رونوشت کامل Episode #39 Navigating Relationships During Menopause

they were experiencing some emotional things that they were unfamiliar with. 00:03:56.319 --> 00:04:16.800 Um, and it started to dawn on me that a lot of these women were in the perimenopause, last menopause timeline of their life, which might explain why now all of a sudden they were having this amplification of anxiety and depression and struggles in their relationship and um difficulties with their self-esteem. 00:04:16.959 --> 00:04:24.079 And so my practice kind of shifted naturally towards working with women, and that's what I specialize in now. 00:04:24.319 --> 00:04:30.800 Um, I have a lot of experience working with children, families, people who've experienced trauma, grief. 00:04:31.040 --> 00:04:33.920 So that stuff still comes up in the work that I'm doing. 00:04:34.160 --> 00:04:35.279 But like you, Dr. 00:04:35.360 --> 00:04:36.959 Kat, I am a woman in midlife. 00:04:37.040 --> 00:04:39.199 I'm having this experience as well. 00:04:39.519 --> 00:04:48.399 And I want to talk about the mental health impact of being in perimenopause and menopause and what that does to us personally, what it does to our relationships. 00:04:48.639 --> 00:04:50.720 So that's how I found myself here. 00:04:50.879 --> 00:04:54.319 Um, and I'm just so thrilled to be able to participate and have this conversation. 00:04:54.480 --> 00:04:56.160 So thank you so much for including me. 00:04:56.399 --> 00:05:00.160 And it's so apropos because May is mental health awareness month. 00:05:00.480 --> 00:05:04.000 So you'll see lots of stuff in the media this month and people speaking up. 00:05:04.079 --> 00:05:09.279 And, you know, I think the hardest part is mental health and behavioral health has such a stigma. 00:05:09.439 --> 00:05:16.639 Um, and a lot of people are afraid to seek help, you know, because they're afraid to, you know, be labeled or, you know, be judged. 00:05:16.800 --> 00:05:20.480 But part of Mental Health Awareness Month is like, let's get this out in the open. 00:05:20.560 --> 00:05:21.519 Let's talk about it. 00:05:21.680 --> 00:05:31.519 Let's make this part of normal communication and everyday, you know, conversation so that it's not so taboo and it's not stigmatized and so that more people will get the help they need. 00:05:31.759 --> 00:05:32.160 Yeah. 00:05:32.319 --> 00:05:32.560 Yeah. 00:05:32.800 --> 00:05:33.360 Absolutely. 00:05:33.600 --> 00:05:36.720 I'm so glad to be having that conversation, kind of like what you're talking about. 00:05:36.879 --> 00:05:48.079 There is more of the um, you know, in what you're seeing on your side of the aisle with respect to medical care and a conversation happening around that and better access for women and better education around that. 00:05:48.319 --> 00:05:50.319 I want the same on the mental health side. 00:05:50.639 --> 00:05:51.040 Right. 00:05:51.199 --> 00:05:58.160 Um, because there are so many factors that are happening for us now that maybe it's the first opportunity we might have to

even consider going to therapy. 00:05:58.319 --> 00:06:03.759 Um, and taking that leap, there's a there's an element of bravery and courage that I think that requires. 00:06:04.000 --> 00:06:13.360 And it's such a gift in my experience to be invited into an opportunity to have conversations with women and their loved ones about this, you know, time in life. 00:06:13.519 --> 00:06:21.680 Um, and I want to do, you know, a service, if you will, in that way for them to help that process be, you know, to navigate it more smoothly. 00:06:22.079 --> 00:06:22.240 Yeah. 00:06:22.399 --> 00:06:32.160 And I think, you know, we can start off probably talking about how, you know, for anybody that has a history of anxiety or depression, and you mentioned that, you know, it can get exacerbated during this time. 00:06:32.399 --> 00:06:38.319 But often so many of my patients come in and um, you know, come to us just saying, I just don't feel like myself. 00:06:38.480 --> 00:06:53.199 And so when we don't feel like ourselves and we don't feel like our best self, it affects all those people around us and every relationship that we're in, whether it be a romantic relationship, a professional relationship, whether it's friends, kids, dealing with parents. 00:06:53.360 --> 00:07:01.839 Um, and you know, with women in midlife, you know, we're kind of in this position where we're taking care of children, but also maybe caring for aging parents. 00:07:01.920 --> 00:07:06.720 And there's a lot of stressors and a lot of demands on women in this time frame, too. 00:07:06.879 --> 00:07:10.959 So it's just like this perfect storm, this tornado of things that are happening. 00:07:11.120 --> 00:07:25.839 Um, and when you're internally having so many changes and so many symptoms that it's hard to deal with, it makes it very difficult to stay resilient and to to kind of roll with those punches and to be flexible when it comes to your relationships. 00:07:26.240 --> 00:07:28.399 I don't know if you can talk about that a little bit more. 00:07:28.720 --> 00:07:39.839 Yeah, I think that, you know, what I discover whether it's, you know, just I'll be honest, whether it's people I see professionally or even my girlfriends, because right, I'm having this conversation with my girlfriends, which is a blessing, right? 00:07:39.920 --> 00:07:47.759 I'm glad that we're having this discussion, is you know, an opportunity to really start to uncover who you are. 00:07:48.079 --> 00:07:59.120 And that involves maybe deciding that there are things that you have had as part of your background that no longer serve you, and things that you have now that you really want to pursue. 00:07:59.439 --> 00:08:08.800 That doesn't necessarily mean a shattering of everything you know, um, although I I do acknowledge that that sometimes is the path that ends up, you know, being what we walk. 00:08:09.120 --> 00:08:15.600 But I think um you mentioned this is sort of the better, the best time of your life, right? 