore we see that huge shift in aging.

Correct. Okay. So when they are getting this though from their doctors, because they've been going to the same obgyn for years or whatever is. And they are feeling, it's almost like this gaslit feeling or maybe I'm crazy, it's in my head. What do you want women to know? And I'm asking this because I knowing I almost know your answer, actually, I do know your answer, but I want to hear you share this with women because I've listened to you so many times and you've helped me feel very empowered to ask these questions. What do you want these women that are literally sitting there, they're dealing with their doctors right now to know?

Well, at the end of the day, their ob gyn, as much as they may love them for maybe delivering their babies or something like that, isn't probably the doctor that you need to be having this conversation with. That's where we'll start. And simply, it's because they don't. They receive an ob gyn, receives about as much training in menopause as any other doctor does in nutrition, which we all know is zero. So they don't have much kind of tools in their toolbox beyond the postnatal care of a woman. And that is part of the problem. Right. So they're going to reference talking points for the medical societies. They're going to give you kind of what they're told to tell a woman in menopause. So you really have to decide who is the doctor that I want to entrust my aging with.

Right.

Who is going to prevent disease, risk escalation, who is going to really care about how I age in my health span.

Right.

Etc. So you probably have to find a new doctor to for one. And that doesn't mean Marie and I are anti obgyn. We tell all of our clients, keep your obgyn. You need her for your breast exams, you need her for your pelvic exams, you need her for all those other things as we get older. You know, this is not to put down OBGYNs. They're just not trained and skilled for this. So who should they go to look for like anti aging doctors, longevity doctors, doctors, maybe functional medicine. Unfortunately, that words kind of got bastardized recently, you know, so. But looking for a doctor who really is invested in women's long term health beyond the postnatal years, and that can come in all different kind of stripes. You know, asking them sort of things like if you were to give me hrt, what is the purpose for which you'd be giving it to me?

Right.

And if they say to stop your hot flash, they also might not be the person.

Right.

You really want to get someone who's interested in saying, well, I want to protect you from heart disease because yes, fun fact, breast cancer is not the number one killer of women. And yet we all seem to have this inflated fear of it.

Heart disease, Right.

Heart disease is the number one killer. So you know, asking a doctor a simple question such as what would you use hormone replacement therapy for with me, their answer is going to tell you a lot.

Okay, this is really important here because I hear this all the time that they are. This is, this is so common. This is so common. I would say most of the conversations with women, it goes like this. I went to my doctor, they would not test for all the things that I asked for. They told me that they would temporarily give me hormones to help offset the symptoms. So this is not optimal levels, which I want to ask you about. Or they told me go on birth control pills. They're telling menopause or post menopausal women to go on synthetic birth control pills.

Right? Yeah, it's, it's, it's essentially it's the wrong doctor. And so what I would say, what I want women to know when they go in to their doctor, this may even choose change. Who they go to is what a profound neurological and, and just body wide physical change that is. Again, let's take symptoms off the table. Symptoms like let's just pretend they don't even exist. I mean, I know they do and I don't want to, you know, kind of deny a woman's lived experience. But if we just even took symptoms off the table, like this is a profound shift going on, one that has very, you know, consequential health impacts for women. And Natalie, we don't always see these until we hit 60s or 70s, right. And we have this beautiful like, you know, our lifespan, we can live, you know, 30, 40, maybe even 50 years. Postman as postmenopausal women.

Totally.

Right. You're maybe you're a super ager. Like do you want to live that in as good health as possible or just patching up symptoms? And you know that that discussion starts at 40 something, 50, something like that.

There is a. I had a message recently on Instagram and this one really stood out to me. She had said she'd been listening to my podcast, she had heard all of me talking about optimal hormones. I think, I believe she Follows you all too. And she went to her doctor and said, I really want to be on hormone replacement. She asked her doctor order test, which she did. And her doctor, who was a lot younger than her and not in even close to perimenopause, said, hormones are risky. I'm not comfortable prescribing them. I will give you a very small dose, but I need you to basically sign this waiver that I gave you all the warnings.

Yeah, well, I mean, there are still black box back, black box warnings on FDA approved bioidentical hormones. And, you know, we've got plenty of doctors trying to like now sign petitions and get Congress to remove warnings on Advil.

There's warnings on everything.

Exactly. But they're still, they're based on this old research. You know, we don't have a lot of doctors graduated from curriculum in medical school that actually, you know, espouses the benefits of hormones. And so you're always going to hear that one of Maria's favorite terms is, look, doctors are down on what they're not up on.

Right.

And so if they're saying to you, I'm not comfortable with it, that's code for, I have no training in this. And in a way, what they're saying is I respect hormones because they're powerful and we all should respect hormones. But I personally as a physician have no training in this and I don't want to be to blame if I screw it up, because I'm probably going to screw it up because I'm probably not going to look at it well.

Right.

So, you know, those things are not sadly uncommon. And again, it's just know who you're asking from. And women, we need to interview these doctors. I mean, women really need to start to understand, like, what are you seeking hormone replacement for? You know, what is it that you're comfortable with? What are your goals? And then ask a physician questions and if his answers or her answers don't align with your answers to those questions, you know. Yes. Yeah.

