The Essential Menopausal Toolbox with Dr. Mary Claire Haver

Dr. Mindy Pelz
On this episode of the Resetter podcast, I bring you the one and only Doctor Mary Claire Haver. Okay, you all had asked for this. I have received messages after messages asking to bring Doctor Haver onto the podcast. So many of you know her book, the New Menopause, has been just taking over the world and firing women up. And I have been waiting months for this interview because I respect her on so many levels.

So if this is new, if Doctor Haver's work is new to you, let me just give you a little background on her and then let me tell you about what you're about to hear. So Doctor Mary Claire Haver is a board certified Ob GyN. She has helped thousands of women going through perimenopause and menopause. That's actually her specialty. And her goal is really to empower women through knowing how to talk to their doctors, knowing what type of medications are available to them, knowing lifestyle tools.

She had a national bestselling book called the Galveston Diet. And then her new book, the New Menopause New York Times bestselling book was released a few months ago. She has not only an incredible educational background, but an incredible experience with menopausal women. And you'll hear in this conversation, what I really appreciate about her is her heart and the way she delivers the message of menopause to women. It's about empowering you.

And that so lines up with everything that I stand for and are teaching you as well is you have the right to speak up for amazing health. And that's what you're going to hear in this conversation. We went to a lot of places in this conversation that you, I hope, have never heard before. I hope you'll walk out of this conversation with a tool set you didn't know you had. It was incredibly deep and the topics were vast.

So let me give you an idea of a few. I wanted to talk about the new research that's out there right now. A new study was put out by Lisa Moscone. When I brought her on this podcast. She talked about she had had some findings on the female brain.

Those findings were released last week. Doctor Haber and I break that down. So what does it mean? What are the new findings on what's happening to estrogen receptor sites in the brain in the postmenopausal years? We talk about that.

Then we talk about how do you decide if HRT is bioidenticals? How do you know if that's right for you? Then we moved into what are some of the key things you need to know about lifestyle. So really important that you understand where lifestyle fits into the menopausal picture. And then from there we go into symptomatology.

We talk about everything from hot flashes to muscle loss to visceral fat to brain changes. And what resources do we have for all of that? This is definitely the most extensive conversation I have brought you on the perimenopause and menopausal journey. As you will hear, doctor Haven and I line up on many of the lifestyle recommendations that we are both giving. It was just a beautiful conversation around how do we lift women up?

How do we give women a voice, and how do we give women tools to navigate the menopausal process? And that's what you're about to hear. Welcome to the Resetter podcast. This podcast is all about empowering you to believe in yourself again. If you have a passion for learning, if you're looking to be in control of your health and take your power back, this is the podcast you let's talk about how to properly break your fast.

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Okay, well, let me just start by welcoming you, doctor Haber. Your work has inspired me. I have been watching you do your Facebook's lives and all your videos. And as somebody who puts out a lot of video content, I know how hard it is. I can feel your passion and I feel your heart for what you're trying to do for women.

So I just want to welcome you to my podcast and say thank you. I can't wait to have this conversation with you. I'm just so excited to be here because again, I've been watching you, following you, and just love your communication style and how effective you are at inspiring women to look at themselves. Habits, changes, so that they can live a healthier life and not accept the status quo. So, yeah, let's do this.

Yeah, let's do it. So I'm gonna start this off with. Over the last couple of days, I've been diving into your book. And I gotta tell you that one of the threads of thought that keeps coming to me is, we needed this book like, I'm 54. I needed this book when I was 40.

I know when I was in practice working with lifestyle, with women that this book was needed 2030 years ago. And I'm so happy you wrote it now in the lens from which you wrote it from. But I also feel like there's this cracking open of a cultural conversation that's happening around menopause. There's like an empowered feeling that women are starting to embrace because of books like this. So what is it that's happening in this moment around the conversation of menopause that wasn't happening decades ago?

Dr. Mary Claire Haver
You know, when I look at the options that our mothers and grandmothers had, and when they got to our age in their fifties, it was like, this is as good as it's going to get. And they just calmly accepted what the world offered to them, by and large, which ended up with them having 20% of their lives spent in poorer health than their male counterparts at three to four times higher risk of Alzheimer's, much higher risk of fragility, and ending up three to one needing long term care facilities for extended period of times more than their male counterparts. Our generation, the elder millennials and the gen xers like us, because I'm 55, are saying, absolutely not, like, this is not okay. And how we approach, study, and conceptualize our menopause, which is from the last minstrel period until we die, okay? They know that if we just stay on the path that has been laid out for us by society, by how medicine treats us as females, as we age, is going to lead to these poor outcomes, and we're not willing to put up with it.

And this is the exciting part of what I'm doing, is, yes, I'm getting some pushback from the establishment. You know what? That's okay. Take me out for it. I don't care.

You know, because I know that we are the menopause, you know, the messages that we're giving women that are resonating with them are leading to change in their habits and health and options that are gonna lead to better quality of life as they age. Yeah, yeah. And I so agree with you that there's, like, I keep saying to many of the health people in the health world that are educating women, I keep saying, can you feel it? Do you feel it? Like there's something going on, there's something inside women that are now, we are now being like, no more.

Dr. Mindy Pelz
You can't treat me like this. You can't gas like me in an office. You can't give me an antidepressant for my menopausal symptoms. There's like this real rising up, and I call it what I've been phrasing. It is the patriarchal hex that women have been under, this sort of hex of accepting mediocrity when it comes to our healthcare system.

And by patriarch, I always want to say, it's power over. It's not men. Right. Some of the loudest voices that are of the status quo are female. So I want to be very clear.

Dr. Mary Claire Haver
This is nothing to do with men, you know? Right. Women are probably the worst at trying to continue a narrative, at least in my world, and we're just not standing for it. Yeah, yeah, yeah. And so with that in mind, I really want to move into, in this conversation, when you look at the symptoms of menopause, what I see that gets highlighted and profiled and media grabs onto, although this is changing, is hot flashes.

Right. But I can tell you, as a 54 year old woman, like, hot flashes was. Yeah, it was a thing. But can we talk about the mental changes that happened throughout the menopausal journey? Because those were the changes that were affecting every relationship in my life.

Dr. Mindy Pelz
So when I look at the research and about how these estrogen receptor sites are still very active in us post menopausal through the. Yeah. How do we. What is that telling us about menopause and how we need to do it different? Okay, so let's back up to the first part of your statement of, you know, forever.

