What Every Woman (and Man Who Knows Her) Needs to Know About Menopause

Hi there. Great to be with you here on. the Oprah podcast. Whether you are in. pmenopause. or menopause or post-menopause. So that means millions of you. I have. the book for you. It's called the book. of menopause. Real talk, real science, real strategies for your next chapter. And believe me, it's the next chapter. The editors at Oprah Daily have curated. the most crucial information that we've.

all learned over the years about. menopause from doctors and from. psychologists and from all of the health. experts. Uh joining me in the tea house. is the editorial director of Opra Daily, Par Guzman. Hello, Par. >> Hello. You and I know that anytime we've. talked about menopause on Oprah daily, I. mean, we were one of the first to start. this conversation several years ago, I. think the New York Times had done an. article and then we did a whole.

conversation about it in the Hurst. building in New York. And anytime we. talk about it, it actually becomes the. most read content. Women are in real. need of, I think, reliable information. and also what we've seen from Oprah. daily in need of community. So what what. have you been hearing from women? >> I think the the storytelling uh the. sharing of people's experiences has been.

this incredible accelerator. You know, there is the research, there is the. journalism, there is the storytelling. that we do as a brand, but then the. women themselves talking to each other. and talking to us and sharing their. symptoms and sharing their experiences. has been this incredible ground swell. Did you notice that there has been a. moment of breakthrough when like there. was before and now there's this moment.

where it seems that more women are open. to talking about it. >> Absolutely. And I think it is not unlike. the me too movement where it takes a few. brave souls to kind of break the ice and. break the silence. >> and normalize the conversation. And I. think part of it is that it's still, you. know, very felt very shameful for a. really long time until recently. I mean, you're you 20 years ago when you went. through menopause and tried to get. people to come on the show, they. wouldn't do it. And now. >> nobody, particularly anybody famous, wanted to say they were going through.

it. Yeah. >> And so it's like a Naomi Watts who kind. of, you know, broke broke the ice and. then. >> Halib Berry. >> Halle B. Exactly. Drew. >> Drew. >> Yeah. >> Yeah. um and Maria Shrivever and you and. you know and and then it gives pe it. emboldens others to share their stories. and to uh normalize it and to to feel. okay about it and not feel so alone. >> Yeah. Well, I share my own story in the. book. I was around uh so you can find my. story in this book um menopause real.

talk real science and I was around 48. when I started experiencing hard. palpitations and I went to as I say in. in in in this book I went to five. different doctors I mean one after the. other after the other and none of them. had answers and it wasn't until I picked. up a book at the office that I I learned. that what I was experiencing I'd and. having these heart palpitations and. sleeplessness were indications of. menopause. So, what was it like for you?

>> Well, I didn't have heart palpitations, but I had sleepless nights. I was my. mind was racing. I had more than usual. anxiety. I'm a little prone to anxiety, but there was more than normal. >> And I went to the doctor and I have a. wonderful OB/GYN who I really trust. delivered both my children. And she. said, "Oh, let's do let's you know you. your your levels are fine." We did the. bloods and the levels were fine, but I. said, "No, I I pushed back and I and I.

got hormones, but I think a lot of women. don't feel brave enough to sort of push. back against the the you know, the. advice of their doctors and and I think. she has even changed her tune in the in. their last few years since I since that. first visit when I first came to her. about that." But I I think about all the. women who don't feel emboldened to say, "Wait a minute.". >> Yeah. The moment their doctors say, "No, you shouldn't," which I've had doctors. who said, "No, you shouldn't do. hormones." The moment you hear that, you're just like, "Oh, okay." Okay.

>> Yeah. >> Well, women spend 41% that's nearly half. of their lives in the post reproductive. state, you all. And even though I I I. have to say I've been doing I've been. talking and talking and talking about. this for a few years now, there's still. so much that you all don't know that a. lot of people don't know. And why do you. think that is? >> I think there's still a lag in education. in medical schools. I mean you will talk. to some of the experts we're having. we'll have on today. I think you know.

they will tell you that they didn't even. learn this in medical school. So there. is a lag in you know midlife women's. health education even among doctors. And. then of course there was the famous. women's health initiative which set. which set it back by you know two. decades essentially. >> That's right. Uh and. >> so many women suffered because of that. >> That's right. >> Because of that misrepresented study. actually. >> Yes. >> So many women did. So Congress just. recently held its first ever hearing on. menopause calling for more research,

more education. So, does that mean that. the tides are finally beginning to turn, do you think? >> I think I am I am cautiously optimistic. that the answer is yes. But we cannot. take our foot off of the gas pedal in. terms of continuing to tell stories, continuing to write stories, continuing. to put pressure on government, on on our. own doctors. I think even just our. individual advocacy is so important when. we go into the doctor's office and. demand something else and actually will.

