Habits and Hustle - Episode 514: The Best of Habits & Hustle - Dr Mary Claire Haver (The #1 Menopause Doctor)
Episode Date: December 26, 2025This episode is part of The Best of Habits & Hustle, a series where I revisit some of the most impactful conversations we’ve shared. In this one, I sit down with Dr. Mary Claire Haver to break down... what’s happening during perimenopause and menopause and why so many women are left confused and guessing. We get into why estrogen matters far beyond hot flashes, how muscle loss and belly fat accelerate in midlife, and why strength training becomes non-negotiable as women age. She cuts through the fear and misinformation around hormone therapy, who it’s really for, and why women deserve better conversations with their doctors.She also shares a no-BS take on testosterone for women, GLP-1 medications, and why there are no shortcuts if you want to protect muscle, metabolism, and long-term health. Dr. Mary Claire Haver is a board-certified OB-GYN, Menopause Society Certified Practitioner, #1 New York Times bestselling author of The New Menopause, and founder of The ‘Pause Life. She’s become one of the most trusted voices helping women understand what midlife is actually asking of their bodies. What We Discuss: (08:43) The difference between perimenopause and menopause (21:12) Why estrogen matters far beyond hot flashes (23:07) Muscle loss, belly fat, and metabolic changes in midlife (46:06) Why strength training is non-negotiable as women age (27:10) Hormone therapy myths and who it’s actually for (25:50) Testosterone for women and when it makes sense (38:27) Pellets, patches, and safer hormone options (52:04) GLP-1 medications and the risk of muscle loss Thank you to our sponsors: Therasage: Head over to therasage.com and use code Be Bold for 15% off Air Doctor: Go to airdoctorpro.com and use promo code HUSTLE40 for up to $300 off and a 3-year warranty on air purifiers. Momentous: Shop this link and use code Jen for 20% off Manna Vitality: Visit mannavitality.com and use code JENNIFER20 for 20% off your order Prolon: Get 30% off sitewide plus a $40 bonus gift when you subscribe to their 5-Day Program! Just visit https://prolonlife.com/JENNIFERCOHEN and use code JENNIFERCOHEN to claim your discount and your bonus gift. Amp fit is the perfect balance of tech and training, designed for people who do it all and still want to feel strong doing it. Check it out at joinamp.com/jen Find more from Jen: Website: www.jennifercohen.com Instagram: @therealjencohen Books: www.jennifercohen.com/books Speaking: www.jennifercohen.com/speaking-engagement Find more from Dr Mary Claire Haver: Website: www.thepauselife.com Instagram: @drmaryclaire Tiktok: @drmaryclaire Youtube: @drmaryclaire Facebook: @drmaryclaire Pinterest: @thepauselife
Transcript
Discussion (0)
Hi, guys. It's Tony Robbins. You're listening to Habits and Hustle. Crush it.
All right. Well, hi. Nice to meet you. Same. It's really nice to meet you. You've been doing very well with this book. I have to say, I've seen you like everywhere.
Yeah, it's kind of overwhelming, but it's great. I can imagine. I can imagine. I mean, first of all, I think it's the way you describe and explain things in such wonderful layman's terms that people can
to really understand what you're talking about, really, you know, which I think is half the battle,
right?
So I think it's my superpower that, you know, I've done it for years with patients.
It's just one-on-one in the office.
And then I just was able to kind of take that skill and start talking about it on social
media.
And who knew?
You know, I started with no followers like everybody else, so.
Wow.
When is you actually?
Oh, by the way, actually we can start and we could talk about this because we actually
haven't, well, let's actually just, let's just say we started because it's actually very
organic this way. I think it's great. And you pronounce, I wanted to say who you are. The book is
called the New Manipause by Dr. Mary Claire Haber. It's a wonderful read just because you
explain things, like I said, exceptionally well. And you explained in a way that everybody can
understand very, sometimes very scientific things that are quite difficult. So, and you were just
not to interrupt you were saying you started on social media how long ago have you when did you
actually start i want to say i started on facebook like everybody else right in our age demographic
really just for friends and family and then before there were business pages or anything and
someone asked me a question one day it's just about gynecology stuff and i answered it like on
social and then like that's and i there are a lot of people were like oh my god i did it you know and so
I was like, does anybody else have any questions?
And it just kind of grew organically from there.
And then we had a business page.
And then during the pandemic, my kids were like,
mom, you should be doing this TikTok thing.
And I was like, no, that's for kids and dancing and whatever.
But I was like, whatever.
And so I just put a toe in the water on TikTok and it exploded.
Like, it was crazy how fast it grew.
And then, you know, my dopamine is firing every two minutes.
And, you know, you're like, oh, my God.
and I grew to a million followers on TikTok within like a few months.
And then that conversation just got bigger and bigger.
And then we really started getting busy on Instagram, which really was where most of our demographic hangs out now.
Wow.
So is that, you know, it's true.
I think that Instagram became the new Facebook.
You know, when we would be like, oh, like our moms were on Facebook.
And now it's like actually our grandmas are on Facebook.
up and you know you're right like i believe like it's instagram is for our demo and then ticot which
is for the younger however like you were just saying you thrive on ticot which is there's a lot of
crossover there is but i do tailor my message depending on how i explain things knowing that
ticot schemes younger and mostly male like well no actually 89% of my followers on ticot are
female, 98% on Instagram or female. So I'm a little bit broader and trying to talk to a wider
on, you know, so I really do Taylor. And Facebook is my age plus, like 55, 65, 70 year olds who still
want to learn. And so, but I have to really curate that message. So it's, but it's fun. You know,
it's like a gig. It is. But do you still have a practice? You still see patients. Yeah.
How often are you in, like in office, in patients?
So I'm in clinic about two days a week, and I have a team who fill up the rest of the days
so that I can work on my other businesses and social media the other three days a week.
Wow.
So social media has become like, how much of it would you say is your business now, social media?
Like 70%.
So what, you know, time spent 70, 60% probably.
But it's like I'm researching something for the book or for the next book, which we are still kind of playing with.
and I'm like, oh, this particular subject would make a great informational video for Instagram,
you know, and so then I'll make a long form video for YouTube, which is where we do like
long teaching. And then we could cut that down. Like, we've gotten really good about being
efficient with the same message. Right. You know what? Actually, now that we're talking,
it makes sense why you would do so well on Instagram, because if it is the age demo of 40s, 50s,
late 30s, let's say, that's who would be affected by, you know, paramedopause, metapause, right?
So you're, like, you're, like, right in that strike zone of information that is completely of interest.
