June 4, 2024 • 27 mins
Even in 2024, menopause is a taboo subject. But lately, women like Halle Berry, Jennifer Anniston, Drew Barrymore, and Gabrielle Union are speaking out. We join the conversation with Dr. Jennifer Ashton to answer all of your menopause questions: from first symptoms, to libido, to muscle building as you age. Dr. Ashton is a double board certified physician in obstetrics and gynecology. She recently stepped down as ABC's chief medical correspondent to launch her own wellness company called Ajenda, which focuses on women’s health and wellness.
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Speaker 1 (00:03):
Hello Sunshine, Hey, Brightside, besties. Today we're talking to doctor
Jen Ashton, ABC news chief medical correspondent and the founder
of Agenda, a source for science backed medical information. Doctor
Ashton is breaking down everything we need to know about menopause.
Speaker 2 (00:19):
It's Tuesday, June fourth.
Speaker 3 (00:21):
I am Simone Boyce, I'm Danielle Robe and this is
the bright Side from Hello Sunshine. Well, today we're talking
about menopause. And there have been a lot of high
profile people talking about menopause recently. So when you probably
saw the video of Halle Berry shouting I'm in menopause
(00:43):
on the steps of the Capitol Yes, I finally realized
she wasn't gonna say it, so I thought, Okay, I
have to do what no man can do.
Speaker 1 (00:51):
I have to say it. I said, I'm in.
Speaker 2 (00:53):
Menopas Okay, Okay.
Speaker 3 (00:55):
I just love seeing one of the hottest women to
walk planet Earth talking about men pause on Capitol Hill.
Speaker 1 (01:01):
It's powerful. It's truly an iconic moment, Danielle. And also
just this past week, Jennifer Aniston opened up about her
experience with menopause. So in The Hollywood Reporter, she spoke
about how she wished she had more information before going
through it herself. She wished that we were all talking
about it more so, Jennifer, we are giving you exactly
what you asked for, Okay, to answer all of our
(01:22):
burning questions about menopause, We're bringing in another Jennifer, doctor
Jen Ashton. She's a double board certified physician in obstetrics
and phanacology, and she's been a trusted adviser on women's
health to patients and viewers for years. You know her
as ABC's chief medical correspondent for the past thirteen years.
Speaker 3 (01:41):
She has literally been telling me what I need to
know since COVID. I started following her career actually during COVID,
and I watched so much of her coverage. She was
such a voice of reason and I think she gave
so many people comfort during that time.
Speaker 2 (01:56):
Absolutely.
Speaker 1 (01:57):
And the latest is she's actually leaving a at the
end of June to focus all of her attention on
a brand new venture. It's a new women's wellness company
called Agenda. She launched Agenda with this free newsletter that
brings a daily dose of health news, wellness tips, and
resources straight to your inbox. And she's also about to
expand it big time. Into a full digital media company
(02:19):
with a lot more content on the way.
Speaker 3 (02:21):
Yep, and we're diving into it all and of course
chatting menopause, what fitness regimen is best, what symptoms to
look out for, and why the best loob may be
on your.
Speaker 2 (02:31):
Grocery store shelves. It's all coming up.
Speaker 1 (02:33):
We'll be right back, y'all. We're back, and we're here
with doctor Jen Ashton. Welcome to the bright Side, doctor Ashton.
Speaker 2 (02:53):
Thanks, I'm so excited to be here with you.
Speaker 3 (02:55):
Guys, Doctor Ashton, you left your position at ABC to
launch your new company Agenda. Now, to leave that position
means that you must be very passionate about women's health.
Where does your commitment to menopause education come from?
Speaker 2 (03:12):
Oh my gosh.
Speaker 4 (03:13):
Well, first of all, thank you for your kind words,
but also for recognizing the magnitude of that career and
professional decision that I made, because no one gives up
my position, you know, to do something else. And I
became a doctor because I wanted to help people and
(03:35):
have an impact.
Speaker 2 (03:36):
And I never in.
Speaker 4 (03:38):
A million years could have expected or dreamt that I
would reach millions and millions of people every single day
with the insight and analysis and perspective. That has been
my job as chief medical correspondent at ABC, and in
my mind, you know, the way I'm hardwired is to
(03:59):
waigh up every day and face a challenge and continue
to push boundaries and move the needle. And for me,
I feel that the needle needs to be moved in
the fields of women's health and obesity medicine, and that's
why I started Agenda, which is my free newsletter. But
it's going to be growing very very quickly to a
(04:20):
whole digital platform and multimedia kind of entity that can
provide a lot of important content and solutions for women.
So I'm really excited about it.
Speaker 3 (04:32):
Simon and I have been in women's spaces, in particular
in the realm of journalism for years, and I think
we're both recognizing that the conversation on women's bodies and
research over the last few years is finally expanding, I
think in large part due to women like you who
are making it important to people. Why do you think
(04:54):
menopause just hasn't really been talked about in the cultural
zeitgeist until the last few years.
Speaker 4 (05:00):
Well, first of all, I think we can all do
like a standing ovation that it finally is being talked about,
and there are a lot of great people that are
talking about it today. I just feel lucky to be
one of them. There's more than enough room for a
lot of people in this space, and so we do
need a lot of messengers and good communicators.
Speaker 2 (05:23):
But I think that the reason it.
Speaker 4 (05:26):
Hasn't had its moment until now, if you really want
to know, and I would love to hear your opinions
on this, I think it's because of the societal way that,
unfortunately women are viewed, which is largely as a passive
kind of victim and largely as just a human being
(05:49):
with reproductive currency.
Speaker 1 (05:51):
Yeah, and the same goes for some non binary folks
and trans women too. There are so many factors when
it comes to why we haven't felt comfortable talking about menopause.
I'm so happy we get to talk about this with
you because we want to get into the nitty gritty
of the physiological processes that take place during menopause. So
what happens to our bodies during menopause and can you
(06:13):
break down those systems for us?
