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April 27, 2022

Raging Gracefully: Menopause and Telehealth

A Conversation About Menopause, Treatment Options, and the Telehealth Process

Nina Collins is in conversation with Alloy co-founders Anne Fulenwider and Monica Molenaar about menopause, treatment options, and the telehealth process.



About Monica:

Monica Molenaar is a serial entrepreneur and an advocate for frank talk and common sense solutions around women’s health and wellness. At the age of 40, Monica tested positive for the BRCA gene and elected to remove her ovaries prophylactically to reduce her risk of breast and ovarian cancers, thereby ending her natural production of estrogen and sending her into surgical menopause overnight. This began a multi-year journey trying to make sense of all the misinformation and lack of clarity around this phase of life. It was only after starting to supplement with estrogen and progesterone that Monica found relief from the menopausal symptoms affecting her quality of life and was able to get back to work. She was inspired to start Alloy to make sure that other women entering menopause would have an easier time than she did accessing credible information, effective and safe solutions, and a supportive community.

About Anne:

Anne Fulenwider is a former magazine editor and a believer in the power of storytelling. She began her career at the literary magazine The Paris Review, spent ten years at Vanity Fair editing such writers as Carl Bernstein and Dominick Dunne, and in 2009, was named editor-in-chief of Marie Claire, overseeing all content and brand extensions in the United States. While at Marie Claire, she became the mentor on Project Runway Allstars, served as a judge for the Pulitzer Prizes, and launched a conference for entrepreneurs called The Power Trip. Fulenwider has interviewed women including Melinda Gates, Mindy Kaling, Tracee Ellis Ross, Gwyneth Paltrow, and Anne Wojicki on stages such as the Makers Conference and South by Southwest. After her mother died of a sudden heart attack in 2016, Fulenwider became motivated to make an impact in women’s health. Inspired by all the women she’s met who are building a better world for women by disrupting industries, she became an entrepreneur herself in 2020, joining Monica Molenaar to change the conversation around women’s post-reproductive health.


This transcript has been auto-generated and lightly edited. Please excuse and errors in spelling or grammar.

NC: Hi everyone - this is Nina Collins from Revel. This is our uh recording our live recording of our weekly podcast Raging, Gracefully and this week I'm very excited to have Anne Fulenwider and, tell me if I don't pronounce anything correctly, Monica Molenaar, Ann and Monica are the co-founders of Alloy. The website is, it's one of the new and leading telemed companies for menopause um, and so we're gonna have a conversation about telemedicine and about Ann and Monica and why they started this and I'm going to give you a brief little overview. I'm not reading from anything it's from memory, so if I get it wrong, you guys just correct me: um Monica's kind of a serial entrepreneur went to Stanford business school um had a health issue. I think in her 30s and had to have an opt to have her ovaries taken out, I think discovered she had the brac gene and was sent into early menopause and really really struggled and so through her personal experience of kind of eventually getting to estrogen and progesterone as a solution. She started to get really interested in why women aren't dealing with menopause in a more proactive way. Why doctors aren't telling us what we need to know all the things that a lot of women our age realize like how screwed up it is the way we're not given enough information and the way it's the way it all pans out. So she set out to create a company that would address those issues. Anne comes from editorial and kind of from the fun fancy new york magazine world. She worked for lots of magazines, so she comes from content and she was most recently, I believe, the editor-in-chief of Marie Claire um, I'm not sure how they came together. Maybe we'll learn how they came together. I don't remember, and then we at Revel just started working with them. So alloy is our newest, we're very proud our new partner in our exclusive partner in telemedicine. So I've been aware for a long time as i've been in this menopause space for like six years or so um of this emerging world of telemedicine for menopause, I'm a big fan of it. I think it makes a lot of sense um, but I've also seen a lot of companies kind of come and go. We did like little things here and there with different companies in the past um. You may remember names like what was that called curie md? Yeah, there have been various ones and there are various ones out there and we at Revel decided we really wanted to partner up with one so that we would have kind of a medical expert, um and so Alloy is now our medical expert, and this podcast is kind of the launch of our relationship. Although Anne i think Anne and Monica did yesterday launched their support group on the Revel site for women in menopause, which is a great idea - and I heard it went really well so that's my introduction. Welcome really glad to have you guys 

AF: Thanks so much Nina great to be here.