Dr. Mary Claire Haver
It seemed like menopause treatment was defined by hot flashes. You were 100% right. Hormone replacement therapy was developed in the forties, fifties, sixties, you know, through that pathway, simply to get rid of hot flashes forever. We defined menopause symptoms by the presence or absence of vasomotor symptoms. 85% of us have them for 2025, 30% of us, they're severe and life disrupting.

But that was it. There was no talk around the brain changes which led to mental health and cognition changes, the musculoskeletal changes, which, you know, with your background, you probably know what better than anyone with neuralgia, arthritis. Oh, my God. Frozen shoulder, all of that besides frozen shoulder, hair, teeth, gut, you know, every single organ system in our body is affected. And the old guard, you know, who wrote the papers on face and motor symptoms, who really define menopause by, you know, and everything else that we are going through at this age was attributed to aging, nothing to do with hormone depletion.

And that's where the new research is going. So the beautiful study that just got published in Nature magazine by our friend doctor Lisa Moscone, who's a neuroscientist who in her entire career, has studied the female brain and its relation to dementia and Alzheimer's, okay? That is what she does. She PET scans brains left and right. She's at Will Cornell.

She's amazing. She is the first person in history to look at the female brain by PET scan through the menopause transition, menopause brains and looked at the activity of estrogen receptors. What we thought was estrogen receptors fall off and die as we go through menopause. No, they actually upregulate. The brain is starving for estrogen.

It's creating its own estrogen through peripheral conversion of estrogen to estradiol and some testosterone. It is dying for estrogen. Parts of the brain, the hypothalamus, pituitary, the functioning, the cognition, the memory centers are lighting up like firecrackers in post menopause because the estrogen receptors are like, help me, help me, we need estrogen. The old guard attributed the cognitive. We know that women are having cognition changes through menopause.

They only attribute that to the loss of sleep from vasomotor disturbance. Lisa proved them dead wrong. This is literally due to the loss of estrogen in the brain that lubricates and makes everything work better. And we take that away and the brain stops dysfunctioning. All stops functioning normally.

Also, we know great research coming out of Australia. We have a 40% increased risk of mental health disorders through the menopause transition. So in perimenopause, when the levels become chaotic before they plummet, you know, in postmenopause, that's when we see the biggest disruptions to our mental health. Yep. And forever.

That got dismissed as this is a time in your life, you're stressed out, teenagers are driving you crazy, your parents are getting older, your job is more demanding. You're not, you know. No. It is literally the disruption of neurotransmitters in our brains due to the chaotic fluctuations of our hormone levels. And here's the third thing that Lisa's discovered, and I've seen it also in the liver literature.

Ssh, as we know. Right. Follicular stimulating hormone, which is made in our pituitary, that makes us ovulate. Basically, to simplify it, FSH rises in perimenopause and then gets really high in postmenopausal, stays there for the rest of her life. New data is showing that those FSH alone, without the estrogen depletion, is toxic to the liver and the brain, increases the rate of atherosclerosis.

Alzheimer plaques. Yeah. In the brain, just the FSH elevations. And if we can get those FSH levels down, those processes get easier. I mean, it's just explosive what's happening right now in the menopause world.

I'm so excited. Yeah. So there's such a great explanation so does that mean that everybody should go on hormone replacement therapy? No, that means that everyone deserves an informed conversation about the particular benefits of hormone replacement therapy and how it may affect her life. I don't think it's for everyone.

No, it's a medication. You need a full discussion of the risks and benefits. But what's happening in modern medicine is that a woman walks in with hot flashes. So classic vasomotor symptoms. She has a 10% chance of getting the diagnosis of menopause put on her chart.

No, period. It's a diagnostic, it's a diagnosis. Wait, I don't even. That seems like a 10%. So if so, in that 10%, if she's offered treatment, four to one, it's an antidepressant versus menopause hormone therapy.

You know, only six to seven depending on who you read. Six to 8% depending because we don't track the compounding pharmacies. Right. So it's only the FDA approved stuff, but right now it's four to 5% are getting FDA approved HRT medications of women who are eligible. Yep.

So do I think all women need it or want it or whatever? No, but I think everyone deserves an informed conversation, not only about the risks and not only about hot flashes, but about the cardioprotective and neuroprotective benefits. Yeah, I love that thought. And the way you phrased it is that every woman deserves an informed conversation, which is amazing. Now, I will tell you, what I've seen, not only in my clinical practice, but in our online community, is that there's no one size fits all when it comes to HRT and we can't.

Dr. Mindy Pelz
And this is what I love about your books is like. And this is the lens in which I see things, is we can't leave lifestyle out of this conversation. So what I just want to make sure the women that are listening to this is as exciting as this is. It doesn't mean you put a patch on and life's going to be like how it was. I wish, right?

Dr. Mary Claire Haver
I mean, I've had to completely overhaul my nutrition, my movement strategies, my stress reduction, my boundaries, my. You know, I. I think I'm like you in that, you know, I'm 55, I'll be 56 in about a month. I literally am living my best life. I have better relationships, better intimacy, better health.

I'm wealthier, I'm helping more women than I've ever helped in my life. Super proud of my past and everything I've done, but this is it. And I want everyone to feel that way right at my age and beyond. But had I not overhauled how I eat, how I think, how I move my pharmacological choices, I wouldn't be here today. Yes.

Dr. Mindy Pelz
Amen to that. And here's what I love about my conversation with Lisa that's bleeding into this conversation, is that as I was going through my perimenopausal years, I kept trying to figure out what's going on with my brain. And I brought guests onto my podcast, one of which was doctor amen who I love. But when I asked him, what's going on with the female brain, he said, well, it was because you weren't meant to live that long. And I thought, well, that's a horrible answer.

I think I was meant, I want to live to 100. So that's a horrible answer. So when I brought Lisa on, she talked about how the brain changes and brought up this idea of the grandmother hypothesis and how our brain actually becomes a more highly functioning brain post menopausal years, that amygdala calms down, it starts to be more empathetic. We can see the bigger picture. And when I saw that, my brain was like, so basically, the brain changes that are happening in menopause are setting us up to be cultural leaders that women in their postmenopausal years are their absolute best, to your point, living their best lives.

But that's not the message that's getting sent down to women. No. It's like you're developing Alzheimer's at a higher rate because you live longer, and that is not true. That is absolutely, yes. So if we were to take a woman at 40 and say, here's what's coming down the road, here's what I recommend you do so that you can land at 55 and 54, where I'm at, and we both are at living your best life, what advice would you give?

