Episode 469: Tamsen Fadal: Breaking the Menopause Silence (100+ Symptoms Your Doctor Never Mentioned)

22:19There is vaginal estrogen that is pretty safe for all women. And that's helpful for painful sex because that's just another area that really is terrible for women to be dealing with. And then, yes, the other things are those lifestyle changes. So I'm just hopeful that some of this research shows different ways to go about things. And when we did the book, I made sure we did a lot of the non-hormonal options that are out there only because I kept thinking of my mother, like, what would she do? would she be, they were like, good luck. You know, it'll only be 10 plus years of suffering and then you'll get past it hopefully.

22:53So I kept thinking about her when I was writing that, because, you know, we're talking about a lot of women that still are not comfortable or can't do it. A hundred percent. That's what I think, that's what I really liked about the book as well is because of the non-hormone, because I think people are very, I mean, and you can say all you want that there, you know, the fears are there. It was overblown. It was not, it was, it was done. The data didn't support it. The data didn't support it. It was a selected study, all the things. But psychologically, people can still be very scared to go on hormones.

23:24I'm glad you said that because I agree with you. We could talk till we're blue in the face. But the truth of the matter is, is that if you have a set belief, despite any of the data, and look, I put a lot of those references in the back because I am not, I'm not a doctor. And it was really important for me to go deep into that research and make sure that we answered all questions and made sure that women felt comfortable and made sure that women could do the reading of it themselves. But if you don't feel comfortable with that, there's nothing I'm going to say that's going to change your mind, maybe, but not everybody.

23:52And so I wanted women to be aware of, you know, what that study was, where we are today in 2025. I mean, that study was 23 years ago now. I know. You know, it's humble. But imagine how long that has taken to take root. So it has taken root down here and to think we're just going to be able to like, you know, to toss that aside in a few years, it's not going to happen. So we've got to get those women some help. I agree. Have you noticed in your findings, though, that it's mostly functional medicine doctors who are much more progressive with this versus MDs, like OBGYNs? Right. Yeah, absolutely.

24:25I mean, I think that it all comes down to educating. And a lot of those doctors are educating themselves. I sat down with one when I was in Chicago, actually, and she had moved into more functional medicine. and she said, you know, I really did this studying myself about all of it because it wasn't just menopause, but it was just a little, it was everything. And I think, you know, when you're talking about root causes, that is extremely important, especially during this time, because there are gut issues, there are thyroid issues, there are cholesterol issues. There's a lot of things that come up during this time, along with all this other stuff of being a woman.

24:58Right. What are you going to, so how about, okay, so in the workplace, because you talk about that, What can people do in the workplace? Like, what is the options? I mean, right, you know, like in some workplaces, which is great, some of the benefits will cover hormone therapy or at least hormone, you know, go to a place and get coaching, whether it's telehealth or something else, but not enough. And so I think, you know, if you're in the workplace and you were dealing with those kind of symptoms and you feel like you're comfortable enough to go in there and address it with HR, that's what I did.

25:29And unfortunately, at the time, they're like, what's a menopause policy? Like it wasn't even hard. It didn't even, like I was gluing words together, you know, and I said, well, they did it in the UK. You're like, wow, wow, like Charlie Brown. You're talking a whole new language there. It was. I was like, here it is. Yeah. Because the UK really has been very advanced with a lot of things way ahead of where we've been for a long time. And hopefully, you know, we catch up. But I think if you are willing or able to go talk to HR and try to do anything, whether it is finding a way to have group conversations for women's groups, finding a way to educate women or bring a speaker in there just to talk so you feel a little more comfortable, and then obviously benefits.

26:08I mean, there's other things like, can everybody have a fan at their desk? You know, if you're working in a factory, can you change uniforms? There's some actual real changes because we all work in a different environment. You know, we all work in different kind of workplaces. Not everybody is sitting in a corner office. So we have to take that into consideration too when we're talking about these kind of changes. What are some of the things that are top of mind that you really, like I said before, I'm going to go back to the question, from the experts, the doctors, the people that you, 42 people you interviewed, what were some of the things that really surprised you the most?

