Why Perimenopause Makes Women Feel Crazy: It’s Not In Your Head with Dr. Pavan Brar |341

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[SPEAKER_00]: Hey everyone, welcome to the Bomb Life Podcast.
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[SPEAKER_00]: I am Elizabeth, you're host, welcome to the show.
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[SPEAKER_00]: It has been an interesting past month.
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[SPEAKER_00]: If you have been listening to all the episodes, you know a lot of these stuff have been coming out.
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[SPEAKER_00]: We're hitting every single topic.
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[SPEAKER_00]: A lot of my personal stuff has been coming out.
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[SPEAKER_00]: A lot of things on the brain and healing.
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[SPEAKER_00]: It's just, it's been such,
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[SPEAKER_00]: an incredible year, honestly, with this podcast.
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[SPEAKER_00]: And I couldn't do without you guys and all listeners don't be a stranger to the show.
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[SPEAKER_00]: Please keep writing in the email to contact us as it's Melissa Volgo at gmail.com.
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[SPEAKER_00]: Or you can DM me at it's Melissa Volgo.
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[SPEAKER_00]: So make sure you're following me on all social media platforms, Facebook.
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[SPEAKER_00]: You can find me at it's Melissa Volgo YouTube, everything.
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[SPEAKER_00]: Um, this episode is all about hormones.
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[SPEAKER_00]: Okay.
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[SPEAKER_00]: We're talking about period metaphors and metaphors now.
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[SPEAKER_00]: I say this in the episode before you hit that stop button if you're a guy.
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[SPEAKER_00]: It really is important to understand how the female body works.
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[SPEAKER_00]: Um, because especially if you're in a relationship, right?
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[SPEAKER_00]: There are so many divorces and breakups and, you know, just what we like to call in the life crisis, but it's not really a crisis when people start entering into their 40s, 50s, 60s, and there's a lot going on with the body, with the hormones chemically, all of it, and imagine if we just had an understanding of these hormones to work with them, so they don't.
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[SPEAKER_00]: totally destroy our life and flip tables and just make us feel like that we're crazy and then then women are crazy, women think that women are crazy and that men are crazy for thinking that we're crazy and it just keeps going on and on and imagine if we had an understanding of it and then actually help with it because it's not like back in the day where you just get old, you suffer, you die.
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[SPEAKER_00]: No, we have medical interventions that we can do now, bio-identical hormones, things that are naturally going to be recognized and used by your body.
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[SPEAKER_00]: but we have to have an understanding of it and then you have to be willing to do the work too.
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[SPEAKER_00]: That was one thing that our guest today said is like, she always asks her patients like, what are you willing to do?
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[SPEAKER_00]: And that's such a great question to ask ourselves like, what am I willing to do, what am I willing to give up, what am I willing to sacrifice, what am I willing to learn to be consistent with?
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[SPEAKER_00]: because consistency is key and you have to be consistent in what you do with your health, fitness, your workouts, everything, and then also your supplements like if you do get on some type of HRT, you have to be consistent with it.
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[SPEAKER_00]: You can't slack off because when our body is fully functioning, right?
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[SPEAKER_00]: So when we are in our prime and our hormones are growing, they don't
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[SPEAKER_00]: Take a day off and like, no, no, I'm not going to do my tithatsistastron today.
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[SPEAKER_00]: I'm not going to give you your progesterone, you know, now like, no, our body is a well, well machine that likes to do things consistently.
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[SPEAKER_00]: So when it starts to get to different stages of life and that consistency naturally dropped off, that's where the supplements come into play to pick right back up.
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[SPEAKER_00]: So that consistency keeps happening.
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[SPEAKER_00]: Does that make sense?
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[SPEAKER_00]: Um, I see this in the end of the episode two and I wanted to make sure I said it in the beginning as well.
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[SPEAKER_00]: We have to remember that hormones are not magic.
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[SPEAKER_00]: They are not some magical pill that you take and it makes everything go away.
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[SPEAKER_00]: And Dr. Brer on here today completely agreed and I see so many people that I have a conversation with and we get on the phone and they're like,
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[SPEAKER_00]: It's just my hormones.
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[SPEAKER_00]: You know, I think I need to get my hormones checked.
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[SPEAKER_00]: My hormones are out of whack.
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[SPEAKER_00]: Like that's why I'm getting weight.
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[SPEAKER_00]: Like then it's like, oh, okay, sure.
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[SPEAKER_00]: Yes, they're probably as a problem.
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[SPEAKER_00]: Something might be going on.
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[SPEAKER_00]: But also, what are you doing with your health and fitness?
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[SPEAKER_00]: Like, when was the last time you worked out?
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[SPEAKER_00]: When was the last time that you lifted?
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[SPEAKER_00]: When was the last time you actually paid attention to how many calories are going into your body?
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[SPEAKER_00]: How many grams of protein are you eating every single day?
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[SPEAKER_00]: That's where we need to start.
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[SPEAKER_00]: That has to be the foundation.
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[SPEAKER_00]: And then yes, we have providers like Dr. Braer and other people that we have on the show that can help fill in the gaps and help ways to enhance your life, but you have to take control first.
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[SPEAKER_00]: And if you are someone that is struggling right now, get on the phone with me, email, DM, anything.
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[SPEAKER_00]: And then let's just have a conversation and see what is the best route to take.
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[SPEAKER_00]: Did you start home with therapy?
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[SPEAKER_00]: And you're like, okay, I'm feeling better.
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[SPEAKER_00]: We'll shit.
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[SPEAKER_00]: Your metal is hot.
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[SPEAKER_00]: It's time to strike.
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[SPEAKER_00]: Let's keep the conversation going and get you on a good workout plan or nutrition or figuring that all out to enhance that and make it better.
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[SPEAKER_00]: Um, I just I can't stress enough that you guys you don't have to suffer alone.
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[SPEAKER_00]: You don't have to figure this out alone.
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[SPEAKER_00]: You don't have to figure out like what is the best workout that I should be doing?
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[SPEAKER_00]: You know, well, how do I make sure I hit all the parts of my glutes and the four parts of my quads?
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[SPEAKER_00]: Like, and what if I don't feel like it one day?
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[SPEAKER_00]: Like, you don't have to,
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[SPEAKER_00]: hold that shame and guilt of not getting up.
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[SPEAKER_00]: We're here to help you.
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[SPEAKER_00]: I'm here to help you, but you'll take the first steps and have a conversation.
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[SPEAKER_00]: If you don't want to get on a phone, it's fine.
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[SPEAKER_00]: Like email, we can go back and forth in a DM.
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[SPEAKER_00]: I do that all the time.
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[SPEAKER_00]: We have spots opening up this month for busy to bomb.
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[SPEAKER_00]: So if you are female, you just have to be female to get in there and get a part of a program and a group and take it slow, get on workouts, get the accountability in the help.
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[SPEAKER_00]: And if you're more serious and you're like, no, I think I need one on one.
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[SPEAKER_00]: I think I need someone like helping me daily, making sure I show up because my life is so busy and I'm like, I need that coaching.
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[SPEAKER_00]: Awesome, maybe that's what you need, but we won't know until we start a phone call.
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[SPEAKER_00]: All right, so today's guest is Dr. Broward, Dr. Poveen Broward, and she's the co-founder of Core Medicine and aesthetics.
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[SPEAKER_00]: She's a board certified family medicine physician and a metapause certified practitioner, her commitment to wellness and aesthetics has shaped her own journey, and she went through several life-style changes while transforming her own life in her early
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[SPEAKER_00]: including losing 50 pounds through life lifestyle change, like that's incredible.
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[SPEAKER_00]: But she spent her 20s dealing with the ups and downs, a weight loss, the emotional challenges, the frustration, like you guys all know what that's like, and she knows how important is to have someone in your corner when you're dealing with your health and fitness as well as your hormones.
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[SPEAKER_00]: She came up became a mother later in life, and she dealt with hormone changes that came along
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[SPEAKER_00]: pregnancy postpartum and with these hormone changes comes with weight fluctuations, fatigue, mood swings, sleep deprivation, all of it, and she has learned how to be the practitioner she has today and how to help others through her own journey.
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[SPEAKER_00]: And I always say that like makes the best coaches.
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[SPEAKER_00]: That makes the best people to lead you that have learned learned.
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[SPEAKER_00]: their own journey.
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[SPEAKER_00]: Her goal is to blend medical based treatments with patient centered approach to help patients reclaim their energy, balance their hormones, and feel confident in their skin.
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[SPEAKER_00]: So today we're talking all about metapods, paramedopods, having an understanding of it.
