unPAUSED with Dr. Mary Claire Haver - The Holderness Family Gets Real About Perimenopause

Episode Date: April 28, 2026

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Kim and Penn Holderness, the husband and wife content creators behind the widely popular Holderness Family, bestselling authors, and winners of The Amazing Race Season 33. Together they built an audience of millions by finding the humor in real life, and in this conversation they turn that same lens on perimenopause, ADHD, marriage, and the particular chaos of midlife. Kim opens up about the perimenopausal symptoms that arrived before she had any name for them: the anxiety that made everything feel like being chased by a bear, the panic attacks triggered by nothing she could identify, and the growing sense that something was fundamentally wrong with her. She describes walking out of her doctor's office with no treatment after being told her symptoms were normal, the financial reality of having to seek out a functional medicine doctor to finally get the estrogen and progesterone support she needed, and the combination of hormonal and psychiatric care that eventually helped her feel like herself again. She also speaks with real honesty about her postpartum anxiety, perimenopause and depression, and her OCD diagnosis, and how all of it left her desperate for a voice that would simply say: this is hard. Guest links: The Holderness Family  The Holderness Family (Instagram) The Holderness Family - Music (YouTube) The Holderness Family - Comedy (YouTube) The Holderness Family (Facebook) The Holderness Family (Substack) The Holderness Family (TikTok) Laugh Lines with Kim & Penn Holderness (Apple Podcasts) PC’s Playbook Podcast (YouTube) Books: “ADHD Is Awesome,” by Penn and Kim Holderness “Everybody Fights,” by Penn and Kim Holderness To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

This episode contains references to child loss and death. Some listeners may find it distressing. Please listen with care and step away if you need to. He is the world's most sensitive understanding husband ever. He's like, don't need to explain it. We're good. Just go lay down and go for a walk, whatever you need to do. So everything felt like I was being chased by a bear.

And I really thought something was wrong with me. So that started before any of the physical stuff started. Yeah. And I was relieved to hear that, like, oh, that happens in perimenopause. I just thought I was going crazy. So when did you hear that, though? Like, when did someone say, hey? You told me on the internet, which is like going to make me cry. Yeah, I mean, even the postpartum depression stuff, like, there weren't women talking about it. They were talking about, like, how wonderful it was to have, like, a newborn baby. And I was like, I can't even walk on the stairs

without, like, fear of tripping. And it was, it was so hard. And then pari menopause hit. And I just thought I was going crazy. I'm like, and I'm so sorry you're marrying me. The views and opinions expressed on unpaused are those of the talent and guests alone and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment. There are some people who feel special to you even before you ever meet them in

life. I know it sounds strange, but if you've spent years laughing with them, learning from them, and seeing your own life reflected back at you in their content, well, that connection is real. And Kim and Penn Holderness are absolutely those people for me. This husband and wife content creator team have had me and pretty much all of their followers laughing for years with their parodies, skits, and blogs that tap right into the realities of family, relationships, and life. They are bestselling authors, award-winning podcast hosts, and they were the winners of season 33 of the amazing race. Through the miracle of parisocial relationships, I felt like I knew them long before we ever met.

And then about a year and a half ago, we finally met in person at the South by Southwest Film Festival. Then right after that, I promptly left my phone in an Uber, which honestly just tracks for me. Penn somehow managed to figure out how to track it down, contact the driver, and get it delivered back to me. I'm not sure I could have done that by myself. He said it was because ADHD is a superpower, because apparently leaving your phone behind all the time comes with a skill set in person. They were exactly who they are on camera.

Warm, sharp, funny, real, no performance. No polish beyond authenticity. Then we discovered something else that made the night even more surreal. We both had books publishing on the exact same day. And for those of you who have never, published a book when two books come out on the same day in the same category, that usually means competition. The same lists, same ranking, same pressure. Kim and Penn with ADHD is awesome, and me with the new menopause. And yet there was never even a whisper of rivalry. We cheered each

other on from the very beginning. When the New York Times bestseller list was announced, I was on vacation and intentionally limiting my social media. But then Kim texted me with the news. We had taken the top two spots on the list together. I honestly could not have written a better ending to a story if I even tried. I was screaming from the rooftops for all of us. Over the last few years, I've watched them navigate midlife, perimenopause, ADHD, and marriage. And we're going to dive into all of that. So today's conversation with them feels like a long time coming. It feels personal, it feels joyful, and it feels deeply aligned with what unpaused is all about. I'm Dr. Mary Claire Haver, a board certified, obstetrician gynecologist and certified menopause practitioner. I'm also an outjunk professor

of obstetrics and gynecology at the University of Texas Medical Branch. Welcome to Unpaused, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life. Welcome to Unpaused. So excited to have you guys here. But in case anyone who is listening has been under a rock and doesn't know exactly who you guys are, I kind of went through your high points in the intro. But what is your origin story? We met in a bar where all normal people meet. No, we were actually television news reporters in the same market in Orlando.

And we worked at competing stations. And so we worked the night. So we did like 11 o'clock live shots. And then TV news business, local news, it's very incestuous. So like we would all like collapse our, you know, live shots. And then we'd all meet out at a bar somewhere. So... On like a Tuesday.

On a Tuesday. Yeah. So I thought his name was Ben for like the first two weeks I knew him. And then I saw him do the worm at a nightclub. And I was like... It's pretty typical story.

Back off, ladies. That man is mine. So was it love at first sight or this might be a mistake? But I need to do this. For me, it was love at first sight, but then he had a girlfriend and then I had a date like three guys

named Steve in a row. And so it took us a little while. But once we like decided, It was pretty quickly. I think we were engaged within like nine months and then married nine months after that. So it went kind of fast. Yeah, we started out friends,

which I just thought would be like a smart way to get to know her better because I never... It was cool. It was all pretend. I wanted to be, but she was on her tramp page that she was describing with the three consecutive steves. And so, you know, I was a sounding board for some of that. And I was dating people too. This is a menopause podcast, and he just said trampage.

Okay. You're the one who taught me that word. Yes. I am going to have to steal that. Yeah. So, you know, ladies, you got to kiss a few frogs. And that's okay. But once we started dating, it was very obvious that it was it.