00:08:15.680 --> 00:08:20.319 Because it's your it's midlife for you and it's the start of this next amazing chapter. 00:08:20.399 --> 00:08:24.240 And I think if we frame it that way from a mental health perspective as well, right? 00:08:24.480 --> 00:08:36.720 That it isn't a crisis in a way that there's no opportunity for improvement or growth, then I think we uh go into the conversation about mental health with the expectation of a positive outcome. 00:08:36.960 --> 00:08:37.519 Yes. 00:08:37.840 --> 00:08:40.639 Um and yes, absolutely. 00:08:40.799 --> 00:08:49.039 If you have had a history of depression or anxiety or attention-related concerns, that's another one that I have a lot of, you know, people that are concerned about. 00:08:49.360 --> 00:08:51.600 This time of life will magnify that. 00:08:51.919 --> 00:09:07.200 But you can get a lot of really good support from your physician, from a therapeutic practitioner to kind of help navigate that process and um end up in a place at the end of this where you feel much better about where you're going than when you started. 00:09:07.600 --> 00:09:11.039 But it is a process, it doesn't happen overnight, um, right? 00:09:11.200 --> 00:09:12.480 Kind of like starting HRT. 00:09:12.559 --> 00:09:15.759 Like it's not, it's not anonymatic, you're gonna start it, it's gonna be effective. 00:09:15.840 --> 00:09:17.279 You're gonna maybe have to change the dosage. 00:09:17.360 --> 00:09:20.399 And then, right, there's a lot of things that are happening in that space. 00:09:20.559 --> 00:09:22.159 The same thing happens in our relationship. 00:09:22.320 --> 00:09:24.080 Like we have to give it some time. 00:09:24.639 --> 00:09:30.000 And I know that that can feel a little bit challenging because we're not maybe very patient. 00:09:30.080 --> 00:09:36.480 And there's expectations that are being placed on us, and sort of we get looked at sometimes in a negative light by the people around us. 00:09:36.639 --> 00:09:40.480 Um, because some folks don't necessarily understand what's happening. 00:09:40.639 --> 00:09:43.919 Um, but some of that is because I don't necessarily know what's happening. 00:09:44.000 --> 00:09:46.159 Like I'm trying to figure it out for myself. 00:09:46.399 --> 00:09:54.399 So one of the things that I like encourage people to do is be candid and open with the people that you're close to about what's happening for you. 00:09:54.639 --> 00:10:16.960 Understanding maybe that I don't really know, but I'm trying to figure it out, and recognizing that you can have a lot of willingness to work on something, and then you have to match that with information and um kind of a commitment to that, and that you know, the the combination of those two allows you to kind of move forward in some way that is many times better than where you started. 00:10:17.200 --> 00:10:17.840 Yeah. 00:10:18.240 --> 00:10:21.039 And and true growth doesn't happen easy, right? 00:10:21.200 --> 00:10:27.519 I

mean, so sometimes you have to go through a little bit of growing pains and turmoil before you come out on the other side. 00:10:27.679 --> 00:10:34.399 But generally, you know, when you go through that and you're working through it, there's always something better at the other end, usually. 00:10:34.480 --> 00:10:36.879 We don't always see it when we're in the thick of it, right? 00:10:37.679 --> 00:10:39.200 No, but it's interesting. 00:10:39.360 --> 00:10:56.000 I I tell this story often that the the Japanese word for um crisis is made up of two distinct characters uh in the Japanese alphabet, one of which is the if the if the character stands alone, it is the word for crisis. 00:10:56.320 --> 00:10:58.320 And opportunities is a crisis. 00:10:58.720 --> 00:11:00.240 Or crisis is an opportunity. 00:11:00.399 --> 00:11:00.799 Sorry. 00:11:00.960 --> 00:11:05.360 The the the kanji word for um crisis includes the word opportunity. 00:11:05.600 --> 00:11:07.360 My apologies for mesameta. 00:11:07.519 --> 00:11:08.399 It's an opportunity. 00:11:08.799 --> 00:11:10.639 That's what I tell people, right? 00:11:10.879 --> 00:11:17.200 Yeah, um you may be at a place in your life where you are willing to look at some things for the very first time, right? 00:11:17.440 --> 00:11:20.320 A lot of women come to me and say, I don't have a BS filter anymore. 00:11:20.559 --> 00:11:23.039 Like I am over it, right? 00:11:23.440 --> 00:11:26.720 I want to be honest about who I am, I want to live my life authentically. 00:11:26.879 --> 00:11:28.960 That really matters to me, right? 00:11:29.440 --> 00:11:42.000 And so how can I how can I have this conversation with the people that I care about in a way that they learn and understand like who I am showing up as now is the very best version of myself. 00:11:43.200 --> 00:11:43.600 Right. 00:11:43.840 --> 00:11:46.320 And some of that is this the process of uncovering it. 00:11:46.480 --> 00:11:48.240 So yeah. 00:11:48.720 --> 00:11:58.320 And there's beauty in that growth too, because you know, once you figure out your own journey, then you know, it's only better and best things after that, I think. 00:11:59.039 --> 00:12:00.720 Yeah, yeah. 00:12:00.960 --> 00:12:03.360 So I think the other thing, oh, sorry, go ahead. 00:12:03.440 --> 00:12:14.879 No, sorry to say I think the other challenge, right, is just like the variation in the physical menopause symptoms, your mental health journey through this period will look different than that of the people around you. 00:12:15.440 --> 00:12:15.679 Right. 00:12:15.840 --> 00:12:19.679 And I think we do sort of this comparison thing, right? 00:12:19.919 --> 00:12:23.840 Much like we might do when I have symptoms and my girlfriend has something different, right? 00:12:24.000 --> 00:12:25.759 Your mental health journey might look different. 00:12:25.919 --> 00:12:29.120 That doesn't necessarily mean there's something wrong, but right. 