The Psychology of Menopause | Tamsen Fadal

20:35Dr. Michael Gervais:I do want to get to the practical piece. And before we go there, I want to go to 20%, I think, of women in the workforce in the US are in menopause. If we add perimenopause, it's going to at least double that. Okay. So let's say between 20 and 40 % of the U.S. workforce are in the age range where hormones are fluctuating, where there are biological, sociological, and psychological impacts from it. And I want to be a great teammate, right? So we've got a real mission that we're on and we need everybody to be great for that thing for us to give a chance. So how can, just coach me up. How can I be a great teammate to, you know, not to make the blunder maybe that your dad eloquently, like, you know, but how can I be great and not reinforce the stigma, not make it awkward, but be direct, be kind, be like, just a great teammate.

21:25Dr. Michael Gervais:Like coach me and our entire community up. I would love to, because I think that men really have a place in this conversation. And for the beginning of the conversation, when we were first starting to have it, women were like, we're taking care of it ourselves. And that's how we felt, how I felt. But now I realize men have to be a part of this conversation. We're everywhere all together. Even if you're not in a relationship with a man, you're dealing with one at work, or you're talking, or you might have a son or a brother, whatever that is. So, you know, I think in the workplace, a couple of things, and I think that this is where it can start.

21:56If you're somebody that is able to implement policy and change in a workplace, have some type of say when it comes to insurance policies or, you know, health care or whatever that is. If you're somebody that has that kind of say, this should be on the table there so that it's part of the healthcare system. So maybe it doesn't even have to be a conversation within the workplace. That's one area. Another area is we talk about, I talk to a lot of like HR departments and a lot of HR leaders. And the big question is, how do I go bring this up to my employees without making them feel uncomfortable and myself feeling uncomfortable?

22:28I have been to so many big companies that will bring me in and say, just talk about it. So they'll feel comfortable talking about to this third party, me, or somebody else that might have an expertise in this kind of conversation. So they can talk to you, relate to you, read a book. I have two films on it. So I bring assets. What are the films so people can look? Oh, the M Factor 1 and 2. The M Factor 1 is shredding the silence. We've been in over 1 ,000 cities with it. We bring it into communities, give it to them for free. Well done. Thank you. It's really been a learning curve for me to understand what's needed.

22:58And then the M Factor 2 was before the pause about perimenopause because I think we have got to talk to younger people too. Okay. We've got to talk to younger women and younger men so they understand what's going on. So the second area, I think, is dealing with HR and being able to bring a third party in so that that's not the responsibility of the workplace to say, we're having a menopause seminar, everybody, and we're leading it. Yeah, right, yeah. Because I don't think that's always comfortable.

23:21Dr. Michael Gervais:But if they bring you in, there's an expertise. Yes. And obviously, you have an eloquent way of talking about it, and you bring some levity to a very serious condition. Thank you. Yeah. I try to because I think it can be really – if I go in there and I list all the symptoms, they're like, just get out. Lady, just get out of here. But I think it's really important. And I see what's interesting is that a lot of the men in those rooms come up to me afterwards and they go, oh, my gosh. I had no idea what my wife was going through, but all of a sudden I was living with a stranger. Or, oh, my gosh, my wife has not wanted to have sex with me or be intimate with me or have me even touch her for a long time.

23:59I didn't know what was going on. I thought it was me. And so that's been a really exciting breakthrough, I think, in this conversation over the course of the last five years. And then I think the other way is to make sure that there is an open policy where somebody can feel comfortable going in there and have the conversation and say, hey, I need a fan at my desk. Or, hey, I might need to do XYZ and go see the doctor because I've got to go get this taken care of. I worry about the workplace, and we have a lot of legislation state to state that is being, you know, is passing right now, which is exciting.

24:30But I worry about the workplace because I never want it to harm women. We have women working longer than ever and in bigger roles than ever before. And I don't want that to ever harm them. Where somebody goes, oh, gosh, we don't want to bring her in here because she's going to be going through this for 10 years. That concerns me.

24:46Dr. Michael Gervais:Yeah. So that was what we were scrimmaging yesterday is like, where does performance and biological slash psychological challenges impact performance? Like, where is that kind of imaginary line? And I don't think there's an easy answer. Well, and I think that that's also why when I say there's so many different areas we have to tackle at the same time, we have to tackle educating the doctors. There's no question about it. Like that has to happen. You go docs, you go HR. I go docs and telehealth because telehealth is able to move people faster than anybody else, which is super exciting because we're able to get women in, get them seen.

25:21They're not waiting six months for an appointment. They're able to, if they decide to go on hormone therapy to help, great. If they decide to do on something that's non-hormonal, great. but at least they're being seen at a quicker pace, quite frankly, than going to offices. So that's one area. And then the other area is educating women in general so they understand what to look for so they can go in as their biggest advocate. Because unfortunately, the onus is on women to go into a doctor's office, which is why I give so many free resources away because I don't know how else to tell them what to do.