And then we, the rest of history. So you fall in love, get married. Are you still working as TV reporters at your respective station? I took a job as a correspondent at Inside Edition. And so we moved to New York. Oh, wow. And then he was, working for ABC Sports, DSPN, and so we lived there.

Our daughter was born in New York, and then we ran out of money and space. So he took a job in North Carolina. So that's where we are today. So when did all of the internet stuff start? We had two small kids. He took some convincing, but then we did it. And then we did this Christmas Jamies video, just sort of announced to our local, like our friends, our family.

Like, yeah, I thought that maybe like my Aunt Linda would, like, share it on Facebook and we'd get a few phone calls about it. It was a slow news week, which, like, remember those. And I think every, like the Today Show, Good Morning America. See it? Like, everybody ran that video. It got 17 million views in a week. And so that sort of changed everything.

We tried to use that video as the opportunity to, hey, let's reach out to other companies and we can help produce and do what the amazing people in this room are doing to edit and shoot. And like, because we really were interested in that part. And the blowback kept being like, great. So when are you going to come in in your Christmas? jammies and we're like, no, it's not what we're going to do. It was very early in the influencer years and there wasn't really like a handbook on how to do it. Most of the people who were doing it were that we talked to. It was like vloggers who really let people intimately into their

lives and showed their children like all the time and the fights they got in and those were most of the people we got exposed to and that wasn't something that either of us were interested in. I mean, yes, our children were in these videos early, but we wanted to give them like agency and choice, which we didn't for the first one. We didn't realize it was going to be this big of a deal. You're just like making a family video that went viral. And I'll go ahead and answer the question. Like, we're still worried that we're going to screw our kids up

and we probably already have. And they'll let you know. But that wasn't the kind of content we wanted to put out there. So it took a while to figure it out. We talk very openly that we did not know what we were doing. We put our kids on the internet before they

had the ability to consent. Any criticism of that from them, or anybody else is very fair. We have asked our kids, and it is open. I'm like, we will delete any video, the Christmas jamies, any video you want. And we're logged in, hit delete. Like we, and they are, they're like, no, it can stand.

I do think it's tough to be a kid in high school and have your teacher say, oh my gosh, I saw your parents' video, like in front of the whole class, and that's happened a couple times. So I think that was not their favorite. But they also know it comes with a lot of good. So your videos, I love, because for multiple reasons,

and I love that you're really leaning into the menopause, peri menopause space with the videos and your experiences. They don't feel like comedy about people. They feel like comedy with people. You know, like you're not making fun of the experience. You're like actually talking about the experience in a different way. What's that been like for you guys?

Well, I think that just in general are, sort of family motto, our business motto, is giving people permission to laugh. So that's at the core of what we do. And also, we never punch down. And if we're going to make fun of something, we're going to make fun of ourselves. But also with the perimenopause and menopause stuff,

it's hard because I don't want women to look at these characters I'm playing maybe or what we're doing and be like, oh, they're not capable of doing anything because they have brain fog. Because women are capable of a lot. And I don't want to weaponize menopause and make it seem so terrible.

You're not at all. It's just relatable. It's just, but there's like a fine line. We've deleted videos that we've edited because I'm like, God, this makes women seem like they're just incapable of handling life because menopause is so bad. And we still have to handle life. Yeah.

You know, so it's kind of like a needle worth threading there. What are you seeing in the comments, like, on those videos? For the most part, is thank you for helping me feel seen and understood. And do you have a camera in our house? And then the second most common thing is, my doctor bleeped this up. Like those, right? That would be number two. And that was like really eye-opening to me because I'd heard you say it. I'd heard her say it.

But then hearing it from the general population. And we didn't even mention a doctor in the video. But that's like one of the main comments. Between that and meeting all of your great friends in Austin, that was very eye-opening about like a real deficit in the world when it comes to health care. So on this podcast, we've had a ton of clinicians, a ton, mostly clinicians. We had two males so far. You're the third. Let's go. And I'm a doctor. Yeah. That's why I have this square on my blazer. Okay. So my, on Instagram, we all look at our demographics, right? That's our

bread and butter. And on Instagram, I am 98.5% female. Yeah. Okay. And you don't want that. You don't want an echo chamber. No. But nice, because the podcast we just started, shameless plug, is 40% male. Oh, wow. This year? So we got dudes listening. So, like, you're talking to, you know, what about y'all? Like, what is your breakdown on your demographics? We're not quite 98.4. That's amazing. I think we are, like, 85% women.

We are on our main platforms. YouTube, it's a little bit different. And, like, every platform has its own, like, favored gender. Yeah. It's so funny, though, like, there's a reason why we're 85% female. Do you want to know? Tell me. Okay. Well, first of all, Kim is amazing, and she's the star, and I'm totally okay with that.

But second of all, men don't know how to do social media in general. I'm just going to be stereotypical with the 40% here. If you guys, like, if men like our videos, like if my friends like our videos, they'll text me. Dude, your video was really funny. Thanks. Did you hit that little heart button? Do you anything else? Comment? No. I'm not going to let people know that I watch videos. Like, okay. So that's how we,

as a business, spread and grow into the algorithm. When we made male-friendly content, I'd get lots of text messages from my buddies, but it wouldn't do well because it wasn't making the algorithm because no one was commenting. We were on vacation with like some of our best friends. We had a video we had pre-shot. It came out that day. And our friend, he goes, yeah, that's really funny. I took his phone and I hit the heart button. He goes, are people going to see that I liked that? I'm like, they are, Chris. They are.

I'm like, because you liked it. He goes, I have to hit a heart button. Like, it wasn't masculine enough or something. I mean, should we have like a little brew button or a dude button? Or like a, like a, like a, like a, like a, like a muscle. Like you feel like a big strong man. Like a rock sack. But the truth is, like, when it comes to our business, on the engagement side,

men don't feel compelled or even comfortable sometimes doing that. We talk about all kinds of stuff. Usually it's relationships. Most of the time when men come up to us in airports and stuff, they say, even if I think there's some of them relying. Rather than saying, man, I love your videos. They're like, man, my wife really loves your videos. This one, this one, this one, and this one.

I'm like, it sounds like you know about our videos too. My husband is obsessed with you guys in a very healthy way. He talks about videos I've never seen. I love it. Oh, that we do. And it's like the bro videos that you do. Yeah, with the other guys. Yeah.