leave a practice if they they are you. know even even if there's a whiff of. resistance and I actually encourage. women to say to call if they're you know. interviewing a new doctor or they're. going to see a new doctor make sure that. they are open if they are of age if they. that they're open to hormone therapy. because many doctors are still. resistant. If you have an older older. doctor, they're going to be resistant. because they're still basing it on the. misrepresented study. So, how do you. believe polar we begin to um.

just uh eradicate a lot of the shame. that women have around menopause? You. know, we've written about it. consistently on O magazine, on Oprah. daily. I've talked about it, but there's. I can't believe that people are still. like embarrassed about it. >> I feel the same way. And I think I think. the more I think social media helps a. lot. >> Yeah. I would do. >> and this is where social media is a. force of good because you hear. >> lots of women women who you admire,

powerful women and regular women and I. think the more you hear it the more the. shame goes away. I think you know in. some ways I think storytelling is the. antidote to shame. >> I agree. You know, the minute we circle. >> storytelling is the antidote to. everything because storytelling allows. you to know you're not the only one. that's ever gone through anything. >> That's right. >> Period. >> Yep. >> Every story we share on the Oprah. podcast comes [music] from a place of. intention. Each guest has their own. journey and my [music] hope is that.

sharing it with us here can help light. the way for somebody else. And as the. official insurance partner of this. podcast, Geico understands that every. journey feels a little easier when you. know you have [music] support along the. way. It's the time of year when the. weather changes, days get shorter, [music] calendars fill up, and you find. yourself back in motion again. Taking. the kids to [music] school, running. errands, heading home after the sun. sets. During these busy days, it's the. people who show up in small, steady ways.

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Well, Dr. Mary Cla Haver is an OBGYn and. certified menopause practitioner. She's. a regular contributor to O Daily and a. big contributor to this menopause book. and the author of the New York Times. bestselling books, The New Menopause and. the New Parameopause. Dr. Haver, thanks. for being here. Great to see you again. What's happening with our hormones. during parameopause? because so many.

women are experiencing that at an early. age. It starts like in their 30s now. >> Yeah. So if the average age of menopause. is 51 in the United States, but we have. a pretty big window of when that might. happen. So that's just average. We're. looking 46 to 55. Now back that up 7 to. 10 years when perry menopause begins. And as far as what hormones are doing, I. wish I could tell you it was this slow, beautiful, gentle decline till the end. of ovarian function. But actually, it's. a roller coaster, something we've named.

the zone of chaos. So on the way out, as. the ovaries deplete their egg supply, the brain is working harder and harder. to try to get the hormones out of the. ovaries, and that is causing very. erratic shifts in our hormone levels. So. estrogen levels can get as high, you. know, higher than they were in your. entire life outside of pregnancy. And we. see crashes in progesterone. And so that. really manifests early on in our 30s and. 40s. We we see the brain symptoms first. typically, not the hot flashes. Those.

come towards the end of pmenopause. We. start seeing sleep disruption. We see. mental health changes like Polar was. talking about, and we see brain fog. So. those are usually when I'm really trying. to dig in to see is this you know are. these symptoms going to be permenopausal. in the patient those are the ones I. start focusing on early. >> and explain why hormone therapy is an. effective well first of all you need to. explain I keep saying the misrepresented. uh you know. >> women's health initiative health can you.

explain that that is what set us on a. course of everybody having such great. fear about it and I think a lot of women. weren't even around or thinking about. that women's health initiative at the. time that it came out but are living or. experiencing the results of it because. their doctors, their mothers, their. aunts all saying no no no hormones. So. let's talk about what happened with the. women's health initiative and why.

>> Sure. So, we knew from observational. data in the 80s and 90s that women on. hormone therapy, and that was about 38. to 40% of the population um seemed to. have lower rates of heart attacks, they. seem to live a little bit longer. We. knew that their bones would be stronger. But as far as the heart disease. question, it was, well, are these women. healthier and wealthier and just have a. better lifestyle and that's contributing. to their decrease because they they can. afford hormone therapy, they can afford. to go to the doctor, the time, the. money, the access or is this really.

hormone therapy? So that's what the. women's health initiative set out to. study. If we put women on hormones. versus placebo, is this decreased risk. of heart attacks due to the medication. or just due to lifestyle? So the average. age of the woman in the study was 63. years old. Much older than a typical. woman would be starting menopause. therapy. We had two arms. If you had a. uterus, you got estrogen plus a. progesterrogen. If you didn't have a. uterus, you got estrogen only. And they. started collecting data. They they. collected so many lifestyle factors.