00:12:29.279 --> 00:12:31.759 It's it's unique and individual to you. 00:12:31.919 --> 00:12:35.360 Um, and those things are still navigatable. 00:12:35.679 --> 00:12:46.320 So um I really encourage people not to like compare yourself too much to the woman next to you in that regard because that's a unique experience for you, um, as much as it is for them. 00:12:46.799 --> 00:12:52.480 Um and that just like in the medical side, your treatment strategy may look a little bit different depending on the woman's presentation. 00:12:52.720 --> 00:12:58.240 The same is true for what we do on our side of things in terms of where do we need to spend time and focus. 00:12:58.559 --> 00:13:00.080 So yeah. 00:13:00.480 --> 00:13:01.039 Yeah. 00:13:01.440 --> 00:13:03.600 It has to be individualized, really. 00:13:03.759 --> 00:13:04.240 Yeah. 00:13:04.559 --> 00:13:04.879 Okay. 00:13:05.120 --> 00:13:05.759 Yeah. 00:13:06.000 --> 00:13:06.320 Yeah. 00:13:06.399 --> 00:13:22.720 I'm sure a lot of the women listening, um, you know, if you have questions about certain things that you're navigating in your own relationships and how that is applied to your experience and some of the struggles that you've had, you know, we we have this great resource on the call tonight. 00:13:22.799 --> 00:13:24.639 So utilize her. 00:13:24.799 --> 00:13:26.480 Um ask away. 00:13:26.720 --> 00:13:28.000 Yes, ask away. 00:13:28.080 --> 00:13:38.960 But anything goes, any questions related at all to midlife, perimenopause, menopause, relationships, mental health, but also physical health, you know, anything goes. 00:13:39.120 --> 00:13:46.399 So any questions you have and that you're wondering an answer to, or if you just want to share information, you can put them in the chat. 00:13:46.559 --> 00:13:49.120 Um for someone to ask questions. 00:13:49.200 --> 00:13:54.000 And and this is hard because I think that this is sometimes the mental health aspect too. 00:13:54.080 --> 00:13:57.360 Like, you know, you're putting something in the chat, your name is next to that in the chat. 00:13:57.519 --> 00:14:00.480 So it's fighting that stigma again that we talk about. 00:14:00.879 --> 00:14:08.399 So, you know, raising your hand and recognizing, like, hey, I have an issue that might be mental health related is hard to do. 00:14:08.559 --> 00:14:10.159 I think it's really hard to do. 00:14:10.399 --> 00:14:16.559 Um, but I'll tell you, I think therapy should be integral to everybody's health care. 00:14:16.879 --> 00:14:21.039 I don't think it should be like when you look at health plans and you look at medical insurance things. 00:14:22.720 --> 00:14:25.519 We don't have to go to the call. 00:14:26.720 --> 00:14:31.600 I really think you have it shouldn't be an ancillary add-on, right? 00:14:31.759 --> 00:14:33.840 It shouldn't be this separate thing. 00:14:34.000 --> 00:14:36.000 Um, and especially in women's health. 00:14:36.080 --> 00:14:50.480 I mean, we go through so many physical hormonal changes that affect our mental

health throughout our lifespan as women, you know, whether it be um, you know, in puberty and then in pregnancy and postpartum and then in midlife and going through perimenopause and menopause. 00:14:50.879 --> 00:14:52.879 So many changes and ups and downs. 00:14:52.960 --> 00:14:58.240 And and our mental health is very linked to our estrogen levels and then our hormone levels overall. 00:14:59.039 --> 00:14:59.679 Yeah. 00:15:00.320 --> 00:15:08.399 Yeah, I I sometimes am uh so pleasantly surprised to see new research related to the hormone connection to mental health. 00:15:08.480 --> 00:15:18.080 It it sheds um a light on things for myself in just personally, but also professionally, um, that there is a lot of connection being made around that. 00:15:18.159 --> 00:15:21.120 And I'm so glad that the conversation is happening about that. 00:15:21.440 --> 00:15:29.759 Um But I think, you know, the one thing I want to say is a lot of women have this concern like it's you know, it's something wrong with me. 00:15:29.919 --> 00:15:32.639 It's the language that I hear a lot of the time, right? 00:15:32.799 --> 00:15:37.039 It's something wrong with my relationship because I feel like there's this level of struggle. 00:15:37.360 --> 00:15:42.480 And I think that being really attuned to that language is is really important. 00:15:42.799 --> 00:15:56.000 Um and if we think about this more as like this is a time of transition, not unlike other times that we might have gone through a transition in our lives, we look at that as you know, short term, right? 00:15:56.240 --> 00:16:07.360 Now the length of that transition might look different again for you and you know, your friend or the person next to you, but it's still just a period of time that we are working through to navigate, right? 00:16:07.440 --> 00:16:10.639 Like the parametal pause timeline is different for every woman. 00:16:10.879 --> 00:16:13.519 The mental health journey as part of that is also different. 00:16:13.919 --> 00:16:26.879 But if you're feeling for the first time in your life, this sort of intense, almost unrecognizable level of like challenge with your emotions, please don't hesitate to reach out to find somebody to talk to about that. 00:16:27.200 --> 00:16:33.840 Start with your physician, do some research about who's available, interview multiple therapists. 00:16:34.240 --> 00:16:42.960 If I can say anything about that, just like I would encourage people with respect to their medical provider, don't feel obligated if you talk to a therapist and it's not a good fit. 00:16:43.759 --> 00:16:46.720 That is a really important part of the work that we do. 00:16:46.879 --> 00:16:48.720 I don't want to be a bad fit for someone. 00:16:49.120 --> 00:16:54.879 And I tell every client that I work with if at any point you feel like this is not working for you, please let me know. 00:16:55.120 --> 00:16:58.159 I am more than happy to work to get you connected to somebody else. 00:16:58.399 --> 00:17:03.360 And I think that women are finding themselves in a really vulnerable position at this time, right? 