You know, like the algorithm is serving him completely different content than me, like the spontaneous stuff, is like your bro videos. Yeah. That he loves. Yeah, he has a crew of bros. He gets to hang out with online. So when you decided to do some menopause-focused concept, perimenopause focus content, because you're doing your actual real lives.

Like, were you worried? Were you, like, worried about pushback? Or? It's interesting because we had an agent at one point. I was turning 40 and we started doing a lot of like, I'm 40 content. This was almost 10 years ago. And this agent said, you really shouldn't be telling people how old you are. Because if, you know, part of what we do just to be completely transparent is like we partner with brands and that, you know, brands are really turned off by that.

So we got new agents because what am I going to do? Hide the fact that I'm aging. we did have a discussion because it is very sensitive and people get uncomfortable when women freaking age and we just decided our channel,

we focus on what's happening in our lives and we try to make it funny what was ruling our house at the time was my peri menopause and bless his heart he came up with a name for her, Perry. And he's like, Perry's here, huh?

And so he even like wrote those sketches I wrote the first skit. Was that therapy for you? So here's what, it was connection to me. So it was, I'm like, honey, some of this stuff is funny. She's like, yes, I know. I'm like, well, listen, I'm going to create this character. It's not you.

It's Perry. It's Perry. So Perry's not you. And she's like, I love it. Let's do it. So I wrote it in very few notes from the first draft. Kim is so, so, so good at poking fun of herself. She's the most self-aware woman I've ever met.

I said, I think that was like one of the things I said in our vows. Like, I knew this very early on. She is a wonderful woman who looks at herself occasionally as a hot mess and is super aware, sometimes even real time when she's acting irrationally. She'll say, yeah, I'm acting irrationally right now. And it is, it's great. And I've tried to be more about, more like that myself. So in these videos, like letting there be Kim that that we all know,

and also this other part of Kim that has to do with everything that's perimenopause. And may or may not have been terrorizing your household. Right. And let's face it, it was Kim. Yeah, but that was Kim. But before we even put it out, we laughed at it and we felt connected.

I wasn't fed up by it, but I was confused about some things that were going on. Yeah, let's talk about that because I think we have a very large audience that is not a woman, you know, listening to this podcast, which is new for what, what I put out there.

And I know every guy out there who has a wife who's starting or in the middle of this is like hanging on. So now you're the subject expert, okay? What was it like? Like you guys are in your 30s, living your best life, two kids, you're doing all this, you know, building this life together. And what was changing? The first things I noticed was there were moments that I think in the past she would process

in real time and move on from. And I think she was just having time. difficult time processing some of those things. And a lot of them weren't really, even things that were going on in her body. It was empathy she was feeling for other people or for the world around her. Because perimenopause begins in the brain.

Yeah. And that resilience change, that mental health, the processing changed. So yeah, I love the way you put that. The way she was processing things was different. How did you notice that? Because you don't, when you're in it, you know, you're not observing it.

You're in it. You have to be able to zoom out. And so it felt- I couldn't for a long time. Well, he was wrong. Well, I knew that for a long time, here's like my emotional capacity in my cup. And I could handle everything that was being poured into this.

All of a sudden, my cup felt so small. It felt like I was like there was a fire hose being poured into like my capacity to deal with anything. I mean, I was like, driving down the street, shaking. I remember I was like in the Whole Foods and I was shopping and it was like grabbing the spaghetti sauce and for whatever reason like that trick, spaghetti sauce, right? Like marinerara, like, nothing. I put it down.

I called Pan, I'm like, I'm coming home. I'm leaving my grocery cart in aisle three and he's like, okay, got it. And I'm like, I don't know what's wrong with me. And I've had panic attacks before, but I was like, this was usually triggered by something. This was freaking Marinera. And he is the world's most sensitive understanding husband. He's like, don't need to explain it. We're good.

Just go lay down and go for a walk, whatever you need to do. So everything felt like I was being chased by a bear. And I really thought something was wrong with me. So that started before any of the physical stuff started. And I was relieved to hear that, like, oh, that happens in perimenopause. I just thought I was going crazy. So when did you hear that, though? Like, when did someone say, hey?

You told me on the internet, which is like going to make me cry. cry. Yeah, I mean, even the postpartum depression stuff, like, there weren't women talking about it. They were talking about, like, how wonderful it was to have, like, a newborn baby. And I was like, I can't even walk down the stairs without, like, fear of tripping. And it was, it was so hard. And then pari menopause hit. And I just thought I was going crazy. I'm like, and I'm so sorry you marry me. Like, you deserve, like, somebody who's, like, happy and can handle life and I'm so sorry. And I was like, apologizing to my kids.

I was like, you have a mom that like can't deal. And then I went to my doctor, bless her heart. She's like, yeah, this is normal. And but I walked out with nothing. You know, normal means common. Not. Not you should deal with this. So because I have a husband who like, sorry.

Don't. Like, I'm trying to like get them back into my eyes to my not scared isn't. Ron. Thank you. I would have given you this, but it's totally fake. I just, like, I just reached for it and was like, well, shit. This must be a cheap laser. What's the point of it?

Sorry, like, back to you. It's not about me. Well, because we, you know, have the access, I booked an appointment with, like, a functional... Right. Anybody, please. And so we could pay for that. And that pissed me off too. Because I was like, our family, like, he was like, absolutely do what you need to do, pay for what you need to pay for.

But not everybody can do that. And so now it's being talked about people who are getting it covered by insurance. But like four or five years ago and then she, this sweet angel of a doctor gave me progesterone. And I was like, boo-hmm. Like, I was like, I didn't feel like stabbing people all the time. There was more to it. A couple years later. Yeah, a couple of years later, I ended up, she recommended I go talk to a psychiatrist.

We unpack some stuff. I am on like a wonderful combination of medicine there. I'm loving life. Everything is great. But without that, I just look at women walking around this world that are being told this is normal. And walking out of the doctor's office with a pat on the back. The most likely time for a woman to commit suicide is between 45 and 55. That feels right.

Like that feels awful. There's a reason. But I have to say, like, I have the happiest marriage. I have healthy kids. I have a wonderful life. And I'm like, I want out of here. Like, I can't. I hear it.

It happened to me. I hear it not to that degree. But I've heard this inpatient. I have a good life. Everything's great. I built this life. I built the life of my dreams and I'm not okay. Yeah.

