This Is Woman's Work with Nicole Kalil - 179 / What You Need to Know About Menopause with Thara Vayali

Episode Date: January 11, 2024

Did you know that menopause happens in ONE DAY? Well, if you didn’t (like me) you need to listen to this episode. It’s about preparing yourself in your 30s and 40s for this inevitable transition, and because I’m not a doctor I’ve invited Dr. Thara Vayali to join me. Thara is hey freya’s resident doctor of naturopathic medicine, a nutritionist, herbalist and supplement formulation expert with over ten years of clinical expertise and over five years of experience in digital health. She practiced as a licensed naturopathic physician in British Columbia, Canada and has over 10 years of clinical experience in women’s health. She speaks internationally and writes about health and wellness, stress, resilience, empathy, and mindfulness. I don’t have a lot of regrets, but the biggest one is not appreciating, valuing, listening to, or understanding my own body for most of my life.  I know none of us would wish this for our daughters, sisters, nieces or best friends. And I certainly don’t wish it for you. So let’s talk about and celebrate our bodies. Let’s share resources, experiences and information!  Like what you heard? Please rate and review  Connect with Hey Freya:  Visit the hey freya website: https://www.heyfreya.co/ (promo code: heyWORK25 for 25% off) To take the at-home Stress Test, click here To learn more about Thrive, the women’s daily multi-vitamin with stress support, click here To shop other products, like Rest (for great sleep), Quench (to help with hydration), and Calm (to reduce anxiety), click here For all products use promo code heyWORK25 for 25% off!! I personally use their Thrive & Nourish Supplements and love them! For CakesBody’s grippy, not sticky, nipple covers visit cakesbody.com and use Promo Code: TIWW to get your 10% discount!

Hey there, podcast family. Have I got some ridiculously cool news to share with you. You might remember back on episode 96, we featured Casey and Taylor Capuano, twin sisters who started a business that I predicted would be the million dollar idea. Well, they were just featured on Shark Tank and have gone way past that million dollar mark with their grippy, not sticky, reusable and seamless nipple covers. Offered in different sizes and for different skin tones, Cake's Body is reinventing the traditional bra, preventing nipple freakout across the globe, and donating a dollar for

every product sold to women's health causes. And here's the icing on the cake, pun intended. As a special treat for our listeners, Cake's Body is offering 10% off your purchase with promo code TIWW. I wear my cakes daily. It wouldn't get on a stage, go out for dinner, wear a swimsuit, or run on the treadmill without them. Visit cakesbody.com or use the link in show notes and be sure to use the promo code TIWW to get your 10% off. I am Nicole Kalil, and one of the things that shocks me the most about being a woman in the 21st century with all our access to information, our global connection, and the

amount of actual experts and so-called experts that are out there in the health and wellness space is that so many of us still have no idea what to expect, very little access to solutions unless we go searching for them, and still feel shame about the things most of our bodies do that they are literally designed to do. I mean, it wasn't until my mid-40s that I even heard about cycle syncing, and I was still hiding tampons up my shirt sleeve when I would head to the bathroom in corporate offices just a few years ago. I didn't know until a couple of my girlfriends told me that I might poop on the table when giving birth and that hemorrhoids and buckets of tears are a normal part of postpartum or that my nipples might feel like they were on fire and actually cause me more pain than childbirth itself. I mean, I had three different medical experts misdiagnose me until I finally did the research and figured out myself that I had thrush, which is a very common symptom when breastfeeding that I didn't know about. All I knew is that feeding my child was the most

painful thing I'd ever experienced. And it took every ounce of self-control and love for this tiny human to not toss her off my boob to make it stop. And now I'm yet approaching another one of these things that most women will experience and I know almost nothing about. And I visited three different doctors, had blood work done, vaginal ultrasounds, you name it. And I am no closer to knowing what to expect or how to really support myself through menopause than I was before. Now, you may not be anywhere close to menopause yourself as the vast majority of our listeners are younger than I am, but I am still going to encourage you to listen because you should have an idea of what's coming. Because I don't want you to feel wholly unprepared for this inevitable stage of your life.