They collected heart disease data, breast cancer data. And what they saw. was an early signal that in the estrogen. and progesterine group only there was a. very small signal not great that there. was an increased risk of breast cancer. What happened was they called a press. conference and announced to the world. that hormone therapy causes breast. cancer versus placebo. >> We got a 26% increase in breast cancer.

and that's why we stopped the trial. But. that really wasn't the entire story. This was an older population. They. didn't have mammograms before starting. hormone therapy. We didn't know how many. of these women so may have had an early. breast cancer before they started. hormone therapy. And we didn't see that. signal. This didn't make the news in the. estrogen only arm. So it terrified. women. It went viral before the. internet. Right. It was the number one. >> Everybody just dropped their medications. the next day. Everybody just literally. >> they were calling their doctor in a. panic. I remember I was a chief.

resident. So my last year of my training. program, we were giving hormone therapy. It was expected to have that. conversation with a patient. And then it. was like full stop. She's terrified of. breast cancer. We don't want to give her. breast cancer. And it took off like. wildfire. And everyone was terrified. And all meaningful training in menopause. stopped at that point, too. >> Education around menopause. I mean, it. was just Yeah. And so it wasn't until I. saw Sharon Malone speak in 2023.

that I realized what the implications of. the WHI actually were. I was still. operating under the well hormone therapy. might give her breast cancer so we. really want to look at alternatives. It's a last you know it's the last thing. we're going to consider when she's. having very disruptive hot flashes. No. discussion around bone density. preservation. No discussion around. mental health or any of the other things. we know the full body effects of. estrogen loss can do. >> Wow. So it was that late in 2023 with. Sharon Malone. You were one of those.

doctors who was tentative about it. >> Yeah. Very tentative. And I remember. sitting in the audience in tears. Like. how did I not know this? I am board. certified. I get reertified every year. I read all the journals. I do I check. all the boxes. And no one had put this. information in front of me to say it's. actually really really safe for the vast. majority of patients. It's going to be a. huge benefit versus the risk. Every. woman deserves the conversation. And. just seeing it dismantled and taken down. made me realize how much of a gap I had.

in my own education and knowledge and. how I had really not been of full. service to my patients. >> Well, so let's switch gears today. Dr. H. today that the GLP1s. and hormone therapy are a gamechanging. duo for menopause. Uh belly fat. >> Uhhuh. >> Why? >> So, great point. And we know that women. on hormone therapy have less.

accumulation of visceral fat versus. those not on hormone therapy. So, visceral fat for your for your listeners. is the very special fat that wraps. around our organs. So, I had for years. had patients going through the menopause. transition saying, "Something's. happening in my belly. It's bigger. I've. changed nothing in diet and exercise.". And they would in their little paper. gowns at a well woman kind of grab their. tummies and like Mary Cla, what's. happening here? And I'd just be like, >> "Work out more, eat less. This is, you. know, things get harder as we get older, etc." Never knowing that there was a. hormonal component.

>> attributed here. When we add in the. GLP-1, they work synergistically. together. So, there was a recent study. that came out looking at women on just a. GLP-1 versus GLP1 plus menopause hormone. therapy, they lost 30% more weight. >> Wow. >> In that study, and when we look at body. composition changes, it's the type of. weight that we're looking at. So, they're losing visceral fat, that belly. fat, which is inflammatory, dangerous, leads to heart disease, diabetes, stroke, versus just subcutaneous fat. So.

all around the board, I mean, and in my. clinical practice, it really is a game. changer for my patients combining the. two. >> And and what are the benefits of hormone. therapy other than it easing hot flashes. or allowing you you to sleep at night? I. mean, I I didn't sleep for two years and. then I had a click of estrogen and the. lights went on. I mean, the sky got. clearer. I I I no longer felt like I was. moving behind a veil. So all of that was.

was worth it to me. But now I hear that. there are actually improvements for you. know your heart for inflammation for. other things. >> So we know that women So we have four. approved FDA approved reasons hot. flashes premature menopause preservation. of bone density in a postmenopausal. patient um and for the general urinary. system. But we have estrogen receptors. throughout the body. So our patients are. telling us in observational data, brain. fog is better. If your hot flashes are.

