0:00

Hi, everyone. I'm Brené Brown, and this is Unlocking

0:02

Us. Welcome

0:09

back to our new eight-part series that

0:12

I am calling On My Heart and

0:14

Mind. We started the

0:16

series with my conversation with Valerie Korr on

0:18

the power of revolutionary love and being a

0:20

sage warrior. I have talked

0:22

to Dr. Sarah Lewis on her

0:24

stunning new book, The Unseen Truth,

0:26

and my friend and Unlocking Us

0:28

alum Roxanne Gay. And I had

0:31

a, wow, just a

0:34

really eye-opening and provocative conversation

0:36

about her essay on black gun

0:38

ownership. Before the series

0:40

is done, you'll also hear from me

0:43

and my sisters on grief, love, and

0:45

unexpected joy. And this

0:47

episode is all about the pause,

0:50

about the menopause. I'm

0:52

talking to my friend, also

0:55

my doctor, one of them, Dr.

0:57

Mary Claire Haver, who is on

1:01

the kind of zero-bullshit policy

1:03

with menopause and helping

1:06

so many of us understand what's going

1:08

on, what's not going on, and

1:11

how the American

1:13

medical establishment has a lot of

1:16

catch-up work to do. Support

1:25

for this show comes from ABC's hit

1:27

drama Grey's Anatomy. The landmark 21st season

1:30

promises the drama, suspense, and all the

1:32

feels fans come to expect. New

1:34

romances, new medical and personal emergencies,

1:37

emotional twists and turns, and all

1:39

your favorite characters, including

1:41

Meredith Grey. Watch new episodes

1:44

of Grey's Anatomy Thursdays at 10, 9 central

1:46

on ABC and stream on Hulu. US

2:00

airlines based on the number of

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international destinations served. And

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now you can easily meet your business travel

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started at

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uafly.co/podcast. Before

2:32

we jump in, let me tell you a little bit about Mary Claire Haver.

2:35

Dr. Haver is a board certified

2:37

obstetrician and gynecologist. She graduated

2:39

from LSU Medical Center. She completed

2:41

her residency at the University

2:43

of Texas Medical Branch in Galveston.

2:47

She is a certified

2:50

medical specialist and menopause

2:52

society certified menopause practitioner.

2:55

In 2021, she established Mary Claire Wellness,

2:58

a clinic dedicated to providing comprehensive care

3:00

for menopausal patients. In

3:02

2023, she published her first book, The Galveston

3:05

Diet. I discovered her before

3:07

I saw her, actually. She's in my neck of the

3:09

woods, so it made it easy to see her. I

3:12

discovered her on social media. She has, I

3:14

think, 4 million followers across platforms.

3:17

And she's so good at

3:19

demystifying information, backing up claims

3:22

with really solid research. I

3:24

just am a huge fan. If you do know

3:26

her, this is a fun conversation. If you have

3:28

not met her, I'm so excited that you get

3:30

to meet her. We're going

3:32

to talk about her new book, The

3:35

New Menopause, Navigating Your Path Through Hormonal

3:37

Change with Purpose, Power, and Facts. And

3:40

let's jump in. Okay,

3:46

I just have to say for everybody listening, Mary Claire and

3:48

I just keep looking at each other going, are you

3:50

ready? Are you ready? Are you ready? I'm

3:53

so excited. Dr. Mary Claire Haver, thank you

3:55

for being on Unlocking Us. Oh my gosh,

3:57

thank you so much for having me. I'm

3:59

loving it. I look forward to this conversation for a month.

4:02

I have to tell everybody, I want this claim to

4:04

fame. I was following

4:07

you, Mary Claire

4:09

Haver, before Mary Claire Haver was cool. Just tell

4:11

them it's true. It's absolutely true.

4:14

I think I found out you followed

4:16

me when I had like three followers.

4:19

And I was like, oh my God,

4:21

that was amazing. So yeah, you're an OG.

4:26

I'm an OG, what are we

4:28

calling ourselves now? The menopossi? The

4:30

menopossi. And MP. The menopossi,

4:32

yeah. Yeah, and MP. All

4:34

right, I'm going to start with tell us your

4:36

story. I want to know all

4:38

about you. I

4:41

mean, like, where were you born? Take us

4:43

through high school. Sure. I

4:45

was born in Lafayette, Louisiana. I'm

4:48

one of eight children to the same parents. I

4:51

grew up in Lafayette, went to high school at

4:53

a small, well, big for

4:55

Lafayette, at the Catholic school system and

4:58

the Catholic high school. And

5:00

then one of my older brothers went to college. The rest did not.

5:04

I enrolled in the local university in

5:06

my town, which was U.S.L. at the

5:08

time, but they've changed the name to

5:10

U.L.L., University of Louisiana at Lafayette, because

5:12

we were broke and I could walk

5:15

there and actually got

5:17

a fabulous education and

5:19

worked my way through. So it took

5:21

me five years, no regrets. And have

5:23

an undergraduate degree in geology of

5:25

all things, but no one was majoring

5:27

in it at the time because, and I loved it.

5:29

I didn't know I was going to be a scientist

5:32

when I grew up. I thought I'd be an actress

5:34

or ballerina, but I had to

5:36

take a science class and that one sounded cool. And

5:38

I absolutely was a fish in water. And it was

5:40

one of those moments where I'm like, I

5:42

think I'm smart. Like, is

5:45

that a thing? Like, I didn't try in high

5:47

school. I just kind of showed up, did my

5:49

thing, graduated the middle of my class. Everybody was

5:51

happy and went to college because

5:53

that's kind of what you did. And I didn't like the

5:55

options available to me at the time if I didn't go,

5:58

right? So. But

6:00

I really kind of found my academic

6:02

chutzpah when I was in university and

6:05

took the geology class, fell in love with science,

6:07

and I took another one. And then I took

6:09

a third one and they're like, hey, we have some

6:11

scholarship money over here and I'm working my way through

6:13

school. So I was like, well, that sounds

6:15

cool. Let's see what happens. And ended

6:18

up almost at 4.0, did great, got

6:21

a scholarship to study in New Zealand,

6:25

went to New. So I've worked for an oil

6:27

company as my little part-time job through college. And

6:29

they basically had a job ready for me. Then

6:31

I get this scholarship to go study abroad. So

6:34

I go do it and while I'm down there, I have this

6:36

whole like, this is not my

6:38

path. I love this as science,

6:40

but as far as sitting at a desk drilling

6:42

oil wells for the next 50 years, this

6:44

is not gonna be for me. And

6:47

the host family that I was down there

6:49

with were all in medicine and they're like,

6:51

you should think about doing something medical. So

6:54

I wrapped that up, got back to the States,

6:56

went back to work and

6:58

told my boss, I think I'm gonna apply to

7:00

medical school and had to take one year of

7:03

organic chemistry. I didn't have the right level of

7:05

O chem. I was gonna ask if

7:07

you had O chem. I had everything

7:09

I needed to apply, but O chem.

