121: SOLO EPISODE: Menopause research, hormone therapy and spiritual consciousness

Hotflash inc founder and host Ann Marie McQueen talks about the first-ever perimenopause month, Hot Flash Day (courtesy of Stripes) and the annual meeting of The Menopause Society of North America. 

She talks about sleep, hot flashes, weird quirks of research; hypnosis and cognitive behavioral therapy. Some new numbers on how many women in the US are taking hormone therapy (it’s way less than you think) and asks why only estrogen is considered hormone therapy. She talks about three of her best friends, who were transformed by exogenous hormones. And she talks about her own spiritual awakening through menopause, which sounds annoying but hopefully is not. 

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Transcript

hotflashinc-_1_09-10-2024_193842: 0:00

Hi, Anne Marie McQueen here from Hot Flash Inc. Coming to you from hot, hot Abu Dhabi. It's the first perimenopause month ever. Uh, we're heading into menopause month in October. Over here, we're having the first GCC menopause summit. I'm going to be having a role in that. I just noticed that Stripes, Naomi Watts company, announced the first Hot Flash Day. Uh, it's the Menopause Society of North America annual general meeting this week at lunch today. I just sent out of my sub stack. A hot take on seven studies. There's like 80 different panels and presentations going on there. And I'm looking through, I wish I could go and just soak up the entire thing. A lot of stuff on hormone therapy, which is a great, uh, a lot of studies on, uh, cognition. I see hypnosis, CBT, I see cannabis, I see sexual health, I see bone health, I see AI. I'm going to be looking, I can get some access, so I'm going to be sort of diving in and, but you know, um, delving into things that I want to learn more about. I, in my newsletter that I just sent out, I was really impressed to see. A study that compared cognitive behavioral therapy to clinical hypnosis for reducing hot flashes and improving menopause symptoms. Now, first when I saw it, I thought, why can't you just study one? Why do you have to pit them together? Um, and I didn't realize, but in the 2022 non hormone therapy position statement that the menopause society put out, which I covered on my sub stack, they meant they covered CBT cognitive behavioral therapy. It's one of the only evidence based non hormonal. Things that they can endorse, but I didn't realize that they also endorsed clinical hypnotherapy. And at the time they said there were two studies, but this just shows you how chaotic this is because this was studied at Baylor University in Texas and they found eight studies, right? So that was just two years ago. I don't, I don't think. Six studies have been done since then on clinical hypnosis. I see a lot in the space, something that I saw when I moved to the UAE and You know, I've been in the UAE for 16 years. I almost said 600 years, but sometimes it feels like that. Uh, you know, there wasn't a lot when I came here and this country has blown up and so many people have done really cool things for the first time. But when I worked at the newspaper that we launched here, the national, we started to say like, we need to calm down on this is the first, this is the first, because people were complaining, people were claiming all the time. to be the first at this and the first at that. And then you would look and they weren't. And the menopause space is nascent. Yes. I know Gen X didn't discover menopause. Someone on Substract told me that last week and I loved it. You know, she's right. Like everyone who encounters something think that thinks that they are the first to discover it. I experienced this with friends who had fertility issues. And I remember once my friend, A friend of a friend at a party, we were outside having a cigarette, which I always used to enjoy a social cigarette. She was trying to have a baby and could not. She had her first baby and was like, lackadaisically sort of going to have another one. And then her sister had trouble having a baby and found out she was in early menopause. And then my friend of a friend found out that she was in early menopause. Which I obviously knew about, but, and I knew it wasn't great if you wanted to have a baby. She went on to have a miracle baby and all was well. But I remember her cornering me, and this happens when you're a journalist working for a big newspaper, saying, no one's talking about this. I remember she was smoking, she's like, no one's talking about this. I remember thinking, um, everyone's talking about it. Like, it's all I hear about. I know because I'm not married and I don't have anything on the horizon, and I'm worried about having a baby, so I'm I'm hip to it. So anyway, uh, what's happening in the menopause space, my point is that there's a lot of people saying the first, and when I read through research in a bulk like this, studies large and small, it's very common for them to say, you know, this is the first study believed of its kind. And this is, you know, shockingly true in this space because I've said before, we have, I think 1. 