waking you up, it absolutely will help. with sleep. When sleep gets better, as. you know, everything gets better. >> Gets better. Yes. >> Yes. And so we also know muscular. skeletal symptoms can get better. Of. course, the general urinary system, things like vaginal dryness, recurrent. UTI. There's a big push on social media. to really spread the knowledge about the. safety of vaginal estrogen and how you. can safely use it with your systemic. estrogen as well. and you probably. should um to decrease the rate of, you. know, vaginal dryness, painful sex, an.

orgasmia, like patients will come in and. saying, "I'm struggling with orgasm. It's taking longer. I can't have them. anymore. I want to have them because the. tissue is changing down there." So, estrogen can go a long way there as. well. >> Wow. Wow. And you say osteoporosis is a. silent threat to women after 40. And so, what can we be doing to protect our. bones? >> Great question. So the biggest rate of. bone loss actually begins in pmenopause. and waiting till 65 for when that. insurance approved first bone density.

scan I think is a mistake. You know we. start asking to screen our patients in. perry menopause. We want to know what. the baseline is. And so what can we do? Hormone therapy is FDA approved for. prevention. So that's one thing. But I. think lifestyle is key here. And a lot. of women don't understand especially if. they're on a GLP1, right? You must eat. adequate protein. So, we need a stimulus. for the bone and we need to feed the. bone. The bone needs calcium. The bone. needs vitamin D. The bone needs protein. Okay? And the stimulus is going to be. movement, especially resistance.

training. The most effective way to. protect your bones by moving your body. is weight training and jumping. Yeah. Okay. More than jumping, but I will. definitely do the weight training. Yes. [laughter]. >> That's fantastic. Thank you, Dr. Haver. It's always so great speaking with you. Maybe you're feeling it, too. [music]. With so many ways to reach each other, it can be easy to mistake being [music]. reachable for being truly connected. But. I've learned that what many people are. longing for is just to be heard, truly.

[music] heard by another person. That's. what we're trying to do here on the. Oprah podcast. I see you contemplating. and I can see that [music] you're seeing. yourself a different way after he said. that. making space for real connection. [music] because every time we stop and. actually listen to each other, something. shifts, something opens. AT&T [music]. believes that, too. The right connection. at the right moment between the right. people can change the course of a day, a.

relationship, and even a whole life. So. the next time you reach for your phone. to call someone [music] you love, know. that AT&T is with you. Keeping that. connection strong because AT&T is there. when the connection matters and. connecting. changes everything. I want to bring in neuroscientist and. director of the women's brain initiative.

at Wild Cornell Medicine New York. Presbyterian Hospital. Also the author. of the New York Times bestseller, The. Menopause Brain, Dr. Lisa Muscone. It's. so nice to see you here. So nice to see. >> Hello. It's so good to see you. Thank. you so much for having me. Hi to her. >> Hi. >> Hi. Hi. So, you've described menopause. as a renovation project on the brain. explain how women's brains change during. menopause. >> Yes, I think that's a beautiful way to. think of menopause and also very.

graceful in some ways. And. >> so most people associate menopause with. the function of the ovaries, which is. fair enough, but in reality, menopause. is a neurologically active phase. It. impacts the brain as surely as it does. the ovaries. And I think many women. intuitively know that we have so many. women in midlife coming to the clinic. saying something is going on with my. brain and then we start talking about.

symptoms and when women say and what you. were saying with Mary Claire, hot. flashes, night sweats, insomnia, depression, irritability, anxiety, brain. fog, memory lapses, those are all. possible ible symptoms of menopause that. have nothing to do with the function of. the ovaries but they come from the. brain. Those are neurological symptoms. that come from the ways that menopause.

can change the brain. So I think that. the notion that menopause is a. renovation project on the brain is very. appropriate. It takes some of the fear. out of the word menopause to your point. before. >> and it's very important to understand. also as women that the hormones that we. think of as sex hormones like estrogen, progesterone those are actually brain. hormones as well. They serve very.

important functionalities in the brain. So when they come to physically when. they decline after menopause, the brain. needs to shift gears and adjust to a. different hormonal environment. But the. important thing to realize is that the. brain has the ability to adjust and to. just carry on. The ovaries may close. down shop, but the brain needs to keep. working. And I find that to be really a.

sign of resilience and plasticity that. we don't quite celebrate enough and we. don't appreciate enough. And then of. course the symptoms are no picnic. So. those need to be addressed. But both. things are really important to to. appreciate. >> What is happening when we're having. brain fog? You know, we're talking about. how up to half of women report brain. fog. So what is actually. >> happening in our brain? So brain fog is.

one of the most common symptoms of. menopause and one of those that we. really don't talk about but that is. potentially even more disruptive to. women than hot flashes and night sweats. In clinical terms, we talk about. cognitive fatigue or mental fatigue, which I find to be a really good way to. capture the experience that so many. women have that they're tired. Then it. takes them longer to do things. They. have trouble multitasking.