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[SPEAKER_00]: Like what is the truth about?
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[SPEAKER_00]: bio-identical versus a prescription.
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[SPEAKER_00]: It's something, this is a conversation that I hope to have again in another month with a different gas because we have to add this conversation.
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[SPEAKER_00]: Often frequent, know what the heck we're dealing with, and remind us that we're not crazy.
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[SPEAKER_00]: There are a lot of things going on and now you have help with it.
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[SPEAKER_00]: You can have help with it.
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[SPEAKER_00]: You don't have to suffer and deal all with this alone.
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[SPEAKER_00]: So this is real and we're here to just keep educating you and giving you more and more information.
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[SPEAKER_00]: All right, everyone.
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[SPEAKER_00]: Check out the show notes.
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[SPEAKER_00]: There's links in there where you can find her where you can book a call with me and for now, enjoy the show.
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[SPEAKER_00]: Welcome to the Bob, my podcast today.
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[SPEAKER_00]: We have Dr. Public Barron show.
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[SPEAKER_00]: Welcome, Dr. Barron.
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[SPEAKER_00]: Hi.
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[SPEAKER_00]: Thank you for having me.
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[SPEAKER_00]: Am I saying your last name, right?
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[SPEAKER_01]: Yes.
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[SPEAKER_01]: You're welcome.
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[SPEAKER_01]: It's always like, there's too many too many consonants in my last name was what I just told us.
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[SPEAKER_00]: It addresses with my head, but always get physicians name for them and I hate it.
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[SPEAKER_00]: I'm like, now I'm just going to clarify in the beginning of the episode.
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[SPEAKER_00]: Like in my nail in this.
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[SPEAKER_00]: I'm excited to have you on because this is we're going to be talking about hormones, Metapause, Perry Metapause.
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[SPEAKER_00]: So if you're a man listening right now and you're going, God, not the episode for me.
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[SPEAKER_00]: Before you hit that stop button, just know it's really important for you guys to have an understanding, especially if you aren't married.
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[SPEAKER_00]: which I think like a really high majority of our male listeners are in a relationship or marriage.
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[SPEAKER_00]: You really do need to understand the female body.
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[SPEAKER_00]: You don't have to completely understand it and like whatever, but the more you have an understanding of it, the more empathy you can have towards it and know that like she's not crazy, you're not crazy.
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[SPEAKER_00]: Like there is science behind this
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[SPEAKER_00]: Dr. Pavan, you were saying before we started that like this is like the highest time of a woman's life for divorce, too.
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[SPEAKER_01]: Yeah, I mean, so it's a high time for divorce.
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[SPEAKER_01]: I think a lot is happening like with communication.
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[SPEAKER_01]: And again, like being understood plus women don't know always what's going on with them.
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[SPEAKER_01]: So like they feel crazy too, right?
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[SPEAKER_01]: But it's a really high time for depression, anxiety, and like you can't sleep, you're having new disorders.
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[SPEAKER_01]: So it's hard to be in your own body and in your own brain.
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[SPEAKER_01]: But I'm sure it's hard for other people too, because everyone's like, it's going on here.
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[SPEAKER_01]: You know, like I have literally said to the words,
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[SPEAKER_01]: Um, which is so funny because like as a doctor, it's like you forget like your patient and a doctor as a doctor, if someone told me I don't feel like myself, it might click for me what's going on.
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[SPEAKER_01]: Right.
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[SPEAKER_01]: But as a patient, I just said that had no idea.
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[SPEAKER_01]: So I think it's important for everyone to know like what's happening here with the body and the brain and that it's real.
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[SPEAKER_00]: It is, it is, we're not, we're not crazy, but absolutely women get called that all the time.
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[SPEAKER_00]: Like we're crazy.
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[SPEAKER_00]: Yes.
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[SPEAKER_00]: I go and it's like, we got a lot going on in the inside.
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[SPEAKER_01]: Yes.
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[SPEAKER_00]: So you're the co-founder of core medicine and aesthetics.
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[SPEAKER_00]: Gosh.
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[SPEAKER_01]: I don't even know where to start.
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[SPEAKER_01]: I feel like I'm working two full-time jobs.
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[SPEAKER_01]: I also still work in the hopped bottle.
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[SPEAKER_01]: And so yes, it's very full, but it's
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[SPEAKER_01]: It's like, but you know, when I'm here and I'm working with my patients with career amount of pause, menopause and like also weight loss and stuff, it's just so fun to talk to people and when they tell you like, oh my gosh, I have not slept like that in 10 years or whatever that feels good.
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[SPEAKER_01]: And then I love, you know, to go home and hang out with my kids, they're super young.
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[SPEAKER_01]: I have an infant and my toddler.
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[SPEAKER_01]: And in my 40s.
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[SPEAKER_01]: So yeah, there's a lot going on, but it's also really fun.
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[SPEAKER_01]: And then my husband's awesome.
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[SPEAKER_01]: He's super supportive.
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[SPEAKER_01]: So we just make it work.
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[SPEAKER_00]: I love it.
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[SPEAKER_00]: How long have you guys been married?
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[SPEAKER_00]: um, six years.
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[SPEAKER_00]: Oh, I love this and an infant in your 40s.
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[SPEAKER_01]: I have an infant in my 40s.
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[SPEAKER_01]: I'll be 43 in next week.
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[SPEAKER_01]: So that's kind of part of how I got into all of this was just like my like hormonal fluctuations and what the heck is going on?
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[SPEAKER_01]: I wasn't sleeping.
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[SPEAKER_01]: I'm like, is this stress because I work a lot?
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[SPEAKER_01]: Is it?
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[SPEAKER_01]: I'm not sleeping because I have small children and so you know it like it took a lot for me to even just get there and be like oh my gosh Okay, I just put all the pieces together finally so right.
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[SPEAKER_00]: Yeah, and then you guys opened up Core medicine and aesthetics like That was crazy.
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[SPEAKER_01]: I we opened we were opening while I I was taking calls in the hospital a few hours after having
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[SPEAKER_01]: my baby.
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[SPEAKER_01]: But my entire post part of I'm opening this business.
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[SPEAKER_01]: So yes, the timing of it was really funny, but it's how it worked out.
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[SPEAKER_01]: And it's something.
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[SPEAKER_00]: It was meant to.
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[SPEAKER_00]: Everything happened.
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[SPEAKER_00]: It was meant to.
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[SPEAKER_00]: So, and I bring that up like married kids, everything that you're doing.
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[SPEAKER_00]: I bring that up because, you know, a lot of our listeners are in the same exact boat.
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[SPEAKER_00]: They have like this fast-paced life.
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[SPEAKER_00]: They have kids.
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[SPEAKER_00]: They have a lot going on.
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[SPEAKER_00]: And in all of that mess, you have found a way to figure out your hormones and be able to help other women.
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[SPEAKER_00]: And I just say that and I bring it out because I want women to know and understand, like, it is possible.
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[SPEAKER_00]: It doesn't matter what type of life you live,
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[SPEAKER_00]: It is possible to create change.
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[SPEAKER_00]: You might need some HRT hormone replacement therapy.
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[SPEAKER_00]: The options nowadays are so much available in greater than even just five, 10 years ago.
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[SPEAKER_00]: Yeah.
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[SPEAKER_00]: I mean, you don't have to sit and suffer in silence.
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[SPEAKER_00]: You guys, like, we don't anymore.
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[SPEAKER_01]: Yeah.
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[SPEAKER_01]: I think that's kind of one of my biggest things that I want to get across to like people.
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[SPEAKER_01]: And like just my girlfriends that even is like, there is no badge of honor to wipe not go your way through this.
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[SPEAKER_01]: I mean, you can, you can wipe not go your way through hot flashes, but you can't with
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[SPEAKER_01]: off to your process and, you know, hard to leave and there's long term effects and so it's not just like about symptoms and yeah, I agree like life is busy.
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[SPEAKER_01]: Why do you also need to add to that by not feeling your best, you know, if something's off, like if you're vitamin D's low, you're going to take vitamin D if you're blood pressure.
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[SPEAKER_01]: So you're going to take your blood pressure for medicine.
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[SPEAKER_01]: So this is like a real thing happening like I don't know.
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[SPEAKER_00]: Why you wouldn't want to also work with that part of your body right right and you know, it's crazy too is like when you look back on it our parents weren't on any of this like I know my mom isn't on any type of bio identical hormones or progesterone my grandma certainly wasn't they were literally on nothing so that's kind of who
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[SPEAKER_00]: You know, we always learn and our parents like pave the way for us and we learn from them.