1 million studies on pregnancy. When you look in the PubMed database from the beginning of time, a lot of studies done when they started recording it, but you have only not even 100, 000 on menopause and less than 10, 000 on perimenopause. And as we learned from Susan Davis, the hormone therapy expert from Manassas University in Australia, that's a great episode. If you want to go back and listen to that to hear about testosterone, but she said, there's actually no studies on testosterone and perimenopause. There are so few studies on perimenopause, everyone's just extrapolating from menopause to perimenopause, but they are indeed two different things. You know, just for example, the perception of estrogen just declining is erroneous. Estrogen rises and falls during, as it declines over time in perimenopause. And when your progesterone is falling, that can put you in a position where you have high estrogen and a lot of the irritation and breast tenderness that can come from that. So you can see why that's one small reason why you would want to parse out the studies. When I'm looking through this stuff too, I just get so frustrated about certain things and I feel crazy because I think, how am I, Anne Marie McQueen, sitting here at my desk, wondering why scientists don't do this? Figure this stuff out, but we all know how workplaces work. We know how industries work. We know people don't talk to each other and we know people, um, keep things close to their vest. So we're still seeing studies where they're not making a distinction between progestins, synthetic progestogens, which is synthetic progesterone. also known as progestin. There's other, you know, longer names for it. And progesterone, the version, oral micronized progesterone that you take that is most like what your body makes, also comes in compounded versions. They're just not separating out those things. And we have other research. You know, over here, that's suggesting that those things are where you raise a risk. We're still also promoting estrogen only therapy and only really counting hormone therapy when it contains estrogen. And my gosh, like loads of women are only taking progesterone or only taking testosterone. Are you not on hormone therapy if you're not taking those? If you, if you don't have estrogen in the mix, that's redonkulous. There's also DHEA, pregnenolone. I'm taking those two things. I'm going to talk more about that when I interview the right experts. So that is frustrating to me. Another thing that is frustrating is that the narrative is so simple. You go through this thing called menopause. You have these hormones in your fertile years and they protect you and then you don't have them anymore and you're unprotected. Puts you at a huge risk for disease. The reality that's a lot more nuanced is that there's, there are middle steps, right? Like one of the studies that's being presented at the menopause society meeting this week is about hot flashes at night. And they wanted to know when most of them were happening. And it turned out that in this group of women, they studied 59 percent of them were happening in the second half of the night. And that's the half where we do have our REM sleep. And that's the most restorative sleep. And when your REM sleep is disrupted, there's, you know, data already that this sleep is so essential, that's where we repair and restore. So the risk is greater for cardiovascular disease, but you can see when I'm saying that it's not really the menopause or the hot flashes, the menopause is causing the hot flashes, but it's not causing the cardiovascular disease. And when you break down these different issues, You, you find that a lot. There's like a middle step or two that's glossed over in the, you lost your estrogen, you're at risk for disease. You have to question like if you left hormone therapy out of the mix and you were able to address the hot flashes as many women are through all sorts of things like, you know, hypnosis, my gosh, pycnogenol, which I talk about all the time. I, that's not my help lashes, uh, or, or whatever other thing that you've, you use, um, then it's not going to be an issue, right? If your sleep is going to be okay, then that's not the only thing that we can do. And often I find the studies on hormone therapy are very much like they go in with that angle. Um, and you know, Um, I'm still like have this pipe dream of a long term randomized controlled trial comparing healthy women who go on hormone therapy and healthy women who don't go on hormone therapy and adjusting for all the confounding factors and then getting the data to say, Hey, um, like they lived longer, they didn't get cancer, they didn't get heart disease. And we don't have that data and you know, they're not recommending hormone therapy to prevent dementia and to prevent cardiovascular disease. The Lancet commission on dementia this year looked at hormone therapy for the first time and they did not recommend hormone therapy to prevent dementia as in if you don't want or need to go on hormone therapy, they're