26:39And that also, that's the first part of the question. And then the second part that you found to be like really helpful thing, tips for other people that people may not, when they listen to this podcast, that they can maybe like, oh, I never heard that one yet. Yeah. Yeah, I think that for me, the surprising part was obviously that lack of education that scared me quite a bit, but made me really determined. I think that the other thing was the fact that, you know, we have so much research that hasn't been done on a lot of things. Women weren't even part of studies until the mid-90s, like mandated to be part of studies.

27:11I thought that was just crazy. And then I think my other concern was the dismissal of women. You know, really like thinking that women can suffer through it and not realizing there's those long-term health ramifications that are possible when it comes to bone and brain and heart health. And so that scared me quite a bit because I didn't realize that when we were talking about treating menopause, we weren't just talking about these symptoms we're talking about. We're talking about long-term longevity, you know, health span. So that's one area. And then I think that some of the tips that I thought were helpful really came in the area of sleep.

27:45Sleep was a huge area that I was going to just like make it a chapter along with brain. And then I realized like that was a chapter that I really leaned into quite a bit because it's where women suffer, you know, along with weight, weight gain and belly fat. But sleep was a place where people were really, really suffering. And so to understand, you know, the importance of that sleep hygiene, a sleep routine, understanding how important it is to get up in the morning and get moving, how important it is to make show that you're in bed at the same time as best as possible and getting up at the same time, light and how light impacts us in so many different ways.

28:19So I didn't understand how important all that was. And when I did the initial interview, I'm like, oh, there's so much more. So I went back and did another interview with another specialist because I really do believe that if women can at least get something handled, and that's not always easy because our hormones are everywhere fluctuating and we wake up in the middle of the night and then we're wide awake at three o 'clock in the morning for no reason. But I feel like if at least they can start tackling that part, which you can do right away, then at least you have a fighting chance to start feeling a little bit better.

28:46And then belly fat's another big one too. Belly fat's a huge one, right? A huge one. It's a huge one. And I see a lot of incredible experts out there that are focused on fitness for women over 40, which is, I think is really, really important because a lot of women didn't go to the gym and do weights. We did cardio. We stayed away from the boy weight room. We were like, no, we're going to sweat it out until - We did aerobics. We did aerobics on that dang step. Yeah, the step aerobics. That blue step. So I do think that there's a learning curve there that we have to have. There's a lot of, you know, the thing is there's so much like cross information, right?

29:22I agree. Well, you know, people, you know, cold plunges, for example, is the thing. Do you have one? Yeah, I do have one. Oh, gosh, that's awesome. But I'll tell you something. I had a doctor on here. Dr. Stacey Sims was on here. And she's got such great information. and you know what i liked about her was she's very she was contrary to all the a lot of the like the noise out there right yep yep and like to be honest she said that the cold plunge for women is actually not beneficial i know i know right this it stresses your body too much which didn't bother me that much because i don't really love it i believe me i was thrilled i wanted i wanted an excuse cover yours up right right not to do it let's find like five more things that she said Oh, I've got a million.

30:07I broke down a whole. I'd like to have some more of that. I have SoulCycle. Okay. I knew that one. Well, that's the other thing. Like some of the hits and stuff that a lot of women, you know, have thought was great. There's a lot of people that are saying like, no, that's not necessarily where you need to focus. Well, because like heavy car, like all the spinning and the, and like the intensity. Oh my God, what we've done to ourselves. Because number one, it breaks down your muscle or your lean muscle mass. A hundred percent it does. And especially as you get older, you need more muscle. So it's like doing the opposite of what you're trying to accomplish.

30:37Well, and I also think about women that have not been offered hormone therapy too, because there is a whole generation, if not more, that never got that option.

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32:39So what I saw in the book when I was like pre-my little, you know, those little dog tags, whatever, you did a big chapter on relationships, divorce. Yeah. Why did you do that? Well, I went through a divorce in my early 40s, which I'm assuming I was already in that area of perimenopause, but didn't know. But I was dating my now husband in perimenopause into, and I got married in menopause. And I realized that there were a lot of questions that I had. Sex wasn't comfortable. I had no libido. I got married and I was like, I don't have any libido. And it's really upsetting because you're like, oh my gosh, is it the relationship?