And so I'm here because of some good pharmaceuticals. and a loving husband. Sponsored by Pfizer. It's sponsored by whoever wants to sponsor it, right? Whatever I'm taking. And I got on my journey and it got to the point where we were able to see the funny in it. And that is sort of what we do is that we get to look around at our lives and say like, is that funny? And when you zoom out and you're out of crisis and I was out of crisis at that point, I'm like, it is kind of funny what we're going through here.

And anybody my age is probably going through this in their marriage because it becomes a family issue at that point. What if the problem isn't your skin? It's the makeup. Because at a certain point, the products that used to work just don't anymore. Foundation starts to look flat. Blush sits differently. And by 3 p.m., everything feels dry, heavy, or overdone. The reality is, a lot of traditional makeup was never. designed with changing skin in mind. That's where OG comes in, a certified organic beauty brand that delivers luxury-level performance. Instead of loading products with fillers and heavy pigments, OG's crystal contour collection is made with nearly 90% skincare ingredients. Green coffee oil, hajoba, elderberry extract, ingredients that nourish the skin while you're wearing the makeup.

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That's OGEE.com slash unpaused and enter the code unposed to get 20% off. History That Doesn't Suck is a legit, hard-hitting American History podcast told through entertaining stories. as we approach America's 250th anniversary, now might be the time to go back and learn how we got here. With more than 200 episodes, you can binge your way, decade by decade, defining event to defining event from the founding into the 20th century.

Join me, Professor Greg Jackson, for History That Doesn't Suck, an Odyssey podcast, available on Apple Podcasts, Spotify, or wherever you get your podcasts. So tell me your side of this. She did not conceal any of this, I don't believe. I think that we talked about it pretty openly. I think part of me was trying to help her diagnose because there's, you know, there is a lot of,

like, questionable, like, what's going on? So just medically, you'd had some pretty intense menstruations throughout most of your life to the point that you thought you might have endometriosis, where now it's endometosis or whatever. Adomiasis. And so. The endometriosis is an evil twin. Yeah.

Right. So I had been trained with some moments that you even said. This is happening right now. This is really heavy. Like I'm feeling. To the point where he's like, it was Shark Week. Like, I know when Shark Week was. Like, I get that.

I will say that like, as this is all happening, you know, like, as a man who wants to feel connected and to feel intimacy, like, that's going to ebb when this happens. And so I felt like I could be useful and helpful. but also lonely because I can't super relate to what she's doing. And I've got to give her more space than I'd like to. I think that's like stuff that it's all past and gotten a lot easier. And I've learned that like intimacy means something different from when you're 20 and it's just all the time. That's exactly how we did it, guys.

But like all of that was hard. And I like actually feel for men who say the same thing because I think that there's shame that comes with it and that limits communication and intimacy. And there's also just like fear. Like, is this what it is, what she is, what we are? What would be your advice? I mean, there's guys listening going, okay, bro, you know, you're the only dude talking about this on the internet,

so let's, you know. I think finding new connection points, like, this is a really good opportunity to do that. I think that our Disney Prince nature of wanting to like sweep someone off their feet and be the solution, this is going to be the time that you learn that that's not what you do. This is where you listen. and you empathize and you're there for her in ways that you're not normally there for people. And like that's really strengthened our relationship. I think me learning that.

Also, I got a really good piece of advice. We had this guy on who does like, he's a guy who's on TikTok talking to other husbands about perimenopause. Oh, I think on who that is. He's amazing. Yeah, yeah, yeah. So he said something about intimacy. I'm not just talking about sex, like intimacy and connection that like it really only works. when the woman is relaxed.

For guys, we could be skydiving. Yeah. And everything's going to work. But imagine all the things that's going on in their body and understand how impossibly difficult it is to just be relaxed. And so that was like a really cool piece of advice to me as well because I was feeling that.

Do you feel like this was the hardest season of your marriage? I do believe for Penn, his love language, is physical touch. And when I was in my feelings, I did not want to be touched at all. And so he, I had to communicate to him. This has had nothing to do with my love for you. I love you so much. Because he wants to, when he sees me in panic, in crisis, he wants to.

And there are moments, I love that. The moments I want, like, just, like, wrap me up and hug me. But you usually, like, three to six feet. Yeah. You like COVID. You like that sort of amount of. I'm like, I want you here, worse, but not yet. But I don't want you touching me.

Right. Exactly. And once he's. he sort of realized that that's the way I could operate, I will say our relationship is deeper and better. I think we're closer now than we have been. But yeah, there were some bumps in the road because it's hard not to take it personally, right?

Because you do go from like having like a very nice regular sex life to, you know what? I just can't be touched right now. Or any sort of not, not just like, like having sex, but any sort of that intimate feeling when you have true connection with your partner, because sometimes I just needed to be alone. And I think he got it quickly,

and he learned not to take it personally. But yeah, it's hard not to take it personally. So here's the toughest part. Like, she's been incredibly communicative about it. And I believe her. Like, I don't think, like, the first instinct you get when something like this happens is, it's me, right? Every guy, they get that.

And then the next instinct, which you don't want is somebody else? Like, is there something else that would make her happy? Right. Does she maybe want to be with women? Like, you know, that's... I mean, sometimes.

Right. Why not? Why not? That's easier. And so, like, I'm completely at peace with trust and totally understand that she's saying what she believes, but then my subconscious has no control over that.

So I have, like, crazy dreams, like, from time to time. And I can't do anything about that. But for men, that I would guess, is the biggest challenge. And there are a lot of men out there. And Penn hears from them that do not believe whatever is happening here. Yeah, that's a whole different thing. And that's a divorce waiting to happen.

And, like, that's a different podcast. But he, there are some men that have walked up to me like, yeah, that menopause stuff, right? Like, she's full of it. Stuff like that. And Penn is a good ally, ladies, because he will say, actually, and he'll throw some science at them. So. Do you feel like you're on the other side now? Of what?

of, I guess we're never going to get to the other side. So, like, I didn't know I was going through perimenopause when I was going through it. Like, we learned how to pronounce it in medical school and residency. And, like, it's a transition. I'm still having periods. I don't know, but, like, I couldn't stand for him to hold my hand. I was aggravated with everything.