They have trouble with their memory. They have trouble even coming up with. words. Right. >> Right. The the word fumbles can be very. disruptive. what is happening. >> and concentrating too right. concentrating because I remember when I. was going through it and doing pray and. minopause I did know that that's what I. was experiencing but I you know as much. as I love to read I I couldn't finish a. chapter. >> I could I couldn't like finish a chapter. >> and that is very upsetting to to so many. women we need our brains to function.

right we we need our brains to feel. >> good also for quality of life. >> and we have So many women come into the. clinic with brain fog. I I run an. Alzheimer's prevention program and we. had so many women in midlife come to us. with this brain fog really worried that. number one they could be going crazy. >> That would come up over and over. I. think I'm going crazy. I think I'm. losing my mind. Or brain tumors. So many.

women coming to us saying there's. something wrong with my brain. I'm so. worried that I'm having a brain tumor or. even more so early onset dementia. >> So the symptoms this brain fog the women. can experience can be so severe and so. debilitating to really prompt serious. concerns about mental health and brain. health. So I would like all women to. know that brain fog can happen for many.

different reasons. Menopause being one. of them. It needs to be taken seriously. without panicking. If it is menopause. and we can do all sorts of tests to. understand where it coming where it's. coming from and what to do about it. If. it is menopause very often it goes away. It's temporary and it should go away. when the transition is complete. >> If the symptoms persist or interfere. with daily life.

>> or you're giving home or you're given. therapy for it, you're given home. therapy for it. It can go away. because. my brain fog went away with with with uh. estrogen and progesterone. >> That is very important information I. think and something that we're looking. into more thoroughly right now. It's. tricky to measure brain fog and some. clinical trials have shown that estrogen. therapy is can preserve cognition. Um, we do need to better understand if.

it can also bring it back like you were. saying for you. >> it works so beautifully for some women. it doesn't. So we really need to. understand who responds and why and then. generate recommendations for for all. women. >> You talk about the three Ps about. puberty about pregnancy and. parameopause. How are puberty and. pregnancy relevant to menopause? >> Yes, and I find this so important to.

talk about it. So, puberty, pregnancy, and pmenopause are all neuroendocrine. transition states, which is a mouthful, but it's really it's it means that the. brain and the hormonal systems are. changing at the same time. And it's the. same system the women are born with the. neuroendocrine system that directly. connects the brain with the ovaries. And. this is one of the most important. systems that we have in our entire.

bodies. And this system is turned on at. puberty with the arrival of sex hormones. and then it's really boosted during. pregnancy should the woman get pregnant. It crashes after um pregnancy during the. postpartum phase and the brain needs to. adjust another time and then it is. partially turned down after the. transition to menopause because at that. point of reproductive life is over. And.

the brain needs to adjust to every one. of these phases. And I will add that. even just having a menstrual cycle is a. little bit of a stress test on the brain. because every time the ovaries cycle, the brain microcycle, they're very small and subtle changes, but they're real. >> and some women really feel the effects. Other women are less impacted, but they. are very real symptoms. And at each one.

of these transition states, we have. actually similar symptoms. I think we. all know that teenagers can be spacey, can be moody, could be sweaty, right? Pregnant women likewise, there's. potentially mommy brain or baby brain, which is the same thing more or less as. brain fog. Um, there can be depression, there can be mood changes, but also. changes in body temperature. Almost 30%. of pregnant women had hot flashes, but.

we never worry about it. Right. >> Right. >> And then we go through menopause and we. experience some similar symptoms from. the brain's perspective, but they could. be more frequent, more severe, more. disruptive, and they may last longer. So. the difference here is cultural because. puberty is celebrated. We're so happy. about. >> pregnancy even more so. We throw. parties, we have balloons, >> right? >> And then menopause arrives and nobody.

wants to talk about it and you're. basically left alone. But it's the same. system that is changing over time. So I. think it's important to appreciate that. menopause is not an alien event that is. hijacking your brain or or. >> yeah women we should have celebrations. when women go into menopause. Halib and. I were talking about this on a special. I think there should be a big party when. you transition into menopause. Really?

>> Yes. I told my husband. Yes. >> I was telling my husband when I go. through menopause, we're having a party. >> Well, one of the things too that has. been so informative and that we talk. about in the menopause book um written. by the O Daily editors that nearly. twothirds of all people living with uh. Alzheimer's are women. Uh, I think. that's a wakeup call. What have you. discovered about women and Alzheimer's? You were saying you're working on.

