Episode 331: The Truth About Perimenopause with Dr. Arianna Sholes-Douglas
For their final Midlife & Menopause Month episode, Dor & Elise interview Dr. Arianna Sholes-Douglas, author of The Menopause Myth: What Your Mother, Doctor, and Friends Haven’t Told You About Life After 35. They talk about how to approach a doctor about a discussion about perimenopause, the great (and some not-so-great) things to look out for in this transitionary period, and what’s really going on with hormone therapy.
We hope you enjoyed Midlife & Menopause Month! We’ll have more themed episodes coming in the new year.
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Transcript
This podcast transcript is AI generated.
Doree (00:10):
Hello and welcome to Forever 35, a podcast about the things we do to take care of ourselves. I'm Doree Shafrir.
Elise (00:17):
And I'm Elise Hu. And we are just two friends who like to talk a lot about serums,
Doree (00:21):
And this is our last midlife and menopause episode has gone so
Elise (00:28):
Fast.
Doree (00:29):
It has gone so fast. I was going to say, it's not like we will never talk about these things again. No, no. But yeah, we've, we've had some amazing guests on this, actually went a week longer than we were anticipating, just because we had so many great people that we wanted to get to them all.
Elise (00:46):
So we have spent the month of November doing our very first themed series that was selected by you all by popular demand. You all wanted us to talk more about midlife and menopause. And so we've had these amazing guests. We had Lynn Slater kick it off. Then Caroline Paul Reshma Saja, and then Emily Nagaski. And today we have an extra bonus guest essentially, because this is beyond our original announcement.
Doree (01:13):
It's true. We talked to Dr. Ariana Sholes-Douglas. We were like, oh wait, we should have an actual medical doctor on the show. Yes. Yeah, that might be good. And she was, oh, she was just so, she was so great. She was so good. She was wise, she was funny. She was compassionate. She was charming. I mean, I'm obsessed with her.
Elise (01:41):
I wish she could be our doctor. She is based in Tucson, Arizona. She's in
Doree (01:46):
Arizona. Be a bit of a schlep to
Elise (01:48):
Yes, it would be a bit of a schlep.
Doree (01:49):
Although I will say after I moved to LA from New York, I continued seeing my dentist for quite some time.
Elise (01:57):
You would fly back to New York
Doree (01:58):
Every
Elise (01:59):
Six months?
Doree (02:00):
No, and I was going back to New York a lot for work. So every time I knew I was going back or if the timing was right, I would schedule a dentist appointment. And
Elise (02:12):
That's kind of nice.
Doree (02:13):
It was nice. I really loved my dentist. And then I was like, this is ridiculous. I need to get a dentist in Los Angeles. Anyway. How's it going?
Elise (02:26):
Speaking of medical, I am allergic to cats and dogs, but I have both. And so every once in a while I have these mornings. My thing about allergies and my intolerances, it's just like, well, I'm just going to eat through it, or I'm just going to fight my way through it. I know that I'm allergic. I did that pin prick thing.
Doree (02:46):
My
Elise (02:47):
Back was just inflamed. Apparently. I'm like the kid from my girl. I'm allergic to everything, really? But I don't live that way. Yeah. I'm just going for it. I'm going for it anyway. And so I have very hairy golden retriever and I wake up and my eyes are all itchy and my skin is now, I don't know if you can see door, but I have a rash breaking out, and then I've been sneezing nonstop. So it's been kind of a thing. I, I'm an accidental Flonase influencer one time. This is a true story. Oh my God. Tweeted about how much I rely on Flonase. I was like, I just, due to all my allergies, I'm allergic to dust. I'm allergic to pollen, I'm allergic to cedar. I have to Flonase all the time. And Flonase saw it. This was back in the day, we were all on Twitter shit. Flonase saw it, and they sent to NPR West, a box of Flonase, no, I don't know, like 24, at least 24 of the little bottles of Flonase that I can shoot. And then they had the mist kind and the original kind.
Doree (03:56):
Oh my God, that's so
Elise (03:57):
Funny. From my friends at Flonase, it was so nice. This is not, I'm not asking to get another box, I'm just saying thank you. Sure, yes. Anyway, what's going on in your corner of the world? You sound much less congested.
Doree (04:16):
Yes. I'm not congested yet. Thankfully. Knock on wood, I am allergic to dust and cats though. Although I will say my cat allergy seems to have gotten a lot less severe. It was never super severe. But it used to be that if I went to someone's house who had a cat, my eyes would start watering, my throat would get scratchy. And it happened pretty quickly. And now I feel like that hasn't happened as much in the last 10 years or so. I didn't really do any exposure therapy. I don't have a cat, and I was never allergic to dogs, thankfully. So that was, and I never had seasonal allergies either, so that was also a big relief. But I did have a documented dust in cat's allergy. Speaking of dust this morning, Matt had dropped his phone under our bed.
