transcript

Speaker 1:
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Speaker 3:
[01:30] This podcast is sponsored by Talkspace.

Speaker 4:
[01:32] Last year, I went through many different life changes. I needed to take a pause and examine how I was feeling in the inside to better show up for the ones who need me to be my best version of myself.

Speaker 3:
[01:45] When you're navigating life's changes, Talkspace can help. Talkspace is the number one rated online therapy, bringing you professional support from licensed therapists and psychiatry providers that you can access anytime, anywhere.

Speaker 4:
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Speaker 3:
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Speaker 5:
[02:47] Welcome to Unbiased Science, where we bring scientific method to the madness. I'm your host, Dr. Jess Steier. My lovely co-host, Sarah, is taking a break this week. She will be back next week. And instead, I am joined by not one, not two, but three, unbiased science ladies who I'm so happy we're really shining a light on because they're doing all of this incredible work. And as we'll talk about in a moment, we span three generations and we're here to talk about women's health with a focus on menopause because I have some questions. And this is going to continue as a series that will air on our YouTube channel, but we wanted to kick it off here formally on the podcast and introduce you to these ladies. So without any further ado, let me tell you who we've got here. So we have Dr. Sarah Berg. Now, Sarah is a board certified OBGYN and Menopause Society certified practitioner. You may have seen her videos on our Instagram over the last few months. She has over a decade of clinical experience caring for women across all life stages. She is the founder of Selfhority, a digital platform dedicated to delivering science-based accessible education on women's health with a flagship course on menopause. All right. Welcome, Sarah. Next up, we have the amazing Veronica Jaramillo. I hope I'm saying that correctly. Veronica is a Canadian food scientist based in Montreal and holds a master's degree in food safety from the amazing McGill University. She is the co-founder of the Food Truth Project, which is incredible. If you're not following it on social media, please do so immediately. You won't regret it. Where she delivers engaging workshops and creates online content grounded in evidence-based science. We love to hear it. She focuses on food, nutritious and wellness misinformation, bringing a practical and informed perspective shaped by her experience in both academia and the food industry. She's especially passionate about breaking down misinformation that disproportionately targets women, including topics like dietary supplements and diet culture. This is so relevant to today's conversation, because there's a whole lot of menopause supplements I'm seeing on my feed. All right. She's dedicated to making food science accessible and helping consumers build a more confident, informed relationship with food. You're going to be obsessed with Veronica and all of these ladies. All right. And finally, and finally, we have Jen Bordnick. Now, I just want to read to you what Jen wrote here, but I want to tell you that she's being very modest. So she said she's a lady from suburbia living through menopause. She's also our Chief Strategy Officer at Unbiased Science and a health researcher. She's going for her DRPH at GWU and she's focusing on misinformation. She's also a married mother of two and a DC policy wonk. Jenny? Jenny's here? Jenny, Sarah and Veronica, I'm so excited to have you here. All right. So let's get into it. By the way, we were chatting for 15 minutes before we hit record, and I'm like, everyone stop timing. This is too good for the pod. Can I ask, I know you're never supposed to ask a lady her age, but can we maybe self-identify our generation so we could sort of explain what we're doing here? I'll tell you, I'm a millennial. I'm actually turning 40 in four months, which is pretty bananas. I'm very excited about that. Does anyone else want to volunteer?

Speaker 6:
[06:35] I'm a Gen X, representing Gen X in the five.

Speaker 7:
[06:38] I am a millennial. I'm solidly in my 40s, so living the best life. For me, it's been the best.

Speaker 6:
[06:46] The 50s are better.

Speaker 7:
[06:47] I believe you. I think it's only getting better.

Speaker 8:
[06:50] Yeah, I've been hearing that. I hear it's only getting better, but I am a Gen Z, and I just turned 26.

Speaker 5:
[06:58] Oh my goodness. Okay, so we're here to talk primarily about menopause, but also I think there's gonna be a lot of stuff that comes up. So, Sarah, as an OBGYN, maybe just to open it up and then let's just chat, do you think it's too soon for a Gen Z or even a millennial to start thinking about menopause?

Speaker 7:
[07:22] Absolutely not, guys. I think, did you like the voice? I was really going for it.

Speaker 5:
[07:28] I loved it, I loved it.

Speaker 7:
[07:29] I think it's the fact that we don't even acknowledge it, even when we're in it, that's a problem. So the earlier we just have it on our brain scan, like thinking it through, just like when you were in your, like nine or 10 and your parents are like, let's go watch a movie about what's gonna happen with your body. We should probably be doing the same thing in our 20s, 30s, so that we're as healthy as we can be, so we can live our 40s, 50s, 60s, 70s, 80s, 100s, in our best quality of life.

Speaker 5:
[08:01] If I make it to 40, I'll be shocked. Sorry.

Speaker 7:
[08:10] Bring it down, Jess.

Speaker 5:
[08:12] I'm sorry. Okay, bringing it back up, bringing it back up. So Veronica, as Gen Z, I'm trying to think back to when I was in my 20s. Is this even on your radar at all? Like, are you thinking menopause, perimenopause? No.