25:49You know, I'm like, here's a symptom tracker. I don't care if you write it down manually and tell the doctor what you're dealing with so at least they can start on a path of getting help.

25:58Dr. Michael Gervais:I like that a lot, like the consumer advocacy or patient advocacy for sure. Because again, I'm not working with this population, but if someone were to come to me and give me the list of symptoms and I'm not trained in it and I miss it and I'm like, oh, good. You know, I've got a protocol here. But it is actually biological, meaning if it's a hormonal thing, I'm wasting time and energy and resources. And if a patient client were to come and say, hey, doc, are you sure? Because I'm actually, I'm 52 years old and I've been having this trend. And I go, oh, like that would have been, yeah. Okay, but go now drop down to the layer of teammate.

26:32Dr. Michael Gervais:So my teammate, either as a peer in the organization or I'm reporting to, or as a direct report. It does not matter to me the directionality. But my teammate or the person I'm working with in an office is 48, 52. whatever. Yep. Dealing with symptoms or not symptoms or whatever it is. Yeah. Just coach, coach me up. Being aware of it. First of all, I mean, being aware of it, being willing to, and it depends on how close you are or how comfortable you feel of talking about this openly, because I don't think there's anything wrong with that of, Hey, my wife is going through perimenopause. She's been dealing with X, Y, Z.

27:06Like, I don't care how people bring it up into a conversation, but I will tell you this from experience over and over the minute I crack open the door a little bit to have the conversation. People open it up so quickly because they want to talk about it because it's not been talked about before. And I really think that that's something that's important. I mean, when I go into places to talk, I had a cameraman running after me down the hallway. He's like, how do I bring it up to my wife? How do I bring it up with not insulting her? And I said, I don't know. Say you heard this girl talking about it on TV and, you know, I don't know if you're going through this or not, but it was really interesting.

27:39Because here's why. It's not just about menopause, perimenopause. It's about long-term health. We're talking about brain health, heart health, bone health. We're talking about long-term ramifications if we're not dealing with what's going on right now.

27:52Dr. Michael Gervais:There you go. And that's health. You'd bring that up to anybody. Yeah, it's foundational. What do you think the cost of losing talent in the workplace is for not addressing something that is, again, biological? Oh, it's a huge cost. I know that Mayo Clinic had a study that had come out not too long ago. I think it was like two years ago. And it said there's$1.8 billion being lost when people are not showing up to work because of symptoms, when we're losing top-tier talent because these people are people that are very wise and have been in the workplace a long time and very experienced. That's a huge number.

28:26And that's what companies will listen to.

28:27Dr. Michael Gervais:Wait, why are they not coming to work? Symptoms, not able to come to work because they're not feeling right. They're missing time at work because of menopause symptoms. Some people have very severe symptoms of menopause. People are not just hot flashing. There's other things that are going on. And I think that when you're talking to workplaces, if workplaces aren't going to talk about, okay, yeah, I know women go through all sorts of things. They're going to have children. Then they're going to go into this cycle. If we're not talking about any of those things and we just talk about what we're losing in terms of money, I think that that's where we see a lot of people paying attention.

28:58Dr. Michael Gervais:Did you have that condition or experience? experience or are you? Myself. Yeah. No, you know, I did not show up to work, but I did not show up to work necessarily as good as I could had I known 10 years earlier that's what I was going through. If I knew I was going through that, I would have, for me, because I can do hormone therapy and I really understand it now, I would have hopped on hormone therapy and I would have been sleeping at night. I would have been feeling better. I wouldn't have been having hot flashes. I wouldn't have had that incident on set, but I'm glad I did because now I feel like I can educate other people.

29:27I wouldn't have cared. I wouldn't have known.

29:29Dr. Michael Gervais:Isn't that something where oftentimes our moments of great confusion or despair or whatever turned into a real purpose? It really did. It was never a conversation I'd had. I lost my mom early. I think she wound up was going through a medical menopause, but we had no idea. She didn't die. Yeah. My mom passed away from breast cancer. But because she went through breast cancer, she had gone through chemotherapy and a double mastectomy. I think it put her into a premature for menopause, a medical, surgical menopause. Okay. I'm going to go back to this. Coach me up again. Like, do I bring it up? Do I not bring it up?

30:02Dr. Michael Gervais:Do I? I'd rather you insult somebody and help them than not bring it up. Okay, great. And then I hear like an HR narrative, which is like, wait, hold on. Like now I've made like somebody feel uncomfortable, but I was actually trying to be a great teammate. But I think that's okay to have those conversations out loud. I don't think you're saying, hey, you look like you're gaining, you know, you look like you're not yourself anymore. Or you look like you've gained a little weight and you're not sleeping. Is it menopause? That's obviously not what we're talking about. But I do think you can be a great teammate of being open to that conversation if you're bringing it up in a way that is as comfortable as you can bring it up.