Dr. Mary Claire Haver
So I have a little talk that I do that's like what I would tell my 35 year old self. So roughly the same thing, nutrition over calories. You know, this whole cultural. I grew up with it. My whole life.

I worked out to be thin, and I ate to be thin. Those are my two goals, because thin meant healthy. Okay. Certainly being spin or is more healthy than being morbidly obese. My genetics was never going to allow that to happen to me.

It'd be almost impossible, okay, to be morbidly obese. So I have been privileged for that. But I just focused on calorie counts. That's all they taught me in medical school. I knew about washi or core and scurvy and severe vitamin deficiencies and stuff.

But basic day to day nutrition I had, I went back to school at like 48 to learn about nutrition and so, and then incorporate that into my practice which you know, then I wrote into a book. But so you know really focusing on nutrition over calories, are you getting enough fiber? So like I have a few tenants that I focus on. Foods rich in fiber also are rich in so many other things, vitamins, minerals, nutrients, you know, so it's like you're killing multiple birds with 1 st. But most women in the US are only getting about 10 grams of fiber per day.

Great studies coming out looking at cognition and fiber intake in elderly patients, looking at fiber intake and gut health. I mean we all know, most of us know that now. And so women should be getting minimum 25. The health benefits for at least cognition seem to max out around 32 grams per day. That's three times what most women are getting.

So nuts, seeds, legumes, crunchy vegetables, fiber, you know, berries, I getting food rich in that rather than just like oh, locale, you know like how much fiber are you getting? How much magnesium are you getting, what's your vitamin D level? You know like looking at those things and the rest kind of falls into place and then you go from a place of restriction to a place of I gotta eat more. Are you getting enough protein? Oh my gosh, like I was not getting enough protein.

Yeah, for sure. What's your recommendation? What are your recommendations on protein? Because we've had some really deep discussions on this in my, and in my membership group and people are struggling to get 1 gram of protein for every pound of body weight. So again there's a big mental shift that has to happen.

It had to happen for me. But when we look at the, you know, the WHI, the women's health initiative which kind of threw out estrogen as an, you know, optimal treatment. It's just a data set, there's really good data that came out of there. For example, they looked at fragility scores in menopausal women and protein intake. And the women who had the highest level of protein intake, about 1.4 to 1.8 grams/kg of lean body mass.

So just under, just under one per pound had, just looking at that had lower fragility scores. We are not eating enough protein to counteract the sarcopenia of aging and so upping your protein. So I'm recommending for my patients and I do it in kilograms. I have a body scanner in my office, I measure their muscle mass. I look at their visceral fat, and, you know, I'm really pushing closer to that 1 gram per pound, you know, of healthy body weight.

And they, because they're, they're usually about 50 or 60. So I'm like, don't think it's tomorrow. This is a transition. Okay. So we're gonna, you know, don't, don't think you have to fix everything today.

You've been living this way. We're just gonna get you. Let's make our goal by the end of the year. You know, we have like an six months to a year. Let's get you up.

And so every month you're gonna try to increase here, increase there. And protein supplements can be a great segue to get there. I always prefer you to get your protein through food supplements are great, but they don't replace whole food and good nutrition. And so for my patients who are transitioning to get to these higher levels, sometimes a protein shake or sour, some of the bars can be a great way to help them until they figure out how to incorporate more of the protein rich foods in their diet. What would you say to the vegan ize?

Dr. Mindy Pelz
Do you really? It's possible, but it's tough, you know? Right. You can be healthy without HRT for the rest of your life. It's tough.

Dr. Mary Claire Haver
It's harder. And so, you know, all of these are not absolutes, but if you choose to be vegan, it's definitely healthier than, healthier than the western diet. We know that, of course. But you're going to struggle. It's going to be harder for you to get the recommended amount of protein to avoid the frailty as you get older.

You know, the goal is not to be thin. The goal is to stay out of a nursing home. Oh, my God. That's so that you need, you need to. That's what I asked my patients all day long.

I'm like, let's get rid of the acute problems. Yes. Get rid of the hot flashes, the night sweats, the brain fog, those things that brought you here. And then we're going to set a course for the next 30 years. Okay, and what, what are your goals?

What is your, what does your mom look like? And look, if their mom is kicking ass at 95 and going to the grocery store and driving herself and playing with grandkids, I'm like, let's do what she does. Okay. Yes. But if your mom, like, mine, is frail and demented at 80, I'm like, we're not going to do what she did.

Let's look at what we can change, you know, because that's your genetics. Yeah. I love that. Okay, so that number one is nutrition. Anything.

Movement. Okay, so movement. All right. I worked out to be thin. Cardio.

Dr. Mindy Pelz
Cardio. Cardio. Pick up some weights. We cannot counteract the effects of sarcopenia of aging without resistance training, most of us. And so I.

Dr. Mary Claire Haver
Now, the majority of what I do is not focused on cardio. I do some cardio, of course, you know, I set up my. I have a walking gym. My treadmill is a working desk, and so I walk while I work on an incline with my weighted vest. So I love the way to vest as a hack.

They're cheap, they're multiple sizes. You want to start with about 10%, but great studies done in the elderly of us, you know, which is nine years away for me, by the way. And looking at prevention, like, improvement in their balance, in their strength, and in their bone density scores. Great data on weighted vests with protein intake, sometimes vibratory training. There's lots of little hacks and things that we can do, but, like, really focusing on strong over skinny.

Dr. Mindy Pelz
Yeah. Oh, I love that. Strong over skinny. I just got a weighted vest. I just told my husband this morning.

I'm like, I'm a wrecker now. And he's like, what? Like, yeah, I'm gonna start wrecking. I'm like, it even has a fancy. Yeah, it's a form of wrecking.

Dr. Mary Claire Haver
Wrecking. I like that it distributes the weight evenly over the shoulders rather than just all on your back. And so my husband is all into it now. So we have, like, six of them. So in different levels.

Dr. Mindy Pelz
How much? So, I can tell you, in putting my own exercise variation together, that I've definitely found weightlifting to be great, but I've also found walking to be incredible, especially when my brain's on fire. So what would give us a view of what, like, a week would look like as far as exercise variation? So I recommend to my patients, for as far as cardio goes, we want about 150 minutes a week. That seems to be kind of the tipping point and most of that in zone two a little bit, you know, do a few sprints here and there.