Alzheimer prevention and I keep reading. that hormone therapy can actually lower. Alzheimer risk. Is that true? >> It's a very big question. Is actually. one of the most controversial and. important questions that we're asking. right now in the field. Um, my my answer. personally is that we need more. research. We need more data. What we. know right now is like Mary Claire was. saying, um, we have observational. research suggesting that women on.

hormone therapy may experience a lower. risk of Alzheimer's as compared to women. who do not take estrogen therapy, especially those uh who experience. menopause because of of anctomy because. of a surgery. Um, those are. observational studies. They're very. important. They're a really good first. step, but they do not provide definitive. evidence. Definitive evidence comes from. also other sources of other types of.

studies like clinical trials. The. question we should ask and the question. we are asking now is what if women in. midlife. started taking micronized estradiol. micronized progesterone the patch other. types of hormone therapy that are. perhaps more prevalent and more commonly. used now could that lower our risk of. Alzheimer's and the research is ongoing.

I'm actually really happy to let you all. know that we have launched launched a. $50 million research program that looks. exactly into this question. Oh, that's. good. >> It's called CARE. >> Yes. I'm told. >> is the largest global research program. on women's health, menopause, and. Alzheimer disease ever attempted. >> I designed it. I have the honor of. directing it. We're moving really fast. We have three years to give you this. answer and the year and a half is.

already gone. >> Mhm. So very soon I hope we will have. the answer that the women need. They. need to have like the rigorous. evidence-based. answer that also clinicians are. comfortable with. >> I hear that female neuroscientists are. also studying something called the. cognitive load. Explain what that is. Cognitive load is a very interesting. variable that is not typically assessed. in cognitive science or neuroscience.

which asks the question. of how much are we asking this woman's. brain to do. >> right women in midlife are often a. little bit squeezed between multiple. responsibilities there may be young. children aging parents your career There. are so many things that are happening in. midlife and all of them require an. enormous amount of cognitive reserve and. resources which are not unlimited and.

there's so much pressure and this mental. overload for so many women that is not. being taken into account and I think. it's really important to study women. brain health in relationship to the. environment that the women are actually. living in. Well, Par uh knows this very well that. Oprah Daily has covered the invisible. mental load. We talk about this all the. time. Yeah.

>> The invisible mental load that women. carry and and and I know you hear a lot. about this from our subscribers. What. are they saying? >> And I think as it relates to. permenopause and menopause, I think. sometimes. it's hard to distinguish what is just. the complexity of modern life. to your. point about being sandwich generation, raising children, maintaining careers, maybe taking care of elders, it's a. major major load and it's hard to know. what's what when people think, am I. losing my mind or do I just have too.

much on my plate? It's a really simple. question and I think. >> both can be true. >> Yeah, exactly right. >> Actually, both can be true. >> Um, and while we don't want to assign. anything and everything to parmenopause. or menopause, we need to we need to pay. attention to these things. And I think. you know science will help us even. there's so many you know AI AI for good. in in in this case you know looking at. huge data sets and seeing. >> sometimes atypical symptoms that you. know start to form a pattern and you.

know can lead us to the conclusion that. this symptom and that symptom that we. never ascribed to permenopause or. menopause are actually symptoms of that. And so. >> what are our readers saying what are. they saying? >> I I think women are totally maxed. I. mean, I think that's the the short. answer. I think um and I think I think. partners are coming along. I think. they're they're, you know, stepping in. and and sort of picking up some of the. slack. But I think women just naturally, biologically, intrinsically, and also,

you know, through societal pressures. take everything on. And and I think they. are, you know, now once again the power. of sharing their stories with other. women, at least now they're comparing. notes and and trying to figure out. what's what, what's medical, what's just. too much. Uh and I think, you know, we. are these are the forever questions that. we're asking. >> Dr. Msone, you've said one of the more. surprising things you've learned is that. post-menopausal women are generally.

happier than younger women and generally. happier than they themselves were before. menopause. And I'd have to agree with. that. Why is that? >> Why is a very very interesting question. I found that to be except really. surprising in terms of the research. which is still limited. Um, but what. those studies show is that when women. are asked about. life contentment and emotional.

well-being, they do tend to report. higher levels of both after menopause. than before. And we do know that. happiness tends to take a dip in midlife. and then go back up later on in life. There are some explanations, potential. explanations for this. When it comes to. menopause, one of the best studies that. I've seen looks at the functionality of. the brain. And there are some parts of. the brain that are very tightly involved.

in emotional regulation. One of those is. called the amygdala. And what scientists. have found is that the function of the. amydala is. specifically changed after menopause in. that things that would drive you nuts. before menopause don't quite have the. same effect on brain activation. You. don't react as much as you used to. >> Is it also because you just know more? You just know more.