Speaker 8:
[08:26] I'm not. Honestly, I'll be completely honest. I'm not. I think most people around my age are worried most about like their fertility. So like people my age are certainly like get pregnant and have babies. Like, I'm not I'm not thinking about that just yet. But I think it's we hear it first because when we're with our moms, because if you're like, I'm 26, I don't have that many other like 40 year olds in my life, really. You know, it's like our communities are kind of separate. Yes, except for you guys, of course, except for my lovely ladies at Unbiased Science. It's like my mom is in her 60s, so and it's still kind of taboo. So I don't really hear a lot about it. But I'm a little worried because should we be thinking about it now? Should we not? So I'm really interested to hear what Sarah and everyone else has to say. But to sum it, I don't think about it. Not one bit.

Speaker 5:
[09:16] But before I want to hear from you, Jen, because you openly said that you're going through it. But just real quick, I'm curious, Veronica, even though you're not really thinking about it, are you still seeing, like is your algorithm serving up for you, stuff about like menopause supplements and stuff like that? Or not so much?

Speaker 8:
[09:33] Definitely. And I did a post a long time ago, a couple months ago about a very popular supplement that was targeted for women and to hormones. And I broke it down and I was kind of sassy about it. And in the comments of the video, they were like, what would you know? You're 26, you don't know anything about what it's like to be perimenopause or menopause and have your hormones all up around. And then I was like, oh, maybe I don't.

Speaker 9:
[10:00] That's for sure. But the supplement is still garbage, but I digress.

Speaker 8:
[10:04] So yeah, I'm dissociated from it. But I do still see it a lot in my feed. So it's definitely something worth learning about.

Speaker 7:
[10:11] I could see that because you do so much with supplements. And supplements are really pushing women. And they like, you say the word supplement, and all of a sudden your algorithm is going to be full. And they're like, well, we're just going to try to sell her everything. So I could see where you hit.

Speaker 6:
[10:25] I have to say, though, I learned so much from our post that we did, I guess, last month or two months ago. And it made me think back. Because I didn't realize perimenopause could start in your 30s, right after you had your kids. And it's making me think now, right after I had my kids, and I was going through all this stuff, that was perimenopause. Why didn't anybody tell me all that stuff in my late 30s and 40s was probably related to menopause? Like, it's so aggravating.

Speaker 5:
[10:52] Okay, wait, I'm going to out my husband right now, who is a physician. He's an emergency physician. But I'll tell you, like, there's been some stuff going on, some wonky body stuff. I'm figuring it out. But I mentioned, I'm like, could this be perimenopause? And he's like, Jessica, you're not even 40 yet. So Sarah, what say you?

Speaker 7:
[11:10] I get it. I get it. Because we're not given a lot of education in medical school, especially. And then even in women's health about it, even though it's a majority of a time frame, you're taking care of a woman, it's hard. So I always tell people like, give that doctor a break because they weren't given the education. So I hear all the time, I know more than my doctor. I came in and I hope you know more about your body than anyone. So doctor included. But with grace, know that they don't want to bring you wrong information. They just also weren't educated as well. So this is an information from all sides. You don't feel educated. They don't feel like it, and they're coming in hot and hearing all this stuff, and you're getting the algorithm telling you to come in and ask your doctor this, and they maybe never got that background. And Jess, you know how many hours a doctor works. So they may not be able to delve in behind the scenes because they just get home from work. And if we watch the pit, they just need to decompress and be done. So it's hard on every end because I don't think we're getting that education out there, which is why I love we're talking about it, because the more we talk about it, the more it'll push for everyone to learn about it.

Speaker 5:
[12:21] Well, and speaking of, we're talking about it. So we bust Jen's chops, because Jen is our resident unbiased science prude. And I'm just going to tell you right now, it might come out before this episode airs. I think it will. We're working on a post right now about the, oh, she's covering her eyes, about the clitoris because what, Sarah, we finally mapped the nerve endings or?

Speaker 7:
[12:49] We finally mapped the nerves in the clitoris. And also it may be the first time most people realize it's more than just the pencil eraser edge. It's like, it looks like a wishbone going back there.

Speaker 5:
[13:04] Jen, please. Can I talk more about it?

Speaker 7:
[13:07] Vagina, vagina, clitoris.

Speaker 5:
[13:08] Wait, you say clitoris, I say clitoris.

Speaker 7:
[13:11] This is so great. English language is amazing. Clitoris, clitoris.

Speaker 6:
[13:15] Dolores, it rhymes with Dolores from Seinfeld.

Speaker 5:
[13:18] There's a Seinfeld episode where Jerry's girlfriend says, you know, her name rhyme with the part of the female anatomy. And he was trying to guess what it could be. He guessed Mulva at first, which is one of my favorites. And then we go on to realize that her name is Dolores, cause it rhymes with clitoris. So anyway, that's what we're referencing for any non-Semperomica.

Speaker 9:
[13:40] Yes. That's how we know like there's an age gap difference. I love you guys, but I don't know any Seinfeld references.

