Make the Most of Menopause: Tips on Finding a Doctor, Red Flags, & Non-HRT Options

middle school through menopause. I'm your host, Bree Luck, joining you as we embark on a journey of self discovery and questionable decisions. Get ready for heartfelt conversations, expert insights, and personal stories that'll have you laughing, crying, and saying, thank goodness I'm not alone.
[00:00:35] If you've lost your midlife crisis survival kit, we've got you covered. So join me, won't you? And together we can pause to go.
[00:00:49] Bree: Y'all, it is taking me so many takes to get through today's episode. I'm having just one of those nights where the words won't come out of my mouth. [00:01:00] So I'm just gonna talk .\ today we have a really informative episode to wrap up. This is the fourth episode on menopausal hormone therapy.
[00:01:11] Bree: And today we're tackling three big issues. Number one is finding the right medical care during perimenopause. Number two is understanding when it's not a good fit. And number three is exploring alternatives if menopausal hormone therapy. isn't for you. So we're going to dive in.
[00:01:30] Bree: But before we dive in, I want to remind you that I am not a medical practitioner. I am not a menopause expert. I am not a research scientist. I am simply a perimenopausal mama. Skimming through the internet, reading studies and getting all nerdy in the hopes that I can figure out what the heck is going on in our bodies. now let's talk about finding a [00:02:00] menopause informed doctor. You want someone who really knows their stuff. That's what it comes down to. So you gotta do your homework. The absolute cliff notes for menopause care is the North American Menopause Society or NAMS. You've heard me talk about them before.
[00:02:19] Bree: They have a directory of NAMS certified menopause practitioners. These are healthcare providers specifically trained in menopause care. So check out the NAMS website, which is menopause. org. Not hard to remember for this directory. Now, You may feel like you don't want to leave your doctor, or maybe your doctor would be right, but you're not really sure.
[00:02:46] Bree: Well, it's not just about credentials, so whether it's your first visit with a doctor or your 50th visit with a doctor, during your visit, I'd like you to pay attention to how do they approach [00:03:00] your concerns.
[00:03:01] Bree: Are they listening? Do they take your symptoms seriously? Recently, a friend of mine talked to her doctor about her really intense hot flashes and the doc just shrugged and he said to her, well, that's menopause for you. No, that's not the response we're looking for. next, come prepared with questions.
[00:03:23] Bree: What are their views on hormone therapy versus non hormonal treatments? How do they handle symptoms like mood swings or sleep disturbances? And here's a big one. Ask about their approach to lifestyle changes and natural remedies. Do they dismiss them out of hand or are they open to a holistic approach?
[00:03:45] Bree: A good doctor should also review your personal and family medical history. This is crucial for understanding your specific risks and needs during menopause. If you have a history of, say, breast cancer or [00:04:00] heart disease in your family, knowing this can influence your treatment plan.
[00:04:05] Bree: Finally, don't forget about the vibe check. You're building a relationship here. You want someone who's not just knowledgeable, but also someone you're comfortable with. Someone you can be honest with. Someone who respects your perspective and makes you feel empowered in your healthcare decisions. So there you have it.
[00:04:25] Bree: Finding the right menopause informed doctor is about doing your research, asking the right questions, and trusting your instincts. Remember, you deserve a health care provider who understands your journey and partners with you every step of the way.
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[00:04:41] Hey there, listener. I have a quick favor to ask. If you are enjoying pause to go and want to show us a little love. How about buying us a coffee? On the, buy me a coffee app. Now here's the fun twist. My perimenopausal journey has gotten me down to just one cup of [00:05:00] Java a day. Can you believe it? So when you buy me a coffee, you're actually treating me to a delicious liver supporting mug of dandy blend.
[00:05:10] It's kind of like coffee, but you know, with a twist anyway, your support on buying me a coffee helps to keep this podcast going and growing. So. Just click the link on pause to go.com website, buy me a coffee, every sip. I mean every bit counts. Thanks for fueling our journey together with your generosity.
[00:05:36] Bree: Now let's talk about recognizing when your health care provider might not be the best fit for your menopause journey.