00:17:03.600 --> 00:17:07.200 The women that I talked to who went to see a physician and were totally dismissed. 00:17:07.279 --> 00:17:09.599 And I'm like, you need to go see somebody else. 00:17:09.759 --> 00:17:14.400 I would say the same thing about being in a position where you're looking for a therapist that's a good fit. 00:17:14.640 --> 00:17:18.079 And if you're going to therapy with your partner, same thing, right? 00:17:18.240 --> 00:17:24.880 The therapist that you would see one-on-one might not be the best fit for the for working together between you and your partner. 00:17:25.279 --> 00:17:29.759 Um and so it's okay to say, like, this isn't it for me. 00:17:29.920 --> 00:17:32.079 I want to consider something else. 00:17:32.240 --> 00:17:36.240 Um, but I understand that that's that's a that's a big vulnerability. 00:17:36.319 --> 00:17:40.559 Um, but I want to I want to put that out there because I think that that it's really important. 00:17:40.880 --> 00:17:42.079 Yeah, well, I think that's true. 00:17:42.160 --> 00:17:46.880 I mean, we we talk about that on these webinars a lot that you know, women shouldn't take no for an answer. 00:17:46.960 --> 00:17:58.960 And I think that so much we feel we we have this sense of obligation once you've kind of made a commitment, but that's it, it doesn't mean like you have to stay with that person and and don't take no for an answer. 00:17:59.119 --> 00:18:06.480 It's okay to shop around, it's okay to keep going until you get someone you feel you know heard by and you feel listened to. 00:18:06.720 --> 00:18:08.640 Um, I think it's so very important. 00:18:09.440 --> 00:18:10.079 Absolutely. 00:18:10.319 --> 00:18:13.519 And we we do actually have a question from Cindy real quick. 00:18:13.680 --> 00:18:18.319 I just want to to jump in and see if there's yes, some answers on this one. 00:18:18.480 --> 00:18:25.119 Um, Cindy says, I've been trying to get my boyfriend to read a bit about what I'm going through, but with no result. 00:18:25.279 --> 00:18:27.279 Do you have any suggestions for me? 00:18:27.599 --> 00:18:36.799 I think it's really hard to hand a man a book or a magazine or something, you know, a handout about a medical thing and expect them to want to read it. 00:18:36.960 --> 00:18:44.960 But um, my suggestion would actually be to try to find um like maybe one of the documentaries, the docuseries that have been out. 00:18:45.039 --> 00:18:48.000 There's been several different ones on menopause really recently. 00:18:48.240 --> 00:18:50.400 Last year, I think the M Factor came out. 00:18:50.559 --> 00:18:59.519 I was actually in one um that you can stream online um called Four Days, um, and it's about five episodes of menopause and perimenopause. 00:18:59.599 --> 00:19:04.240 There was another one too, the um that was another, but I I didn't get to watch

that one. 00:19:04.319 --> 00:19:08.960 It was made um recently and released, I forget what it was called, but that might be better. 00:19:09.039 --> 00:19:20.160 It might be better to like sit in front of the TV and like watch something for entertainment that might spark a conversation and might be educational too, while as well as visually appealing. 00:19:20.240 --> 00:19:23.920 I think that that might that might be a good way, but I don't know if you have other suggestions, definitely. 00:19:24.240 --> 00:19:27.920 Yeah, so I actually find a lot of really great information on Substack. 00:19:28.000 --> 00:19:29.920 I don't know how many people here are reading Substack. 00:19:30.160 --> 00:19:36.400 There's a lot of really good conversation happening um related to menopause, paramenopause, relationship issues. 00:19:36.480 --> 00:19:48.319 There was a wonderful article in the USA today that my girlfriend, my neighbor, actually sent me talking about um I'd have to, I can I can get the resource for you, Maddie, and send it if it's something that we're allowed to share. 00:19:48.480 --> 00:19:50.400 Um yeah, send it my way and we'll see. 00:19:51.119 --> 00:20:02.400 And but I think it was talking about like the dynamic and the shift of like communicating with your partner or how men are kind of finding themselves um like at a bit of a loss and not really knowing like what to do or what to navigate. 00:20:02.559 --> 00:20:11.359 Um, but there are some amazing resources on Substack uh practitioners, people in midlife who are writing this both for us as women and for our partners. 00:20:11.440 --> 00:20:24.400 Um so I would encourage maybe that if if if it's something that you were resonate for you and you know your partner better, um, that might serve as another really good way to kind of have a small introduction into the conversation, along with what Dr. 00:20:24.559 --> 00:20:32.240 Todd is talking about in terms of some of the um amazing you know programs that have been out there, like she said in the last year related to this conversation. 00:20:32.480 --> 00:20:36.000 So um I wish I had a great book. 00:20:36.160 --> 00:20:41.519 Like there isn't, I I don't know of a book yet that's not geared for men. 00:20:41.680 --> 00:20:54.960 Most of everything is wonderfully geared for us, which is such an amazing experience, but we're not not that I'm aware of at least, not there yet on this the side of how to help men feel more open and understanding about this process. 00:20:55.279 --> 00:21:13.359 The other thing, Cindy, if if you guys are ever on long car rides, um, our episodes of these webinars, we we actually have a podcast um called the menopause hour um that's made by Winona that would be you know short and sweet episodes kind of going over some key topics, that might be a good option, like in the car. 00:21:13.680 --> 00:21:15.759 He might be like, What did you put on, babe? 00:21:15.920 --> 00:21:17.359 Like, what's going on? 00:21:17.839