Because I don't want this to be another thing that any of us go through feeling alone or ashamed, confused, or conflicted. For me personally, I have no issues with the aging part of menopause. I welcome it because I fully embraced getting older and I equate it with getting better. As it relates to confidence, women's confidence peaks and even surpasses men's confidence in their 60s. And I can't freaking wait. I'm going to give zero fucks and it's going to be so good. And I can feel myself getting closer. I still give a few fucks, but not nearly as many as I did when I was in my 30s. So we'll touch on the aging part, but what I really

want to focus on is the experience of menopause and perimenopause and what we should prepare ourselves for. And because I'm not a doctor or any sort of health and wellness expert, I've invited Dr. Thara Viali to join me. Thara is Hayfraya's resident doctor of naturopath medicine, a nutritionist, herbalist, and supplement formulation expert with over 10 years of clinical experience and over five years of experience in digital health. She practices as a licensed naturopath physician in British Columbia, Canada, and has over 10 years of clinical experience in women's health. Her path to motherhood and recognizing how many of us feel helpless in our healthcare journey

has compelled her to advocate for a broad scale awareness about women's physiology and body literacy. She speaks internationally and writes about health and wellness, stress, resilience, empathy, and mindfulness. Thara, thank you so much for being here today. I'm so excited personally to have this conversation because it's been very challenging over the last few years. So again, thank you for being here. And I want to start by asking, why don't we as a society know more about menopause? Is this just a me thing? Like, am I not paying attention or is this actually happening?

Well, first, absolutely not. This is not just a you thing. This is widespread across our whole nation, across our society in general. I think one of the things to recognize here is it isn't just about menopause. And you've stated this prior and in the introduction, really stating that each stage that you arrived at, you felt wholly unprepared for. And I think this comes right back to really the misogyny implanted in us right at the beginning, which is as soon as a female starts to menstruate, most of the knowledge about her body gets taken away from her. So it immediately gets handed over to a healthcare professional who's going to help them make that decision.

So there is very little what I call body literacy is awareness of the physiology of what's actually happening in your body, given whatever's going on. It starts with bleeding, bleeding out of the uterus. There's very little information given to a teenage female around what that even means in a cycle. Why is it happening? What are the hormones? All of that is just completely swept away under the idea of like, here's how you deal

with it. Here's, here's just how you deal with it, not here's what's going on. And so it starts right at the beginning when we step into these life cycle phases, and it moves into our experience through pregnancy, our experience postpartum, all the years leading up to menopause, which don't have a name now, has started to gather a name called perimenopause and into menopause. Each one of those stages, the focus is on here's what to do, which disempowers us even more. Here's what to do is not here's what's going on. Because once you know what's going on, as you experienced, then you can do some problem solving yourself. If no one tells you how to learn about your body and what to look out for, you don't have the opportunity to even take that solution finding into your own hands. And so that's part of why we don't understand about menopause.

I think there's a lot to that. And also the fact that we're not talking about it or hearing about the experiences of it all that often. And as you said, seeing it as more of a problem to solve than something that's happening in all of our lives. I don't know if other people feel this way, but when I was approaching perimenopause, I thought there was something wrong with me. And yes, I did some Google searching, but I have just learned from experience that anything medically related on the internet is going to freak me out more than it's going to help me. And so I didn't know how to even treat the experiences that I was having because my assumption was that there was something wrong. Maybe I'm a bit of a hypochondriac too, but anyway.