7:11

So he's like, and I said, listen,

7:13

the class is on this day, this

7:15

time, he said, make it up on

7:17

the weekends. So I would walk in

7:19

my little outfit with my heels to

7:21

my class, take my class. The lab

7:23

was like all Wednesday afternoon. I looked

7:25

like Merlin, pouring all these beakers and

7:28

creating potions and then would walk back

7:30

to my job. And I applied

7:32

to med school that year, so I

7:34

got accepted contingent upon passing organic chemistry,

7:36

which I did. And so

7:39

I got to medical school as a

7:41

geologist. Everyone is nodding along

7:43

at the first class and I am

7:46

lost, lost. What are they

7:48

talking about? I learned none of this in undergrad. And

7:50

I was like, all the loans

7:53

were so expensive. I'm like, I'm stuck, I have

7:55

to figure this out. And I did, just

7:57

tripled down, found some great study partners.

8:00

and finished medical school top

8:02

of my class. Wow. Yeah.

8:04

And met my husband, Chris,

8:08

when I was working at the oil company, and he

8:10

actually helped me fill out my applications and helped me

8:12

write my personal statement. And so

8:14

we got married between my junior

8:16

and senior year of medical school, and

8:19

we didn't actually live together full time

8:21

until I started residency, just because logistics

8:23

and where he was working and medical

8:25

school and everything. So I teased

8:27

my children. We did it backwards. We didn't move in together

8:30

until we'd been married for a year. So

8:32

we still

8:35

survived. We survived. And in medical

8:38

school, I decided OB-GYN. That

8:40

was my last rotation of my third year,

8:42

and I absolutely fell in love with the drama,

8:44

fell in love with the babies and all

8:47

the things, but really grew to

8:49

love as I practiced. Once I

8:51

got out of training, the gynecology part

8:53

of it, the one-on-one relationship with

8:55

my patients. And so

8:57

I was a

9:00

academic professor teaching residents, teaching medical

9:02

students. I was a program director

9:04

in charge of the curriculum for

9:06

the residents for over 10

9:09

years. So it was when I

9:11

started going through menopause and my patients were

9:13

going through it with me. So my patients

9:15

were aging with me as I was getting

9:17

older. I was having babies. They

9:20

were having babies, right? So you kind of age up with

9:22

your patients in general. And I

9:24

started realizing, I don't

9:26

know enough about menopause. I would have

9:28

told you I was a great menopause provider until I actually

9:30

was menopausal. And everyone

9:33

was complaining of weight gain. And

9:35

I was terrified of hormone therapy because

9:37

of the fallout from the Women's Health Initiative.

9:40

And everything I know now

9:42

about menopause care is basically self-taught in what

9:44

I learned through the Menopause Society. So

9:47

in 2018, I left the university, and

9:52

I became a hospitalist because I really wanted to figure out

9:54

how am I going to focus on menopause? How

9:56

am I going to do this? Because in a 15-minute

9:58

visit with a patient's feet It's really

10:01

not enough time to unpack the menopause

10:03

trauma. But I was terrified to

10:05

give up my surgical privileges. We worked so hard

10:07

for that. So I became a hospitalist so I

10:09

could go part time and still operate and do

10:11

all the things, keep up my skill

10:13

set. And then COVID hit. So

10:17

being a hospitalist during COVID, I've never worked

10:19

more hours in my life. So grateful to

10:21

have been part of the solution and doing

10:23

patient care. My husband was so

10:25

frustrated sitting at home and I get to run away and

10:28

go to the hospital. But once things calmed

10:30

down, I decided, OK, I'm going to go for

10:32

it. And Chris and all my friends were like,

10:35

just try it. Because I was like, I don't know if anybody will come see

10:37

me as a menopause vet.

10:39

Like, who's going to come to a

10:41

menopause doctor? I can't afford to take

10:43

insurance because, again, 15-minute visits. And

10:46

he said, open the doors, see

10:48

what happens, price it reasonably,

10:51

and just try. If

10:53

you feel you can always go back and go back and do perhaps

10:55

mirrors or whatever you want to do, which is an honorable thing

10:57

to do. Really, very

10:59

few people in the Houston area were doing this.

11:01

So on a wing and a prayer, I took my

11:03

girlfriends out to dinner. We kind of walked

11:06

through how to run a clinic. And

11:09

I threw up a shingle and it

11:11

was extremely successful. And now

11:13

we've just hired number four nurse practitioners to

11:15

help us expand the clinics and was able

11:17

to write the book and talk about my

11:19

experiences. And here I am today. I

11:22

am so frickin' glad that I asked

11:24

you about your story because I didn't

11:26

know your story. Wait,

11:29

where are you in birth order with these

11:31

eight folks? Fifth. So let me

11:33

expand on that a little bit. So I have

11:35

four older brothers. They were born within five years.