33:20Is it us? Am I not attracted to him anymore? Is he not attracted to me? It was very unsettling. And then I also was thinking about the fact that like, wow, what if I was going through this dating? Because I actually did have like a real drive with him when I was in perimenopause. I hit menopause and I was like, that was it. So I really felt like it was important to lean into that and also not to feel uncomfortable with it. And I think sometimes that we reserve sex for this like whimsical fun, you know, like it's fun, it's young when we're young and then we're older and we don't have that conversation.

33:49And I think it's a real shame. And I think that a lot of women don't feel sexual or sexually attractive or feeling, you know, like, you know, they're in their hot girl air. And so I really wanted to, I really wanted to like lean into that a little bit. And so, you know, I interviewed Emily Morris. I interviewed a number of different doctors. We talked about testosterone. We talked about vaginal estrogen. We talked about lube. We talked about things that like, we shouldn't just be talking about as like toys. You know, we should really be talking to them as part of a bedroom routine. And so also that women can know their own body too.

34:20Cause I think that that's the beautiful part of sex during this time is that we know ourselves as well. And it's not just like, Oh, I hope he knows what he's doing or hope she knows, you know? And I think that that's important that we know ourselves in a relationship. Cause I found, I, I, I like, I found that really interesting and probably like very smart, right? Because if you're someone who's new to dating again, like in this, in that, in this stage of life, right? And you are going through this, right? Like you don't, like you wouldn't know the difference between if it's just a symptom, like, oh, your libido's low or am I just not interested in this person?

34:54And then like the whole relationship can go, you know, basically blow up. Yeah, and it really is, I think, very under-talked about. And I think it's really uncomfortable. And I don't know the last time I've ever been in a doctor's office where they were like, okay, how are you feeling? How's your weight? How's your sex life? No one has ever asked me that. No. And because we make it be like, oh, that's a private thing. Well, no, because that is all tied up in everything that we're going through right now, especially that. And also, I shouldn't even say just like dating, right? Because if you're married forever.

35:27Yeah, of course. That's another thing. Right? And so it affects like, you know, I wonder how many relationships, kidding aside, have ended. Oh, sure. Right? because like the woman's not interested anymore and it's not because the guy doesn't understand or the partner doesn't understand yeah right and they don't or they think it's because like there's no interest anymore or that like their their the romance is gone whatever it is romance is dead but who knows but maybe it's just that very easily i bet you a lot of people are not even keeping that like are not kind of cognizant that that could be a no i don't think so and i think it's very i'm sure it's very prevalent and you know there was a study that was done and i I can't remember the year, but it was talking about the number of women in midlife that were filing for divorce.

36:11And I thought that that was very interesting, initiating. Much higher than men. Much higher than men. And so I was really aware of some of those conversations, and I think there's so much more to do. But I wanted to touch on it because I thought it was important to bring that up and to also talk about, you know, I wish I had done another chapter on this and I just couldn't, but I put it in this one. I did like a love letter to my partner. and so I really wanted, and that's what Emily read actually in the bookstore, but I thought it was really important for partners who might not have, you know, they might not have had the conversation before to be able to hear something of like what a woman is thinking or going through during this time.

36:48I thought that was really important because I don't, I don't think it's easy to verbalize and I think it's really difficult to communicate sometimes when you can't even communicate it with yourself. Right. And I think that's, again, it comes down to like not understanding the shame. Not understand what we're going through. We're just learning. We're on a learning curve right now. Exactly. And I think like, you know, it's become like one of those things like, you know, your husband or boyfriend, whatever is like, oh yeah, she's on her period or she's like dealing with this. Like it's very much like kind of like - It's hormones talking.

37:16It's hormones. Exactly. And it's like not taken seriously. Yeah. Not at all. Definitely not taken seriously. Not at all. It's not taken seriously. And it's also been kind of very mocky. And I think that that's what we have to get beyond. And I think the media has not done a great job of that. I mean, we didn't talk about any of these kind of studies. I don't remember any of these kind of studies. I remember studies when I was on the air doing the news about heart, about weight gain, about risk of stroke, Alzheimer's all the time, food groups, all the different, like, you should eat eggs, you shouldn't eat milk, you should have to eat milk, all that stuff.

37:50I don't remember talking about perimenopause or menopause. I don't remember talking about any of that stuff. No. And so— It's not sexy. It's not sexy. I don't know if it, you know, well, now it is, but it wasn't. Yeah, exactly. Now it's a little more sexy. So what is your routine? How did you kind of overcome those symptoms and kind of go through menopause in such a good way? Like, what did you do? Well, I don't think I did in such a good way. I think it was a struggle for a long time. You know, I had some really like dark days that I didn't even know were perimenopause. I think that - But you got over the hump, I guess.