And I was going to ask you, and now I kind of just figure it out myself, like, is it because I'm in that age demo now
and it's possibly, like, affecting me that all I seem to see now are things about metapause and perimenopause and hormones?
Well, me too. And I just think, well, that's all I, you know, like that. I'm like, is it we're talking about anything else, anywhere else? Yeah. You know, I'll see some of my favorite creators on TikTok and they're like, now you've seen the video about Lowe and the crop top. I hadn't seen it. I had to go dig and find it. Like the algorithm is only showing me doctor menopause stuff. So I, you know, but that's my fault. Well, I also think, though, like in this business, so like I talk to a lot of people in like productivity and health,
wellness, fitness, longevity, all the things, right?
And obviously also business mindset.
But I will say I have noticed a major uptick and upswing in even people who don't
necessarily talk about hormones and metapods are now putting these guests on their shows
because it's a very hashtag friendly thing now, right?
So people are what they're doing is they're gravitating to people who will get them
views and what's trendy and popular.
And this has become a very trendy, popular area because I guess it was a vacuum.
There was a dark zone.
No one was talking about it.
I think I was willing to talk about it before a lot of other people were and before other people
had educated the cells.
You know, we don't have a great medical training program.
You know, part of the medical curriculum for standard, you know, osteopathic, like regular
MD or a DO does not include a robust menopause curriculum.
So you have this whole generation of practitioners who are.
out practicing who really know like the most cliche minimum about menopause.
Yeah.
And I went back to school and educated myself, you know, and decided to talk about it and
share what I'd learn. Some of it is shocking, you know. Yeah. And so I think that's, you know,
and then I found the menopausee, which are kind of my, my social media friend group of other
like-minded practitioners who are doing the same thing, some in sexual medicine, some in general
medicine, some cardiologists, you know, we've all kind of bonded together this sisterhood. And
couple of good men. And it's incredible. And so I'm always like, oh, I'm booked here. Here,
go talk to my friend, Dr. Men, you know? Yeah, yeah, yeah. Put her on your podcast. Trust me.
She's amazing. I love that. I love you called Metapausee. That's hilarious, by the way.
And we're in the miniverse. You know, we have all. That's so great. Okay, so let's start
for the beginning, okay, because there's a bunch of stuff when I read your book and a couple
things really were shocking to me. And I'll get to that in a second, but let's first talk about
what really is the difference between paramedopause and metapause, because I think there's a lot
of confusion. And nobody really knows. Let's start in the middle. We'll go back to the very beginning,
and then we're our way back forward. Okay. Menopause is one day in your life. That's it. One day.
medically it is one day after or the day that is one year after your last menstrual period
the LMP, the final menstrual period, you know, if it's naturally occurring, okay?
That is a terrible definition, you know, it was designed by people who, what if you don't
have a period? What if you've had a cysticomy? What do you have an AED? What if, you know,
you have polycysticivarian syndrome? Like, you can't define your menopause that way. What it
represents is the end of your ovarian function of the ability to create estradiol and progesterum.
So let's go way back to the beginning. When we were in our mother's uteruses, so you're in your mom's
tummy and you're a fetus and you're growing and you're about five months along. Okay, she's five
months pregnant. You have the maximum egg supply of your whole life right then and there before
you're even born. And they start deteriorating from that minute. By the time we're born,
we have one to two million eggs in our ovaries that are active. Very different than males who
have testes that make their genetic material, what we call germ cells in medicine. So the eggs
are the female germ cell to the sperm or the male germ cells. Okay. They make their stuff
fresh every day from puberty till death if they, you know, a healthy man. Females have to live
with a set egg supply. And then it ages, our ovaries age twice as fast as the rest of our body. This
is the fascinating thing to me. So here we go. We go through puberty, okay, and we start ovulating.
And every month, you lose about 11,000 eggs in the race to have the one ovulate, okay? And the
quality of those eggs is deteriorating every single day because you were born with them. They get
hit by X-rays and environmental things and they're just getting older. They're aging very, very
quickly. So by the time we're 30, we're down to 10% of our X supply, and by the time we're 40, we're down
to about 3%. This is why fertility declines as we age, as well as the risk of a chromosomal
abnormality like Down syndrome and the others, okay? Because that egg quality, the health of that egg
is deteriorating with age. Menopause represents, you're done. The eggs are gone. And when that
happens, you can no longer ovulate. There's no more eggs left. So there's no more. And in that
ovulatory process is where the estradiol is made and then the progesterone after ovulation.
what is perimenopause okay so here we are normal reproductive cycles in a healthy female okay
your ovulation every month is a cycle so we have the hypothalamus is in the brain right
and then the pituitary sits right below it two glands that are part of our endocrine system the hypothalamus
has a little sensor in the blend that is always looking for estrogen and it's also looking for
thyroid hormone and some other stuff okay so it's like all right estrogen we're good
we're good, we're good. We're getting low. It sends a signal to the pituitary gland that says,
hey, tell the ovaries, we need more estrogen. So the pituitary sends out LH and FSAH in different
pulsatile fashions. I'm simplifying this greatly. And says, hey, gone. Says, hey, ovaries,
let's get an ovulation going. We need some estrogen. So the ovaries are like, got you, boss.
They start looking for that one egg to ovulate and the cells that line that egg are starting
to produce estradiol, more estradiol, more estradiol, more estradiol, it's pumping water around
that egg, and then the mix a cyst that pops, the egg comes out, gets caught up by the fallopian tube,
blah, blah, blah, and the whole thing starts over again every single month, okay? The second half
of the cycle, the progesterone is made in the corpus ludium, that little sack left behind
where we ovulated from. And that is a very predictable, repeatable pattern for healthy women
month after month after month after month. It looks like an AKG, when you look at the hormone
surges, every month, which is why we have this phase.
we act like this, that phase, we act like that, and we have metabolic changes, we have
all kind of changes throughout the month. Paralyptus, the ovary is starting to not respond to those
same signals because it can't. It's harder. It can, but it needs more juice. So the health
hypothalamus is like, hey, I told you we need more estrogen. And the pituitary is like,
I set the signal and the hypothalamus like, well, it must not have heard it. Send more. So we get
these bigger surges of LH and FSAH. And the ovary is like, okay, it's coming. It's coming. It might be a little
delayed, and you might skip a period, or it's a few days late, but then all of a sudden,
all right, we got it, and the egg comes out. Because you had so much more stimulating hormone
to make that happen, we have a bigger surge of estradiol. So what used to be this very
predictable EKG, month after month after month, now becomes erratic. You get surges of estradiol,
much lower drops. Progesterone lags quite a bit. It's often quite low. So now you're in the hormonal
zone of chaos in perimenopause on your way to those final eggs until you're done. And that
perimenopause process could take seven to ten years. Okay. Yeah. I mean, so that's what's
interesting. But I want to go back a second because I know that you've said that. I've heard you
talk about it about, I'm still on the fact that you are at 30 years old, you only have 10% of
your eggs. That is an insane number. That's almost like 90% are gone. Doesn't it make more
sense now? You know, like, why this is happening to you? Does that mean, though, at 30 years
old, you're then, you could be technically in perimenopause because you are losing these eggs,
like that's such a rapid scale? So average age of menopause is 51 in North America, okay?
