“The Talk” about menopause: solutions and strategies for menopause symptoms (part 1)

Jen Hardy [00:00:11]:

Welcome to the fabulous over 50 podcast where we encourage, inspire, and Power women to find their fabulous and live the life of their dreams. And today, I am so excited because as I’ve been talking to every one of you, The biggest issue that everyone’s facing is menopause and our body’s changes, not just at 50, but before, During and after. What are the symptoms? What should we expect? And why doesn’t anyone tell us all of these things? You know, when we go through puberty, people have The talk with us. Right? The talk about what to expect and what we’re going to face and how to handle it and how to handle the symptoms of periods and cramps now that stuff, no one does that for menopause, but that’s what we are doing today. And I’ve got Kristen Mallon, and she has been Looking into all these things for over a decade, and she is brilliant and open and honest, and she is here for you. So Here she is to start the talk. Alright, Kristen. I am so excited to have you here.

Jen Hardy [00:01:20]:

Oh my gosh. This is The talk of the century right here, and thank you so very much. And I thought I’d let you introduce it because the way you Explained it is so much better than the words that I have. So, yeah, just go for

Kristin Mallon, CNM, MS, RNC-OB [00:01:35]:

it. Yeah. So I think today, we’re gonna have The talk that we haven’t been having at all, and that’s the talk about menopause, perimenopause, postmenopause. You know, most of the time when we’re in adolescence, we have someone that kind of sits us down and has the talk with us about puberty and probably about sex and sexual health and birth control, And no one does the same for us at that time or in our, adolescence or young adult life or even into midlife for what to expect about menopause, premenopause, and postmenopause. So, you know, with longevity, we really wanna change that. We wanna open up. Wanna crack open the conversation about menopause, perimenopause, and postmenopause, talk about hormone balancing, talk about what happens, what to expect, and all the different options that Go along with that time in our minds.

Jen Hardy [00:02:25]:

Yeah. Because in all the women that I’ve been talking to, in the months that I’ve been doing this, this is the one thing that everyone says, Oh my gosh. You know, no matter, you know, the women from even, like, 35 to 60, all of them. They’re all having these things happening with their body and, you know, what is is it connected to menopause? Is it perimenopause? Is it you know, Does it have something to do with something else? And when you and I had our last conversation, you were saying there were some symptoms that I know I’ve experienced, and I had no idea that went with that, so I just love that we’re having this conversation. Can you talk a little bit about your company too and what you do and and your history so people know how you know so much about this

Kristin Mallon, CNM, MS, RNC-OB [00:03:09]:

topic. Yeah. So I’m a certified nurse midwife. I’ve been working in private practice since 2006, and certified nurse midwives, we really work with women throughout the lifespan. So we work with Adolescent women, you know, a lot of that is about cycle control and birth control in the, you know, the teen years, then through childbearing, Labor and delivery, postnatal care, and then into perimenopause, menopause, and postmenopausal care. And over the last 10 years or so, a lot of what I’ve done has really Kind of morphed into longevity care because a lot of women have been using, their OB GYN. So midwives are kind of like a substitute for an OB GYN As a primary care doctor, because I think primary care is kind of morphing in so many different ways, and we we see there’s so many different options that when it comes to primary care, both Out of pocket cost and using insurance, that we’ve learned so much. I’ve learned so much over the last decade in terms of what tests are available That I was like, wow, this is a really great opportunity to kind of take this to a much larger scale, work with, a whole bunch of different clinicians that are kind of trained in the perimenopause midlife space.

Kristin Mallon, CNM, MS, RNC-OB [00:04:16]:

Because when reproductive longevity kind of is over, women start to think about their long term longevity, and kind of open this up And and really provide, like, what we’re doing on a very small scale, what I was doing in my private practice to much larger audience, much bigger, Like, opening up it up to way more women, and then that’s where Pemgevity Health was born. My cofounder and I, she works in the diagnostic lab space, and then I worked in the clinical space. So we kind of see that, labs and diagnostic information is half of the puzzle, clinical and the symptoms, and what the woman’s reporting herself is the other half of the puzzle. We put them together, then we come up with this very comprehensive plan of care, which is really what FAMEJEVITY health is all about. We use all different modalities. We use functional medicine. We use functional medicine testing. We use Hormones, we use bioidenticals, we use natural supplements to really help women in whatever way they wanna be helped, and however they wanna Navigate the midlife transition and the different kind of hormone changes that come with that.