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[SPEAKER_00]: And if we look back, it's like none of those women were on it at all.
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[SPEAKER_00]: And that's our example.
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[SPEAKER_00]: You know, but those women too, that generation, they're also the ones that I talk to women and they're like, I can't remember my mom not on a diet.
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[SPEAKER_00]: They are the generation.
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[SPEAKER_00]: They are the slant-fast group, too.
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[SPEAKER_00]: Yeah, that's her example.
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[SPEAKER_01]: Yeah, and I, I feel like I constantly want to apologize to women.
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[SPEAKER_01]: Let's say the generation above ours would be like, I'm so sorry.
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[SPEAKER_01]: That's like the study that we always talk about the WGI came out.
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[SPEAKER_01]: And like,
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[SPEAKER_01]: Women used to be on hormones for this, like they've been on them for years, you know, in the 70s, 80s, like we've been doing it.
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[SPEAKER_01]: And then the study comes out and like all these women came off.
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[SPEAKER_01]: So there's just entire generation or two, just like lost out on all of these benefits.
14:55.138 --> 15:03.703
[SPEAKER_01]: And then yes, you hear like, oh, my mom's a little crazy or my mom's, you know, and it's like, well, no, there was a lot, you just didn't talk about it.
15:05.202 --> 15:22.268
[SPEAKER_01]: And then a lot of them are like, now that they're learning to their like, is it too late for me, you know, if I think about women like, man, how many of these women who had heart attacks or who have arthritis or who have all of these like medical problems, how many could we have helped, you know, but we're there now like this gets talked about lots.
15:22.348 --> 15:23.869
[SPEAKER_01]: I'm really excited about that.
15:24.209 --> 15:46.119
[SPEAKER_00]: Yeah, that's why like your sister had I was in conversation with her and that's how we got you on the show and I'm like, yeah, we need to keep having conversations about this frequent often all the time because people forget or they put their health on the back burner and we, yeah, you know, podcasts, people listen to it and then it takes from the back of the brain and
15:48.801 --> 15:52.005
[SPEAKER_00]: I remember hearing something about this two years ago and I never took action and now things are worse.
15:53.226 --> 15:55.069
[SPEAKER_00]: Okay, so let's explain like real basic.
15:55.289 --> 15:57.452
[SPEAKER_00]: What is Perry Metapause?
15:57.812 --> 16:01.537
[SPEAKER_00]: Like just so we have a good recap and refresher of what that is for everyone.
16:02.343 --> 16:05.667
[SPEAKER_01]: Okay, so real quick, menopause is one day.
16:06.047 --> 16:09.291
[SPEAKER_01]: It's when you haven't had a natural cycle in 365 days.
16:09.411 --> 16:12.354
[SPEAKER_01]: Okay, everything after that is postmenopause.
16:12.534 --> 16:15.437
[SPEAKER_01]: And then everything before that is perimenopause.
16:15.637 --> 16:18.120
[SPEAKER_01]: So it's like five to 10 years of your time.
16:18.140 --> 16:20.182
[SPEAKER_01]: It can start in your mid 30s.
16:20.222 --> 16:21.864
[SPEAKER_01]: So it's a little bit earlier, even.
16:21.884 --> 16:22.605
[SPEAKER_01]: I know.
16:23.245 --> 16:26.526
[SPEAKER_01]: And especially in your 40s, people are starting to see things.
16:26.686 --> 16:30.367
[SPEAKER_01]: And so really what's happening is that your hormones are fluctuating.
16:30.787 --> 16:34.749
[SPEAKER_01]: That's the fluctuation, like the height and the low like your body doesn't like that.
16:34.769 --> 16:36.149
[SPEAKER_01]: Your brain doesn't like that.
16:36.509 --> 16:38.450
[SPEAKER_01]: And that's where you're having a lot of your symptoms.
16:39.030 --> 16:45.312
[SPEAKER_01]: And so anything clashes, night sweats, you're starting to have moved changes, anxiety, depression.
16:45.972 --> 16:54.359
[SPEAKER_01]: sleeping at night, joint pain, a gentleman at a urinary syndrome, which is like that you can have more UTIs.
16:54.419 --> 16:58.102
[SPEAKER_01]: You're tissue in your vagina literally atrophies.
16:58.502 --> 17:01.104
[SPEAKER_01]: You drive a giant a painful inner force.
17:01.245 --> 17:04.387
[SPEAKER_01]: We talk a lot about word finding brain fog.
17:04.467 --> 17:07.890
[SPEAKER_01]: I think that's a lot of these sometimes some of them are early menopause.
17:08.270 --> 17:12.535
[SPEAKER_01]: where like your progesterone is done down and then you have some more estrogen related symptoms.
17:12.555 --> 17:15.838
[SPEAKER_01]: That's the one people always think about estrogen when they're thinking of hot flashes.
17:16.279 --> 17:23.506
[SPEAKER_01]: So yeah, it's a huge time of your life where you're going through lots of different changes because your hormones are fluctuating going up and down, up and down.
17:23.847 --> 17:27.230
[SPEAKER_01]: They don't just like start going down steadily and then you're done.
17:27.551 --> 17:29.393
[SPEAKER_01]: It's total chaos.
17:30.402 --> 17:36.383
[SPEAKER_00]: Well, and imagine like, if this is happening and you don't really have an understanding and you're just, you know, yes, whatever.
17:36.463 --> 17:48.346
[SPEAKER_00]: And you have this total chaos going on for years, no wonder by the time women have kids and they're like in middle school or high school and then that's a whole other stage.
17:48.386 --> 17:52.807
[SPEAKER_00]: And you know, crazy in this of life, they just feel like I'm fucking losing it.
17:53.685 --> 17:53.885
[SPEAKER_00]: You.
17:55.087 --> 18:01.676
[SPEAKER_01]: I think even just like even if you did nothing, okay, you never took hormones, nothing, you didn't exercise into anything.
18:02.036 --> 18:05.440
[SPEAKER_01]: I think sometimes just having the information up, oh, was this?
18:05.501 --> 18:06.282
[SPEAKER_01]: Does what's happening?
18:06.462 --> 18:11.789
[SPEAKER_01]: Even just that is enough to not feel crazy, and then we're always just
18:12.467 --> 18:14.088
[SPEAKER_01]: trying to get it out with what is it?
18:14.148 --> 18:15.628
[SPEAKER_01]: Why don't I feel like myself?
18:15.648 --> 18:19.530
[SPEAKER_01]: Why don't I feel good and we're just searching for answers everywhere.
18:19.850 --> 18:21.811
[SPEAKER_01]: And so I think that's another thing that makes you feel crazy.
18:21.831 --> 18:23.011
[SPEAKER_01]: It's like, was it my job?
18:23.351 --> 18:24.712
[SPEAKER_01]: Is it my, you know, marriage?
18:24.812 --> 18:25.472
[SPEAKER_01]: Is it my friendships?
18:25.592 --> 18:28.173
[SPEAKER_01]: Is it because, you know, and you're just trying to find a reasons.
18:28.373 --> 18:28.574
[SPEAKER_01]: Mm-hmm.
18:28.594 --> 18:30.674
[SPEAKER_01]: And you need to be so frustrating.
18:30.754 --> 18:33.456
[SPEAKER_01]: But it's a lot of reasons all right.
18:33.476 --> 18:33.816
[SPEAKER_01]: Any other?
18:34.256 --> 18:35.476
[SPEAKER_00]: What are you seeing right now?
18:35.596 --> 18:36.137
[SPEAKER_00]: I hate to use
18:42.869 --> 18:45.812
[SPEAKER_00]: You know, that come into your business and stuff.
18:45.832 --> 18:47.694
[SPEAKER_00]: What are you seeing most common right now?
18:48.875 --> 18:57.423
[SPEAKER_01]: So I think a lot of younger people are showing to come in now to when they're starting with those sleep and mood changes.
18:57.723 --> 18:58.043
[SPEAKER_01]: Really?
18:58.083 --> 18:59.665
[SPEAKER_01]: Like there's a lot of light.
19:00.594 --> 19:07.396
[SPEAKER_01]: mid 30s and a lot of them are coming to see me because, um, you know, we're still getting told you're too young.
19:07.456 --> 19:09.797
[SPEAKER_01]: This can't be very meant to pause or menopause.
19:10.517 --> 19:15.799
[SPEAKER_01]: Uh, so it doesn't get taken seriously sometimes because we're really focused on like, well, how are you sleeping?
19:15.819 --> 19:16.859
[SPEAKER_01]: How much caffeine did you drink?