Speaker 5:
[13:49] Real Housewives is my jam, cause I need to let my brain like rot. And Summer House and all that, the Bravo TV sphere if anyone watches. But okay, back to the subject at hand real quick.

Speaker 6:
[13:59] We should do a show just on Summer House.

Speaker 5:
[14:01] Yes, yes we should. Hello, okay, Sarah, what are some of the signs of perimenopause and does it like totally vary depending on the person or what does it look like?

Speaker 7:
[14:13] It is a hot bag of variety. So you may just float through it and have no idea and get to the other end and be like, what are people talking about? You are rare, you are a unicorn, but just know you exist. For most people, it's a mixed bag. You could have a couple of symptoms, you could have none, but they're all over the place. And I think we need to root this in the idea that estrogen or your female hormones don't only go to your ovaries and uterus. So we always talk about it down there, but they're literally feeding every organ in our body. Our body is used to feeling it in the brain, in the heart, in the joints, in the bones. Wow. I know, seriously. I didn't know that. It's almost like once you think of it that way, it kind of gives a light bulb moment like Jen said. A lot of the things you're thinking, is this just I'm postpartum? Is this like I'm maybe showing my early signs of dementia? I'm having a racing heart rate because I'm anxious and I've never been anxious before.

Speaker 5:
[15:14] Always been anxious. Yeah, go on.

Speaker 7:
[15:16] But it's just like I'm having a flare. They may all be symptoms. And I could laundry list you, which wouldn't be very fun, but it's one of those things, a lot of symptoms we would never put in our female talk-to-my-female-doctor box may belong there. And that's why a lot of people end up seeing five to seven doctors before they even where perimenopause or menopause shows up. And we know how long it takes to get a doctor's appointment. So that could be a couple of years of your life where you're just, yeah.

Speaker 6:
[15:47] And that's depressing.

Speaker 7:
[15:48] And that's the other thing is because it's not a fast process. It's not something that you, if you're trying to find answers, that things are just gonna get better on their own. For most people, an average of four to eight years, but many, it's over a decade of symptoms before things start settling down.

Speaker 6:
[16:04] Now, when you say a decade, you mean before you hit menopause?

Speaker 8:
[16:07] So you're talking like 40 to 50?

Speaker 7:
[16:09] Yes, before you even hit menopause, a decade of symptoms that may be the wind up. So, and that's where I think people, because they think they're, they're even having everyone tell them, you're too young, but they're not realizing that you're not menopausal yet, per se, but you're in the rev up time where things are happening.

Speaker 8:
[16:30] Is that compounded with the fact that people like to dismiss women's health concerns, or like, oh, you're just being hysterical or dramatic, or it's like, it doesn't matter? Or is that people like, okay, I should, you know, I'm having all of these symptoms, but I don't think it's worth talking about because even like women ourselves will dismiss our own concerns. I mean, like, it's not important enough to go see the doctor. I have a million other things to do about my responsibilities on my kids, so like, is it compounded with the fact that we don't trust ourselves enough or everyone else doesn't trust ourselves to go see the doctor about this? Because I might be actually serious.

Speaker 7:
[17:04] You're hitting like every one of the things on the head. Like the idea that you're like second guessing yourself. You also have been told probably before that this isn't a real issue, that it's just aging, that it's something else. I mean, Jen, I'm sure you felt like everybody was telling you, oh, you just had a baby, it's fine.

Speaker 6:
[17:25] Right, right. It's normal to be anxious.

Speaker 7:
[17:27] Yes, like of course you're anxious. And because also a lot of, and thinking future, you talked about women in their 20s, 30s thinking more about fertility. Because we may don't have babies at 18, 20 anymore, a lot more people are having them closer to 40. Literally, perimenopause and having babies are like two icebergs coming at each other in a night. So you're like, is it postpartum? Is it perimenopause? I don't know.

Speaker 5:
[17:59] Yikes. Jen, can you tell us a little bit about what life's been like? What you've been dealing with?

Speaker 6:
[18:04] I mean, I would just say like, all through my 40s, I would go to my doctor and she would say like, are you having any symptoms? And I always thought it was just hot flashes. I didn't have hot flashes. So like, I didn't really know like sleeplessness and like starting to gain weight and, you know, anxiety and like depression. And I didn't know until actually I had to switch my meds for, you know, anxiety, depression. My psychiatrist said to me, oh, this is really normal. Women go through this all the time, you know, when they're doing perimenopause. And I had no idea because no doctor had told me that. So I think that's one thing. The sleeplessness is like insane. I wasn't a big sweater, but I would just, you know, you know, you hear like, I thought a hot flash was like, all of a sudden, like you're drenched in sweat, but it's not. It's just that you're a little bit warmer than everybody.

Speaker 5:
[19:01] Although, wait, did you see that video recently of a woman at a, I think it was like a sports game. I'm sure you saw this, Sarah.

Speaker 9:
[19:10] It was where her steam coming off her head.

Speaker 5:
[19:15] Wait, you didn't see this?

