The Body Collective - Menopause & Aging With Confidence

Episode Date: October 24, 2024

In episode 5, we’re talking about how we can find strength as our bodies change throughout our lives. We’re chatting with Dr. Mary Claire Haver about her New York Times bestselling book, The New Menopause, and we’re debunking misconceptions we hold around aging. Plus, we’re breaking down what it means to be an athlete with New York Times columnist Tressie McMillan Cottom. In this last conversation of the series, you’ll also hear what our hosts have learned this season and how they plan to take those lessons with them beyond the show.  The Body Collective series is sponsored by WeightWatchers. The content in this podcast should not be taken as medical advice. Please consult your healthcare professional for any medical questions. You can follow our hosts  Katie Sturino @katiesturino on Instagram   Hunter McGrady @huntermcgrady on Instagram   Ashley Longshore @ashleylongshoreworld on Instagram Tracy Moore @thetracymoore on Instagram And our guests Dr. Mary Claire Haver on Instagram @drmaryclaire  and Tressie McMillan Cottom, PHD on Instagram @tressiemcphd  Stay up to date with us on Twitter, Facebook, and Instagram at @LemonadaMedia.  Joining Lemonada Premium is a great way to support our show and get bonus content. Subscribe today at bit.ly/lemonadapremium.  Click this link for a list of current sponsors and discount codes for this show and all Lemonada shows: lemonadamedia.com/sponsors To follow along with a transcript, go to lemonadamedia.com/show/ shortly after the air date. You can share your story at https://www.speakpipe.com/bodycollective See omnystudio.com/listener for privacy information.

Lemonade. Hey, everyone. Welcome to the Body Collective podcast. We're here to change the conversation about weight. We're going to take everything we've learned about shame, unlearn it, and transform it into a source of power. And I'm doing it with some of my greatest girlfriends. You're going to love them.

Who am I? I'm Katie Storino. I'm the founder with some of my greatest girlfriends. You're gonna love them. Who am I? I'm Katie Storino. I'm the founder of MegaBabe Beauty. I'm a body acceptance advocate, and I am the co-host of this podcast. Hi, I'm Hunter McGrady. I'm a mom of two, a plus-size model, body image advocate, and we are going to dive in. And my name is Ashley Longshore. I'm an artist, an entrepreneur, an author, and an overall wild

woman that loves chicken strips and ranch. Let's do this. My name is Tracy Moore. I've been a broadcaster in Toronto, Canada for over 20 years and man has my body changed over my time on television. Well, let's face it, everyone, we are in a whole new era for the body. With medications on the rise, people seem to be talking about weight more than ever. But how do we do so in a way that feels healthy, empowering and informed? In this series, we're chatting with friends and experts to help us navigate the hard conversations they are hard so we can listen to our bodies, advocate for ourselves, and feel comfortable in our own skin,

the most important thing. So no matter what your journey with weight is, and I know we've all been there, please trust, this is a judgment-free zone. And today, we're talking about how our bodies change throughout our lives. We're chatting with author and New York Times columnist Tressie McMillan Cottom about becoming

an athlete in midlife. And we have a very fun segment with Dr. Mary Claire Haver about her book, The New Metapause. Seriously, let's just get into this. I'm thrilled, truly, to kick off this segment with the one and only Tressie McMillan Cottom. She's a New York Times columnist. She's the author of the book Thick, and she's a sociologist and professor at the University of North Carolina, Chapel Hill.

Tressie, welcome to The Collective. Thank you for having me at The Collective. Hi, ladies. Welcome. Tressie, I, like, full on fell, like, head over heels in love with you at the making the shift. Like, I embarrassingly ran up to you at the end. I put my phone out. I did all the things people do to me and annoy me.

And I clicked it, and I was like, I love you. It was everything you said was so nuanced and so on point. So I just needed to fangirl, and now we can continue. And I remember you because It was everything you said was so nuanced and so on point. So I just needed to fangirl and now we can continue. And I remember you because you looked fabulous. Thank you. Yeah. Well, this episode, Tressie, is about aging, about riding the waves of our body changing.

Tressie, you wrote a very thoughtful and hilarious article about becoming an athlete in middle age, mid age. Tell us more about that, please. Yeah, I like mid-age because, you know, I'm not really sure what middle age is. I remember asking. It's a downer label. Yeah, I remember it was like, scientists or something.

You know, I'm surrounded by these people. And I was like, well, what is the official cutoff? And they really didn't have one. So I think it's just like this thing that we apply to people, especially to women, that is one of those, like, you know it when you see it kind of things, which is why I think I don't like it. If it was just like a box that was like a set number range,

I'd be like, okay, fine, I'm in that range. But I think it's like a judgment call, and that I don't like. But anyway, but I can see it, I'm not young. That's all right. I'm something. I'm hanging in there. Today is the youngest we'll ever be. That's exactly right. I'm not getting any younger. Excellent.