19:17.139 --> 19:19.060
[SPEAKER_01]: Which by the way, all of that's relevant.
19:19.660 --> 19:22.381
[SPEAKER_01]: Um, you know, we keep getting hard side right checked.
19:22.821 --> 19:23.601
[SPEAKER_01]: That's all relevant.
19:23.661 --> 19:24.442
[SPEAKER_01]: I check all of that.
19:24.482 --> 19:25.242
[SPEAKER_01]: We have to be really
19:28.703 --> 19:33.387
[SPEAKER_01]: but it's also important to always keep that in the back of your mind because there are different symptoms at different ages.
19:33.787 --> 19:43.775
[SPEAKER_01]: So I'm seeing a lot of that and then like more mid 40s, I'm getting a lot of the half lashes and then across the board, brain fog.
19:44.275 --> 19:48.759
[SPEAKER_01]: Everyone is coming in with the brain fog, but TIG, that's a big one.
19:49.219 --> 19:52.682
[SPEAKER_01]: I think because those are two of the things that I think make people feel
19:58.126 --> 19:59.627
[SPEAKER_01]: in a generation of doing it all.
19:59.807 --> 20:02.828
[SPEAKER_01]: And then one day you're like, well, I'm still doing it all, but I'm not coping.
20:03.269 --> 20:03.509
[SPEAKER_00]: Right.
20:04.249 --> 20:04.449
[SPEAKER_01]: Right.
20:04.489 --> 20:06.150
[SPEAKER_01]: And so it's a lot of that.
20:06.250 --> 20:08.191
[SPEAKER_01]: And that's, I would say that that was for me too.
20:08.311 --> 20:09.552
[SPEAKER_01]: Like, okay, I don't get it.
20:09.652 --> 20:10.852
[SPEAKER_01]: I've been a doctor forever.
20:10.872 --> 20:12.793
[SPEAKER_01]: I've, I have tons of friends.
20:12.893 --> 20:13.673
[SPEAKER_01]: I like to go out.
20:13.693 --> 20:14.874
[SPEAKER_01]: But I like to do all these things.
20:14.954 --> 20:16.055
[SPEAKER_01]: And now I'm just like,
20:17.895 --> 20:44.540
[SPEAKER_00]: Yeah, I don't feel like I can keep up with my life and so I think that that's a lot of what women are feeling is just like overwhelmed the tea brain fog just not feeling like themselves so when you have that patient come in and they're like I have the brain fog I'm not sleeping well like what's the first thing that you start testing like what do you have like a standard test that you like run in the blood work and we're looking for this this this this this this.
20:45.600 --> 20:48.622
[SPEAKER_01]: So, I do it and take before they ever come.
20:48.682 --> 20:53.926
[SPEAKER_01]: I get their labs drawn and we do not take with all of their symptoms, but I want to know everything.
20:53.986 --> 20:55.227
[SPEAKER_01]: I want to know about your lifestyle.
20:55.587 --> 20:56.648
[SPEAKER_01]: I'm not sure you're sleeping.
20:56.928 --> 20:57.729
[SPEAKER_01]: Do you exercise?
20:57.769 --> 20:58.329
[SPEAKER_01]: Are you lifting?
20:58.469 --> 20:59.750
[SPEAKER_01]: What supplements are you on?
21:00.591 --> 21:01.912
[SPEAKER_01]: Because it all plays a role.
21:01.972 --> 21:07.016
[SPEAKER_01]: So, if someone comes in and they're not sleeping and they're not exercising, they don't drink water.
21:07.036 --> 21:09.217
[SPEAKER_01]: That all makes the difference to me.
21:09.377 --> 21:10.178
[SPEAKER_01]: And then, lab-wise,
21:10.638 --> 21:14.061
[SPEAKER_01]: Typically, for Perry menopause, we're not checking estrogen and progesterone.
21:14.141 --> 21:20.646
[SPEAKER_01]: And I hear people a lot being like, yeah, you know, I just, my hormones are out of well, back, I need to get my hormones tested.
21:21.206 --> 21:25.269
[SPEAKER_01]: And I often have to be like, well, yes, you do, but probably not the ones you think.
21:25.409 --> 21:31.574
[SPEAKER_01]: Like, we're not testing your estrogen and progesterone in Perry menopause because it doesn't really make a difference because they're fluctuating they're going up and down.
21:31.894 --> 21:35.937
[SPEAKER_01]: So you only really get a snapshot of what's happening in that moment, and not in overall picture.
21:36.777 --> 21:40.118
[SPEAKER_01]: But if someone would be interested in testosterone, I always check your testosterone.
21:40.238 --> 21:47.100
[SPEAKER_01]: I check a sex hormone binding law of B-line, which is like a protein that binds up your estrogen and your testosterone.
21:47.200 --> 21:54.242
[SPEAKER_01]: So sometimes like you might have levels that are high total levels, but what's available for your body to use is bound up.
21:54.702 --> 22:04.065
[SPEAKER_01]: And so I think that's an important lab to check because maybe your totals, someone's just checking a testosterone level on you or checking an extra dial and it's fine, it's normal, but what's available is not.
22:04.725 --> 22:19.049
[SPEAKER_01]: I like to check a fasting in this one because that gives kind of let's you know ahead of time you're headed in the direction of like metabolic disorders that you've been in stuff even before and maybe your A1C goes up and then we check like a blood count, a thyroid, your free T4,
22:21.470 --> 22:28.595
[SPEAKER_01]: of item and D, almost everyone is low on that and that also has tons of symptoms like fatigue and you know brain fog, things like that.
22:29.756 --> 22:32.477
[SPEAKER_01]: And then like your kidney liver functional.
22:32.898 --> 22:42.484
[SPEAKER_01]: So we do like basic labs and then a few extra ones, the ferritin, I like to check the ferritin because it's going to be low before your iron panel shows us that you're
22:43.240 --> 22:53.445
[SPEAKER_01]: Well, then also, if it's very high, that's a marker of inflammation, which is another thing that's happening in Korean metaphors is it's a pro-inflammatory time in your life.
22:53.885 --> 23:03.570
[SPEAKER_01]: So kind of like to check some labs that may be normally wouldn't get because they're like, I don't know how to, I guess, I would call it like the pre labs before something's wrong.
23:03.931 --> 23:05.311
[SPEAKER_01]: Right, I mean, you some information.
23:05.831 --> 23:06.052
[SPEAKER_01]: Right.
23:07.092 --> 23:09.773
[SPEAKER_00]: What, when do you check for estrogen for gesturing?
23:09.793 --> 23:11.134
[SPEAKER_00]: Like a what point do you know?
23:11.214 --> 23:12.914
[SPEAKER_00]: Like maybe we should take a look at this.
23:13.395 --> 23:15.776
[SPEAKER_00]: Maybe this is something that you should get on.
23:16.776 --> 23:21.078
[SPEAKER_01]: So I, so in very many of us, it's totally based on symptoms.
23:21.198 --> 23:26.820
[SPEAKER_01]: If you've come in and we go through your checklist and I can tell that based on your symptoms, you're having low estrogen or progesterone.
23:26.880 --> 23:28.201
[SPEAKER_01]: Yeah, I'm going to start treatment.
23:28.701 --> 23:34.243
[SPEAKER_01]: So when would I check in estrogen, I would check it if you're on treatment and you're not responding to it.
23:34.503 --> 23:36.324
[SPEAKER_01]: So we're tight trading it and you're just like,
23:36.924 --> 23:40.067
[SPEAKER_01]: My hot flashes are not gone and we have you on good adequate doses.
23:40.588 --> 23:51.258
[SPEAKER_01]: I might check one to see are you absorbing it because we use a lot of topical and we use estrogen to patches are really our go-to product now because the risk is so low with them.
23:52.179 --> 23:55.402
[SPEAKER_01]: But if you're some people don't respond, they're not absorbing it.
23:55.682 --> 23:57.584
[SPEAKER_01]: And so then that's not helpful to them.
23:57.944 --> 23:59.326
[SPEAKER_01]: So I would want to check it then.
24:00.327 --> 24:11.618
[SPEAKER_01]: Also, if someone's very concerned about osteoporosis, they have a lot of risk factors, we have some data now to say, this is the level I want your estrogen in to have maximum bone protection.
24:12.038 --> 24:15.502
[SPEAKER_01]: And then you can always check those levels to confirm the menopause.
24:16.022 --> 24:21.846
[SPEAKER_01]: being in menopause, you are going to consistently have low-epicrogen progesterone and consistently have high-epicage.