38:22Yeah, I got over the hump. Yeah. And so I really had to focus on what was important. Like I did, I did the typical, I don't need to sleep. This is, it gets fine. I can push through everything. And then I realized one day like you, you're, this is, this is it. Like, this is the time that's going to set you up as more. I've studied this for the next 30 to 40 to 50 years. So you better figure it out, girl. Like, you know, I really, I really did have to stop a little bit and refocus what was important. And especially past 51, because that's when I lost my mom. So I didn't really have that roadmap of what, when she was 51, what that looked like past 51 years old.

38:57And so, you know, I did decide to do HRT and I do, and it was a big game changer. Huge, right? Very helpful with sleep, very helpful with hot flashes, very helpful with night sweats, which were a big problem. I really did change workout routine, like, immediately as soon as I realized what was going on with strength training. Though I always really liked lifting weights, but I thought I had to do cardio to like the crazy, you know, amount. And then, you know, I did focus on my sex life quite a bit. I really did. It was not a, that wasn't like, okay, I'm doing some vaginal estrogen and lube and everything's fine.

39:28Like it really did have to take conversation and commitment to it and really kind of, you know, figuring that out and being open and honest about conversations that were uncomfortable. Right. Well, I told you before, like Emily is like one of my best friends. So like. You're lucky. You've been having this conversation forever. No, I was going to say, she talks about this with me all the time. And I'm always like, I hear it all the time. Yeah, it's like. You know what I mean? I'm like, oh God. You know, it's like, it's because, you know, I always laugh and joke around with her because it's part of her vernacular.

39:55That's how she talks. It is. We went on this trip. Her and I went on a biking trip to Croatia and like every with like a bunch of people. We don't know. We didn't know them. Yeah. We had to have dinner with them every night. And like her wording and her verbiage is very different than what like a normal person would be. It was hilarious. It's great. It's great. So funny. So funny. Well, it's funny to watch how people are like, what? I know. It just rolled off her tongue, though. Oh, yeah. she doesn't think anything about it. We were in Martin's and Noble and we were like, this is, it was at the Grove and it was a few weeks ago.

40:25And we were in the middle, like where you are, you're kind of like by the, you know, I think there was like cookbooks and I don't know what else was behind us. And we went to do the Q and A and people were like, um, I want to talk about my sex life. And I was like, great. And then we're like, Ellen and I were talking and I kind of looked around. I was like, we're in the cookbook section of the bookstore. Is that okay that we're like, but it was great. And the store was awesome about it. It was really wonderful to see it so open. And they came up afterwards. They were like, thank you. And I was like, no, thank you.

40:54I feel like all of it, the sex stuff, the sex talk is becoming a little bit more mainstream. It is. It's still uncomfortable, though, to a lot of people, me included. Not because of anything. It's just like, I'm not used to it. I don't think any of us were. Nobody is. None of us were. And I do think that paying attention to mindset with all this is really, really important because I didn't have any way to control stress. I didn't pay attention to any of that stuff. I was like, oh yeah, okay. I'll have time to meditate. Sure. Exactly. I didn't have those habits built in. And so I had to learn them.

41:30So what are your habits? Like what do you do every day now? Yoga's huge for me. Even if I can do 10, 15 minutes, like that is my meditation. Really. That's what I do. Every day? Well, if I do it, it's short. It can be very, very short, but that's what I do in the morning. Like I go outside and walk in the morning first thing, come back and do that. And then I'll decide if I'm lifting weights, but I can't do like three hours of working out. Like I don't, I just don't have that. And I don't have that. I don't want to do that. I don't want it to be where I'm not looking forward to something. Lifting is huge for me.

41:55And then with stress management, I, you know, I really have gotten into a place where I understand what I can and can't do and understand my focus. It takes a lot of focus for me nowadays, different than what it used to. It takes a little more brainpower, different than what it used to, but I've embraced that part of it. And I let myself, you know, be okay with it. I'm okay. If I have to go to bed perfect. And I can't be all the time. Right. No, it's also having grace with yourself, I think is a big piece of it. Yeah, it's huge. It's huge. I was saying to a friend, I was like, yeah, we were at a hotel and I said, I'm just going to go to bed early because I just really need to like, I need to like take care of myself tonight.