So I'm a huge believer, and as I know you both definitely are, this is your whole business here in really empowering women with information so they know what to ask, so they have the knowledge and they, they're clear what to ask there. So assuming someone's got the knowledge, they're reading your book the Great Menopause Myth, or they're listening, they're learning, they're understanding. Now they're scared of these few things. Help me, help me with this. Number one, they say my insurance does not cover the Testing or the treatment? What do you want them to know?

Well, insurance has to cover it for those who have the right diagnosis code. So this for better or for worse. And everyone can come and shoot me, but we tell our clients all the time, if you're stuck with your OB gyn, go tell them I'm having horrible hot flashes. They're required to dose.

Okay, good to know.

You know meds. In that case, ask for a DEXA scan. If you're postmenopausal, you probably started through some osteopenia. If you've been postmenopausal without any hormones, DEXA scan also medically, you know, recognized as a number one reason to go do it. So we would say fake a hot flash, just tell them you got all the time, or go get a DEXA scan. But the reality is, is that, you know, health is expensive as we age, for better, for worse. And you don't always need insurance to get things. If you can get someone to prescribe it. There's Goodrx, the new Amazon pharmacy. I mean, women can get a patch like $24 a month. I mean, this is not, you know, gonna bend our wallets in half. So.

So I. I have a Health Share, not actually insurance. I use something called Health Share, where it's you.

You're.

So we pretty much pay out of pocket for everything unless it's catastrophic. But what I find is the cost of using hormone replacement is offsetting the cost of disease later.

Well, that's what I was gonna say. Pay now or pay later.

Right?

I mean, how much is that statin and the Metformin and the Zoloft and the sleeping pills and everything else.

Not to mention the lost quality of life.

Exactly. Yeah, yeah, yeah. So, but I think do. Women do have this notion that it's wildly expensive. And Maria and I would say even for something that we consider kind of the Cadillac of hrt, right, we're talking like physiologic dosing of creams and arrhythmic fashion, all this kind of crazy stuff compounded only. And you're paying about 100 to $130 a month if you're including testosterone as well. Most of us are probably able to find $130 a month. And if you're not, then ask for a commercially available medication and get it through Goodrx.

Makes sense. Makes sense. Okay, the next question I get all the time, which I'm sure you do too. Someone says they've been diagnosed with estrogen positive breast cancer or they have a history of estrogen positive breast cancer or they have a history of breast cancer. So they are either scared to do it or they're told by their doctor they are a hard. No, sure, I will take this one.

A couple of reasons. So. So most women who are, if there's a family history of breast cancer, they're contraindicated for hrt. Unfortunately, where the nuance gets lost is it's really, you have to have a first year relative who was diagnosed and treated prior to the age of 60. The vast majority of breast cancers are diagnosed postmenopausally, which means most of the mothers or grandmothers, et cetera, that had breast cancer that this woman thinks makes her ineligible for HRT, most often they are 60 and older. And so that actually is not a disqualifying situation. Right then for those who have a current, let's say, diagnosis, it's definitely a risk, benefit, benefit analysis that needs to happen. I can say from personal experience that you advocate with your physician. And I looked at mine and said, if you take away my HRT while I'm being treated for breast cancer, what are you going to do for my brain, my bones, my heart, my vagina and everything else? And they looked at me and said, I don't have a good answer for you. And I said, okay, well, my quality of life depends on maintaining the intactness of all those things. And I do believe in the research that shows that my course of breast cancer is going to be less aggressive and less recurrence risk and all these things. And therefore I'm going to stay on it. And so most women, you have to be in a position to advocate. But even at the very least, if you, let's say, are doing chemotherapy or you're on SERMs, which are selective estrogen receptor modulators, they're drugs that can sort of act at the receptor, but they're not a hormone like estradiol. Yes, some of them are totally fine to take alongside hrt. Others require the HRT to be halted until the cirm horse is done. Again, there are other ways to address it, such as vaginal estrogen. This can really help a woman's quality of life while she's going through treatment if her treatment protocol is such that hormones aren't allowed at the time. So there's, you know, not every woman's breast cancer is the same. And I think we need to kind of really step back when we hear some of these stories and realize that, you know, someone who's got triple negative breast cancer and someone who has Estrogen receptor positive, but maybe it's not got lymph node involvement yet, and it's just a local invasion or et cetera. It's all different. Every single woman's cancer biology is different. Every single woman's cancer situation is different. And so there isn't a one size fits all recommendation with respect to HRT and cancer. You really need to have that conversation with your oncologist and, you know, be educated.

Going in synthetic birth control. Let's talk about that for a minute. What if somebody's on that right now because their doctor prescribed. How urgent is this for them to get off of it if they are close to menopause, postmenopausal, and can they. Should they be testing their hormones while they're on that?

They should not be testing their sex hormones on birth control, because if you did that and you had pretty good levels of hormones, and you can be pretty assured that your birth control is not working, because the point of birth control is really to kind of shut that down. So women on birth control actually are in a menopausal, like, state. So, you know, you say how urgent. I mean, Natalie, we do have to kind of. We do have to acknowledge the fact that pregnancy, you know, can be an issue for some women, and, you know, that's why they use it. I would say that's in a different category, so to speak.