11:38

Me and my- I was wondering if you were the first girl. My

11:40

sister, then my two little brothers. And there's

11:43

about a five-year gap between the boys and

11:45

then the second family, as my mom always

11:47

called it. So Jett,

11:49

the oldest, was diagnosed

11:51

with acute lymphocytic leukemia when my

11:53

mom was pregnant with the fourth

11:56

son. They almost

11:58

lost him a Hail Mary drive. up

12:00

to Memphis. He was one of the first patients at

12:02

St. Jude's. They were able to get him in remission

12:04

while my mother was taken across the street for

12:07

preterm labor. Can you imagine the stress? You

12:09

know, while we were living with grandmothers and

12:12

aunts and we're all dispersed around our hometown

12:14

while they're fighting for my brother's life. So

12:16

he goes into remission. He's doing

12:18

great. Everybody comes home. We go back to normal

12:20

life. My mom has, so I

12:22

have my little sister and then my mom

12:25

gets pregnant. Jeff comes out of remission

12:27

at about 18, 17 and a half maybe.

12:30

I'm like seven. Okay. So the

12:32

whole next three years of my life are keeping

12:35

him alive. Right? Like that's all I remember is

12:37

hospital visits and doctors and he's in

12:39

remission. He's out of remission. And so

12:41

he's fighting, fighting, fighting. My mom gets

12:43

pregnant for number seven. And

12:46

then Jeff dies when mom is

12:48

about six months pregnant for Jeremiah.

12:51

And then we have Jeremiah and then

12:54

she couple of years later has my

12:56

baby brother John. But that was a

12:58

defining moment in our family. Like everything

13:00

changed after his death. My

13:03

parents, I don't know how

13:05

they survived it. Very rarely does the

13:07

couple survive the death of a child.

13:09

So off we go under real life, college,

13:12

med school, oil field downturn.

13:14

My parents go bankrupt. I'm

13:16

struggling to get through college. I made it.

13:19

Everything's fine and great life lessons there. Bob,

13:22

my second brother was gay. He

13:25

passed away. So I'll tell you his story. So, you

13:28

know, I had this one fabulous brother who was so

13:30

much fun to have as an older brother. He would

13:32

dress me up, put makeup on me, make me close.

13:34

He had a sewing machine. He was one

13:36

of my best friends and, you know, coached

13:38

me through cheerleading in high school, practiced

13:41

with me for drama. And then he

13:43

developed HIV and hepatitis as a lot

13:45

of men did. And he'd been

13:48

with the same partner for 35 years. So

13:50

Bob in 2015, which is part of

13:53

my menopause story, had been

13:55

fighting end-stage hepatitis, basically. And

13:58

we get the call. that

14:00

he's had a stroke and he's in the

14:02

hospital. He's alive, but his brain's not

14:04

functioning that well. And then we get another call

14:06

that he's in a coma. So, I

14:08

rush home and my sister and

14:10

I, she

14:13

was a hospice nurse at the time. We did

14:15

his end-of-life care. And it was a beautiful way

14:17

to die, with all your family around you. So,

14:20

you know, he also had some behavior

14:22

choices that he was

14:24

never able to kick, that probably hastened his path

14:26

to death. And I had

14:28

to deal with loving him through those choices

14:31

and accepting that. And I

14:33

really fell apart after his death. My

14:36

leave was given at the hospital. I wasn't able

14:38

to take much time off because I took so

14:40

much time to do his end-of-life care. And

14:43

I was just like put a band-aid on myself

14:45

and like, you know, go to work and I

14:47

would cry all the way home and cry all

14:49

the way there, like get the emotions out and

14:51

then patch myself together to take care of him.

14:53

The meantime, I'm in menopause. Like, I don't know

14:56

it. So I had

14:58

stopped my contraception right

15:00

before he got really sick at the end. And,

15:03

you know, what I was attributing to

15:05

grief, definitely there was grief involved.

15:07

You know, I'm not gonna knock the psychological

15:09

impact of that on me. But I was

15:12

like, hot flashes, body aches, not sleeping. And

15:14

I'm thinking, oh, I'm just grieving, I'm grieving,

15:16

I'm grieving. Then when the grief fog started

15:18

to lift, like six months later, I'm still

15:20

having all these symptoms. And then I'm like,

15:22

when was your last period? Oh,

15:25

my God. Like, I didn't have regular periods ever,

15:27

so this wasn't unusual for me. And I was

15:29

48, so on the young end. And

15:32

then I was like, I think you're in

15:34

menopause. Like, I guess let myself, you know,

15:36

like, I couldn't even realize this was

15:38

my job. Yeah, I know, I know. That

15:41

I was menopausal, like fully. And

15:44

was absolutely miserable and terrified for myself to

15:46

start a tortilla. Basically went to the woman

15:48

who was taking care of me at the

15:50

time and said, my clinician, and we

15:52

just had a heart to heart. And I was like, I

15:54

can't live like this. I'll just take

15:56

the risk. And I didn't realize that

15:58

the risks have been so overstated. and overblown

16:00

and really had been walked back. I'm still following

16:02

the 2002 guidelines. And

16:05

I reluctantly went on HRT,

16:07

terrified. Absolutely life-changing

16:11

for me. How? I

16:14

got my resilience back. I

16:17

was flying off the handle at everything.

16:19

I didn't realize the hit to my mental health.

16:22

I didn't realize the hit to my cognition. You

16:24

know, I just thought I was getting older. Like,

16:26

I was forgetting the keys I get in the

16:29

car at and nowhere was going. I was struggling

16:31

to like, just common words. I was struggling with

16:33

patients to explain things that were just so easy

16:35

to me before. And I really

16:37

thought, am I having early dementia? My grandmother had

16:40

horrible dementia. And then

16:43

when I started HRT within six weeks,

16:45

I'm sleeping through the night again, hot

16:47

flashes have gone away, and I'm just

16:49

feeling like I've got myself back. And

16:52

at the same time, I'm going through

16:55

the weight gain. So I was changing

16:57

my nutrition, changing my exercise. Making so

16:59

many life changes at that time. You

17:01

know, looking at my brother and his

17:03

life choices and how that affected him

17:05

and realizing we had the same genetics.