>> Yeah. >> More. [laughter] It's true. What do you. think? >> I think it's I think it's both. I think. this thing that we call wisdom probably. does have some sort of neurological. signature. I think when fear and. reactivity goes offline, you prioritize. things that are more important. I think. there is something to there's some truth. to this. You just give fewer fs. >> Yes. >> Later in life. I mean, you just do. Yeah. >> And and I think it's what you're saying, Dr. Muscone that you know the amygdala.

kind of takes a backseat and I think our. abstract thinking our wisdom what we. call wisdom is sort of this you know um. when when it when we don't have. interference from fear anxiety you know. annoyance uh we can sort of come to full. fruition in our midlife. >> you actually become more of yourself. totally more who you supposed to be. What do you wish every woman would be. asking her doctor. >> about prevention? It is so important for.

all women to be able to discuss uh. prevention when it comes to brain health. with their doctors starting at a at a. much younger age. You know, a woman can. do everything right. She can get her pep. tests. She can do her mamograms. She can. do perhaps a colonoscopy, measure her. cholesterol, insulin. But we're never. asked [clears throat] about mental. health. were never asked about brain. health unless you just had a baby, right? And then you would go to the.

pediatrician and they would do a little. screening test to make sure you don't. have postpartum depression or something. worse. But there's really no framework. to support women's brain health. throughout life. So I really wish that. all women would go to their doctors and. say okay what can I do now. >> to support my brain. >> today tomorrow and for the rest of my. life? How do I prepare for things that. will happen to me like menopause or or. other how do I really prepare for the.

rest of my life? And I really wish the. doctors had the answers. So, I hope that. the research we're doing will contribute. and I hope that all women appreciate. that there are so many things that we. can do to support their brain health at. any age and any time of your life and to. really think more of your brain like a. muscle if you will. There are things. that we can do to strengthen our brains. and support our brain health. We can. exercise our brains properly. We can.

feed our brain properly. We can take. care of our brain properly. and their. brains will do so much more for us in. return. >> And what we're learning now is that. exercise to the brain is its own. medicine. >> Yes. >> Yeah. >> Yeah. >> Yeah. It's not just about staying fit. It's not just even about resistance. It. is medicine for the brain. >> Also medicine for the brain. >> Yes. So when we exercise, actually a. specific protein is being released. It's. called iodine that goes inside the brain.

and really supports the health of your. neurons. So there's a direct chemical. protection that goes from the rest of of. your body inside your brain every time. you exercise which is one more reason to. remain physically active. >> Dr. Msone, you've been wonderful. Thank. you so much. Thank you for your. contribution here and in our menopause. book. Thank you so much. >> Thank you so much. Okay, pillar, there's. a chapter on what menopause does to your. relationships and another about what men.

are sharing themselves about menopause. in the menopause book. >> So, what have you and the other editors. come to know about the people who are. supporting their spouses? >> Well, first of all, uh the most. supportive spouses are the ones who are. actually reading up and and hopefully. >> buying this book and and other books. like it. Uh I think you know information. is is power and understanding. I think. sort of baseline compassion rather than.

this business of just hormones. I think. there's a lot of language that needs to. be um rethought. I think when we dismiss. women's, you know, changes in women's. health as just hormones, we're kind of. dismissing the whole woman herself. because in some ways, >> you know, hormonal health is women's. health. This is something that I've. learned. You know, Dr. Pointer, Elizabeth Pointer, who we we talk about. in the book, you know, sort of put it. very plainly that this notion of, you. know, a woman's entire life really is a.

kind of series of, you know, um, inflection points like like the ones. that we tal we we just heard about from. Dr. from Moscone that we need to. normalize that conversation that it's. not actually the exception like hormonal. flux is the rule and I think we need to. kind of. >> turn it upside down. And I think we kind. of think, oh, it's going to calm down. And it does. There are certain. inflection points and things level out. and, you know, normalize. But, you know, some of those inflection points can have.

can be very disruptive to marriages. Um. it can you know I don't like this. conversation that you know there's a. divorce rates go up during midlife and. and and this is all true and sometimes. um you know sometimes women are sort of. out of their heads and they are not who. they want to be in certain moments but. sometimes this the loss of estrogen. which is sort of the the pleaser hormone. for lack of a better word uh when that. you know subsides it reveals you know.