NC: So, okay, so tell me how old you each are. First of all, 

AF: I just turned 50, like two weeks ago: 

NC: Okay, happy birthday.

AF: I’m getting used to it. Thank you. 

MM: And the week before she turned 50. I turned 48. 

NC: All right, so you guys are kind of on the youngish side right and Monica went into early menopause and Anne, are you still? May I ask you personal questions? Are you? Are you still getting your period? 

AF: Of course we always I mean we go right into you, know vaginal health and periods, etc. Yes, I'm perimenopausal, so I um and really I know that by age. In fact, this is to go really deep. Just right now is the first month I have actually missed my period, but I've had plenty of perimenopausal symptoms of like um, really mine were mood-related, and it took me a while to figure out that that was pretty menopausal symptoms. So I'm fully impaired wITH kind of mood-related. 

NC: That's interesting so because you're 48 right? 

AF: No i'm 50. 

NC: You just missed your first period. So yes, you've had a good stretch. But when did your, when did your mood start? When did the symptoms start for you? 

AF: Um, I mean well, like maybe my whole life, but certainly I mean to be perfectly frank: I've been on some sort of antidepressant or ssri, or something almost my entire 40s. So and yeah, and so I think the funny thing is like I started to really um - feel anxious depressed. Like really sort of stressed out and to a point where I was like, I really need to. In fact, I was seeing already a cognitive, behavioral therapist and she was great, but she was like yeah, you need something stronger, so I um you know, sought out someone who could prescribe for me and also you know to talk about stuff as well. I do both but um, but it wasn't until like all this attention and first of all, my journey into this whole world was really you know, based on Monica's being a canary in the gold mine, for our sort of you know cohort because she was so early. She really that's, really. She really woke me up to it all. I certainly was aware of it. My mom died a while ago, so I haven't ever talked to her about it. So long story short I've really recently, in fact, there's an article in wall street journal not that long ago about the fact that many many perimenopausal women are being prescribed antidepressants um when it may very well be a hormonal issue, and you know this is the thing About all this right, there are 34 names, symptoms of perimenopause and menopause, and so a lot of us are going to different specialists for different things. Like my hair's falling out or my skin is terrible or going you know, trying various weight loss, ish things when and certainly all the mood stuff, when really the holistic picture is that your hormones are fluctuating wildly, and so, if you treat that so I'm in The process again open book here of trying to maybe lower my dose or wean myself off of the um antidepressants for the first time in almost 10 years, um and simultaneously starting a low-dose birth control, though 

NC: Oh that's really interesting, god that I have a million things I can say to all this so first of all your joke that you've always had mood issues. You know maybe your whole life. I think there's a lot of truth to that. I have to say I always say this I feel like I've got, I say this all the time now and I must be boring, like I feel much healthier now than I ever have in my life at 52, and sometimes I wonder if it's because of the lack of estrogen, like a lot of like my experience of Moodiness and depression and anxiety up and down throughout my life, and now that I'm I mean I am on hrt, so I'm on a regulated amount, yeah, but it's much lower right and I think I have lost a lot of I mean I don't know. Maybe it's also therapy, maybe it's just experience and wisdom, but a lot of the moodiness and drama of my earlier years feels like it's behind me, which is a gift. I do wonder if that's a post-menopausal thing, 

MM: It's it's there's. Actually, I just read on vacation a book called the happiness curve. I think - and it's basically about the like millions of data points, support this idea that essentially likes in particular for women, but i think for everybody like your unhappiest year is 51, so you go down. You know down down down the happiness curve and then at 51 you start going back up and like it sort of goes from there, so actually um. You know you're in it like you're. The best is now to come. Essentially, where you know you can sort of pull in all of the experience from your life thus far, i have the same experience, I'm also on hrt and i feel very even and strong, and you know like I'm. I think it just is sort of a different um. It's like a good new normal. You know so because you're not wildly fluctuating, but so it might be less than what you're and it is less a lot less than what your body made used to make. Naturally. But it's enough to kind of keep you stable in where you want to be um and do all that you know stay productive and 