I don't know what happened. When I say that I was not an athlete as a child, I mean, not even in the casual sense. So like these days, I feel like all kids grow up with some sort of athletic, you know, obligate. And I'm like on the cusp there where I was raised by wolves. Like I didn't have intensive parenting, you know, that thing where your parents have a schedule for you on the fridge and your son. No, we just existed.

And so I didn't have a whole lot of coordinated activities like that. And of the ones that I had, they were academic. You know, I was a nerd. And so the only thing I did was like I danced. I was on like a community like dance class for years. But like I don't know how to play on a team. I don't really know how things are scored. I just, that world to me is really foreign.

And so I don't think of myself as a person who athletes. But during the, during the pandemic, you got in, you wrote this wonderful sub stack, which everyone should check out about getting into being on a Peloton and like basically your getting into being on a Peloton and, like, basically, your why for being on the Peloton. Can you tell us more about what inspired you to start moving your body like that? Yeah, COVID happened and I think I felt my body for the first time because we all had to stop, right? So there's this pause and I think all of the distractions that I had to not think about a

body were mostly gone. Right? I'm not on a plane every week, that kind of thing. And I did not do it because I wanted to change the way I looked because again, we weren't going outside. So there was also like just this end of like the, you know, the gaze just sort of went away for a little bit. It's like, who are you if you don't do things because you think people are looking at you? And that really changed my understanding. And as it turned out, when I can be bad at something,

when I can be sweaty, when I can be ugly in the privacy of my home, which is what Peloton just totally nailed for me. So it took away the gaze entirely. Like even the instructor can't see me. And that for me, as it turned out, was amazing. Like there were days I got on and I had on like a cute outfit because I had a cute outfit, you know, work out outfit. There are days I got on in my underwear. Nicole Sarris Oh, yeah. I love working out at home in my underwear. You're struggling without an audience.

Exactly. Another big part was that I got outside for maybe the first time in my life, like deliberately got outside because you remember how hard it was to like leave the house. And so there weren't there weren't a lot of things to do. But one of them that you could do was hiking. Like you could go outside and you could walk. And when I realized that that's all hiking was, it was just walking around. You make it sound so simple. Yeah, well, apparently it is.

That's what I'm saying. I was stunned because if you like, look at how people take hiking so seriously, I thought you had to have all this gear. With the maps. The maps. Yeah, the maps. And I'm not a map reader, you know? But as it turned out, you could just get out there and walk.

Like, nobody can stop you. And that's what I did. I loved the, and I'm gonna look up the hashtag, Tressie Didn't Die. That's it. What a beautiful way though to approach movement because as you say it, you think about all of the barriers that are up for people to actually go to a gym

because a gym feels like a performance. It does. And so when you're at home and you can be saggy and jiggly and not know the moves properly, there is some liberation in that. And I love the idea of hitting some of these milestones in mid-age. There's no limit to when you are going to figure out what brings you joy. And that might be at this time in your life. Am I right? Let's talk a little bit about those whys. So for you, Tressie, the why

was, I'm bored, I'm at home, let's do this, I feel my body, let me see how it feels to have it do different things. Yeah. Ashley, for you, if you're thinking about your why, what drives you? What makes you want to get up in the morning? What makes you want to feel good? What gets you there? What are your whys? I mean, I love to work. I love my job. I love people. I love the idea that anything could happen in a day. I love the optimism of a day. I love the idea that it could be a shit storm or it could rain money.

I love the endless opportunity of a day. What I would love to get to though, and what I love right now about Tressie is that I've been thinking about joining a gym for three years because I feel like I need to be in a situation where I'm not leaving that class because I would feel bad if I did because everybody would see me.

I would love to come in tune with that connection with my body and myself for my mind. Again, this isn't about aesthetics, to push myself to be disciplined enough to do that. I don't know how to carve out the time in my day between what inspires me with work and my career and doing this for my mind and my health, my health, not aesthetics, health. Yeah. So I will say one of the things that helped or that I discovered in doing, and I've moved on, I'm like you have kind of now gone back to a gym,

but a very different kind of gym, by the way. So I also learned there are different types of places and I didn't think I understood, like there are different gym cultures, different workout cultures. Because again, I didn't grow up with it, so I didn't think I understood. Like, there are different gym cultures, different workout cultures. Um, because again, I didn't grow up with it, so I didn't understand. But the thing about working out at home for me was exactly this, Ashley.

You can do it for... There was times I got on that bike quite literally for five minutes. But five minutes counts. I mean, like, literally everything counts. I'm going to tell you my why. My why has just recently come into view. I'm a former D1 college athlete.

I love a physical challenge. I love competition, but I'm also just like Ashley, it's hard to prioritize that in your day when you have 50 other plates in the year. But in the past six months, I would say that a new thing has come into focus. My parents are aging. I'm watching that like them and my relatives struggle.

And I'm like, oh God, I have to move now so I can move then. And this is the first time in my life that has really clicked in. Yeah. That it's actually like, oh, like I could be 70 and like not able to pick up a bag of groceries. Yeah. Yeah.