Normal is still 45 to 55. So 95% of women will have their final menstrual period between 44 and 54 years old,
meaning menopause is 45 to 55, right? Because it's a year later.
Okay. And so that seven to ten years, let's back that up. So most women will start seeing some
disruption in the force between 35 and 45s. You follow me? Yeah, I totally am. So what?
Now, 30 is possible, but that's putting you in a different category, either early or premature
menopause, but it's possible. Okay. So my question, is there a way, is there a natural way to
keep your eggs healthier and healthy at a younger age? Great question. Wouldn't there be a great
study on that, but we haven't been done it. So now, we know that there are things we can do
to chip away at our eggs. Historectomy, you lose four and a half years off the shelf life
of your ovaries, okay? Having one ovary removed, you lose a year and a half. Being African-American
or, you know, having African genetics, you lose two years. You know, you go through younger,
your symptoms are more severe. So if you smoke, you lose about two years. If you smoke, you lose about two
years. If you have chemotherapy, if you have abdominal surgery, there are multiple things we can do
to chip away at the natural shelf life of the ovary, but we have yet to discover things that will,
you take twins and they're otherwise healthy, what can one do to push her menopause out? We have
no idea. Now, there's studies going on right now looking at medications that can turn off the
signaling that causes the ovaries to age, but they're all experimental. We're not there yet.
but they're looking at it.
Because, so basically you're saying there's nothing that you know of as of yet that could.
No, and I literally have read every study on the subject.
Like, we know that there's things you can do to mess it up, but there's no pill potion,
no matter what anyone says on the internet, that will extend the life of those ovaries.
And also what that is interesting, yeah.
Which is interesting is because, let's say people who have fertility problems, right?
And you look at somebody who you think would have no problems who are super healthy,
They appear to look super healthy.
They're doing all the right things.
They're eating well.
They're exercising.
They're not smoking, doing drugs.
And they're unable to have a child, which means there's some disruption in their air quality.
But then you see a crack addict on the street and they can have 47 kids.
So, you know, as an OBGYN resident who was older, who had massive fertility issues and needed lots of drugs and medication and all the things to actually have a baby, I lived to that.
Right.
looking at people making all of these incredible choices and able to conceive and I couldn't, you know?
Right.
And it was hard and hard to not be resentful or, you know, and then you have your baby and you eventually get pregnant.
For me, I was lucky.
And, you know, but yeah, it's almost like menopause symptoms.
You can definitely, if you make poor lifestyle choices, you're not going to have as easy of a menopause.
But even people who have the most on-point nutrition exercise, the whole.
whole nine yards can still suffer horribly. So it's not 100%. Right. So does it really depend
how much of it is genetics then of what your experience is versus lifestyle? Well, we know that in
the age of menopause is definitely genetic. There's a huge genetic component. So if your mom went
through early, especially if she had premature or early menopause, you're much more likely to have that
than her. Now, it's not, of course, you get half your DNA from your dad. So that's going to play in a
factor too, but we always ask, how old was your mom if she knows, you know, when did she go
through menopause? If she can figure that out. Most ladies don't know in my mom's generation,
you know. Yeah, I know. I never talked about it. They never talked about it. They never clocked it.
It was very, like, I don't know if it was, it wasn't a shameful thing. It was just something that you just
never, something that was like private or you just kind of dealt with on your own in the back.
So my mom was on HRT.
and she never came off of it until her 70s.
And, you know, she did really well.
She's not doing well now in her 80s.
She's on a walk.
She's got on a walker for 10 years.
And she's now demented and dealing with dementia.
And she's a mess.
But I remember her being in a dark room and shutting the door.
Now, I was one of eight kids, so our house was crazy.
But I would love myself in a dark room, too, if I had that many kids.
Yeah.
And she would, in a dark room.
My dad would blame menopause. It's menopause. It's menopause. And then she got on hormones. And I don't remember that being the thing again. So I have a lot of questions about hormones. But before, I want to first ask you about a couple different things. Because some of these signs for perimenopause really surprised me. One of them, because I had this last year, people made fun in me, but I had a frozen shoulder. And everyone, you know, my friends were like, oh, that's the old person. That's the old person.
And so my sports medicine doctor's like, oh, yeah, because a lot of middle-aged women get frozen shoulder.
I was like, what are you talking about?
I thought I got it because I'm a workout fanatic, overuse, wear and tear.
Well, that may be a part of it, but if he says capsulitis is directly, like, you are much less likely to develop an adhesive capsulitis if you're on HRT.
Okay, I'm not on anything.
I've never taken anything.
I've never done anything because I have something that most people are like, I think,
a lot of people are fearful, which I want to talk to about.
And by the way, HRT is hormone replaced in therapy.
Replaced in therapy, yeah, for people who don't know.
But so to me, that frozen shoulder symptom was shocking to me that that could be one.
So it's because it decreases.
So can you explain why?
Yeah.
So here's what your audience should understand.
Estrogen does a lot of fabulous things in our body that we take for granted.
It is a hugely powerful anti-inflammatory.
hormone. And when it goes away, we lose resilience to a lot of musculoskeletal inflammation and
diseases. So we see more joint pain. We see arthritis. We see arthrogyz. There's a direct, the collagen
is not as healthy without estrogen. The tendon joint interact, you know, where those things
kind of hook up is less elastic. We see more stiffness. I mean, we 80% of women will have
some form of musculoskeletal syndrome of menopause, and for 20% of us, it's going to be their most
severe symptom, their most bothersome of all things. And this correlation was just made in the last
few years. So what we learned in modern menopause medicine, which is going to take a whole
generation to propagate back down through the ranks, is that there are estrogen receptors
everywhere in our body, our brains. So cognition issues, mental health changes, our hearts, palpitations,
are loves asthma, our gut, gut health, you know, the quality of your gut microbiomes,
how you absorb glucose, everything is related when estrogen goes down.
The musculoskevallus system, muscles, bones, joints, osteoporosis, the general urinary system,
you know, both the bladder, the urethra, the vagina, the vulva, the labia, all of it,
terribly affected by the loss of estrogen.