Dr. Mary Claire Haver
You don't have to do much to get the Vo two max up. So, like, shoot for about 150 minutes a week of cardio. So that's, like, 33, you know, five walking sessions for 30 minutes a week, or 345 minutes if you have to crunch it down, and then two to three days of progressive load resistance training, a push day, a pull day, you know, just making sure you're hitting everything. Don't forget about stretching, and don't forget about balance. You know, those are the things that are going to decrease our risk of an osteoporotic fracture.

Dr. Mindy Pelz
When you're in the middle of a fast, do you ever hit a wall and then you really start to struggle? Like, I know this happens to me sometimes. Like I'm going along, I'm feeling really good, and then bam. All of a sudden I'm out of energy, I'm starving, and it's like my brain is turned off. So check this out.

If that's happened to you, there's a really good chance you're running low on minerals. Fasting makes your mitochondria produce more energy. It speeds up fat burning, it helps you make more ketones. So your brain is really sharpen. But the part of fasting that we don't talk enough about is that those benefits often come at an expense to your body.

So you got to look at your body doing the right thing at the right time, always. And when you hit that crash, it's a large chance that your body has had to use a ton of minerals to be able to supercharge you in the fasted state. And if your minerals are already low, you can end up depleted. So that is why I love b minerals. They make a full spectrum mineral supplement that is perfect for fasting.

It's in a liquid form, it literally tastes like water. You just have to take a shot halfway through your fast and you can keep going a whole lot longer without the hunger and the fatigue. So if you want to experience the, if you want to try it in your fasting window and see what kind of results you get, just go on over to beanminerals.com and enter the code mindy for 20% off. And as always, let me know how it works for you. I'm really excited to bring this information to you all because you deserve to thrive in your fasted state.

As a menopausal woman, I have been mildly, maybe deeply obsessed with hacking my way to better sleep. I promise you, any product out there for sleep, I have tested it and either decided I love it or thrown it out. And one of the products that has not reached my trash can and is one of my favorites is cured nutrition sleep products. So I love taking their Zen product about an hour or two before bed. And then I pair that with my PMF mat to allow my body and nervous system to wind down and relax.

They also, they didn't just stop at Zen. There's something about the word zen that I love when I take it, I just reminds myself like, it's time to be Zen now. But they also have other products that help the nervous system calm down, help your body move into sleep much quicker. And it's a CBN night oil. And you compare it with Zen with their nightcaps, which is a CBD mix with MCT oil.

And that combo has been like a tranquilizer for me. So, and I don't wake up groggy. It puts me to sleep, keeps me asleep, and it's definitely become my go to for my nighttime routine. So super grateful for cured nutrition. And if you want to try their products, you just have to go to curednutrition.com pels and you can save 20% off, which is really awesome.

So it's cured nutrition. Curednutrition.com pels pelz and I hope you love it as much as I do. Give it a whirl. I recommend you give it up a month. When you get the bottle, give it a month.

Get it some consistency to start to build in your system and you will start to sleep as well as I am. So I hope you enjoy it and cheers to a good night's rest. And what about yoga? Where, I mean, because like a Sarah. God yoga, depending on the type, stretching, balance, and if you're doing a lot of vinyasa and you know, you're getting a lot of, you know, you see yoga arms all the time, you know, these women are ripped.

Dr. Mary Claire Haver
And so again, yoga can be fantastic for relaxation, for stress reduction. It's just we must also push our muscles. So you have to do the more aggressive forms of yoga to get that to happen. Okay, great. Okay, so second is movement.

Dr. Mindy Pelz
What's after that? So nutrition, you know, strong over skinny. Nutrition over calories. Educate yourself. Educate yourself.

Dr. Mary Claire Haver
You know, learn our books, you know, there's so much great information out there, websites, whatever, you know. And realize you don't have to accept a status quo. But if you probably don't change the habits you've got right now at 30, for most of us, this is not going to go as well as it could for you through this aging process that includes menopause and changing your mindset around how you look to how you feel and so important again, but it should not be the primary driver of the choices for your health. Yeah, I continually say that I feel like I'm partnering with my hundred year old self, like literally every day I'm like, what do I need to do today to make my hundred year old self proud? And if I always keep her in mind in my day to day, I know I'm going to love 100 when I get there.

Dr. Mindy Pelz
So I like where you're going with your thought process on that. What about fasting? We have to bring fasting up, so. No, yeah, I love fasting. For the anti inflammatory benefits.

Dr. Mary Claire Haver
Those are clear. It's very, you know, neuroinflammation, we have great data. Systemic inflammation, we have great data. Where my patients are struggling as we're aging is protein. And so myself, I used to break my fast at noon, typically what time is.

Yeah. And I'm kind of, I bumped my window back about 2 hours so I can have enough time to get the protein in. And I'm not walking around all day with a chicken breast, you know, in my hand and so gnawing on a chicken breast. And so I feel like I'm still getting the benefits, the anti inflammatory benefits. The data for weight loss is not great.

And again, I'm not focusing on just being thin as a measure of health, and I'm discussing that with my patients. Right. But I do think there's a place for it. And there's some great data on anti inflammatory benefits. Yeah.

Dr. Mindy Pelz
And what Lisa and I discussed is what we've seen. And she's seen this, I've seen this where something about the ketone, in fact, I keep diving into like, does the ketone actually activate one of the estrogen receptor sites? Because something happens when somebody has, when a menopausal woman has a ketone going through her body, that the brain fog's gone, the mental clarity and focus is back. And she agreed. But I said, well, where's the research on that?

She goes, unfortunately, we don't have any. We don't have any. But have you experienced that for sure? I mean, in my personal life, you know, I fast in the morning is, you know, after my, after my sleep. And so I just keep going.

Dr. Mary Claire Haver
And I am absolutely my most productive in the morning, again, it's quieter. I'm an empty nester now, you know, there's lots of things feeding into it. But like, I am doing my best work, my best writing, my best reading, researching in those fasting hours, for sure, hands down. And many of my patients say the same thing. Yeah.

Dr. Mindy Pelz
Yeah. So I think we can debate, like fasting lengths and fast and protein, all that. And then I really lately have been like, we can't stop talking about the ketone for menopausal women, just a small amount, because it does seem to supercharge the brain in a really unique way. So another concept that I've been thinking a lot about is the different rhythms that women put themselves in. So one of those rhythms being the circadian rhythm.

So I'll give you an example. I have a good friend who's in her early forties. She just spent six months traveling from many crazy different time zones, and her whole cycle is completely off. So she meanders into Ob's office yesterday, and there's a conversation about, do we have to adapt your HRT? And one of the things I kept saying to her is, you just took yourself out of your own circadian rhythm.