I guess I'm talking about the. The ones that are on it because they're physicians, like in that physician manage your symptoms. Yes.

Yeah, yeah.

Bad. Bad idea. Just. Just a bad idea. Not shaming anyone by saying that. You have. See, one of the things women don't understand is that they. They typically can have just a very simplistic. And Chris and I both had this years ago as well, so I'm not putting anyone down. But it's not just about, hey, I'm gonna take some hormones, and, you know, it's gonna work. It's like you have receptors, okay? Hormones work when they dock into receptors in the body, okay? Whether we're on birth control, whether we are just time out for menopause, and we've got low levels of endogenous or natural hormones in the body. Receptors, they kind of like, maybe if they're robust, they go like that. They kind of, like, flattened, okay? And when those receptors are like this, your HRT does not work, or it works really poorly, right? So, you know, and then we've got the hrt, We've got misfolded proteins, We've got cancer risk. We've Got gut disorders.

Clotting.

Yeah, clotting.

Yeah, clotting. Yeah. And then the other thing too is that birth control puts a woman in a state of various nutrient deficiencies. And what's really, really sad is the specific nutrients that hormonal birth control depletes are actually incredibly important for receptor function. And so this woman might be like, okay, I'm off my hormone, my birth control, but it's going to be a longer on ramp for her. And so that's why, in our opinion, it's like the sooner you can get off, the better, because this damage is being done and it's going to take a while to unwind it, if you can at all. We know women who have just really struggled to get optimal outcomes with their HRT simply because they had so many years on birth control. Yeah.

And our age group, our Gen X age group, especially because, I mean, I was on it at age 15 because I had.

Yeah.

Because my period was not normal. And that was what we did, you know, so 20 years on it.

Yeah.

Which is we were just conditioned that this is what we should do. So. Yes.

Yeah.

Okay. What about.

Can I make one quick thing, though? Yeah, of course. Talking about oral birth control or we're talking about birth control and I think most of us in our brains are thinking oral birth control pills. I do want to shout out the Mirena and the, the hormone based IUD because they are also having an impact. And I think too many of us were lied to and told, oh, this is a local delivery of hormones. This is only in the uterus or only in the cervix. And you don't have to worry about these things. That is false. That we now have even MRI studies that show that the progestins and let's say the Mirena IUD actually trigger breast tissue changes in the breast. Okay. Last I checked, the breasts aren't directly connected to the uterus.

Right.

So we know that there is a systemic uptake of hormones from hormonal based IUDs. And so we would say everything that we just said about birth control and kind of the context of oral birth control. The exact same applies for the hormonal based IUDs.

So copper IUD, not the hormonal base if you want it to be. Truly no hormones.

We call it the least bad choice.

Yeah.

The least bad choice. Okay.

Yeah, yeah.

Copper ID still have their own issues with heavy bleeding and all kinds of other things.

Yes, yes, they do. And copper can act as what's called a metalloestrogen so it can alter some receptor signals itself.

So, yeah, I want to talk about something that no one has really talked a lot about with estrogen, or at least I'm sure you have, but I don't hear this regularly, but I really notice this in myself, and I notice it with people is the appearance of our skin when you're on it or you're not. I can look at a woman and tell that she's not on estrogen.

Oh, you get it. You need to be in the group chat with me and Maria that we're always like, you know, this is a nice.

I've always called it a nice side benefit. Like, I. You know, it's just really nice. I'm super more fascinated with the idea that I'm protecting my brain and giving myself every chance, you know, at avoiding or at least greatly delaying the chronic diseases of aging. But I'm, like, thinking, okay, I'm, like, reaching my mid to upper 50s here, and I kind of, like, still like my skin. I mean, I still want a facelift someday.

I'm just saying that a lot of my audience.

I know.

I just triggered Chris. Yeah, But. But you know what? I may be able to push that.

Way off, because this is what's funny to me. I'm all for baby. I'm all for cosmetic surgery, all for whatever makes people happy. Okay. And I will say it's a beauty thing, too. I mean, estrogen makes your skin look better. It does.

It does.

I'm, like, literally looking at your skin now. It looks beautiful.

So, yeah, Yeah. I mean, what. But I think women want to know why, right? Because there's a lot of marketing around hormones being used in skin care products right now, and I think we need to address that topically like that. Yeah, yeah. If we take systemic hormone replacement therapy, it changes the fluid retention in our tissues. It changes the collagen matrix in our tissues. It changes, you know, so much that's going on. That's why we see the skin benefits. It's not sort of a, you know, perceived benefit. It is a true benefit. They've looked at these things. They understand how it works and why it works that way. So if we were to take HRT and we get skin benefits, but we get all these other benefits, we're protecting our bones, our heart, and all these other things, as well as our mood, and we're not isolating, and we want to have sex and all these good things. We don't probably need the Estriol face creams that are being thrown around Everybody just want to say that, like save your money because even if you swear you noticed a benefit in some estrogen based face cream, the reality is is that's where it stops. Yeah, protecting your bones.