--> 00:21:30.240 Um, but at least maybe if you can get through part of one, you know, maybe that could help to stem some conversation and maybe maybe then he'd be interested in learning more after you get a little bit of a taste, you know, that kind of thing. 00:21:30.559 --> 00:21:32.480 Yeah, absolutely. 00:21:34.000 --> 00:21:36.799 And well, I I also think it would be really helpful. 00:21:36.880 --> 00:21:44.000 I mean, I'm sure Cindy, please let us know if that kind of also answered your question or if you have any uh any other follow-up questions about that. 00:21:44.160 --> 00:21:59.839 Um, but I I'm guessing that there's probably a few people, and I know that I'm always very interested in this as well, and I think this is a great call to do this in and ask about is kind of what the overlap or how it looks like to kind of manage, especially when you're in midlife, going to paramedics. 00:22:00.400 --> 00:22:07.039 Going through menopause, like what it looks like to manage medication and also kind of going through like the emotional side. 00:22:07.119 --> 00:22:08.960 And like how do those two kind of work together? 00:22:09.039 --> 00:22:10.559 Is there like a push-pull? 00:22:10.720 --> 00:22:17.680 Or how would you both kind of um approach that kind of approach to perimenopause and menopause? 00:22:19.279 --> 00:22:45.519 I mean, I think that you know, taking care of yourself, it's it's kind of like a you have to take a holistic approach and it's about trying to fit in, you know, what works in your schedule during the day, not trying to make big, huge wholesale changes all at once because it's hard as human beings with, you know, set in our ways and with schedules and with certain habits to change things, you know, whole like whole circle, you know, around. 00:22:45.680 --> 00:22:51.440 Um, and so I think, you know, when you're trying to navigate starting medication, you want to stick to simple things. 00:22:51.599 --> 00:23:07.119 I always encourage patients to kind of focus on sleep hygiene, making sure they're getting plenty of good sleep, focus on their nutrition, go back to basics and try to focus on those as they're incorporating changes like a medication into their into their day-to-day routine. 00:23:07.279 --> 00:23:21.119 Um, and then I think, you know, when you're navigating relationships too and you're and you're dealing with all of that, like don't expect you're gonna fix everything overnight and that everything is just gonna be instantly better when you start taking hormone therapy. 00:23:21.200 --> 00:23:25.359 Um, you know, it's gonna take some time, it's gonna take some adjustment, that kind of thing. 00:23:25.519 --> 00:23:30.640 You know, so it's like a juggling act rather than a push-pull, I would say, Maddie. 00:23:31.680 --> 00:23:42.480 Um, you know, and it's about trying to kind of keep all the balls in the air, you know, and juggling those, um, but try trying to find the best way that works for you as an individual, and that's the hardest thing. 00:23:42.720 --> 00:23:50.880 Um, but then when you come out the other side and the wisdom that you have as a woman and you know, how you navigate that is your own journey. 00:23:50.960 --> 00:23:58.240 And and many women come out of it so gracefully and you know, really have crafted a great life for themselves. 00:23:58.480 --> 00:24:02.480 And menopause is that time period, it shouldn't be so negative. 00:24:02.559 --> 00:24:07.440 It's like a, you know, really that causes you to pause to reevaluate your life. 00:24:07.839 --> 00:24:09.200 My daughter's sneaking behind me now. 00:24:09.359 --> 00:24:10.720 We can see you on the camera. 00:24:12.559 --> 00:24:13.680 We love real life. 00:24:14.160 --> 00:24:14.799 Real life. 00:24:15.279 --> 00:24:17.599 She's, I think she thought she was out of breath. 00:24:18.000 --> 00:24:21.039 She didn't so cute. 00:24:21.279 --> 00:24:22.480 Um, yeah. 00:24:22.640 --> 00:24:25.759 So, you know, and I lost my train of thought, obviously. 00:24:29.039 --> 00:24:34.559 Um, but yeah, it's it's a lot to to navigate, but I think that um everybody has their own journey. 00:24:34.640 --> 00:24:41.759 Oh, what I was saying is that the pause, you know, make this be your impetus to kind of pause and reevaluate your life, you know. 00:24:42.000 --> 00:24:52.799 You get to redesign how you want your life to be from this point forward, you know, because and we can redefine ourselves all the time as human beings if we're brave enough to, you know. 00:24:53.279 --> 00:24:53.680 Yeah. 00:24:54.400 --> 00:25:07.200 Yeah, I think, you know, one of the things I talk to people about is the continued conversation about the importance of your relationship in the sense of physical and mental health care at the same time. 00:25:07.599 --> 00:25:07.839 Right. 00:25:07.920 --> 00:25:19.920 If a woman comes to me and she has not been to her OBGYN, we have a pretty candid conversation about that because there's a lot of potential benefit for you know having the conversation and starting to look at that, right? 00:25:20.000 --> 00:25:30.400 There was a recent study that, you know, the typical treatment for women of this time frame for mental health-related issues was some form of antidepressant. 00:25:30.480 --> 00:25:32.880 Um, that is now no longer the standard of care. 00:25:33.519 --> 00:25:35.279 It's estrogen, right? 00:25:35.359 --> 00:25:36.319 And thank God for that. 00:25:36.480 --> 00:25:38.160 Not to say that there's not room for both. 00:25:38.319 --> 00:25:41.440 And I am not a medical provider, so I am being really cautious. 00:25:41.519 --> 00:25:56.720 I'm but there are a lot of women who might have tried um, you know, I work with them who they're seeing a nurse practitioner or a psychiatrist or even their primary care for mental health-related concerns and are getting some support around that, but aren't quite feeling like it's enough. 00:25:56.960 --> 00:25:57.119 Right.