And it was an inflection point in a lot of things. Our parents were starting to get old and need us more. Kids were becoming teenagers. Like, like, many of us in the stage, there was all of this. other stuff. And then my resilience wall was coming down. You know, my brother was dying. And I do feel like now, now we're totally empty nested. Okay. And he's retired from his job. He's now helping me in our bit. You know, I just feel like we're lifers now. Right. You know, but it was in that

perimenopause time and figuring it all out that I felt like that was the furthest apart we were in those times where I was like, are we going to make it? Got it. Like, am I better off not in this relationship that did bubble up a few times. I do believe we are on the other side of whatever that was. I still very much am aware of what's happening. I'm very perry right now, like a very peri menopausal. I am medically really like tapping my foot waiting for actual menopause because I'm hoping that it's coming. I promise. So you guys want it to come? It's like as a clinician, it's treating a woman in perimenopause. Yeah.

It's like pinning the tail on a moving donkey. Right. And, you know, you get that tail on, the donkey goes over here, and then you got to switch this and whatever. Like, once they're postmenopausal, it is so much easier for me as a doctor. Is there like, do you know, how do you know? A blood test.

Like, you know, medically. The candy can and goes off outside your vagina. Yeah. Yeah. The clothes for business sign goes up. And that's good. So as far as what's going on hormonally, you flatline. And that's like easier to resuscitate. So blood tests. So blood test and listening to

symptoms. But, you know, the brain stuff calms down a lot. So my patients who like their main complaint was the mental health or cognitive stuff, that is much easier to kind of manage in postmenopausal. And then the bleeding stops, you know, and so the... Okay, so it's just your period, stop getting your period. Right. That's the... And that coincides with subsiding some of these wonderful traits, then, like, love you, but things that you don't like very much. Oh, yeah, right. Right.

Okay. And so, you know, once we kind of put out the fire, the management and stuff, you know, once women are post-menopausal, we're focusing on the next 30 years. Like, at that point, her whole focus shifts to keep me out of a nursing home, you know, like. The longevity stuff. Like, I got, yeah, look, I don't want to break.

I don't want to lose my independence. So, like, and I know I have a window of opportunity here to set myself up for success for the next 30 years. So that's, like, the funest part of my job. The most difficult part is helping her manage pari metapause. Got it. Which wasn't even a thing. Like, that was not a thing.

We couldn't treat a menopausal patient until she was a year past her last period. So we just let her, like, wing it. I feel so sorry for my mom, and people in my mom's generation, because they were told to get off estrogen and freaking deal with it. My mother was sedated.

Like, I remember the beta-sol pills, you know, that I had to go get when she was having a moment, a crisis. And so, you know, I'd go get her little pills. of butosol and like go bring them to her. And, you know, it was probably a placebo effect because, like, she'd take one and immediately everything was better. So, you know, I was in medical school and that memory bubbled up because we were in pharmacology. And I was like, what? This is something they gave for seizures. Like, yeah, butalbatol. It is a cousin of phenobarbital. I mean, and if, and if I weren't

on all the medicine I'm on right now, I would say give it to me. Is there like a connection between, like, how strong someone's menopausal symptoms are with, like, how much empathy they're, like, how much empathy they're feeling in the world around them? Like, how much... You know, no one's looked at that. What we know is if you had a really rough postpartum, like if you had postpartum depression, postpartum, you know, anxiety, any of that stuff,

you are a ringer for having a rougher mental. The healthier you are. Now, I hate to say this because I have triathletes, you know, who just get gobsmacked through the menopause transition. But it tends to be the healthier your diet, the more you exercise, the more your, you know, the symptoms will be worse. But I mean, you know what, throw that out the window. It is what it is. But I don't think anyone yet is looking at, if you're more empathetic person, then all of a sudden your resilience, they pull out the carpet from under your feet. if you're going to suffer worse. Menopause, and we have estrogen receptors,

progester and antistocin receptors everywhere in our body. So someone's top priorities might be her joint pain. She is not functional, you know, but her mental health is fine. You know, it is such a cornucopia of, like, how this might hit you. So what I've learned through just taking care of menopause now is like, what are your goals?

Yeah. For you, it was mental health, it sounds like, you know, like, you're an athlete. Yeah. That's not an issue for you. Like physically, I mean, besides wild, periods. There's not, nothing. Yeah, for some, it's like, I can't be bleeding through a meeting. Right. You know, and changing a diaper. You know, with the bleeding or amoeia. Yeah. Like, I'm totally fine.

15% of us won't have hot flashes. So, you know, you just your thermal regulatory center is fine in the brain. But, you know, we see across, historically across the menopause transition, we double the amount of women who need an SSRI. And what we're learning now is we probably should start them early soon and often on, estrogen, progesterone, whatever combination, to stabilize mental health. And they may need something, an SSRI or SNRI, you know, one of the antidepressant, anti-anxiety meds still. But we probably were overtreating with some of these meds

when really what they needed was estrogen, you know, or some hormone support. I believe it. I had really wild postpartum anxiety, depression, and then that's when I first got diagnosed with OCD. I'm probably glad I didn't know that a wild postpartum experience would have made, because I think I would have been anxious about.

About that. Well, we've ripped the Band-Aid off, and now we're telling the world. Sorry. Sorry, guys. Talk to me some more about that because I had remembered, in medicine, back when I, this was when the Andrea Yates thing happened, and it was right by where we were training. So she was in Clear Lake 20 miles from Galveston.

Do you remember this? Andrea Yates drowned her children. She had postpartum hallucination. and her voices telling her to drown her children. Anyway, so, like, it was that or you were fine. I was not taught anything in between. We had screening. Like, we didn't want to miss the woman

who was gonna hallucinate and, like, destroy her family. You know, so we were screening for, like, the most of your symptoms. Really, it was like, you'll be okay, this will pass, you know. Yeah. So I remember having intrusive thoughts with Catherine, my oldest, of her drowning. She's in a carrier. She can't, like, swim, you know, like, there's no... We're not near a pool.

She's fine. Yeah. I remember being, like, at my six-week appointment, I was asked, like, are you, or do you have visions of hurting your children? And, like, oh, God, no. Like, that wasn't it... That's how we were screaming. Are you thinking about hurting yourself or someone else?