NC: I mean that's not good. Just for us right I mean if we can get the right treatment, things can be really good and that wall street journal article that you referenced about depression. That'S actually, I think I mentioned to you guys that I was actually interviewed by Maria Shriver a couple of weeks ago last week for the today show it hasn't aired yet, but she wanted to talk about exactly that, and so the question is: are we taking? Because I'm also on Prozac and we've been on prozac, I don't know which one you take, but I've tried them all. Okay, i've only done prozac, it kind of seems to work enough for me. Although another recent article, I'm sure you saw in the new york times last week, said that antidepressants, don't actually do anything and it's really effect, but I've been on it on and off my entire adult life, and I had gone off it before menopause and then went back on because there was some evidence that it helps with hot flashes. I went on it again basically before I went in hormones so part of what this i always get to this place in this conversation, which is that it's so [ __ ] confusing. All of this, because, like you and at 50 you're saying you're going on birth control pills, which often when a woman goes to her doctor for the first time with menopausal, symptoms or perimenopausal, symptoms, usually what they say is they offer you Trazadone or some sort of Sleeping pill and they offer you may be antidepressants and maybe birth control pills, so why birth control pills at this stage as opposed to hormones? Are you not ready for hrt 

AF: So um, honestly, our medical chief medical officer at alloy, who we should really just give huge props to and who, I hope, you'll have on the podcast next time, um Dr. Sharon Malone? Who is amazing. We found her by listening to her speak with Michelle Obama on Michelle Obama's podcast two years ago, and exactly right. We had been so confused, even as people researching. How should we start a company in the menopause space, we're still kind of confused about all of it and the way that dr Malone really explained it all was so clarifying and helpful and easy it made. It seem easy um, but it's her advice, really um. My gynecologist has retired. I have yet to find a new one um. If anyone has any recommendations in new york city, please let me know, but the um. Her advice, basically, is that, while your period is because I've, you know a lot, I've still 11 periods in the past 12 months. So, when you're that that um still menstruating at that rate, her recommendation is to regulate the um cycle, is of birth control and I'm really excited because also the other thing that's happened in perimenopause is that my menstrual cramps have gotten debilitating like it's so crazy um. The shorter periods but like I basically have to take the day off and just pound advil and it's like I'm 15 again or something. 

NC: Oh, that's awful. I never had cramps, it's so individual, so it's kind of mad because there's no one answer, 

MM: but basically the scientific reason behind that and why it's it's not sort of sharon's a pin, dr Sharon, dr Sharon's opinion, how we commonly call her but um. You know sort of the medical, greater medical opinion, because when you're perimenopausal you're still, you still can get pregnant um and you need cycle control because your hormones are going up and down, and so that is what is causing a lot of the symptoms like hot flashes And night sweats and um mood ups and downs and so um, if you, if you only, would take menopausal hormone treatment or hormone replacement therapy, it's about a quarter of the dose. So it won't regulate your cycle and it won't protect you from getting pregnant. But it's the same basic uh ingredients, essentially menopausal hormone treatment is bioidentical. Um, plant-based sort of what's called is more natural estradiol than birth control pills, which are typically made with synthetic estrogen and progestin. But it's, it is the same molecule pretty much and and does the same thing. But you when you're still menstruating. You need more estrogen and progesterone to regulate your menstrual cycle and then, when you, when you have when you're, not menstruating anymore and your ovaries are not producing estrogen, which is well, I mean that, is that that's. The definition of menopause is that your ovaries are not producing estrogen, and that is the only thing that's causing. All of these symptoms is the lack of estrogen in your body anymore. Estrogen is responsible for hydrating. Your cells, for example, which is why your skin gets drier and your hair gets drier and your vagina gets drier and all those things, and so, when you add some back the texture of your hair, you know sort of stays more or less what it was before. Your skin is not as dry your you know, your vaginal tissue is still healthy and um supple wet so um. 

NC: So that is why this is a very good explanation. I have to say I'm impressed because I've been doing this for six years. That was very good yeah. 