00:25:57.519 --> 00:26:04.400 And so I say, have you have you consider talking to somebody about perimenopause or menopause as part of you know this conversation? 00:26:04.559 --> 00:26:07.920 And some of them, depending on their age, are like, oh no, there's no way. 00:26:08.319 --> 00:26:10.000 Well, maybe. 00:26:10.160 --> 00:26:15.359 I mean, I think I was in perimenopause long before I actually knew that I was in perimenopause, right? 00:26:15.519 --> 00:26:19.680 And looking back now, it's very easy for me to be like, oh, is that what was going on? 00:26:19.920 --> 00:26:21.680 But I didn't know, right? 00:26:22.319 --> 00:26:28.880 And so, you know, you may not be a great candidate for, you know, hormone replacement therapy. 00:26:28.960 --> 00:26:44.640 That may not be an option for you, but at least having the conversation um as part of the the work that we do, you know, on the emotional side, because sometimes that can be a very big driver and support for you. 00:26:44.880 --> 00:26:52.880 So um, so I think I think the relationship is is of the two, mental health and medical side is um is very intertwined. 00:26:53.119 --> 00:26:53.519 Yeah. 00:26:53.759 --> 00:27:06.640 No, and I would say probably at least 70% of women who end up coming to us for hormone therapy have been given an uh an antidepressant before they they reach us to get hormone therapy. 00:27:06.799 --> 00:27:08.960 And it may help some symptoms slightly. 00:27:09.200 --> 00:27:09.519 Absolutely. 00:27:10.160 --> 00:27:14.160 Um, but it it's not it's not full circle, it doesn't encompass everything. 00:27:14.240 --> 00:27:17.440 And it really, you know, it's not the standard of care for really treating. 00:27:17.519 --> 00:27:22.559 So it's it's only gonna put a band-aid on some of the symptoms and not really help, you know, everything. 00:27:22.799 --> 00:27:23.119 Yeah. 00:27:23.279 --> 00:27:23.839 But yeah. 00:27:23.920 --> 00:27:33.920 And I think a lot of women get, you know, kind of offended too, though, when they're going and talking about hot flashes and night sweats and they're talking about all these things happening, and then they're given an antidepressant. 00:27:34.400 --> 00:27:41.119 And especially if that's done in a 20-minute visit where you don't really feel like you got a word and edge wise, it's really difficult. 00:27:41.359 --> 00:27:42.000 Yeah. 00:27:42.319 --> 00:27:42.720 Yeah. 00:27:42.960 --> 00:27:43.519 Absolutely. 00:27:43.839 --> 00:27:44.160 Yeah. 00:27:44.960 --> 00:27:48.799 And we do have another question from Cindy as well. 00:27:49.279 --> 00:27:52.319 Um, if if if we're ready to move on from that question. 00:27:54.240 --> 00:27:59.920 Um, it's it's kind of it's not quite a second part to her original question, but a little bit of a follow-up. 00:28:00.240 --> 00:28:06.960 Um, she says, Am I wrong in thinking that my guy is gonna help me make this easier on both of us? 00:28:07.200 --> 00:28:17.119 So I think just kind of around what the role of um a boyfriend can look like and be within perimenopause, menopause, midlife. 00:28:17.759 --> 00:28:20.400 I don't think that that's the wrong perspective at all. 00:28:20.720 --> 00:28:29.119 But I I think that there's some element of an understanding like he doesn't know necessarily any more than you do. 00:28:29.359 --> 00:28:33.920 And you know, you're you're both encountering this in many cases for the first time, right? 00:28:34.000 --> 00:28:41.839 So, unless you watch a parent or a close person in your life go through that recently, like our recollection of that is minimal. 00:28:41.920 --> 00:28:55.039 I mean, I remember my mom having hysterectomy, but I don't I don't recall, you know, as a young, you know, I was probably I was a teenager, right, what that looked like in terms of the dynamic between my parents and their relationship. 00:28:55.359 --> 00:29:03.599 So unless you have something more immediate, I wouldn't expect you or your partner to know um, you know, and have sort of all of the answers there. 00:29:03.839 --> 00:29:16.720 But I do think that in the uh structure of your relationship, there's a lot of opportunity to learn these things together in a way that can actually enhance the bond in the relationship as opposed to pull it apart. 00:29:16.960 --> 00:29:21.440 Um the thing I think is struggle, is a struggle for men. 00:29:21.519 --> 00:29:27.920 If I and I don't want to speak with a stereotypical perspective, but a lot of them want to fix it and they're not able to, right? 00:29:28.000 --> 00:29:29.839 And some of that's the dynamic of your partnership. 00:29:30.000 --> 00:29:44.000 If you are in a partnership where your partner is always in this perspective of, I want to fix this, but they're not able to do so, that can be a really difficult and kind of helpless feeling, which can leave them floundering and a little bit uncertain about what to do. 00:29:44.480 --> 00:29:57.440 Um, if we if we want to talk briefly about like the component of like physical intimacy and relationship, and if I am having a hot flash and you know, night sweats and don't feel good about myself, and what am I gonna do potentially, right? 00:29:57.599 --> 00:29:58.559 Push my partner away. 00:29:58.799 --> 00:30:01.359 It has nothing to do with him at all. 00:30:01.839 --> 00:30:04.640 But is he internalizing that is something he did wrong? 00:30:04.960 --> 00:30:06.960 Right, and it's not that, right? 00:30:07.039 --> 00:30:10.319 Your sexual desire has dipped because you have maybe low testosterone, maybe. 00:30:10.480 --> 00:30:20.960 I mean, there's a number of reasons why that happens, but the discomfort of acknowledging that, right, and feeling like if I'm your partner, like I'm responsible for that, you're not you're not attracted to me. 00:30:21.119 --> 00:30:23.519 It's not usually what it is at all, right? 00:30:24.079 --> 00:30:35.599 And so a lot of that is, you know, stuff that you all will again potentially be