Right.

But if you took systemic hrt, you actually get the skin benefits and everything else as well.

Well, that's the same with eating collagen versus just putting a collagen cream on your face. That's going to be a night and day difference.

Yeah.

Okay. I've got a lot, a lot more questions that you. Every time you say something, I have another question that's coming up in my mind and thinking of what people have asked me, I want to know about different levels because every doctor has a different opinion about levels. And I know that we've even gone back and forth a little bit on my own and I feel like I work with some amazing doctors, but they tend to err on this conservative like let's just keep it here and then I'll see something that you all will post about, about. No, we need it higher to get the benefits. It gets very confusing. How do we actually know what we need? I know. Is it you or one of you has said that your back starts hurting when you're not high enough?

Yeah, well, me, I'm like in joint, both of us. But joint pain is one of our like bellwethers for oops. My estrogen's too low.

So what is too low? What is high? How do we. It's very confusing for us to know.

Yeah, I mean I think if we looked at like Marie made the point that if we had a 35 year old woman and she was low hormones and we would raise all the red flags and we'd restore her hormones and they'd use all sorts of interventions in order to make sure that they came up. Well, if we then say, okay, if that's the case in pre menopause, what is the kind of technically lowest average during our pre menopausal years? So if any woman were to Google kind of the hormone chart, right. You would see that we have this climbing peak from our cycle day one, around day 12, then it starts to decline. So first half of the cycle, follicular phase, second half of the cycle, luteal phase, the average kind of mid range for luteal phase I. E. The lower points of estrogen throughout a woman's 28 day cycle, the average is about 150 picograms per milliliter. So if we know that at 35 a younger woman who starts to Fall outside of these numbers, receives treatment. Why would we then tell a menopausal woman that 60 to 80 picograms per milliliter is sufficient? The other thing to keep in mind is that a lot of women, most, I would say the vast, fast, vast majority, are taking what we call static hormone replacement therapy, meaning the same dose every single day. So ostensibly, their level is level.

Right.

Their hormone amount is a level. Like when you see.

When you have a patch just on you and you're just wearing. Okay, correct.

It can be done with creams, etc. Other things, but. So you're taking the same dose and you just kind of have the presentation. If I tested you middle of the month, end of the month, you know, first of the month, you're going to have about the same level. Well, that's not how our bodies ran when we were making our hormones to begin with. And you have to start asking yourself, well, is 80 or 60 picograms per milliliter sufficient one day of the cycle or every day of the cycle? We were never that low. Every day of the cycle. Might someone drop that low, let's say, right before their period at the end of the luteal phase? Sure.

But remember how bad of a mood you were in when that happened?

Exactly, exactly. But it's one day that we were that low.

Right.

So if we really look and we say, okay, the average bottom. The average bottom over the course of the cycle, taking out all the peaks and changes, is about 150 picograms. Why are we not restoring women's hormones postmenopausally to the levels that we would want to see premenopausally for optimal health?

Right.

And so there is that.

You just kind of described the patches getting a woman up to like 6:60 to 80, which we have seen, but we've seen a lot more than not women getting up to. Oh, gosh, I spoke to a woman today who was like. I was like zero when I started, and the patch got me up to 18.

But normally, like, okay, my patch went. Took me from 20 to 150. So I don't know if that's just. So I don't know if that kickstarted some of my own. I don't know what.

You might. You might have some adrenal hangover. You know, adrenal production. And you might have a tiny bit of ovarian still. Very possible that you still have that. So again, talk to us when you're 58.

Right.

Yeah. And see if that same patch is keeping you there? Because the reality is even the largest dose of a patch, which again, not a lot of women understand the nuance that we have this massive range of dosing of the patch, even in of itself. But the largest dose at 0.1 milligrams, that package insert says it is incapable of getting above 80-90 pograms ML. So women who are like, but I'm getting higher, it's like they have their good. And some other stuff. Yeah, yeah.

And I, in my case, I'm not. I'm might be an anomaly too because I'm not fully menopause yet. I mean, my numbers would indicate that, but I, I get a period every few months. It's like something's I'm in perimenopause.

So we'd posit it's not going to be sustained there for you or any other woman who's seen numbers higher than that. And that's even the 1mg patch twice a week.

Right.

Did I hear right that you both use two patches? Was that.

Did I at one point? We both did, yeah.

Okay.

Yeah.

I used patch plus cream actually at one point. Yeah.

Okay.

Yeah. For me, two patches twice a week was my highest that I got was 93 picograms per ML.

Wow, interesting. So you would use cream too to get to the numbers that you want?

Yes. Yeah.

Okay. Is there ever an age that's too late to start hormones?

Technically, no.

Okay.

But what this is goes back to that whole myth that meant that menopause isn't just about menstruation fertility. It is about these age related declines or hormone driven age related declines.

Right.