Okay, no, check, move on. Move on. And it was actually our pediatrician. I think it was, like, our, like, a 12-week appointment or something with my son, and Penn was there, and I was having trouble nursing, and I wasn't sleeping. And like, there was just so much going on. And the doctor came in with like a can of formula.

And it was like, you need to take care of yourself. You are there and looked at him like, she needs to get some help. Because I was just like, he wasn't gaining weight. And it was this whole, and I was just could not handle it. And the doctor asked, how are you doing? And he was there because I couldn't drive. Because I was so afraid. I had visions of semi-truck hitting our car.

Mm-hmm. I couldn't walk downstairs holding him because I would like sit on my butt and scoot down because I would never hurt my, I had visions of the opposite. So it wasn't until the pediatrician flagged it. And then he drove me to a psychiatrist. Should there be a better way to ask that question in the screening? Yeah. I mean, it's probably better now.

But, you know, the way we were, this happened, we had no screening before, right? We knew about postpartum depression, but like, you know. And it's so shameful. Like, the patients were so reluctant. I remember, like, people bringing in their, like, husband coming with the wife and, like, she's not okay. But you didn't want to be the Andrea Yates. You didn't want to be thought of, like, I could hurt my kids. Because, you know, it'd just be crazy.

Right. And that's, like, when mommy bloggers were, like, a thing. And it was, like, 2008, 2009. And I was desperately seeking a voice that would say, like, this is really hard. And I think women were afraid to say it was hard because they didn't want to be thinking, like, oh, I'm going to go hurt my kid. And it sounds, it sounds unnatural, sounds incriminating. Right. Especially if you ask it that way.

Maybe something like, were you really surprised to get this thought that you quickly pushed away, but it's not what you really believe in? Yeah. That's probably a more accurate thing. Or the best of the doctor was like, you know, I had this thought when I was. Because, again, empathy is this way. Making you feel normalize it. Empathy is how this movement is growing. Yeah.

It's you guys sharing your stories and feeling not broken, not alone, and, like, there's a way to get out of it. I think that's the internet good and bad, as we've all learned. It's allowed the sharing of experiences that were kept hidden before and people going, oh, that's me. Yeah. You know? I feel seen. Right. So you got diagnosed with ADHD.

Yes. As an adult? Yeah. Not as a kid. I was 21. How? College? How?

Do you want to know what happened? Yeah. So I, first of all, I was on academic probation twice in college. On purpose? He had an awesome time in college, you guys. I had the ability to go to classes more than I actually did. But no, I mean, my Ritalin was my mom growing up. But way before anyone knew what ADHD even was, she helped regulate my emotions.

And she helped me get my homework done. She, like, knew that I was smart, but that I needed some self-starting skills, which she tried to instill in me, and then when that didn't happen, she just kind of said, here, come on, I'm going to hold your hand and do this with you. And so I was getting some bad grades in college, but I still was having an awesome time. I was at my grandmother's funeral,

in between my junior and senior year. And she was like the first time I had no grandparents on one side of my family. So there was this big beach trip that our family took for two weeks, and it was the most important week of the year, two weeks of the year for me, because I really felt at home. And I think everyone had ADHD,

there probably. We all got along great. And so the family was having this talk about what we were going to do next in this room in Tarburn, North Carolina. And I started daydreaming about all the great times we'd had and like, what are we going to do now? And all of a sudden, my aunt Zell, she says, Penn, I'm sorry, none of us can concentrate because you're chewing on a used fly swatter. So I picked up a fly swatter. In East, there's a lot of flies in Eastern Carolina in the summer. And while I was thinking, I put it in my mouth and I started chewing on it with no idea that I was doing it whatsoever. But it was like whatever, that was a fidget for me, right? And that was gross. And everyone laughed. I did not laugh. I felt like I went from, you know, you're a space cadet,

you're an adorable space cadet, to is there something fundamentally wrong with me? So I drove myself to a doctor and he diagnosed me very quickly. And did you even know that was a thing? Yes. I had heard of it before. Okay. Did you feel like an alien? Before or after? I felt like an alien most of my childhood. Okay. I mean, I would chew on my shirt to the point that there was a saliva circle that went all the way around here. I had a lot of like acquaintances, but not a lot of close friends because I did not know how to let people finish their story without jumping in. I had wild creativity and understanding of music that most of my friends didn't have.

but when I was asked to take piano in a recital and sit and look at music, I couldn't read the music and didn't want to read the music. I just wanted to hear the sounds and just reproduce them. So, like, in some ways, good alien, but in a lot of ways, just kind of bad alien, the most important thing was I cried all the time. Like, if something didn't go my way, it flooded me emotionally, and it went on way, way later than most kids. Like, it happened to me in high school sometimes.

So that was probably in the playground. society that I lived in, probably the most alien that I felt. And then after you got the diagnosis, you felt you had a name. Yeah, but no one explained the emotional side of ADHD in the 90s. And I think they're just barely doing it now. I just felt like it was like all in reference to how you were doing scholastically. Right. Yeah.

You know? That was the measure of... It's not how you see the world or this was, we need you to do well in school. That's why I did it. And they gave me drugs. I took them. They gave me something called dexedrine, which apparently is like... A diet.

Math. Yeah. No. You can cook it. So I was on meth my senior year and I cut better grades. Yeah. I'm like, this is amazing. They gave me no behavioral interventions or systems or anything.

Understandably, like this was, it was a medical model. They looked at a problem and they tried to fix it. And so it actually took quite a while to realize, A, that I, the medicine personally was stunting my creativity. And all the music that I heard in my head, I didn't hear. anymore. And then much later, after I'd found a job that actually worked for ADHD, which is, if you're watching us on any device, most of us have ADHD, because it just is conducive. But much later, a lot like a, you know, a woman who starts getting overtaxed with a family and a job, like stuff started falling through the cracks for me in my mid-40s. And that's when

we started working on the book. How's the book going? And you guys have a new book. We do. The book is growing great. It continues to just sell. People are interested in it. And we didn't expect it. And the book is. Oh, it's called, sorry, it's called ADHD is awesome. And we have a children's book. And we have a new children's book this year, too. I know. We're writing a bunch of books about ADHD, which wasn't the direction we thought we were going to go in. But much like you, we thought we had like a hopeful, positive message around it. And do ADHD and menopause have so much in common? And I'm not even talking clinically. Like, they both need to be distilled. They're both underdiagnosed. They're in a lot of times not perfectly understood by health care and by doctors. Yeah. Right? There's deniers out there who say it's not a thing.

