December 27, 2024 • 27 mins
This episode originally aired on June 4, 2024. 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.
Speaker 2 (00:04):
Hey vam. If you miss our conversation with doctor Jen
Ashton the first time around, well you are in for
a treat today because we are turning to the board
certified obgyn and former ABC News Chief Medical Correspondent to
answer just about every burning question you've had about menopause.
It's Friday, December twenty seventh.
Speaker 3 (00:24):
I'm Simone Boyce, I'm Danielle Robe and this is the
bright Side from Hello Sunshine, a daily show where we
come together to share women's stories, to laugh, learn and
brighten your day.
Speaker 2 (00:37):
Today we're giving doctor Jen Ashton and encore. She's a
double board certified physician in obstetrics and gynecology, and she's
been a trusted adviser on women's health to both patients
and viewers for years. You know her from her run
as ABC's Chief Medical correspondent and as co host of
Good Morning America.
Speaker 3 (00:54):
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 (01:08):
Absolutely, and in June, she left her work at ABC
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 a free newsletter that brings you a dose
of health news, wellness tips, and science backed resources straight
to your inbox. She launched Agenda with a free newsletter
that brings you a daily dose of health news, wellness tips,
(01:29):
and science backed resources with an emphasis on women's health
in menopause.
Speaker 3 (01:34):
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 grocery store shelves.
Speaker 2 (01:44):
So let's bring her in, doctor Jen Ashton, Welcome to
the bright Side. Thanks.
Speaker 1 (01:49):
I'm so excited to be here with you. Guys, doctor Ashton.
Speaker 3 (01:53):
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 1 (02:08):
Oh my gosh. 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.
(02:28):
And I became a doctor because I wanted to help
people and have an impact. And I never in 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,
(02:52):
you know, the way I'm hardwired is to wake 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
(03:13):
to be growing very very quickly to a 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 (03:27):
Simone 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
(03:49):
menopause just hasn't really been talked about in the cultural
zeitgeist until the last few years.
Speaker 1 (03:55):
Well, first of all, I think we can all do
like a stand in 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.
(04:18):
But I think that you know the reason it 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
(04:40):
of victim and largely as just a human being with
reproductive currency.
Speaker 2 (04:47):
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 in to the nitty gritty
of the physiological processes that take place during menopause. So
what happens to our bodies during menopause and can you
(05:08):
break down those systems for us?
Speaker 1 (05:11):
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,
(05:32):
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 2 (05:49):
And that's perimenopause.
Speaker 1 (05:51):
Yeah, that's perimenopause. I'm glad. I was sitting down for that,
doctor Ashton.
Speaker 3 (05:56):
You had me I talk for a living and I
was a little speechless.
Speaker 1 (06:00):
Well, I heard like a lot of sighing and deep breathing,
and I was like, oh my god, are you okay?
Speaker 2 (06:05):
I know, it took me a minute.
Speaker 3 (06:06):
I couldn't respond at first.
Speaker 2 (06:10):
Yeah.
Speaker 1 (06:10):
I kind of have kids, I know. And so that's like,
there's so much here 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
(06:32):
is just like the medical system and how we deal
with women, and by the way, also how we deal
with ourselves. Don't even get me started. I could give
you three examples of my own life where I've dismissed
and ignored and denied physical symptoms that I'm having. And
I'm a doctor for quite out, so like, this is
(06:54):
just what we do. And then when you realize the
actual physiology, you're like, oh my god.
Speaker 2 (07:01):
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 1 (07:13):
Well, it's complicated, right, It depends on the organ system
what the effects are. But you know it increases blood flow.
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
(07:34):
the tissue, whatever tissue you're talking about, stronger, more vibrant,
and in terms of the uterus, it stimulates the lining
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 important to the brain. It's kind
(07:56):
of the calming down hormone. It has a big action
in your GI tract in terms of gut motility. And
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,
(08:18):
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
could be one pound of paune or it could be
ten pounds of pounge, And the part of the reason
for that is that their testosterone level is dropping.