They happen in our 40s even when we're still cycling. So the risk or the concern for older women, let's say you're 71 and you really are like, I get to start hormones, let's go. You want to make sure that the changes over the last 30 years have not left you in a disease. Risk for cardiovascular plaque mobilization, things like that. It doesn't mean you can't start. It just means one, you should probably have a full cardiovascular workup. Something like a cac, Coronary artery calcium score done. Probably look at your lipids, look at some inflammation markers, things like that. So a nice deep look under the hood with good labs and then B, you probably will have a lower dose of starting and a slower ramp as you go. That's just caution. That's caution. Because hormone states of deficiency leave us with, with disease risk and metabolic changes. So we need to sort of, you Know, take that into consideration. Why is there this notion that 65 is some magical moment that we're supposed to take all women's hormones away? Simply because the studies didn't really go beyond age 65. That's it. There is zero evidence that hormones are risky after that age. And in fact, UTIs, you know, genital urinary symptoms, things like that, that really plague a lot of the older women. I mean, we've got clients who literally say that they can't get a vaginal exam because they can't even get a pencil. This is something the width of a pencil inserted. That's a massive failure of their physicians. Yeah. Had she been given hormones, she wouldn't have to deal with that. So, yeah, I mean, caution. Look under the hood. Know your situation, you know, metabolically, and then absolutely don't decline hormones.

So I have a friend, a good friend, because I'm preached to. I preached to everybody about hormone replacement. And my, My good friend who's in her early 60s, she had not been on any hormones because of the fear of cancer. Okay. So got her with the right information, and she went to a doctor who agreed. Started on hormones. I'm certainly not the doctor, in my opinion, put her on way too much too fast. And what happened was she started having bleeding, she started having cramps, she started having breast. Worn out the. She gained weight, like, like, worst case scenario, which sort of made her feel like all of her fears were right.

This was a bad outcome. Yeah.

Help us with that. Like what you just said.

You, you.

I think you said. I think I heard you say you want to start slower, gradual.

What would.

What advice do you give to somebody that's postmenopausal 10 years, that wants to.

Dabble if older, for sure, starting slower is better, but it's not even just necessarily starting slower. It's also like, okay, but there's. That's not even that unusual. Okay. Eating the cramps, the, the tender breasts. Like her. Her hormones have been kind of absent, right?

Totally. She was zero. Estrogen was zero.

Went in there and woke up the receptors and, you know, grew. Aligning can have sore breasts. Oh, you know, Kristen, you can speak more to the weight gain type issue, but. So that's not super unusual. But we would all also have to ask is like, was she given.

Maybe.

Even testosterone straight out of the gate? Estrogen, progesterone.

Progesterone and. And estrogen in her case.

Okay. So it's super common for women who are on daily progesterone, not cyclic, which Is something that we do, you know, recommend as a strategy to have kind of random bleeding.

Yeah.

Okay.

So if she was to cycle that progesterone. Right. Kind of would mimic, like, a natural cycle. Like, the propensity for random bleeding would.

Be a lot less now with those symptoms, like, because obviously those are concerning for women. I mean, no women want to gain weight starting this. Is this something that levels out? Is this just a real thing that. To be dealing with, like, with that when you start that late it. When people say they gained weight from doing hormone replacement.

Yeah. Usually they weren't counseled as to what to expect. Marie and I kind of say there's, like, blues. So mood changes can be common. Women suddenly are like, I'm so weepy. What's going on? I thought these hormones were going to make me feel better. So blues, boobs. The breast tenderness is so common. And, you know, we could do a whole nother podcast in this. But looking at what happens to breast tissue as we age, it remodels from mammary gland tissue. So good breast tissue to fat tissue. As we lose hormones, our mammary glands, our breasts turn to fat. That is actually the risk for cancer because we know that that fat produces estrone. It changes this whole aromatase issue. There's a lot going on there. So when women then have probably had those breast changes already and they add estrogen into the tank, you're remodeling from fatty tissue back to mammary tissue. And that is tender. It can be tender. For a lot of women, it's not uncommon. Something like a little iodine rubbed on the breast usually gets rid of it for them. And it is temporary. It could be. Be a month. It could be three months. It might be six to nine months.

But adjustment period.

Yes. And a lot of women quit, and then they blame the hrt, and we think that's just tragic.

You know, even in relationships, do not rip off your patch and throw it in the trash. My friend that's listening right now. That just did that. Do not do that.

No. I mean, expectation setting is everything.

Right.

And so we didn't set these women's expectations that, like, there might be some discomfort in the months ahead. That's normal. And it's okay. It's actually your tissues responding in a very vital way to these hormones. But most women are like, oh, again, when you're predisposed to think that hormones are bad, you feel these changes, and you're like, I knew it. You know?

Yeah, Okay. A little nuanced question about the patch, does it matter where you put it on your body? It does where you want to put it.

Belly.

Okay. Can you put it on your inner thigh, on your butt or in your, any, any place else that has fat?

If you want to bikini line is going to be best. Don't put it anywhere in the chest wall near the breast. Some women will swear putting it on the shoulder or the back of their arm works. Inner thigh probably not the best area to do it. And if you have more adipose tissue around your belly, probably the lower the better. You don't necessarily want it right over the fattest part of the belly.

So mine is currently on my butt because I'm lean on my abs.