It's going to sound really, really trite, but there was this Instagram reel, you know, whatever that I saw during this sort of transformation in my life. And it was a trainer showing the connection between the move you do in the gym and the move you would use that for in real life. So she's like, oh, you deadlift so that you can pick up the laundry, you squat so that you can do this. And she showed it really like visually, you know, like at kindergarten level.

And for whatever reason that super resonated with me, like suddenly there was a purpose for the movement. And I was like, oh, yeah, no, because, yeah, I want to be able to, like, lift the thing over my head. I want to be able to pick up the garbage. I want to be able to put my luggage in the overhead bin, right, without any help. And for whatever reason, and I think of that still to this day,

especially when I'm lifting. I'm like, oh, yeah, I'd do this for that. Yeah. Yeah, it gets in your brain. It got in my brain when I'm lifting. I'm like, oh, yeah, I'd do this for that. Yeah. Yeah. I saw that reel. It got in my brain. I saw that and I was like, yes. Finally, someone talking about, like, I don't look like the typical gym person, but that's why I'm doing it.

I don't want to be able to take my groceries into my house. I've got to get my act together. I've got to do this for myself. Ashley, we can do it. No, we can do it together too. Or, you know, like, I love a motivation buddy. Tressie, what advice do you have for women whose body compositions are changing due to, like, pregnancy, perimenopause, menopause?

Uh, so, you know, yeah, your body changes. Uh, listen, you talked about perimenopause. Like, it's, you know, it comes for you, and it does not send RSVP first. It is wild. Uh, I honestly, but comes for you and it does not send RSVP first. It is wild. Honestly, but weirdly for me, my body changing has been a little freeing. So like, I now know what I'm fighting against.

When you're young, it's like, oh, you have no excuse, right? You're young, all your hormones are good. So if you don't look the way you should look, if you're not the size you should be, you're just a lazy, bad, immoral person, right? In a weird way, like the expectations have been lowered for me. And so now I'm like, no, I'm solidly built.

Like that's great. Like I have embraced the like diminishment of expectation that I should be sexy all the time, that I should always be fit, that I have no excuses. And I am welcoming that because now, if I exceed your expectations, it's a lot easier to exceed your expectations. Now people are like, oh, wow, you look so great.

And I can hear the implication is for your age, and that's fine. All I take from that is, wow, you look great. Like, I don't care what the reference point is. So embracing the fact that the bar has been lowered for you is really great. Two things before we say goodbye to you. I wanted to say I have a girlfriend who always used to say, even when we were in our 20s, she's like,

don't I look so good for like a mama four, like in her 40s? Like she used to say that in her 20s. She was not a mama four. She's still not a mom of four, like in her forties. Like she used to say that in her twenties. She wasn't a mom of four. She was not a mom of four. She's still not a mom. And now she's 50. And she used to say that at 25, like, wouldn't I look good? And we'd be like, yeah.

I see, I love that. I loved it too. I'm like, this is great perspective. But also your friend Tara that you mentioned in your sub stack, who was like, I want to be mid age because I can do whatever I want. And we have this thing in our house that's like, we're grownups. Like I say this to my husband, like we're grownups.

No one can tell us it's bedtime. And there's something so beautiful about that. So thank you for that perspective. Thank you for saying that. And yes, and shout out to my friend Tara. She did, she totally changed my whole worldview on this. She said she'd wanted to be middle age her whole life. And I was like, what?

She was like, she wanted autonomy. She wanted control over her life. She's like, and I'm here, I finally got it. I can, yes, I can sleep whenever I want. I can take that trip whenever I want. You know what the problem is, I think, is that we confuse being a grown up with doing the things that we should do, when really being a grown up empowers you to do so much

of what you want to do. And so Tara, just remind, if you're not doing something you want to do, nine times out of ten, that's on you now. Yeah, you're right. Middle age needs a rebrand. They need a new PR team. It really does. It's freedom. It's total freedom.

I agree. Love. Tressie, we had such a great time with you. Where can people find you? Oh, well, let's see. They can find me online. My username pretty much everywhere is Tressie MC PhD, Instagram, TikTok these days, not on Twitter so much anymore, but all of those other places. And they can always read the column in the New York Times. So awesome. So cool.

Thank you. Love you. Love you. Thank you. After this short break, we're joining New York Times bestselling author, Dr. Mary Claire Haver to talk more about staying strong as our bodies change. Hey, listeners. At Weight Watchers, we're all about building a community to support you through any stage of your life journey.