Speaker 2 (08:39):
Evolutionarily speaking, what's the reason for the paunch? Is it
to protect the organs?
Speaker 1 (08:46):
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 2 (08:57):
WHOA does that mean that menopause is an adaptation that
we developed later on? Like? Where did menopause itself come from? Well?
Speaker 1 (09:06):
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. But human beings are among
(09:26):
the only species on Earth that go through that stop
ovulating and then continue to live a significant span of
their life. Most mammals can reproduce up until the point
that they die, Thank God, can't I mean, thanks God?
(09:46):
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
live past menopause. Really right now, you could live to
(10:11):
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 years of scientific or evolutionary data on
(10:34):
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 2 (10:45):
I love that framing. I love that.
Speaker 3 (10:48):
We're going to take a quick break, don't go anywhere.
Speaker 2 (11:05):
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 1 (11:19):
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
(11:43):
sign saying hello, this is a perimenopausal symptom, and it's
so obvious because you're literally going to see it right.
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
almost always underrecognized, even by other medical professionals. And if
(12:08):
you start head to toe, that could literally be anxiety, depression,
emotional liability, brain fog, headaches. 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
(12:32):
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, 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
(12:54):
couple of seconds or minutes and then disappears.
Speaker 2 (12:58):
You know.
Speaker 1 (12:58):
I started getting random musculos skeletal ages, and I thought
it was just from working out, you know, hard or whatever,
and I didn't connect the dots on my 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
(13:20):
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 feel when
you started going through menopause? What was running through your mind?
Speaker 3 (13:35):
Well?
Speaker 1 (13:35):
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 (13:46):
But I'll tell you.
Speaker 1 (13:47):
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, we're not
fun to recognize. And I think it required a lot
(14:08):
of kind like self dialogue and saying, look, this is
a 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
(14:28):
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,
(14:50):
oh my god, like this is not pretty.
Speaker 2 (14:54):
Did month nine right? Get this baby out? Month eight even? Yeah,
like I'm done? Yeah.
Speaker 1 (15:02):
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 2 (15:23):
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
(15:45):
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 eating up to and during menopause.
Speaker 1 (16:03):
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,
(16:23):
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
(16:45):
don't have a libido. It's I've been with the same
person for twenty five years, right, So I think the
answer to that, other than get a divorce or have an.
Speaker 2 (16:55):
Affair, is as their girls work, yeah.
Speaker 1 (16:59):
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 women that gives an
additional one satisfying sexual encounter a month. Personally, if that
(17:22):
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 2 (17:30):
It's almost insulting.
Speaker 1 (17:32):
It is the vaginal dryness. 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 2 (17:50):
Everything else like like cooking, yes, vegetable oil, canola oil,
coconut oil, olive oil, you better believe it.
Speaker 1 (17:59):
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 cracked driveway.
It will dry out your vagina ultimately, even if it
(18:24):
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 non pliable.
Speaker 2 (18:34):
Did you know you can use coconut oil as lub
I didn't.
Speaker 1 (18:38):
I've heard of people using it in their hair.
Speaker 3 (18:40):
But I have to tell you, doctor Ashton, not once
have we been taping this show where Simone and I
kind of casually look at each other like, whoa, oh.
Speaker 2 (18:48):
You've blown our minds times over today. Oh good you
our minds, But I mission accomplished.
Speaker 3 (18:56):
I want to actually ask about hormone therapy because this
is a big topic of conversation around people going through
menopause or perimenopause.
Speaker 1 (19:06):
Do you recommend it? 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
(19:27):
because of flawed 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 (19:43):
By the way.
Speaker 1 (19:44):
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 improved men right.
But there are also non hormonal prescription medications that are
(20:06):
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 3 (20:29):
We have to take another short break, but we'll be
back in just a minute.
Speaker 2 (20:33):
Don't go anywhere, and we're back. I want to pivot
into fitness here for a second. I know that you
are a fitness girly as well, doctor Ashton, and yeah,
so I know that there are some thoughts out there
(20:55):
on hit workouts and women's bodies that it's potentially not
good for bodies. Do it anyways? I do it in moderation.