Bring a routine back to your circadian rhythm, and then see what's necessary in the changes of your HRT. So where does circadian rhythm fit into a woman's hormonal rhythm? We. I have. You know, there's definitely a relation because melanocortinous, you know, I mean, we know, and melatonin, the natural melatonin, and all of these.

Dr. Mary Claire Haver
All of these little hormones talk to each other in the hypothalamus, in the pituitary. And so we just. We are not studying women. We're not studying female animals in the labs. You know, like, because of this exact thing, all of these rhythm rhythms are disrupted as our hormone cycle change when we're pre and perimenopausal, and it makes us harder to study.

So they're like, she's just a small dude with breasts. Let's just study them in and, like, you know, so we need more research here. And I'm not saying that absence of evidence isn't. I think Peter says this. The best.

Absence of evidence is not evidence of absence. We. I just can't go around recommending things off the bat without, you know, God, this is something that would be fascinating to look at. Right. You know, I definitely think there's a correlation.

Dr. Mindy Pelz
Yeah. So. And then that also leads me to the nervous system rhythm. And this was something that actually came up the first time I went on diary of the CEO, is I made a bold statement that women need more rest, and I got a lot of. Great data coming out.

Yeah, I got a lot of mixed, like, back at me. A lot of feminist women were, like, appalled that I said women needed more rest. But what I know about the nervous system is you're stuck in fight or flight, and your hormonal system is shutting down. So where does rest and recovery have to be? Highlighted in the menopausal experience.

Dr. Mary Claire Haver
So we are in perimenopause. We are in a zone of chaos, okay? The normal signals that used to cause ovulation, we become resistant to. Because we are losing our egg supply. We're born with all of our eggs, okay?

May last us until we go through menopause. Perimenopause begins when we reach some critical threshold in the quality and quantity of our egg supply. So, in general, by the time we're 40, we're down. By the time we're 30, we're down to about 10% of our egg supply. By the time we're 40, we're down to about 3%, just to give you perspective.

And at birth, we have one to 2 million eggs. So. So here we go. So the normal signals that the follicular cells that surround our eggs create the pathway to make estradiol and testosterone. And so LH and fsH, each month when we're premenopausal, we get this ekg, like, very predictable rise and fall of our hormone levels.

If you're healthy, if you're in the same time zone, if you're, you know, like, if all the planets line up, you know, on day 14, this is gonna happen. Day 15, day 16, and on and on and on. The whole cycle repeats itself. Okay? That is how God made us.

That is the perfect way, right? Yeah. Now we hit perimenopause, we reach that critical threshold. So the hypothalamus is constantly sensing until we die, looking for estradiol in the blood. When it doesn't see it or when the levels drop, it sends the signal to the pituitary through GnRH to say, make.

Tell the ovary to make the estradiol. We're running low. Lh and fsh start pulsate. Pulse pulsatilling, start pulsing out of the pituitary gland. Talking to the ovary, the ovaries, like, I can't respond.

I don't have enough eggs left. So the hypothalamus says, hey, where's the estrogen? Come on. I, you know, send the signal. Pituitary said, I did, and it says, send more.

That's where we see the rises of our fsh level in perimenopause, way higher than we ever were in our premenopausal years. Finally, we get that pulse, we get that boost. The egg is like. We get the egg come out, but it's a much higher estradiol level because we needed much higher fsh to make that happen. So we get bigger surges in our estrogen, though, the timing is off.

It's delayed, and then we have a much bigger crash and progesterone to where it used to be, menopause. So she's a little slow. So timing is off. So that affects our periods in multiple different ways. Too heavy, too light, too much, too little.

You know, everything's off on the table. It's abnormal uterine bleeding. Aub is what we call it in my world. 90% of us have horrific aub through the perimenopause transition that's affecting our sleep, that's affecting our cognitive abilities, that's affecting our mental health. Like, everything becomes chaotic.

So, like you said, the nervous system is like, what the heck is going on? Our nervous system thrives on uniformity, you know, knowing what's coming, knowing it's predictable, you know, not only in our day to day activities, but how our body's reacting to the normal stresses of life. And I know I'm going off on tangents here, but I get so excited. No, no, I love this. You keep going.

All of it means perimenopause, zone of chaos. Zone of chaos. Absolute zone of chaos. So. And when I say that, women are like, oh, my God.

Thank you. Thank you. I'm not crazy. So, yeah. And I think that, you know, I've been saying that.

Dr. Mindy Pelz
I hear you saying that we have so many people. Like, if there's one thing that women need to hear is, you're not crazy. When I. When I look at the statistics on suicide, the most common time for a woman to commit suicide, suicide is between 45 and 55. And I'm like, yep, I get that.

Dr. Mary Claire Haver
Our SSRI use doubles through the menopause transition. You know, doubles. It's crazy. 20% of the population, you know, like. And no one.

Everyone's like, okay, this is just. It is what it is, you know? Right, right. It's insane. Which is why I hope the women listening to this, the women that follow you and me, like, feel like they can rise up now and speak their truth during these years, instead of being gaslit and told that you should take an antidepressant.

Dr. Mindy Pelz
The other interesting piece that I've been really thinking about is I saw a study that showed how powerful estradiol is for stimulating different neurotransmitters. I call it her girl gang. She's got a girl gang of serotonin and dopamine and acetylcholine. And so when she goes away, her girl gang can potentially go with her, and there's like, this neurochemical armor that comes down, and what I experienced was it was like, all my traumas, all the unresolved stuff in my life that I hadn't dealt with was, like, right there for me to deal with. So what do we know about emotional healing during this time and what we need to do to deal with traumas?

Dr. Mary Claire Haver
So I have one of the menopause, she's coming. I'm doing a conference in Galveston in January. She's coming to talk about menopause and trauma. And like you said, we lose our resilience. So I love how you put that.

The armor comes down and all of a sudden it, you know, that's why I. So for healing what I've seen success in my patients. So we know that restoring the estrogen levels through menopause hormone therapy better than SSRI at decreasing the. But I think there's power in revealing those traumas so that we have the space to, like, rectify them because they're always kind of behind a wall. The best thing to do besides building the wall higher is to, like, open the door, manage them, you know, get rid of them right.

Through therapy. And so putting up boundaries, that's what I did, you know? Yeah, me too. It doesn't mean I doesn't love the person. I still love them.