Speaker 4 (06:16):
Yeah, the short answer is our estrogen and progesterone go
right down the toilet and there are literally estrogen and
progesterone receptors all over our bodies head to toe, from
skin and hair follicles to our brain, to our heart,
(06:36):
to literally every organ system. And that can happen very suddenly.
It's not like a slow, peaceful, gradual walk off into
the sunset. And it can start. It can start in
a woman's mid thirties, mid thirties.
Speaker 1 (06:54):
And that's perimenopause. Yeah, that's perimenopause.
Speaker 2 (06:58):
I'm glad.
Speaker 3 (06:59):
I was sitting down for that, doctor Ashton, you had
me I talk for.
Speaker 5 (07:02):
A living and I was a little speechless.
Speaker 4 (07:05):
Well, I heard like a lot of sighing and deep breathing,
and I was like, oh my god, are you okay?
Speaker 2 (07:10):
And it took me a minute.
Speaker 1 (07:11):
I couldn't respond at first. Yeah, I kind of have kids,
I know.
Speaker 2 (07:18):
And so that's like, there's so much here.
Speaker 4 (07:21):
And I think that when you take that physiology and
then you put that in an arena or an environment
where at baseline we know that women tend to be
taken less seriously by physicians. This is just like the
medical system and how we deal with women, and by
the way, also how we deal with ourselves.
Speaker 2 (07:44):
Don't even get me started.
Speaker 4 (07:45):
I could give you three examples of my own life
where I've dismissed and ignored and denied physical symptoms that
I'm having.
Speaker 2 (07:54):
And I'm a doctor for con so like, this is
just what we do.
Speaker 4 (08:00):
And then when you realize the actual physiology, you're like,
oh my god.
Speaker 1 (08:06):
So you mentioned two key hormones, estrogen and progesterone. Both
of them play a pivotal role in reproduction. Can you
explain how these hormones factor into the lead up to menopause.
Speaker 4 (08:18):
Well, it's complicated, right, It depends on the organ system
what the effects are.
Speaker 2 (08:23):
But you know, it increases blood flow.
Speaker 4 (08:25):
Let's just take estrogen to the skin, right, or to
the vagina, to the vaginal mucosa, or to the skin
on your face, or to the hair follicles on your head.
It brings blood flow to the area and it makes
the tissue, whatever tissue you're talking about, stronger, more vibrant.
And in terms of the uterus, it stimulates the lining
(08:48):
of the uterus to receive a fertilized egg and it
does that every single month, right, And then progesterone dilates
blood vessels. It's very import to the brain. It's kind
of the calming down hormone. It has a big action
in your GI tract in terms of gut motility. And
(09:11):
then we can't forget that our ovaries make fifty percent
five zero percent of the testosterone in our bodies. So
as we get closer and closer to menopause, and every woman,
and I literally I want to underscore, every woman will
start to say, what the hell is going on? I'm
gaining like this paunch in my belly and that that
(09:35):
could be.
Speaker 2 (09:35):
One pound of paunch or it could be ten pounds
of punge.
Speaker 4 (09:39):
And the part of the reason for that is that
their testosterone level is dropping.
Speaker 1 (09:44):
Evolutionarily speaking, what's the reason for the paune? Is it
to protect the organs?
Speaker 4 (09:51):
No, you know, that's a great question. I love the
way you're thinking about it. But we have to remember
that if you really look back to evolution, women didn't
live long enough to go through menopause.
Speaker 1 (10:01):
WHOA does that mean that menopause is an adaptation that
we developed later on? Like where did menopause itself come from?
Speaker 4 (10:10):
Well, I mean, first of all, I am not I
always think it's a mark of a good doctor to
say what he or she knows and what they don't know,
and I'm not an evolutionary biologist. I would love to
interview one myself, and I love the way you're thinking
about it, because I agree with you it's incredibly cool
and interesting to ponder that.
Speaker 2 (10:29):
But human beings are.
Speaker 4 (10:30):
Among the only species on Earth that go through that
stop ovulating and then continue to live a significant.
Speaker 2 (10:40):
Span of their life.
Speaker 4 (10:42):
Most mammals can reproduce up until the point that they die,
Thank God, can't I mean, thanks.
Speaker 6 (10:50):
God, literally get a little break there, yeah, I mean, geez, Okay,
So anyway, But the other thing, the other flip side
of your questioning, which I think is really really important,
is that you know, one hundred and one hundred and
fifty and two hundred years ago, quite literally, women didn't
(11:10):
live past menopause.
Speaker 4 (11:12):
Really right now, you could live to one hundred right.
My daughter is twenty four years old. Her life expectancy
could easily be one hundred right. So for her, if
she goes through menopause at fifty, she has half her
life still ahead of her. And there's a lot about
that second half that we just don't have hundreds of
(11:35):
years of scientific or evolutionary data on which I think
is exciting but I also think we need to recognize
menopause is a life stage reserved for the lucky few
who are still living.
Speaker 1 (11:50):
I love that framing.
Speaker 3 (11:51):
I love that we're going to take a quick break,
don't go anywhere.
Speaker 1 (12:02):
We're back with doctor Jen Ashton. Let's get into some
of the more common symptoms of menopause, Doctor Ashton, How
does our body tell us that we're in menopause? What
are some of the early signs.
Speaker 4 (12:16):
Well, you know, as I used to say to a
lot of my patients, the hallmark one is vaginal bleeding.
It's menstrual bleeding. And it could be irregular periods, and
that could be you know, longer, shorter, more irregular. It
could be literally any type of change from your baseline
bleeding pattern. Right, that's your hormones. Like holding up a
(12:40):
sign saying hello, this is a perimenopausal symptom. And it's
so obvious because you're literally going to see it.
Speaker 1 (12:47):
Right.
Speaker 4 (12:48):
The other ones, though, I think, are they may be
more common. They are probably more distressing on some level.
I know they were for me personally, and they are
are almost always underrecognized, even by other medical professionals. And
if you start head to toe that could literally be anxiety, depression,
(13:12):
emotional liability, brain.
Speaker 2 (13:14):
Fog, headaches.