I'm curious if you think that there are any exercises
that we should be moving away from in as we're
moving towards perimenopause and menopause. How have you shifted your
fitness routine.
Speaker 1 (21:15):
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,
(21:37):
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.
Speaker 2 (21:59):
Right.
Speaker 1 (21:59):
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, it's
lifting weights and lifting heavy weights. You know, I have
the body I have today half because of my genetics
(22:21):
and of the other fifty percent, probably forty eight percent
of that is because I've lifted weights my entire life.
Speaker 2 (22:28):
Yeah, muscle. You prioritize muscle.
Speaker 1 (22:31):
Muscle, Yeah, muscle, 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.
Speaker 2 (22:41):
I certainly have plenty of it. This is a safe space,
thank you.
Speaker 1 (22:46):
My goal is to have big muscles to hold up
the creepy skin. So, yeah, like when I go to
the gym, I pick up twenty pound dumbbells in each hand,
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
(23:07):
each hand.
Speaker 2 (23:08):
I'm with you.
Speaker 3 (23:09):
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 menopause.
Speaker 1 (23:20):
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. I need to know what you mean
because there are crickets when it comes to this conversation
(23:40):
that you don't see any male gynecologists talking about it. Okay,
there are plenty of them. Why why so quiet?
Speaker 2 (23:48):
Great point?
Speaker 1 (23:49):
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 2 (24:00):
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 controversy
and empowered to talk about it.
Speaker 1 (24:11):
Yes, but again, this can't just be a one sided conversation.
This has to be everyone fill 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 2 (24:30):
Can I add one more to the list. Yeah, I'm
calling on Hollywood to give us our first menopausal action hero.
Speaker 3 (24:38):
Oh interesting, I thought you were going to say rom com.
But I like action hero.
Speaker 2 (24:42):
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 male.
Speaker 1 (24:56):
Would be amazing. Yes, Marvel, Marvel goes my Yes. Well, listen,
I'm working on that, ladies. I want to tell you
because part of agenda is developing television and media content,
and I will break the story on your podcast. But
I am pitching for development some both scripted and unscripted
(25:19):
in the menopause perimenopause space, and I'm going to get
it done. I mean, I am like, I'm not giving up.
Speaker 3 (25:28):
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 Okay, awesome, awesome. Thank you so much for the
education and for talking with us today.
Speaker 1 (25:42):
Doctor Ashton, Oh.
Speaker 2 (25:43):
My god, you guys are great.
Speaker 1 (25:46):
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. Thank you for saying that.
Speaker 2 (25:58):
Doctor Jen Ashton and 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.
Speaker 3 (26:16):
We'll be back Monday with an encore of our conversation
with the Connie Chung. Listen and follow The bright Side
on the iHeartRadio app, Apple Podcasts, or wherever you get
your podcasts.
Speaker 1 (26:29):
The bright Side is a production of Hello.
Speaker 3 (26:31):
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This week's episodes were recorded by Graham Gibson and Joel Morales.
Speaker 2 (27:11):
Our theme song is by Anna Stump and Hamilton Lighthouser.
Speaker 3 (27:14):
Special thanks to Connell Byrne and Will Pearson.
Speaker 2 (27:17):
I'm Simone Boyce. You can find me at Simone Boyce
on Instagram and TikTok.
Speaker 3 (27:21):
And I'm Danielle Robe on Instagram and TikTok.
Speaker 1 (27:24):
That's ro Ba y.
Speaker 2 (27:26):
We'll see you Monday, y'all. Keep looking on the bright side.
Hello Sunshine.
Speaker 2 (00:04):
Hey vam. If you miss our conversation with doctor Jen
Ashton the first time around, well you are in for
a treat today because we are turning to the board
certified obgyn and former ABC News Chief Medical Correspondent to
answer just about every burning question you've had about menopause.
It's Friday, December twenty seventh.