Elise (05:16):
Oh, no. Annoying.
Doree (05:17):
We have an adjustable bed, which I actually love. I think adjustable beds are the secret to life, but we couldn't reach it. And then finally we put up his side, Henry was in on it. He was trying to get the phone, and I finally reached it, but there was so much dust under the bed that I was like, oh God, this is so gross. So yeah,
Elise (05:48):
I'm sure for this, I'm sure there's cleaning. Every once in a while I get cleaning because my TikTok algorithm also shows me restocking. I find it very calming. Just watching people who are organized stock their fridges with beverages or stock their drawers and organize their snacks. It's really, there's something very satisfying about it.
Doree (06:11):
I love that. I love that.
Elise (06:12):
And so I'm guessing my TikTok. Yeah, yeah. But I'm guessing my TikTok algorithm is soon going to start sending me ways to get into nooks and crannies.
Doree (06:21):
Oh my God.
Elise (06:22):
While cleaning.
Doree (06:23):
Totally. Yes. Yes, yes. Well, my dad has been here for
Elise (06:30):
A few days. That's right.
Doree (06:31):
Yes. And my mom gets here tomorrow, and it's been good. It's been nice to have Henry hanging out with my dad. There is an element of feeling like he needs to be entertained. He'll be like, what are we doing today? And I'm like, I don't know. I have to record what are doing today. Yeah, exactly. And I'm also kind of like, you can take Henry somewhere. And he's like, well, now his whole thing is he doesn't like to drive in Los Angeles.
(07:02):
My dad too. And I think I mentioned this, or no, maybe I mentioned this to you in an IRL conversation, and I sympathize with that, but I'm also like, we have the exact same car that you have at home and it's not a hard car to drive. And you could drive a couple miles and take him to a park he likes or something. You know what I mean? I'm feeling, you know how we talk about the sandwich generation? Yes, yes. I'm feeling like the IRL embodiment of the sandwich generation, just in this microcosm of the Thanksgiving holiday. Now, a lot of people talk about the sandwich generation in terms of their parents being sick and having to take care of them. Knock on wood, my dad is in excellent health and very physically able. But I am feeling this like, ooh, got to satisfy my dad and my son to them, to everybody. I'm also the only woman, I'm the only female in the
Elise (08:03):
Oh
Doree (08:03):
Yes. Outnumbered. It's my dad, my husband, my son, and my male dog. So I'm so much testosterone. So much testosterone. And I'm like, does the woman have to do all the mental labor, the emotional and mental labor here?
Elise (08:21):
Well, yeah, you should definitely. You should definitely draw some boundaries there. And it sounds like you have, you're sort of like, I've got to work. I'm podcasting.
Doree (08:28):
Go find something to do. Yeah. Well, I literally was like, here are my car keys. Go ahead, take him somewhere. I dunno. I went down a whole rabbit hole of Thanksgiving meals in Los Angeles. Needless to say, a lot of the good value ones were booked, which I get it. I started doing this research five days before Thanksgiving, but we did find one that is a buffet that I
Elise (09:02):
Love. A buffet.
Doree (09:03):
Yeah. I was like, you know what? A lot of them were quite expensive for a three course meal, which I was like, okay, it is a lot of food. But it also seemed like you were definitely paying a Thanksgiving premium. And I was like, why don't we pay the same amount of money for what sounds like an amazing over the top buffet
Elise (09:28):
And all you can
Doree (09:29):
Eat experience an extravaganza, all the experience. Yes. They also have for lower, they have a kids' buffet also, so
Elise (09:39):
Oh, fun.
Doree (09:39):
Henry. And the kids' Buffet has mac and cheese, chicken tenders, tater tots and broccoli, all my favorite foods. And Henry goes, I don't think I like tater tots. I was like, okay. He's like, can I get mac and cheese, chicken tenders and broccoli? I was like, yes, bud, you can. Oh, sweet boy. So sweet. So yeah, so I'm feeling like everything is
Elise (10:11):
What a great idea. Do it, do the thing.
Doree (10:14):
I was going to bring stuff in. And then actually my parents were like, what if we went to a restaurant, our treat? And I was like, okay.
Elise (10:23):
Yes, yes to that.