saying, don't go on it just to prevent dementia. That's not what the tone is on social media. The tone is you're kind of a dumb, dumb dummy. I was also surprised because one of the studies looked at hormone therapy use in the U. S. Now, I don't have any of the details of how they collected this data, but it was low. Like it was, it was from 2007 to 2023 and in all categories, like 40 up to 59, uh, the highest percentage was six and they all fell in the time period. By like almost half. So it's not just stagnant. It was declining. And I think everyone blames the women's health initiative and assumes that there's barriers to women getting hormone therapy. But I just think we have to, and I do think that's true. I mean, I had my own barriers to getting hormone therapy. I have a doctor who literally won't prescribe it. She she's scared. And I have to get another doctor. But anyway, um, I don't think we can just assume it's because women can't get hormone therapy that they're not on it. Like there's loads of other reasons. I don't think we can assume that they're scared and they shouldn't be. I don't think we can assume any of that. Like we need to study a large group of women who earn on hormone therapy and find out why and adjust for all the confounding factors, socioeconomics and location and race and all of that. So, um, it's a really cool time. We were in a really cool place. And I still love talking about this. One thing that still bothers me about the entire conversation is that this is a bio psychosocial transition. It has been the journey of my absolute life. And you know, I'm a year out of menopause and you know, I lost my father this year. So it's very hard to figure out where I am, but I have done a ton of work on myself. I have shed a lot and processed a lot. And changed a lot. Health wise. I mean, I don't drink anymore. I, I really healthy. I, um, I processed a lot of trauma. I do a lot, like I do breath work and I do morning walks. I just do a lot of healthy things that maybe I didn't do before. And, um, I'm unrecognizable to myself, but it's not just like things are moving through me. Anger from the past feelings, habits that I've had. They're all moving through me. I am, I have had an awakening. I now know for sure that I'm part of something larger, that there's some sort of. You know, unified field that I'm part of. I can feel it. I, I've, I'm learning about my own energy and how to protect it. I'm learning about how to manage it. Um, I'm learning about how to connect with people. I'm learning how to let things go. So it just, it hurts my heart having gone through this and changed so many things and seeing it reduced down to we're losing our hormones and we've got to replace them. And I always want this to be a place where. You can come and get the nuance that is the reality. And if people want to go and they're busy and I understand if they want to go have the simple story, there are other places to do it. But here is where we're going to ask questions and try to figure things out. And I've talked about this a bit before, but I have three very good friends and they have all had their lives changed by hormone therapy. And, you know, these are healthy women too. Um, and they're smart women and. And they all tried to put off taking hormone therapy for some sort of reason, you know, and then they just said, I can't. And mostly because of sleep and mood. And you know, I was asking someone really close to me, like, what made you finally like, what made you hold off? And she said, just like lingering doubt and fear. And, um, and I, I don't think that's wrong. Like, I think that you should. Be very careful about what you go on and you need to have a clear idea of how you can get it and how long you might want to stay on it and take great notes and figuring out how you feel and noting if you have side effects. You know, for example, they did a study on older women who stayed on hormone therapy and one of the most reported side effects was postfaginal bleeding. Well, I don't know about you, but I like, I don't want that side effect. That's just one thing I don't want. That would make me very angry if I had that. It's not going to stop me from going on hormone therapy, but. That's something to contend with. And I'm told by experts that it it's usually managed and it can be dealt with and it becomes less of a factor over time. But anyway, all I'm trying to say is we're figuring everything out in real time and man, it's confusing. Another woman wrote to me on Instagram this week and she's gave me her report. She went to her doctor and it was. Like a long list of things she, she complained about, anxiety and body pain. And no, this doctor didn't even twig, nothing about perimenopause. She's in her forties, in her mid forties and she's figuring it out for herself. And you know, I talk to women all across the spectrum and you're dealing with like gut issues and you're dealing with. Oh, there's, there was an older woman who wrote to me and said, she can't even have a hormone graze her skin or she breaks out. So you know, that's, that's the