Speaker 3 (00:24):
I'm Simone Boyce, I'm Danielle Robe and this is the
bright Side from Hello Sunshine, a daily show where we
come together to share women's stories, to laugh, learn and
brighten your day.
Speaker 2 (00:37):
Today we're giving doctor Jen Ashton and encore. She's a
double board certified physician in obstetrics and gynecology, and she's
been a trusted adviser on women's health to both patients
and viewers for years. You know her from her run
as ABC's Chief Medical correspondent and as co host of
Good Morning America.
Speaker 3 (00:54):
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 (01:08):
Absolutely, and in June, she left her work at ABC
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 a free newsletter that brings you a dose
of health news, wellness tips, and science backed resources straight
to your inbox. She launched Agenda with a free newsletter
that brings you a daily dose of health news, wellness tips,
(01:29):
and science backed resources with an emphasis on women's health
in menopause.
Speaker 3 (01:34):
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 grocery store shelves.
Speaker 2 (01:44):
So let's bring her in, doctor Jen Ashton, Welcome to
the bright Side. Thanks.
Speaker 1 (01:49):
I'm so excited to be here with you. Guys, doctor Ashton.
Speaker 3 (01:53):
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 1 (02:08):
Oh my gosh. 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.
(02:28):
And I became a doctor because I wanted to help
people and have an impact. And I never in 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,
(02:52):
you know, the way I'm hardwired is to wake 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
(03:13):
to be growing very very quickly to a 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 (03:27):
Simone 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
(03:49):
menopause just hasn't really been talked about in the cultural
zeitgeist until the last few years.
Speaker 1 (03:55):
Well, first of all, I think we can all do
like a stand in 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.
(04:18):
But I think that you know the reason it 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
(04:40):
of victim and largely as just a human being with
reproductive currency.
Speaker 2 (04:47):
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 in to the nitty gritty
of the physiological processes that take place during menopause. So
what happens to our bodies during menopause and can you
(05:08):
break down those systems for us?
Speaker 1 (05:11):
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,
(05:32):
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 2 (05:49):
And that's perimenopause.
Speaker 1 (05:51):
Yeah, that's perimenopause. I'm glad. I was sitting down for that,
doctor Ashton.
Speaker 3 (05:56):
You had me I talk for a living and I
was a little speechless.
Speaker 1 (06:00):
Well, I heard like a lot of sighing and deep breathing,
and I was like, oh my god, are you okay?
Speaker 2 (06:05):
I know, it took me a minute.
Speaker 3 (06:06):
I couldn't respond at first.
Speaker 2 (06:10):
Yeah.
Speaker 1 (06:10):
I kind of have kids, I know. And so that's like,
there's so much here 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
(06:32):
is just like the medical system and how we deal
with women, and by the way, also how we deal
with ourselves. Don't even get me started. I could give
you three examples of my own life where I've dismissed
and ignored and denied physical symptoms that I'm having. And
I'm a doctor for quite out, so like, this is
(06:54):
just what we do. And then when you realize the
actual physiology, you're like, oh my god.
Speaker 2 (07:01):
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 1 (07:13):
Well, it's complicated, right, It depends on the organ system
what the effects are. But you know it increases blood flow.
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
(07:34):
the tissue, whatever tissue you're talking about, stronger, more vibrant,
and in terms of the uterus, it stimulates the lining
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 important to the brain. It's kind
(07:56):
of the calming down hormone. It has a big action
in your GI tract in terms of gut motility. And
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,
(08:18):
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
could be one pound of paune or it could be
ten pounds of pounge, And the part of the reason
for that is that their testosterone level is dropping.
Speaker 2 (08:39):
Evolutionarily speaking, what's the reason for the paunch? Is it
to protect the organs?
Speaker 1 (08:46):
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 2 (08:57):
WHOA does that mean that menopause is an adaptation that
we developed later on? Like? Where did menopause itself come from? Well?
Speaker 1 (09:06):
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. But human beings are among
(09:26):
the only species on Earth that go through that stop
ovulating and then continue to live a significant span of
their life. Most mammals can reproduce up until the point
that they die, Thank God, can't I mean, thanks God?