Okay. So I want to talk about that a little bit here today. Let's start with perimenopause. What does that mean? What stage of our life typically are we talking about and what might we be actually experiencing in that time? This is a great space to begin because what you asked us then is what does it mean? And I think that's where we begin is definitions, because I think a lot of words get thrown out there. And we attach our symptoms to that word without really knowing what it means. So first, let's define what menopause is, so that we all have an understanding of that. Menopause is this moment in time. So you are always not menopausal until that moment that it has been 12 months that you haven't had a period. That's what menopausal means. So it's

just this, it's a, it's a pinpoint to say, okay, you've hit the 12 month mark. You are now menopausal. And then every day after that you are post menopausal. Okay, so menopause is like a day. Exactly. Okay, amazing. And the way that we talk about it, though, is that often the transition into menopause has never had a real clear definition by multiple groups of people. And so some people will say menopausal symptoms as it's the years leading up. And some people will say that's perimenopausal. And some people will say that has nothing to do with menopause.

That's just you being emotional or whatever or too hot. Like nobody attaches it to your experience of your hormones. And so what it is, is that there are the word peri means around. And so there's just like it's around menopause, which is generally what happens in many female reproductive situations. Generally, what happens in a lot of female reproductive conditions is that there's a lot of vagueness. They're like, it's about the uterus. That kind of the idea. It's about your ovaries.

And so perimenopause can be anywhere in the 10 to 15 years before you hit that day. And for some people, it might only be in the one year or three months before you hit that day of menopause. And the reason that it's called perimenopause is very specifically related to not knowing what your period is going to do, not having a regularity to it for many, many months in a row. And so that's a very strange definition, because some people are on birth control pills for that entire time. Sometimes people have had a regular cycle since they've been 13. Like the definition itself is very hard to pinpoint.

But we are speaking about when we're talking when women are talking about going through perimenopause is I'm hitting my mid 30s, mid 40s, and things are changing. And it doesn't seem like it's about my diet. It doesn't seem like it's about my lifestyle. I am almost the same. And everything feels like it's off kilter, my sleep isn't working, even how I my energy isn't working properly. My weight is changing, I am getting hot flashes, all of that is the description of what perimenopause means. And it kind of attaches to this idea that it might be to do with might have to do with your hormones. So just to be clear, there is no real definition of perimenopause. And I think that's in our favor. I think it's

a really good moment for us to say, Hey, this is the time to not be diagnosed with something, but to actually understand what's happening in my body. And so perimenopause gives us this opportunity to say, Hey, maybe I can start to understand what's going on with my cycle. Do I have a cycle? Maybe I don't have a cycle, because I've been taking oral contraceptives for a long time. Maybe I have a regular cycle, and I'm still having these symptoms. Do I count? Does this count as perimenopause? And so that's, I think, where to begin around what exactly is perimenopause. It's the 10 to 15 years. But just because you're 35, or just because you're 40 doesn't mean you are in perimenopause. Depending on your body and what your life has been like up to that day, you may not experience perimenopause at all. You may just come through your period, stop. Maybe you'll have some symptoms in that three months to a year and then your period stop. So it's not a given. But I think when people say they get perimenopause, they're having perimenopausal symptoms,

what they're saying is, hand up, I need help. Yeah. Something's changed. Right. Yeah. So for me, I'll just use me as an example. About five years ago, the first symptom that I was aware of was irregularity in my periods, in my cycle. And I used to be like, you know, I could set a watch by it. Right. And so that was a little confusing. And then I had like where I would skip a month and then everything would be fine. And so that's where I thought something was wrong going to the doctor and but weight gain and more specifically, a really big challenge with losing any weight has been that sort of next symptom that no matter what I do or how I, that was, I think there, and then the hot flashes started just like a couple months ago. And now I'm starting to notice a little bit with sleep, but we're talking about a almost five-year

period of time at this point that I've been in this perimenopause. And when I asked doctors, there's obviously the conversation about hormone replacement has come up. I prefer not to do that if I don't have to. Not that there's anything wrong with it. It's just a preference. But outside of that, I haven't gotten any advice or tips or tricks or anything to help manage these new changes. And I don't know if symptoms are even the right word. So maybe we could talk a little bit about that. Like, do you have any recommendations for hot flashes? Because that's the basic question, right? Ripping off my clothes in certain environments is not kosher. The most important question is how do I stop sweating through all of my shirts? But I think one key piece to call out here is that the capitalist corporate machine pushes women to work as hard as they possibly can to constantly