30:36Dr. Michael Gervais:Let's say you're in the corporate environment and you're going through about, let's just stay on half flashes for a minute. And you are the lead on a project. You got great momentum. You've got all the kind of seasoned wisdom about the client and the profession. And it's pitch time. and you're the point person and you're having like you're in a phase where it's like, man, these hot flashes are uncontrollable. I do not want to show up to my client's office in front of whatever number of people, pitch this brilliant idea and have them think that I'm a nervous wreck and that I'm not confident because that's what sweating ovens obviously looks like, right?

31:15Dr. Michael Gervais:Would you shoulder tap somebody and have them sub in for you? Would you address the room and be like, hey, everybody, I got something that I believe in. It's going to be amazing. And I've got this thing that's going on. It's called menopause. I'm sweating. It's not nervousness. I'm going to kick ass. That's me. You would do the second. A hundred percent. I used to do it in the studio after I found out. I'm like, guys, I'm sweating. It's a hot flash. Sorry about that. And there would be a little of a laugh because that's what this was. It was a self-deprecating moment. But I'm telling you that I taught so many people as a result of that.

31:46Dr. Michael Gervais:And if you were on air having a hot flash, that's kind of like the pitch moment. Absolutely. What would you do? I mean, I think that that's the only way to do it. I probably did do it during that time because I was told not to bring it up on television. And I did because, remember, we're at a different time now. This is a few years back. And they said, could you please stop talking about this over and over again? Just please stop. Nobody wants to hear about this all the time. And I said, everybody needs to hear about it. Over a billion women globally, 1.2 billion women globally are in this transition in life.

32:14Everybody needs to hear about it. Because I really think it's unfair actually to men too in this conversation. for them not to know what's going on. I do. And I wouldn't have said that five years ago.

32:24Dr. Michael Gervais:Is this an unfair understanding that I have? Is that when menopause kicks in and it's happening, it doesn't go away. And it is not something that women are wanting, meaning hair, skin, this, that, and the other mood, weight, whatever this symptomology is, that it's like you just kind of endure it. Or there's a way to gracefully work with it where wisdom is part of the experience as opposed to like, I'm just going to grind it and fight through it. Like teach me how you think is the best way to approach this. Yeah. I love this question. I think my answer has changed over the years. I think my answer would have been years ago, go to a doctor and see what they tell you to do.

33:06And if you've got a good doctor, that's going to listen. And then, you know, I think what, what happened and what caused me to do the films, write the book, really lean into the advocacy part of it is I realized that women have to, have to take charge of it. And that has to be from top to bottom and bottom to top, like all over. It needs to, you need to really take charge of that. So I think for me, it's, you know, it's getting that the help that you can get if it's, if it's hormone therapy, but it's also really understanding the other things that need to be done because you're never going to waste your time doing these things because we're talking about long-term.

33:36I always call it the next 30. Like the next 30 years is really what we're talking about. We're not talking about just this transition in time where your hormones are going to change because they're going to balance out at some point and you're You're going to be – you know, menopause is one day after you haven't had your cycle for a year. That's what it is. That's what menopause is. All these symptoms of chaos are the things that are leading up to it that are perimenopause. You've got this one day of menopause.

33:59Dr. Michael Gervais:Symptoms of chaos. That's so good. That's what they are. Because I can never pinpoint what they are. It's just chaotic. And then after that, it's called postmenopause, but I kind of hate that word. So you're just menopausal the rest of your life. But I don't even think you need that title anymore, And I hope we get to a place where we're not doing that, where it's just like, this is that next chapter of your life. But what's important when we're going through this and trying to beat the symptoms or at least work with the symptoms, I think it's important to say, okay, what do I want the next 30 years of my life to be like?

34:30If you hit menopause at 49, you're probably most likely pending something really going to be at 79 years old. What do you want to do to make that great? And this is a really good time to start focusing on yourself.

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37:05Dr. Michael Gervais:from a evolutionary standpoint what is the reason that this is this is probably more philosophical than anything else but is it to remove childbearing to reduce or remove childbearing at a certain age because of the complications that happen both to child and mother is that the kind of most i don't know basic evolutionary i think that's the most basic evolutionary i mean and if you think about it. These are also the women that have come back and are helping, you know, helping the women that are younger with children at some point. You know, these are the mothers that are, there was like a grandmother hypothesis that, you know, a lot of people talked about for a long time.

37:41A lot of people have gone like, oh, we're not going to talk about that anymore because these women are more than just grandmothers now. You know what I mean? When they hit this age period.

37:47Dr. Michael Gervais:There was some research. There was a lot of research about it. Yeah. That women that had grandmothers that were alive and active were able to have more children. Is that, is that, do I have that right? I think so. What I turned to was a lot of the research that had to do with the brain of understanding that, you know, when you're perimenopausal or when you're perimenopausal, you've got all this activity going on. You've got this nurturing during this time until you hit menopause. And then menopause, not that you're not nurturing anymore, but really it's a different part of your brain that's clicked on now where you're not kind of so empathetic.