That's why we created the Body Collective. Here's a clip from a real Weight Watchers member speaking about their experience, sharing how vital that power of community is when it comes to health. Take a listen. I know for a fact one of the reasons I have been so successful on my Weight Watchers journey is the Weight Watchers community. The Weight Watchers community has been instrumental in my success providing a strong support system that makes all of the difference. From sharing tips and recipes to celebrating all of our wonderful milestones together, the camaraderie is truly uplifting. Knowing I'm not alone in my journey has motivated me to stay

accountable and inspired. There are so many different people from different walks of life, and we have a commonality together, and that's us together on a weight loss journey. This collective encouragement has transformed what can be a challenging journey into an uplifting and empowering one. are you a pop culture connoisseur with strong opinions? Join us on Pop Culture Debate Club, a new podcast from Lemonada Media and the BBC. Each week, two pop culture experts battle it out

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you get your podcasts from Lemonada Media and the BBC. We and me personally are so excited to welcome guest Dr. Mary Claire Haver to talk about her New York Times bestselling book, The New Menopause, Navigating Your Path Through Hormonal Change with Purpose, Power, and Facts. Plus, we'll get into how to find strength as our bodies change throughout our lives. Welcome to the show, Doctor. Thanks for having me. Yes. So honestly, this is, I talk about this all the time, a lot to myself, a lot to my husband, and sometimes on the internet. I am wondering if I am actually in perimenopause.

I read that when you started perimenopause, you were shocked to find so little resources available, and that made you spring into action. Can you please tell us about your experience? How did it go down for you? So I was in a state of confusion. In my medical school, we received maybe a one hour lecture on menopause total. And the word perimenopause was never mentioned

in a four year curriculum. Wow, that's crazy. Then I did four years of obstetrics and gynecology. And obstetrics as most of us know is everything to do about pregnancy. Getting pregnant, staying pregnant, postpartum, all of that. That's a little more than half of what we spend our time on.

And everything else about the health of a woman gets shoved in the box of gynecology and it's really important stuff. Oncology, pediatric gynecology, reproductive endocrinology, and then menopause is just this afterthought, really. And I think we received maybe six hours total of lectures in four years on menopause. And we had no menopause clinics or like someone holding our hand through the process of, you know, what happens when we

lose our estrogen production from our ovaries and how to treat that patient. It was not, it was just kind of like, okay, you need to check these boxes and answer these questions correctly on a test. But I was never sat down with patient care in those four years and taught like, this is how we manage these patients who are going through all of these different symptoms. Wow. Preparing menopause, which is the transition to menopause, which can

last seven to 10 years before your last menstrual period, so between 35 and 45, it's happening for the vast majority of women. It wasn't even mentioned. It was an afterthought. So here I am in clinical practice going through perimenopause, gaslighting myself. I had no idea it was 35 to 45 that was perimenopause. People think that's so young, right?

But that's actually the norm. Well, and then we have this entire generation of clinicians who have never been taught anything about this. And these women are coming in with all of these vague complaints. And they're like, ah, tough to be you, just part of being a woman, because that's what they were taught.

You know, it's not that they're bad people. We just are doing a terrible job educating our clinicians about, you know, the entire menopause transition. Listen, I'm definitely in it. How would Katie know if she's in it? What should she be looking for, what should she do? Great question. So in my clinic, I listen to the patient and I believe her. How would Katie know if she's in it? What should she be looking for? What should she do? Great question.

So in my clinic, I listen to the patient and I believe her. I do blood work to rule out other things that also kind of look like perimenopause, like sometimes autoimmune disease, you know, muscular skeletal disorders, you know, chronic headaches, hypothyroidism, hyperthyroidism, you know. In medicine, we love a duck if it walks like a duck Yeah, we have boxes and lists and you rule out all these things menopause and perimenopause are really weird ducks because each of us have our own genetic expression of How this loss of sex hormones or this perimenopause is the zone of chaos, and then postmenopause is flatlining.

And so actually what we're learning now is you're much more likely to be symptomatic in perimenopause. Things kind of come together once you go through postmenopause. I mean, the thing that people talk about all the time is hot flashes. That is the extent to what I know about menopause.

And I'm finding if it is in fact, it sounds like I am in perimenopause. I've noticed personality changes. Like I'm a raging bitch maybe two weeks out of the month versus like a few days before my period. My period is still regular. I've also noticed pain in my shoulder, like just different things that I've seen.

And I'm like, oh my brain fog. Oh, the brain fog. my shoulder, like just different things that I've seen. And I'm like, oh my brain fog, oh, the brain fog. Feels like I have a lobotomy every day. Let me walk you through, let me blow your mind here. Okay. So every month when we're ovulating in a healthy person and a healthy patient, you have the brain gets involved.

So we have a couple of glands in the brain called the hypothalamus and the pituitary glands. You've probably heard of those. Okay, and they are sending signals. So the hypothalamus talks to the pituitary. Pituitary sends signals to the ovaries. It's time to ovulate. Because the hypothalamus has a little finger

in the blood supply constantly checking for estradiol levels. And when they get low, it sends a signal to the brain. And that leads to a very predictable ebb and flow of hormones, very reproducible month after month after month. So 28 days, 32 days, 26 days, whatever it is for you, you have this rise and fall that is very normal for you of where your estradiol hits, where your progesterone hits, when they hit. Day 14, you this, day 28 you do this, day 16 you do that. And it goes month after month after month.