Doree (10:26):
All right, Elise, before we introduce our guests and take a short break, I do just want to give an update on our giving circle because yay. Yay. We were raising money for Arizona and we had set a goal of $25,000 and I am very happy to report that we got 92% to our goal. We raised over $23,000
Elise (10:49):
And that was a stretch goal. We were like, that was a real, we're just putting it out here to try and get here because this election matters so much.
Doree (10:57):
Over the course of doing all of our Giving Circle stuff, we've had 643 people donate to the Giving Circle to the various election cycles, which is so cool. It's a lot of people.
Elise (11:08):
Yes. And then there has been coverage, I think in Politico recently about the state's project and how it's directed. Giving actually did keep so many legislatures in progressive hands or keep them very, very close. So even having a narrow margin makes a huge difference. And that's because of really targeted giving to state legislative races that you all participated in. So thank you so much.
Doree (11:33):
Yeah, it's really cool. Alright, let's introduce our guest, Dr. Ariana Schultz. Douglas, she's the author of the book, the Menopause Myth, and the founder and visionary of Tula Wellness. She has practiced medicine for over 20 years and board certified in obstetrics and gynecology and maternal fetal medicine. Dr. Ariana specializes in integrative women's health and honors, a patient-centered approach and healing partnerships between patient and physician. And like I mentioned at the top of the show, we just had such an amazing conversation with her. And just a reminder, we have our website Forever 35 podcast. We have links there to everything we mentioned on the show. We're on Instagram at Forever 35 podcast. Our Patreon is at patreon com slash forever five. You can shop our favorite products at shop my US slash forever three five, our newsletters at Forever 35 podcast.com/newsletter. And you can call or text us at five nine one zero three nine and email us at Podcast gmail.
Elise (12:38):
We'll be right back with our guest.
Doree (12:48):
We are so excited to have Dr. Ariana on Forever 35. Welcome to the show.
Dr.Arianna Sholes-Douglas (12:53):
Thanks for having me guys.
Doree (12:56):
So we have a lot of questions for you about menopause, perimenopause, all the things, but we're going to start with a question that we ask all of our guests, which is, what is a self-care practice that you have?
Dr.Arianna Sholes-Douglas (13:08):
I mean, I have several of them, but most recently I light my fire pit and then I have a little standing gas lighter in the back. It's getting cool. I just sit on my patio and I'm in Tucson, Arizona, and I just look out at the Catalina Foothill Mountains and I'm, there's just something so magnificent about looking at those mountains and the sunset. So that's what I would say my go-to these days for sure. Love it. Love it.
Doree (13:39):
I'm feeling like relaxed, just hearing you describe that. Oh yeah. I can only imagine how it is. Yes.
Elise (13:47):
Well, Dr. Ariana, you are the capstone of a month. We have been devoting to midlife and menopause. So it is perfect to have you here as our kind of final interview in this series because you wrote a book recently called The Menopause Myth. So I'd love to know what is the big myth and what inspired you to write the book?
Dr.Arianna Sholes-Douglas (14:09):
Well, thank you. It's actually the menopause myth, what your mother, doctor, and friends never shared with you about life after 35. And so the subtitle is really what inspired me is because I'm a gynecologist. I'm an obstetrician gynecologist. I was practicing high risk obstetrics for the last 20 years, and I started going through perimenopause in my late thirties, but it just never even entered my consciousness that that's what was happening. I had all of the symptoms and including night sweats, and I don't even know what I was thinking was happening, but it never occurred to me. And as this kind of progressed and I eventually became menopausal, I was like, wait a minute, if I don't understand any of this, and I wasn't prepared and I had no idea, I didn't really know until literally a few years in and I was like, wow, if I don't understand this, how is it that the average woman could even possibly understand this? If I'm a gynecologist, I'm supposed to be trained, which I was not, and most gynecologists are not. So that's what inspired me to write it because I just knew that that was a serious void of information that women had. And I couldn't, in my mind even fathom that it was happening. And it's actually not a new book, it's the fifth year anniversary of the book actually. But the knowledge, the information is still pertinent.
Elise (15:36):
How much education are medical students and residents getting in this area now
Dr.Arianna Sholes-Douglas (15:43):
It is very, very, very slowly changing in specific programs, but there was actually a study that was done about a year or two ago looking, they surveyed residency directors to find out exactly how much of the residency curriculum is being dedicated to this topic and less than 2% of any curriculum. I mean, we're talking less than, I shouldn't even say 2%. It's two hours. There's a few programs out there, and this is in medical school. I don't think they're getting much these days unless that's slowly changing. But in residencies, a good residency program had about five hours. That was probably what the average was for a good program. But there was no specific curriculum. There just isn't. And what they did is in some of their answers, I won't say they smudged the data, but it was like if there was a clinic where there was menopausal women, they included that, but it wasn't specific to menopause training.