[00:05:45] Bree: We don't want it to happen, but sometimes it does. First, if your doctor dismisses your symptoms as just a part of aging, that's a big red flag. Menopause is more than just [00:06:00] getting older. It's a complex transition that deserves attention. Second, if your doctor seems clueless about menopause specific treatments, it's a concern.
[00:06:11] Bree: You need someone who's up to date on the latest research and options, from hormone therapy to alternative treatments. Third, are they open to discussing various treatment options? You want a provider who explores all the avenues, not just the ones they're comfortable with. Fourth, if you feel rushed or unheard during appointments, that's a problem.
[00:06:35] Bree: Your concerns deserve time and attention. You're not just another appointment on their schedule. Your experiences and symptoms are valid and important. A quick story that I had with my doctor. So my general practitioner is awesome. I really love her. I've loved working with her for years now.
[00:06:56] Bree: She has been through it with me and I [00:07:00] really feel like she checks a lot of the boxes. she's not menopause certified, but she is informed and I know that she's Always learning and growing. I like knowing that about my doctor. The big issue that I had was that I wasn't able to get into an appointment with her.
[00:07:20] Bree: so last year I had a pretty acute medical. Incident and I really wanted to check in with her about my care So I called the front office And they said she can't see you for another month. So you should go to the emergency room if it gets any worse. Well, that almost caused me to stop seeing this doctor. So when I went in for my most recent annual physical, I had a real conversation with her about it. And together we talked about ways that I could get in touch with her so that she could actually [00:08:00] make the call because she said, I would have seen you with that condition.
[00:08:05] Bree: that let me know that my doctor cared about finding the right way to communicate with me so that my needs were heard and met.
[00:08:14] Bree:
[00:08:14] Bree: Fifth, watch for reluctance to refer you to a specialist. Sometimes you need a menopause specialist or a different kind of expert. A good general practitioner knows when to pass the baton. Sixth, if they downplay the emotional and mental impact of menopause, it's a time to reconsider. Menopause isn't just physical.
[00:08:40] Bree: It affects every aspect of your well being. So if you're nodding along to these warning signs, what do you do? Well, it's time to consider a second opinion. Start by asking for recommendations from friends or family members who have had positive experiences. Hey, you can go to the Pause To Go [00:09:00] podcast group and meet up with other listeners and ask them what their opinions are.
[00:09:05] Bree: Look for doctors with specific menopause expertise. And when you make that appointment, be clear with them about why you're seeking a second opinion. Discuss the issues you faced with your previous doctor and what you're hoping to find in a new one. Remember, you deserve a healthcare provider who understands and supports you through this chapter of life.
[00:09:30] Bree: All right, now we're going to talk about alternatives to menopause hormone therapy. If you're like me, and menopause hormone therapy isn't in the cards for you right now, if it just doesn't feel like the right fit, if you have a history of breast cancer, or uterine cancer, or you just feel like it's not something you want to do, There's a whole menu of alternatives backed by science and reputable sources like the NIH, the NAMS, and leading alternative
[00:09:59] Bree: medicine resources[00:10:00]
[00:10:00] Bree: Let's start with lifestyle changes. You've heard it before, I know you're rolling your eyes, but diet and exercise are pivotal the NIH also suggests a diet rich in calcium and vitamin D for bone health. We're talking leafy greens, we're talking dairy if you're not intolerant, and fortified foods. Some people think that phytoestrogens like you might find in soy products like tofu and edamame might offer some relief.
[00:10:33] Bree: that was found in a study referenced by NAMS and also fiber. Fiber includes whole grains, fruits, and veggies, and they can help with weight management and overall well being. Shocker, I know. Exercise. Exercise is about more than looking good and keeping fit. It's about balance and mental health.
[00:10:55] Bree: The NIH recommends at least 150 minutes of moderate aerobic [00:11:00] activity each week. That can include swimming, walking, hiking, dance classes, hula hooping, any kind of regular physical activity can help with weight management, improve mood, and is excellent for heart health. which is crucial during menopause.
[00:11:19] Bree: Now let's move on to mind body techniques. Yoga and meditation are more than just trends. According to a study cited by the NIH, yoga can help reduce hot flashes and improve sleep quality. Meditation, particularly mindfulness meditation, has been shown to improve mental well being during menopause. Just 10 minutes a day can make a significant
[00:11:43] Bree: difference
[00:11:44] Bree: two other approaches that I have found very useful that have mixed evidence about their efficacy are EFT tapping, and hypnotherapy. EFT emotional freedom technique or tapping, where you [00:12:00] tap on pressure points while repeating certain phrases to yourself.