Perimenopause begins when we reach a critical threshold in our egg supply. So at birth we have about one to two million eggs left because our maximum egg supply is when we're five months in a year in a row. Like in the womb, in the mom, growing five months, you're five months along, mom is five months along, that's when you have your max eggs.

So you start losing them immediately. One to two million at birth. By the time we're 30, we're down to about 10% of our egg supply. By the time we're 40, we're down to 3%. Okay? So now you're like seeing the process. Yes. For whatever level that is for you, when you reach that critical threshold, those signals coming from the brain, it's getting harder and harder for those same signals to work

because we don't have as many eggs and the quality is much poorer because of age. Okay. So what used to cause an ovulation no longer does. So the signals go down and the ovary is like, sorry guys, not enough, can't really do it. I'm trying, but it's not working. So the brain gets mad and the brain says, hey, where's my estrogen?

And the pituitary is like, dude, we sent the signal. And they're like, send more, send it. So all of a sudden we get these bigger bursts of those stimulated hormones in order to force and push that ovary to get that egg out that month. So we have delays in our ovulation and then those bigger bursts are leading to higher estradiol levels. So what used to be an EKG look in chart, if you've ever seen those ovulation charts, seven flow month after month is now chaotic. We have

much higher rises of estradiol, much bigger drops, progesterone never quite gets to where it's gonna be. And the timing is very, very chaotic. That leads to, now let me blow your mind again, we don't just have estrogen receptors in our breasts and our uteruses and our ovaries, right? We have them in every single organ system of our body. And the thing that gets the hardest, hit the hardest in perimenopause is the brain.

Wow. 40% increase in mental health disorders across the menopause transition, and brain fog, our loss of cognitive abilities. What? Wow. And we're just letting women walk around like this? Thinking that they have dementia. No.

Yeah. That is honestly how I feel. I feel like that. I feel crazy. Imagine I was a straight A student. I blew the top off of all of my boards. I did every review course demanded of me every single year to keep up my OB-GEN certification from the American College of OB-GEN.

I had not heard of any of this. Wow. Until I got curious and self taught about menopause because I realized I sucked and I couldn't, I wasn't taking care of patients the way they deserved. And I was suffering and I couldn't, my husband's like, fix yourself. You're a smart girl. You know, like. What did you do? So I learned, you know, I read everything. I started in the nutrition area. My first frustration, or my patient's frustration, sadly, because it was more cosmetic than truly health related,

was weight gain. And so weight gain in the form of abdominal fat gain. So sure, things were getting curvier in other places, but like belly, I remember my patients would sit there at their well, woman, bless their hearts, I've taken care of them for years and grab their tummies and shake it at me and say, what is this? And for years I would pat them on the knee. I was a terrible menopause doctor forever and tell them I work out more at less. No, because it's all they taught me in medical school. Work out more at less, she's fat because she's lazy. Like none of the bio-cyclosocial impacts, none of you know, GLP once was not a thing.

And so I have this bias in my head and I had been privileged so until it happened to me. So my first like toe in the water was what the hell's going on with the weight gain. And so I reached out to the PhD nutritionist at the university I was employed at and was like, okay, this is not how, you know, why is this happening? They're like, well, we know a lot about inflammation, something's happening with menopause, here's a bunch of articles. And I just went down rabbit hole after rabbit hole after rabbit hole, and my

mind was blown. And so from there, so then I started talking about it on social media, like the weight gain and why it might happen. And here's some nutritional things you can do and like eat more fiber and more protein and no, no, no. And so my social media world exploded just because I was talking about menopause. We blew up on TikTok, you know, and then Instagram

and yeah, but as that conversation continued, the questions were pouring in. What about my brain fog? What about my knee pain? What about my shoulder? What about... So I'm doing all these deep dives and realizing I need to write.

And people are begging me to write a book because I'm teaching, teaching, teaching, teaching. So that's how the new menopause came out was just me answering questions on social media and realizing there are connections here. I'm starting to meet other people in this space, go into these conferences, realizing this is much bigger than a hot flash. So doctor, I wanted to ask you something about that because part of the menopause research

has actually been good for my body image issues and part of it has not. And I'm going to, I'm going to explain. So I'm in perimenopause. I always had a waist, always had a flat stomach. Didn't matter what my boobs and my thighs were doing. It was pretty flat. And all of a sudden, so there's weight in the middle now, which was new, and I haven't really done anything different. I'm definitely a fitness warrior. I eat what I like to eat, but I like to feel strong. So one thing that I found, which was eye-opening and good for my body image and self-image was that we should be more concerned about visceral fat,

like the fat on the inside, than how our body actually looks. And I thought that that was important. It's important to test what's happening inside because that's the stuff that can be potentially deadly or awful for your organs or for your health. But on the other hand, I see some of these diets that are related to perimenopause. And sometimes they kind of get me in my feelings a little bit. They feel a little bit restrictive. So can we talk a little bit about that? Like, can

we talk about what we actually need to be doing without making women feel worse and giving them disordered eating, that sort of stuff? To completely validate what you went through. We've got great studies looking at visceral fat. So we can measure that with a DEXA scan, waist-hip ratio or abdominal circumference is a reasonable way to kind of track it much more significant than your weight or your BMI for tracking your risk of chronic disease.