Speaker 4 (13:17):
I mean change in your hair on your head, thinning,
more shedding of hair, more breakage of hair, dry eye,
dry mouth, like ringing in your ears. I mean it
literally could be head to toe musculo skeletal discomfort. The
hot flash, which is like the most glorified menopausal symptom,
(13:42):
doesn't always mean drenched sweat. Sometimes it's just a feeling
of like heat that comes right up from your core
and like lasts for a couple of seconds or minutes
and then disappears.
Speaker 2 (13:55):
You know, I started.
Speaker 4 (13:56):
Getting random musculo skeletal aches, and I thought it was
just from working out, you know, hard or whatever.
Speaker 2 (14:05):
And I didn't connect the dots on my.
Speaker 4 (14:07):
Own symptoms until literally like a year ago. And I'm
a board certified guynecologist. So I think you can imagine
if this starts for a woman in her thirties, there's
almost no chance that her main healthcare provider is going
to recognize that these could be early perimenopausal symptoms. Can
I ask you a personal question, sure, how did you
(14:28):
feel when you started going through menopause?
Speaker 2 (14:30):
What was running through your mind?
Speaker 4 (14:32):
Well? I actually if I hadn't been so busy, I
would have thrown myself a menopause party. And I literally
mean that because I freaking hated my period so much.
Speaker 2 (14:43):
But I'll tell you.
Speaker 4 (14:44):
Something that I didn't feel so good about is I
started to see literally visual changes in my skin, in
my hair, in my body that you know, were not
fun to recognize. And I think it required a lot
(15:05):
of kind like self dialogue and saying, look, this is
the privilege that you're alive and going through this stage.
And then I really tried to actively connect the dots
between menopause and how I felt when I was pregnant
(15:26):
with my children, and I even tried to, you know,
retrieve some of the feelings of going through puberty. None
of those big stages are totally fun, right, Like, I
don't care what kind of pregnancy a woman has. There's
a time for every woman who's been pregnant where she's like,
(15:47):
oh my god.
Speaker 2 (15:48):
Like this is not pretty.
Speaker 1 (15:51):
Did you feel that month nine, right, get this baby
out month eight even like I'm done?
Speaker 2 (15:58):
Yeah?
Speaker 4 (15:59):
And then also what you look like and feel like afterwards,
you know, you have to engage in that nice self talk,
right like, after you've had a baby, you have to
be like, Okay, you know, you just grew a human, like,
don't be such a perfect you know like, And I
felt I had to draw on a lot of that
as I started to go through menopause too.
Speaker 1 (16:21):
Positive self talk, reimagining it as a superpower as opposed
to a flaw. That's something that's wrong with your body,
for sure, Totally we need you to tell it like
it is on menopausal sex. Okay, we have come all right,
we have come to that point in the conversation, ladies.
So I love it. I've heard about vaginal dryness. I've
(16:43):
heard that menopause can cause discomfort and also a significant
impact on desire around sex. So what are some of
the common questions that you get asked about sexual health
in the years leading up to and during menopause.
Speaker 4 (17:00):
Well, it's not so much a question, it's more statements,
And you hit the nails right on the head. It's
a statement of either I have no libido, and usually
that's a woman who's been in a monogamous relationship for
twenty or twenty five years, to which I say, like,
(17:20):
why are you shocked by that? That's not a normal, Like,
it's not natural for two human beings to be together
for twenty five years. So first of all, recognize that
you've already done something that's you know, defies the norm,
and then be cut yourself some slack. I would start
from a position of saying like, yeah, of course I
(17:42):
don't have a libido. I've been with the same person
for twenty five years.
Speaker 2 (17:47):
Right, So I think the answer to.
Speaker 4 (17:50):
That, other than get a divorce or have an affair,
is as their work, yeah, right, is to bring something
new into the equation, because that's the cure for boredom. Right.
So you know, some women find some relief with some
testosterone supplementation. There is an FDA approved libido medication for
(18:12):
women that gives an additional one satisfying sexual encounter a month. Personally,
if that is worth it for you, go for it.
But I don't consider that a big bang for the
wood pardon the pun, literally one one additional.
Speaker 1 (18:28):
It's almost insulting. It is the vaginal dryness.
Speaker 4 (18:32):
We can cure, and we can address whether it's with estrogen,
whether it's with vaginal estrogen. I always recommend literally pure
from the grocery store aisle cooking oils as lubes because.
Speaker 1 (18:48):
Everything else, like like cooking, vegetable oil, canola oil.
Speaker 2 (18:53):
Coconut oil, olive oil. You better believe it.
Speaker 4 (18:57):
The only thing is be careful of your sheets because
obviously it can stain your sheets, but it is safe.
And all the other lubricants, literally all of them, with
any chemical ingredient is like putting ice on a crapped driveway.
It will dry out your vagina ultimately, even if it
(19:21):
makes that initial encounter more comfortable, and it doesn't treat
the root cause, which is low estrogen, which makes the
vagina very sensitive and nonpliable.
Speaker 1 (19:32):
Did you know you can use coconut oil as.
Speaker 2 (19:33):
Lub I didn't.
Speaker 3 (19:35):
I've heard of people using it in their hair. But
I have to tell you, doctor Ashton, not once have
we been taping this show where Simona and I kind
of casually look at each other like.
Speaker 1 (19:45):
Whoa, oh, you've blown our minds times over today. Oh
good yew our minds, but a mission accomplished.
Speaker 3 (19:53):
I want to actually ask about hormone therapy because this
is a big topic of conversation around people going through
menopause or perimenopause.
Speaker 2 (20:03):
Do you recommend it.
Speaker 4 (20:05):
Yes, But here's what I want to say about HRT.
First of all, I take HRT myself. I think the
vast majority of women who are having menopausal symptoms would
benefit from hormone replacement therapy. It has been demonized for
the last twenty two years erroneously so because of flawed
(20:25):
data with the Women's Health Initiative and flawed interpretation of
that study that we're still doing the cleanup on and
a lot of those initial kind of findings have been
retracted or disproven conclusively.