42:31My old mate would be like, what time do you want to go downstairs? I'll totally go to dinner and I'd be dreading it the whole time. I would hate doing it. I'm so, and I'd be like, why did I agree to this? I would be so resentful. And now I'm like, nope, I'm not doing it anymore. And that comes with the age. Don't you feel like that's an age thing? I think so. I still get myself in that situation though. I do too. So you can call me whenever and I'll give you permission to cancel. So this is why I love Emily because like, I, you know, like we make plans a hundred times and we never do half of them because we're too tired, but it's a real friend that you're like, I'm not interested.

43:01I don't want to do it. You know? And that's another thing I want to say real fast. Community is huge during this time. I think I have built a community of people that I feel like really so, so lucky every day to have around me. So lucky. And keep meeting new ones like you. I feel like I'm going to know you for a long time. I hope so. You're adorable. Yes. I feel very lucky about that. I think that's great. You know what I was saying earlier when we were like, oh, what were we talking about? We were talking about the cardio. We're talking about the crazy cardio that we would do because we thought we had to do that to keep the weight off or to like, you know, part of the...

43:37I mean, I had an eating disorder then. I read a true one where I would not eat or I'd eat and I'd go to the gym and I had to work it down. Like every, I wrote down calories, like gum. I wrote everything. Like even everything. Until what time? Until when in life? I got really sick. I was 20, I was, how old was I at that point? I think I started around 26. I had moved to Orlando. Maybe I was 28 by now. And I was, I had gotten sick, like a flu or something. And I couldn't stand up. And my father had to come carry me down two flights of stairs. Can you imagine that? Yeah. And I had like, you know, I was brought to the hospital and then they put me into therapy.

44:16And that's really, that's where therapy really started for me. And it was a game changer. It was. Yeah. But I mean, it took a long time, you know, it took a long time. But I know that it was because of how I, you know, that mindset of what we learned and what we thought was important. And it's so hard to unravel that. Oh, it's still always there. I'm still always back there. It always kicks back there. But it is very hard to unravel. But I'm very, very clear of my why now. You know, my why is not skinny. my why is to be strong and to feel satisfied with that. You know what I mean? Versus never enough.

44:49I'm tired of the never enough. And that's what I feel like I did for a long time. Like it's never enough. I can more, keep going more. And you know, I don't feel like that anymore. I think because also priorities change as you get older as well. You know, they totally change. I don't. I don't. I have two bonus kids. How did you guys meet by the way? Oh gosh. So we met after I swore I would never get married again, ever, never, ever get married again. And then I met him in Miami. He was at a conference for work and I was hanging out at this hotel by the pool with a friend of mine. And she was part of the conference, but I had gone to see her and she said, she saw him and she was like, this is Tamsyn, this is Ira.

45:28And I was like, hey. And I kept going and he went up to his hotel room to watch football. And then the girls that night called him down. They were like, you really need to, you know, he loves to travel. He's like really funny. And I was like, listen, I'm never getting married again. I don't want a serious relationship again. I've been through that already. I'm perfectly happy single. And he came down. He was like really charming and nice, but not like cheesy charming, like just genuinely nice. And then he traveled long distance to come back and forth to see me for almost two years from he was living in California in Santa Monica.

45:59And I was in New York anchoring the evening news. And he would come back and forth. Yeah. And he would be like, he'd go, do you want to go out this weekend? And I'm like, yeah. How about Sunday night? and this poor guy would spend the entire weekend in New York and I would give him Sunday night. I didn't know. I thought he was just like back here for something. I was awful. I love that story. Oh my gosh. Oh my God, it was awful. You're like that. I love it. I do love it because I think that's really good. You don't want to be that available. But I wasn't even trying not to be. I was just like completely not.

46:26I was refusing for myself to be any part of that, you know. So he would just hang out in New York for the weekend. Yeah, I guess. Like he would get a hotel and that's because he was traveling back and forth for work. But on the weekends, he didn't have to be there. And so anyway, so, you know, finally it started to get serious. And then we got a place together in New York and now we go back and forth. So we're bi-coastal. That's so cute. Yeah, he's so sweet. He's very funny. So how long did you date before you got married? Let's see. This has nothing to do with menopause, by the way. No, but it was during the menopause years.