Preach, that's great, good. So let me blow your mind third time. A woman with no changes in diet and exercise, age match because we all go through menopause at different ages, right? So a premenopausal woman of her body fat distribution, 7% on average is visceral fat. That's a healthy range. We need some fat on the inside to keep the organs from pressing against each other, right? We need a little bit.

It triples to 23% through the menopause transition with no changes in diet and exercise. You know what else changes? Her insulin resistance, her systemic inflammatory markers, and her cholesterol. Her LDL goes up, HDL goes down, just from being menopausal. Oh, my cholesterol is so high. Right. And you didn't all of a sudden start changing your diet, right? No. It's like on a this. Like that's what the chart looks like, you know? So to answer back to answer your question,

what would be my top nutrition tips for women in perimenopause? It's more about eat more not less, which is the most beautiful way to live when I lived all of my, you know, the first 48 years of my life, dieting and trying to be thin. And my whole goal was thin is healthy. So I need to eat less. And now I have to eat more all the time.

And it's so much more fun. So I, fiber, you need fiber, lots of fiber. And so most women are getting 10 to 12 grams of fiber in their diet per day in the typical Western diet. When we need 25 minimum, the cognitive benefits and health benefits max out. getting 10 to 12 grams of fiber in their diet per day in the typical Western diet. When we need 25 minimum, the cognitive benefits and health benefits max out summer for us around 38. Wow.

So that's like, what are things rich in fiber? Legumes, which are beans are part of that. Avocado, chia seeds, flax, hemp, berries, you know, lots of things that are crunchy or rich. I take a fiber supplement. Do you think that it goes in water and I drink it? I take a fiber supplement as well. I tell my patients really fight to get that first 25 grams through food. Okay. Because fiber rich foods are rich in a whole lot of other great stuff that we need and give you other health benefits. And so if you can get 35 with food, you don't need a fiber supplement. Wow.

But it's smart for a lot of us. So fiber feeds the gut microbiome, slows the absorption of glucose into the bloodstream. So we have a more steady state, you know, moves stool a little bit quicker through, absorbs water. I mean, there's no downside to fiber. It can cause some gas, but your gut usually adjusts to that. Yeah. And so lots and lots of fiber. Really quickly, I want to switch gears because you had mentioned how women walk around thinking they have dementia, right? And the mental health aspect between hormones and menopause, and I know

that you are so passionate about destigmatizing the idea that women are quote-unquote crazy when they experience these hormonal changes. Can you talk more about that and what you're hearing from women on this topic? So one they're so happy to have validation especially with the brain fog and really recognizing what an impact this has on our day-to-day life and knowing that for most of us, the brain fog will, it may take a few years, but it does tend to get better. Years. Years. So can I ask you, so are there any, I read, did you read the book All Four's? Mm-mm.

Okay. All Four's is a book that came out as very popular summer read and she talks about being in perimenopause and she gets on estrogen replacement therapy. And I know I'm cutting you off right now. And I, but I'm just, I'm wondering, is that an option for people and myself? But I've avoided hormonal birth control my whole life because I was told extra hormones are bad for you, but now I'm shifting my mind.

Do you think that that's? So, well, you know, hormones kind of get painted with a very broad brush. And those of us in the menopause see and really, not only are we conducting research, reading everything that comes out on a day-to-day basis, and clinically taking care of patients, which I think is the trifecta of why we're able to shift the menopause conversation because we actually believe our patients when they tell us what's happening. There's a difference between the synthetics

and what your ovaries made naturally. And we can't assume, like we don't assume all blood pressure medicines work the same or all cholesterol medicines work the same and don't have different side effects or whatever. So great studies coming out right now looking at mental health changes in the menopause transition, so perimenopause, right? And hormone therapy in the form of estradiol, plus or minus progesterone,

is showing to have better clinical benefit to the patient than the SSRIs. Wow. Now that does not hold postmenopause, but this mental health disruption, so worsening, like previously well-treated mental health or new onset, most of the psychiatrists who are in this area are recommending beginning, stabilizing her, giving her back the hormones to stop that crazy feedback from the brain, that chaos, calm the chaos down. It seems to work better than the SSRI. Now, I love SSRIs. I prescribe them. I'm not knocking them, but they're over prescribed in menopause.