be striving to be barely accepted by the society that we're in. And in that process, we are draining what's called our adrenal reserves. And so I'll talk a little bit about our adrenals before I talk about the hot flashes, because they're so tightly linked. The adrenal glands sit on top of our kidneys, so in the back of our bodies. And not many people think about these when it comes to menopause, hot flashes, all of those symptoms. But what serves us is to recognize that the adrenal glands are actually a store for our progesterone and our estrogen when our ovaries are no longer producing them. So we often think menopause means no more eggs, we're done,

the progesterone and estrogen are done. The only solution is hormone replacement, because obviously your ovaries are not producing them anymore. And that is a convenient story if you push people to the point where their adrenal glands are so exhausted they're not producing the compensatory progesterone and estrogen that you would if you had a lifestyle that was nourishing and fulfilling and that allowed you to heal and so this the narrative works really well to be like, well, if we drain your stores, let's not talk about that. And instead, let's just say you're done. You have no estrogen, no progesterone. Therefore, the only solution is to replace it. And so what's key here is that the adrenal glands create progesterone, which is a key hormone in the menopausal transition. And that progesterone creates

cortisol. And that progesterone also creates that estrogen that you so you so critically need during menopause and the perimenopausal transition. The thing with cortisol is it is loud and whiny. And if it if it is in high demand, when we are in our high stress lifestyles, in the peak of our careers, our family life, our caregiving, our social networks, we are in the peak of that. Our cortisol is in high demand. When progesterone gets directed to create cortisol, it drains the reserve to provide the estrogen and progesterone that you need through that perimenopausal transition. And so what, what piece that's missing when we're talking to medical professionals often is that you have an opportunity to build those stores up, you have an opportunity to have progesterone and estrogen in your body without having to take hormone replacement therapy. And that starts with adrenal health. Obviously, many years before, it starts with how we build

our lives, what we allow in our spaces that are distressing, how we are given resources to manage trauma, all of the different supports and bolsters that help us heal. And then there's, there's those of us who had have gone through the system, and we are burnt out. And those of us also need resources to heal those adrenal glands to help our bodies produce what we automatically produce. And so I think what's happened is the focus has become, okay, is there a natural resource to just build estrogen or to give me estrogen? Is it all focused on like what the ovaries don't provide anymore? And instead, what we can do is really focus on adrenal health. And then you get to build your adrenal machine that creates those hormones for you. Okay. So I'm taking two, I think really big things away from this first, how impactful our stress or lack thereof, or how stressful our lives are is going to impact our perimenopausal transition and menopausal life. And so I suggested earlier that you didn't need to be in menopause to listen to

this episode. If you are not, be thinking about your stress levels and what you can be doing to support and manage those today. And then the second takeaway is for all of us, our adrenal health is really important as it relates to stress and perimenopause and menopause. Am I on track? You got it. I think that's like the number one takeaway that, that isn't being spoken about is that our cortisol levels and our stress in those years leading up to menopause are one of the most impactful ways that our experience of perimenopause occurs. It's directly related. Now I have yet to meet or interact with a single woman where I'm like, do you feel stressed? And they're like, hello? Yeah, that's, that's me. I think we all can acknowledge that we're pretty

stressed on a regular basis. Yeah. How do we know if we are in fact stressed to where it's actually affecting our bodies and or how stressed we might actually be? So I believe, hey, Freya has like a stress test. That might be an option. But are there ways that we can actually objectively tell how stressed we are? I think that's a really good moment to recognize that we are all stressed. That's, stress is a pressure upon us. And living in the society where we are in, the pressure is high no matter what. So that's a given. And I think what we want to understand