I still, you know, they're so my family. This is my family I'm talking about, and I hear you, but I have put up walls, and I have no guilt or shame about doing it now. I used to feel so guilty when I had to prioritize my own mental health over theirs, and now I'm like, no, you know, I have my own children to take care of. I have my own, like, family that I built my own life, and this is my priority. And I, you know, you are part of my life, and.

But I have boundaries that I'm not going to allow you to cross, and that is healthy for me, you know, and I don't have any guilt or shame over doing it. So I think that's one thing. I also, for the first time, sought therapy. I always thought it was woo woo. You know, I started in, and that therapist taught me to incorporate journaling and gratitude and, you know, taking out time, and it's made me a better mother, a better partner, a better, you know, and so that was really, really powerful.

But it did take that armor coming down for me to realize I was in crisis mode and I could not continue or I was going to destroy my family that I built, you know, and so I had to get help. Yeah. You know, you and I, I feel, like, have similar paths through menopause and how we approached it, because, you know, I went into my forties like, an extreme runner, like I was, you know. Marathon runner.

Dr. Mindy Pelz
And I was, like, paleo at the time. Like, I did everything extreme until I realized it didn't work and I had to have more variation. And then in my early fifties, those traumas that I hadn't dealt with, I felt like they were there for me to deal with. I, too, went into therapy and tried to work on dealing with those. And in the boundary making, in the production pace that so many women, high achieving women are at, one of the key things that I've recently discovered is that many women just aren't feeling safe.

They're not feeling safe within their doctor's office. They're not feeling safe within their marriages. They're not feeling safe within corporations. And when a woman's body doesn't feel safe, her hormones, I don't care how much cream you rub on yourself, are never gonna be in balance. So can you talk a little bit about, do we have strategies for helping ourselves feel safe?

What can we do as. As women coming together to create cultural safety? Where should we speak up so that we continue to create an environment of safety for women so our hormones can balance? So the. So when we look at the doctor's office, this is a systemic issue.

Dr. Mary Claire Haver
And how we're training our clinicians. And, you know, what, you know, besides me educating, you know, the masses via social media and my patients in my clinic, I'm also part of advocacy groups that are fighting for legislative change, you know, fighting for menopause to be required study, you know, in the medical societies, in the residency programs, in the. And not just, like, the treatment of hot flashes. Like, it's the gender health gap, you know? And so there are now charges leading, like, we're not little men with breasts, you know, to Stacey Sims is, you know, we're not little men.

And, you know, like, we need to study how these drugs affect women. One of the. So that, you know, and then train our clinicians so that a woman has a safe space to, you know, females have a space to discuss this, and that the clinicians are trained and understand how we. Our bodies age differently than men's, you know, and how unique we are and how our needs need to be meth individually in the workplace. You know, there's lot.

We're still working on that piece. That's a big one. One in five women of our age are quitting their jobs not because of life stress, because they don't feel like they can do their jobs anymore because of the brain poke, you know, and they're not feeling that they have a space to discuss what's going on or any accommodations that can be made. And so that is a piece we're working on as well. Jennifer Weiss Wolf is writing.

She wrote the legislation to get women's health, like, more funding for women's health in general. And so she's working on tools where, like, we can present on social media. Here's how to write your congressman. Here's how to talk to your boss here. You know, here are things that we can do.

I think we are, honestly a generation away. I think our daughters, I don't know if you have children, but you have two daughters, 20 and 23. I think by the time they are our age, this will be so much better. There'll be no more taboo or, you know, it'll just be, how do we most effectively allow women to thrive during this time instead of her putting on armor and battle to go and get what she needs? But so, you know, I think we're a generation away from that.

But it's like, so we have just hacks now on ways for us and our generation to kind of survive and thrive through this until we get the rest of the world on board. Yeah, I love the way you're thinking about that because it does take time to change a culture. Although menopause, like, I feel like we've gone from a cultural hush about menopause to a little bit of cultural chaos where I said to a friend the other day, I was like, you know, do you feel like we have a lot of menopause books out? And she's like, it's so overwhelming. And I feel like the more we can unify voices, the more we can give the power back to the women that are going through the process and let her use her own intuition as to, is this, am I being treated right?

Dr. Mindy Pelz
Yeah. Which brings up a really interesting point. When you're in your healthcare office or you're on your healthcare journey, where does that women's intuition kick in? Let's use you as an example. Somebody walks into your office, you give a protocol, maybe a woman, and I'm not.

No criticism of what you might say, but maybe a woman's like, that doesn't feel right for me. Where does a woman's intuition need to come into the health conversation? I think it's critical. You just need to arm a woman with information and education, and she will make good choices for herself. The end.

Dr. Mary Claire Haver
And so I just had a woman write in and say, my doctor told me I wasn't having enough hot flashes to warrant treatment. And I was like, how much do we have to suffer before we qualify? My job as a clinician is to offer options, not to judge symptoms. You know, it's like, really her decision. I'm just laying out her options to include nutrition, stress reduction, sleep optimization, pharmacology, supplements, whatever.

And then she gets to make her own choice as to what she wants. She may change her mind in two years, but this is. It's not a one size fits all. It's really up to her. We don't.

I don't think we do this to Mendez. We lay out their options. They make a decision based on what they think is best for them, based, hopefully, based on facts and not fear. And moving forward, if a woman doesn't, I do not lose sleep over it. That is her choice.

Right, right. But you're a unicorn. I don't know if anybody has ever told you that. I'm trying to create more unicorns. So I'm developing a training program for clinicians to fill in that gap that they didn't get, you know, until we can get all the training programs on board.

So I'm developing a training course for healthcare providers. Yeah. So they can know what I know and then help patients make better decisions. Yeah. Amazing.

Dr. Mindy Pelz
Going back to the 20 year old. So, one of the things that I noticed in fast, like a girl, I got a lot of mama bears coming to me and saying, how should my 20 year old eat? How, you know, what. What. What should lifestyle look like?

My 20 year old suffering? And one of the things I can say for my 24 year old daughter and I, we've had multiple conversations over the years about birth control. And when you look at just the pill, the studies on the pill are very interesting as far as the changes they make to the microbiome are not great, and the nutrients they deplete out of our system are not great. And so I've been thinking a lot about if somebody's been on birth control for two decades and they come screaming into perimenopause, they're already in a bit of a depleted state. What do we need to know about the 20 year old and the chronic use of birth control?

And what would the woman going into perimenopause need to know if she had been on birth control for a long period? So, you know, we have the contraceptive benefits of oral hormonal contraception. And that does, because it goes through the gut, does appear to have the most disruption of the gut cycle. The transdermal transvaginal transmucosal options tend to be a little bit better because they just go right into the bloodstream for that. So.