38:19You're not child caring. You're not taking care of children and caretaking all the time. And that's when you hear women being like, I have no more Fs to give. is that you're now focused on yourself during this time, which is why I think we use the word wisdom and wise all the time. But we see women come on the other side of this and go, hey, this is the best time of my life. And I see it over and over again. And I wish that we could show younger women those examples so they understand this is a transition you're going to go through, hopefully with enough advocacy, education, doctors being trained, new advances in medicine and science.

38:53Here are your two solutions, five solutions, ten solutions. Do one of these, and you're going to be on the other side of this without any problem.

38:59Dr. Michael Gervais:Which is hormone therapy, which is sleep and behavioral kind of practices. Exercise, lift heavy weights, do some cardio. Yep. You know, invest in - Protect your bones. Protect your bones, yeah. There's a nutritional category, which is against like the protein. And you've written all about, your chapter headings are exactly that. You know, so you've hit all of those. Can you give us just a couple of things that you're practicing amongst those four or five that we just mentioned. Yeah, I think it can be overwhelming when you get that list. You're like, wait, I got to sleep and heart and bone and what?

39:31My bones? I never thought about my bones. Did you at 20 years old? It was like, you know, I just wanted to not break one. This is a long-term life practice, not a let me try to get through this as best I can practice. I think what happens is women go, oh, I really got to focus back on myself right now. If I want to be okay during this time, like I'm paying attention to me. In journalism, we, you know, stayed up late, Got up early, like worked all ends of the clock. Stress was immense. We were always on a crunching, traveling. And so I don't think I ever went, I want to really work on my stress management.

40:02That was never a conversation I had, like ever. And I wasn't in elite sport. And so that was never part of my conversation. But for the majority of women, they're working, raising kids, dealing with family, caretaking, you know, a lot of the sandwich generation, not focusing on themselves. And I think this has been a time, you know, for them to do that, whether it's in the 40s or in 50s. And I see it over and over again. And so that gets me excited, but I hope they're not. I don't want them to just do it for this to get through. I want it to be for that long term and really understand why they're doing it.

40:34And I think it's for everybody.

40:36Dr. Michael Gervais:Yeah, niche down to be super practical. There's so many symptoms. So for me, the number one, one, one thing that I focus on first has to be sleep. And I would say that to anybody because you're not going to remember to make a doctor's appointment if you're not coherent about what's going on. You're not going to want to get up and work out. You're not going to want to go make a Mediterranean diet. If you are sleep deprived, it is the single worst thing that, you know, I believe that. So with my sleep, I pay full attention to it. I pay full attention to the scrolling that I used to do. I mean, my sleep routine, I never had a sleep routine.

41:05I didn't even know what sleep hygiene was back then. But I've had enough doctors that I've talked to about sleep to pay attention to what to do if I can't fall asleep and how to get up and get out of bed as quickly as I can to be able to come back to bed to go back to sleep. I talked to one of the doctors and she said, I go into my kitchen when I can't sleep and I read cookbooks. And I said, why? She goes, have you ever just sat and tried to read a cookbook? And I go, never. And she goes, that's why. And I said, oh, that's a really good idea. So getting out of bed and not, you know, fighting that is a big deal.

41:32Sleeping in a cool room, which I know there's a lot of, you know, back and forth if you've got a partner and that can be frustrating.

41:37Dr. Michael Gervais:What temperature do you like? I like about 68. Yeah, so do I. My husband likes like 72. And so there's two degrees is a lot. It's actually a big difference. It is a big difference. It's a huge difference. We have a mattress solution that we love that has temperature changes on both sides. Has it really been a big difference? I think I got to get serious about that again. Yeah, yeah. Because I really believe we have a lot of tools out there that we didn't have before to be able to handle some of these things. And that's a really great one to have so you're not sleeping out on the couch to, you know, just get out of bed.

42:08Blankets off or on or whatever. Blankets off, on off. Like the foot in and out of bed all the time is like kind of the running joke. I do go to bed at the same time every night as best I can. And I really try to do that. And I live between New York and LA, so it's hard. So I find myself having to get into bed, you know, try to pair those times up and do the same thing in the morning. And then in the morning, I never did this before either the last four years, out of bed and walking. And I don't care if it's 10 minutes in New York City down the block to go get coffee or it's here in LA and getting out by the water.

42:37But I do that every morning I'm out.

42:38Dr. Michael Gervais:Yeah, first light and last light are both interesting behavioral kind of things that you can do. But they're easy. You know, they're easy because they're not asking too much of you. They're not asking you to go to the gym and do, you know, 30 minutes of cardio and then weightlifting. So that is one area that I think is the most important if there's anything else. And then the second area, I guess I would say, for me anyway, is I know working out is really important, but I think food is my second. Like I really have to have the focus there. And the fact of adding all these, you know, supplements can be so confusing.

43:08And I think women have cabinets full of them because a lot of things promise. And by the way, if anybody sees something that's like, menopause everything, we can fix it all. That is not going to fix anything. So I just hope that that's something that people know because a lot is being sold to women right now to fix everything.