24:21.906 --> 24:24.788
[SPEAKER_01]: So it actually gives us a diagnosis and information, right?
24:24.868 --> 24:32.073
[SPEAKER_01]: And whereas in Perry Menopause, it's just fluctuating, so you have to like, time it with your cycle, time it, you know, and it can even fluctuate throughout a day.
24:32.233 --> 24:35.896
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[SPEAKER_01]: All right, back to the show.
25:36.208 --> 25:36.488
[SPEAKER_00]: Right.
25:36.928 --> 25:51.117
[SPEAKER_00]: Yeah, and you really aren't going to get that data until you've had probably several done to be able to look at like, oh, this is trending low that that you your testosterone is continuously low or whatever, but yeah, that one blood test that one screenshot.
25:51.978 --> 25:54.539
[SPEAKER_00]: That's like, oh, that was that for that moment, right then.
25:54.599 --> 25:58.982
[SPEAKER_01]: And then even then like sometimes your assertions actually high in perimenopause.
25:59.677 --> 26:07.362
[SPEAKER_01]: So that's what I mean by it's like fluctuating so much because your brain is trying to tell your ovaries like you need to ovulate.
26:07.482 --> 26:10.444
[SPEAKER_01]: So it's pushing out all this hormone to make you ovulate.
26:10.464 --> 26:12.585
[SPEAKER_01]: So sometimes your estrogen is actually high.
26:12.926 --> 26:19.310
[SPEAKER_01]: So then that's not helpful either because now if you're trying to go based off low estrogen and you have high estrogen, that doesn't really leave you any error.
26:19.550 --> 26:19.830
[SPEAKER_00]: Yeah.
26:20.150 --> 26:20.671
[SPEAKER_00]: Interesting.
26:21.491 --> 26:22.071
[SPEAKER_00]: What um.
26:23.112 --> 26:23.913
[SPEAKER_00]: What is the difference?
26:23.933 --> 26:28.940
[SPEAKER_00]: Because I've said that I said this like bio identical and I know a lot of people don't know that verbage.
26:29.060 --> 26:33.626
[SPEAKER_00]: What is the difference between a bio identical hormone and then like a prescription?
26:33.746 --> 26:39.273
[SPEAKER_01]: We have so bio identical means that it's like molecularly the same as what your body is producing.
26:39.614 --> 26:41.216
[SPEAKER_01]: That is your extra dial.
26:41.816 --> 26:43.498
[SPEAKER_01]: that is a prescription.
26:43.958 --> 26:45.239
[SPEAKER_01]: So you don't have to compound that.
26:45.259 --> 26:48.261
[SPEAKER_01]: We have FDA approved everything.
26:48.301 --> 26:50.924
[SPEAKER_01]: We have gels, patches, vaginal rings, topicals.
26:51.324 --> 26:53.306
[SPEAKER_01]: So all of that is a prescription.
26:53.466 --> 26:57.649
[SPEAKER_01]: Okay, can get it compounded if you do in your provider chose to.
26:58.009 --> 27:05.335
[SPEAKER_01]: And then the synthetic estrogens that are conjugated, equine estrogen, that comes from a pregnant horses urine.
27:09.078 --> 27:13.339
[SPEAKER_01]: Yeah, and then there's estrogen that is made from like plant sources and stuff.
27:13.379 --> 27:24.422
[SPEAKER_01]: So there are there's different types of estrogen and like the studies, most of them that we had for that that are the popular studies, were on conjugated equine estrogen.
27:24.502 --> 27:29.203
[SPEAKER_01]: So I know that that's not what we use anymore in HRT, but they have been heavily tested.
27:29.223 --> 27:30.483
[SPEAKER_01]: So I like to let people know that.
27:30.503 --> 27:33.284
[SPEAKER_01]: Like if you're on it, it's not automatically bad.
27:33.564 --> 27:34.344
[SPEAKER_01]: We've tested it.
27:34.404 --> 27:36.565
[SPEAKER_01]: We know we have lots of studies.
27:36.905 --> 27:40.306
[SPEAKER_00]: right, is there risk of not being on hormones?
27:40.746 --> 27:45.127
[SPEAKER_00]: Like, I mean, if you have a woman that's just walking around like, I'm fine.
27:45.147 --> 27:45.787
[SPEAKER_00]: I don't need it.
27:45.827 --> 27:46.947
[SPEAKER_00]: Like, oh, I had some blood work on.
27:46.967 --> 27:51.228
[SPEAKER_00]: They said everything was normal and I'm just now she's like in New Orleans 40s and a 50s is there risk?
27:51.928 --> 27:52.348
[SPEAKER_00]: Not good enough.
27:52.588 --> 28:01.470
[SPEAKER_01]: I believe that there is risk because we already, we have the data to show that if you are on estrogen.
28:01.890 --> 28:02.150
[SPEAKER_01]: But
28:02.903 --> 28:08.848
[SPEAKER_01]: You know, in your period menopausal years or even within 10 years of menopause, that's kind of our data lies.
28:09.168 --> 28:10.269
[SPEAKER_01]: It's like the most beneficial.
28:10.829 --> 28:17.614
[SPEAKER_01]: We have a decreased risk of death, all cause mortality, heart disease dementia.
28:18.255 --> 28:20.236
[SPEAKER_01]: It prevents osteoporosis.
28:20.777 --> 28:22.578
[SPEAKER_01]: It helps with you TDIs.
28:22.958 --> 28:30.964
[SPEAKER_01]: So like one thing I see a lot in the hospital as a hospital physician is your older ladies with a hip fracture.
28:32.145 --> 28:33.327
[SPEAKER_01]: And then that's it.
28:33.988 --> 28:36.532
[SPEAKER_01]: After that, just downward denial.
28:36.812 --> 28:41.279
[SPEAKER_01]: I mean, they just never quite get back there or like frequent UTIs.
28:41.319 --> 28:43.723
[SPEAKER_01]: I mean, people are dying from UTIs.
28:44.083 --> 28:46.026
[SPEAKER_01]: So this is all preventable stuff.
28:46.347 --> 28:46.567
[SPEAKER_00]: Yeah.
28:47.143 --> 29:01.868
[SPEAKER_01]: So I believe that there is a risk, I mean, not everybody is a candidate for every government, but there are benefits, like even if you have breast cancer, you can be on vaginal estrogen, which improves so many lives.
29:01.888 --> 29:14.193
[SPEAKER_01]: I'm talking like painful intercourse, getting UTIs, the dryness, the discomfort, I mean, just the urgency and frequency of urination like everyone can be on the vaginal estrogen.
29:16.404 --> 29:22.493
[SPEAKER_00]: Yeah, and so many women are going into their physician and they're just not being educated like this.
29:23.174 --> 29:28.662
[SPEAKER_01]: Yeah, it's it's it's it's tough to be a physician.
29:29.678 --> 29:43.917
[SPEAKER_01]: Right now we're like a menopause physician because I am frustrated and I don't think that this is just like a menopause doctor needs to know this, like everybody needs to know this, you know, but we aren't educated on it.
29:44.017 --> 29:46.961
[SPEAKER_01]: I mean, I know that it's in social media a lot.
29:47.723 --> 29:50.145
[SPEAKER_01]: a lot of physicians saying, like, yeah, we weren't taught this.
29:50.385 --> 29:51.085
[SPEAKER_01]: We, we weren't.
29:51.265 --> 30:03.293
[SPEAKER_01]: I mean, I remember being a resident in the hospital and I had a nine-year-old woman on estrogen and I was like, oh my goodness, like I was horrified that she was still on estrogen and she was co-latching it.
30:03.333 --> 30:05.054
[SPEAKER_01]: She was like, you will not stop this.
30:05.294 --> 30:06.035
[SPEAKER_01]: Oh, my gosh.
30:06.655 --> 30:28.474
[SPEAKER_01]: Okay, but it's not all therefore there was a huge gap in the medical system and the education, but I think I really do believe that people are trying to catch up now and everyone needs to know because what's one big thing we see, one of them in their 40s of palpitations having a million dollar cardiac work up more than once, and by anything wrong.
30:28.914 --> 30:32.678
[SPEAKER_01]: Well, it would be helpful if your cardiologist was like, maybe
30:33.646 --> 30:46.082
[SPEAKER_01]: It's this, you know, or you're going to hear your knowledge just with frequent ETIs, well, maybe it's we need visual estrogen, you know, it's I think every physician needs to be educated on it because it affects your entire body and your brain.
30:46.382 --> 30:48.105
[SPEAKER_00]: Yeah, what is it with the palpitations?