Jen Hardy [00:05:13]:

That’s awesome. Yeah. And I know I used midwives for several of my children that I had, and the experience was so much better for me than it was with, you know, typical clinical Doctor setting. But a lot of women don’t realize that they can use a midwife for other parts of their lives, so that’s good information to put out there.

Kristin Mallon, CNM, MS, RNC-OB [00:05:32]:

Yeah. So midwives, a lot of times, you know, midwife really is a German word that means with women. And so we don’t just Do although a lot of when midwives focus on birth and childbirth, but a lot of us get very attached to our clients and our patients, and so we wanna stay with them and do all of their gynecological logical care throughout their life. So the difference between midwives and OB GYN is primarily a big difference is we’re not surgeons. So we don’t do GYN surgery. We don’t do five word removals. We don’t do hysterectomies. We don’t do cyst which is cyst removals.

Kristin Mallon, CNM, MS, RNC-OB [00:06:00]:

So that’s where the distinction kind of ends. But I think midwives in general are kind of known, and I I believe this is true about myself and I know a lot of my colleagues. We We do a lot of holistic care. So a lot of really personalized care trying to meet women where they’re at. And so bringing that to This menopausal time in a woman’s life has been really fun and really cool with, with MWD

Jen Hardy [00:06:20]:

Health. That’s awesome. Alright. So where do we start If we’re having the talk with women.

Kristin Mallon, CNM, MS, RNC-OB [00:06:27]:

Yeah. So I think we kind of touched on it really briefly at the beginning, but You mentioned that women that are reaching out to you and women that you talk to really from, like, late thirties all the way into their sixties are kind of working with These types of changes. And so I think that’s really where to start is that hormone changes happen for women, and this is Kind of what I’ve seen, and it kind of coincides with what diagnostic laboratory, information shows us is that every decade in a woman’s life is very, very different. And so that’s different for how a man goes. So a man is really kind of the same up until puberty, has this spike in puberty that kind of goes up, Peaks for a long time, and then it kinda comes down hormonally. But for women, every decade is very different. 0 to 10 Is 1 set of hormones, 10 to 20 is another set, 20 to 30, 30 to 40, 40 to 50, etcetera, all the way up into the eighties. And I think most women could relate to this.

Kristin Mallon, CNM, MS, RNC-OB [00:07:22]:

Like, it’s so common for women to be you get into your thirties and like, oh, my period’s different. My period was never like this before. I’ve had my period for 15 years, and I’ve never experienced my period this way, and also in their 31 and they’re kind of experiencing, menstrual changes that are different or they’re starting to experience breast pain or PMS symptoms that are different. And so hormones really kind of peak for women around thirties, the the early thirties. And then they to kind of come down, and this is where we start to see kind of fertility, especially for women that have never had any children, fertility changes, and fertility struggles start to happen in the mid to late thirties. And so the perimenopause or the premenopausal changes are really happening in the late thirties and forties. Then the menopausal time is when there’s been 1 year with no menstrual period, and that is The average for women is around 51. And then the postmenopausal time is really from the fifties and into the sixties.

Kristin Mallon, CNM, MS, RNC-OB [00:08:20]:

And hormonal changes can really go Along with women on all decades along that time. And so I think timing is really, like, the 1st place to start.

Jen Hardy [00:08:28]:

And I know for me, And someone had told me, when you turn 30, things are gonna shift, and they did. The like, the literally, the month I turned 30, I felt a shift. And then 40 wasn’t bad, but then around 50, I also felt another shift. So what you’re saying is that’s normal and that’s natural. And so if you’re listening and these things are happening, it’s not just you. And that’s, I think, one of the best things to know, right, is that we’re not alone because A lot of us feel like we’re alone, and so we’re afraid to talk about it, which I think is what’s happening. And then we don’t have the information we need.