Speaker 6:
[19:16] Well, I haven't seen that one. No.

Speaker 9:
[19:19] Yeah.

Speaker 5:
[19:19] Wait, Sarah, you saw it?

Speaker 7:
[19:21] It's in my algorithm.

Speaker 6:
[19:22] Yeah.

Speaker 7:
[19:23] Yeah.

Speaker 6:
[19:23] Okay.

Speaker 5:
[19:24] Of course.

Speaker 6:
[19:25] Yeah. So I would just say like all of those things. The thing that like just drove me crazy though is nobody really ever suggested it could be related to menopause or hormones. Nobody ever brought up hormones. And because there isn't really like a test or anything, I guess, maybe they feel like it's not something they can diagnose. I don't know, Sarah.

Speaker 7:
[19:44] And I think that you're hitting that exact problem. You were seeing so many different people, you're kind of getting the different symptoms. And I call it the little boxes. Like they're all treating perimenopausal symptoms, but they're treating them in very distinct boxes. And it's so great that the person that is managing your mental health had the ability to say, hey, this is something in your head, but not in the bad way. You're having brain changes, and this is ramping up because of the hormone shift you're having. That affects your brain. And I think the brain is the big one that really freaks women out. And they also, like you said, Veronica, they're scared to say it, because they also are scared that this is the beginning of a down spiral. And so if they say it out loud, it means it's real. And so instead of saying like, I think I'm having this brain fog and this word finding and this like, I used to be able to do 15 things at a time and keep them lined up. And now I like can literally do one thing and then I have to go back to my list and I have to write everything down.

Speaker 6:
[20:48] It's a memory thing, isn't it?

Speaker 7:
[20:51] I mean, it's scary, right?

Speaker 6:
[20:52] Yeah.

Speaker 7:
[20:52] We know.

Speaker 6:
[20:53] Yeah. And nobody says like, and I think they're trying to reassure you because they're like, oh, this is normal for women your age. And maybe it is normal, but is there something you can do about it?

Speaker 7:
[21:03] Exactly. It's that idea of like, they're telling you you're normal, and they may be thinking, oh, she's in perimenopause. That's a normal stage. Instead of saying, literally saying it out loud, you're in this stage of life. So they think, oh, she's fine. She doesn't want to do anything about it, but there's a huge miscommunication that probably happened there.

Speaker 6:
[21:23] Yeah. All right.

Speaker 5:
[21:24] I have one thing to say, Jenn, you might want to plug your ears, but I'm going to tell you right now, my feed is filled with a lot of the lady part? anatomical impacts. So this, you know, severe dryness, which I do understand is a symptom, and maybe you could talk about that, but also the latest multiple videos, TikTok and Instagram, about your labia, I don't know, labia minora, majora, I'm not sure, like shriveling up and getting sucked into your body, and just, I don't know. They're wrong. They're painting a picture. Stop it. That happens. Does that happen, Sarah? It does.

Speaker 7:
[22:04] I'm not going to lie. I cannot tell you how many times I diagnose someone with changes of perimenopause during their pelvic exam. They will say nothing's wrong. They're like, everything's fine. And then I'm doing the exam, I physically see changes that I know have to bother them. And you're just like quietly like, I see some skin changes, you know? And my favorite analogy for it is that if this was me, I would be like the cat that scooters along their carpet on the butt because I just need to itch it, you know? Like that's how it would feel to me. So the fact that someone doesn't feel comfortable mentioning makes me very sad.

Speaker 5:
[22:45] So to confirm, there is a big ol nugget of truth there. There are some, yeah.

Speaker 7:
[22:53] It's not just clickbait, no.

Speaker 8:
[22:55] Okay, okay, okay.

Speaker 9:
[22:57] It shrivels up and comes back?

Speaker 7:
[22:59] Well, it doesn't, I mean, that's a little dramatic, but it does, like any dry skin, like think about even on your arm or your elbow or like, you know that look where it looks almost like ashy?

Speaker 9:
[23:11] Yes.

Speaker 7:
[23:12] That's part of it. And then it's not moist.

Speaker 10:
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Speaker 3:
[24:01] This podcast is sponsored by Talkspace.

Speaker 4:
[24:03] Last year, I went through many different life changes. I needed to take a pause and examine how I was feeling in the inside to better show up for the ones who need me to be the best version of myself.

Speaker 3:
[24:16] When you're navigating life's changes, Talkspace can help. Talkspace is the number one rated online therapy, bringing you professional support from licensed therapists and psychiatry providers that you can access anytime, anywhere.

Speaker 4:
[24:28] Living a busy life, navigating a long distance relationship, becoming a first step father, Talkspace made all of those journeys possible. I could speak with my therapist in the office. I could speak with my therapist in the comfort of my home. I was never alone.

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Speaker 13:
[25:01] I'm here on the job site with Dale, who's a framing contractor.

Speaker 12:
[25:04] Hey, good morning.

Speaker 13:
[25:05] Dale traded up to Geico Commercial Auto Insurance for all his business vehicles. We're here where he needs us most.