Our ability to sleep, our ability to process alcohol, our ability to be
resilient to stress and mental health changes. How our liver hugely affected. Massive increases
in cholesterol with no changes in diet and exercise through the menopause transition. Massive changes
in visceral fat for most women. Through the menopause transition, zero changes in nutrition
or movement. And we see increasing visceral fact in position. So when do we know if a symptom
or an ailment we're having is because of a lack of estrogen versus just some other
thing else. Yeah. So the thing about perimenopause and menopause is that it's usually a
constellation of things. And so we have validated scoring systems that were developed, I think,
in Australia, where they look at severity of like 12, 15 different symptoms, and then you get a number
score. And the higher the score, the more likely it is to be related to your pari menopause. So I have
a patient coming in with multiple vague complaint, and she's still having regular periods, you know,
so I can't use her cycle to kind of judge where she is in the process.
I will do blood work to rule out hypothyroidism, autoimmune disease, you know, multiple
different things, nutrition deficiencies.
I want to make sure I have a good baseline on all of that.
But if everything else comes back normal, we're not checking hormones in pariametopause.
Why?
Because it is the zillot of hormonal chaos.
And it depends on the minute of the day as to what your levels could be.
So a one-time blood test, a one-time urine test, a one-time saliva test,
is rarely diagnostic for perimenopause. So those of us who do what I do don't, we don't use
hormone levels. They're not helpful. So they'll come back normal 98% of the time. And so even though
you are just completely chaotic, remember, in a regular healthy cycle, the estrogen level is
peaking mid cycle and dropping off, you know, it's low at the beginning. It peaks mid cycle. It
drops off and you have a second small rise and then the whole process starts over again. So
without predictable timing of when the blood's drawn in relation to your cycle, which goes away
because it's so chaotic in perimenopause, it's not helpful. So if your doctor's charging you
hundreds of dollars for all these hormone tests, I would save your money and find a different
provider. That's interesting because everything goes through where your hormones are. Like,
what do you mean? I'll tell you. So like they'll say, oh, you have low testosterone and you have low
this. Well, okay, testosterone is very stable in a woman. So there is a low level of tea. That's
different. Estrogen goes crazy. Progesterone goes crazy. Tea is stable or down. So that's a good
one to check. So is there some type of correlation with perimenopause and low testosterone?
Because I have like zero testosterone. And a lot of my friends are the same. So women have a more
steady state decline in testosterone throughout their life just like men. So men have about,
they peak at 19 and it's about and they kind of drift off a little quicker until like mid 30s
and then it's like a 1% decline until they die you know and so if so only about 30% of men have
testosterone low meaning dysfunction for women once we go through menopause we lose like half of our
testosterone is being produced in the ovary that drops off 20 you know 50 75% we never go to zero I mean
And it's going to be low, but you still have the adrenal pathway working to produce some testosterone.
But not to say you wouldn't benefit from replacement, but it's not surging and falling throughout
the cycle. And it's not chaotic in pari menopause. It's usually kind of low. So that's a reasonable
one to check. But I just put people on testosterone. I know they're low. They're in pari menopause.
Especially if they have no libido.
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So I want to, actually, so I want to ask you about HRT, hormone replacement therapy, who's a good candidate, who is not?
Is it a myth that HRT is something you should stay away from if cancer or breast cancer runs in your family?
I think there's a lot of fear around it.
So the HRT is hormone replacement therapy or menopausal hormone therapy, depending what you read.
and basically I look at it as giving your body back the exact same hormones that you used to make when you were your healthiest
to allow these critical processes to continue unfettered as well as they could.
What's happening is when we lose our estrogen, we have an acceleration of cardiovascular disease,
we have an acceleration of neurodementia, we have an acceleration of osteoformative,
and frailty. We have, you know, all these things kind of skyrocket rather than go with this
usual path due to with aging. We have an acceleration of the chronic diseases associated with
aging. And the disease is specifically affecting women, including autoimmune disease.
And women on HRT, especially starting young in their menopause, like early in their menopause,
in perimenopause or in the first 10 years of menopause, have a lower all-cause mortality,
50% decrease risk in cardiovascular disease year for a year, and a decrease in cancer.
So where did this come from? Like, you know, don't eat soy because it's estrogen producing, right?
Oh, God. Women who have high soy diets have lower breast cancer rates, by the way.
So where did this whole thing, remember this whole thing about 20 years ago? Like, I've been staying away from soy my entire life because I thought that that was going to kill me.
That was never been proven. Never been proven. Nothing. And now when it goes,
go and look at demographic data on women, sorry, no, lips or on women who have naturally
high soy diets like Asian women, but we eat at a mommy all the time, they don't have breast
cancer like we do. So here's what happened. There was, we've known for years that women on
hormone therapy is 38% of women were on before the WHOI, so about 40% of menopausal women were
on HRT, not only for hot flashes and night sweats, but for the protected benefits of decreased
osteophorosis, decreased heart disease. We knew that that was the thing. But it was observational
data. So there was the healthy woman hypothesis, meaning, are women on HRT just healthier because
they're wider and more educated and they have more access to health care, you know, and we're just
seeing an artifact? Or is this real? And the way to prove it is a randomized control trial.
So finally, we had a female leader of the National Institutes of Health. She puts the study together.
It's amazing. I mean, we're like so excited. It's a high quality study, thousands and thousands of
patients, and they're like, okay, the end result that we're looking for was, is heart disease
going to be delayed or stopped with hormone therapy? So they chose the average age of the patient
as 63, okay? Yeah. Not 50, the average age of the woman starting hormone therapy. 63. Why? Because
they can't run the study forever. It's too expensive. So we're going to start later to see if there's
cardiovascular benefit because these women aren't going to have heart attacks until they're in their
70s or 80s. So to save money. And that means.
sense. They were also tracking multiple factors. They were looking at frailty scores, all kind of
stuff. So here we go with this study, and we have two arms. We have women who have uterces
and women who don't. Two groups, okay? The women with uterces got estrogen and progestogen
or placebo. And then the other group got estrogen only because they don't have a uterus
or placebo. Here we go. So remember, average age 63. They see that versus placebo. The rate in
breast cancer went from four out of a thousand women per year to five out of a thousand women per
year on the medication. So that is a 25% increase in relative risk. Not absolute risk,
relative risk. They stopped the study, call a press conference before the paper was published,
before any physician could look at it. It was the number one news story, medical news story of 2002.
It was on the cover of every single newspaper, ABC, Good Morning America, Nancy Snyderman, got
on there. It was like, I took all my patients off. People are throwing their estrogen in the
trash. The estrogen-only arm showed a 30% decrease risk, you know, breast cancer. It was the progestogen,
which was synthetic. So then, but what did the headlines say? Estrogen causes breast cancer.