is what is the impact of the stress on my body? Like you said, you you're all your friends will say, yeah, of course, I'm stressed. But not everybody's bodies will react the same way. Because we've had different upbringings, we've had different coping mechanisms, we've all been through it differently. And so just because you're stressed doesn't mean and I'm stressed, and we're even in the same situation doesn't mean that my body will respond similarly. And learning about where your cortisol levels are, whether and again, they're not supposed to just be high or just be low, that there's a natural rhythm through the day. Learning where your rhythm is in a day is really helpful to understand if you are essentially what I would call hyper activated cortisol or hypo activated cortisol, understanding that will allow you to make some choices around the types of support you might need. And Hayfrayer offers a measure stress test, which is an at home test, it's not something that

you would be able to get at your PCP or your general practitioner, that you would, this is something that is often offered through naturopathic physicians. And my goal really is to, to create access for these, to not have them gated behind clinic doors. You can learn about these things that you're in your own home. Amazing. Okay. I want to talk a little bit about in preparing for our conversation today, you, you had sent some things and there was a reference to a study that was released that shows a link between women who are caregivers having worse perimenopause and menopausal symptoms, which just feels like a shitty form of torture at this point

in time. But tell us about that. So now that we've talked, so when people read that without the context of this podcast, they're like, oh, that's, that's just a sad association. And then when you listen to what we've been talking about, which is around the impact of the drain on the adrenals to the store of progesterone and estrogen, it becomes a very clear link to why caregiving, which is heart-wrenching sometimes and really emotionally stressful for some, that that is a drain on the progesterone and estrogen in the adrenals. And so there is no doubt that that will impact someone's menopausal symptoms. Okay. So if we are a caregiver or we find out that our body is processing our stress and not the most optimal ways, what are things that we can do about that?

Or maybe what are just, whether it's stress or menopause, what might we be looking to put into our bodies or to do to help manage some of these symptoms? And so the best information out there, the most evidence around menopausal symptoms is around lifestyle and diet always, right? I always call that the wah, wah, wah. Yes, that's exactly what I just did. Thank you for being upfront about that. Yes, being honest. And so the way I like to describe this is imagine that you needed help crossing the road. And so you're going to cross this road and the support is going to come and help you cross this road. That is your lifestyle and diet. You're going across an even ground and you have some really valuable tools that have evidence behind them to support you to get across

that road. What most women are experiencing in our current society, being really ground in our work environments through the nuclear family, through all these spaces where we're not getting support, is we have fallen down a pothole as we walk across that road. And the same resource is just sticking out its hand saying, hey, I can help you. But we need help out of the hole first. The lifestyle and diet are exceptionally useful tools. And you'll see lots of people who are like, that worked for me. And that's great, because they didn't fall down the hole. But if you are in the hole, the lifestyle and diet tools are just not enough. And so that's where I bring forward lots of beautiful herbal and nutrient suggestions and ideas for women to be able to say, just help me out of this hole so that I can take on what I need to take on. And it's really important to recognize that most things that we take for that my goal is not

so not just so that you can keep grinding. Right, not just so that you can fall down the hole again in the next two steps, is the idea is that it gives you the energy so that you do take those lifestyle changes. And so a lot of that comes from herbal medicine in roots, and I can go into those if you'd like, but a lot of times you want to be able to chat it out and talk about each of them. Some people will want to talk about each solution that's out there. Yeah. So I know, again, Hayfreya has a product that's designed very much for adrenal health. Can you give us maybe a few examples of either the-

Yeah, why? Yeah. The why, yeah. So really important that our product, and this is something that I discovered, is that there are lots of adrenal health products out there, but none of them are formulated for women in mind. They don't consider the deficiencies that we might have

or the concerns that we also have on top of our adrenal health. And so our product Thrive is specifically formulated for this demographic, the perimenopausal demographic, where we are burning the candle at both ends. And so there's nutrients and minerals that are really specific to not just the adrenals, but also the thyroid, also the hormone system. The herbs that most people are curious about are also in there. So bring those up, because those are the kind of the, they're in the news a little bit more. So the biggest influence for adrenals in our multi package of stress support is ashwagandha, which is making