You're just complaining. And then on top of that, apparently menopause gives you ADHD. So like, or makes you feel like you've got ADHD. Unmasked is the term we're using now. Yeah. So, you know, your resilience drops, your coping skills drop, your whatever. And you, you know, it's a spectrum, right? I'm on the other end of it where I can hyper-focus

and shut the whole world out. And that's great when you're a doctor and studying for medical school. It's horrible when you have children who are like, Mom, Mom, Mom, and you're so focused on what you're doing. But it's exploding right now, the conversation around changes in cognition and attention and focus in the menopause transition. And so what have you guys seen on your social media?

It's really complicated because women, are underdiagnosed with ADHD, like way more so than men. It took, like my kids, both have it. Right. Yeah. And it's because y'all are tougher than us, you're better at internalizing your difficulties. So when you're a kid, the time that it's most often diagnosed, it's masked. My kids were well-behaved. It's masked because you-

They were pleasantly staring out the window, not causing any distractions. We're allowed and we're doing karate in the middle of church. And so, like, we get diagnosed. And then for women, they become women. they become moms. They have to do, so like, they have to do sign-up genius. And that's like the low-key... Cryptonite.

Cryptonite for ADHD. And for some reason, like, every time I'm on sign-up genius, I'm the only dude who's on there. But I think those executive functioning challenges really happen when you become a working parent or even a parent, right? And so then they're getting diagnosed at a later age kind of close to perimenopause.

I think those waters are muddied for us, We've, like, that book was written largely for parents who have kids with ADHD and for maybe teenagers or 21-year-old young adults who have been diagnosed. And so the parents are reading it and going, whoa. Wait a second. So many people. We had a girlfriend and she's 50. She read it just because she was, like, being supportive of us.

And she's like, holy should pen. I think I have ADHD. And she went and she did the full diagnosis with the psychiatrist. She did everything. She goes, my childhood makes sense. so much more sense. And a lot of women are being diagnosed when their kids get diagnosed

because they're filling out the questionnaire going, holy crap, that's me, that's not normal. And I think it's such a relief for women just to have a name for it, right? And you could be gentler on your nine-year-old self, right? Like, looking back. We love being part of the conversation on ADHD. And finally, finally, there are studies being done on women and girls,

now. Yeah. Because all the other ADHD studies, it was mostly male participants. This is all of medicine. And all of medicine. Unless you're pregnant. So, yeah. On the governor was Duke University. They have a women's center for ADHD. And so awesome. But you know what medical studies, the good ones take a long time. So we would love to get a megaphone and talk more about women with ADHD. But the studies are just lagging. What we do know is that genetically, women are just as likely to have ADHD, but they're chronically underdiagnosed. And we've been, you know, we get to go to these book signings. And we met so many people and the moms that come and hug pen for their kids to be seen.

But they have tears in their eyes because they just got diagnosed. But then they'll put the audio bug on. The husbands will listen to it and just be gentler. And I think once there's like an understanding, because when there's the mom who's ADHD and the house is sort of like falling apart, it's really easy to like blame her, you know? And if there's an explanation for it and if there are systems that could be put in place.

Listen, like when you give a kid or an adult or anybody, whatever the condition is, an understanding of what's going on in their brain, they immediately are more likely to want to get to work and try to make it less than an excuse to like try to make the world around them. Ben to its well. I loved your book because as a parent, as a doctor, I was one of the not naysayers, but, you know, I really felt like people who would medicate their children,

this was a cop out. You just need to love them through this, you know, and then I tried to love my daughter so hard through it and got tutors and a lot of screaming at the table. We went over this question 75 times, you still got it wrong, you know, whatever. And then finally, a couple of her teachers were like, you should go get her tested, you know. And my older daughter had had some dysgraphia

and we had gotten her all the stuff. But my youngest had this core group of friends, she's still best, best friends with. It's the most beautiful relationship. And they were all straight A, perfect, perfect, perfect, grades, all the things. And my daughter was always on the struggle bus, you know. That's so hard.

And she was growing up with this thought of, I'm not smart. Oh. And we took her to the pediatrician, and she said, let's get her tested. And I think you're going to be able to give her a gift. That's a really great way to put it. And I burst into tears because all of my prejudice and bias and everything I felt about this diagnosis and me as a failure as a parent and I didn't love her enough and I didn't provide the right structure or whatever she needed. You know, she's like, let's give her a gift. How to turn out?

She's fabulous. She's perfect. Her grades shot up immediately, which, you know, that's, again, another problem, parental thing of like, if my kids are making good grades, I'm a good mom. That doesn't equal well-being, right? Yeah. And then my older daughter was diagnosed much later. She coped and had skills, you know, whatever until the MCAT.

That was her breaking point of, I need some help here because I can't, all these systems I had in place aren't working. for me to get through this next level. And then, of course, she's been on meds through med school and doing great. You know, everything is fine. But, like, God, you know, in reading your book, I sobbed because I wish I would have had that as a parent,

you know, when they were little and I didn't get it and I didn't understand, even though I was a doctor and I wasn't a pediatrician, but, you know, it just would have been so much easier for my kids and I would have brought them in sooner and just been a better resource for them. And I mean, listen, we're not against medication at all. Medicine's been grace, but there's a lot of things that are just don't require medicine.

And you can't medicate. Yeah. Yeah. And in our school system, it's like hard to get extra time. Our kid has ADHD and he has a learning plan. Extra time is like really hard to get. But I'm like, wait, if they, if he can get 100 on the test if he has extra time. Like, why does it?

What, what job is he going to have to recite all of like pre-calculus in like 30 minutes as opposed to 45? anyway. It's, yeah, that whole timing thing is. It's wild. It's wild. Amazing. Now it's time for the MIDI pause. I'm Dr. Mary Claire Haver, host of the podcast Unpaused, bringing you a word from MIDI

Health. Today we're facing the truth. Aging is inevitable. But how you age, that's completely in your hands. This stage of life is not an end. It's an evolution. And with the right strategies, you can reclaim control over your body, your mind, and your future. I call it my menopause toolkit, and it starts with six foundational pillars.