So this is so interesting because all of relative risk, which is what is like your individual
risk as a patient, was 0.8%, less than 1% per year. So then you're saying that anybody,
who's in perimenopause, who has deficient hormones, should be going on HRT.
They should consider it. They deserve the conversation, and that's what's not happening.
Not that they would not choose it. It is a shared decision between the patient and her provider.
They're being denied access and conversations around it. Doctors are just saying they don't believe
in it, like it's Santa Claus or it's going to kill you. They have it. All of those findings have
been redacted. Okay. And what is the reason behind it like this whole that's going to kill you?
because if you're just supplementing your body with what it had before,
what is, like, where is the disconnect?
How is that something that is dangerous?
Okay.
So say you, breast cancer is a healthy cell that has gone through a malignant transformation, right?
Through dits to the DNA, you know, if we look at how we're dividing cells and all that.
If your breast cancer cell through the malignant transformation retains its estrogen receptor,
which healthy cells have to have to be healthy.
Okay?
Yeah.
We need estrogen receptors to make the breast cells do what they do.
If it retains its breast cancer, it's estrogen cell, it is now estrogen receptor positive,
and they can use that receptor against the cancer cell to stuff the breast cancer from growing.
So if you have an estrogen receptor positive cancer that, you know, that we don't want to feed,
then you might be getting tamoxifid or a serum or one of the anti-estrogens or the aromotogens
is an aromatase inhibitor, you know, to fight your breast cancer.
That's totally reasonable.
So not everyone is a candidate for a hormone therapy.
If you have a hormone-sensitive cancer anywhere in your body to that particular, to estrogen
or progesterone, you're not a candidate.
If you have severe liver disease, you're not going to process and break down estrogen
the appropriate way.
You're not a candidate.
If you have unexplained vaginal bleeding, you've not had the ultrasound or workup or biopsies,
you're not ready for HRT.
So there are, you know, patients.
All of these are very nuanced conversations, but just because you've had breast cancer does not
mean that you are going to be categorically denied hormone therapy.
But what was the first thing you said if you have hormone, like you said something,
like if you're somebody that has a hormone issue.
Positive cancer?
Like if you have cancer not to go on it, yes, obviously.
But the other, you said cancer, vaginal bleeding, you said enough and you said.
Severe liver disease.
So other than those things, you think that anybody else.
For the big ones. So like, family history, no problem. Blood clots, don't do oral estrogen, do transdermal. You know, again, nuanced conversations, so much misinformation.
These poor women are crying to me who are absolutely suicidal at the end of their rope. Like, they are miserable. And they've been told, oh, your grandmother had a blood clot. And you can't, you know, I'm like, what? You know, these people don't know, haven't educated themselves. The system is not educating them. I agree. We have so much work to do. This is why.
The truth is most people I know who are getting hormone therapy, they're not going to the regular OBGYN, a regular doctor. No, they're going to some back alley place. They're going to a back alley place. They're going to these, like, rando doctors, these functional medicine yahoos that I don't even know who they are, who are giving them, I don't know what. Are these meds, they're going to med spas, really. They're going to med spas. That's the truth.
Trest up as functional medicine. You know, that's where they're going. And they're going.
Masquerading. Oh, and you can get your Botox.
And you can get your Botops, you get your philop.
I love Botops.
Listen, I'm just saying it's you're going to these like second rate places that are not even a proper medical facility.
So women have a long history in this world of having to go to alternative or back alley places for needed medical services.
And they're going to do it.
And this is just another example.
So where do people find it?
Like if I went to my OBD.
It's getting better.
Yeah, no, no.
Well, she'll say like she'll say, like she'll say,
oh here take this like what is it's like if you do so are you saying go to your doctor your
regular normal doctor have trying to have an intelligent conversation about hormone therapy
that does include not just estrogen but you're saying hormone therapy is also testosterone
progesterone everything right now are they do like subcutaneous shots that people are putting in or
is it like maybe but you can get safe efficacious high quality bioidentical hormones
therapy from your local pharmacy with insurance, if you haven't, you know, if that's your
jam, for $30 a month.
For all the hormones?
No.
So testosterone in the U.S. is not FDA approved.
And I don't know what the same board is in Canada, but you're going to have to be out of pocket
for testosterone because there's no, FDA has not gotten a room to improving it for women,
even though we have tons of studies to show how helpful it is.
So for my patients, we can do, I usually do an estrogenial patch, an oral
macronized progesterone, and we do some topical testosterone in the form of a cream, usually
from a compounding pharmacy. Right. That's what my doctor always recommends these creams,
but the creams from when I understand, because like I haven't done any of these, but I want to,
they don't do anything. The creams are not very... So you never want to do a progesterone cream
with estrogen. Like if you, if you do a progester, remember, it's a huge molecule and it doesn't
absorb. Oh, testosterone. Yeah. So I've got a couple of trusted pharmacies that work very closely with
the pharmacist, but still, it's not, they're not as regulated, you know, no one's going in to
test to see in a compounding pharmacy. It's really what they're putting in there. Were they
having a bad day that day and they didn't, you know, so like the things coming from Walgreens
and the FDA approved stuff, they go through extensive testing and monitoring. Yeah.
So we know 98% of the time, what they say is that it is in it. So that's my preferred
source. I don't have that option for testosterone because there's not an FDA-approved
option. And it's really hard on Texas where I practice to get them the men's
version. There's a gender ban. And you only if you have gender dysphoria or you're transitioning,
can you legally get, they'll turn you in. Wow. Yeah. So what about pellets? Are you putting people,
you can't even do that, right? Absolutely not. No, no. Pelots are just, you know, I don't want to
demonize the pellet. Okay. It is simply another compounded form of therapy. There's nothing magical
about it. It's not better. It's not safer. It might be more convenient, but you can't take it out.
once they put it in, you're stuck for three months. And let me tell you, it is the most profitable
for your physician. So here's the red flag. You go into your health care provider and they only offer
you pellets. All we do is pellets, run. Because you are there to make them money. Because if they're
not having a logical discussion and they're making you promises like, girl, you're going to feel so
good. I don't make those promises. I'm like, listen, we're going to try this. We're going to try
this. Nothing's better than your 25-year-old ovaries. I can't put those back in you. You know,
we were just trying to get you to some level of
you can function again and then we'll figure out the rest.
It's so funny.
And the only laughing, yeah.
People who do, only pellets are in it for the money
and not in it for the patient.
And they're not dealing with the side effects.