So you could like kind of in your upper butt cheek.

Yeah. Is that okay?

Totally fine. Yeah.

Personal question there. Okay. What about, let's talk about some of the other hormones. We talked a lot about estrogen. How important is progesterone to be on board and what are your thoughts on testosterone? I, I, I know that you think that that gets over prescribed, so I want to talk about that a little bit.

Yeah, progesterone is important. It is kind of like the start, you know, it's, it's in the supporting role. We are both love our estrogen more than anything else and we kind of tolerate our progesterone like it's okay, but it doesn't have like all the wonderful benefits that estrogen does. But you know, it's so important that's important for the heart, important for the brain, important.

Helps you sleep too, right?

It helps.

I think it helps with sleep onset. Not in all women, which is really, really interesting. I've, we've gotten back reports that it actually some women have a paradoxical effect and.

Interesting.

And almost like rev them up. Yeah. Helps with sleep onset. I will share this. This may not not be everyone's experience, but when I was years and years and years ago when I was doing static daily progesterone, I lost that sleep benefit like after say a few months of taking progesterone every single day, it was like, oh, it just like wasn't doing anything anymore. And I think again, that was a receptor sensitivity thing because optimally we don't take progesterone on a daily basis.

Got it. Yeah. So you take it, you foul, you follow a natural cycle with that. So you take it up, tell your period would have been and then you take a break.

So if you're 14, it's 14 through 28. Yeah.

You take a break. Okay.

Yeah, yeah. Of everyone with or without a uterus, Progesterone is to be beneficial in those areas that Maria described. And then for testosterone, you know, testosterone can be important to some women. I think where we are over prescribing it because we get a lot of bang for our buck in the beginning, right. Women will be like, oh my God, my energy, my libido, my whatever. Okay, well, two things are usually happening there. One, you're getting kind of newbie early wins because you just got some hormones put in your body and you probably had none. And two, if you have that palpable of a change, it's probably because your dosing is at what's called supraphysiologic levels, meaning levels way higher than what your body ever saw naturally. Now there's a lot of younger women right now who are all in on testosterone.

Yes.

And Marie and I will say, ladies, you need to give your adrenals some love because the vast majority of you are in the pickle that you're in not because of a testosterone deficiency, because of adrenal dysregulation. And so, you know, stop the under eating, stop trying to get your snatched waste and your shredded bodies, you know, stop the over exercising, stop the scrolling until one in the morning. Get your lifestyle foundations in place. If you're a 38 year old and you're chomping at the bit for testosterone, you've got other low hanging fruit that you're. So we're kind of hard on that. You know, the studies show that less than 25% of women actually need testosterone as they go through this transition. So, okay, those of us who are older and we've got these lifestyle foundations in place, you know, can we benefit from it? We can. Again, if it's going to be at physiologic levels, meaning natural levels that we once produced, probably not going to be this like humdinger event for you. Okay. It's very simple. It might be like, wow, after six months in the gym, I'm actually benefiting from this stuff. If you're expecting it six weeks in the gym, again, your dose is too high.

Right.

So why are we so cautious with it? Because the female imperative is estradiol. That is what drives our body. And you're going to hear people say, oh, testosterone's the largest hormone or largest volume of hormone in the women's body. Okay. But testosterone actually becomes estradiol, that it is just one kind of link in the chain and at any given time it's transitioning to other things. And so is it always this massive amount of testosterone that we need? No, we need estrogen. That's what's triggering the brain protection, the bone protection, the breast protection, all these things. Can testosterone play a role? Yes, but estrogen and testosterone share a cell wall at the receptor. So Maria talked about those docs, the signal the hormone needs to go in and sit on.

Right.

Well, they share a wall. And because they share this cell wall at the receptor, taking testosterone before your estradiol is optimized, you can block up to one third of your estradiol uptake. And we see it all the time. These women, again, early wins. They think things are going well. Maybe they're even given a full blown cocktail of estrogen, testosterone and progesterone. And they're like, this is working. And then they're like, wait, wait, what happened? It's not working any longer. It's because a few months later. Yeah, yeah, you lost the plot. You were supposed to go after the estradiol. Yeah.

So I have a number of doctors that have shared with me that they had patients that came to them. They were on way too high testosterone doing pellets, specifically, not injectables, but. But actually the pellet. And like very strong. And then when they went off it or went down, they went through severe depression, anxiety, withdrawal, and like even suicides. Yeah, I've heard a number that's scary to me.

And voice box changes. You and I can't hear our own voice box lowering and lowering in its decibel, so. Or in its tone. So that's irreversible. Right, That, I mean, anxiety. Hopefully we can get some, you know, counseling and some assistance and we'll get through that phase. You're not changing your voice backs. Noise box. Back to the feminine one. Clitorises, they get enlarged, they grow little mini penises. When women are. There is a whole industry of surgeons who will correct your clitoris because if you're too high of testosterone, that's not normal, that's not okay.

Do you think pellets are ever okay to do? Are you more of a fan of injecting or cream?

We're not fans of pellets at all because they're just so not physiologic. They can't mimic.

Yeah.