MM: No so I mean it actually is, is has been so over complicated and it's actually really a pretty simple situation: um, but uh. It'S it's not even that you can't. There are some perimenopausal women who do use a patch um, for example, but um. It'S if you have regular bleeding, for example, like it, won't control that so a lot of women kind of feel a little bit more anxious because they don't you don't know if it's a period or if there's some other reason why you're bleeding! 

NC: So that's why the birth control pill to really because that was what was originally suggested to me, which i didn't do yeah a couple questions from the audience before we go on. Someone says what is the difference between hrt and menopausal hormonal therapy and I would say there is none. What's that wonderful, fabulous doctor in northern California, Jen gunter, I think she calls it. She doesn't call it hrt. 

MM: There was a some people, don't like the word replacement, because it suggests that we're missing something that we need. We are. We are missing something that we need. So i don't. I don't personally have any problem with replacement, but that's why the it was changed to menopausal hormone treatment instead of -

NC: oh, that's really interesting. I think that's really. We are replacing something we need duh. 

AF: Well, I think it was just that we're supplementing it and we're not replacing the same high dose that we had earlier before menopause, and so the medical establishment does now call it mhd or mt, or even we've, seen e-t for s or h, hormone.

NC: uh. I see. Okay, so that, but of course, that's only going to make it more confusing for women right a lot of different names, um and then another question is: what does the research say about depression and menopause, which doctor's specialty? Should we be talking to that's a complicated question? 

AF: Um I mean we have a great um medical advisor at um alloy pauline maki, who actually is the researcher she's at the university of Illinois, Chicago who came up with the protocols for diagnosing perimenopausal, depression um, and she has much more to say on the topic. But she has basically explained to us: I mean in the simplest layman's term, lay women's terms, lay persons terms um, it's it has to do with that fluctuation and uh of hormones and like sort of the wild mood swings um it can cause. Depression can cause anxiety. Um, you can even call those heart, those palpitations that feel like anxiety, it's hard to tell if that's anxiety or um physical first um, so it's definitely increased and if you have um, if you experience postpartum depression, then you are at much greater risk of experiencing depression. During um, perimenopause and menopause - and I also experienced postpartum depression, which I didn't figure out sort of self-diagnosed later because basically, no one talks about these things - I was really. It really was listening to Brooke shields describe postpartum depression that actually, I heard her description. I was like, oh, I feel just like that. I was like sitting on the floor with my nine-month-old. I was like. Oh, that's what I feel, so I really there's so much value to having these conversations and getting the conversation out of the dark and just sort of bringing everything into the light is so so valuable and really, in my case, therapeutic yeah. 

NC: No postpartum depression is something I have not experienced. It sounds really rough really hard and not something people talk about enough and I can imagine a lot of women suffer with a real confusion about it. The other thing that of course people will be familiar with. Is you know when I first googled all the symptoms of menopause, that impending sense of doom came up, which was really I mean made me laugh. It was crazy like that's a little-documented symptom of um, but that feeling of kind of anxiety and depression. It's not quite like the deep dark depression. It's a particular kind of, and I also felt like it was tinged with a kind of nostalgia right because you bring in all these other aspects of like am i going to be irrelevant? Am I going to be sexually unattractive? 

MM: It's been like shown, I think, through her research, that it that it's different, it's a different form of depression, it's its own thing, perimenopausal and menopausal, anxiety and depression. 

NC: That's really helpful to know, and that is the way I lived. I experienced it that way, but again we're not told that and that's confusing so to the person who asked that question. I think part of the debate right now is a lot of us are on ssris. Should we be or should we be on hormones and or is there a you know, another combination of a drug that hasn't been made, 

AF: Yeah that is really right, like we're kind of cobbling together our treatment and 20 of women between 40 and 60 are on ssris. We're the highest demographic being prescribed antidepressants of any democracy, and some of that i think, there's the physical symptoms and then there's also the reality of our lives at this age. Right there's the sandwich generation thing is very real. I don't have that actually because my mother is dead and I don't really talk to my father. I have four kids, but I often can't imagine what it would be like to be caretaking for parents and dealing with teenage kids at the same time. So that would make you depressed in and of itself right that's hard and ageism and ageism in the workplace and pain yeah. 