[00:12:05] Bree: So I've been tapping for years and I have found it to be very effective in stress management and anxiety management and moderately effective in symptom relief. But a non medicinal approach to symptoms and discomfort and pain that I have found to be quite effective is hypnotherapy.
[00:12:32] Bree: I use an app. It's really simple. I don't have to go to a hypnotherapist. I use an app called I think it's called Reverie. I will link it in the show notes. And I just do one five minute session a day. it's really been a game changer for me. All right. For those considering supplements, we're going to tread pretty carefully because you'll hear for [00:13:00] most of these supplements that I talk about, I'm going to say something like, There's mixed evidence for this.
[00:13:07] Bree: There's evidence for and against this. We don't really know. , but even so, I'm going to go through some of these herbs with you because I also am interested in them. I like to look for natural remedies, um, and I'm willing to take the risk on something that hasn't been thoroughly investigated or that has mixed reviews. one other thing that we know about natural remedies is that there's a lot of individual difference in these supplements.
[00:13:40] Bree: They're not as regulated as we might think they are. So that means that we can't always count that we're getting the same amount every time. So we have the individual differences of the actual. Supplement quality coupled with the individual human differences, and , [00:14:00] in my view, that's going to cause a lot of variability , in outcomes.
[00:14:04] Bree: It's always good. To know when something is evidence based and when it is not. These are not, but I still find them intriguing. All right. these are the natural remedies that NAMS, recommends.
[00:14:21] Bree: Or talks about on their website. The first is Black Cohosh. It's received a lot of attention, particularly for its potential effects on hot flashes. mixed results, but anecdotally, a lot of people suggest that it does,work for them. They used to think that Black Cohosh Sort of worked like estrogen in the body, but it doesn't.
[00:14:51] Bree: It doesn't. That does help to reduce the concern about its effect on hormone sensitive tissue, like the uterus and breasts. Black [00:15:00] cohosh has a really good safety record over a number of years. Although there have been some studies that link black cohosh to liver problems. So as with all supplements, if you decide to incorporate supplements into your, routine, talk to your healthcare provider about it.
[00:15:20] Bree: And also every time you go to the doctor and they say, what medicines are you taking? Include your supplements. It's important, even if you have to take them with you. All right. The next one is Red clover. So, in five controlled studies, there's been no conclusive evidence that showed that red clover leaf extract reduces hot flashes.
[00:15:45] Bree: However, there's a fair amount of anecdotal evidence that red clover has helped some folks. Uh, there are few side effects and no serious health problems with use. Uh, although, In some [00:16:00] other animal studies, they show that, uh, red clover might have harmful effect on hormone sensitive tissue.
[00:16:08] Bree: The next one is Dong Quai. This is definitely what my acupuncturist gave to me. It did nothing for me, by the way, or if it did, I don't know. It tasted okay. It was fine. It was kind of musky. It was fine. Um, so, Dong Quai has been used in traditional Chinese medicine to treat gynecologic conditions for over a thousand years.
[00:16:29] Bree: Uh, but there's been only one randomized clinical study and that was to look at its effects on hot flashes. And, uh, it was not found to be useful in reducing them in that study. However, that was one study, and, we need to learn more. Dong quai should never be used by, uh, People who have fibroids or blood clotting problems, or take drugs that affect clotting, as that can cause bleeding complications.[00:17:00]
[00:17:01] Bree: Ginseng. rEsearch has shown that ginseng may help with perimenopausal and menopausal symptoms, particularly mood symptoms and sleep disturbances,
[00:17:12] Bree: it does not appear to be helpful for hot flashes. Kava! Kava, There's no evidence that Kava decreases hot flashes. However, it may decrease Anxiety. But, uh, the FDA has issued a warning to patients and providers about kava because it can cause liver damage.
[00:17:33] Bree: So like in Canada, you can't get kava right now. The next one is evening primrose oil. I mean, that just sounds like it's got to do something soothing, right? At least to me, this is promoted to relieve hot flashes. However, there is only one randomized placebo controlled study, and that only had 56 [00:18:00] women in it, and it found no benefit over the placebo.