Plus you have little scars all over your body. You have to keep surgically implanting them. Right.

Talk about expensive, too. Yeah, I mean, you know, if women are worried about the cost of a patch or cost of compounded hormones, they got to realize they've just become A lifelong client every three months for this person to get it.

And that just feels like a lot of visits to the doctor.

What about injectable versus cream? Any preference or differences there?

Which hormone?

Testosterone.

Yeah. I mean, we prefer cream. There are some people experimenting with gel, and we've seen gel work for some and cream work better for others. I think the problem with the injectable testosterone right now is it's, again, being dosed very high in women. There are a lot of femtech platforms out there, so virtual telehealth kind of thing. They can't give pellets via telemedicine, but they can give men's testosterone injections by telemedicine. And so a lot of these women are on, again, these wicked high doses.

Yeah.

You know, are there ways to microdose testosterone at a woman's level? Yes, but, like Maria's husband's dose of his cream versus Maria's dose of her cream. Maria is what, A factor of 10 times higher? 10.

A factor of 10.

Yeah. Yeah.

One thing I didn't ask about for any of these methods was troches and biased. Can we talk about both those things? I went off bias because of you too, by the way. Yeah, that's what got me on the patch.

Oh, you also didn't have good levels on bias.

No, I wasn't having anything. It wasn't doing anything for me.

Yeah, troches are okay. I mean, they're not great, if I'm being honest. They are expensive. They taste nasty. You know, the presentation for pharmacokinetics for a troche is really like three times a day. That's a lot of.

Just a lot of different parts of the mouth.

Right.

Like if you stuck on it one cheek, the next one you got to do in the other cheek.

Yeah. And then, like, if it's estrogen, you. You're swallowing some. Not all gets absorbed here. You're just swallowing something and you're swallowing it.

You're getting it in your liver. You're getting it.

Well, you're. I mean, all hormones are going to get processed by the liver, even stuff that we put on our skin, but they go directly through the digestive system, and that can create estrogen. When we do estrogen as a trochee and we swallow it, that can create some more inflammatory proteins. It can definitely create more estrone. Body's going to create estrone regardless of what method you use. We don't want to, you know, like, make it create a ton of estrone because it's Going through different. The digestive system.

Yeah, yeah, yeah. And then bias for women who are unfamiliar. Biased is a combination of two different. So when we say estrogen, we're talking about an umbrella term. There isn't actually an estrogen in the body. There's a family of hormones that fall under that umbrella. We have estrone, which Maria just mentioned, that isn't necessarily dangerous, but it's not the. The estrogen that we want most active because it only really has an affinity for one of the receptors. And then we have estradiol, which. So we have two different types of receptors. Predominantly there are more than that for estrogen, but predominantly too. Estradiol influences both of them evenly. Estrone only does one. That's kind of growth. And then we have estriol that does the other. That is more kind of the brakes. So biased. What is a compounded medication beloved by doctors who. Marie and I will just put it out there. Are afraid of estrogen. They're afraid of estradiol. And so they want this gentler, more safe approach, which. I hate the use of that when they say it because it's implying that estradiol is unsafe. And there's nothing showing that estradiol, you know, bioidentically is unsafe. So what's really at play here? Well, there was one little study, one that looked at the urine of pregnant women. Six pregnant women just don't put that out there. So estriol is the predominant estrogen of pregnancy. Okay. So we produce it in large volumes because it sort of downregulates the immune system to prevent us from rejecting the DNA of the male sperm that's now combined with our egg for the penis. So it has a role. What's a fun fact is that estradiol will convert into estriol in non pregnancy states when the body needs it. Okay.

Okay.

So what's the problem with estriol is that it was given a hat tip for saying that it will prevent breast cancer. Breast cancer, because these women in pregnancy didn't get breast cancer and their urine showed a lot of estriol in it. Okay, very frustrating because again, was that estriol in their urine, that metabolite always estriol, or was it estradiol at one point that had converted?

Right.

We don't really know. And the reality is pregnancy, for better, for worse, is not a guaranteed protection against breast cancer. We know women can get breast cancer even during pregnancy, but unfortunately, this study allowed a certain group of physicians to say, oh, if the pregnant lady's urine had A lot of estriol and they didn't get breast cancer. Estriol is the hormone that we should use in post menopause to protect women. And so biased is a combination of estradiol with estriol in sometimes different ratios. And it's given to a woman because it's quote unquote safe. And the sad thing is, is it does not get her levels up, up. You never see levels high enough. We also haven't talked about another hormone called follicle stimulating hormone, which is a brain hormone. Okay.

A great, your fsh fsh, great thing.

For women to track because our brain is constantly, even, you know, from our entire birth to death, surveying the system to say, how much hormone do I need? Do I need more thyroid? Do I need more insulin? Do I need more estradiol? Do I need whatever. If our brain is unhappy with the levels of estradiol in our body in order to cause all the wonderful actions and causes, the good things, it will increase follicle stimulating hormone because it's trying to communicate to the ovaries to say, hey, do better, I need more.

Right.

So why is that relevant? Because we see time and time again women who are unbiased.

That was me.

Really high FSH levels.