Speaker 12:
[25:11] Yep, they sure are.

Speaker 13:
[25:12] We can make it easy for him to save on all his insurance needs all in one place with coverage that fits his business and bottom line. Oh, shouldn't have looked down.

Speaker 10:
[25:20] It's all right.

Speaker 13:
[25:21] We're so far up here.

Speaker 10:
[25:23] Look at me. Take a deep breath.

Speaker 13:
[25:24] Oh, I'm good. So good.

Speaker 12:
[25:26] Get a commercial auto insurance quote today at geico.com and see how much you could save.

Speaker 6:
[25:30] It feels good to Geico.

Speaker 7:
[25:31] It's dry, so it does tighten up. And for a lot of women, it does look like it's like the color changes. It goes from being pink and healthy looking to like a white color. It's not getting dirtier than it used to.

Speaker 6:
[25:44] Oh, wow.

Speaker 5:
[25:46] Is there any... For those ladies, I'm hoping maybe they're still sexually active if they want to be. Are there things that can be done to help with that? And Jen is dead. We lost Jen. Bye, Jen.

Speaker 7:
[26:06] But also, like, I just want to... The safe space for all people, women, like...

Speaker 5:
[26:12] Safe space.

Speaker 7:
[26:13] Look at your vagina. It is not...

Speaker 6:
[26:15] Okay, but answer that question. That's gonna be boring.

Speaker 7:
[26:19] Like, use a mirror, look at it.

Speaker 8:
[26:22] I was gonna say...

Speaker 6:
[26:23] Okay, okay, okay.

Speaker 8:
[26:24] We're probably not looking at our vaginas enough, right?

Speaker 9:
[26:27] Because, like, wouldn't it be like...

Speaker 6:
[26:28] Oh, my God...

Speaker 8:
[26:28] .put a mirror in front of you, wide, open legs?

Speaker 9:
[26:32] Like, who's doing that? I'm not doing that.

Speaker 6:
[26:35] I'm not doing that. Again, save space.

Speaker 9:
[26:38] I've done it.

Speaker 7:
[26:40] Like, do not cringe at your body. It's just body parts. Do you think any man out there is, like, ashamed to look at his penis?

Speaker 9:
[26:48] He's, like... Please, please.

Speaker 5:
[26:51] They're flopping around.

Speaker 7:
[26:53] You want to say, ashamed thing. There's nothing wrong with looking. You are not a creeper if you look at your vagina. It's healthy to know what your anatomy looks like. Like, you won't know there's a problem if you don't look.

Speaker 6:
[27:05] Okay, but there's a treatment for that.

Speaker 7:
[27:07] Yes, okay, yeah. Yes, chill that out. Sorry, Jen. Sorry, Jen. Yes. So, vaginal estrogen is one of them, and I know estrogen, like, the idea of giving hormones, scares people, and I get it. We could talk for hours about it, but local estrogen, just giving back that estrogen that we know is going away during this time period, super safe. There's almost no one that we'd say this is off limits with. Even if you had breast cancer, even if you've had a heart attack, even if you're in the hospital, you are actually okay to use it. And so, not only for that, but there's also that kind of tissue in your urethra or your bladder area, and it can markedly decrease how many urinary tract infections you have as well. So it's helping the whole area. Oh yeah.

Speaker 5:
[27:58] Hold on, hold on, hold on. Question for you, Sarah. Wait, okay, if you finish your thought, but we have to go back to you, TI. Please go on.

Speaker 7:
[28:05] But this is also like moisturizers, and just like you do skincare for other places, you use skincare there. So start now, Veronica, your stage of life. And then if you're starting to have any symptom changes, as soon as you'd even think about like, could I be perimenopausal? I, as someone in that phase, start considering using vaginal estrogen, even if you're using other hormones, you could still use it there, like it's its own system. Okay.

Speaker 5:
[28:35] Is that, is it prescription only, or do you get it over the counter?

Speaker 7:
[28:38] They're actually considering making it over the counter. That's how safe it is. Oh, really? Wow. It's been in the talk. So that's what I've been trying to think. You know, you think as your doctor hat, you're like, is that safe? Should it be a prescription? The only reason I think is it's really nice for the doctor to talk with you about it beforehand, but safety wise, I don't see a huge problem. But again, I know I might get some pushback from that, but I'm really trying to think of any negative reasons. And as someone that wants more people to use it, I can't come up with a lot of them.

Speaker 5:
[29:10] Okay, I have so many questions.

Speaker 6:
[29:12] UTI.

Speaker 5:
[29:14] UTI, so I'm someone who's very prone to UTIs. I've had many in my life so bad that I've had it travel up to my kidneys. I had pyelonephritis, horrible. Oh my gosh, Veronica, like sending love is brutal. I tell you, Jess, I've been there with you. So does UTI incidence increase as you get older and menopause, or did I misunderstand?

Speaker 7:
[29:35] A hundred percent.

Speaker 6:
[29:37] Which I learned recently.