AF: We could just go on and on I'm like, where do we pick this up body images good reason to go on drugs? 

NC: All right from the audience, I am a healthy woman, starting hrt at the age of 62 for bone heart health, since it was never previously supported by my physicians. My physician recommended it. I only stay on it for max three years due to risk of blood clots developing with age. Your thoughts do you feel, staying on hrt, long term, a benefit or a risk? It's a really good question. I mean my understanding is that, like I went on at 50 and was basically told that I shouldn't stay on it beyond age 60., and I was told I mean i'm interested to hear your story because I'm often told that older women closer to 60 shouldn't Start it that that's too late that you really need to start it early, but then I'm recently hearing a lot of stories of women in their 70s who refuse to go off it and they're perfectly fine. So what do you think?

AF: Monica's definitely taking this question. 

MM: First of all, I've been on it for eight years already and I will not go off of it and I um you know I'm as high risk as they come. I'm brac positive my mother had breast cancer twice her mother had breast cancer twice and I was told by my surgeon at sloan kettering that it's really important to take because it of the protective benefits of your heart, your your bones and your brain so and pretty much. Every one of our medical advisors, including one who's 80, have been and still takes. You know her hrt have been taking it forever and, and she looks amazing, she feels amazing. 

NC: If I stay in hrt, will it look good 80? 

AF: Yes, honestly from our you know, non-scientific research on this, although we'll get there we'll do a study on it. Yes, she looks amazing. 

NC: Do we think jane Fonda is on hrt, because - 

AF: I think a lot of people who the women who are like really still engaged and and healthy, like a lot of them, will be taking hrt it. Just, although you know women who are older now at sort of that age are of the generation that we're told to go I'll go off of it, so there are fewer women. You know that that are on it than could be um, and that certainly were at a at a point in time. Before 2002 was the biggest selling um prescription or the most prescribed drug. I hate calling it a drug because it's really not but the most prescribed prescription in the united states, um and what's really interesting, I don't know, was hormones - was - was estrogen wow and that's most prescribed across men and women like it was just you know, yeah so, And we can it's a big can of worms open but 20 years ago, exactly um a study came out called the women's health initiative. It was actually the study was had been going on for a long time, but it was abruptly stopped and there was a press conference and um. Basically, the idea that this is dangerous was put out into the ether um and has really since then been walked back completely by the entire medical establishment. However, I mean there's a very very small population of women for whom this is risky for the vast majority of healthy women hormones are an option, including those who have been told previously they're, not again we're not doctors um, but the um, the the sort of pr Problem of menopause and hormones began exactly 20 years ago. There'S like it's it's before that it was literally considered a miracle solution: um fountain of youth. There was sort of a controversial, but an um sensational book called Feminine Forever that came out, I think, in the 80s that, like this was like to keep women sexy and young forever, which you know is not our goal. We just want to feel great and do the stuff we want to do, including feel sexy and great. If that's, what you want to do too um, but anyway, so 20 years ago, is when this. This whole thing became such controversy and when, frankly, that sort of left open the idea that a you can do all this natural stuff, some of which helps, but mostly what helps is the phytoestrogens um or that you need this like super fancy, expensive concoction of Very specific tailored hormones to you, those that also works, because it's replacing or supplementing your natural hormones um. But this idea that this is complicated, as Monica said earlier, is just detrimental to women's health and, in fact, um. What's the medical term, all-cause mortality in women who are on estrogen is lower than all cause mortality than women yeah. So, like you know again, all cause mortality is lower for women on hormones than women, not on hormones. Yes, like basically the overall damage to women's health, and this has been published in the new england journal of medicine. It's not you know anyone's here's opinion the overall detriment to women's health as a whole, since that's how it came out has been um. 