(09:46):
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
live past menopause. Really right now, you could live to
(10:11):
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 years of scientific or evolutionary data on
(10:34):
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 2 (10:45):
I love that framing. I love that.
Speaker 3 (10:48):
We're going to take a quick break, don't go anywhere.
Speaker 2 (11:05):
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 1 (11:19):
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
(11:43):
sign saying hello, this is a perimenopausal symptom, and it's
so obvious because you're literally going to see it right.
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
almost always underrecognized, even by other medical professionals. And if
(12:08):
you start head to toe, that could literally be anxiety, depression,
emotional liability, brain fog, headaches. 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
(12:32):
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, 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
(12:54):
couple of seconds or minutes and then disappears.
Speaker 2 (12:58):
You know.
Speaker 1 (12:58):
I started getting random musculos skeletal ages, and I thought
it was just from working out, you know, hard or whatever,
and I didn't connect the dots on my 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
(13:20):
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 feel when
you started going through menopause? What was running through your mind?
Speaker 3 (13:35):
Well?
Speaker 1 (13:35):
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 (13:46):
But I'll tell you.
Speaker 1 (13:47):
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, we're not
fun to recognize. And I think it required a lot
(14:08):
of kind like self dialogue and saying, look, this is
a 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
(14:28):
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,
(14:50):
oh my god, like this is not pretty.
Speaker 2 (14:54):
Did month nine right? Get this baby out? Month eight even? Yeah,
like I'm done? Yeah.
Speaker 1 (15:02):
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 2 (15:23):
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
(15:45):
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 eating up to and during menopause.
Speaker 1 (16:03):
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,
(16:23):
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
(16:45):
don't have a libido. It's I've been with the same
person for twenty five years, right, So I think the
answer to that, other than get a divorce or have an.
Speaker 2 (16:55):
Affair, is as their girls work, yeah.
Speaker 1 (16:59):
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 women that gives an
additional one satisfying sexual encounter a month. Personally, if that
(17:22):
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 2 (17:30):
It's almost insulting.
Speaker 1 (17:32):
It is the vaginal dryness. 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 2 (17:50):
Everything else like like cooking, yes, vegetable oil, canola oil,
coconut oil, olive oil, you better believe it.
Speaker 1 (17:59):
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 cracked driveway.
It will dry out your vagina ultimately, even if it
(18:24):
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 non pliable.
Speaker 2 (18:34):
Did you know you can use coconut oil as lub
I didn't.
Speaker 1 (18:38):
I've heard of people using it in their hair.
Speaker 3 (18:40):
But I have to tell you, doctor Ashton, not once
have we been taping this show where Simone and I
kind of casually look at each other like, whoa, oh.
Speaker 2 (18:48):
You've blown our minds times over today. Oh good you
our minds, But I mission accomplished.
Speaker 3 (18:56):
I want to actually ask about hormone therapy because this
is a big topic of conversation around people going through
menopause or perimenopause.
Speaker 1 (19:06):
Do you recommend it? 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
(19:27):
because of flawed 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 (19:43):
By the way.
Speaker 1 (19:44):
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 improved men right.
But there are also non hormonal prescription medications that are
(20:06):
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 3 (20:29):
We have to take another short break, but we'll be
back in just a minute.
Speaker 2 (20:33):
Don't go anywhere, and we're back. I want to pivot
into fitness here for a second. I know that you
are a fitness girly as well, doctor Ashton, and yeah,
so I know that there are some thoughts out there
(20:55):
on hit workouts and women's bodies that it's potentially not
good for bodies. Do it anyways? I do it in moderation.
I'm curious if you think that there are any exercises
that we should be moving away from in as we're
moving towards perimenopause and menopause. How have you shifted your
fitness routine.
Speaker 1 (21:15):
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,
(21:37):
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.
Speaker 2 (21:59):
Right.