navigating or having our conversation about for the first time, but that doesn't mean that there isn't an opportunity for resolution, right? 00:30:35.680 --> 00:30:46.640 There are a lot of women who find themselves on the other side of this in better, more enriching and intimate relationships as a result of this experience, not in spite of it. 00:30:48.240 --> 00:30:50.559 Yeah, I think that's important to think about too. 00:30:50.640 --> 00:31:01.200 Um, you know, and not only that, not only just the hot flashes and night sweats, but physical intimacy can change just because of the genito-urinary changes of perimenopause and menopause. 00:31:01.279 --> 00:31:09.039 So, you know, changes in lubrication, changes in the blood flow to those tissues, um, you know, sex can become painful for some women. 00:31:09.359 --> 00:31:25.519 And that's a huge part of a relationship and you know, a partnership with anybody, whether it be a boyfriend, a partner, you know, anything, or a non-male partner, even if you have a female partner and they're a different age than you and maybe they're not going through it, it can be difficult to navigate that. 00:31:25.680 --> 00:31:42.720 And so I think that, you know, one of the best things for any relationship at all is just improving communication, you know, having that ability to be frank and honest and be able to let them know like what you're feeling and what's going on and have the conversations like, hey, I love you. 00:31:42.960 --> 00:31:43.920 It's not you. 00:31:44.160 --> 00:32:02.480 My body is just not responding the way I want it to, and I don't feel comfortable in my own skin, you know, being able to say that to a partner, um, you know, and finding other ways to to still be intimate, maybe without, you know, sex per se, you know, like other things, you know. 00:32:02.640 --> 00:32:06.880 Um you have to be creative, um, I think, you know, to make sure. 00:32:06.960 --> 00:32:09.039 But I think communication is key. 00:32:09.680 --> 00:32:14.240 Yeah, I think there's the component of connection in relationship, right? 00:32:14.559 --> 00:32:18.960 Um, and that I think is a lot of times what the conversation really is about. 00:32:19.119 --> 00:32:27.519 So I think that's something else to consider is if the topic, let's say, is intimacy or like a disconnect related to intimacy, is that really the concern? 00:32:27.680 --> 00:32:32.880 Or is there potentially something else underneath that that is driving that concern? 00:32:33.119 --> 00:32:40.240 Is it maybe a combination of there's a lack of physical intimacy, but there's some lack of maybe emotional connection that's happening at the same time? 00:32:40.400 --> 00:32:43.200 Um, because those things happen in tandem often. 00:32:43.519 --> 00:33:00.799 And, you know, so but I think that the hard part is that vulnerability we talked about a little bit before as it relates to women making a decision to look elsewhere to get it, you know, an answer if they've gone to their physician and gotten a know, or they maybe want to consider starting therapy, but they feel scared about that. 00:33:01.119 --> 00:33:06.319 Um the openness to you know allow that vulnerability, I think is really important. 00:33:06.880 --> 00:33:13.519 Um, and that you kind of build up from there to a better version of yourself. 00:33:15.680 --> 00:33:16.160 Yeah. 00:33:16.400 --> 00:33:19.039 Now you said your practice is all virtual. 00:33:19.200 --> 00:33:20.160 I think that that's great. 00:33:20.640 --> 00:33:28.000 I mean, I can I can tell you I have utilized virtual therapy and it's it's it's a godsend for people that are busy and that have scheduled. 00:33:28.480 --> 00:33:41.119 Um, just in the way that you know Winona has helped to open up treatment options for patients that otherwise don't have access, you know, with telemedicine, you know, we're able to reach people that don't have someone in their neck of the woods to really help them with this. 00:33:41.200 --> 00:33:44.160 I think that virtual therapy is a great addition to that too. 00:33:44.319 --> 00:33:44.640 Yeah. 00:33:44.799 --> 00:33:46.000 Um yeah. 00:33:46.160 --> 00:33:53.839 So, and I think that people can be braver doing things through the internet too, um, than actually driving to an office. 00:33:53.920 --> 00:34:03.920 And and, you know, a lot of people have this um, you know, the stigma of mental health and they think they're gonna be on the couch, you know, like it's Freud, like they're gonna be psychoanalyzed. 00:34:04.160 --> 00:34:04.640 Oh, yes. 00:34:04.720 --> 00:34:13.679 I've had I've had clients join me from bed, um, you know, their car um on their lunch break, or because that's the only place that they have privacy. 00:34:14.159 --> 00:34:22.559 Um, you know, I you know, we started doing a lot more mental health care via uh, you know, telehealth during COVID. 00:34:22.880 --> 00:34:24.639 And it was a wonderful resource. 00:34:24.800 --> 00:34:27.920 Um, but that is that has not shifted away, right? 00:34:28.000 --> 00:34:40.320 We have the ability, and I would encourage women if if if local kind of accessibility in terms of what's available around where you are is not the best, consider potentially looking into virtual care. 00:34:40.400 --> 00:34:45.519 Um, it's not less effective, I found, because we use this medium to communicate. 00:34:45.840 --> 00:34:52.880 Um, again, there's still some, there's in some ways a little bit more flexibility or a little bit more freedom, um a little bit more comfort. 00:34:52.960 --> 00:35:00.480 You're in the comfort of your own home, you're not in somebody's office that is maybe a little bit uncomfortable or foreign to you, or right. 00:35:00.639 --> 00:35:07.199 Um so you know, that I think really is wonderful that we're still having that opportunity to to meet this way. 00:35:07.280 --> 00:35:09.199 I mean, we're heck, we're doing it now, right? 00:35:09.280 --> 00:35:12.320 It's a wonderful

opportunity for us to have this conversation this way. 00:35:12.559 --> 00:35:18.559 So um, so yeah, it's it's a it's a great opportunity to find a provider that's a good fit for you. 00:35:21.119 --> 00:35:22.719 I think that's great. 00:35:23.599 --> 00:35:24.480 Amazing. 00:35:24.880 --> 00:35:28.079 Well, it looks like say it again, Dr. 00:35:28.239 --> 00:35:28.320 Kat. 00:35:28.480 --> 00:35:28.880 Sorry about that. 00:35:29.039 --> 00:35:30.239 Cindy's typing, it says. 00:35:30.559 --> 00:35:31.440 I was gonna say yes. 00:35:32.880 --> 00:35:34.239 I see Cindy's typing. 00:35:34.320 --> 00:35:36.000 Well, well, she just stopped. 00:35:36.079 --> 00:35:40.079 So we'll we'll give it a second and see if she wants to drop anything in there. 00:35:40.239 --> 00:35:43.280 But it looks like that might be all the questions that we have. 00:35:43.360 --> 00:35:46.000 We'll give Cindy a second in case she wants to say anything. 00:35:46.159 --> 00:35:48.000 Cindy, no pressure either way. 00:35:48.320 --> 00:35:50.079 I know you've already asked a couple questions. 