Speaker 2 (20:41):
By the way.
Speaker 4 (20:42):
So I think that you know, only four percent of
women who are suffering with menopausal symptoms in the United
States are prescribed hormonal therapy. Four Even if that became
forty percent, that would be a huge, huge improvement, right.
But there are also non hormonal prescription medications that are
(21:04):
great options, and there are complementary medications or products. So
it's like a menu of options, and it's not one
size fits all. And I think that women should just
keep educating themselves because a lot of doctors, unfortunately are
not current in the medical literature and so they might
be anti hormone and they don't need to be.
Speaker 1 (21:26):
I want to pivot into fitness here for a second.
I know that you are a fitness girly as well,
doctor Ashton, and so I know that there are some
thoughts out there on hit workouts and women's bodies, that
it's potentially not good for worms bodies. I do it anyways.
I do it in moderation. I'm curious if you think
that there are any exercises that we should be moving
(21:49):
away from in as we're moving towards perimenopause and menopause.
How have you shifted your fitness routine.
Speaker 4 (21:56):
I love talking about fitness, so I'm so glad you
asked about it, and I've learned a lot about it
from talking to professional trainers. But yes, women should shift
how they work out the closer they get to menopause,
but they ideally should start doing that even in their thirties.
And what I mean by that is that you know,
(22:18):
for so long I only did two types of workouts,
long cardio or weight training. Now they're both great, right,
But as you know, as someone who likes to work
out under the umbrella of cardio, there's zone two cardio,
there's endurance cardio, there's hit cardio, and they're all important, right.
(22:41):
I will say that if I had to say one
single most important fitness kind of tool that women even
in their thirties should start preparing their bodies for.
Speaker 2 (22:54):
It's lifting weights and lifting heavyweights.
Speaker 4 (22:56):
You know, I have the body I have today half
because of my genetics and of the other fifty percent,
probably forty eight percent of that is because I've lifted
weights my entire life.
Speaker 1 (23:10):
Yeah, muscle. You prioritize muscle.
Speaker 2 (23:12):
Muscle, Yeah, muscle.
Speaker 4 (23:14):
And I'm going for strength and I'm going for power
and to be vain by the way, which you know
we all have our vanity. I certainly have plenty of it.
This is a safe space, thank you. My goal is
to have big muscles to hold up the creepy skin.
So yeah, Like when I go to the gym, I
(23:36):
pick up twenty pound dumbbells in each hand. Yeah, and
I try to curl them as many times as I can.
And maybe that's four each, maybe that's five. I don't
really care, but I'm curling twenty pounds in each hand.
Speaker 1 (23:49):
I'm with you.
Speaker 3 (23:50):
What are your thoughts on the support people receive from
family and friends and partners during menopause, because I've heard
you talk about how men need to be a part
of men.
Speaker 4 (24:00):
No pause, Yeah, absolutely, and it's something that has been
missing from this conversation so far. I've been wanting to
write an article for a long time called Menopause. It
actually starts with men Revolutionary.
Speaker 1 (24:15):
I need to know what you mean because.
Speaker 4 (24:18):
There are crickets when it comes to this conversation that
you don't see any male gynecologists talking about it. Okay,
there are plenty of them. Why why so quiet?
Speaker 2 (24:29):
Great point?
Speaker 4 (24:30):
Why so timid? Like you're either for women's health or
you're not. This is a big part of women's health.
If you're a man and you're an obgyn, why aren't
you talking about menopause?
Speaker 1 (24:42):
Do you think they feel scared in this environment, like
they like it's not their story to tell, And maybe
we as women need to support make them feel controversial
and empowered to talk about it.
Speaker 4 (24:52):
Yes, but again, this can't just be a one sided conversation.
This has to be everyone filled the boat, all hands
on deck, and not just because that's like smart pr
or smart optics, it's the right thing to do.
Speaker 1 (25:12):
Can I add one more to the list. Yeah, I'm
calling on Hollywood to give us our first menopausal action hero.
Speaker 3 (25:20):
Oh interesting, I thought you were gonna say rom com
but I like action hero.
Speaker 1 (25:23):
I want an action hero because I want to see
a strong ass woman who's going through menopause and who
is you know, lifting her weights in the gym. I
don't know. Maybe she's fighting crime, maybe she's maybe she's
fighting all the mail.
Speaker 2 (25:38):
Would be amazing.
Speaker 5 (25:39):
Yes, Marvel goes menopause. Yes, well, listen, I'm working on that, ladies.
I want to tell you because part of agenda is
developing television and media context. I will break the story
on your podcast, but I am pitching for development. Some
both scripted and unscript did in the menopause perimenopause space.
Speaker 2 (26:04):
And I'm going to get it done. I mean, I
am like, I'm not giving up.
Speaker 3 (26:09):
You're the type of person and woman that when they
put their minds to something, it happens. So I have
no doubt. I'm excited to I'll be at the first
screening same.
Speaker 1 (26:18):
Okay.
Speaker 3 (26:18):
Awesome, awesome, Thank you so much for the education and
for talking with us today.
Speaker 1 (26:23):
Doctor Ashton.
Speaker 2 (26:24):
Oh my god, you guys are great.
Speaker 4 (26:27):
You guys are doing really great work, and you're getting
not just good answers out to people, but you're asking
the right questions, which I think is super cool and
super important.
Speaker 2 (26:37):
Thank you for saying that.
Speaker 1 (26:39):
Doctor Jen Ashton is a physician, Emmy Award winning journalist
and the founder of Agenda. You can find her on
Instagram at doctor j Ashton. That's it for today's show.
We'll be back tomorrow with Kathleen Griffith to talk about
entrepreneurship and her new book, Build Like a Woman. Tune
(27:02):
into the Brightside on the iHeartRadio app or wherever you
get your podcasts.
Speaker 4 (27:06):
Y'all.
Speaker 1 (27:07):
I'm Simone Voice. You can find me at simone Voice
on Instagram and TikTok.