Elise (16:53):
So that means this flows outward, this ripples outward because then if patients are coming in exhibiting or complaining of symptoms that might align with menopause, the doctors might not immediately, like their minds might not go to it.
Dr.Arianna Sholes-Douglas (17:07):
Oh, not only would their minds not go there. In some cases they're just, maybe not intentionally, but they're gaslighting patients because the patients are coming in and they're saying, I have this. I'm perimenopausal and I cannot tell you how many women have come into my office if I had a dollar for each one. But they come in and they've gone to their gynecologist who's either said, I don't believe in hormone therapy. Oh, basically just kind of suck it up. It won't last that long. Or you're just too young. You couldn't possibly, because they have had no formal education, they don't know.
Doree (17:42):
Do you think that social media is starting to change this? To me, it feels like there's just so much more awareness of, maybe it's because I'm of the age and I'm getting targeted for it, but it does seem like there's so much more discussion of it. It's a shift than there was before.
Dr.Arianna Sholes-Douglas (17:58):
It's a huge shift. I mean, I've been in this space five years now, and within the last two years it's just taken off in every direction from anywhere from the providers that are available, these virtual online clinics that are popping up to the ability to just get good information. There's still some bad players out there, but for the most part, there are some great doctors, nurse practitioners, just providers out there that are just giving some really good information to people and they're getting empowered. And yeah, I see it. It's a big shift.
Doree (18:40):
So if someone thinks that they are in perimenopause and they want to talk to their doctor about what to do, how do you suggest they approach it? What should they be asking for? What is the conversation they should be having with their doctor?
Dr.Arianna Sholes-Douglas (18:59):
This gets a little tricky too, because at the end of the day, you're going to have a couple of different possible responses if you're going to a doctor that seems informed. One thing that a lot of women or patients think is that, oh, I need to have my labs checked. I need to know what's going on. And the reality is that your labs are fluctuating just like they were during puberty. So I tell patients, think of this like a reverse puberty. During puberty, we expected people to have these mood swings and do all the things, but they got to sleep in or just have an attitude and do whatever, could just kind of suffer through it. But these days we're working where we got jobs, maybe we have kids, we got other things. And so at the end of the day, we are having the symptoms of perimenopause, which are going to last longer than puberty on average, and they're going to be as erratic.
(20:00):
So any point in time where you're checking the labs, they're not necessarily giving you any clear cut information. It's all based on symptoms. So one thing is you don't necessarily want to go in and say, Hey, I want you to check my labs. Because oftentimes either they'll say, Hey, well, I'm not going to check your labs or your labs aren't going to tell me anything. And that frustrates people, but it's not about the labs, it's about the symptoms. So if you have insomnia, irritability, you have brain fog, night sweats, I don't need labs to determine that you're perimenopausal, right? But I'm still going to get your basic labs. I want to know what are your lipids? What's your thyroid doing? There's all of these other factors that are going to contribute to you're feeling. It's not always just what is my estrogen level? That's just not a piece of information that's going to guide any real type of therapy.
(20:54):
So you want to have the conversation that you're having these symptoms, you think it's perimenopause, and at that point, if your provider isn't like, I don't know how to put this, but if your provider doesn't get it, if they're telling you no or don't worry about it or dismissing you in any way, you either need to decide to have a conversation with your provider and say, here, this is why. I know. And it's a shame that as women, we have to do this in 2024, but the amount of time and attention that has been placed on women after they're reproductive is almost nothing, right? Like 0.03% of all research on women is done for women after age 50, and we only get 10% of all research dollars for anything. So we're really not equipped in this area to help women and navigate this the same way. So unfortunately, as a patient, you got to walk in prepared and empowered and have all your information. And if you know that your provider isn't, like if they're not jiving, then you got to make a decision there.
Doree (22:03):
I think that's so helpful, and I think we are so conditioned to not push back on medical providers, especially as women, that I think it's so important to hear this from a medical provider. So thank you.
Dr.Arianna Sholes-Douglas (22:21):
And I'll also add that if your provider is not doing it, then you can go to a site called menopause.org, and that is the website of the Menopause Society. And so there are providers who have done special training in this area, and unfortunately that's probably your best bet at this point, is to go look on that site, find a provider in your area. So at least you are talking to somebody who has knowledge about this. I'm not saying they're necessarily going to be your perfect provider, but at a minimum they've been trained and they're going to give you the latest data. They're going to suggest what is the most current recommendations, and they're not going to be living in 2002, which is when that Women's health initiative study came out and basically poo-pooed estrogen. And since that point, we've just kind of, everybody stopped prescribing the estrogen, women stopped taking it. And so that mentality of that study has just continued to affect, I think, in my opinion, is one of the worst things that could have happened to women's health because it informed a whole generations of doctors on how they're going to approach this topic. And then we just stopped talking about menopause at all, just because there was no estrogen, then why bother?