Nutrition focused on anti-inflammatory foods, protein, and fiber. Movement, especially strength training and daily activity. Protecting your sleep, because it is the backbone of your hormonal and cognitive health. Working with a knowledgeable provider on personalized pharmacology, managing stress through mindfulness, gratitude, and embracing progress over perfection. and finally community, because no one of us should be doing this alone. That's exactly what Middy Health is built around. Care for women that focuses on maximizing health span and helping you with your menopause toolkit. Living longer, more active lives, not just longer ones.

Midi offers personalized care that leverages evidence-based interventions tailored to your life. It's never too early or too late. Wherever you are in your journey, Midi Health will meet you. there with the solutions you need. Women come to Mitty to address the symptoms they experience every day. Midi partners with you to find the right treatment, whether that's HART or a non-hormonal solution, giving special attention to the four areas that matter most as we age, hormone optimization, specialized nutrition, resistance training, and targeted therapies. Progress starts with a personal plan. That's why the Mitty approach centers on a holistic combination of solutions,

from medications to lifestyle changes with a care plan built for your body and your needs. By doing so, Midi Health is setting a new standard for health care. As the nation's fastest-growing women's telehealth company, Miti provides accessible insurance-covered services designed by medical experts. Building on its leadership in perimenopause and menopause, METI fills the critical health gaps women face at every age and life stage. If you want a clinician in your corner who truly understands what your body, and brain need right now, that's exactly what Midi is built for. Go to join midi.com, join

M-I-D-I-D-Com, and connect with one of their clinicians today. Now you are half-empty-nusters. Yes. How's that going? You would text me a few times giving me a heads up. I was not prepared for how sad I was going to be. You told me, but like until you live it, so my, my daughter's off to college, my son's at home. I think the lack of estrogen in the house, I felt like, it's just like, I'm just very aware of how much testosterone there is in my house right now. I'm obsessed with my son. I love my son so much. But when she left, I was very unprepared for how sad I was going to be. And it's just cruel that this happens during perimenopause. Yeah, that's a lot going on at the same time. It's a lot going on at the same time.

How do you keep your relationship from turning into a shared Google calendar since you're working together so much. Oh, that is such a funny question. Like, who makes the decisions on what you're going to do? I know you have managers and all that now, but... We're more, like, the... Making the content. Creative. So that's been really useful.

Still, the question is a good one because it's hard to be off sometimes. Like, even when everyone's done, you go to work unemployed every single day because whatever it is that you put out is out. And then whatever is next is it's not like a six-month lead time like a movie,

it's one or two days, like, what's next? And so for that reason, we've talked about this, like the challenges of going to dinner and, like, not talking about work. I think we were a lot better about it. I think we are still married because we have Amory, Sam, and Desmond, who work with us, and they take a lot of the, just the work part of it out so we can stay married. Yeah.

Because when it was just the two of us, it was, that was really hard. And it was all we talked about. So now we challenge ourselves, like, we go out to dinner and we don't talk about, like, work. But now our next challenge is to go out to dinner and not talk about word work or kids. Yeah, that's. What are we going to talk about? And it gets kind of, yeah, like, what? I literally bought conversation cards.

No, those are great. It was great because I asked a couple questions and it got off of, I'm like, we've been married long enough that I need conversation cards. But it was great. It's like conversation Viagra. No, seriously. It's... Yeah. Oh, my God.

Yeah. And it was... It keeps the dinners from spiraling into like, okay, but then he has a basketball game when we get back, but then we had to leave town on Saturday. We did this last night. Yeah. Okay. This is going to end.

Like, he's 16. I know. And then what are you going to talk about? I mean, so the big things you talk about at dinner are work, kids, extended family, just like other people. Our parents, our parents. Whatever. I get, like, if she asks me, I can talk about space and science fiction for six straight hours.

But that's a one-sided conversation. Yeah, I actually pulled out my camera because we were having a dinner. It was like, no works, no kids. And then I asked him about the book. Sure, I'll talk about quantum entanglement. He's, the book he's reading. And I just, he was talking for so long. He didn't even realize I'd taken out my phone and hit record.

Because he was just, if you need filler on a podcast, he can come on and talk about space for, really a long time. So, but I try to be interested in it because he's interested in it, but I'm, I know, I know. So, but it's a good question. But honestly, when she got the conversation things, even like the book of questions, I think everyone who ever, like, went to a camp where they were like trying to hook up with a girl at a Christian camp, but you wanted to ask him a question, like, you probably have, like, wait, that was too much information. There's this thing called the book of questions that would, like, is a really good way to get to know people better. How many girls do you hook up? I was unsuccessful all the time. You guys have

got to make your own set of conversation cards for middle-aged, like over the hump. Yes. You know? That's a good idea. We're going to call it Conversation Viagra. Can I get any commission on this? Yeah. Conversation Viagra.

Like, you know, for those of us who make it over the hump. Make it over the hump. I mean. And then what are we going to talk about for the next 30 years? Honestly, I'm very excited. We're going to do this. I know. I'm obsessed with my son.

I'm going, you're going to have to like peel me off the floor when he goes to college. But I am looking forward to that time in life. All right. Thank you so much for coming on on podcast. Well, I'm very thankful for you and all the work you're doing. And I'm just, it makes me so sad that my mom didn't have a you, you know, way back one. So thanks for what you're doing. And thanks for having us here.

And I'm glad to see you haven't lost your phone. Thank you, my hero. Yeah, he's good like that. Well, thanks for having us. All right. You can find more information about Ken and Penn and Penn's books, podcast, and social channels at theholdernessfamily.com. You can find full episodes of unpaused on YouTube at Dr. Mary Player. I'd love to hear from you about this topic and anything else that's on your mind.

You can find me on Instagram at Dr. Mary Claire and get honest and accurate information on health, fitness, and navigating midlife at the pauselife.com. My new book, The New Peri Menopause, is available now everywhere you buy books. If you're loving this podcast, I have an important request. Please take a moment to follow Unpaused on your favorite podcast app. Following and listening is what pushes this information to more women who need it. So if this podcast has helped you feel seeing, understood, or supported, hit follow right now so you never miss an episode. Thank you for being here with me. Let's keep going, Unpaused.

Unpaused is presented in conjunction with Pod People. I'm your host, Dr. Mary Claire Haver. The views and opinions expressed on Unpaused are those of the talent, and guests alone and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment.