Karol Markowicz Show: Going Menopostal with Amy Alkon

make them a little more cohesive. I want to jump around from topic to topic less and I want to have a wider point. I'm almost at the two year mark of this podcast, and I've learned a lot since I started. I love my listeners and I respect your time, so I want to spend this summer figuring out how to make the monologues less jumpy and more coherent so

that my listeners get more out of them. I'd love to hear from you all about what you'd like the monologues to be going forward, or anything else you'd like to tell me at Carol Markowitz Show at gmail dot com. I'd love to hear from you. Please let me know how your summer's going. Thanks for listening coming up my interview with Amy Alkin. But first, folks, we're seeing something truly disturbing. Anti Semitism is on the rise around the world,

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and medical institutions are so at fault here. You know, people think, oh, you're going to bash doctors. I don't. Actually, this is the responsibility of med schools and providers to provide. If the doctors aren't trained in science, someone needs to be there, you know, nerds to you know, say okay, here's what the science says, and to generate practice standards, which are the guidelines doctors go by to treat you. And then the other the other two myths of that

doctors are trained in diagnostic reasoning. I'll a doctor house. If anyone's seen that show.

So it's vital that we look for underlying conditions. And then the third one is that doctors, this is so horrible. They are not trained to correctly assess risk. So they can't tell you what's my risk of this or that they either will not get it right or they rely on these overblown pharmaceutical company rep percentages that are actually not meaningful to individuals at all. Their comparisons of one

group to another. So when they say like fifty percent less risk, well that might be you know, it's a very small number. You know, it's not your risk, it's just this group to the other one. And so these are huge problems. And then there's a scandal in gynecology that people don't know about. So in gynecology, almost no doctors have any training, not even an hour of training in menopause or perimenopause science, right because they it's medical education,

medical education is so terrible. These schools are lazy. There's no reason to change them because they're just dodgy bureaucrats who run them, you know, taking in the donation dollars, and why start these programs in diagnostic reasoning and proper risk assessment? These cost money, These require change. New hires will just do what we're doing. And this is horrible. This is horrible because the father of evidence based medical David Sackett, said, fifty percent of what you learn in

med school will be wrong. The problem is we don't know which fifty percent, and it changes. The medicine changes so quickly. Now, so doctors. They when you go to the doctor, they treat you. They will send you guide ecology departments will send you to a baby doctor. Doctors who are maternity specialists, and those doctors are made to treat you in something they have zero training and expertise. And this is medically unethical. This is unethical. They should.

I write about this in the book by a cardiologist I think her name is Sarah Holland she said, you know, she's doing these massive cardiovascular operations. And she said, if my patient wants me to prescribe allergy medicine. I apologize and say, I know it would be more convenient, but I don't know that area. She might prescribe the wrong thing.

And so because of this, doctors, you go to your doctor with perimenopausal symptoms, you know, and the doctor doesn't know what they are, dismisses you, norse the symptoms, doesn't treat you or mistreats you. Doctors will give patience antidepressants. This is terrible. I think people have been reading in the news. You know, there are great tapering problems for people, and what they don't do. They might antidepressants can bring

down hot flashes, but they don't. They don't solve all these problems that you have and unhealth underlying unhealth in perimenopause, for example, your bones. They don't protect your bones the way our natural hormones do. And what doctors don't know the cause of great suffering during perimenopause. And I should name some of the symptoms so women get hot flashes. This is how I started the book. I was sitting here. I live in Venice, California. This is like the most

temperate place in the world. You know, It's breezy summer day, and all of a sudden. I'm sitting here at my desk and I'm sure. I'm like, why do I feel like I'm locked in a trunk in the everplace? He's crazy? I thought, oh my god, I hot flash. And you know, you want to go to your doctor and say, I'm uncomfortable. What should I do? But I know better. I've been coached since around two thousand and seven by this very

generous epidemiologist and biostatistician, Sander Greenland. He's a co author of the seminal book in the field, and he has helped me learn how to critically evaluate research and look and see if the methodology is adequate. All studies are flawed, but are they so flawed that you cannot you know that they're not conclusive about anything, and you look for a body of work. You don't just go buy one study. This is a problem where people say, oh, do your

own research. Well, you have to know what to look at, and you have to look at a great deal of research to know you know where, you need to know the whole landscape. So all of this is so terrible, So you go to your doctor. I oh, so sorry, I cut off my story. Basically, I started doing this deep dive into the research to figure out what the sciences, and I saw this just massive gap between the practice standards.

These are the standards for treating you, the guidelines for treating you that these doctors, I mean, they just read them off a list because they don't know themselves, no training, and they're victims in this. It is horrible to expect a doctor to do this. And this is you know, status quo in these departments. So people don't say no, they want to keep their jobs. They just get there. They're young and new, so they just okay, do the

best I can. That's horrible. That's horrible, you know, And so they don't have any ability to really know what's going on with you. And so women are left with these symptoms and some of them. One of the things

I went through a horrible perimenopause. Now perimenopause, I should say, is that transition period to menopause, three to ten years leading up to menopause, when your hormones start to go whack out basically, and what people don't know, what doctors don't know, they think that perimenopause is this menopause light that your estrogen.