issues in the marriage that need to be. addressed and so you Both things can be. true. Um I think there can be a lot of. understanding and you know going along. for the ride on the part of of the. partner but also I think women need to. look at the things that bother them you. know when when that sort of you know. pleaser hormone starts to to sort of. subside. >> I hear a lot of our Old Daily community. members are getting support from each. other. Freda is joining us. Freda, hi.

there. Hi. >> Hi. Tell us about the support you found uh. in the O Daily community. >> Oh my goodness. First of all, thank hi. Oprah and hi Polar. Thank you so much. for bringing me into this such important. conversation around menopause. I always. heard my mom and her friends saying the. change the change and I never knew what. this change was and when I started going. through parameopause I couldn't go to my. mom. So, I had to arm myself with some. trusted source and I came across Oprah.

daily and I was able to take that. information to my doctor, get on hormone. therapy and I am running around here. like a teenager now. I am so excited. >> Tell us what happened. Tell us what. happened when I I I often say I did my. first click I because I still do the. creams. I did my first click and I was. like woohoo. slept I sky got clearer bluer veil. dropped all of it. So what happened with. you Freda? >> With me what was happening is my mood.

like I I'm know what I'm saying is. insane and my husband thinks I'm insane. I think the kids were thinking I was. insane and I knew I was going through a. lot of different changes. Vaginal. dryness, brain fog and I said okay I. can't do this anymore. And I took that. information that I found on Oprah daily. to my doctor. I was confident enough to. speak with my doctor about hormone um. replacement therapy and I just man I. just ran with it and I just I'm just. excited like I'm joyful. Well, I feel. like I'm in my 20s again, believe it or.

not, and I'm in my third year of law. school. And so, I need, you know, I have. to focus. And that brain fog is just. gone. And Oprah Daily has been a big. part of that. And I thank you. And. please keep bringing that information to. Oprah daily because it, if it helped me, I'm sure it's going to help other women. >> Well, we thank you. We thank you so. much. And I know your husband thanks us, your children thanks us, [laughter]. everybody thanks us. Thank you. So, Par, what is the biggest surprise you and the.

editors discovered while putting all of. this information together? >> You know, I think I continue to be. surprised by the same thing. Uh, that. women still go to their doctor's offices. and are discouraged from getting the. care that they need. I know we've made. huge strides and and now there's, you. know, greater access to to doctors who. are supporting midlife women's health. But I continue to be amazed that women. are still fearful. >> um about hormone therapy and and that.

doctors are still reluctant to. prescribe. I think that continues to to. you know. >> even here yeah even hearing here today. that until 2023. >> doctors yeah we're still tentative about. it. >> We're still tentative and I think it. just you know. >> and if you get the wrong doctor you're. not getting it. >> right. And so I think you know it's. changing. It's definitely changing and. that makes me very happy. >> And so you and the editors wanted to do. this book because.

>> well there are a million great books now. that have been published that we have. actually you know from some of our some. of the guests that were on today. We um. don't pretend to be doctors. We are. journalists and we have really kind of. cherrypicked and collected and distilled. what goes on in your brain, your body, your mind, your spirit, your. relationships with your spouse, with. yourself, with your children. Um, and. really it's it's a primer that you can. dip in and out of. It is um extremely.

accessible. Anyone can read this and it. should be passed along, I think, to. spouses and children as well so that. they. >> The reason why I like it is because it's. so readable. I mean, it's it's it's like. you and you can just open to any page. and find out the information that you. want. It's so readable. >> It's it's packaged in a way that you can. dip in and out of. So, it doesn't it. doesn't feel like a textbook. >> Yeah. And if you know somebody who is. going through it, is going to go through. it, you're going through it, this is the. perfect It's a manual. I think it's like.

a manual. >> Absolutely. >> It's a manual for getting through it. Thank you, Par. >> Thank you for having me. >> Thank you. A big thank you to all of my. guests for joining us. Dr. Mary Cla. Haver, Lisa Mosconei, Dr. Msone, and and. to you Freda for being such an avid O. Daily uh subscriber and reader and. viewer. The Book of Menopause, real. talk, real science, real strategies for. your next chapter. And if you're a. woman, it's coming. It's available. anywhere you buy your books. And see you.

next time. Go well, everybody. If you. want to learn more about what's going on. [music] in your body and brain during. menopause, consider this book your. guide, your here's what's real, [music]. here's what's changing, here's what you. can do next companion. Just scan the QR. code right there on [music] your screen. to get your copy of this book of. menopause. This is actually a great time. to take good care of yourself. I promise. it's really, really helpful for getting. to the other side. our listeners [music]. tell us that the podcast is resonating. with you and is serving as a bright spot.

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