00:35:50.320 --> 00:36:00.639 Well, I kudos to Cindy because she's the brave one of the 14 or so people that are on the call, you know, that have um that has you know asked a question and had something to want to talk about. 00:36:00.800 --> 00:36:01.440 So that's great. 00:36:01.599 --> 00:36:02.880 Thanks for being here, Cindy. 00:36:03.199 --> 00:36:07.840 Yeah, Cindy said, I'm 54 in the last three years, menopause has changed everything. 00:36:08.000 --> 00:36:15.199 Like you said, not comfortable on my own skin, having a hard time building self-esteem, um, which I think is very relatable. 00:36:15.599 --> 00:36:20.320 Yeah, I think there's a thing that starts to happen now is we start to see ourselves differently. 00:36:20.559 --> 00:36:25.599 Um, and and some of that is a is a challenge, um, sort of the navigation of that. 00:36:25.679 --> 00:36:27.599 Who am I at this juncture of my life? 00:36:27.840 --> 00:36:28.079 Right. 00:36:28.239 --> 00:36:30.639 What am I, what, what's going to be next for me? 00:36:30.880 --> 00:36:31.119 Right. 00:36:31.280 --> 00:36:34.079 But I think it's not just menopause that creates that. 00:36:34.239 --> 00:36:36.239 A lot of other transitions happen in midlife. 00:36:36.320 --> 00:36:39.199 Your kids maybe are moving out of the house and you're becoming an empty nester. 00:36:39.519 --> 00:36:40.000 Like Dr. 00:36:40.079 --> 00:36:44.639 Katz said, you're working on maybe supporting and looking after your parents, right? 00:36:45.039 --> 00:36:54.960 The transition seems to all happen around this cluster of time, but it isn't always just the menopause components that we're confronting at this particular time. 00:36:55.360 --> 00:37:08.079 Um, but you might go to therapy at this time in your life because you are dealing with empty nest syndrome and you are dealing maybe with working um to support your family and discover through the process that maybe menopause is having an impact, right? 00:37:08.639 --> 00:37:18.800 So um I think it's really important to have these conversations around, you know, the intersection of this time in your life and what may also be going on for you. 00:37:19.039 --> 00:37:29.440 Um, you know, to work to get yourself support and help and to not feel scared or shameful about what you're going through. 00:37:29.760 --> 00:37:30.320 Yeah. 00:37:30.639 --> 00:37:31.920 Absolutely. 00:37:32.320 --> 00:37:34.639 Well, thank you so much, Dr. 00:37:34.800 --> 00:37:40.239 Kat, and thank you so much, Stephanie, for just really giving some of your time tonight. 00:37:40.400 --> 00:37:45.920 I feel like we were really able to dive a lot into what it does like look like to navigate your relationships during menopause. 00:37:46.000 --> 00:37:50.960 And I feel like you've both given um some really, some really great points as well. 00:37:51.119 --> 00:37:53.679 And we did just have uh and Dr. 00:37:53.920 --> 00:37:58.159 Antonia Alford says, I just started the vegetal estriol cream. 00:37:58.239 --> 00:38:03.519 I explained to my husband what is going on with me because intimacy is non-existent. 00:38:03.679 --> 00:38:11.119 So I think kind of what you all were talking about earlier about how that can have like a lot of different sides to it as well, with what's going on. 00:38:11.679 --> 00:38:15.519 Um, yeah, but thank you both so much for your time. 00:38:15.599 --> 00:38:18.320 Um, and for everyone who's on the call too, I know that Dr. 00:38:18.480 --> 00:38:19.840 Kat mentioned a few of these things. 00:38:19.920 --> 00:38:32.559 I just wanted to also remind everyone um is that if you are if you really enjoyed tonight's session or you're interested in more questions, um, you can find the menopause hour on um Spotify. 00:38:32.719 --> 00:38:37.840 Um, it's our podcast at Winona, and we have a lot of really great um episodes in there. 00:38:38.000 --> 00:38:42.079 We have um eventually have like events like this, which are really great. 00:38:42.239 --> 00:38:50.079 You can listen going to the gym on your work break on your way home, if your boyfriend's in the car, lots of different times that you can listen to that. 00:38:50.239 --> 00:38:57.920 We also have some really great interviews that we have with our ambassadors, um, which is like kind of some deep dives into what their menopause journey has looked like. 00:38:58.159 --> 00:39:07.280 Um, also, if you are already a Winona patient, um, you can ask any question that you ever have to your Winona doctor in your patient portal. 00:39:07.440 --> 00:39:10.559 Um, that is always a great resource to be able to utilize. 00:39:10.719 --> 00:39:13.440 They are there 24-7, available for you. 00:39:13.599 --> 00:39:14.639 They want to hear from you. 00:39:14.719 --> 00:39:16.480 It's a great place to ask questions. 00:39:16.639 --> 00:39:22.960 Um, another great place is we do have more doctor dialogues like this, and then we also do have live QA's. 00:39:23.039 --> 00:39:25.760 Um, so we would love you to come to one of those. 00:39:25.840 --> 00:39:27.519 I would love to see y'all's faces again. 00:39:27.599 --> 00:39:29.360 I'd love to hear some more questions. 00:39:29.599 --> 00:39:32.800 Um, but thank you everyone so much for being here tonight. 00:39:32.960 --> 00:39:34.000 Thanks for tuning in. 00:39:34.159 --> 00:39:43.920 I know a lot of the time it is just a really big thing to kind of come to an event like this and just take the time to listen and absorb, and like that can be so transformative as well. 00:39:44.079 --> 00:39:45.360 Um, but so thank you, Dr. 00:39:45.440 --> 00:39:45.599 Kat. 00:39:45.920 --> 00:39:48.000 Thank you, Stephanie, for your time. 00:39:48.159 --> 00:39:51.280 Um, and we will hopefully catch everyone next time. 00:39:51.599 --> 00:39:53.599 Yeah, thanks for coming out tonight, everyone. 00:39:54.320 --> 00:39:54.880 Thanks, guys. 00:39:55.360 --> 00:39:56.639 Have a great evening, everybody. 00:39:56.880 --> 00:39:57.599 Good night. 00:39:57.920 --> 00:39:59.440 Thanks for spending time with us. 00:39:59.599 --> 00:40:04.719 We hope today's conversation helped you feel more informed, more supported, and a lot less alone. 00:40:04.880 --> 00:40:07.760 If you're ready to go deeper, download the Winona app. 00:40:07.920 --> 00:40:17.280 It's free, it's for you, and it's filled with resources, real stories, expert insights, and a vibrant space to connect with women navigating the same season. 00:40:17.519 --> 00:40:18.400 Have questions? 00:40:18.639 --> 00:40:20.480 Join our next live QA. 00:40:20.639 --> 00:40:22.960 Until next time, take care of yourself. 00:40:23.119 --> 00:40:25.519 We'll be here when you're ready for more.