Doree (23:36):
So we're just going to take a short break and we will be right back.
Elise (23:48):
Well, this actually leads to one of the listener questions that we got and our listener writes, my question is regarding HRT, how do I know when to start it before perimenopause symptoms begin or wait until I'm experiencing them? Is HRT which stands for hormone replacement therapy? Is that out of the question? If I have a family history of breast cancer, also, how do I find a knowledgeable doctor? You just kind of addressed that. Dr. Ariana, sorry, lots of questions, but I'm so glad that we're finally talking more openly about menopause.
Dr.Arianna Sholes-Douglas (24:24):
Yeah, so the last question we talked about, so how do you know, so we're not going to start and then we actually call it in the medical community now, MHT, menopause hormone therapy or ht, it's just semantics, but we don't generally use HRT because of the word replacement, and we're not really replacing. So just point of fact. So hormone therapy, once you are symptomatic, even in perimenopause, that is an indication to start hormone therapy if you are so inclined. But before we even start hormone therapy, I'm going to ask, how are you sleeping? What are you eating? What are your stressors? Because this is a time of life when all of these things kind of just coincide, right? There's this intersection of I got a 22-year-old child on the spectrum. I got aging parents, I have work stress, I have life. And so all of this is happening at the same time.
(25:27):
My hormones are changing, and so what are those things in my life that I'm not doing, that I am doing that are exacerbating it? So for example, having a glass of wine at night to help me relax is actually going to disrupt my sleep and give me more hot flashes. So I'm not saying that hormone therapy is the answer to everything. We have to look at this much more holistically. But if at the end of the day you're ready and you think this is for you, then once you are symptomatic specifically with hot flashes and night sweats. But I would also say that if you're having difficulty with sleep, oftentimes that sleep is disrupted because of the night sweats. And so when we treat the night sweats, we treat the sleep, which then will help treat the brain fog that came because you didn't sleep, and all the things that kind of escalate as a result. So getting that sleep hygiene, and if that means hormone therapy to assist to help with sleep, then you would start there. But you're not going to just start it. Oh, I think I'm going to be getting perimenopausal, so let me just get ahead of this. It doesn't work that way.
Elise (26:34):
Then are there certain symptoms that you haven't talked about that people might not recognize as possibly perimenopausal symptoms?
Dr.Arianna Sholes-Douglas (26:42):
Absolutely. I hear a different one literally every month. So the most recent one that, I mean I've heard about it, but I'm hearing it more recently, is a whole burning mouth, burning mouth syndrome. I've personally had some patients and then I was speaking somewhere recently and somebody was like, I had the burning mouth, and I was like, oh, okay. And then I literally just talked to somebody today and they're like, I have burning mouth. I was like, get out of here. So burning mouth, there's what we call musculoskeletal syndrome of menopause, and that encompasses all of the muscle aches and pains. So joint pain is actually more prevalent for the population than hot flashes. It's one of the most frequently recorded symptoms of perimenopause. It's joint pain, but not only joint pain, frozen shoulder. Now there's this, another one I just saw on Facebook. Somebody text me and was like, something about the gluteal tendonitis.
(27:40):
I was like, okay, there's one. But if it's musculoskeletal and you're having these weird symptoms, for sure, those are ones that I think don't get discussed a lot. I think another one is we can't really dismiss is the anxiety and depression that really, if you had a history of a depressive episode prior to this, then you're three times more likely to have a more significant episode during this transition. And so in addition to the hormone therapy, that may be helpful, you're going to want to think about all the other ways to help with mental health, whether it's therapy and medication, but the anxiety, the palpitations, and the sense of women just feeling like they're getting early Alzheimer's, like the brain fog and another phenomena is A DHD. So we don't know if it's women who just didn't get diagnosed with a DH ADHD and we've just kind of been working through it, or is it just another kind of weird neurocognitive change that's happening?