Dr. Mary Claire Haver
But, I mean, good nutrition is good nutrition, you know, and it's especially important if you're going to utilize contraception. Now, we, you know, it has the same effect if you're utilizing it for. For, you know, medical management of a gynecologic issue. And so, you know, for myself, I was a PCOS patient. Never heard of nutritional advice for PCos.

It was birth control pills. The end. I was on birth control pills. Actually was really happy with them. But I got on these forums before the Internet, so I'm old, right.

And so I got diagnosed in medical school, and then I found these chat rooms back before social media, you know, the early chat rooms, talking about using nutrition to treat pcos. And I was absolutely fascinated, you know, and then metformin came out as a treatment option for. And I was like, oh, well, that makes sense because it's, you know, insulin, insulin resistance, you know, and I was like, God, if we just started with nutrition for this advice, you know, instead of going right to birth control pills, we could probably treat most pcos, you know, and use other forms of contraception. So I just think we're not giving patients the full picture because we're not teaching the clinicians, you know, the full picture of how the, you know, what the effects of these things are. I don't think we're doing adequate counseling for, you know, for.

I love contraception. Women who don't need to be pregnant, you know, we need to have lots of ways for them not to be pregnant who aren't ready for it, or this is not a good idea for them. And so, you know, I do see the backlash because we not doing adequate counseling of the demonization of birth control pills, you know, good and bad. I have long term athletes who are coming in for just to suppress their cycles so that they're not bleeding while they're swimming. Right.

Like the big swimmers. Yeah. And because it's really disruptive for them. But also, we lose a lot of testosterone when we suppress ovulation. And I'm like, that might impact your performance.

Let's look at other options rather than what your girlfriends were telling you where to pill. Maybe a Mirena IUD might be a better option for you. If you're looking for cycle control and contraception, your cycles will probably go away and then you'll still be ovulating in the background. So you still have your normal hormone cycles and you get that good testosterone to keep your muscles and burn strong, you know, and not affect your athletic performance. I think these are nuanced conversations.

Dr. Mindy Pelz
Well, yeah. And I think this is why we have to, like you go into your forties, you need to look back and go, what, what have I, what is my lifestyle been? What toxins have I been exposed to? What has depleted me? Because it's a different game once you go into those perimenopausal years, which is why I want to highlight this.

The other piece is toxins. I recently saw, a year ago I saw a study that in menstrual blood they're actually measuring phthalates, pesticides, plastics and forever chemicals. And so when we bleed every month, we're actually. That's a good way to do it. Yeah.

And, yeah, so the men's, but we have a lot of younger generation that they're not bleeding anymore. And then what do we do with the postmenopausal woman that doesn't have that detox anymore and we live in this toxic culture that we're in. Do you have any hacks or strategies you recommend for menstrual women when it comes to helping the toxic load? I have to go back and look at that research. I haven't really, you know, that is one area that I have very little training on again, because it's probably newer research looking at menstrual blood and what's coming out of there.

Dr. Mary Claire Haver
I'll say it to you like ten years. All I do is post menopause. Menopause. But I'd love to read it. Yeah, send it to me.

That's fascinating. Yeah, I'll send it to you. Because then it leaves this question. If you're not bleeding every month, then you're not detoxing every month. So what strategies?

Dr. Mindy Pelz
You know, I've been recommending simple things like, you know, chlorella, of course, the fiber, I love the fiber thing because, you know, you, if you feed the estrobalome now, you know, make sure you're having bowel movements every day. Like there's a lot sweat every day. There's a lot of great ways we can detox, but I think we should be aware that we don't have the menstrual detox. And so I'll send you the article because I think it's really interesting. My other question is the visceral fat change.

So I always laugh because I'm sure you get this. Like, the videos that do the best on my YouTube are menopausal belly fat. And I love where you're like, let's keep you out of the nursing home. Yeah. What do we do about the visceral changes?

Dr. Mary Claire Haver
To be honest, doctor pells, that is the biggest pain point for patients. Again, they're coming from the mentality of, I have to be thin, da da da da. And then all of a sudden, through their menopause transition, with no changes in their diet and exercise, they suddenly develop a belly. And that gets people's attention because it's about 90% of us, and I was one of them, and I'm like, this is impossible. Like, everything they taught me in medical school was calories in, calories out.

This is impossible. I've changed nothing. And you go and you look at the literature, and it's like, are you really only eating that many calories? Are you sure? Are you really working out as much as you saw?

I'm like, I'm telling you, this is happening to me. So when you break down, what is happening? So estrogen is a really powerful anti inflammatory hormone. And when the, you know, the shield comes down, the estrogen levels drop. All of a sudden, our systemic inflammatory markers increase, and that drives fat to the intra abdominal cavity.

Insulin resistance increases with no changes in diet and exercise. That drives fat to the intra abdominal cavity. Once that fat hits the intra abdominal cavity, it is much more pro inflammatory than our subcutaneous fat. So for your listener, subcutaneous fat is the fat we all know gives us breast, hips, cellulite. We don't like it.

It's cosmetically distressing, but it's a very different actor than our visceral fat is much higher in the neuroendocrine, you know, production of inflammatory hormones. And so the higher our levels of visceral fat, the more likely we are to develop cardiometabolic disease. So they've measured it in a premenopausal woman, the average percentage of total body fat that is visceral is 8%. She goes through the menopause transition, that increases to 23%. Wow.

It triples through the menopause transition. I don't have to tell a woman this. She knows it's happening. Yes. So what do we know?

Nutrition. So HRT can help attenuate this. It's not perfect. Okay. High fiber diets, 25 grams or more.

Less likely you will see a decrease in visceral fat, limiting added sugars, not sugars found in cooking, not sugars found in natural foods. Sugars put in there from cooking and processing. Women who limit those added sugars to 25 grams or less per day. Much lower levels of visceral fat, normal vitamin D levels, much lower levels of visceral fat. Probiotic diets rich in probiotics, much lower levels of visceral fat, and all the ensuing health changes.

So lower visceral fat, lower hypertension, lower cholesterol, lower insulin resistance and lower diabetes, lower stroke, on and on and on. What, what levels do you like vitamin D to be at? So in my clinic, and from what I've read, you know, in the functional medicine world, though, I'm not classically functional medicine trained, so I don't want anyone to, I don't want to pretend that I am 60 or above is what I'm shooting for, you know, so, but most of my patients who have, who are not supplementing, it's really hard to get it through our diets. We decrease absorption, all the things we're protecting our skin, rightfully from excessive sun exposure for skin cancer. And so that is leading to lower levels of vitamin D.