Speaker 3 (27:12):
I'm Danielle Robe on Instagram and TikTok.
Speaker 2 (27:15):
That's r O b A.
Speaker 1 (27:16):
Y See you tomorrow, folks. Keep looking on the bright side.
Hello Sunshine, Hey, Brightside, besties. Today we're talking to doctor
Jen Ashton, ABC news chief medical correspondent and the founder
of Agenda, a source for science backed medical information. Doctor
Ashton is breaking down everything we need to know about menopause.
Speaker 2 (00:19):
It's Tuesday, June fourth.
Speaker 3 (00:21):
I am Simone Boyce, I'm Danielle Robe and this is
the bright Side from Hello Sunshine. Well, today we're talking
about menopause. And there have been a lot of high
profile people talking about menopause recently. So when you probably
saw the video of Halle Berry shouting I'm in menopause
(00:43):
on the steps of the Capitol Yes, I finally realized
she wasn't gonna say it, so I thought, Okay, I
have to do what no man can do.
Speaker 1 (00:51):
I have to say it. I said, I'm in.
Speaker 2 (00:53):
Menopas Okay, Okay.
Speaker 3 (00:55):
I just love seeing one of the hottest women to
walk planet Earth talking about men pause on Capitol Hill.
Speaker 1 (01:01):
It's powerful. It's truly an iconic moment, Danielle. And also
just this past week, Jennifer Aniston opened up about her
experience with menopause. So in The Hollywood Reporter, she spoke
about how she wished she had more information before going
through it herself. She wished that we were all talking
about it more so, Jennifer, we are giving you exactly
what you asked for, Okay, to answer all of our
(01:22):
burning questions about menopause, We're bringing in another Jennifer, doctor
Jen Ashton. She's a double board certified physician in obstetrics
and phanacology, and she's been a trusted adviser on women's
health to patients and viewers for years. You know her
as ABC's chief medical correspondent for the past thirteen years.
Speaker 3 (01:41):
She has literally been telling me what I need to
know since COVID. I started following her career actually during COVID,
and I watched so much of her coverage. She was
such a voice of reason and I think she gave
so many people comfort during that time.
Speaker 2 (01:56):
Absolutely.
Speaker 1 (01:57):
And the latest is she's actually leaving a at the
end of June to focus all of her attention on
a brand new venture. It's a new women's wellness company
called Agenda. She launched Agenda with this free newsletter that
brings a daily dose of health news, wellness tips, and
resources straight to your inbox. And she's also about to
expand it big time. Into a full digital media company
(02:19):
with a lot more content on the way.
Speaker 3 (02:21):
Yep, and we're diving into it all and of course
chatting menopause, what fitness regimen is best, what symptoms to
look out for, and why the best loob may be
on your.
Speaker 2 (02:31):
Grocery store shelves. It's all coming up.
Speaker 1 (02:33):
We'll be right back, y'all. We're back, and we're here
with doctor Jen Ashton. Welcome to the bright Side, doctor Ashton.
Speaker 2 (02:53):
Thanks, I'm so excited to be here with you.
Speaker 3 (02:55):
Guys, Doctor Ashton, you left your position at ABC to
launch your new company Agenda. Now, to leave that position
means that you must be very passionate about women's health.
Where does your commitment to menopause education come from?
Speaker 2 (03:12):
Oh my gosh.
Speaker 4 (03:13):
Well, first of all, thank you for your kind words,
but also for recognizing the magnitude of that career and
professional decision that I made, because no one gives up
my position, you know, to do something else. And I
became a doctor because I wanted to help people and
(03:35):
have an impact.
Speaker 2 (03:36):
And I never in.
Speaker 4 (03:38):
A million years could have expected or dreamt that I
would reach millions and millions of people every single day
with the insight and analysis and perspective. That has been
my job as chief medical correspondent at ABC, and in
my mind, you know, the way I'm hardwired is to
(03:59):
waigh up every day and face a challenge and continue
to push boundaries and move the needle. And for me,
I feel that the needle needs to be moved in
the fields of women's health and obesity medicine, and that's
why I started Agenda, which is my free newsletter. But
it's going to be growing very very quickly to a
(04:20):
whole digital platform and multimedia kind of entity that can
provide a lot of important content and solutions for women.
So I'm really excited about it.
Speaker 3 (04:32):
Simon and I have been in women's spaces, in particular
in the realm of journalism for years, and I think
we're both recognizing that the conversation on women's bodies and
research over the last few years is finally expanding, I
think in large part due to women like you who
are making it important to people. Why do you think
(04:54):
menopause just hasn't really been talked about in the cultural
zeitgeist until the last few years.
Speaker 4 (05:00):
Well, first of all, I think we can all do
like a standing ovation that it finally is being talked about,
and there are a lot of great people that are
talking about it today. I just feel lucky to be
one of them. There's more than enough room for a
lot of people in this space, and so we do
need a lot of messengers and good communicators.
Speaker 2 (05:23):
But I think that the reason it.
Speaker 4 (05:26):
Hasn't had its moment until now, if you really want
to know, and I would love to hear your opinions
on this, I think it's because of the societal way that,
unfortunately women are viewed, which is largely as a passive
kind of victim and largely as just a human being
(05:49):
with reproductive currency.
Speaker 1 (05:51):
Yeah, and the same goes for some non binary folks
and trans women too. There are so many factors when
it comes to why we haven't felt comfortable talking about menopause.
I'm so happy we get to talk about this with
you because we want to get into the nitty gritty
of the physiological processes that take place during menopause. So
what happens to our bodies during menopause and can you
(06:13):
break down those systems for us?
Speaker 4 (06:16):
Yeah, the short answer is our estrogen and progesterone go
right down the toilet and there are literally estrogen and
progesterone receptors all over our bodies head to toe, from
skin and hair follicles to our brain, to our heart,
(06:36):
to literally every organ system. And that can happen very suddenly.
It's not like a slow, peaceful, gradual walk off into
the sunset. And it can start. It can start in
a woman's mid thirties, mid thirties.