17:07

So my brother right above

17:09

me, Jude, so right after Bob dies,

17:13

I get a phone call that Jude's in the

17:15

hospital and they see a

17:17

mass. My sister-in-law was a radiologist

17:19

technician, so she's sending me pictures of

17:21

his scans. And I'll never forget,

17:24

I was at a meeting at a restaurant, and

17:26

I was like, excuse me, and I'm picking up

17:28

the phone and I'm seeing the images come through

17:30

from my sister-in-law, and it's giant masses in my

17:32

brother's liver. And I just

17:35

was like, I can't, I can't do this

17:37

right now. You know, like, I'm just barely

17:39

recovering from Bob. And

17:41

he ended up having metastatic

17:44

esophageal cancer, stage

17:46

four, widely metastatic. By the time he was

17:48

diagnosed, I've fought that for two years. COVID,

17:51

in the middle of COVID, we're sneaking across

17:53

the border to go help him and go

17:55

try to see him and spend time with

17:57

him. When all the craziness of COVID was

17:59

happening. And he's like, I don't care

18:01

if I die of COVID. Please come and see me. I love

18:03

you. I miss you. And so

18:05

we got him through that. I

18:07

did his end of life care. And

18:10

then my dad died nine months later.

18:13

And so I don't

18:15

know how my mom has done it. You know,

18:18

three kids, her husband, she's

18:20

87. She's not doing well. It's

18:23

just, yeah, been a lot. But part

18:26

of what motivates me and keeps

18:29

me going and fighting the kind of

18:32

people who aren't pro women

18:34

having great health into their last 30,

18:36

40 years of their life, I'm

18:39

just saying I will not stand down. I will fight

18:41

for the health of women for every

18:43

decade of her life, especially the last

18:46

three or four. Because now,

18:48

today, Brené, I'm 56. I

18:51

am healthier. I'm wealthier. I

18:53

have better relationship. I have better boundaries.

18:56

What I've got with my children now, I

18:59

want every woman to have. But

19:01

had I not addressed my menopause

19:03

in realizing that the way the

19:06

health care system is currently set up is

19:08

not built to serve a woman after reproduction,

19:12

studies aren't done on females throughout her reproductive life.

19:14

It's harder to study females because we have hormonal

19:16

changes. And then when hormones walk out the door

19:18

in menopause, women are just

19:20

kind of left behind. We forever in medicine,

19:23

forever in studies, have been assumed to be

19:25

small men with breasts and uteruses. And so

19:27

we'll just study the men and we'll just

19:29

apply what we've learned to

19:32

females. What's happened, the end result of

19:34

that, is that females are

19:36

living 20% of their lives in

19:39

poorer health than their male counterparts. We're

19:41

much more likely to have dementia and Alzheimer's.

19:44

We're much more likely to lose our

19:46

independence and old age and require nursing

19:49

home care. It's three to one. And

19:52

so when my patients come in now that

19:55

I just focused on these last few decades, we

19:58

put out the menopause fires the best way. We

20:00

can't HRT not HRT nutrition extra to that.

20:03

And then we start try to help her chart that course

20:05

for the next 30 years. Cause I'm

20:07

like, tell me about your mom. Tell

20:09

me about your aunt's how's their health. And

20:11

when they're like, she's 95, she's

20:14

cooking, she's cleaning, she's doing great. She's playing with

20:16

it. I'm like, let's do what she's doing. But

20:18

for most women, that's not the case. There's a

20:20

reason it's a place for mom. Okay.

20:23

There's a reason there's a company called a place for mom and

20:25

not for dad. For mom is

20:27

that we are not enjoying the health

20:29

that we could because I think one

20:31

of the main things is we're not

20:33

addressing menopause and that

20:36

these studies were never known on females.

20:39

And that's my focus and advocacy

20:41

and trying to get increased funding

20:43

in the NIH for women's health

20:46

after reproduction. I

20:48

can see how

20:51

your fight is fueled by

20:54

the love of your family and the loss of your brothers. And

20:59

I've put off this conversation with you for as

21:01

long as I can put it off like the podcast. I mean,

21:03

you and I've had plenty of conversations off the record. I'm

21:08

so pissed off

21:13

and I got so much like if I

21:15

get through this without crying, I don't know,

21:17

I got so much grief from

21:20

my mom. Like

21:22

when I started following you, she

21:25

was already in the throes of dementia.

21:29

And I thought about all

21:31

the things that corroded

21:35

her life. I mean,

21:37

her frozen shoulder, all

21:39

of these things that doctor

21:41

after doctor said, you know, we're in

21:43

your head and

21:46

the UTIs and the dementia and

21:49

the don't get close to HR to

21:52

any kind of hormone therapy. And

21:54

my mom just frickin'

21:57

as the survivor that she is. just

22:00

slugging it out until

22:02

you can't win, until

22:05

she's just dying. And

22:08

she doesn't know who we are except maybe

22:11

in flashes. And

22:13

what do you make of

22:16

the collective grief and rage? Do you see

22:18

it or is it just me? No,

22:20

it's not just you because I talk to women

22:22

every day and it is

22:25

the rare patient who

22:28

is not watching their mother not

22:30

live a

22:33

healthful life who is plagued with something

22:35

for decades. You know, no one expects

22:37

to get out of this alive. We

22:39

all know something's going to take us

22:41

out one day. Right. Yeah.

22:44

But the collective experience of

22:46

females and the way we

22:49

were trained to address female

22:51

complaints is we're taking

22:53

something biological and assigning a

22:55

psychological cause. And we

22:57

are basically small emotional men. There's

23:00

a reason why hysterical is a word

23:02

and we don't have testarical. And

23:05

that has got to stop. That has got to

23:07

stop. Now, light at the end of

23:09

the tunnel here. My daughter is in medical school. She's

23:12

a second year. She is well

23:14

aware. Her classmates are well aware

23:16

and they are not going

23:19

to put up with this. They're going to

23:21

believe they're female patients. And just automatically when

23:23

you come up blank as a clinician, not

23:25

to automatically assume it's all in her head.

23:28

So I think there's hope for the future.

23:31

We are slowly, slowly, slowly getting more

23:33

and more research funding dollars into health

23:36

after reproduction for females drops in the

23:38

bucket so far. But there is awareness.

23:42

And I think we're going to get there.