Speaker 1 (21:59):
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, it's
lifting weights and lifting heavy weights. You know, I have
the body I have today half because of my genetics
(22:21):
and of the other fifty percent, probably forty eight percent
of that is because I've lifted weights my entire life.
Speaker 2 (22:28):
Yeah, muscle. You prioritize muscle.
Speaker 1 (22:31):
Muscle, Yeah, muscle, 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.
Speaker 2 (22:41):
I certainly have plenty of it. This is a safe space,
thank you.
Speaker 1 (22:46):
My goal is to have big muscles to hold up
the creepy skin. So, yeah, like when I go to
the gym, I pick up twenty pound dumbbells in each hand,
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
(23:07):
each hand.
Speaker 2 (23:08):
I'm with you.
Speaker 3 (23:09):
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 menopause.
Speaker 1 (23:20):
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. I need to know what you mean
because there are crickets when it comes to this conversation
(23:40):
that you don't see any male gynecologists talking about it. Okay,
there are plenty of them. Why why so quiet?
Speaker 2 (23:48):
Great point?
Speaker 1 (23:49):
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 2 (24:00):
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 controversy
and empowered to talk about it.
Speaker 1 (24:11):
Yes, but again, this can't just be a one sided conversation.
This has to be everyone fill 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 2 (24:30):
Can I add one more to the list. Yeah, I'm
calling on Hollywood to give us our first menopausal action hero.
Speaker 3 (24:38):
Oh interesting, I thought you were going to say rom com.
But I like action hero.
Speaker 2 (24:42):
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 male.
Speaker 1 (24:56):
Would be amazing. Yes, Marvel, Marvel goes my Yes. Well, listen,
I'm working on that, ladies. I want to tell you
because part of agenda is developing television and media content,
and I will break the story on your podcast. But
I am pitching for development some both scripted and unscripted
(25:19):
in the menopause perimenopause space, and I'm going to get
it done. I mean, I am like, I'm not giving up.
Speaker 3 (25:28):
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 Okay, awesome, awesome. Thank you so much for the
education and for talking with us today.
Speaker 1 (25:42):
Doctor Ashton, Oh.
Speaker 2 (25:43):
My god, you guys are great.
Speaker 1 (25:46):
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. Thank you for saying that.
Speaker 2 (25:58):
Doctor Jen Ashton and 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.
Speaker 3 (26:16):
We'll be back Monday with an encore of our conversation
with the Connie Chung. Listen and follow The bright Side
on the iHeartRadio app, Apple Podcasts, or wherever you get
your podcasts.
Speaker 1 (26:29):
The bright Side is a production of Hello.
Speaker 3 (26:31):
Sunshine and iHeart Podcasts and is executive produced by Reese Witherspoon.
Speaker 2 (26:36):
Production by Arcana Audio. Our producers are Jessica Wank, Krista Ripple,
and Amy Padula. Our senior producer is IT'SI Kintania and
our engineer is PJ. Shahamat.
Speaker 3 (26:47):
Arcana's executive producers are Francis Harlowe and Abby Ruzika.
Speaker 1 (26:51):
Arcana's head of production is Matt Schultz.
Speaker 2 (26:54):
Natalie Tulluck and Maureen Polo are the executive producers for
Hello Sunshine.
Speaker 3 (26:59):
Julia Weaver is supervising producer, and Ali Perry is the
executive producer for iHeart Podcasts. Tim Palazzola is our showrunner.
This week's episodes were recorded by Graham Gibson and Joel Morales.
Speaker 2 (27:11):
Our theme song is by Anna Stump and Hamilton Lighthouser.
Speaker 3 (27:14):
Special thanks to Connell Byrne and Will Pearson.
Speaker 2 (27:17):
I'm Simone Boyce. You can find me at Simone Boyce
on Instagram and TikTok.
Speaker 3 (27:21):
And I'm Danielle Robe on Instagram and TikTok.
Speaker 1 (27:24):
That's ro Ba y.
Speaker 2 (27:26):
We'll see you Monday, y'all. Keep looking on the bright side.
Hosts And Creators
Simone Boyce
Danielle Robay
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