46:56Yeah, exactly. It'll all count. So he says that we only dated for, let me think, we got married in 2021. and he says it was only like a few years because he didn't count the first years. Like that wasn't dating. That was ridiculous. But we met in 2017 and we got married in 2021. So, you know, it was four years. I love that. Yeah. Yeah. So you're like, you're living, you're a perfect example of someone who's living their best life in these years. Like you're a great poster child. Thank you. Uh, yeah, he's, he, um, you know, he made, he made it very easy because I said, I want to walk the earth with him.

47:30Like he's just so fun. And like, he's the first person I want to call, but not in like a cheesy way. But we just really have a great time together. So it's nice. And he's very patient. Like, I don't, have you been on social media at all today? Today? No, I haven't been. I've had 55 podcasts. Oh, I'm sorry. So there's this, there's this AI graphic everyone's making of themselves, like of themselves in AI, like whatever they're, whatever they like to do in mind. So we made one of my husband and we posted it. Like he's very serious businessman. So we posted but he's like, fine. You know, he goes, I did not approve this.

48:01Like joking. Yeah. He's just, cause he's so straight and serious, like straight. He's got a good temperament though. Yeah. He's very good. He's very good. He just tolerates it. I love that. He's got two kids. You said he does. He has two adult kids who are wonderful. Um, one is 30 and one is 32. Not like it's my business or anybody else's, but I want to know. I don't have any secrets. I don't have any secrets. Uh, yeah. so we have a good time together and I just, I love them. And I have a nephew who's going to be 14. So he loves my little nephew. And so it's, it's nice. It's, it's fun. It's not what I expected.

48:35I didn't, you know, I thought I was like going to be alone with my chihuahuas the rest of my life. That's what I was, I was banking on. And now look, now you're living your best life here. Now I'm talking to you about menopause. I had no idea. And a book would have thought like this whole, which is why I love this. I love like humans, the story behind it, right? Like how it kind of - plans that like, I'm definitely doing this. None of my definitelys, you know, like that didn't happen. Totally. Make a plan. God laughs. That's basically the story of life. No, I think so too. And I think I look at, you know, so many of the women right now that are learning about this.

49:08I'm really grateful. Like I'm grateful that they are starting to have resources. I'm grateful that the conversation is picking up and that there's help available for them. Totally. So yeah. Thank you. By the way, thank you for staying longer. I know that this whole thing was a total cluster. It was not. Stop apologizing. Stop now. Because I feel bad. You were sitting out there. No, I didn't. I left. I left and came back. So it's fine. We're good. We're way good. I'm so happy that you were able to stay longer. No, I'm so happy I did. And that you came on the show because I really - You're such a joy.

49:40No, you're a joy. And your book, I really - And there's a bazillion menopause books out right now, but yours is truly exceptional. And because I love when people compile the best information out there and, and drill it down in layman's terms for the average person. It's the only way I could remember it. Well, that's the problem because so many of these books are very medical and sciencey and from one perspective, right? So I like that you kind of, you kind of took the best of the best and kind of put it together and sandwiched it into a book. And I love that there's more awareness on this and it's becoming less shameful.

50:16Because of people like you, you're having podcasts and talking about it and sharing. And I think it's a really big deal. I mean, I don't think that, you know, any of us realize how much if one woman listens to it and then repeats it to somebody else or repeats it to somebody else or a guy is listening, it makes a big difference. It really makes a difference. It makes a difference. And I think it makes a difference when people speak to like to reach you where you are versus - A hundred percent. Right? Above. A hundred percent. And you do a great job of all of that talk and explaining it. Thank you.

50:43The book is called, I have it somewhere, but it's not around. It's okay. I didn't bring it either, so it's fine. It's called How to Metapause. And Tamsin, you're great. Follow her on Instagram. Thank you. It's at Tamsin Fidel, right? At Tamsin Fidel. And where else do people find you? If I need your arm routine, that's it. Okay, I'll give that to you too. At Tamsin Fidel or, you know, How to Metapause. That's it. That's where we are right now. That's where we are right now. That's where we are today. Thank you so much. Thank you. Bye. Thank you.