(28:51):
But there are some women, myself included that I think for me, I had, I'm pretty sure I had 80. Well, I did. I've now been tested and it's official, but something happens when our estrogen levels fall. And I mean, in one way it's beautiful because I think the fog of just people pleasing and giving a damn about certain things goes away. But the other thing that comes with that is this lack sometimes of that clarity, this ability, your executive function, your cognition, your disability to be sharp. And for some people that significantly affects their productivity. And then we treat them basically like they're A DHD. It doesn't really matter what the diagnosis is per se. We know that the same treatments specifically stimulants can be helpful. So I have several patients that it's like, no, it's not. You haven't gone and had official diagnosis, but you meet all of the criteria. This is happening during this time period. And so once I make sure we've got all the other things on board, if stimulants are going to be helpful for them, I have several patients where it's changed their lives.
Doree (30:02):
Wow, that is fascinating. I've never heard about that before.
Dr.Arianna Sholes-Douglas (30:07):
Yes, A DHD,
Doree (30:10):
That's really, really interesting. Okay, this is another question from a listener. They're asking about estrogen face cream. They said they've read about it lately and this morning had an appointment with my hormone specialist. I'm 45 and am on, they refer to it as HRT for progesterone and testosterone. Thus far, my estrogen is still hanging in there and had planned to ask about it, but she brought it up before I even did. Anyway, I'm going to give it a try. She said she uses it two to three times a week. Just wondering. She was asking if anyone in our community has any experience with it, and I would love to hear what your thoughts are on estrogen face cream.
Dr.Arianna Sholes-Douglas (30:50):
Yeah, it's a thing, and it actually, it's fairly safe because the way the skin that we're putting it on doesn't really absorb as well. And so we're not getting so much of the systemic impact of it. And just like with vaginal estrogen cream, there's actually a study that just came out in the beginning of November that vaginal estrogen cream, not only does it not cause breast cancer, but it doesn't increase the risk of recurrence of breast cancer in patients that are using it. So you can liken the vaginal cream just so you can to your face because we're putting basically the same formulation or something similar to it, but it's even getting less absorption just because of the skin that's on the face versus the mucosa that's in the vagina. And yeah, I have patients on it. I could probably promote it more. I have aesthetics in my clinic, but yeah, it's a thing. Do it. Okay.
Elise (31:52):
Okay. And this brings me back to the earlier listener question about is hormone therapy out of the question if I have a family history of breast cancer?
Dr.Arianna Sholes-Douglas (32:01):
Absolutely not. Absolutely not. Your family history of breast cancer has nothing to do. We've already pretty much established that estrogen doesn't cause the breast cancer, but if you have an estrogen positive cancer by taking estrogen, you are at risk of increasing the risk of accelerating that growth of that cancer. But I want to put this in perspective because when we talk about the risk of breast cancer and estrogen, we're talking about even if you use that data from that WHI study, we're talking about a risk of less than 0.01%. So we're not talking about risk of anything, nothing. It's well below 1%. So this is how I try to reassure patients in general that even if it did cause cancer, let's just go with, okay, maybe it does. We're talking less than 1%. And when we talk about the bone health that we're losing bone significantly three to 5% of muscle mass every decade.
(33:06):
I mean, these are real, significant health issues. So somebody who is at risk for osteoporosis should take estrogen or consider estrogen even if they're not symptomatic. That's another indication. If you are, or if you've had your uterus or ovaries removed, or specifically your ovaries removed before 35 or 35, at least by 35, then we're recommending that you're going to start hormone therapy and be on that at least till age 50 52. So I know that's kind of a convoluted answer, but the answer for the breast cancer is no, there's, that's a big myth. That's another myth that if my mother had breast cancer, it has no bearing on you taking hormone therapy.
Elise (34:00):
Okay. Dr. Ariana, we have talked about some unpleasant physical symptoms. So I kind of want to flip it since we are broadening this to just this life transition and this life stage of midlife. What's awesome about this phase and this time in our
Dr.Arianna Sholes-Douglas (34:17):
Lives? What's awesome? Yes. What's awesome is that you are coming into your own. You are really, I mean, I call it a stage juicy. So that's actually, I started a podcast just to help educate women not only on what's happening, but also to help them see that this is a time to really embrace your juicy life. So my tagline is, juicy lives, juicy experiences, and juicy vaginas. We want all of it. And so at the end of the day, think about it like this. As your estrogen levels fall in your brain, your brain chemistry actually changes. And there's a book out there, the Female Brain and Luanne Brenin really just eloquently describes how we basically lose the veil of estrogen and we kind of really step into our own upgrade. And you have a choice at this point. You can either bemoan the whole experience and really look at all that you're aging, this and that, or you can just really realize that I'm not tethered to the same things I get to create.