Speaker 7:
[29:40] That's why you're going to start using vaginal estrogen right now. And it's going to like change your life.

Speaker 5:
[29:44] Okay.

Speaker 7:
[29:45] Like it is also like a lot of people, and again, sorry, Jen, but they'll start to say that vagina smells different during this time. And it's a pH thing. It's a chemical thing.

Speaker 6:
[29:58] Sorry, Jen, and then it's mine, or you're saying this.

Speaker 7:
[30:01] No, no. I have not examined Jen. I am not her doctor. None of her facts. I'm saying I'm sorry, because I don't want her to cringe, not because I know what her vagina smells.

Speaker 1:
[30:13] Okay, okay, okay.

Speaker 6:
[30:15] I know. I'm just, she's saying it.

Speaker 5:
[30:18] This is very different than our usual unbiased episode. I'm trying to remember. I think the episode that will air before this, I'm talking with an immunotoxicologist. We're talking about PFAs and microplastics, and here we are talking about vagina smells. So here we go.

Speaker 6:
[30:33] I cannot wait to see the comments.

Speaker 5:
[30:35] Oh, yes.

Speaker 7:
[30:36] But the vaginal estrogen can kind of, that really affects people. So they think they're having infection, infection, infection, when actually it's just an odor change because the pH has changed. And so that can also help there because again, the last thing anyone, everyone's already uncomfortable enough around their vagina, but then when there's a smell change, they get really anxious. So think about that.

Speaker 6:
[31:01] So should just the basic like estrogen patch and stuff that I'm on, should that be like helping with UTIs? Or would I have to go back and get like something extra?

Speaker 7:
[31:10] I recommend using the vaginal estrogen as well, something localized to the vagina as well. So even if you're using the all body system stuff, I still think it's worth getting something specifically there.

Speaker 6:
[31:24] Okay, that's good to know.

Speaker 8:
[31:26] Could I ask Sarah why women are more prone to UTIs with perimenopause and menopause? Like is there an anatomical reason? Is it a hormone issue? Like why is this happening?

Speaker 7:
[31:35] Because the estrogen, when you don't have it anymore, that tissue that's protective, so the pH changes in the vagina, so that protective biome changes. And so it's easier for the bacteria to travel. So literally that smell change is also the biome change, which we talk about a lot in your GI health kind of situations. But is there?

Speaker 6:
[32:02] Okay. We should do a panel on this.

Speaker 5:
[32:04] A couple of rapid fire-ish questions, bioidenticals. I don't know what's the story with those. What are they? Is that an actual thing? Because I'm seeing that marketed a lot. Let's start there.

Speaker 6:
[32:17] What is a bioidentical? I don't even know what you're talking about.

Speaker 7:
[32:20] It's just a molecular term. That means that what you're getting looks exactly like something your body makes. And so, quick story, I promise. When the WHO, so that big study that made everyone scared to use hormones came out, and so everyone threw away their patches and their pills or whatever they were using because they thought they were going to get breast cancer and die of a stroke because of hormones, a market came around that said, oh, we're going to compound what your body makes. And we're, they use the word bioidentical to really rev up revenue marketing strategy. It was genius. So 80% of people stopped using the products that their doctors were prescribing. And then literally the market for, and I call it like the puppy mill, the puppy mill of compounding bioidentical hormones came out. And so people started getting compounded hormones. And there is definitely a place in the world for compounded medications, but this was truly a marketing strategy. So then they kind of took the word and they said, bioidentical equals compounded hormones. Not true. Now we have a lot of medicines that have gone through all the rigorous level, you know, ABC one, two, three of having FDA approved studies done that are bioidentical. The molecular is similar to what your body makes out there. So it is a word that means something very different than the marketing world is putting out there for you.

Speaker 6:
[33:55] So how do you know if it's a good med or not? Like what you're looking for something that's approved or?

Speaker 7:
[33:59] Exactly. Like you don't have to go to a compounding place to get bioidentical medicines. Most of the medicines now being prescribed as hormone therapy are bioidentical. It's just not the word we think about in the doctor-patient relationship. So estradiol, which is just the type of estrogen that you're usually, yeah, the one you're probably on right now. I got that one right now. So you are on bioidentical hormones. So even though it's not like the marketing world of the compounded, that's what you're on. And so that's, I think, the idea a lot of doctors are trying to get out there is that bioidentical doesn't mean compounded, bioidentical just means relatively the same. And what you're likely on from your doctor, from a pharmacy, from a like triple checked and looked at, is likely bioidentical.

Speaker 5:
[34:46] Okay, next question. What are, I've seen ads for menopause tests, and then also, I know you're chomping at the bit to respond, and then a slew of supplements. So I'm, what's real, what's not, and then what are you, like, what are your patients coming in that you feel like you're needing to address and debug?