23:44

I think it's going to take a generation. Things in medicine don't

23:46

move quickly. But I think

23:48

there is hope in the future. Support

23:57

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Things people love. I

25:29

have a story that's similar to yours in some ways because

25:31

Steve was in residency when

25:33

we got married. We did not live together.

25:35

I was in graduate school. We

25:38

commuted to see each other and we

25:40

got married in that one week

25:42

the residents have off between third

25:44

and fourth year. And we went

25:46

to San Francisco because we had

25:49

to go so we're really close

25:51

and there were six other residents

25:53

there on honeymoons from different

25:55

residency programs. So I speak that

25:57

language. pregnant

26:00

I was in my PhD program and

26:03

I had really,

26:06

really significant hyperemesis. And

26:11

the things that stand out

26:13

for me about getting pregnant in the PhD program is

26:15

that at the time there was a male head of

26:17

the PhD program who looked at me when I told

26:19

him I was pregnant and said, we

26:22

really thought you were going to be someone. We

26:24

really thought you were going to have a career.

26:26

And then I was like, Jesus, it's

26:28

a pregnancy, not a lobotomy. And then of

26:30

course I get very, very sick and

26:33

I have to take a leave of

26:35

absence because my multi-linear statistics professor would

26:38

not let me throw up in the

26:40

trash can during class. And

26:42

then when I had hyperemesis, I

26:45

had a female doctor and I picked her because she kind of looked

26:47

like a hippie and I thought this will be good for me. And

26:50

she said, I'm wondering what we

26:52

know about hyperemesis is, yeah,

26:55

are you worried about attention from

26:58

people shifting from you to the baby?

27:02

And is this a psychological reaction that you're

27:05

having? So I was

27:07

taught the same thing. I

27:09

was taught that there's a significant percentage

27:11

of hyperemesis. Now this was in the

27:14

90s. That is psychological.

27:16

We were putting people on antipsychotics

27:19

for hyperemesis. That

27:21

has been completely debunked. We have found

27:24

the receptor in the brain that is

27:26

causing this. And I have to shout

27:28

out to Shannon Clark writing Galveston, who

27:30

presented to the FDA. She's done the

27:32

most research on this and bravo for...

27:37

It's unbelievable to me who had

27:39

hyperemesis with number two, who would,

27:41

you know, stuck on I-10 and

27:43

traffic would open the truck door and throw up

27:45

it like, take off my lap and

27:49

throw up in the lab coat and just put

27:51

it on the side, you know, while I was

27:53

in the car on the way to go deliver

27:55

a baby. And this was before Zofran became widespread

27:57

use and all these new medications that, you know...

28:00

actually treat the root cause of

28:02

hyperemesis. But yeah, 15% of women

28:05

who are pregnant have significant

28:07

hyperemesis. And we were trained

28:10

that the majority of those, it

28:12

is attention-seeking or something psychological. And

28:14

she can't help it, but it

28:16

really is a psychological cause. I

28:19

mean, could you imagine? I've lost 18 pounds. I'm having to

28:22

get IV fluids. I

28:28

can't keep down anything.

28:30

And then I'm told that it's in

28:32

my head. And then

28:34

I start to think, oh my God, am

28:36

I going to be a shit mom? Like

28:38

what's happening? And I leave my OB-GYN for,

28:42

because Steve's a pediatrician. And I

28:45

go to one of his friends who I didn't want to go

28:48

to, because he's kind of like a good looking guy that I

28:50

know outside of the hospital. And I'm like, oh God,

28:52

okay. And he's like, what do you mean in

28:54

your head? And he's like, this

28:56

is not in your head. He's like, let me show you some

28:58

blood levels. Let me show you what's going on in your body.

29:00

I bet you've never had a miscarriage. And I said, I haven't.

29:02

And he said, yeah, your

29:05

progesterone levels are through the roof. It

29:07

would make an NFL player throw up all

29:09

day and night. You have these massive protective

29:11

factors going on. You've got probably some

29:13

gene stuff going on. My mom had

29:15

hypermosis. And he said, and you

29:17

might be better in 18 weeks and you may not.

29:19

And so at 18 weeks, I started swimming

29:22

a mile a day, including

29:24

the day I gave birth. I was in good shape. I was

29:26

lucky that way. But I

29:28

thought that could have upended

29:30

me almost permanently to be told like this

29:32

thing that I really wanted and that we were trying to

29:34

have happen, that I

29:36

was attention seeking. Like

29:40

what the actual hell.

29:43

So one of

29:45

the most popular

29:48

treatments for hot

29:50

flashes that is being

29:53

touted as, you know, this is

29:55

the route we should go, especially in Europe,

29:58

is cognitive behavioral therapy. Which

30:00

I love, you know, for a

30:02

multitude of things. I mean, I

30:04

love too, but shut up and

30:07

sit down. As a psychologist, cognitive

30:09

behavioral therapy, if you just outthink

30:11

your hot flash, if you change

30:13

your perception of your menopause, it's...

30:15

Yeah, okay. This

30:18

is today. We have got

30:20

to stop automatically attributing. I can't tell you

30:23

how many, you know, I read these research

30:25

papers all day, and when I get to

30:27

the inevitable, but this is a tough time

30:29

for women. This is a difficult time. Her

30:32

children are leaving. Her, you know, I'm like,

30:34

you never, I don't know, you know the

30:36

psychological research better than anybody. But I

30:39

don't see that when I read research studies

30:41

for men. I don't read a lot, but

30:43

you never see, it's a tough time in

30:45

his life when you look at erectile dysfunction.

30:47

He's really stressed out at work and all

30:49

these things, and it's automatically in so many

30:51

of these articles, so ingrained.

30:54

When we look at female sexual function, okay,

30:57

loss of libido. This is, and when we look

30:59

at it in a woman who's got no pain,

31:02

she can orgasm, we've ruled out the

31:04

anatomic causes, has a great relationship with

31:06

a partner, used to have a good

31:08

libido, and now it's gone, and

31:11

it's just stressing her. She misses it and she wants

31:13

it back. When I tell you that is

31:15

25% of my patient population, I

31:19

was taught nothing about that in

31:21

medical school or residency, and the

31:25

answers coming out of clinicians' mouths who I

31:27

think are well-meaning are, have

31:29

some wine, go on date night. Instead

31:32

of, this is biological, and

31:35

we have FDA-approved medications and testosterone

31:37

options for these patients. But

31:39

so many of the older research is it's

31:42

psychological. She doesn't love her husband, and she's

31:44

sitting here telling me, I have a great

31:46

relationship with this person. I've been with them

31:48

for X amount of time. This used to

31:50

be amazing for us, and now it's gone

31:52

for me and it's distressing me, and it

31:55

just kills me. I'm

31:57

automatically assuming there's something wrong with her here.

32:00

and that it's psychological or

32:02

attention-seeking instead of this is

32:04

a biological neurotransmitter change and

32:07

it is affecting that part of her brain. And we

32:09

have ways that we can fix it. I

32:12

follow you voraciously on social media.

32:14

Bless your heart. You're

32:17

really brave. And

32:20

you and I share the experience of kind of

32:22

being shot out of a cannon into that space.

32:24

That's a brutal, unhinged,

32:27

dysregulated space. Yes.

32:31

How has that been for you? I

32:34

got some great advice from actually Shannon Clark who kind

32:36

of blew up in the OBJEN space

32:38

on social media before I did and she

32:40

was kind of my guide through the early

32:42

days. And she said, if

32:45

something doesn't feel right or you're gonna do something you feel

32:47

like might be controversial, sit on it for 24 hours and

32:50

then go back and look at it. Take the emotion

32:53

out of it and then go

32:55

back and look at it. So that has been great

32:57

for me. That's great advice. The

33:00

menopause space is exploding and I've been shot

33:03

out of a cannon into it.

33:05

So we have people who

33:07

are downplaying the female experience. So

33:10

there's several things that are coming at me. One

33:13

that I'm causing women

33:15

because we're educating them as to what

33:17

might happen so they're prepared and have

33:19

a plan. That it's actually making the

33:21

experience worse for females. That we don't wanna educate

33:24

them because now they're gonna fixate on these things

33:26

and think that they have them. These

33:29

are PhD people saying this to

33:31

me. That we best

33:33

not, don't educate. Don't

33:35

educate them, yeah. Yeah, so the

33:38

don't educate them. The people

33:40

who are seeing a financial opportunity,

33:42

good or bad. Now, I have

33:44

financially benefited from this, full disclosure,

33:46

through my clinics, through Galveston Diet

33:48

and that whole world. But that

33:52

are creating plans or

33:54

supplements and promising miracle

33:56

cures. Real nutty shit, yeah. So

33:59

there's that. And

34:01

there's people who just don't

34:03

want other people speaking in the menopause

34:05

space, you know, early voices in the

34:07

menopause space who are feeling kind of left out

34:10

and left behind. And so what I

34:12

love about the menopause is it's a

34:14

group of thought leaders,

34:16

clinicians. We have multiple

34:19

specialists from across the board,

34:21

cardiologists, psychiatrists, reproductive endocrinologists, sexual

34:23

medicine specialists, orthopedic surgeons

34:27

for the frozen shoulder part of it in the musculoskeletal syndrome

34:29

of menopause who are saying, quiet

34:31

the noise. We're bonding together. Do we

34:33

agree 100% on everything? No, because

34:36

we're humans. But we are all

34:38

here realizing there's a

34:40

problem. We have bigger platforms.

34:42

We're going to educate. We're going to elevate each other.

34:45

So you always see me talking about other people's books,

34:48

sharing other people's videos, because

34:50

I don't want to hold the megaphone for

34:53

the rest of my life. You know, I feel like

34:55

this message, we are so much stronger together.

34:58

And the more brain power together. And

35:01

so I have 28 clinicians coming to

35:03

Galveston in January for the new menopause

35:05

conference. And it sold out in two and a

35:07

half days, 800 seats. We're going

35:09

to have a live stream digital option. It's going

35:11

to be insane, but it is

35:14

thought leaders. Tamson Vidal, who did the

35:16

menopause documentary, we have cardiologists, we have

35:18

Avram Blooming, we have oncologists really to

35:21

just set the record straight. So that

35:23

it's not for doctors. It is for

35:25

lots are coming. But it is for

35:27

lay people as a way to educate

35:29

and bring in all the voices and

35:32

let them ask their questions so that

35:34

we can elevate this. And women realize

35:36

they're not stuck. You can thrive at

35:38

this age. And so many women are

35:41

not. And they're being denied

35:43

good education and the opportunity to live their

35:46

best lives for the last third of their lives.

35:49

There's so many things that I profoundly

35:51

respect about you and your work. One

35:53

of them is I love how you

35:56

are constantly bringing up peer reviewed articles,

35:58

your democratizing. the information

36:00

in them, you're helping us understand it.

36:03

And I've seen moments where you've also

36:07

come on and said, hey, I've

36:10

said this in the past, here's a new study, it's

36:12

changed my thinking, I was wrong,

36:14

the new data convinces me that we need to think

36:16

about this differently, here's what I've learned and here's what

36:18

the new data say. I have

36:21

so much respect. And then I've

36:23

seen you not back down around reproductive rights.

36:25

No, just

36:28

last night from the comment

36:30

about execution after birth,

36:33

that's not a thing. That doesn't happen.

36:35

And as an obstetrician who has sat

36:37

at the bedside of

36:39

thousands of women in the most joyous,

36:41

the most horrible, the most gut wrenching,

36:44

the most mundane, I cannot,

36:46

every emotion, every possible scenario

36:49

at the bedside through the

36:51

birth of children. And

36:54

to accuse obstetricians of

36:56

execution of newborns is

37:00

ridiculous. So I reposted something

37:02

from a friend who's a reproductive endocrinologist. And

37:04

of course, my DMs were full this morning

37:07

of, I love you,

37:09

I love what you say, but

37:11

don't get political because I'm gonna have to

37:13

unfollow you. And I'm like, I will not

37:15

stand down. I will not

37:18

unfollow me, I don't care. No

37:20

obstetrician is executing newborn children.

37:23

That kind of rhetoric is so

37:26

insulting and harmful, not only to every

37:28

woman who's given birth in

37:30

every situation, but to the

37:32

healthcare providers who are out

37:34

there doing their absolute best,

37:36

sometimes with impossible laws and

37:38

situations. So, sorry,

37:40

I got so emotional, my ear pod fell out. It's

37:44

worth it. Abortion care is

37:46

healthcare. It always has

37:49

been, it always will be. It's

37:51

not for everyone. I respect your

37:53

decision, but until you have been

37:56

in the situation and stood at

37:58

the bedside of someone making

38:00

impossible choices and the fallouts from

38:02

that, you really don't have a

38:04

voice in this discussion.

38:08

Amen. Before

38:12

I get off this, not

38:16

just reproductive rights and abortion care

38:18

as health care, which I just

38:20

don't even understand the complexity of

38:22

that actually, I've been surprised

38:25

on your social media to see, I

38:30

want to understand it. This is

38:32

not an indictment. I'm really curious. Help

38:35

me understand, what do you make of the

38:38

pushback against some of your work from

38:41

male trainers? That

38:44

has been very surprising to me. Yeah.

38:48

Not all. I'll tell you right first of

38:50

all, not all. Amazing. Yeah. I have a

38:52

male trainer who's my age who

38:55

thought he was introducing me to your work. And

38:58

I'm like, no, I'm part of

39:01

the original MCH gang. So

39:03

not all male trainers, mine's

39:05

amazing. I have been surprised

39:07

by, I don't even know how

39:10

to stereotype, younger, I don't know

39:12

who they are. What's happening? They take

39:14

these courses to become

39:16

trainers. And some are accredited, some are

39:18

not. But they

39:20

are taught calories in, calories

39:23

out is

39:25

the way. I was taught that in medical

39:27

school. But still, but they're still taught that?

39:29

Not now. We now know that a person's

39:31

weight health is multifactorial.

39:36

It is not just calories in,

39:38

calories out. It is biopsychosocial. And

39:42

these trainers have been

39:44

taught, this is it. This is the system. This

39:46

is the way. Calories in, calories out. Women

39:50

for decades, me included. I

39:53

had thin privilege. Thin was healthy, Brené.

39:56

And as long as I was thin, I was good to go. Little

39:59

did I know. that constant caloric restriction

40:01

and cardio was eating away at my

40:03

bone and muscle strength for the critical

40:05

years of my life. And

40:07

that I should have been lifting heavy because

40:10

I'm a naturally low muscle person and

40:12

that muscle is what is going to

40:14

protect me from diabetes. So these

40:16

trainers calories in calories out, it's your fault

40:19

because you're lazy or you're just not trying

40:21

hard enough. And here I am sitting at

40:23

the bedside or sitting in the clinic. And

40:25

these women are swearing on a stack of

40:28

Bibles that they are calorically restricting. They're doing

40:30

all the things. And

40:32

the latest research in

40:34

women through the menopause transition is with

40:37

no changes in diet and exercise. You

40:41

go from so visceral fat, you have

40:43

a body composition change, undeniable science, meaning

40:46

where and how you just deposit

40:48

fat changes. I don't have to

40:50

tell a menopausal woman this, she knows. No, you don't even have

40:52

to, yeah, I got you, I got you. But the

40:54

math. I get it, I see it. You

40:56

have of your total body fat,

40:59

7% is visceral, which is intra-abdominal.

41:01

That is the dangerous fat. I'm not talking about

41:03

your curves. God gave you that, okay? Postmenopausal

41:06

through the transition goes up to 23%

41:08

on average, 23%. She

41:13

did nothing different. Her insulin resistance

41:15

increases as well as her LDL

41:17

drops and her LDL goes up.

41:19

So her cardiovascular disease risks increase.

41:22

There are these sweet, well-meaning trainers,

41:25

most of them, who

41:29

have built a billion dollar industry on

41:31

shame, on

41:34

shaming women that they're not trying hard enough,

41:36

they're not doing enough and creating these programs.

41:38

And the women are on little hamster wheels, trying,

41:41

trying, trying, trying, trying, trying, trying. And

41:43

the trainers are coming back and saying it has to work.

41:46

So now with modern science,

41:48

with GOP ones, with HRT,

41:50

with understanding female physiology and

41:53

what she's going through, I'm

41:56

not saying workout isn't important. It is. Calories

41:58

are important, but. It's much more complex

42:01

than that. I do see trainers now

42:03

starting to embrace this and I'm trying

42:05

to elevate their platforms and their voices

42:07

who are understanding. It is more than

42:09

that. But when I

42:11

see this egregious, absolute

42:14

shaming and people coming out and

42:16

saying, you're menopause is not a

42:18

thing. You're menopause is not causing

42:20

your weight gain. I don't

42:22

stand for it. And those are the funnest videos

42:24

I've ever made in my life. And

42:26

so because I've come out with- They are good

42:29

to watch. With article after article after research article

42:31

and I just pop them up. And then I

42:33

show pictures of visceral fat and I talk about

42:35

cardiovascular disease risk and has nothing to do with

42:38

your weight or your BMI. Well, very little, not

42:40

as much as your abdominal circumference and the amount

42:42

of visceral fat, not to say that how much

42:44

you weigh is not important. And so,

42:46

you know, getting women to

42:48

let go of this number on the

42:51

scale as a measure of their health and

42:53

their risk of chronic disease and their risk of

42:55

going into a nursing home is

42:57

so freeing. And so now in clinic,

42:59

we talk about eating more, not less.

43:02

Eating more protein, eating more fiber, eating

43:04

more fruits and vegetables, eating more plants,

43:06

instead of, oh, watch this cat, I

43:08

can't eat that. And

43:11

for myself, my patients are, it's

43:14

just a better, it's so freeing

43:16

mentally. So yeah, I'll keep coming

43:18

after them. They're getting quieter, but

43:21

it's threatening their industry. And

43:24

instead of embracing the woman on the GLP1 and

43:27

like how can I change the program to serve

43:29

her better so that she ends up healthier, a

43:32

woman on HRT or the combination, the

43:34

ones who are doing that successfully, the

43:36

women are flocking to them and they're

43:38

having much better outcomes with their programs.

43:42

I can feel the tide shifting. I mean,

43:44

I think when, a couple of things,

43:46

you know, when you've got my trainer, who's my age, saying,

43:49

you need to read about this menopause and

43:51

you know, Mary Haver's

43:53

really doing some good work over there and

43:55

she's down the street. And then

43:58

you've got Peter Atia, who's... who's kind

44:00

of a bros bro saying that what

44:02

we've done to women is the biggest

44:05

medical ball

44:07

drop in the last 100 years. And

44:10

then I saw someone on your page that

44:12

I thought was really interesting, where it was

44:14

a young trainer, super fit, what you'd

44:16

expect, saying, just imagine

44:19

if when guys turn 50, their

44:22

balls start shrinking. And this happens,

44:24

and this happens, we'd have a

44:26

billion dollars worth of products and research.

44:29

And then up pops your head. Now listen

44:31

to what he's saying. I'm

44:34

like, and I didn't know it

44:36

was a stitch from you, but then

44:38

when your head popped up, I was like, of course. And

44:41

look at her amplifying

44:43

the voices of people who are saying,

44:46

I care

44:48

enough about my coaching clients and training

44:50

clients to unlearn,

44:52

relearn, and own some stuff. That's

44:54

powerful, right? And I think you are responsible for

44:57

a lot of that. And you're a

44:59

menopossi. Really, I do.

45:01

We're trying, and we're trying to

45:03

walk the walk as well. Like

45:05

you see, like, we're CEO cellists willing. So

45:08

many of us are showing, we're actually out

45:10

here lifting weights and trying to put

45:12

more plants on our plate and make

45:14

sure we're getting adequate protein and really

45:17

trying to show what we're doing

45:19

to kind of set a course away

45:21

from what society

45:24

has built for us, which is long

45:26

term loss of independence in our older

45:29

ages. And decreasing the risk of

45:31

that starts right now. Not

45:34

waiting till we break. Support

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45:44

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scammers disposal are ever changing. And

45:54

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46:04

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46:14

Do you want to be a more empowered

46:16

citizen but don't know where to start? It's

46:19

time to sharpen your civic vision and

46:21

ignite the spark for a brighter future. I'm

46:25

Mila Atmos and on my

46:27

weekly podcast, Future Hindsight, I

46:29

bring you conversations to translate

46:31

today's most urgent issues into

46:33

clear, actionable ways to make

46:35

impact. With so much

46:37

at stake in our democracy, join

46:39

us at futurehindsight.com or wherever you

46:41

listen to podcasts. What

46:46

are you excited about? What are you excited

46:48

about? Now, this conference in January, you told

46:50

me it's already sold out, but we'll put

46:52

a link to it on the episode page.

46:54

But tell me what you're excited about in

46:56

your own advocacy, in the world of medicine.

46:59

What's exciting for you? So at

47:02

the conference, we have about, according

47:04

to the director of the women's health

47:07

research at UTMB in Galveston, there's

47:09

about 50 medical students who want to present

47:12

on menopause. You know? Shut

47:15

up. From everything from metabolic, so my daughter's

47:17

working on the metabolic syndrome of menopause. Her

47:19

friends are doing some of the orthopedic data

47:21

and they realize they have a pretty high

47:23

chance of getting published, which is kind of

47:25

a big deal right now. They are like

47:28

going all in on this. So that kind

47:30

of thing, I'm super excited about. This next

47:32

generation, like, they don't put up with

47:34

anything. My kids hold me accountable for everything that comes

47:36

out of my mouth, especially on social

47:39

media. Seeing that enthusiasm, seeing

47:41

Gen X rise

47:43

up and say, I'm not going to

47:45

accept this. There's a better world for

47:47

me out there. I want this to be better for

47:49

the next generation. Like, they're not just so into

47:52

themselves. They really want better

47:54

health choices for their daughters, their

47:56

nieces, the younger females in their lives. That

47:59

excites me. Every time I see

48:01

Jennifer Weiss-Wolf or all of the legislative

48:03

stuff that's happening behind the scenes and

48:06

it's really bipartisan to improve

48:08

our health, you know, let's uncouple reproductive rights

48:10

for one minute. Yeah. Because

48:12

everything in women's health kind of gets skewed towards reproductive

48:16

health care, which is important, important,

48:18

100% important. But

48:20

I'd like to have a conversation about

48:22

the gender health gap and

48:25

that, you know, research, the studies not being

48:27

done in women. You know, let's look at

48:29

statins, Brené, and I'm not telling anyone to

48:31

throw their statins out the window, but

48:33

there is no data to

48:36

suggest that a statin in

48:38

a woman will decrease her primary risk

48:40

of a heart attack. It is not

48:42

preventative for women. It is for men.

48:45

Baby aspirin never been shown to be preventative

48:47

of a heart attack for women, only for men.

48:49

But yet we're routinely recommending this stuff all the

48:51

time. Ace inhibitors never been shown to be effective

48:53

for women, only for men. For

48:56

primary prevention of a heart attack. You know,

48:58

the cardiologists are not happy about this. They're

49:00

working on solutions, but yet today we're still

49:02

routinely recommending statins for every woman with high

49:05

cholesterol. You know what actually decreases your primary

49:07

risk of a heart attack? Is

49:10

HRT, starting young, within

49:13

the first 10 years of your menopause. So

49:17

that's the kind of thing more women are becoming

49:19

aware. They're not putting up with it. They're demanding

49:21

more research and study so that their health can

49:24

equal that of a man's and we not be

49:26

in the lower 20%. How

49:29

many crippled up mothers are

49:32

we gonna have to bury

49:35

before people start saying, what is happening?

49:38

I was in a conversation the other day with a

49:40

bunch of my girlfriends, and we're in our mid to

49:43

late fifties. And

49:45

they were talking about the stress

49:47

on their dad as caregivers and

49:49

how all of their fathers have become caregivers

49:52

for their mothers and how that's changed so

49:54

much. And I was like, yes,

49:56

that's hard. Can we talk

49:58

about why?