Menopause is a significant transition in a woman’s life, and in this episode, Dr. Angela Walker and Dr. Sylvia Morris share their personal experiences and professional insights on the topic. They discuss attending a screening of “The Impactor,” a documentary about menopause, and delve into various aspects of this phase, including symptoms, hormone replacement therapy, and the importance of open conversations. Dr. Walker and Dr. Morris, both medical professionals, emphasize the need for women to advocate for themselves and seek informed medical advice during menopause.
Music courtesy of Dealer’s Choice Sound Recordings, Inc.
Music artist: djezi
—
Watch the episode here
Listen to the podcast here
Real Menopause Talk: The M Word Demystified
Dr. Angela & Dr. Sylvia Get Personal On Menopause
We are so excited to be back. This is a little bit different than our normal. We are just going to talk to each other about something that happened to us that we thought was significant enough to talk to our audience because it’s relevant to a lot of the women that we know. If it’s not relevant to them now, it will be. Live long enough. We’re going to talk about the big M word, which is Menopause. First of all, we wanted to give a big shout out to Dr. Dawn Mandeville, the menopause expert in Atlanta.
We were so excited to be invited to go to the Atlanta Screening of the M Factor which is a documentary type film talking about all things menopause. Sylvia, I’m going to let you take it from here because I know we had had so many things that we want to share about the experience and just the topic in general.
We want to thank Dr. Dawn Mandeville for inviting us to the screening of the M Factor. The M Factor when it comes to your city, go see it. Every woman ought to see the M Factor because there’s so much information. We don’t always talk about menopause. We are now in this moment where Gen Xers are now entering menopause and Millennials are also entering menopause or perimenopausal. We are talking about menopause. I remember my mother having hot flashes but I don’t remember having a conversation with her about menopause. Did you and your mom talked about menopause?
Generational Perspectives: Discussing Menopause With Mothers
Yes, because mom had surgical menopause because she had fibroids in her 40s. At that point, I’m guessing I was not in medical school yet, but somewhat versed in like, what you should do and what you shouldn’t do. Back then, you had large fibroids and bleeding heavy. All that. She was finished with childbearing and she was a candidate for hysterectomy. Back then, hysterectomy and ovaries out. The thoughts have changed.
What did they do now?
It depends. Now, you should have a good discussion if you’re considering hysterectomy and with your provider because the recommendations if you’re ovaries are normal, appear normal, and there’s no indication to remove the ovaries just because you’re having a hysterectomy does not mean you need your ovaries out. Studies have shown that keeping your ovaries can help with longevity. Women tend to do better and live longer if they are able to keep their ovaries.
For our audience, do they examine the ovaries in the OR? How do I know that my ovaries are normal or okay?
This can maybe two episodes. It’s your personal history. A personal history of breast cancer, or do you carry BRCA gene, and all these things that would be considered. Lots of different factors but in general, yes. If in surgery and your ovaries appear normal, and there’s nothing else in your history that indicates we should be concerned about ovarian cancer. It’s no longer a recommendation that we remove your ovaries.
It’s a different discussion than it used to be. When you asked me, it was a long way to the question that you asked me. Did we talk about menopause? I don’t know that we necessarily talked about it then, but I do remember telling my mom that it was okay to be on hormones. Again, this was before 2002. I finished residency in 2001. Before 2002, we knew that hormones helped to prevent osteoporosis. We knew that it helped with the symptoms of menopause. Also, at that point, we always told patients that helped to protect against heart disease.
Menopausal symptoms are significantly longer in years for black women. Share on XIt was the thing to do. Certainly, at that point, and her life, I told her it’s okay. She did discuss things like that with me. I’ll tell you the one other thing that my mom has discussed. She’s been 65 or 58, and she says to me, “Why do I still have these hot flashes?” That was something interesting that came up in the movie that we don’t talk about.
As Black women and the menopausal symptoms are longer in years like significantly longer. The data and don’t quote me because I don’t have my stats down. It’s around six years for symptoms in White women, once you enter menopause and ten years for Black women. Those are just averages but that’s a significant difference.
It is. I remember when I first started having hot flashes. At the time, I had no earthly idea what was happening. I would walk into a room to give a presentation. I was a consultant at the time. I would be looking for that thermostat to make sure it was cool in the room. I distinctly remember I was in Torrance, California. Shout out to the South Bay.
I gave this presentation and a little bit of sweat started rolling down the side of my face. At the end of the presentation, this wonderful sister came up to me and said, “Are you having hot flashes?” I was like, “Maybe I am. I’m just hot.” “No, sweetheart. You having a hot flash.” That was probably a decade ago. It took me more than a little while.
I cycled through all of the natural supplement ways of dealing with your hot flashes, then I finally went on the CombiPatch. This is not an advertisement. Nor is this a recommendation. This is simply just me sharing my personal journey. Certainly, I have felt better on having hormonal replacement because I’m able to sleep better. I’m less hot and I’m not breaking out into a sweat anytime I go anywhere or do anything or get upset.
Hormone Replacement Therapy: Benefits And Considerations
I love this. This is just real talk. We’re both in menopause and I can share my story. They talk about in the movie how as gynecologists, there’s very little time that is spent in our medical education and residency education on menopause.