They're not, I mean, it's horrible.
So like, but if you're, if you're physician's like, look,
we got pellets, we got patches, we got rings,
da-da-da-da-da-da.
You know, my patients can't afford pelvic.
You know, there are hundreds of dollars a month
where they can pay 30 or 40 or 50 maybe and go get what they need.
I'm only laughing in a, not because it's ha ha funny, but like, I live in L.A.
And everyone's running to these particular doctors that I know here.
And he's just like doing one, like he's basically banking like one, like he's doing like a hundred pellets on these people, poor people.
Here's what.
Yeah.
Guess what about pellets, about biotee.
They don't make a woman's version of the testosterone pellet.
They just put the men's low dose pellet in the women.
and so normal physiologic range of a healthy female, you can Google it right now for testosterone
is about 25 to 70, okay? Pica Graves for a desolator. Don't worry about that. The biotee literature,
I went and signed up on biotee because I wanted to see what they were teaching these people.
They say, no, no, no, no one's died yet. Let's run them between 150 and 250, okay? That is at transitioning
levels that basically taking these women and turning them into teenage boys and sure their libido goes
up but this is not without side effects and risk and so no thank you i would just want i'm i try to
get my patients 50 60 in the high normal range you know they're very happy and they're not having
the beards and the cholesterol and the side effects and the in the and the antigen and the acne and the
hair loss and that you know because that's what i'm scared of these women are coming to me after getting a
Tell it, I'm drawing their levels during the three and four hundredths.
And I'm like, girl, what are you doing?
That is why I am scared to go on these things because it was going to, the guy says to me,
because I went to one of my friends who's like, you know, this girl, she's a famous girl.
She's like, you have to go see my doctor.
He's amazing.
He's going to make you feel amazing.
So I go.
Yeah, you want.
But at what cost?
Right.
And he wanted to put it.
He's like, don't worry.
We're going to start really low.
it's going to be in about 150, whatever amount.
That's double.
That is double high mammal for women.
And I said to him, I'm like, my doctor told me it was about my normal level should be
at this place or whatever.
He's like, real, he's like, he's like, medical doctors don't have the knowledge.
They don't, they're not, they don't know, okay?
And so, but that, guess who taught him that, oh, you know, biote.
Right.
And this is the best.
When the company who is in, she was giving you the medicine to put in the patient is
teaching you, there's a problem.
Well, and also these pellets are like, to your point, 800 bucks, a pellet.
But obviously I didn't, I do not have any pellet.
But the thing that really kind of was scary for me is all these side effects.
Like, yeah, does it work for, so it's a really 50-50 split.
If I talk to 50% of my friends or people I know who are on it, they like it.
If I talk to another 50%, they gained weight.
They got bloated.
It's an anabolic steroid.
Yeah.
Yeah. So who, this is the question I have for you. Who's a good candidate for these, for high, for testosterone, I mean, women, not men. Why are half the women, you know, just thriving on? And then the other half are really just not liking them. Who's a good candidate for?
So, you know, were they not liking it because they were overdosed and they were in super physiologic ranges. They both got the same doses. Like these all, that's the out of like 10 friends.
It's all the pellets.
They were overdosed, so they don't like it because they were overdosed.
No, no, no, like 10 of the women, five of them, let's say loved it.
Five of them did not like it.
Now, what were their levels?
All pretty low, but this is what my, listen, I'm no doctor, but what I noticed were
the friends in mind who liked it, they were naturally very thin already, and it wasn't
a weight, like they didn't gain weight.
The ones who didn't like it, like gained weight because they didn't have the genetics
that was going to take them, that was going to keep them at a baseline of being very thin.
The thin friends got thinner and more fit.
The friends who were a little bit more, like more voluptuous got more voluptuous and didn't like the...
So higher levels of testosterone, you also convert more estradiol.
So it's a bad.
So we start really low and slowly, slowly titrate up.
Most of my patients, you know, I have three indications to put a patient on it.
Though the sexual medicine docs think that we have testosterone receptors everywhere in our body as well,
and they feel like it's probably helping with cognition, with sleep, and lots of different things.
I started it for low muscle masks.
My whole life, I've not, you know, I just was genetically very low muscle.
And I'm super high risk for fracture and frailty as they get older based on my family history.
And I'm just fighting that tooth and nail.
I lift heavy, I do all the things.
And I was like, I'm going to add some testosterone.
out. So I started in a really low dose. I never thought I had a libido issue, which is what I put
most of my patients on for decreased hypoactive sexual desire disorder. We've rolled out other causes and it's
just down to desire. But I definitely have seen an uptick in that area and I think I would miss it
if it was gone. So I never complained before, but I'm just having like a little more. And I am having gains.
So, but I am working out like a main, you know, I am heavy lifting very consistently much more than I ever did.
and that I'm eating much more protein that I did before.
So what number are you taking testosterone as a doctor?
What do you do it?
So I'm doing 10 milligrams a day, transdermal.
So that comes up, so your levels would be at what point?
So my last level checked was at 59.
59?
So transdermal, does that mean cream?
Cream, yeah.
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Okay, I've got so many other questions. Okay, so let's talk about exercise.
We have to talk about exercise.
We test upon it a few times.
I'm a big believer in strength training and lifting heavy, especially as you age.
I know you talk about that as well in your book.
What can you tell us on the research that you've done of how strength training and metapause
or as you age the importance of those two are together?
So most women peek at their muscle mass at about age 30,
and then we have an age-related decline in muscle mass.
And in order to overcome that natural progression,
we have to work harder and harder and harder every single year.
Or we're just going to have to give up that, you know.
And so as we're living longer than men,
we're becoming more and more frail in those years.
And so when you look at long-term care homes,
66% are female, 33% are male.
And the most likely reason as a woman is going to be admitted is for dementia.
and then for frailty, she can't get off the toilet.
She can't, you know, lift her legs.
She can't get off the floor.
If she falls, she can't pick herself up.
And so this is the end result, or she's fallen and broken, you know, a bone and can't take care of herself.
All of this is pretty much avoidable.
But, you know, my generation, our generation, I was a cardio queen.
I ran.
Everything was about to be thin.
Like, my whole focus for movement was to be skinny, okay, which I had skinny privilege.
I ran marathons.