(35:28):
I don't have the burdens of maybe these little kids are a menstrual cycle, or it just an opportunity for you to explore and transform, in my opinion, to step into who you really came here to be. And so I know that there are the challenges that come with it, but I also think it can be a magical time to upgrade and to embrace your true self. And just to really, it's a time when I say we go from being the necessary nurturers, worrying about taking care of every single person to being the people that we came here to be and saying, you know what? I'm not doing that anymore. Pick up your own damn socks. I'm not doing any of this.
Doree (36:13):
Do you have any other tips or advice for women who might either be about to enter this phase of their lives or are in this phase of their lives?
Dr.Arianna Sholes-Douglas (36:24):
I would say educate yourself and be empowered, because unfortunately, our medical system is not where it needs to be in terms of helping you navigate this the most effectively. So educate yourself, find a good resource and find a trusted resource and learn and really take ownership. Because oftentimes we hand our health and other responsibilities to other people. And it's like at the end of the day, it's your body. It's your experience. And if you want to age with grace and be as healthy as you can so that you can have the best quality of life, you have to take ownership of that. And there's nobody else's fault. You have to take that time for yourself. You have to take it. Nobody's giving it to you. So you got to go get it
Elise (37:17):
And stay juicy, of course.
Dr.Arianna Sholes-Douglas (37:19):
Oh, absolutely.
Doree (37:20):
And always stay juicy.
Dr.Arianna Sholes-Douglas (37:22):
Stay juicy. Girl.
Elise (37:23):
Dr. Ariana, thank you so much. Where can folks find you and your book?
Dr.Arianna Sholes-Douglas (37:27):
They can find me on Instagram at Dr. Ariana and on my podcast, which is new and budding, but it's called Stay Juicy. And
Elise (37:38):
The book is called The Menopause Myth.
Dr.Arianna Sholes-Douglas (37:42):
The book is called, and that's on Amazon, the Menopause Myth with Your Mother, Dr. Friends, never Share with You About Life After 35. Okay, thank you so much. That part. Thank you guys.
Doree (37:53):
Alright, Elise, we are in the intention zone.
Elise (37:59):
We're in the intention zone and stick around because we want to thank all of our Patreon supporters as well. So if you are one of our Patreon subscribers at the $5, the $10 tier stick around after
Doree (38:14):
Intentions, yes, please do that. How did your intentions go this week?
Elise (38:20):
Mine was just to show gratitude, note gratitude, and I think I did pretty well. I have a special thank you to my Polish tennis teacher. I am now playing tennis every once in a while with a former LMU tennis player, a tennis team member from Loyola Marymount, and she is Polish and her partner went back to Poland over the last couple of weeks and picked up a copy of my book, flawless in Polish, because the Polish translation is the first international translation, and she brought it back. That is so, it was so nice. It was her treat. It was such a surprise. So not only does my new tennis coach not stiff me on lessons,
Doree (39:10):
Oh my gosh,
Elise (39:11):
She bought me a book and I was like, can I Venmo you? She's like, no, it's my treat. So anyway, I'm just really specially grateful for her and it was kind of an international mission. She went on and got it.
Doree (39:22):
That's so cool.
Elise (39:24):
Very sweet. And then I've been trying to be less grouchy to the kids and be more grateful for them and have more mother-daughter time. So that's been pretty good this week, especially a week. It is the week of gratitude and taking time for family. But my intention is actually going to be a little bit more specific.
Doree (39:49):
It
Elise (39:49):
Is that my posture is terrible. I often work from my bed, and so not only do I have the neck from looking at my phone, but also from my computer. I also just like my lower back, there's a lot of pressure on my lower back. So I'm just going to make my intention to be strengthening my back. I'm going to do some more back specific exercises and training. I'll remain grateful for everybody and all of the things and moments in my life, but my intention for the purposes of this is back. What about you? Yours was last week. It was about family.
Doree (40:27):
It was about family. It was about Thanksgiving. As I mentioned at the top of the show. I'm feeling like, okay, we've got Thanksgiving under control. I know this is airing after Thanksgiving, but we're recording it before Thanksgiving. I will report back on how it actually went, but I'm feeling like pretty good about it. We have some other plans. We're going to go to the Sconzo Light Show, and yeah, we're going to just do some stuff but not be overscheduled. And yeah, so feeling good about that. This isn't really an intention, but I did read this article in the Wall Street Journal called The Case for Being Ungrateful, that there is an element of gratitude, and I think we've talked about this a bit on the podcast before you started, but there is an element of a gratitude practice that does kind of veer into toxic positivity.