MM: But so to address your question about how long to stay on it. What happened with that study was that the people who were in it, the women who they studied, were an average age of more than 10 years out from their natural menopause. So I think the average age was 63. um. They were chosen for their um high-risk factors for cardiovascular disease because the intent for this portion of the study was to see because women had been have been having such good results and such a lower. They had found that women who were taking hrt had a lower incidence of cardiovascular disease, and so the intent of the study was to see if they studied, if they sort of followed women who and gave hrt to women who had a higher risk of cardiovascular disease. After having not had estrogen or taken estrogen for more than 10 years, would it lower their their risk and their incidence of cardiovascular disease, which they did not find that it did you need, but they did find that if you start taking it within 10 years or Closer to your natural menopause that actually, it did, you know, have positive benefits and that, overall, that the benefits outweighed any risks, and even in that study, the um increase in risk of breast cancer, for which they stopped. The entire study was found to be statistically insignificant, so this was really like a major disservice to all women because of a bad study and a few extra women. It was something like 38 out of 10 000, as opposed to 30 out of 10 000 women were found to have gotten breast cancer. At that point so and my data, my numbers, might be a little bit off but they're. Basically, you know basically correct um and so a lot of the information that they're basing these recommendations on right now, like you, can't start hrt until you're after you're age 60, or you should only take it for a few years or whatever is really not founded in any fact or truth. It'S just sort of trying to like you know skin the onion a little bit in order to give women the some of the protective benefits and, to you know, sort of reduce their symptoms for a period of time. But they haven't now studied it for long enough because, basically like, when are they going to tell us that we can just stay on it? So there are some reasons. People are saying that yeah yeah yeah, a lot of people are saying that and there's like there's a wonderful doctor, Avram blooming, who wrote a book called estrogen matters. 

NC: Who is a he's an oncologist? 

MM: He is um a kind of a you know, not a lone voice, but he's really sort of leading a movement towards um a changed narrative based on studying he's. He really dissected about 25 studies since 2002, and has you know, really been active in um. Writing peer-reviewed journal articles and things in you know journal of oncology and various. You know really well-respected medical journals about the fact that this is you know a real atrocity and creating a public health crisis for women and 

AF: There's a huge movement Nina, I think you've probably talked to people like the huge movement in the UK about this, like everyone in the UK is like fully this is like in the newspapers all the time. There's they just um, ran out like there's a shortage of mht in the uk, because the demand has become so high um, and you know a lot of the activists that we've spoken to over there. Like menopause actors, they've passed laws, there are companies there that are, you know, technological plus, leave in England yeah. 

NC: No, it's a big deal there uh, but I wonder if overall women in England are now taking it longer. I wonder what the statistics are. It also would be super interesting to compare the lives of all these women who were told they couldn't take it to us and like whether it really makes a big difference and then there's 

MM: There's another really interesting one. Dr Louise Newson in England, um, who you probably have heard her talking about giving estrogen to women like i heard her on a podcast, even um, to like women in their 90s, who were feeling depressed and low, and you know hadn't been given estrogen to that point And just the miraculous difference it made um to their feeling of well-being and um. I actually a friend of a friend of my stepmothers who's, also 80 or so i ran into her recently on the subway and she was telling me about her. Her um ring her estrogen vaginal estrogen ring and like it makes her feel like she's 16 again. She can't believe it. 

NC: It's so wow the whole topical estrogen, which isn't even commercial and a lot of women. Just don't even know that they can do it right. Yeah vaginal dryness vaginal pain. I used the s string for a little while before i went on hrt and it was cool, it looks like a diaphragm kind of without a like a and you just stick it up and it stays in for three months, and sometimes I wonder if I should Go back on it if it might improve my orgasms, i don't know um, probably not, but testosterone is sort of. That's that's a whole other nice conversation that we need to have. I'm yeah, I'm very tempted a little bit by the testosterone thing, but then most doctors tell you it's. You know very, very bad for you. 

MM: Well, they don't know how to prescribe it. I can't tell you how I've been actually trying to get a prescription. It's like! It's impossible. 

NC: So we should wrap up in the next few minutes. So let's talk about what alloy does and how people can find you and what they can get from you and what your whole vision is. 