I did all this stuff.
you know, super proud of that. But God, if I could go back and talk to that girl, pick up some
freaking weight, you know, because I chipped away at my bone and muscle strength to be thin. I never
looked at nutrition outside of calories. You know, I tried to eat healthy. I didn't know what that was
until it went back to school. They didn't teach us out in medical school. Just, you know,
don't eat french fries. Okay. So, but for movement, two to three days a week of progressive
load resistance training, that secures the hell out of women because they've never done it. They
don't know how. But it is so important. So when they did studies on elderly women, which is 65 plus,
okay, I am eight years away from that, or nine. How old are you? Fifty-five. Oh, you look great,
though. So almost 56. So they were looking at vibratory training, putting them, they put them in 10%
weighted vests. They had to start lifting. They were doing dead lifts. These women were making major
gains in their 70s and 80s for muscle mass and bone strength and osteoporosis. And I'm like, okay,
I see a person's prevention program. Let's go. There's great studies on collagen. There's great studies on
where a weighted vest. I wear one all the time now. When I'm walking the dog, when I'm doing housework,
when I'm, you know, walking on my treadmill, which I do a lot of work on my walking desk, but I put the weighted vest on to do it.
Because I'm cheating the system. I'm just, you know, I'm never going to be obese. That is not in my genetics.
It would be a lot of hurt. I could do it. Yeah. So, but, you know, for me, it's avoiding the frailty card. And I want to be
90 and playing on the floor of my grandkids.
Yeah, I agree.
For great grandkids.
You know, I want to be climbing a mound.
I don't want to be on a walker like my mother at 85.
Yeah.
Who can barely get around.
She can't get in and out of the tub.
We're trying to figure out converting her bathroom right now.
She sits on the toilet and does a sponge bath.
That is the best she can do right now.
Wow.
You know?
And that, I know, no.
So I'm doing squats.
Like, nobody's business right now.
Because this is my mother.
So these are the things I talk to my patients about.
They're not coming in saying,
not want a bikini body.
We're, you know, those ships have sailed, and it'd be great.
I mean, who doesn't want that?
But they're like, look, I'm looking at my future.
I'm looking at my aunts.
I'm looking at my mom's.
What plan can I get on right now?
What habits can I change?
What do I need to focus on so that I can be healthy and vibrant as long as possible
and not 10 years of horrible morbidity, not being everything in pain, breaking hips,
breaking, you know.
So 50% of women will have an osteoporotic fracture before they die.
Yeah. And men don't do that. Yeah. You know, like, very few men. So it happens, but it's rare. And so
I want to be like a man. I want to die like a man. They just die. Yeah. They live and die.
We have a protracted horrible last 10 years of our life, completely dependent on others. And that doesn't
have to be like that. So this is what we talk about when we talk about menopause care.
And this is we're talking for straight training is an essential piece of it. Do you think that cardio? Because
cardio is known to break down muscle mass, right?
I think you need a walk, a brisk walk, a brisk walk with a weight in vest.
I stop running.
I start going for my knees.
You know, I might do a few sprints just to get my V-O-2 max going, but, you know,
a few sprints here and there, a little bit of Nevada.
You don't have to go crazy, you know, but like, if you're on the couch, get up and walk, baby.
That's it.
Just walk for me.
The weighted vest is amazing.
Yeah, I love it.
If you, okay, all right, you're walking.
Good.
grab a weighted vest. Let's get some hand weights. Let's, you know, let's work. You have to meet
the patients where they are. And, you know, saying you need to do three days of a
training car, she's going to run out of my office screaming. But, you know, she's like, hey, I'm walking
every day. This used to work for me. It's not working anymore. I measure their muscle mass in
clinic. I have an embody scanner. So I'm doing visceral fat muscle mass. You know, I really can look at
their insides and be like, okay, here's the path you're on right now. Here's what we can do to
reverse this. Yeah. I'm a big believer in training, training for your, for your, for your
bone density for the weight of weight of vest is amazing.
And now the cardiovascular data, you know, women are much less, much more likely to decrease
their risk of cardiovascular disease by 20 to 50% if they strength train.
Yeah, absolutely.
More than men.
Like, they can do less strength training and have more benefits than a man.
They can?
Wow.
They will have more cardiovascular benefits with less work.
Oh, I love that.
Yeah.
Okay, let's talk about semi-glutide.
and the, you know, semi-glutide, the GLP-1.
Yeah.
Is there a benefit for going on something like that,
like the ozempics of the world?
Yeah.
If you are gaining belly fat from menopause or for paramedopause.
So most of my patients, you know, again,
I usually defer to people who have training in obesity medicine.
You know, I don't have, unless my patients are obese,
and especially patients with lifelong obesity,
and they've done everything.
They've done every diet.
You know, this is a whole mind, you know,
it's more than just mindset for so many patients.
But I do think that there's a place.
I have a handful of patients on it.
We monitor them very closely.
Before they leave the office,
they know they're coming back every six weeks.
We're monitoring their muscle mass.
We talk about acceptable muscle mass loss.
We talk about protein intake.
Like going to the long-term success of you being on semi-glutide
where you're going to end up healthier in the long run
is really dependent on the doctor who gives it to you
and how they take care of you and monitoring you.
Weight loss at any cost is rarely sustainable
and rarely better for your health long term.
And the reason why I'm even asking you this question
is because we're talking so much about muscle mass, right?
And keeping, you know, lean muscle mass on your body,
it breaks down your, when you lose weight,
you're losing fat and muscle.
If you severely chlorically restrict,
half of what you lose is muscle, which is why so many people yo-yo, because muscle is what
controls on by some metabolic rate. So you've lost 10 pounds, five of its muscle. You immediately put on
another 10 pounds, you know, you go back, but you've gained 10 pounds of fat, and you could never
get that muscle back without eating all the protein and doing all the resistance training. So
this simoglutide is a tool in your toolbox to be healthy. You cannot ignore the value of
nutrition, of movement in the right, you know, doing the right movement, you know, just getting your shots
and not eating is not going to serve you long term.
But also, when you get off, I mean, you're the doctor.
I'd like to ask you, once you get off of it, your appetite, I would imagine, rebounds.
If you don't change your habits and you go back to your old habits, you're going to gain the weight back.
How do you change your habits?
It's not a habit for, it's not about habits.
It's turning off like your hunger.
I'm seeing something different.
So my patients are using that food noise going away.
that time that they now have in their day as a time to, we talk about this, you know, how they're
in it, this is a multifactual disease.
And we talk about habit changing.
Is they successful for everyone?
No.
But I've seen some beautiful results.
And when the patients come in and they've held onto their muscle mass and they see that visceral
fat going down, they're watching their cholesterol go down.
You know, even in simoglidine plus HRT, they lose 30% more weight, by the way.
Really?
More fat.
Yes.
Wow.
Women, menopausal women on semi-glutide lose X amount.
Women on semaglutide plus H or T lose 30% more.
Wow, I'm signing up.
And they're more likely to keep it off because you're more likely to maintain your muscle
mass if you have your hormones on board, including estrogen.