(41:33):
And I'll just read from the article, performative gratitude, compelling ourselves to be grateful when we're not is a form of toxic positivity. The energy we expend trying to avoid the uncomfortable feeling will ironically keep us focused on the problem. Then we feel guilty because we failed to be grateful. And so this is just about kind of acknowledging that sometimes there are things that are shitty, and you don't have to be great. You don't have to look past them and say, well, I'm just because this, I didn't get this job. I have a roof over my head. I'm grateful for that. You know what I mean? And I was kind of like, yeah, I do. I think as in all things, there is a balance. Don't
Elise (42:24):
Invalidate the experience by
Doree (42:27):
Taping it over with happiness. They quote this woman who started to keep an anti gratitude journal, and she lists the things that bother her each day and says the list helps her think through her problems and put them into perspective. A woman whose husband died said she got sick of people telling her that she should be glad she had time to prepare for his death. Wow, okay. And she just said it was really helpful and that when she writes the stuff down, she asks herself, can she let her anger go? If so she writes down three actions to take, then she shreds the list so that no one will see it. And I just was like, oh, this is interesting. In our season of gratitude, I think I like this framing of, well, we can still acknowledge when things don't go our way, or things are hard and not have to always put this positive sheen on everything,
Elise (43:29):
Sheen over it.
Doree (43:31):
So my intention is not like I'm going to be more negative, but it is just helping me. I think about, oh, this didn't go well and I want to name it. You know what I mean?
Elise (43:47):
Yeah, sure, sure. Accepting. I think the regrets.
Doree (43:50):
Exactly. And I think for me also, a big practice over a long time has been being able to feel vulnerable. And there is something about saying when things go wrong that is very vulnerable. You're saying, this didn't go the way I thought it was going to. And so saying, this didn't go the way I thought it was going to, and I'm sad about it. There is something sort of powerful in that too. So of course, I dunno, just kind of thinking about all of this in this season, we'll link to this. It's in, I read it in my Apple News app, my Apple News Plus app, which I pay 9 99 a month for. So I don't know if everyone will be able to see it. I
Elise (44:29):
Can see a gift link though. Yeah, I have a Wall Street Journal subscription. I can give a gift link. So I'll send that to Sammy so we can include it in our show
Doree (44:35):
Notes. Fabulous. Thank you, Elise. And you know what? One thing that we are grateful for in this season is our Patreon supporters.
Elise (44:45):
Yes.
Doree (44:47):
Thank you, thank you, thank you. We thank our $10 month and up supporters every month. So thank you to the following amazing Patreon supporters, Ashley Taylor, Theresa Anderson, Michelle Maya, Barbara Chia, Callos. Amy, Amy Schnitzer, Heather Hale, Megan Donald Brew, Jr. Helen De Moys, Shelly Lee, Kim Beagler, Sarah, Sarah Boozy, Alison Cohen, Susan Eth, Melissa McLean, Linny Jones, Fran, Kelsey Wolf, Donne. Laura. Eddie, Pam from Boston, jet, Apte, Valerie, Bruno, Jane, Thoreau, Julie, Daniel, Katie, Quatro, E Jackson, Alicia, Merritt, Amy Mako, Liz. Rain. J. DK. Jennifer Smith, Hannah M Julia, putt, Maddie, O'Day, Marissa, Lauren Gitlin, Sarah Bee, Maria, Diana, Becky, Hobbes, Haer, Coco Bean, Laura Hadden, Josie, H, Nikki, Bossert, Juliana Duff, Chelsea Torres, Angie, James, Tiffany, G, Diane M. Martin, Emily, McIntyre, Stephanie Ana, Elizabeth Anderson, Kelly Dearborn, Christine Bassis, Alison Markle, Markle. Zulema Lundy. Carolyn Rodriguez, Carrie Gold, a NT, Nikki, Catherine Ellingson. Kara Brugmann, Sarah H Sarah Egan, Jess Bin, Jennifer Olson, Jennifer Hs, Eliza Gibson, Jillian Bowman, Brianne, Macy, Karen, Perelman, Katie, Jordan, Sarah, m Lisa, Travis, Kate, M, Emily, Bruer, Josie, Alki, Tara, Todd, Elizabeth, Cleary. And Monica.
Elise (46:26):
And Monica.
Doree (46:27):
And Monica. Thank you all so much. We're so grateful for you. Thank you
Elise (46:33):
For support us. The Patreon community has been so much fun. That's probably one of my favorite things to do is just pop in on the Patreon and hang out with you all. So thanks so
Doree (46:42):
Much. Love that. Okay. And just a reminder that Forever 35 is hosted and produced by me, Doree Shafrir and Elise Hu, and produced and edited by Samee Junio. Sami Reed is our project manager, and our network partner is Acast. Thanks everybody.
Elise (46:56):
Talk next time.
Doree (46:57):
Bye.