30:49.570 --> 30:52.992
[SPEAKER_00]: in women in the forties and is it the estrogen?
30:53.373 --> 30:54.713
[SPEAKER_00]: What's causing it?
30:55.334 --> 30:55.694
[SPEAKER_00]: It is.
30:55.874 --> 30:57.675
[SPEAKER_00]: It's the fluctuation of estrogen.
30:58.275 --> 30:59.096
[SPEAKER_00]: And that gets it.
30:59.876 --> 31:00.137
[SPEAKER_01]: Yeah.
31:00.717 --> 31:03.839
[SPEAKER_01]: And there's so there's a lot of different things that have been with palpitations.
31:03.879 --> 31:10.423
[SPEAKER_01]: Sometimes they're also related just having hot flashes and night sweat, so hot flashes and night sweats are a little bit different.
31:10.603 --> 31:13.685
[SPEAKER_01]: I know we kind of put them in one category, but hot flashes is sudden.
31:14.325 --> 31:17.587
[SPEAKER_01]: And it's kind of more a period get red, you get hot, you get anxiety,
31:19.288 --> 31:25.830
[SPEAKER_01]: and the night sweats, and they're shorter, and then like night sweats, it can last a can hour, and you wake up in a full body sweat.
31:26.150 --> 31:28.450
[SPEAKER_00]: Okay, huh, interesting.
31:29.231 --> 31:30.731
[SPEAKER_00]: Again, things that people aren't telling us.
31:31.151 --> 31:31.651
[SPEAKER_00]: I don't know.
31:31.671 --> 31:32.031
[SPEAKER_00]: Right now.
31:33.051 --> 31:34.252
[SPEAKER_00]: Can we talk about testosterone?
31:34.652 --> 31:35.052
[SPEAKER_00]: Real quick?
31:35.152 --> 31:35.412
[SPEAKER_00]: Yes.
31:36.312 --> 31:37.352
[SPEAKER_00]: I love testosterone.
31:39.653 --> 31:41.155
[SPEAKER_00]: women I think are still scared of it.
31:41.375 --> 31:50.486
[SPEAKER_00]: They hear the word to stastroon and they're like, oh that's for men and it's okay, I'm not interested and it's like no girl, no.
31:51.647 --> 31:58.355
[SPEAKER_01]: Yeah, so okay here I think some interesting things that people when they hear it find interesting is
31:59.847 --> 32:04.670
[SPEAKER_01]: women produced testosterone at a much lower like amount than men about one ten.
32:04.690 --> 32:04.970
[SPEAKER_01]: Okay.
32:05.550 --> 32:07.672
[SPEAKER_01]: We have more testosterone than we actually have estrogen.
32:08.192 --> 32:09.553
[SPEAKER_01]: I don't think people realize that.
32:10.133 --> 32:18.758
[SPEAKER_01]: And our testosterone and men's like, but our testosterone starts to steadily drop early 30s, you know, around there.
32:19.553 --> 32:24.857
[SPEAKER_01]: And so it is a naturally occurring hormone in our body.
32:25.217 --> 32:29.800
[SPEAKER_01]: And so why, you know, it's just as important I think as estrogen and progesterone.
32:29.840 --> 32:37.225
[SPEAKER_01]: And then the other interesting thing I like to remind women is once they are menopausal, husband, asthma estrogen, then you have.
32:38.225 --> 32:41.547
[SPEAKER_01]: I think people feel like testosterone's for men, estrogen's for women, and it's not.
32:42.128 --> 32:53.635
[SPEAKER_01]: And so I think that's really interesting, but testosterone, yeah, I mean, there are side effects that you can get, but that's from over-dosing yourself on testosterone, which is why I think one of the main reasons you want to be under the carves.
32:53.855 --> 32:55.236
[SPEAKER_01]: Somebody and have your levels check.
32:55.276 --> 33:04.142
[SPEAKER_01]: That's one where I do repeat after I've started so when I'm therapy, but if you get too much and you're getting in a range that's not normal for women, you can have
33:04.462 --> 33:11.404
[SPEAKER_01]: like deepening of your voice, your hair can fall out and get acne, so there's there are different systems.
33:11.424 --> 33:16.825
[SPEAKER_01]: You can get clitoromegaly so that can happen with too much testosterone, but if you start your recovery dose and check it.
33:17.185 --> 33:21.306
[SPEAKER_00]: You're like naming all of the symptoms of when women take steroids.
33:22.146 --> 33:22.826
[SPEAKER_00]: Right exactly.
33:22.886 --> 33:24.427
[SPEAKER_00]: And they want to get better in the gym.
33:26.878 --> 33:40.349
[SPEAKER_01]: And yeah, so testosterone is, I think, a touchy subject for some people because there's a whole push also to get it taken off of, like right now you need a DEA license to prescribe it.
33:40.409 --> 33:41.270
[SPEAKER_01]: It's controlled.
33:42.178 --> 33:57.599
[SPEAKER_01]: Most women are not trying to abuse their topical testosterone that they just want for some keto motivation brain fog which is what I feel that they're yeah, but they're so much red tape around it and there's not a product for women to use.
33:58.099 --> 34:06.721
[SPEAKER_01]: So you have to use one tenth the dose of a man, which is kind of hard to, if we say pea sized amount, that's not really a dose.
34:06.961 --> 34:07.901
[SPEAKER_01]: What does that mean really?
34:08.161 --> 34:16.223
[SPEAKER_01]: But this is the one time I personally like to compound because then I can actually get them in appropriate dose and then we can be testing it and know what they need.
34:16.644 --> 34:19.824
[SPEAKER_01]: But it helps with so much so it's right now, it's FDA approved for
34:23.075 --> 34:29.537
[SPEAKER_01]: is a little bit irritating that we've turned testosterone only into libido when it does so much more.
34:29.777 --> 34:35.658
[SPEAKER_01]: So it is good for your bones, motivation gives people just a general sense of well-being.
34:36.498 --> 34:46.241
[SPEAKER_01]: It helps with brain fog, it helps with muscles, it's important for so many things, just like estrogen testosterone, vitamin D, your thyroid, so many things.
34:47.596 --> 34:51.259
[SPEAKER_00]: So what are the main forms that women are getting testosterone in?
34:51.419 --> 34:52.300
[SPEAKER_00]: Is it a cream?
34:52.500 --> 34:57.404
[SPEAKER_00]: I've heard pellets, pill, do you take it into pill form?
34:58.448 --> 34:58.969
[SPEAKER_01]: You can't.
34:59.209 --> 35:00.410
[SPEAKER_01]: There's a lot of different forms.
35:00.690 --> 35:03.052
[SPEAKER_01]: My favorite one is a topical cream.
35:04.353 --> 35:05.894
[SPEAKER_01]: You can also do a topical gel.
35:06.034 --> 35:08.877
[SPEAKER_01]: The reason I like that the best is that you take it every day.
35:09.177 --> 35:10.938
[SPEAKER_01]: So you can reach more of like a steady state.
35:10.978 --> 35:14.481
[SPEAKER_01]: And that's really always my goal with patients is how do I get you steady?
35:14.541 --> 35:17.204
[SPEAKER_01]: Because like the whole problem is fluctuation, right?
35:17.704 --> 35:19.125
[SPEAKER_01]: So how can I minimize that?
35:19.566 --> 35:20.907
[SPEAKER_01]: And it's easy to dose.
35:21.747 --> 35:27.090
[SPEAKER_01]: I'd say, and you can test levels of it, but yeah, so we could do topical creams and gels.
35:27.510 --> 35:29.111
[SPEAKER_01]: You can do injections.
35:30.012 --> 35:33.193
[SPEAKER_01]: Those are usually like once or twice a week, and then you can do pellets.
35:33.654 --> 35:36.895
[SPEAKER_01]: pellets you put under the skin they last about three months.
35:37.156 --> 35:41.158
[SPEAKER_01]: This is one form I personally do not do, and I do not like.
35:41.858 --> 35:47.263
[SPEAKER_01]: Um, I still think we should take every patient as an individual because some people will tell you I'm not taking a pill.
35:47.343 --> 35:48.323
[SPEAKER_01]: I'm not taking a shot.
35:48.383 --> 35:49.404
[SPEAKER_01]: I'm not putting on a green.
35:49.705 --> 35:51.206
[SPEAKER_01]: I want to put it in and forget about it.
35:51.226 --> 35:51.706
[SPEAKER_01]: Okay.
35:51.746 --> 35:53.728
[SPEAKER_01]: So you have to take that in the consideration.
35:54.188 --> 35:56.850
[SPEAKER_01]: And so I feel like for those people of pellets appropriate.