Yeah. Oh, wow. So, if you go to your doctor in 2023, they looked at the study. Only maybe 40% of patients were offered any treatment for her menopause symptoms, and this is hot flashes. This is just recognizing the old menopause, sleep disruption, hot flashes. 40% of women only offered, and four to one, it was an SSRI versus hormone therapy. Doctors, we lost an entire generation of clinicians learning how to prescribe it safely, the differences, the nuances. And they're like, hey, just try this. Everybody knows how to prescribe it safely, the differences, the nuances. And so, and they're like, hey, just try this. Everybody knows how to prescribe an SSRI. And so, we

have a lot of work to do. I've got one last question. We talk a lot about shame and unlearning here on the podcast. And I'm wondering, do you think age brings a pause to negative self-talk? It's not about external validation of how my body looks, which is a privilege I had for a long time. That has gone and that is probably age and wisdom and raising two daughters who I don't want them to go through that mental beat down. We celebrate their curves, their bodies, their strength, their resilience. Love that. I like leaving on the note of menopause being a good time in your life because I think we

need more messaging in that area so that women will go ahead and get the help that they need and not feel that shame at this time in their lives. So thank you so much for that, Dr. Mary Claire Haver. You're so welcome. Can you tell us where can people find you? We have a website at The Paws Life and the book is available everywhere. It's called The New Menopause. And on social, I'm Dr. Mary Claire. Great.

Love it. Thank you so much. We'll be right back. Ladies, I cannot fucking believe that this is our last episode of the series. This sucks. No. Before we go, I want to take some time to reflect on what we've learned and what we've unlearned in our time together. You know what, it's it's the radical honesty for me. It's the fact that you can see for powerhouse women who are making a name for themselves just by being themselves but are still stuck in the trap and the constructs that have been here

for eons and eons. And it's like, I know that sounds sad, but it also reminds me that we are actually dealing with a lot. Unlearning is a lot. It's a lot for people that are intentionally doing the work. And I can't even fathom how trapped folks feel that have not even started doing the work. And I can't even fathom how trapped folks feel that have not even started doing the work. So for me, it's nice to be in community with women

that can be honest about the fact that we are up against a lot. And we still understand the usefulness and the joy on the other side of figuring it out, of having a beautiful, big, full life where you can master all the goals and eat the cookie. I mean, I just feel safe with you guys. I'm such a crybaby.

No, you're not. It's so emotional. I think it also just goes to show you show you like if you surround yourself with amazing people, women, friends, support systems of people that you can be real with, you can really touch on some deep, deep things in your life and you will always feel better afterwards. And I just love you guys. I really do.

Oh, absolutely. I love you guys. I really do. Oh, absolutely. I love you too. I love you guys. It's been very therapeutic. It's been like my little dose. I have my regular therapy, but then this has been my little dose of friend, sisters therapy, where we're all over the world.

Tracy was just saying, doing spectacular things, making names for ourselves. But I think that this is also a call out just to women everywhere out there and men too. We're really not all that different. Right now we live in such a divisive world, a world where we are often put, pinned against each other. And when you really break it down, when we really unmask ourselves, we're really not all that different. We're the same. We want the same things. We want to be valued. We want to be heard. We want to be seen. And I hope that we brought that to with this podcast.

And our strength is in our vulnerabilities. Really, it isn't about all the, you know, it's amazing when we feel gorgeous. It's amazing when we're successful at work or our relationships. Yes. But honestly, the connectivity is about when those things are not going right. Yes. And we can share those moments with accepting, kind, like-minded people who are also willing to be vulnerable. There's so much strength and magic in that. That is just the ultimate armor, honestly. That's how I felt recording this. I felt almost like I walk through the world doing this work kind of alone.

And Hunter, I know we've talked about this, where you kind of have to strap on the armor and go through it and help people and teach the teachings and learn. But this podcast allowed me to kind of take that armor off because I was suddenly surrounded by three women who could hold, oh boy, okay, who could hold my emotions and my feelings in a way that I don't typically get to feel surrounded by? Because I feel like I'm usually the one in the role

of helping someone else feel or change. And you guys really did that for me. I have left every single one of these episodes with something I have learned or a new thought or just a new emotion to process. Yeah. I just gotta say, but once again, this podcast has opened a lot of stuff up for me

and shaken some stuff around. Yeah. And there's, like, work to be done for myself. Oh, for sure. Same, too. And really, and what you be done for myself. Oh, for sure. Same too. And really, and what you guys said kind of off camera, we just talked about this, was a lot of it is the self-criticism I have around stuff that I do, which I wasn't even aware that I'm doing that.

And I feel like I can hear it in this podcast or the after effects of the pod. And that is certainly something I want to work on. What do you mean? Like you criticize all the work you're doing? Yeah, I'm like, well, you bomb that. No. Yes, yeah. So I'm really, I'm way too hard on myself

is what I'm hearing and I'm realizing. But it's not just about this, it's about other things too. Not my body, but a lot of other- Your performance. Yes. Yes. Professional stuff. I'm like, well, of course. Imposter syndrome, big time. Yes. It's not who I am.

Can I tell y'all something? And I don't know if I've already talked about this on here or not. I saw this quote, maybe it was like a week or so ago, and this is, it has like gotten deep in me and fucked me up in the best way. It's the what if, what if I sucked? What if I didn't sound right? What if I completely screwed this up? What if I fall in my high heels? Versus, even if.