Speaker 1 (06:54):
And that's perimenopause. Yeah, that's perimenopause.
Speaker 2 (06:58):
I'm glad.
Speaker 3 (06:59):
I was sitting down for that, doctor Ashton, you had
me I talk for.
Speaker 5 (07:02):
A living and I was a little speechless.
Speaker 4 (07:05):
Well, I heard like a lot of sighing and deep breathing,
and I was like, oh my god, are you okay?
Speaker 2 (07:10):
And it took me a minute.
Speaker 1 (07:11):
I couldn't respond at first. Yeah, I kind of have kids,
I know.
Speaker 2 (07:18):
And so that's like, there's so much here.
Speaker 4 (07:21):
And I think that when you take that physiology and
then you put that in an arena or an environment
where at baseline we know that women tend to be
taken less seriously by physicians. This is just like the
medical system and how we deal with women, and by
the way, also how we deal with ourselves.
Speaker 2 (07:44):
Don't even get me started.
Speaker 4 (07:45):
I could give you three examples of my own life
where I've dismissed and ignored and denied physical symptoms that
I'm having.
Speaker 2 (07:54):
And I'm a doctor for con so like, this is
just what we do.
Speaker 4 (08:00):
And then when you realize the actual physiology, you're like,
oh my god.
Speaker 1 (08:06):
So you mentioned two key hormones, estrogen and progesterone. Both
of them play a pivotal role in reproduction. Can you
explain how these hormones factor into the lead up to menopause.
Speaker 4 (08:18):
Well, it's complicated, right, It depends on the organ system
what the effects are.
Speaker 2 (08:23):
But you know, it increases blood flow.
Speaker 4 (08:25):
Let's just take estrogen to the skin, right, or to
the vagina, to the vaginal mucosa, or to the skin
on your face, or to the hair follicles on your head.
It brings blood flow to the area and it makes
the tissue, whatever tissue you're talking about, stronger, more vibrant.
And in terms of the uterus, it stimulates the lining
(08:48):
of the uterus to receive a fertilized egg and it
does that every single month, right, And then progesterone dilates
blood vessels. It's very import to the brain. It's kind
of the calming down hormone. It has a big action
in your GI tract in terms of gut motility. And
(09:11):
then we can't forget that our ovaries make fifty percent
five zero percent of the testosterone in our bodies. So
as we get closer and closer to menopause, and every woman,
and I literally I want to underscore, every woman will
start to say, what the hell is going on? I'm
gaining like this paunch in my belly and that that
(09:35):
could be.
Speaker 2 (09:35):
One pound of paunch or it could be ten pounds
of punge.
Speaker 4 (09:39):
And the part of the reason for that is that
their testosterone level is dropping.
Speaker 1 (09:44):
Evolutionarily speaking, what's the reason for the paune? Is it
to protect the organs?
Speaker 4 (09:51):
No, you know, that's a great question. I love the
way you're thinking about it. But we have to remember
that if you really look back to evolution, women didn't
live long enough to go through menopause.
Speaker 1 (10:01):
WHOA does that mean that menopause is an adaptation that
we developed later on? Like where did menopause itself come from?
Speaker 4 (10:10):
Well, I mean, first of all, I am not I
always think it's a mark of a good doctor to
say what he or she knows and what they don't know,
and I'm not an evolutionary biologist. I would love to
interview one myself, and I love the way you're thinking
about it, because I agree with you it's incredibly cool
and interesting to ponder that.
Speaker 2 (10:29):
But human beings are.
Speaker 4 (10:30):
Among the only species on Earth that go through that
stop ovulating and then continue to live a significant.
Speaker 2 (10:40):
Span of their life.
Speaker 4 (10:42):
Most mammals can reproduce up until the point that they die,
Thank God, can't I mean, thanks.
Speaker 6 (10:50):
God, literally get a little break there, yeah, I mean, geez, Okay,
So anyway, But the other thing, the other flip side
of your questioning, which I think is really really important,
is that you know, one hundred and one hundred and
fifty and two hundred years ago, quite literally, women didn't
(11:10):
live past menopause.
Speaker 4 (11:12):
Really right now, you could live to one hundred right.
My daughter is twenty four years old. Her life expectancy
could easily be one hundred right. So for her, if
she goes through menopause at fifty, she has half her
life still ahead of her. And there's a lot about
that second half that we just don't have hundreds of
(11:35):
years of scientific or evolutionary data on which I think
is exciting but I also think we need to recognize
menopause is a life stage reserved for the lucky few
who are still living.
Speaker 1 (11:50):
I love that framing.
Speaker 3 (11:51):
I love that we're going to take a quick break,
don't go anywhere.
Speaker 1 (12:02):
We're back with doctor Jen Ashton. Let's get into some
of the more common symptoms of menopause, Doctor Ashton, How
does our body tell us that we're in menopause? What
are some of the early signs.
Speaker 4 (12:16):
Well, you know, as I used to say to a
lot of my patients, the hallmark one is vaginal bleeding.
It's menstrual bleeding. And it could be irregular periods, and
that could be you know, longer, shorter, more irregular. It
could be literally any type of change from your baseline
bleeding pattern. Right, that's your hormones. Like holding up a
(12:40):
sign saying hello, this is a perimenopausal symptom. And it's
so obvious because you're literally going to see it.
Speaker 1 (12:47):
Right.
Speaker 4 (12:48):
The other ones, though, I think, are they may be
more common. They are probably more distressing on some level.
I know they were for me personally, and they are
are almost always underrecognized, even by other medical professionals. And
if you start head to toe that could literally be anxiety, depression,
(13:12):
emotional liability, brain.
Speaker 2 (13:14):
Fog, headaches.
Speaker 4 (13:17):
I mean change in your hair on your head, thinning,
more shedding of hair, more breakage of hair, dry eye,
dry mouth, like ringing in your ears. I mean it
literally could be head to toe musculo skeletal discomfort. The
hot flash, which is like the most glorified menopausal symptom,
(13:42):
doesn't always mean drenched sweat. Sometimes it's just a feeling
of like heat that comes right up from your core
and like lasts for a couple of seconds or minutes
and then disappears.