35:56.870 --> 36:00.273
[SPEAKER_01]: The thing I don't like about it is once you put it in, you can't take it out.
36:00.653 --> 36:05.656
[SPEAKER_01]: So people reach really high physiologic doses, and then have a lot of side effects.
36:05.696 --> 36:06.997
[SPEAKER_01]: You can't do anything about it.
36:07.377 --> 36:11.219
[SPEAKER_01]: So they get really high, and yeah, they feel great, but then it comes down.
36:11.540 --> 36:13.961
[SPEAKER_01]: So it is less of that steady state.
36:14.341 --> 36:16.542
[SPEAKER_01]: The big ache, and then about.
36:16.582 --> 36:16.963
[SPEAKER_01]: That makes sense.
36:16.983 --> 36:19.604
[SPEAKER_01]: And then side effects you can't really manage, right?
36:20.585 --> 36:25.948
[SPEAKER_01]: And I think that that's kind of one of the important things to note to is when you get on a
36:28.326 --> 36:30.287
[SPEAKER_01]: It's not always going to automatically work.
36:30.847 --> 36:31.968
[SPEAKER_01]: Everybody's positive.
36:31.988 --> 36:33.188
[SPEAKER_01]: Yeah, it's different.
36:33.709 --> 36:35.369
[SPEAKER_01]: And everyone absorbs differently.
36:35.429 --> 36:37.650
[SPEAKER_01]: So you may need more or less than your girlfriend.
36:38.051 --> 36:41.692
[SPEAKER_01]: And so it's important to, and everyone needs a different form.
36:41.752 --> 36:45.534
[SPEAKER_01]: I have people who are like, I'm not wearing a patch because I react to it.
36:45.634 --> 36:52.898
[SPEAKER_01]: I'm not taking a pill because I don't want it to metabolize through my liver and cause the issues that you can get from estrogen, which is increasing clotting.
36:52.938 --> 36:55.359
[SPEAKER_01]: So everybody needs to be individualized.
36:56.618 --> 37:01.841
[SPEAKER_01]: a practitioner who's going to like listen to you, listen to your lifestyle and figure out what's going to work the best for you.
37:02.861 --> 37:05.422
[SPEAKER_01]: And then you have to just test it and that can be frustrating.
37:05.562 --> 37:05.682
[SPEAKER_01]: Right.
37:05.702 --> 37:11.385
[SPEAKER_01]: And women who is trying to get somehow is like, what the heck, I'm on all these hormones and I still don't feel good.
37:11.845 --> 37:12.946
[SPEAKER_01]: That's a possibility.
37:13.226 --> 37:13.386
[SPEAKER_01]: Right.
37:13.406 --> 37:19.709
[SPEAKER_01]: And it just is something that you have to kind of stick with and figure out like, is something making you, is the estrogen making you feel worse?
37:19.749 --> 37:20.890
[SPEAKER_01]: Do we need to try it different?
37:21.010 --> 37:22.010
[SPEAKER_01]: What's going on with your dose?
37:22.030 --> 37:22.730
[SPEAKER_01]: What's going on with your
37:27.312 --> 37:30.336
[SPEAKER_00]: people just want like we're so instant gratification.
37:30.396 --> 37:38.326
[SPEAKER_00]: And it's same with like putting someone on a weight training, you know, like program and it's like, we have to see if this works for your body.
37:38.666 --> 37:42.110
[SPEAKER_00]: We have to see what are you going to get knee pain or shoulder pain or like.
37:42.831 --> 38:05.544
[SPEAKER_00]: You know, are your quads going to respond or your glutes going to take over because your quads are so weak or your hamstrings and it's like we're going to start here, but we're really not going to know if this works until we have you put it on repeat and then see and then reevaluate and people are just like, no, I want to lose the 30 pounds now, I want to be toned now, I want to put on muscle now and I'm like,
38:06.248 --> 38:07.209
[SPEAKER_00]: you haven't lifted.
38:07.229 --> 38:08.670
[SPEAKER_00]: You've never done anything like this before.
38:08.710 --> 38:15.797
[SPEAKER_00]: Like we need to see and weigh and then re-value weight and see how consistent you can be at it because I'm sure it's the same thing.
38:15.997 --> 38:22.723
[SPEAKER_00]: You put people on a program and then they're like, hey, me and I take it two or three times and you're like, no bitch, you're supposed to be doing this daily.
38:22.743 --> 38:28.929
[SPEAKER_00]: And they're like, but I got three doses in and you're like, yeah, that's why how it works.
38:29.209 --> 38:31.071
[SPEAKER_01]: If, yeah, and you're high on the wall.
38:31.773 --> 38:32.073
[SPEAKER_01]: Yeah.
38:32.273 --> 38:39.337
[SPEAKER_01]: I sometimes people will not take their medications like they're prescribed and I'm like, okay, so all you did was give yourself the risk of the medication and none of the benefits.
38:39.637 --> 38:40.057
[SPEAKER_01]: Right.
38:40.077 --> 38:41.818
[SPEAKER_01]: That's a good way to put it.
38:41.838 --> 38:42.098
[SPEAKER_01]: Yeah.
38:42.498 --> 38:46.500
[SPEAKER_01]: So there actually is um studies with Ashwaganda that it can
38:47.240 --> 38:51.781
[SPEAKER_01]: Modestly increased testosterone in men, but I have to say a lot of our studies are in men.
38:51.801 --> 38:53.101
[SPEAKER_01]: We don't have a lot on women.
38:53.982 --> 38:59.283
[SPEAKER_01]: So it can go up by about 57 nanograms, which compared to placebo.
38:59.783 --> 39:05.784
[SPEAKER_01]: So it doesn't seem like they've noticed changes in women and of just in men.
39:05.965 --> 39:07.625
[SPEAKER_01]: So I mean, but here's the thing is
39:08.820 --> 39:15.922
[SPEAKER_01]: As long as something I usually tell my patients if it's not going to hurt you, that's where we rest in benefit comes in in medical history.
39:16.562 --> 39:18.222
[SPEAKER_01]: And I know like, okay, this is not going to hurt you.
39:18.342 --> 39:20.863
[SPEAKER_01]: It may not help, but if it's not going to hurt, try it.
39:20.883 --> 39:24.084
[SPEAKER_01]: I mean, if you really want to try something, try something.
39:24.164 --> 39:27.744
[SPEAKER_01]: I mean, I'm not going to discourage people as long as you know it's not going to cause harm.
39:28.044 --> 39:28.305
[SPEAKER_00]: Right.
39:28.565 --> 39:28.805
[SPEAKER_00]: Right.
39:29.565 --> 39:34.286
[SPEAKER_00]: Uh, can we talk real quick to about how like hormones are not magical?
39:34.906 --> 40:02.485
[SPEAKER_00]: They yeah, we were kind of talking about this before we had the record button because it's it's it's so frustrating And I know you have your frustrations in your line of work and I have mine and I'm like Everyone wants to come in and just be like, oh, it's my hormones, you know, and and I know this is it and I'm like Girl you're not lifting you have no idea how many calories you're taking in a day I bet you have no clue how many grams of protein you're consuming one was last time you worked out one was last time You even just walked
40:03.327 --> 40:07.628
[SPEAKER_00]: And you want to blame your hormones, you know, it's like they are not magic.
40:07.668 --> 40:11.529
[SPEAKER_01]: And even if you do get started on those, you still need everything out.
40:11.609 --> 40:13.209
[SPEAKER_01]: It's a great 100% with that.
40:13.449 --> 40:15.350
[SPEAKER_01]: It's something that we talk about in our consult.
40:15.370 --> 40:23.652
[SPEAKER_01]: So when someone comes in for hormones, I initially give them a lifting guide, a supplement, compared, split, like I tell them all of the non-negotiables.
40:24.032 --> 40:28.073
[SPEAKER_01]: These hormones are replacing what you're losing.
40:29.033 --> 40:53.870
[SPEAKER_01]: they're not we're not yes so we're losing something we're replacing it but they're not going to lift weights for you they're not going to make you go to sleep they're not going to make you drink water all of the basics matter your foundation matters you can take there is no magic pill it's a combination of doing a lot of different things that help you in different ways right so being on estrogen and testosterone isn't going to build muscle unless you're lifting weights
40:54.370 --> 40:55.532
[SPEAKER_01]: it will help you.
40:55.992 --> 41:05.401
[SPEAKER_01]: So, you know, maybe one of the things that is good is you get on your HRT, your mood is better, you're sleeping better, you're feeling more resilient again.