that not all of our cycles are ovulatory. This is one third throader throughout our lives. And this is all the stuff on progesterone and perimenopause comes from the research of Geraln. Pryor, who is this fierce woman who grew up in Alaska with no running water electricity, daughter of missionaries, and brings that fierceness to science. She's an enochronologist and has tried to put perimenopause on the map for its unique hormonal state, and also have progesterone research, which is

very important. So progesterone is made when you ovulate, when the little eggsaft ruptures and the egg is released. So but in perimenopause and then sometimes before you don't have ovulation. You know, normal, you have a normal period. It doesn't seem any different, but there's no eggsact rupture. And what happens that is that you don't have progesterone made because it's makes the litter that's left behind called the corpus lute,

this yellow waxy stuff. And then you have a you have days of progesterone, you know where you if you have an adequate number where you progest your own you know, from the ovulation, then you are protected, your bones are protected, You're able to sleep, which I lost. This insomni is a huge thing. Yeah, and you're not.

we don't care. Write it in the most accessible, understandable language because it's hard stuffed. And I also put in all this humor because you cannot read a book like this. It's terrifying stuff without having these vacations. Right, and so with the sleep thing, what's really important is to do this quantitative basil temperature testing. Now people test their more first morning temperature to see if they're ovulating. Now, the book contains this horrible fact that we do not have

a twenty day menstrual cycle. This is wrong. Some women have much longer ones or shorter ones. And these all of these ovulation apps, I mean, they're leading women who are expecting to know when they're fertile with the wrong information. It's really horrible. But what is effective is measuring your

first morning temperature through this quantitative basil temperature taking. And then what happens is and this is a bit detailed, so you can look this up in the book, but you want to see if you have enough days where you're having progesterone and it's indicated by temperature rise that you are protected, that you have this really important protective hormone. And because I didn't, and you know, I didn't have enough progesterone, I wasn't I wasn't ovulating. My sleep was

so horrible. I had terrible brain fog. I was waking up like you. I mean I never champion. Yes, like someone hit me with a large frying pan. And then and this was like this, I mean, now I lay me down to thrash five or six times a night. The torture. I tried every hot, showers, cold, I mean,

do my feet need to be colder? It was like all this voodoo, you know, and so yeah, science in this I realized I needed progesterone, and I had to fight three battles with TiSER Permanente, my medical provider, to get the progesterone, to get the amount I need, which they do not give you in America. They don't give you an amount protective of the endometrium, which is three hundred milligrams of oral micronized progesterone per night, and then to get it covered, you know, and I should say

my ecologist, he was wonderful. I have a male you know, not like one of those patients like if you're my cancer, if you're my oncologist and you haven't had my lung cancer, well I'm not going to go here. He's fantastic, and so he treated me with great respect and listen, I

am an annoying human being. And I threw just a mountain of studies at him and then at his boss, who was then the head of Kaiser grond Ecology, and they actually met with me and listened and were persuaded by the evidence I provided, and so they covered the drug, gave me the amount I needed, which they'd taken France since nineteen eighty safely, you know. And as they said

to me, well, that's not American you know research. I'm sorry, like our French woman in Martians or to think he's dressed better and eat better food, you know, I mean, it's crazy. So that gave me my sleep. What it also does to protect my bones, my cardiovascular system. And this is a huge thing I want to mention about menopause.

We have this fraudulent research that came out around two thousand and two, the Women's Health Initiative study that basically said, you know, you're gonna get breast cancer your head.

nine years old, seventy five? You don't give does grandma going to the doctorate account of hormones? No? And the thing is what we know now, there's something called the timing. It's a critical window, the time hypothesis, and it's there's good evidence behind this that if you are a healthy woman you don't have plaque building up your arteries. You're not. You're healthy right at menopause and you start ester. Can you initiate it then then it will be health when protective?

And what doctors said the head of Kaiser, the current head of Kaiser Gnecology, this is so appalling. My doctor, my excellent gynecologist who listens and considers the science is out, you know, and so till August. So I had to meet with her. She tells me you need to tape her off estrogen at sixty. I said like, oh, this is so so outdated and so disproven that even the

menopause society they're always behind the times. In twenty twenty two, my point was like last three weeks ago in twenty to twenty two, they came out and there said there is no stopping rule. You know, it's to be decided on individual health. And the thing is people think, well I should get off estrogen. No, if you are, if you're healthy, it needs to be you need to be monitored.

But if you're a healthy person, when you initiate it and you remain healthy and your monitor for that, what you want is to be taking estrogen when you're old, because when do we break bones at seventy nine? And we break them because we fall.

see those so many women. Something happens at fifty women we have we tend to be, many of us timid in some ways, you know, And at fifty, so many women developed this confidence almost out of nowhere, where they will speak up, you know, pitch themselves, put themselves out there, stand up for things. And this is exciting, and you can even if that's not naturally occurring for you. The thing is, you know, our emotions and our way of being.

This is not a mandate. You can choose to be that way, and you can choose to be this about age also to be this way. And the reason that it's it's important to do this is that we can have a whole like third or fourth act. And so my friend I'll give my friend w Levin as an example. She I met at the Alternative Weekly newspaper conferences. I was selling my syndicated column. She was selling John Callahan, the cartoonist, and she was She's an agent. She's really

great at that. Well. She is now a pretty legendary ceramicist. She sells her work all over galleries, you know, the like designers. It's really sought after. And this just happened in a few years and she developed this and this is the way. And like a neighbor of mine, missus Abbot Kinney, she used to be on Twitter. She does literacy volunteering for adults, teaching adults to read at our library here in Venice. So you can volunteer, you can move to Portugal. You know, there's some of it you

can do and you just have to decide. You know that that really I call it old is the new black. I'm old. I'm old. I say it. I'm old, and I'm fabulous. You know the thing you're old? Yes I am, I am.

believe you when you say you want criticism. But that's really important to me, and that is my terror.

me cheer up each time. And that's the way you can. You can choose to have that attitude. And I think that it's really important to do that to understand that.