AF: So our vision is bigger than what you can get right now, yeah, our vision is to be your go-to source for everything you need after 40.. I mean really like anything that um I saw in the chat actually or in the q and a like someone calling this midlife hormonal transition, which I love so we're sort of like really all about um that and everything that happens after you. So, medical, yes and we have telehealth and you go to and you fill out the medical assessment. We have menopause chain doctors going through, assessing and then prescribing various, so you can get estrogen and progesterone and pill form and patch form in vaginal cream. We also have a probiotic. We haven't talked about the microbiome at all, but it declines drastically a conversation, yeah um, so we'll just have to come back up. Our sort of yeah we've only been around since november 15th, so we we wanted to get help to women as quickly as possible, and so that's what we've launched. We also, though, completely believe in a holistic approach to this phase of life, so we are launching other pieces of the puzzle in the next few months, which um we can talk about later. But we really sort of you know Monica's really deeply into nutrition and makes her own sauerkraut and I'm really dedicated to the mental health piece of this. We love to talk about sexual wellness and all the different things that can help with that. You know I'm sure things work has like a toy chest of treasures that she sort of brings out and um. So we're really like looking to expand our offering altogether, but mostly, we really want everyone in this phase of life to know that they're, not alone. In fact, they're like we're all in it together, 

NC: Yeah and everything you talk about is so important because it's all a piece right. It'S like the nutrition and sex and mental health and they are all actually like manageable, but we do need to talk about it and get answers yeah. I love that you make your own sauerkraut. I've gotten really kimchi. I love kimchi. I love kimchi, although you know I was just diagnosed with osteopenia, which I hear is now really really common for women, our age so um, but they told me to eat more calcium, I'm like honestly. All I eat is like salmon and kale and kimchi. So well now and quinoa, and I don't know how to have more interesting um. Oh, when i get to this last question, because it's a good one um someone says “I read a book that says that everyone, men and women alike, should be on small doses of progesterone for anti-aging for life. I hate taking it.” She says. Is there a reason to take that too? Well, I mean I should say that if you're taking estrogen you're - probably you should be also taking progesterone unless you've had a hyperectomy potential to protect so that your the lining of your uterus doesn't um go crazy. I don't know about just taking progesterone. Does anyone do that? 

MM: Yeah? I don't it's, it's not what has been sort of recommended in the you know by the medical authorities and sort of the experts um on menopause as a thing so yeah, i'm not sure about that. 

NC: Basically, my sense to to the quest person who asked this question is that if you're taking progesterone you're, also taking estrogen, they go in the hand um, but that actually remains 

MM: A loss of estrogen. That is really what's causing all of the symptoms. Although progesterone is, you know like i take it at night, because it's sort of it balances the estrogen in the sense that estrogen is more of like the get up and go hormone, and it's also really important for muscle function and and recovery. 

NC: And the progesterone is more of like the calming sleepy hormones, so um yeah, i always take mine at night, and i was told to always do that yeah um. What this reminds me. What this question reminded me of for some reason: do you guys know that drug that people that diabetes diabetes drug that people take that now people think might be the wonder drug? What'S it called um? 

AF: Oh no, but perhaps we need to start selling it. 

NC: Oh um, someone in the audience asked for the website name so we'll put that in the chat and hold on i'm gon na look up the diabetes drug metformin. We need to have a conversation about metformin at some point because um, that's the drug that, like people are saying, might like prevent us from getting cancer and it helps us lose weight and i'm kind of curious about people using metformin in general. So anyway, I want you guys to get uh sharon, dr yeah. We have to ask doctor yeah and but if we ask her everything now yeah Dr. Sharon is going to be doing an event tomorrow and hopefully monthly going forward and we're really excited about it. She'S, a superstar she's, apparently Michelle Obama's gynecologist and she has her own podcast and she's really really smart and I'm just really very excited to have her on the platform and to be working with her through you guys so yeah everyone checks out, um. 

AF: I love this conversation, you guys we have so many more things we can talk about so now this has been really fun.

NC: Thank you, yeah and I'm gonna have a drink with you and i'm actually gon na get to meet you in person. In like a couple hours, I'm very excited so all right, awesome, listening and we'll see you next time thanks. 

MM: Everyone bye take care, bye,

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