41:05.662 --> 41:10.466
[SPEAKER_01]: Maybe that will motivate you to get in the gym or that will motivate you to want to eat your protein or drink your water.
41:10.506 --> 41:13.069
[SPEAKER_01]: So, I feel like they work together and vice versa.
41:13.129 --> 41:13.890
[SPEAKER_01]: I still have people
41:14.847 --> 41:16.209
[SPEAKER_01]: with depression anxiety.
41:16.349 --> 41:26.160
[SPEAKER_01]: And I'm like, listen, the drug that we know that works better than any other drug is exercise for firm depression anxiety period.
41:26.220 --> 41:34.109
[SPEAKER_01]: So yes, it's not a magic pill, but it is one really important part of the puzzle with all the other things we just talked about.
41:34.269 --> 41:34.510
[SPEAKER_00]: Yeah.
41:34.830 --> 41:39.113
[SPEAKER_00]: Yeah, I love that you said puzzle too because I that's the way I describe it to everyone.
41:39.133 --> 41:46.177
[SPEAKER_00]: It's like your life, your hormones, your health and finished during it's one giant puzzle on the floor and right now it's like all scattered.
41:46.818 --> 41:52.902
[SPEAKER_00]: So people like Dr. Pavan is going to find a piece and she's going to match it and find four more that match together.
41:53.702 --> 41:54.203
[SPEAKER_00]: And then like,
41:55.103 --> 42:01.247
[SPEAKER_00]: In the lifting world and nutrition, like you're going to have other people that are going to help you put that puzzle together in this area.
42:01.307 --> 42:04.009
[SPEAKER_00]: And soon it will all come together and we help you find it.
42:04.029 --> 42:07.471
[SPEAKER_00]: I just I can't stress enough like women you don't have to do this alone.
42:08.112 --> 42:16.578
[SPEAKER_00]: They you right you don't have to just sit there and suffer and take no for an answer or you know not live your best life as your kids are growing.
42:17.378 --> 42:24.785
[SPEAKER_00]: you should be growing and starting a whole new life, too, not falling apart and disintegrating in and nothing totally agree.
42:25.246 --> 42:31.032
[SPEAKER_01]: I don't think that culture is changing, medicine is changing, and the information out there is changing.
42:31.312 --> 42:31.492
[SPEAKER_01]: Yeah.
42:31.532 --> 42:34.855
[SPEAKER_01]: So we have a lot of knowledge and people are empowered.
42:34.955 --> 42:36.337
[SPEAKER_01]: So I agree with you.
42:36.377 --> 42:37.778
[SPEAKER_01]: Don't take no foreign answer.
42:38.159 --> 42:39.480
[SPEAKER_01]: Have good conversations.
42:39.640 --> 42:44.705
[SPEAKER_01]: I don't think that you need a doctor who's a woman who's in Perry menopause to understand you.
42:44.725 --> 42:52.974
[SPEAKER_01]: I just think you need to find someone in every realm like even your fitness, your personal training or needs to understand your limitations, right?
42:52.994 --> 42:53.995
[SPEAKER_01]: Or what are you willing to do?
42:54.236 --> 42:55.597
[SPEAKER_00]: That's something I always ask my patients.
42:55.617 --> 42:57.019
[SPEAKER_00]: Well, what are you willing to do?
42:57.039 --> 42:57.259
[SPEAKER_00]: Yes.
42:57.319 --> 43:00.963
[SPEAKER_01]: Because I'm not going to give you a regimen that you're not going to do.
43:01.423 --> 43:05.365
[SPEAKER_01]: the best form of everything in life is the one that you're going to do.
43:05.965 --> 43:14.089
[SPEAKER_01]: So I think that as long as you find someone who can have a conversation and go back and forth, that's how you start making change.
43:15.287 --> 43:15.567
[SPEAKER_00]: Mm-hmm.
43:16.008 --> 43:16.248
[SPEAKER_00]: Yeah.
43:17.028 --> 43:26.775
[SPEAKER_00]: The back and forth is huge because that's going to take time to collect the data to see what worked, what didn't go back, go forth, and really learned.
43:26.815 --> 43:33.500
[SPEAKER_00]: But I'm just so grateful that you came on today and we had this conversation around this and reminded people how important it is.
43:34.380 --> 43:38.683
[SPEAKER_00]: And I know you're just changing lives like every single day.
43:38.743 --> 43:39.804
[SPEAKER_00]: Like every time a woman comes
43:42.506 --> 43:46.867
[SPEAKER_00]: you just change that woman's life forever, you know, and then like her daughters are watching.
43:47.607 --> 43:49.948
[SPEAKER_00]: Like, you know, you're making generational changes.
43:50.328 --> 43:51.708
[SPEAKER_00]: Now people can work with you.
43:51.728 --> 43:56.449
[SPEAKER_00]: We were to kind of talking about this before Oklahoma, New York, Texas, California.
43:56.489 --> 43:58.110
[SPEAKER_00]: Yeah, so we could do telemedicine.
43:58.150 --> 44:06.652
[SPEAKER_01]: I have my medical licenses in those states and we have looked into, you know, because we have some nearby states, Kansas, and other ones where.
44:07.392 --> 44:15.493
[SPEAKER_01]: It's pretty simple to get a waiver, so if there were people who were wanting help in other states, I could easily get a waiver to make sure I can take care of as many people as possible.
44:16.254 --> 44:23.175
[SPEAKER_01]: And then also talk to some people, want to be in person, talk to start with your primary care doctor, to start there.
44:23.555 --> 44:25.655
[SPEAKER_01]: I mean, it's just worth having a conversation.
44:26.295 --> 44:32.036
[SPEAKER_01]: And if they feel like they're not comfortable or knowledgeable enough, knowledgeable enough, they'll send you to somebody else.
44:32.696 --> 44:35.897
[SPEAKER_00]: Yeah, where is core medicine and aesthetics?
44:37.063 --> 44:38.285
[SPEAKER_00]: It's in Tulsa, Oklahoma.
44:38.565 --> 44:39.807
[SPEAKER_00]: Tulsa, Oklahoma.
44:39.827 --> 44:41.929
[SPEAKER_01]: Yeah, I moved here for many mayors.
44:42.009 --> 44:43.291
[SPEAKER_01]: Good, but you're my residency.
44:43.351 --> 44:45.694
[SPEAKER_01]: And then I just never left.
44:45.814 --> 44:49.819
[SPEAKER_01]: I just different opportunities kept popping up.
44:49.839 --> 44:52.082
[SPEAKER_01]: And then I got married, and then I had a kid.
44:52.142 --> 44:55.266
[SPEAKER_01]: And then I opened a business right here.
44:56.467 --> 44:56.907
[SPEAKER_00]: I love it.
44:56.927 --> 44:57.268
[SPEAKER_00]: I love it.
44:57.288 --> 45:04.991
[SPEAKER_00]: Well, we'll put everything in the show notes where people can find you, contact you guys on your social media website, everything, but this was such an amazing conversation.
45:05.031 --> 45:17.257
[SPEAKER_00]: Thank you so much for coming on and just really helping educate people and getting back to the basics and having an understanding of like what this is, what it looks like, what is the truth about things and how you're helping people too.
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[SPEAKER_00]: So thank you so much for coming on.
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[SPEAKER_01]: Well thank you and also thank you to you because you know my sister follows you and she's worked out with you and stuff.
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[SPEAKER_01]: Yeah you are also changing so many lives.
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[SPEAKER_01]: I know that on she had been working with you like she felt like a totally different person and just felt so motivated and empowered again.
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[SPEAKER_01]: So that's us.
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[SPEAKER_00]: I'll never forget my conversation with her.
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[SPEAKER_00]: Like yeah and that was years ago like I totally remember her first conversation and she's yeah
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[SPEAKER_00]: Every one, check out the show notes, find out who you can work with or learn more, keep edging your cating yourself and keep having conversations.
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[SPEAKER_00]: Remember having someone who is willing to go back and forth with you, that's what's important.
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[SPEAKER_00]: Not just shut you down.
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[SPEAKER_00]: So everyone, stay safe, stay healthy, until next time.
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[SPEAKER_00]: The Bound Life podcast is for informational and entertainment purposes only.
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[SPEAKER_00]: The content shared here is not intended as medical for legal or professional advice.
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[SPEAKER_00]: Always consult with a qualified professional, we're making any health fitness, financial or legal decisions.
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[SPEAKER_00]: The opinions shared on the podcast are personal experiences and insight, so if you need expert guidance, go find the right professional for you.
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[SPEAKER_00]: Thanks for listening!