43:23Dr. Michael Gervais:There is a thing happening. Menopause is— Beyond, yeah. Yeah, like it's a great conversation that is happening. So there's more remedies, if you will. A hundred percent. So there's a swell, which is pretty cool. It really is. And I feel like just going back for a second to what you were saying about in the workplace, I think that that's what makes it a little bit easier. to be able to bring up those conversations or in a relationship to bring up those conversations. Yeah, that's very cool. I think it makes it a little bit easier because it has become a word that is not cringey. And it was cringey for a while.

43:53You know, I think it was like, oh gosh, that means old. And, you know, I don't want to be associated with that. And now I hear women saying, yeah, I'm in actresses, celebrities, you know. When Halle Berry comes out and says she's in menopause, like, I want to be there too. You know, and I feel like young women are having that conversation as well, which is super exciting to see the generations.

44:11Dr. Michael Gervais:You've had some prominent female voices on your podcast that have spoken about menopause. Who are some of those? Yeah. Halle Berry was one. She was my first guest, which was super exciting. Naomi Watts had come on to talk about it. Melinda Gates was on just recently making a big announcement about an incredible amount of money that she's going to be donating toward this. I think it'll be a big game changer in terms of helping educate doctors, which is more and more doctors, which is exciting. Because to your point, different disciplines didn't have education about this. Like even the OBGYNs struggle to get somebody to talk about this stage in life because it really wasn't on radars, which is so bizarre.

44:48Well done.

44:49Dr. Michael Gervais:What's the name of your podcast? The Tamsyn Show. Yeah. Well, I mean, well done on all fronts being on the frontier and honestly and earnestly leading it. And so it leads to a couple more questions I have about intimacy, libido, sex. And if your partner spouse is sweating or agitated and irritated and tired, this is not the recipe for great sex. Yeah, that's not the time to be intimate. If I could just put a little asterisk there. I think being understanding about it outside the bedroom is really where you have to have that conversation. I put together this little men's guide because somebody said, are you going to write a book for men?

45:26And I went, no, men are not going to read a book on menopause. I don't care that men is in the title of it.

45:31Dr. Michael Gervais:But they'll read a book about sex. But they'll read a book about sex intimacy. But, you know, I think it's really important to have that conversation outside the bedroom, first of all, and be able to be understanding. I did a visit to a men's group, and there were these six guys talking about menopause. And it was the coolest thing ever. And one of them said, you know, I just got to say, once I learned that menopause was the thing and I wasn't the problem anymore, I'm like, yeah, you can teach an old dog new tricks. Like I'm happy to like learn different things, but thank goodness it's not me.

45:57And I think that that's what a lot of men have been dealing with, you know, of thinking like, wow, what did I do? That I'm not, you know, that I'm not attractive anymore. It's not working between us anymore.

46:05Dr. Michael Gervais:Is there a pause in sex for women in menopause? Meaning like if I take a female's voice, I am just not interested in sex. Yeah. Right, there's just, is there a pause? It depends if you get help. Like, you know, women can start hormone therapy in perimenopause and go right through it. But if you are dealing with painful sex, that's the last thing that you want to be having. And the low libido is a part of these hormones that are really fluctuating in a lot of different ways. The good news is there are solutions for it. There's vaginal estrogen that can help to make sure you don't have painful sex.

46:38And there's hormone therapy that can help with that low libido. And there are prescription drugs out there right now. There's one, Addy. There's Viosa. There's different drugs out there that can help with a sex drive. When we look at these kind of meds, men have like 26 different medications plus to help in the bedroom. And women have like two or three that help with libido.

47:01Dr. Michael Gervais:How about it? Yeah. How about those numbers? Yeah, right. Okay, so drill down one more time. Like what can husbands do to be great teammates, partners? Yes, the understanding of it, not think that we're just, you're gonna jump into like the TV show sex, You know, like we roll into bed and we're all sweating. We're already sweating. So we don't need to do that part. But there needs to be the intimacy part that starts, like the real intimacy part of it. You know, a little more romance, a little having this conversation outside the bedroom, inside the bedroom, being patient in terms of understanding what's going on.

47:33And I swear, I think there have been huge changes in relationships with men just understanding these words. I mean, I think that's kind of hot.

47:41Dr. Michael Gervais:Yeah. Oh, you do? I do. I was on a phone call with a guy this morning and he had my website up and his wife came by and said, I read her book. And he's like, really? I'm talking to her about menopause. I'm like, that guy's totally going to have a great night tonight. Yeah, that's right. He's talking about menopause. Yeah, right. Trying to understand. Yeah. Okay. So I have one experience of menopause that I'm intimate with my wife. I've got to say that she was rad. Just like she does everything in life, she faced it full on. She educated. she researched and then she put in the work to make changes.

48:14Dr. Michael Gervais:And I do think that both of us fell into this uninformed narrative based on, I think, marketing bad information about hormone therapy. So we missed, we're both well-read and well-informed and we missed it. And that would have been a game changer for her. But like I watch her and she is on it on every front, on all five factors that you can invest in. And I don't know if this is right or wrong, but I think you've got to really work to have a chance of being graceful during this phase. Would you co-sign that? Or would you say, no, you're kind of using an old model to address it? No, I don't think that's an old model at all.