Speaker 7:
[35:08] A lot of the marketing is fabulous. I mean, menopause marketing is genius, because they're telling you, you need to spend, like, $300 a month on something to make sure that you manage this beautifully. So they're gonna say, on the marketing side, you'll hear through your algorithm that you need to be tested for menopause, and that you should get your labs done. And then you'll go to your doctor, and you'll say, I need to get my labs done. And they're like, that's not really a thing. And so you think, they don't know what they're doing, and this person does, and I'm gonna send my urine or saliva to this company, and they're gonna tell me actually what's going on with my body. Now, here's a scoop. So perimenopause, I know, thank you.

Speaker 5:
[35:59] Tell me, tell me more.

Speaker 7:
[36:00] The reason your doctor is telling you that is not because they don't want to test you for perimenopause and menopause. It's because we know the hormone levels, what are happening during that time. So we know, and we want you to know, that if I were to test you today for your hormones, and I were to test you six hours later, the labs would look totally different. So it's not that your hormones aren't checkable, it's that they don't give us the story. And what your doctor is telling you, and hopefully telling you, is that your story, what you tell me, and what you bring in, is my best way of knowing what's going on with you. I don't need to waste your money with hormone tests. And so that's what slips the cracks. Now, always, like if you come in and say, I've got tachycardia, or a fast heart rate, or something else, we're gonna check for other things that could be going on, because we're not gonna slap the label perimenopause and menopause on everything, because that's not good doctoring either. So we'll test other things, but we shouldn't be testing things that don't mean a lot, because they vary so much. So you're...

Speaker 5:
[37:12] It's so similar to the thing, switching to food, Veronica, you know, the, well, I don't know, related to food, I guess, microbiome tests, you know, that are sold. And it's the same thing. It's like, if, okay, my, if I tested my microbiome right now, I take a sip of my coffee, you know, my microbiome has changed. It's just a snapshot in time. It doesn't tell the full story. And it's the same exact, right? They'll tell you, so here's a problem with your microbiome, and here's a supplement you have to buy from us to fix it. Right?

Speaker 8:
[37:45] It's the same idea. You're taking advantage of people's low literacy on a certain subject, and we have very low literacy, even as women, about our own reproductive health and the science behind it. And it's same with our food, and nutrition is very nuanced and different for everyone. So because there's the nuance, because every woman is different, and there's a lack of literacy, it's so easy to market and do really great marketing for that specific demographic. And unfortunately, that's where grifters can come in, and people can get really swayed into spending hundreds and thousands of dollars on things they don't need. So it's very intertwined, Sarah.

Speaker 7:
[38:21] And we are a society, understandably, that loves data. We love data. And so we're wearing our watches, we're wearing our rings, we're doing all these things to know as much as we can about ourselves, which is great. But knowing data, so we're saying, I want the data to show how I feel has a number to go with it. And like you said, it's easy for someone to convince them, convince you that you should have a data point to show how you feel, because that's the world we live in.

Speaker 5:
[38:51] Right. Yeah. And I would say, and as a data person, a data scientist, not all data is good data. We don't always need data. Data can cause health anxiety. It could make us think that there are issues going on, you know, that we have this chronic issue, and maybe it's just an acute, you know, something's going on that day, right? So it can cause a lot of unnecessary anxiety and problems. What about supplements?

Speaker 7:
[39:17] Veronica, you and I can talk about this one for a while.

Speaker 5:
[39:22] But Sarah, do you have a lot of patients who come in and they're like, oh, I'm taking this, or should I take this?

Speaker 7:
[39:27] This supplement, again, another one, they are really good at marketing. Because now you think if you're not taking a supplement, you're not being healthy. And that's what I see more often than not. People are coming in saying, look, I'm trying, I'm taking all these supplements to do all these things because the bottles say that they do that. And they've spent a lot of money. And I saw Des Linden, she's a runner and she's hilarious. And she's, you know, runs a marathon, wins it, and then drinks a beer. That's my girl. I know, I know, I know. So she says, yeah, fine, take the supplement, but just know you're peeing out 97% of your money when you take it. So, you know, their supplements are in a different category than the medicines that have to go through all that testing. So they don't have to prove they do something before they can put it on the label. And it's not saying they're not doing something and they're not trying. It's just a different level of proof. So, there may be reasons why you need extra of certain things in your body. But I'm sure, Veronica, you're probably in the same book. If you can get it from food, and most of the studies we have out there, they're showcasing, if you get this with your nutrients in your food, not supplements, that that's the best way to get it because we know exactly what you're putting into your system. Also, a lot of supplements, when they're tested, like third-party tested, whatever they're claiming are in there, most of the time, it's not even that. Or there's something completely different. So we're seeing, I'm sure, your husband, Jess, a surge in liver issues because people are overdoing supplements. And people don't think they're harmful, they think they can't do too many of them. But absolutely, too good of anything is a bad thing.

Speaker 5:
[41:12] Right. It's natural. I can't overdose on it or and there could also be drug interactions, right? That people that we don't know about. Sorry, Jen, what were you saying?

Speaker 6:
[41:22] People are really nervous about going on the hormones. So a lot of them are like, oh, I'm just taking the supplement and they feel better about it. But it sounds like maybe they shouldn't feel better about that.