Very high.

Post menopausally high. And the sad thing is, biased is not something insurance is ever going to cover for every woman out there. It is a cash based compounded medication. You're putting all this money into a hormone that leaves you in a post menopausal state.

Yeah. Literally does nothing with typically with high FSH levels of over 25. And you know, we kind of have this step down approach with, we like to see FSH at minimum below 25.

Okay.

Ideally below 10. And if we want to hit the golden ticket, below five.

Five.

Wow. Yeah.

Yeah. You're not going to get that enough.

And I, I watched this happen. I, I actually argued with you guys, as I did. Right. About bias and difference in what the patch did versus what bias did for me.

Yeah.

But you feel a lot better.

I feel amazing. And my estrogen is normal level and every FSH is great. All of it's great. From switching. Just that.

Yeah. I don't want to trash Estriol completely because there are instances in which it has a really great role.

Right.

It can be used vaginally to protect vaginal tissues. For women who, let's say, let's say they're even dealing with uterine cancer and they really can't have estrogen exposure.

Right.

You could deal with that breast cancer patients, they can use Estriol very safely if that's, that's what their risk benefit decision is. Women who don't want to take systemic but want those skin benefits, Estrel and a skin cream could be a good option for them.

Right.

So there are places to use Estriol as a postmenopausal hormone therapy. It's just not for systemic disease protection.

So as you all listening can probably see, I've had some amazing doctors on the podcast but I always come back to these girls here because they have a way of explaining things that makes everything else make sense. I think you two are just such a huge wealth of knowledge and I, and I love that you spend your time empowering women. So they're educated versus them just relying on their five minute doctor appointment. You get them educated, they get up to speed, they know what they need to ask. They have a book out called the Great Menopause Myth that I am going to tell you. Don't just buy one, like literally you need to buy 10 and give them to all of your girlfriends. This is, is this is important and I'm telling you why it's important. There's a lot of doctors still out there sharing a lot of misinformation and it gets loud and I'm always disappointed to learn if somebody new bashing HRT or not understanding and this is important. We've got to get this messaging out to our friends, to our family, to more women is kind of like us against the world right now. I feel like this is, this is a big deal that we need this information so we're gonna put a link in the show notes the Great Menopause Myth. I'm assuming is there a place you want them to go for it or.

Can they Amazon where they Amazon any book sellers, Anything.

Yeah, okay. But literally do not buy 1, buy 3, 5, 10. Give them as gifts. I think women need this. I was very lucky to get an early copy of this and I thought it was incredible. I read it, the whole thing on a vacation and I thought it was just really, really insightful and helpful. That is the quickest, easiest way to get access more knowledge from them. You also can work with them directly. You have a program. How often do you open this for people that they can join?

It's always open.

It's always open. So you do anytime. It's not like, oh, okay. And what I like about that is you it you really school people in there and empower them to be their own. So this your course is not just for, it's for all women, but also if you're also a health coach and you want to learn more about hormones and be able to talk more with your clients, this is a great course for that. And I know that a lot of people are going to be trying to message you. Do you recommend a doctor? No, do not message them for a doctor. Thank you. If you want access to that, the ways you can get that information is number one in the book that you least know what to ask, the questions to ask, or if you're in their program, you do have some doctors you, you vetted, you vetted that you'll actually recommend to people that are members of your course. And before you all get mad at that, it's very hard to give a recommendation when they don't know your whole medical history. And sending that through Instagram is just really not nice. Don't send them 50 voicemails with your medical.

Hey, can I add something?

Yes.

Can I?

You. We, we've had many clients in our six month coaching program. You know, just regular women like us. We've had several physicians who've worked with us on their own health, dozens of dietitians, nurses, physical therapists, but like regular women, you know. Yeah, housewives, things like that, which is perfectly fine, you know, you're welcome.

Amazing.

But we do actually have, for those who want to go way deeper and really kind of of know everything about hrt, know everything about metabolic health, how to test, how to coach women. We do have a professional mentorship, so.

Oh, that's incredible. Yeah. So, so how do they want them to reach out to you if people want to learn more about this?

Well, they can email us at. Hello@WISEandWELL me out more. Our website is WISEandWELL me. And then obviously Instagram, as you mentioned, we try and be really education forward. I mean the best menopause is an empowered one. And you only can be empowered if you're educated and informed.

Well, I thought you all did a great job with the great menopause myth. I highly recommend that if you're my friend, you're probably getting one for the holidays from me. They're, they're, they're so good. It's so good. Thank you all for everything that you do for women. I think this is such a needed. I know you get a lot of heat for this topic sometimes too, but I just want to just acknowledge you for everything that you do for women in our age group. Okay, we're gonna wrap here, but just so you know, we take this to an after party. We're gonna do that in just a minute for my Three65 community. If you are ever interested in hearing my podcast way before they release and being able to stay on and ask my guest questions, you that's what we're going to be doing in just a minute. So we basically pause it for the podcast and for YouTube. YouTube and we take members only private questions for our guests and you can find out more about that at midlifeconversations.com forward/live. Thank you all for being here and we'll stay tuned for the after party. It.