Oh. Even if I'm not my best. Even if I fall in my heels when I walk in this restaurant to meet somebody, even if I feel fat as hell today, even if somebody comes for me on the internet about how I look, even if I decide I want to try the ozempic again just for my own self, even if, guess what? I'm gonna fucking be all right. Yeah.

Instead of what if. You're still worthy. Even if. Even if. That's a good reframe. Isn't it? Isn't it good? From what if to even if. Because you're gonna be fine, despite any of the things. We're gonna fucking be just fine. You're gonna fucking be just fine.

You're gonna be good. Yes, yes. Amen. My God. I know, I know, I know. I want to run through a wall. Yes. And there's like the shape of Hunter, just like when you go through the wall, you know? Yes, yeah.

And finally, sadly, I don't wanna end. Listeners, I hope you don't want us to end either. Tell someone about it. We have talked a lot about unlearning shame and living in a world without an emphasis on our bodies throughout these five episodes. I wanna take a minute to really envision that ideal world. What does it look like?

What does it feel like? Let's do a little manifesting as an exercise of this show. Okay, so like what is it? I feel like clothing shopping is a different experience. How do I want it? I would love to be able to walk into, you know, big fancy places, because damn it, I'm financially independent.

I got money to spend. Yeah, pretty woman. And to not just go to the shoe department. No. Where's the cape section? Yeah. I would love to be able to go on a trip and be like, oh my God, I brought the wrong thing.

I need to go buy a dress and not feel like I can't go buy a dress. Yeah. There's so much involved in me having to plan out my outfit. Yeah. I'm closing my eyes. I'm manifesting. I'm manifesting to be able to exist in my body without it being brave and without it being a topic,

without it being something political, without it being something that is up for discussion. I just want to exist. I want to post a photo and exist and that's it. Like everybody else in a smaller body. I want that conversation that we are so obsessed with to stop because we are so much more than our bodies.

I want to be able to sit around a table with a bunch of people, but preferably women, and everyone is a different size and everyone is a different shape and it never comes up. And what's on the menu is only discussed for the flavor. Yeah. And what we feel like in the moment. And the conversations are about pumping each other up or talking about our real life vulnerabilities. And our bodies are none of our business and none of anyone else's business.

It's not, it's a non-conversation starter. That's what I want. Yeah, I love that. Okay, that's a wrap on The Body Collective Season 1. We had so much fun getting to know y'all and hearing your stories. And we know it's not always easy to have these conversations, but we hope you've really learned something along the way.

I know we did. Also, can we just say thank you to Weight Watchers for giving us this platform to have this conversation? I don't know about you guys, but I really wasn't sure what it would be like to work with such a big brand and specifically Weight Watchers, but they are evolving. They're evolving with the culture and science and they're ready for these hard conversations to change the way we talk about weight. Yeah, I'm grateful.

Yeah. Let's keep it going. Let's keep it going. Ah! Ah! There's more of The Body Collective with Lemonada Premium. Subscribers get exclusive access to bonus content like outtakes that didn't make it into the show. Subscribe now in Apple podcasts.

The Body Collective is a production of Lemonada Media and Weight Watchers. Your hosts are Hunter McGrady, Ashley Longshore, Tracy Moore, and me, Katie Sturino. The Body Collective series is sponsored by Weight Watchers. The content in this podcast should not be taken as medical advice. Please consult your healthcare professional for any medical questions. This series is produced in sound design by Mariah Gossett. Additional sound design and engineering from Ivan Karyev. Music by APM and our senior supervising producer is Kristin Lepore.

Our VP of narrative content and production is Jackie Danziger. Executive producers include Stephanie Whittle's Wax and Production is Jackie Danziger. Executive producers include Stephanie Whittle's Wax and Jessica Cardova-Cramer. Series consulting and production support from Anna Pascal, Kelsey Merkel, Lauren Seinfeld and Vivian Walsh. Help others find our show by leaving us a rating and writing us a really, really great review. Follow The Body Collective wherever you get your podcasts or listen ad free on Amazon

Music with your Prime membership. Thanks so much for listening. Bye bye. Hi, everyone. Gloria Riviera here and we are back for another season of No One Is Coming to Save Us, a podcast about America's child care crisis. This season, we're delving deep into five critical issues facing our country through the lens of child care, poverty, mental health, housing, climate change, and the public school system.

By exploring these connections, we aim to highlight that child care is not an isolated issue, but one that influences all facets of American life. Season four of No One Is Coming to Save Us is out now wherever you get your podcasts. Why, hello there. This is your pal, Sarah Silverman. You know, the stand-up comic that's not afraid of a diarrhea joke. Oh my God, I'm so brave. I hope you're enjoying this podcast that you're listening to. I am just dropping in here to let you know about another podcast I think you'd like, and it's called the Sarah Silverman podcast.

Each week listeners from all over the world call in and they ask me for advice or they talk about something going on in their life, anything, their silly, asgrosest, deepest, darkest situations, and then I respond whether I'm qualified to or not. Go ahead, search for the Sarah Silverman podcast wherever you get your podcasts. Bye.