Speaker 7:
[41:31] Well, and placebo is amazing. Like, yeah, we know that just thinking you're doing something healthy, like you, there's like tons of scientific research. So it's just thinking you're doing the right thing is going to make you feel better for a lot of people. Sorry, I didn't.

Speaker 6:
[41:46] Yeah.

Speaker 8:
[41:46] And I think it's a, it's a, no, no worries, Sarah. I think it's like a moment for us to just recognize that people who are probably listening to this, they probably are on some kind of supplement. Like, there is a, you know, a good chance that people listening could be on a supplement. And it's a moment for us to like, be, like, open up, open up the conversation and be empathetic, because it's, people often go to supplements because nothing else is working.

Speaker 6:
[42:11] Yeah, totally.

Speaker 8:
[42:12] And it's, they feel truly hopeless in their health journey. And they have practitioners that either don't listen to them, their family could dismiss them. And they feel like they need to do something for themselves because they're struggling and they feel like this is their only option that's left. So it's like, I know we talk about it, I always talk about supplements in a very critical lens, but a lot of people in my community and my family are still taking them. So it's important to like not feel like they're shunned from the conversation, but rather just to open it up and realize like we're doing this for a reason. You know what I mean?

Speaker 7:
[42:44] It's exactly like you said, like they want to be healthy, they wanna do it and they're bombarded with information telling them that this is something that's gonna help. So they're saying, well, why not? Why can't I just try? Let me just try it.

Speaker 8:
[42:57] Yeah, exactly. You're like, what could go wrong? Like, who cares? If it doesn't work, it doesn't work. But like, there are some, you know, as we spoke about, there's some negative consequences that can happen if you, like interactions, liver issues, it could just not be doing what it says it's doing. And it's so much money. It is crazy how much money people can spend on supplements for a variety of different reasons, but there's a lot of other impacts that we don't always talk about.

Speaker 5:
[43:26] Well, I feel like we could talk for 10 hours. Is there anything, and we will, right? Well, this will be a series, so you can hear from us.

Speaker 9:
[43:36] And I love this.

Speaker 5:
[43:37] I'm having so much fun. I hope that the listeners are too. But is there anything glaring that you feel like maybe we didn't address that we absolutely should address before we start wrapping up? Anyone, or Sarah maybe in particular, but anyone?

Speaker 6:
[43:53] Or what should we talk about? Like, you know? Yeah, like, yes, I love that.

Speaker 7:
[43:57] Like, what do people, what are people hearing that they're like, I would love for them to just gab about it for a while. So yes, like people tell us what you want to hear, because we could talk, like she said, we could talk all day, and we want to tell you the things that you actually care to hear from us.

Speaker 5:
[44:14] And so the way that you could let us know, so as with all of our podcast episodes, we drop clips on our Instagram, our Facebook, our YouTube, our TikTok, which we're really trying to breed some life into. And you can leave a comment. We read all of your comments. So if you leave your comments, let us know what you want to hear. We'll definitely read those, and we'll answer them on this series. Everyone should go ahead and follow Dr. Sarah Berg's self-hority. No, self-hority.

Speaker 7:
[44:42] Female health's prioritized, so yourself is priority.

Speaker 6:
[44:46] I know!

Speaker 5:
[44:47] Oh my gosh, I love that. Oh my god, that is brilliant. On Instagram, and is there anywhere else where people can follow along?

Speaker 7:
[44:55] Facebook, LinkedIn, you know. I'm not as cool as TikTok. I need to get young and hip, but one day.

Speaker 5:
[45:03] Sarah, maybe we can... I literally don't even have... Oh, wait, what? You don't have TikTok?

Speaker 8:
[45:09] I don't have TikTok, it melts my brain. I can't do it.

Speaker 5:
[45:12] Well, it does, it does. But unfortunately, that is where we could reach the young people. Sarah, maybe we can coordinate some TikTok dances and try to weave in some evidence as we're doing it. I'll embarrass my children. Can't wait, cannot wait.

Speaker 7:
[45:28] Only if Jen is the front runner in it.

Speaker 5:
[45:31] Oh, my God. Definitely. And Veronica, you can follow her incredible work at the Food Truth Project on Instagram for sure. Is there anywhere else or a website or anything?

Speaker 8:
[45:45] Facebook and LinkedIn. And we do have a website and reach out to whenever with questions.

Speaker 5:
[45:50] Amazing. And you will continue to see these ladies on our regular feed and also on this series that we're super, super excited to launch because people are not talking enough about these topics candidly. So we hope to do so in a way that feels accessible and real because we are all dealing with these issues and it's time that we talk about it. All right, listeners, we're, well, thank you so much for joining us. We hope that you learned a thing or two and you had some fun. As always, please follow along on our social media channels, on our Substack, the unbiasedscipod.substack.com, on our YouTube, on our TikTok, at all the places that we're trying to disseminate evidence-based information. We are so, so grateful for you. Be sure to tune in next week on your trusted source for no nonsense, just science.

Speaker 12:
[46:55] If you like the show, please take a moment to rate, review and subscribe. It really does help the show to grow. Thank you for listening.