That's amazing.
I thought estrogen, again, this is a myth.
Doesn't it make you gain weight?
Is it more?
No.
No, it doesn't.
Okay.
No.
Because when I have, whenever, when you're menstruating, you feel like, why do you feel
so bloated and water it's progesterone it's progesterone okay gosh it's a it makes you retain water
which is why we like blow up when we're pregnant is that what is it so high okay does that mean
semi-glutide i've heard there was a correlation between inflammation and that does it help with
inflammation so talking to the obesity medicine specialist this is not my jam right they feel like
because of the lowered insulin levels which is pro-inflammatory they don't feel like the
semi-glutide is in and of itself lowering inflammation, like it's directly acting on certain
receptors that will lower inflammation. They feel like because insulin levels are going down
and that measure visceral fat's dropping, that those two things combined are lowering inflammation
because insulin is a pro-inflammatory hormone. Well, semi-glutide is like an old,
it's like the, it's like the old version. Now everyone's talking about terseptitide. What is the
difference between, they work on two. My friends call it like,
iPhone 12 versus iPhone 13.
Yeah, yeah. That's exactly.
You know, and so patients are having less gastrointestinal side effects, less nausea, less diarrhea,
less constipation on their terseptide.
And now there's so many that are coming out and they're looking at oral versions as well
to make it easier to prescribe.
I think it's pretty exciting in the next, you know, and you think you spent money on developing
COVID vaccine.
These people are spending some money because they know people are going to buy it.
Oh.
And so developing the latest and greatest on.
you know, decreasing side effects and improving efficacy.
Wow.
Okay.
And then how about in terms of supplementation?
Is there any particular supplement that you recommend?
Yeah.
So remember, supplements are not a mid-a-positor.
Take that away.
Okay.
And supplements are meant to supplement a healthy diet.
You cannot swallow a handful of pills and expect to have miracles if you don't eat what
you're supposed to be eating.
Okay.
So most women are not getting enough fiber in their diets.
And so I really advise, try to get your fiber from food, 25 grams per day, push to 30, 35 with your supplement.
Most of my patients are deficient in vitamin D, our gut changes, are we're protecting our skin from the sun for good reason.
We're, you know, there's lots of reasons why we live in climates.
Well, it's sunny today in Texas, but, you know, so massive amounts of vitamin D deficiency.
So I am recommending a routine vitamin D.
I am recommending a certain bioactive collagen for prevention of osteoporosis, pretty good stuff.
studies on that. It's called Forta Bow. Tumric is not for everyone, but I sometimes will recommend
turmeric, especially if they're having osteoarthritic pain. It does seem to help with visceral fat. It's a
pretty powerful antioxidant, anti-inflammatory. So if you're doing teas or supplements, you know,
but just be careful because too much tumor can be liver toxic. It can. Make sure you're
staying. Oh, yeah. Yeah. So, you know, too much of a good thing is not always the best thing.
And so, you know, we have some supplements that we take to correct deficiencies, magnesium is a big one of that.
Others, we can take it a little bit higher doses past, you know, FDA is to keep you out of a deficiency.
Sometimes higher doses of things can be medicinal like magnesium.
So magnesium al-thuronate has been studied in SSRI-resistant depression.
It crosses the blood-brain barrier really well.
And, you know, a lot of my patients use it for sleep.
So, you know, then we're kind of looking symptom by symptom to see where we can shore up.
I'm doing iron studies and all kind of stuff on my patients to see where they're a decision.
Well, what's, okay, you mentioned magnesium.
Which magnesium would you recommend?
Because it's very confusing.
There's a lot of different magnesium forms.
So like milk of magnesium, right?
That gives you diarrhea on purpose.
Yeah.
It's for constipation.
So they're, you know, depending on the formulation, some of it stays in the gut and it makes everything move quicker.
Some goes into the bloodstream but doesn't get into the brain.
So that's like glycinate and tarate.
Some cost of the blood brain barrier are okay.
So most of my patients are on.
for the neuroprotection, neuro and cognitive benefits or sleep or calm.
And so we're going with the eltheronate is what I'm usually recommending.
But probably glycinate's not a bad choice either.
What does that one do?
So eltheronates for your brain, basically, okay?
Yeah, and glycinate crosses pretty well into the brain as well.
It's cheaper, too.
So if there's only one manufacturer of eltheronate like in the world, I know this because
I looked into trying to provide it to my patients and it was just,
too expensive. And so, and he only farms it out to three or four companies, so, or I think it's a
heat. Anyway, so that was a little more pricey. Which one is it, though? He still has the patent on
it, the L-Saroni. No, no, no, I know. What company? Like, which brand? Oh, Magteen and
Neuromag. So life extensions is the brand I get it from. Oh, life extension. Yes, yes, yes. Gotcha.
Okay, good to know. Well, okay, well, listen, thank you for this. I think this is great information.
and I love that you, like I said, I love that you came on this podcast.
You guys, the book is called The New Metapoth by Dr. Mary Claire Haver.
She is an OBGYN.
Are you accepting patients right now?
Not right now.
I'm full.
I have to, you know, we're expanding our clinic, but right now I cannot take home more patients.
I don't blame you.
I have to take care of the ones I have in my little.
Sure.
Wow.
Well, listen, the book is fantastic.
It gives a really good overview of all these things that we spoke about and it goes more in depth.
And I'm really just, I'm grateful that you came on this podcast.
So thank you for being a guest.
You're welcome.
And where could people find more information about you if they...
So we have the pauselife.com is our website.
We have free guides.
We have free, you know, blogs, tons of information, how to talk to your doctor, what tests to ask for, et cetera.
We are all over social media, Dr. Mary Claire or Dr. Mary Claire Haver.
on every channel you can think of, except for Twitter.
I just never got around to that one, and then now it's weird.
But I'm on Facebook and Instagram and TikTok and YouTube or the big ones in Pinterest.
All the things.
All the things.
Thank you.
I appreciate you being here.
And thank you for just some great, very, very pertinent information.
I'm going to send this to all my friends.
Well, thank you.
Thank you.
I'll speak to you later.
And maybe I'll see you.
when you come to L.A. sometime.
Yeah, I'll be heading out there in May, I think.
For, we'll have our people send you the stuff.
I think May 11th will be out there for a few days.
You are?
Oh, my gosh.
I wish I would have known.
I would have had this in person.
I very rarely do these virtuals because it's sometimes very technically challenging.
Let's put it that way.
Yeah.
Yeah.
But I think we're going to make this work.
So thank you again.
with you soon. You're welcome. Okay. All right. Take care. Bye.