Speaker 2 (13:55):
You know, I started.
Speaker 4 (13:56):
Getting random musculo skeletal aches, and I thought it was
just from working out, you know, hard or whatever.
Speaker 2 (14:05):
And I didn't connect the dots on my.
Speaker 4 (14:07):
Own symptoms until literally like a year ago. And I'm
a board certified guynecologist. So I think you can imagine
if this starts for a woman in her thirties, there's
almost no chance that her main healthcare provider is going
to recognize that these could be early perimenopausal symptoms. Can
I ask you a personal question, sure, how did you
(14:28):
feel when you started going through menopause?
Speaker 2 (14:30):
What was running through your mind?
Speaker 4 (14:32):
Well? I actually if I hadn't been so busy, I
would have thrown myself a menopause party. And I literally
mean that because I freaking hated my period so much.
Speaker 2 (14:43):
But I'll tell you.
Speaker 4 (14:44):
Something that I didn't feel so good about is I
started to see literally visual changes in my skin, in
my hair, in my body that you know, were not
fun to recognize. And I think it required a lot
(15:05):
of kind like self dialogue and saying, look, this is
the privilege that you're alive and going through this stage.
And then I really tried to actively connect the dots
between menopause and how I felt when I was pregnant
(15:26):
with my children, and I even tried to, you know,
retrieve some of the feelings of going through puberty. None
of those big stages are totally fun, right, Like, I
don't care what kind of pregnancy a woman has. There's
a time for every woman who's been pregnant where she's like,
(15:47):
oh my god.
Speaker 2 (15:48):
Like this is not pretty.
Speaker 1 (15:51):
Did you feel that month nine, right, get this baby
out month eight even like I'm done?
Speaker 2 (15:58):
Yeah?
Speaker 4 (15:59):
And then also what you look like and feel like afterwards,
you know, you have to engage in that nice self talk,
right like, after you've had a baby, you have to
be like, Okay, you know, you just grew a human, like,
don't be such a perfect you know like, And I
felt I had to draw on a lot of that
as I started to go through menopause too.
Speaker 1 (16:21):
Positive self talk, reimagining it as a superpower as opposed
to a flaw. That's something that's wrong with your body,
for sure, Totally we need you to tell it like
it is on menopausal sex. Okay, we have come all right,
we have come to that point in the conversation, ladies.
So I love it. I've heard about vaginal dryness. I've
(16:43):
heard that menopause can cause discomfort and also a significant
impact on desire around sex. So what are some of
the common questions that you get asked about sexual health
in the years leading up to and during menopause.
Speaker 4 (17:00):
Well, it's not so much a question, it's more statements,
And you hit the nails right on the head. It's
a statement of either I have no libido, and usually
that's a woman who's been in a monogamous relationship for
twenty or twenty five years, to which I say, like,
(17:20):
why are you shocked by that? That's not a normal, Like,
it's not natural for two human beings to be together
for twenty five years. So first of all, recognize that
you've already done something that's you know, defies the norm,
and then be cut yourself some slack. I would start
from a position of saying like, yeah, of course I
(17:42):
don't have a libido. I've been with the same person
for twenty five years.
Speaker 2 (17:47):
Right, So I think the answer to.
Speaker 4 (17:50):
That, other than get a divorce or have an affair,
is as their work, yeah, right, is to bring something
new into the equation, because that's the cure for boredom. Right.
So you know, some women find some relief with some
testosterone supplementation. There is an FDA approved libido medication for
(18:12):
women that gives an additional one satisfying sexual encounter a month. Personally,
if that is worth it for you, go for it.
But I don't consider that a big bang for the
wood pardon the pun, literally one one additional.
Speaker 1 (18:28):
It's almost insulting. It is the vaginal dryness.
Speaker 4 (18:32):
We can cure, and we can address whether it's with estrogen,
whether it's with vaginal estrogen. I always recommend literally pure
from the grocery store aisle cooking oils as lubes because.
Speaker 1 (18:48):
Everything else, like like cooking, vegetable oil, canola oil.
Speaker 2 (18:53):
Coconut oil, olive oil. You better believe it.
Speaker 4 (18:57):
The only thing is be careful of your sheets because
obviously it can stain your sheets, but it is safe.
And all the other lubricants, literally all of them, with
any chemical ingredient is like putting ice on a crapped driveway.
It will dry out your vagina ultimately, even if it
(19:21):
makes that initial encounter more comfortable, and it doesn't treat
the root cause, which is low estrogen, which makes the
vagina very sensitive and nonpliable.
Speaker 1 (19:32):
Did you know you can use coconut oil as.
Speaker 2 (19:33):
Lub I didn't.
Speaker 3 (19:35):
I've heard of people using it in their hair. But
I have to tell you, doctor Ashton, not once have
we been taping this show where Simona and I kind
of casually look at each other like.
Speaker 1 (19:45):
Whoa, oh, you've blown our minds times over today. Oh
good yew our minds, but a mission accomplished.
Speaker 3 (19:53):
I want to actually ask about hormone therapy because this
is a big topic of conversation around people going through
menopause or perimenopause.
Speaker 2 (20:03):
Do you recommend it.
Speaker 4 (20:05):
Yes, But here's what I want to say about HRT.
First of all, I take HRT myself. I think the
vast majority of women who are having menopausal symptoms would
benefit from hormone replacement therapy. It has been demonized for
the last twenty two years erroneously so because of flawed
(20:25):
data with the Women's Health Initiative and flawed interpretation of
that study that we're still doing the cleanup on and
a lot of those initial kind of findings have been
retracted or disproven conclusively.
Speaker 2 (20:41):
By the way.
Speaker 4 (20:42):
So I think that you know, only four percent of
women who are suffering with menopausal symptoms in the United
States are prescribed hormonal therapy. Four Even if that became
forty percent, that would be a huge, huge improvement, right.