the rounds. It has been around for centuries, as naturopaths, we've used it for a long time. And it is the best evidence for regulating cortisol levels. And so that is one that was intentionally placed in at a really specific dose to assist women who are going through perimenopause, or what I would call is, is this time of life when we need support, when things are changing. So it's one of them. Another is rhodiola, which is also used to build energy and help help women get up out of that hole. And then we also include many vitamins and omega threes as well. Okay, amazing. I feel like we've kind of shifted to stress, but I think it's so important because at least from what I'm hearing, and it makes sense from a personal experience too, is that stress is going to impact our experience we're thinking about perimenopause or menopause, anything we should be looking to put more of in our body or less of, or any lifestyle tips that

you're like, Hey, this is the time to start doing this or stop doing this. I think when it comes to the time of life, when we are periods may be oscillating, the smartest way to approach it is to really understand what an ovulatory cycle is. Because once you understand that you can make decisions in your diet and your lifestyle a little differently. So really understanding what is the follicular phase? What is the luteal phase? And what does that mean in my hormones? What is happening? And it gives you a in my hormones? What is happening? And it gives you a sense then of like, what am I without doing a lab test on your estrogen and progesterone, which is very difficult to just take a moment in time out of 40 days or 28 days, is to really understand and be like, hey, you know, I'm in a higher estrogen phase right now,

I'm in a higher progesterone phase. And those pieces of information can help you understand what would be better to do during estrogen versus progesterone. Estrogen is much more lively, vocal, verbal, and more energetic. And so the things that we might do in our workouts or in time out time outside, those would be more energetic. Our progesterone phase is much more inward and quiet. And so then the way we would approach our exercise would be different. And the same goes for food. A lot of people are interested in doing kind of low carb, no carb keto, those are not as helpful when we're in our ovulatory stage of life, because it's required for our ovulation to operate properly is carbohydrates. And so it's an important thing to recognize almost what not to try at certain times rather than what to try. Okay, so I am sure that you've kicked up some

curiosity and a lot of our listeners. So let me remind you that episode 85 of our podcast talks about cycle syncing and it's actually part two of a two part. So if you want to dive a little bit more into the phases of your cycle, what to be eating and not eating, doing and not doing. And if for no other reason, it's such a great opportunity to get to know your body again and how to best support it. And I couldn't encourage you enough to practice doing that at whatever stage of life you're in today to support you and hopefully make the perimenopause and menopause transition as stress-free or low stress and smooth as it can be. Thara, thank you so much for your time today.

Listeners, if you want to learn more about Hayfreya and some of the products that we mentioned earlier, you can go to hayfreya.co to learn more and shop all of their products. They also generously gave us a promo code. It's Haywork25 for 25% off any Hayfreya product like Thrive, which is the women's specific stress supplement that was mentioned that includes a multivitamin

and helps you heal from adrenal fatigue without that afternoon crash or the jitters like what coffee does to us, right? Or that at-home stress test to measure your levels of cortisol at four crucial parts of your day. Again, that's heyfreya.co and you can find the link plus the promo code for 25% off in the show notes. Thank you again, Thara, for this wonderful conversation.

Thank you for having me. All right. Let me wrap up by saying that I don't have a lot of regrets, but the biggest one, the one that tops every list for me is not appreciating, valuing, listening to, or understanding my own body for most of my life. Why I didn't do that is pretty complex and it involves more than just one thing, but not hearing about other women's experiences with these very normal physical changes, feeling like there was a stigma and somehow a lack of information in a

world full of information contributed to me feeling different and alone. I know none of us would wish this for our daughters, sisters, nieces, or best friends, and I certainly don't wish it for you. So let's talk about it. Let's share resources, experiences, and information, and maybe, just maybe, we could even celebrate it for what it is. A transition, a culmination, a graduation. Maybe we should even get each other balloons and wear funny hats, because you're all valedictorians in my book, Menopause. It's woman's work.