Kristin Mallon, CNM, MS, RNC-OB [00:09:03]:

Yeah. Absolutely. And I think, like, the shifts that we experienced from our twenties to our thirties, and for some women, they it exactly like how you described it. Like, oh my gosh. I turned 30, and then all of a sudden I had my menstrual cycle is different. Or I turned 30, and then I had, You know, spotting before, or I started having breast tenderness with my menstrual cycle, or I started having, PMS symptoms, or my libido changed, fill in the blank with whatever symptom you want. And for some women, it doesn’t have to be 30 on the dot. It could be 33 or it could be 28.

Kristin Mallon, CNM, MS, RNC-OB [00:09:33]:

But just to kind of have that general rough guideline that The twenties are a certain way. The thirties are a different way. The forties are a different way, and the fifties are a different way. And then we’re not really thinking about it Like, pre puberty, reproductive time, post reproductive time, like, it’s not 3 times in a woman’s life. Every decade Is a different kind of hormonal shift, and that might help women to kind of be like, oh, okay. Like, it’s different for me now. Like, How do I wanna approach that? How do I wanna how do I wanna look at that? And, you know, for us, we’re like, okay, labs are a great way. Like, let’s run labs Every decade, we’re really dig into that and compare, like, okay.

Kristin Mallon, CNM, MS, RNC-OB [00:10:08]:

What will what were your hormone levels like in your twenties versus your thirties? Okay. Maybe your DHEA is a little bit lower. How did that make you feel? What symptoms went along with that? How do you maybe wanna supplement DHEA? Now that you’re in their thirties or you’re in your forties and that’s starting to go down, Do you wanna use hormone replacement? You wanna use bioidenticals? Do you wanna use herbs? Do you wanna just use diet and exercise? Or do you just wanna be aware of it And then just know why you’re feeling the way that you’re feeling. And just the knowledge of that is giving you the comfort to be like, okay. Well, now I understand. So I’m able to kind of use that knowledge to kind of work through whatever it is that you’re feeling at the time.

Jen Hardy [00:10:43]:

Awesome. Okay. And we’ll talk about d a DHEA and all those other things in a little bit, like, specifically, how they help or whatever. But for the beginning, I’m wondering if we can start. So pre premenopause and perimenopause, are they the same thing?

Kristin Mallon, CNM, MS, RNC-OB [00:10:58]:

Yeah. Probably. Yeah. So So it’s really perimenopause, which I think is what I think most Peep like, is most commonly used now, and it could also be regional. It could be regional. So it might be different parts of the country that are using these words interchangeably. Premenopause or perimenopause kind of mean the same thing. They really mean the period before menopause.

Kristin Mallon, CNM, MS, RNC-OB [00:11:24]:

And from a medical perspective, medically speaking, A lot of times, most clinicians will really think of perimenopause as the time when the menstrual cycle is changing, and kind of forget about all the other symptoms that go along with So as menopause specialist or someone who specializes in menopausal menopausal treatment, we know that that’s not really the only symptom that goes along with perimenopause. And so We’re not just looking at the cycle change as the only symptom to say this is perimenopause or premenopause. And so, Traditionally, from a medical perspective, when they teach medical students or, like, in the books, a lot of times they’ll be like, okay. Stage 1 of premenopause or stage 1, there’s something called straw staging, Which isn’t really used that much anymore, but, it’s like, okay, menstrual irregularities, which is like the first sign of, Premenopause or premenopause. And that is when the cycle a lot of time tends to get shorter, and this is from a loss of progesterone. And then the cycle will get longer, so the more time in between cycles before the cycle ultimately stops altogether, and then that would ultimately be menopause.

Jen Hardy [00:12:25]:

Okay. So say let’s say somebody’s listening, and they’re a little younger than 50, right, or in their early fifties. And what kind of changes should they think could be part of this? Or could they maybe watch out for or know that are out there? That’s The thing, I think, a lot of us just don’t know what’s out there. Right? Yeah. Absolutely. It’s like walking in a minefield where you’re just, like, randomly stepping on these things instead of having A map right through a park Yeah. Where we could just casually go. So, yeah, you’re you’re gonna give us the map, And I’m very excited about

Kristin Mallon, CNM, MS, RNC-OB [00:13:00]:

this. Yeah. So I think just right off the bat to know that perimenopause really starts for most women around the early forties. So this is when you’re gonna get that, like, again, decade shift early forties, 41, 42, 43 ish, and then plus or minus a few years. So maybe even as early into the Late thirties, maybe 38. You mentioned even 35. I totally believe that some women are experiencing perimenopausal symptoms at 35. That could be absolutely a 100% true.