spectrum that we're dealing with. And then my friend who slept well one night after she put her estrogen patch on, I think about this a lot and I think like every disease that's happened, say dementia, for example, there's not one reason. So when you ask the question, why would a woman write to me on Tik Tok and say she was just asking her mother about menopause? And her mother had no symptoms and she's 53 and she had nothing, nothing, just went through it. So why that? And then you have my three friends who literally weren't sleeping, anxious messes, me who had the worst perimenopause of all time. I mean, I was practically in a psychosis that I didn't even know about panic attacks and nightmares, intrusive thoughts like you wouldn't even believe. And that was just early in perimenopause. I mean, it went on and on. There were nights I didn't sleep. I was waking up at three and four. Yeah. Yeah. Just getting up and starting to work. So why is that? Like what is the reason? And I know there's all sorts of theories. Like there's this, Lara Bryden talks about the evolutionary mismatch and we've seen that in, in, in literature that we're just sort of surrounded by this sort of toxic system. And we have these health problems that are just exacerbating. Our, our situation. So when the hormones that do protect us during our fertile years start to recede, we're just not equipped to make the adjustment and this like narrative of like the estrogen leaves the building and we have all these gasping estrogen receptors, it just doesn't like. And it doesn't acknowledge the incredible wisdom of the human body, like no AI, no computer can, no technology can match this unbelievable system, but it is under attack and your adrenal glands are designed to take up the work of the estrogen that's produced. in other parts of your body that reduces and you actually form new estrogen receptors. Like that's the beauty of the freaking body. That's not the narrative. Everyone just talks about these. empty parking spots of estrogen receptors. I mean, I saw one doctor, she literally had a car and a parking spot to like demonstrate it. Some of the things I see on social media from doctors, I'm like, are you actually kidding me? Some of the things I see on social media period, it's, it's hard to come up with content. I understand. And I appreciate everyone for trying. I just think maybe that if you can find the space to do some work on yourself, whether you're in hormone therapy or not, You can give yourself a chance to become the spiritual embodied conscious person that I think we're all meant to be. I just, it hurts my heart. We're here to do something, you know, whatever this is. I I've been feeling really existential lately, but whatever it is, we're here. How we arrived. We didn't know where we came from. Um, you know, we're just here and then we just leave. I've just seen my father with him when he took his last breath and went, where is he? I know where his body is, but I don't know where he went. I, I'm walking around for six months. Like, where are you? And so. I just want everyone to figure that out. I just want us all to figure it out, to go through the pain or whatever. And it's not just women who are having this experience. You know, I just listened to the smart list podcast, podcast, the episode with Vince Vaughn. I'm a huge Vince Vaughn fan. I'm loving bad monkey. I can't wait it's on. I'm planning my whole day around it. Um, but those guys, the host of that show, Will Arnett and Sean Hayes and Jason Bateman, they're, they're all, I think 50, they're born in 1970, most of them the year Vince Vaughn was too, but they're all talking about themselves and they're having issues. Like Sean Hayes wakes up every night at four o'clock. Um, Jason Bateman was really tired. He's brain wasn't working. Um, on another episode, Will Arnett said he's going through some major, major, major. stuff and he's had to go to therapy and there's a clip circulating where the guys are ribbing him because he said he told his ex wife and Amy Poehler and she was really happy and they're like someone said yeah like 20 years too late. Like menopause, hormones, estrogen, progesterone, testosterone, whatever. It's not the only thing going on at midlife. Like we carry so much pain, so much experience, so much beauty, so much love. And as a friend of mine who's really struggling, a guy in his forties said to me, the vault is full and he just doesn't know what to do. So that's a bit of spiritual consciousness for you tied up in the annual general meeting of the menopause society in Chicago. Thank you so much for listening. We'll be back next week with another guest. As always, I appreciate you so much. If you want more hot flashing, check out my sub stack. There's a free newsletter almost every weekend and a. Hot flash pro subscription where you can support my work and get some of my, more extensive writing. I'm also on social media, Instagram, Tik TOK X at hot flashing, and you can watch these podcasts on YouTube if you want. So figuring YouTube, I hope you have an amazing week. Thanks for listening.