48:52I think that I always get very sad when somebody misses that window, you know? And there is this window. Look, there's guidelines, and the guidelines are changing and being updated all the time, where at one point, If you're 10 years past when you went into menopause, most likely hormone therapy or 60, most likely hormone therapy is not going to be recommended. But even that's changing now. So there are some tweaks to that. But I had to work hard. You did too. Absolutely. I had to work hard at my relationship. I was newlywed, by the way. I was 50 years old, and I was like, I don't think I'm interested in sex.

49:25I mean, my poor husband was like, wait, what happened? Three years ago, it was very different when we met. And so, yes, I think I've had to work at it. I have to think about it. I think about it all the time. And more than I think about menopause, I think about what do I want these next 30 years to look like? And it's very important for women to pay attention to bone health, heart health, and brain health. Those are the three things that can really get impacted during this time. What do you do for bone health? So for bone health, I'm lifting all the time. And if I do supplements, the supplement I'm adding there is vitamin D, K2, and protein.

49:57I've had a protein. I never paid attention to it before. I'm a Gen X 80s girl. I was like, you know, you just got to not be, you know, not have any fat. Did you drink from the hose? Of course I did. I drank from the hose. I ran on this slippery thing down a hill. I, you know, biked without a helmet on. Didn't tell my parents where I was going for hours. Yes.

50:15Dr. Michael Gervais:Right. Okay. So on that front, like, can you address your experience or understanding of the narrative and the science around hormone therapy? Yeah, absolutely. So, you know, hormone therapy, there was at one point before 2002, 40 plus percent of the population in perimenopause, menopause was on hormone therapy. Today, we're just eking up to 5 % of the population. There was a severe, severe drop-off, a very significant drop-off in 2002. There was a study called the Women's Health Initiative that came out with these headlines that got women very confused. And just to kind of filter it all out, the headlines essentially read, estrogen could cause breast cancer.

50:54That is what women heard. That is the scariest thing in the world to a woman. My mom was diagnosed at the age of 44. So for me, that was the cloud of doom that lived over my head all the time. Like, oh my God, when is the day, when is that call going to come for me? So that has something, and today if you talk to women, they don't necessarily know that there was a 2002 study that scared them. But if you ask a woman, what do you know about estrogen or hormone therapy? Most often they'll say like, I don't think it's safe. And so part of my work has really been to explain to women that it's not for everybody, but it is for a majority of people that are able to do it.

51:29If you have not had breast cancer, if you do not have history of a stroke or blood clot, most likely, and there's a couple of other contraindications, but most likely you can do hormone therapy. And now the question is, do you have a doctor that can explain that to you? And then the next step is, if you don't wanna do that, what are my other options? And luckily we have a drug out now that can help with hot flashes. We have the drugs we were talking about for low libido. So there are different things you can do if you're not able to do hormone therapy. And the reason that both sides of the coin are very important to me is because if my mom were here today, I don't know that she was a candidate for hormone therapy.

52:06She had a very aggressive form of breast cancer. So most likely we would have had to figure out some of those other things for her to do.

52:11Dr. Michael Gervais:Very cool. Yeah. Thank you for that. Because that's what I was alluding to earlier is that we didn't realize kind of what was happening. And we hook, line, and sinker bought that idea about estrogen-related cancer. or come to find out it was not right. Well, some doctors still believe that. Some doctors won't prescribe it. Some doctors don't feel comfortable prescribing it. And so that's why I think it's important. When I said at the beginning, the onus is on the woman. It's not only to go into a doctor's office and say, hey, this is what I think I'm going through. It's also finding a doctor that feels comfortable talking about it.

52:38Dr. Michael Gervais:If we knew what you knew, how would men be better partners? Oh, I think men could be great partners. I think you could go along with some of these things that we are being told to do all the time. And women are being told to get outside in the morning, Maybe you get up with your partner. Maybe you go to the gym with your partner and work out. Maybe you figure out how to help with some stress management. I think men can be great partners by just understanding what they're going through or providing solutions. Hey, you know what? We were talking about menopause the other night. I heard this interview, and there's a couple other things maybe we can try.

53:10I think that would be nice to have a partner do that so it doesn't feel like such a woman problem that she has to go through on her own.

53:16Dr. Michael Gervais:And if we knew what you knew, how would we be better leaders in the workforce? Oh, I think that men can be incredible leaders by just being able to be aware of what's going on and seeing it and saying like, what can I do to help my workforce? Whether it comes from what kind of policies we have in the workplace or what kind of things we can implement, what kind of programs we can bring in. Can we bring in some kind of longevity program that makes women feel like, okay, we're not pointing to you as a woman in menopause, but this might be able to help you. What's your call to action for women that are in a leadership position?