[00:18:03] Bree: reported side effects were inflammation, problems with blood clotting in the immune system, nausea, and diarrhea. Suddenly, evening primrose oil isn't looking so good to me. Uh, it can also cause seizures , in patients who are taking anti psychotic medication.
[00:18:19] Bree: So don't mix it with coagulants or any psychotherapeutic agents. those are the herbs I got for you today. As with all therapies, there are some risks involved.
[00:18:30] Bree: So, always, always, always discuss with your healthcare provider any alternative therapies that you are considering, and always stop all herbal treatments at least two weeks before any planned surgery.
[00:18:43] Bree: Herbs are powerful. Herbs are powerful. And now we're gonna talk about non-hormonal medications. So these would be pharmaceuticals, but not hormonal pharmaceutical, pharmaceuticals. Pharmaceuticals, uh, this would be like your antidepressants, like [00:19:00] SSRIs and SNRIs. They can be really effective with mood swings and hot flashes. Who knew?
[00:19:08] Bree: Uh, Gabapentin, as per NIH studies, can help with hot flashes, especially for people who can't do estrogen therapy. These are prescription medications, so you'll need to talk to your health care provider to see if they're right for you. Alright, and I think that's a wrap on today's episode of Pause the Go.
[00:19:26] Bree: I want to take a moment to just reflect on what we've talked about. We've talked about finding the right health care provider and recognizing when it's time to seek a second opinion and exploring alternatives to menopausal hormone therapy. These are more than just topics. They're really part of the journey that so many of us are navigating.
[00:19:49] Bree: You know, menopause isn't just a phase or a series of symptoms. It's a truly significant transition in our lives that can be filled with confusion or frustration, especially frustration, but [00:20:00] also potentially a newfound sense of empowerment and understanding of our bodies. And that's why having the right support, whether it's through a knowledgeable and compassionate healthcare provider, a community of Peers or reliable information, or ideally all three is so crucial.
[00:20:20] Bree: If you feel unheard or dismissed in your menopause journey, know that you're not alone. Your experiences, your symptoms, your concerns, they're valid and they matter. And if the path that you're on isn't working for you, whether it's your current health care provider or a treatment plan that isn't fitting your needs, remember it is okay and often necessary to seek out alternatives.
[00:20:46] Bree: I invite you! So, be proactive in your journey, ask questions, seek second opinions, explore different options. And most importantly, listen to your body. It's the only one you got, and it deserves your [00:21:00] care and attention. as we close today's episode, I have some exciting news to share with all of you.
[00:21:06] Bree: Thanks to incredible listeners like you, the Awkward Sage family, that's what produces Pause to Go, is thrilled to announce the launch of the Awkward Sage Network coming this January. This new venture is It's all about expanding our conversations to offer a wider range of topics that matter to you, health, personal development, professional growth, parenting, aging, and strategies for making the most out of life.
[00:21:35] Bree: We're going to have so many great podcasts on this network. I'm just delighted and excited to share them with you so soon, January. And here's how you can be a part of this exciting journey. Follow us at Instagram and Facebook at Awkward Sage Media. Stay updated with all the latest news, upcoming podcasts, and join a community of [00:22:00] like minded individuals who are passionate about learning.
[00:22:04] Bree: Growing and embracing every aspect of life and also listen to podcasts. Also one more thing, , You can also Join the Awkward Sage mailing list and get the five tips for talking to your medical care provider about perimenopause and menopause downloadable printable PDF.
[00:22:25] Bree: This handy guide is designed to empower you with the right questions and considerations for your next doctor's visit. And I'll tell you, even though I wrote the thing, I printed it up and took it with me to my last doctor's visit so that I would Follow my own orders.
[00:22:44] Bree: The Awkward Sage Network is more than just a collection of podcasts. It is a movement. It is about embracing the awkward, the uncertain and turning them into stepping stones for growth and understanding. So come join us, follow along and be a part of this ever [00:23:00] expanding conversation. As always, Stay curious, y'all.
[00:23:04] Bree: Thank you for listening to the pause to go podcast. Special thanks to code base co working and WTJU radio for their support. This has been an awkward sage production.