Kristin Mallon, CNM, MS, RNC-OB [00:13:31]:

And then sometimes as late as even, like, all the way up to 47, 48, 49, 50, some women get to 50, they have no symptoms at all. And that’s totally common too. And I think so just the timing of that is right off the bat number 1. Number 2 is, It’s not just menstrual cycle changes, which is what we’ve been told. The most common things that I feel like are reported to me are things like insomnia, sleep disturbances, Mood changes, so a lot of new anxiety or worsening anxiety, depression, rumination. Sometimes it’ll be, like, more OCD, like, or any type of, like, attention deficit, brain fog, trouble remembering things. It will also be weight gain, so women will start to gain more weight usually, like, around the midsection or the lower abdomen. I think there’s even, like, a term now from sex in the city called menobelli.

Kristin Mallon, CNM, MS, RNC-OB [00:14:21]:

And that’s really perimenobelli because I think that really happens in perimenopause, not so much menopause. Women can experience Joint pain, they can experience, like, tingling, numbness. A lot of times they’ll have, like, numbness in their hands and their fingers or numbness on their nose. It can change their, sense of taste and smell, so sometimes women don’t get it confused with COVID is is is kind of coming up a lot. Hair loss is another really big thing, Especially frontal hair loss, like what right around the frontal region. Some women will start to get symptoms of, puberty, like what they experienced when they went through puberty. So they’ll start to have more Acne on their face, chin, or back acne, they’ll start to get more breast tenderness again. They’ll get more, Like, premenstrual syndrome changes.

Kristin Mallon, CNM, MS, RNC-OB [00:15:06]:

It’s very common for women to have more fibroids during this time or be diagnosed with Fibroids because estrogen dominance is more common during the perimenopausal time or more common during the forties, or ovarian cysts It’s also very common. There can be a lot of like vague pain too or feelings of being off. So women sometimes will get diagnosed with Rheumatological conditions or fibromyalgia or musculoskeletal pain, fatigue is very common. A lot of women just say, like, I don’t feel right or I don’t Feel like myself or something feels off. So these are pretty much the most common symptoms that I tend to come across in the perimenopausal

Jen Hardy [00:15:47]:

That is a lot. That is a long way, and I know that almost no one that I know has any idea about the length of that list, so thank you. That is so amazing. So if someone’s experiencing these things, at least they can have the peace of mind to say, oh my gosh. It’s not some new, horrible, like, chronic thing that’s gonna take over. Right? So here’s another question. Do these things go away At some point, how long do they typically last? How does that work?

Kristin Mallon, CNM, MS, RNC-OB [00:16:15]:

Yeah. So what’s really happening is, you know, the the hormones Are starting to come to the hormones that were on the rise in the beginning decades of our life are now starting to kind of come down slowly. And those are hormones like progesterone and DHEA and testosterone. So we do with the 4 hormones that are mainly starting to kind of come down. And so It can have different changes on every single woman differently. And that’s also the same thing that kind of happens in pregnancy. So In pregnancy, when women get pregnant, there’s a there’s a rise in, HCG or human endoscopic hormone. There’s a rise in in a hormone called estriol.

Kristin Mallon, CNM, MS, RNC-OB [00:16:54]:

There’s a rise in estrogen. And these increase in hormones cause all these different symptoms for for for women. So some women have constipation and they have heartburn, they have nausea, vomiting, fatigue. So the same thing is happening, but kind of like in reverse. So the drop in hormone is causing all of these symptoms. And certainly the list that I gave isn’t exhaustive because there’s For every day, I feel like I’m hearing of a new symptom and someone is, like, is that really the perimenopause? And I think the more we talk about it and the more we’re gonna start to see patterns of, like, Okay. We’re starting to notice a lot of women 42, 43, 45 are experiencing the same thing, you know, that they’re experiencing Brittle nails or they’re experiencing, you know, excessive salivation or dry throat or, you know, filling the blank.