Most of my patients aren't below 60, they're below 20. They are extremely deficient through the menopause transition. Yeah, yeah. And I would agree higher is better. And getting it up isn't as easy as just dropping some supplements.

Dr. Mindy Pelz
You have to really do it continuously. That has shocked me when watching a lot of women vitamin D levels, how some can get it up quickly and some can't. So it's a really interesting conversation. Of course, we have to talk about alcohol because alcohol is a really interesting one because the glass of wine becomes the thing you're like gripping to as you're going through this experience. But then it creates the lack of sleep.

It creates, yeah. What would you say about alcohol in this process? You know, there's nothing healthy about it really. There's really very few benefits for that 20 minutes high. You're sacrificing your sleep, you're sacrificing calories, you're sacrificing your mental health, you know, and I know for me and most of my patients, and I do drink, if I choose to drink, I'm choosing not to sleep.

Dr. Mary Claire Haver
You know, I've gotten the hot flashes taken care of, you know, with my hormone therapy, but I still don't have the same level of sleep that I used to. I'm much more prone to have a 03:00 a.m. awakening and alcohol is almost 100% of the time going to do that to me? And so I've had to make a choice between sleep and alcohol. Yeah.

Dr. Mindy Pelz
Yes, I absolutely agree with that. And, you know, Peter Attia said this on his podcast one day, and I was like, I really like this. Look at alcohol, which is have it hours. If you're gonna have your glass of wine, have it hours before sleep. Do it with food.

Do it in an environment. Yeah. Do it in an environment where you are in a social setting where it might be relaxing you a little bit so you can have that human connection moment, that there may be a place for it, but you would need to put some boundaries around it so that you don't end up with the 02:00 a.m. wake up. Would you agree with that?

Dr. Mary Claire Haver
Yeah. So I know, you know, so I talk to patients, like, you know, they joke about day drinking, you know, and I love the way that Peter framed that. And, like, it can be let some of those walls down so you can have that connection or, you know, decrease the social anxiety, but just be really mindful and keep those boundaries up so that so many of us are crossing over, and we're more likely to cross over because of the increased stress of perimenopause. And then if you're not sleeping everything, you know, it's like, we got to get sleep as a priority. And if this is affecting your sleep, you know, we really have to look at this carefully.

Dr. Mindy Pelz
Oh, yeah. I have, like, become, like, crazy about sleep, where I just. No, I cancel appointments. I don't go on social engagements, because I'm like, I need sleep, or I can get a little crazy. The last thing I want to ask, and this came up, I actually heard you say this on Mel Robbins podcast, and I thought, wow, I wish I had known this when I was in active clinical practice, which is this concept of the frozen shoulder happening to so many menopausal women.

And I will tell you what I saw in practice is the extreme worker outers. When they hit their late forties, the injuries were not repairing the way they used to repair. So is there anything other than awareness that that might be a hormonal shift, not a structural change? Is there anything we can do for those athletic women that don't want to experience chronic injuries? So, when you start feeling symptomatic, at least Vonda Wright is kind of my go to person.

Dr. Mary Claire Haver
She's an orthopedic surgeon and specializes in menopause. And she says, get early physical therapy, get in there, and get that joint moving as early as possible. Do not wait. We know from the Duke study and now newer studies coming out, women on hormone therapy have decreased incidence of frozen shoulder versus women not, also have decreased length of the time that they're frozen and need less therapy. Long term estrogen is better at prevention than cure for so many diseases.

And when we lose our estrogen, that armor against arthritis, arthralgia and adhesive capsulitis comes down. And so many women are like, thank you, because I felt like I had broken something or done something wrong. And I'm with you. The toughest menopause customers I have are the athletes. You know, they have the biggest mental, like, breakdown when their body composition changes.

It is so hard for them, their nutrition, you know, like they've been running at the, you know, and they. It's really hard for them to accept that all these things that kept you winning marathons and triathlons are not going to tear away at your bones and muscles. And, you know, and we have to look at this differently. And so, yeah, and then the rate of their, you know, once their estrogen levels drop, then all of a sudden the armor that they had against injury or old injuries is suddenly popping up. Yeah, I would 1000% agree with you on that.

Dr. Mindy Pelz
That. That hyper achiever woman. Like, if you're listening to this, you know, you can hear it in both of us. Like, we've been there on many levels. And that rest and honoring the body becomes really important.

Not the push through grit that we learned in our twenties and thirties. It's a whole different skill set. It's crazy. So this has been amazing. And I just, again, I just.

I really love the spirit in which you're bringing this forward. And I love that women are waking up when they hear you, when they hear me. Like, I just. My quest is for women to feel heard and seen and feel like they have a voice in this culture that we haven't had a voice. So I just.

I have to just, again, thank you for everything that you're doing. I just really appreciate the spirit in which you're doing it. Thank you. Same to you. Thank you.

And then the last question, this one will be really interesting for you. I always ask. Every year on my podcast, I have one question that I ask, and this year I'm asking, what is your definition of health? I think too many women will say they want to be healthy, but they don't know what the definition of health is.

Dr. Mary Claire Haver
I think the days that I don't worry about my health are the definition of health. You know, the days that the habits I put into place take any thought process around. I know I've got this. And so to me, good health is not having to think about it. Yes.

Dr. Mindy Pelz
It's like a flow. Like a flow you get into. I love that. So how do people find you and your work? And we will definitely put links to your book, but where can they dive into your stuff?

Dr. Mary Claire Haver
So the book is the new menopause, and it's available everywhere. You can buy books across social media. It's Doctor Mary Claire and just about every platform. And then we have a website with lots of great tools, freebies, information, how to talk to your doctor, how to find a doctor. Da da da@thepause.com.

dot yeah, beautiful. Well, thank you. You know, from the bottom of my heart, I just really appreciate what you're doing for women. And, you know, it's just an honor to have this conversation with you. So I appreciate you.

All right. Thanks for having me. Thank you so much for joining me in today's episode. I love bringing thoughtful discussions about all things health to you. If you enjoyed it, we'd love to know about it.

Dr. Mindy Pelz
So please leave us a review, share it with your friends, and let me know what your biggest takeaway is.

The Essential Menopausal Toolbox with Dr. Mary Claire Haver

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1: Understanding Menopause

2: Lifestyle and Symptom Management

3: Advances in HRT

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