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54:52Dr. Michael Gervais:Spring and summer, they are powerful seasons of momentum. It's a great natural time to step into growth, to refocus, to recommit to who you want to become. And this discount will not be around for long. So go to findingmastery.com slash course code renew 100 for$100 off today because your future is not shaped by what you intend. It's shaped by what you train. I would love every woman to just be educated with the top bullet points of what this is and have an open door policy so women feel comfortable going in and talking about it and never get penalized. There you go. Take me five years forward.

55:28Dr. Michael Gervais:What are we doing in the workplace that's different? Or let's go three years. Three years. And then let's go out like 10 years. I wish now, but in three years, I hope everybody has access to some type of doctor in their programs and their healthcare policies and programs where they can go access this. So it's just part of what happens. You know, we have that when it comes to a reproductive years, we should just have that continuum. Like for some reason, when it comes to women's health, that hormone continuum that, you know, should exist stops right here in midlife and just kind of falls off. So I would love for there to be, hey, guess what?

56:00At this point in your life, we can provide you with telehealth services that are part of your policy. Whatever that is, so women can move into this next chapter because we have a lot of women that are going from having children right into perimenopause. And some women get pregnant in perimenopause. So it's not like there's this big line in the middle of it. This is like what women go through in general. So I hope that we have that continuum where it goes all the way out past menopause and post-menopause because I think we're going to have women in the workplace so much longer. And that's what I'd like to see.

56:30I mean, I'd like to see that right now. I'd like to not have this conversation, you know, about menopause being this like stopping point. What do we do? I want women to know what to be able to do and doctors to know what to be able to do and leaders to know what to be able to do.

56:43Dr. Michael Gervais:There you go. You know, for biology, medication and biology can work sometimes well. Sometimes it's really, really noisy. However, there is still a psychological thing that takes place in context of social structure that values A, B, and C indicators of beauty and does not value people sweating and does not value people that are deregulated because of sleep deprivation or sleep restriction. So there's this thing that happens to our identity. And there's an asterisk here for me. if we're allowing the external world to dictate our internal experience, which my experience has been the most powerful people on the planet, that direction doesn't work.

57:25Dr. Michael Gervais:They are working from the inside out. To your point earlier, it's like, hey, I'm having sweats. You know, like, I got a great idea. You're going to want to hear this. If I sweat, it's not what you think it is. And just kind of owning their experience. Yeah, it's confidence. So can you speak to identity and can you speak to some of the psychological challenges like confidence, like self-esteem, like ambition potentially, like drive. Can you speak to some of those things that you personally went through or that you'd like people to understand a little bit better? Yeah. I had a real lack of confidence when I started going through these things because I wasn't sure.

57:59I didn't know what was going on, first of all, and that I didn't know what to do about it. So just that increases anxiety. Oh my gosh. My whole job, I mean, my whole job was to read. And so I would look at the teleprompter or look at my partner at the desk and I couldn't finish a sentence. I wouldn't have been able to sit here with you. I would have been sweating. I would have been a little panicky that I couldn't, you know, I would be reaching for words. And so I know what that feels like and it's pretty awful. And so I understand when a woman is in a boardroom and goes, oh my gosh, I don't even know what I'm doing here and I have this and I can't figure out what, you know, what the next slide is.

58:37So I understand that lack of confidence And it does have a lot to do, you know, with what you feel comfortable doing next, right? So it's not just confidence in that moment. It's confidence in who am I now? Like, this isn't who I was before. I was this person that would come in here and rule the world. And now I feel like a very weakened, watered-down version of myself. So I understand that. What I also understand is once I figured out what was going on, and your wife could probably attest to this, I felt so much more powerful, not because I had solved menopause, but because I understood that I was now on a track to fixing some of these things that were going on, or at least addressing them if I couldn't fix them.

59:12And I think that that's where I come in because for a long time I went, well, what do I know about this? I'm not a doctor. And then I went, oh, but a lot of the doctors are still learning at the same time. And when I realized that in real time, average women like me were learning at the same time, I went, oh, okay, we do have something to say. And it did give me a lot of confidence in terms of being able to speak about it. And then one by one, I would see women changing and becoming more confident. I saw doctors that had a OBGYN practice of delivering babies switch over to do midlife health. I mean, I saw women making real changes in real time.

59:48Is that the title?

59:48Dr. Michael Gervais:Midlife health? Yeah, they're doing midlife health now, which is essentially treating perimenopause and menopause in those post-reproductive years, which I think is pretty incredible. That's a cool framing. Speaking of framing, let's go above the line, below the line just for a minute. Symptoms to strengths. Yeah, we got to deal with some symptoms and we've got to address some of those challenges. But what percentage of time am I focusing on strength building versus symptom management? And on the strength building side of the equation, like, okay, this phase, if you haven't figured it out yet, we're going to triple down on confidence building, on where it comes from, from your self-talk.