Very little as an internist. Unless you did Women’s Health as a rotation, I don’t remember getting anything about menopause.
Completely. I knew that I have always counseled patience. Average age of menopause is 51 and now it’s 52. I knew all the symptoms and all of that. I will share in our audience as grown up enough. I use the IUD. I’ve used the Mirena IUD forever since my girls were born mostly because it’s very reliable and I couldn’t remember take a pill.
Keeping your ovaries can help with longevity. Women tend to do better and live longer if they are able to keep their ovaries. Share on XThat being said, I didn’t have a period to gauge. I didn’t have erratic cycles. It wasn’t like my I could say “My periods are getting lighter, or I’ve skipped some periods,” which sometimes will happen in perimenopause,” or the opposite. Some people start to have like heavier periods and irregular. I didn’t have that as a gauge. I’m just doing a long. Everything’s fine, and I turn 50. I’m in the office, and I’m like, “What is going on? I’m here till like 7:00.” I can’t think. I leave a patient’s room and I’m like, “What did she just say?”
It’s literally like a complete brain fog. That was my major symptoms and sleep. I was blessed I did not have the hot flashes where I would breakout in a sweat and feel overwhelmingly warm. Now, I did feel warm at times but it was the night time where it’s waking me up, and kicking the sheets off. I knew. In terms of natural things, I exercise in my ideal wheelhouse in terms of all the things that I know that are helpful.
I did do black cohosh. I just knew based on my years of experience the way that I was feeling was not good and that I couldn’t function well. I knew at that point the safety of being on hormone replacement. For me, I only needed an estrogen patch because one thing that I want to get out in this episode, especially since we’re talking about hormones. Again, as Sylvia said, we are just talking to as two females that happened to have medical education, so we can give a little bit of information, but we are not giving medical information.
Talk to your doctors, ladies.
Which is the key part of the movie, is go to your physicians and have these conversations. Needless to say, no woman should be on estrogen alone if they still have their uterus because that’s a setup for uterine cancer. If you don’t have a uterus, then you can take estrogen only. Estrogen alone and a woman has a uterus, it’s just giving one hormone stimulation and it can increase the risk of uterine cancer. You need that progesterone. Your CombiPatch is perfect that you’ve got the two.
What I am hearing is we need a balance because we need to make sure that we have the appropriate balance of hormones. If we’re going to do replacement, again there has to be imbalanced as well.
We’ll probably leave this for a different discussion. I’m not going to go into the whole balance thing because that is a discussion between you and your provider. The most important thing is if you have a uterus, you should not take estrogen only.
Navigating Menopause: Advocacy And Finding The Right Provider
One other thing, if you talk with your OB-GYN or your internist and they are not hearing you or don’t have information that helps your symptoms, then please find a new provider because not everyone has the appropriate skill sets and everyone isn’t able to communicate in a way that may be helpful for you. We don’t want people to suffer in silence.
It’s so important in this situation to be your own best advocate. We talk about advocacy in our last episode. It’s important to know how you feel, document how you feel, and keep records like a diary so when you do go to the provider you can talk and give some sound information about how you’re feeling and what your history has been. Again, I’ll echo you, Sylvia, and I tell patients this all the time. I’m not offended if you need a second opinion.
We need to make sure we have the right balance of hormones. Share on XI’m going to do that myself for me and my family. We’re not all well versed in all areas of our specialty. Hopefully, those of us that know that were in a position where we’re outside our bounds and starting to talk about our patient maybe asking things that we’re not aware of that we can refer them. I feel like I’ve done well and keeping up with menopause and menopausal health. I wouldn’t say, I am a Dr. Dawn Mandeville who’s an menopause expert.
She’s credentialed with the Menopause Society. She’s done the additional training that we don’t get in medical school and residency. It’s valuable to point that out. The most important thing is we’re having the conversation about it. One of the things that came up, it was the discussion afterwards is how our mothers didn’t talk about this.
Quite honestly, a lot of them didn’t know. Not like they didn’t, but some were like you. I may have been having hot flashes but they’ll tell you they didn’t go through menopause. They didn’t have symptoms. It’s just the day and age that we’re in. We have a lot of agency now over our bodies and not tolerating things, but we also have the advantage of media, social media and the notion of not speaking about our health conditions is no longer there. We’re free.
The community. We can have candid conversations about things that are happening to our bodies as you said on social media. There are groups that you can talk about menopause with if you don’t have one anyone in your immediate inner circle. I want to encourage people to start off with their primary care doctor, their OB-GYN, internals, or family medicine doc to have the conversation and then get evidence-based information so that they can do what’s best for their body and knowing their history.
Reframing Menopause: Empowerment And Positive Outlook
It’s a good conversation. I love it. I think our audience is in this place. I wanted to pass on the messaging at the end of the movie that it is not a bad thing to be in menopause. It’s freedom. You no longer have to deal with cycle, period, or menstrual cycle. You are empowered at this age because we have more wisdom about life. We’re still here and we can still do a lot of things.
We have a lot to contribute.
Lots of positive messaging. I love anything that shares information for women to take charge of their body.
This ends our many conversation on menopause. Please stay tuned. Let us know what your thoughts are. Send us an email. Please send us some a note on social media.
Until we meet again. May you be well.
Important Links