But there are also non hormonal prescription medications that are
(21:04):
great options, and there are complementary medications or products. So
it's like a menu of options, and it's not one
size fits all. And I think that women should just
keep educating themselves because a lot of doctors, unfortunately are
not current in the medical literature and so they might
be anti hormone and they don't need to be.
Speaker 1 (21:26):
I want to pivot into fitness here for a second.
I know that you are a fitness girly as well,
doctor Ashton, and so I know that there are some
thoughts out there on hit workouts and women's bodies, that
it's potentially not good for worms bodies. I do it anyways.
I do it in moderation. I'm curious if you think
that there are any exercises that we should be moving
(21:49):
away from in as we're moving towards perimenopause and menopause.
How have you shifted your fitness routine.
Speaker 4 (21:56):
I love talking about fitness, so I'm so glad you
asked about it, and I've learned a lot about it
from talking to professional trainers. But yes, women should shift
how they work out the closer they get to menopause,
but they ideally should start doing that even in their thirties.
And what I mean by that is that you know,
(22:18):
for so long I only did two types of workouts,
long cardio or weight training. Now they're both great, right,
But as you know, as someone who likes to work
out under the umbrella of cardio, there's zone two cardio,
there's endurance cardio, there's hit cardio, and they're all important, right.
(22:41):
I will say that if I had to say one
single most important fitness kind of tool that women even
in their thirties should start preparing their bodies for.
Speaker 2 (22:54):
It's lifting weights and lifting heavyweights.
Speaker 4 (22:56):
You know, I have the body I have today half
because of my genetics and of the other fifty percent,
probably forty eight percent of that is because I've lifted
weights my entire life.
Speaker 1 (23:10):
Yeah, muscle. You prioritize muscle.
Speaker 2 (23:12):
Muscle, Yeah, muscle.
Speaker 4 (23:14):
And I'm going for strength and I'm going for power
and to be vain by the way, which you know
we all have our vanity. I certainly have plenty of it.
This is a safe space, thank you. My goal is
to have big muscles to hold up the creepy skin.
So yeah, Like when I go to the gym, I
(23:36):
pick up twenty pound dumbbells in each hand. Yeah, and
I try to curl them as many times as I can.
And maybe that's four each, maybe that's five. I don't
really care, but I'm curling twenty pounds in each hand.
Speaker 1 (23:49):
I'm with you.
Speaker 3 (23:50):
What are your thoughts on the support people receive from
family and friends and partners during menopause, because I've heard
you talk about how men need to be a part
of men.
Speaker 4 (24:00):
No pause, Yeah, absolutely, and it's something that has been
missing from this conversation so far. I've been wanting to
write an article for a long time called Menopause. It
actually starts with men Revolutionary.
Speaker 1 (24:15):
I need to know what you mean because.
Speaker 4 (24:18):
There are crickets when it comes to this conversation that
you don't see any male gynecologists talking about it. Okay,
there are plenty of them. Why why so quiet?
Speaker 2 (24:29):
Great point?
Speaker 4 (24:30):
Why so timid? Like you're either for women's health or
you're not. This is a big part of women's health.
If you're a man and you're an obgyn, why aren't
you talking about menopause?
Speaker 1 (24:42):
Do you think they feel scared in this environment, like
they like it's not their story to tell, And maybe
we as women need to support make them feel controversial
and empowered to talk about it.
Speaker 4 (24:52):
Yes, but again, this can't just be a one sided conversation.
This has to be everyone filled the boat, all hands
on deck, and not just because that's like smart pr
or smart optics, it's the right thing to do.
Speaker 1 (25:12):
Can I add one more to the list. Yeah, I'm
calling on Hollywood to give us our first menopausal action hero.
Speaker 3 (25:20):
Oh interesting, I thought you were gonna say rom com
but I like action hero.
Speaker 1 (25:23):
I want an action hero because I want to see
a strong ass woman who's going through menopause and who
is you know, lifting her weights in the gym. I
don't know. Maybe she's fighting crime, maybe she's maybe she's
fighting all the mail.
Speaker 2 (25:38):
Would be amazing.
Speaker 5 (25:39):
Yes, Marvel goes menopause. Yes, well, listen, I'm working on that, ladies.
I want to tell you because part of agenda is
developing television and media context. I will break the story
on your podcast, but I am pitching for development. Some
both scripted and unscript did in the menopause perimenopause space.
Speaker 2 (26:04):
And I'm going to get it done. I mean, I
am like, I'm not giving up.
Speaker 3 (26:09):
You're the type of person and woman that when they
put their minds to something, it happens. So I have
no doubt. I'm excited to I'll be at the first
screening same.
Speaker 1 (26:18):
Okay.
Speaker 3 (26:18):
Awesome, awesome, Thank you so much for the education and
for talking with us today.
Speaker 1 (26:23):
Doctor Ashton.
Speaker 2 (26:24):
Oh my god, you guys are great.
Speaker 4 (26:27):
You guys are doing really great work, and you're getting
not just good answers out to people, but you're asking
the right questions, which I think is super cool and
super important.
Speaker 2 (26:37):
Thank you for saying that.
Speaker 1 (26:39):
Doctor Jen Ashton is a physician, Emmy Award winning journalist
and the founder of Agenda. You can find her on
Instagram at doctor j Ashton. That's it for today's show.
We'll be back tomorrow with Kathleen Griffith to talk about
entrepreneurship and her new book, Build Like a Woman. Tune
(27:02):
into the Brightside on the iHeartRadio app or wherever you
get your podcasts.
Speaker 4 (27:06):
Y'all.
Speaker 1 (27:07):
I'm Simone Voice. You can find me at simone Voice
on Instagram and TikTok.
Speaker 3 (27:12):
I'm Danielle Robe on Instagram and TikTok.
Speaker 2 (27:15):
That's r O b A.
Speaker 1 (27:16):
Y See you tomorrow, folks. Keep looking on the bright side.
Hosts And Creators
Simone Boyce
Danielle Robay
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