1:00:23Dr. Michael Gervais:Nothing outside of you can determine your self-talk. You are fully responsible for the way you speak to yourself. Confidence comes from what you say to yourself, and it has to be grounded in real things. Fake it till you make it. Please let that thing fly. It's done. It's like, that is the, we don't want anything fake. I don't want to fake anything. Surgeon, I don't want to fake psychologists. I don't want to fake - Menopause. Nothing, like fake. You just get that out of the system. So developing strengths like confidence, like using this as a moment to say, okay, if you haven't fully figured out your identity, let's do that now.

1:00:54Dr. Michael Gervais:You get to decide. The world does not decide your station or your position in life. Full stop. There's influences that are sometimes harder for other people than whatever. Your purpose, now's the time. Your sense of like efficacy, where power comes from for yourself. All of those asset building strengths, this is a great time if you haven't invested in them to make sure that you own them. A hundred percent. And reducing any type of shame or guilt during this time. I think that those are really big ones because I think that as women, we have spent a lot of time outward, right? Everybody else. and I think you've got to reduce the shame and the guilt and take that inward a little bit because you're not going to be good to anybody else if you can't even function.

1:01:36And quite frankly, I don't know anybody that could under some of those circumstances. Now, I want to say not everybody's menopause is the same. Some people, my best friend went through it without any problem at all. But what she didn't do was address these long-term things. So she doesn't pay attention to bone health. She didn't pay attention to heart. So right now she's got osteopenia, you know? So, so this is that time, whether or not you're dealing with severe symptoms and hot flashes and, and joint pain and low libido, this, these are those years, 40 to 50 to whatever, you know, wherever you are to be focusing on those things.

1:02:08And when we bring up men, it's a great time for men to be doing that too, quite frankly. So I don't, I don't think anybody loses if we're talking about that kind of focus of the strengths.

1:02:17Dr. Michael Gervais:We're in an ecosystem. We're like more like a coral reef than like these individual humans going through life. Like no one's doing this thing alone. No. But that is part of the experience when you are embarrassed by a set of symptoms or behaviors that are compromised. So can you give the women in our community right now like a final word on perimenopause, menopause? Like, can you just share your best with them right now? Yeah, I feel like on the other side of this, I think I've become stronger than ever before. I feel like I see women doing that. I feel like I see women going, you know what, I'm shedding all the BS that I lived with for such a long time.

1:02:54Don't know how I lived with it for such a long time, but I'm not doing it anymore. I wanna say this, there are solutions to all these things. There are ways to be so proactive in it where if you're younger, you can take charge of it now. You don't have to wait till you're 55 years old to start thinking about this stuff. And you're never going to hurt yourself by paying attention to it early. And I can't stress that enough because if I had known some of these things at 40 years old, I wouldn't have been blaming everything else around me. I was blaming my divorce. I was blaming my job. I was blaming all these other things.

1:03:23And in reality, I wish somebody had said to me, go talk to XYZ doctor, go to this person, see if hormone therapy is an option for you, get on it and cruise through these next years. And I think it would have been very, very different because I get very excited when I see how powerful women are. And they really are powerful. And these are incredible times and so wise and have so much to offer in the workplace and or in doing something else. And those second act careers, those second act jobs, they get me more excited than anything. Before I came on, I was talking about a woman who recently switched her career.

1:03:56She's 50 years old doing something amazing. And I went, oh, my gosh. She went through menopause. She's amazing.

1:04:04Dr. Michael Gervais:Tamsin, thank you for leading from the front. Thank you. And thank you for the conversation. And where's a place that you hope people can go get the resources that you're providing? Yeah, TamsinFidel.com. We have links to everything there. And we have a downloadable for men so they can get all that and more. Well done. Appreciate you. Thank you. Next time on Finding Mastery. AI is advancing faster than most of us can fully process. But what if the most important question isn't what this technology can do, but who we choose to become alongside it? Dr. Mike sits down with futurist Jamie Metzl, who has reimagined the Ten Commandments for the age of AI to explore the values we need to guide us and why shaping the future requires all of us to become active participants, not passive bystanders.

1:04:47So join us Wednesday, September 9th at 9 a.m. Pacific, only on Finding Mastery. All right.

1:04:56Dr. Michael Gervais:Thank you so much for diving into another episode of Finding Mastery with us. Our team loves creating this podcast and sharing these conversations with you. We really appreciate you being part of this community. And if you're enjoying the show, the easiest no-cost way to support is to hit the subscribe or follow button wherever you're listening. Also, if you haven't already, please consider dropping us a review on Apple or Spotify. We are incredibly grateful for the support and feedback. If you're looking for even more insights, we have a newsletter we send out every Wednesday. Punch over to findingmastery.com slash newsletter to sign up.

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1:06:08Dr. Michael Gervais:Lastly, as a quick reminder, information in this podcast and from any material on the Finding Mastery website and social channels is for information purposes only. If you're looking for meaningful support, which we all need, one of the best things you can do is to talk to a licensed professional. So seek assistance from your healthcare providers. Again, a sincere thank you for listening. Until next episode, be well, think well, keep exploring.