Jen Hardy [00:17:41]:

Wow. That yeah. That’s a lot. So how long does that all last? Does it stop when menopause starts? Or

Kristin Mallon, CNM, MS, RNC-OB [00:17:48]:

Yeah. So then as the yes. So then in pregnancy, so similarly, like, as the hormones go up and and the body adjusts to the high levels of estrogen, Similarly, like, as the hormones come come down, a woman can adjust to the lower levels of progesterone. So Unfortunately or fortunately, just like pregnancy is so different for so many women, perimenopause can be so different for so many women. So some women might only have a few months of those types of symptoms. And and they kind of don’t really think of it. They might not even remember it, and this is really common, I think, in, women who are maybe, like, in their Cs and seventies and eighties when you ask them about perimenopause, they’re like, oh, I didn’t have any symptoms, but they might just be forgetting or not remembering because maybe their perimenopausal Symptoms are very short. And so it can also be quite long, and and perimenopause can last the average is 4 years Of these symptoms, and for some women, they can even last 7 years.

Kristin Mallon, CNM, MS, RNC-OB [00:18:43]:

In some cases, in very extreme cases, chrymenopausal symptoms can last 10 years.

Jen Hardy [00:18:50]:

Wow. That’s a lot. Now what about, hot flashes and night sweats? Do those happen during that time as well?

Kristin Mallon, CNM, MS, RNC-OB [00:18:56]:

Yeah. So night sweats is also common in perimenopause. That that was a symptom that I that I didn’t mention, but that’s very common in perimenopause. So hot flashes are much more common, And, a symptom of changes in estrogen. And so changes in estrogen tend to happen in the menopausal time, or in the year Where the peer where you’re going many, many, many months now without a menstrual cycle. That’s when estrogen so when you’re still menstruating, estrogen, estrione, estradiol is estradiol is usually high. It’s still high when we run let’s but let’s test some women that are still menstruating. Even if they’re menstruating even if they’re 54 and they’re menstruating every Couple months, their estrogen levels are still relatively high because you have to have a pretty high levels of estrogen to menstruate.

Kristin Mallon, CNM, MS, RNC-OB [00:19:39]:

Once you stop menstruating, that’s when estrogen levels can become very erratic, and that’s when the hot flashes start to ensue. Every once in a while, there is something called the estrobloam, which is a gut gut, microbiome kind of complication, which is about how you filter out recycled estrogens in your body, and that can lead to really erratic estrogen levels even in a menstruating woman. So sometimes women who do have these conditions and have high levels of certain enzymes called the beta glucuronidase, Estrobolone condition, they can have hot flashes in the premenopausal time, but it’s pretty uncommon. And so we don’t find that too often. Although it can happen, so I don’t I never just like in pregnancy too, you know, there’s always the Different extremes in pregnancy, like, some women can have nausea and vomiting pretty extreme throughout the entire pregnancy called hyperemesis. Someone some women can have, Nausea and vomiting all the way through to the end, or they can have different types of hormonal symptoms that tend to kinda ebb and flow and go away. The same thing can happen Here as well. But it’s not common to have the hot flashes and turn it in a box.

Kristin Mallon, CNM, MS, RNC-OB [00:20:44]:

That’s

Jen Hardy [00:20:45]:

common. Interesting. Okay. Yeah. Because I’ve got a friend in her thirties that’s going through that big time. But Also, she’s had a hysterectomy, so that I’m sure has a lot to do with all of that. So here, let’s pause for a second. What about when you have a hysterectomy? At any age, does that throw you into menopause

Kristin Mallon, CNM, MS, RNC-OB [00:21:04]:

then? Yeah. So having a hysterectomy, which is a removal of the uterus, Shouldn’t throw you into a hormonal menopause. Removing the ovaries, which is where the majority of the estrogen is produced. Progesterone as well. The ovaries are really responsible for the majority of the production of our reproductive

Jen Hardy [00:21:25]:

hormones. Oh my gosh. Wasn’t that incredible? She is so knowledgeable, so amazing, and we are going to talk with her again next week and continue this conversation, Wrap it up. And then later on, I’m gonna talk to some of my friends about what menopause is like. And at the very end of this month, we will be talking about menopause and Sensuality and sexuality in our later years. So stay tuned, and stay fabulous.