Many people view menopause with dread — or live in denial that it will ever happen. Kirsten Miller, author of “The Change,” and Dr. Paru David argue that menopause does not have to be a time of gloom and doom. It’s not a disease; it’s a stage of life, and one that some find empowering.
We talked with:
- Kirsten Miller is a groundbreaking feminist author in YA literature, best known for her popular Kiki Strike series. In addition to writing novels, Kirsten spent 25 years as a strategist in the advertising industry. During that time she worked for some of the largest agencies in the world, as well as boutique agencies and an eight-person startup. She’s proud to have quit at least two of those jobs over ads and incidents described in “The Change.“
- Paru David, M.D., is a consultant and assistant professor of medicine at Mayo Clinic. After her internal medicine residency at Banner University Medical Center in Phoenix, Arizona, she joined Women’s Health Internal Medicine at Mayo Clinic in 1999. She has published research and given lectures in the areas of menopause, contraception, menstrual migraine and sexual health. She’s a contributor to the Mayo Clinic Press book “The Menopause Solution.”
We talked about:
- It’s time to talk about menopause. Despite the fact that menopause happens to roughly half the population, it’s shrouded in secrecy and even shame. That means most people who experience menopause walk into it blind and are surprised by the changes they experience. Dr. David and Kirsten Miller want to change that.
- Menopause isn’t the end. Life, careers, interests, relationships — and yes, sex — can extend far beyond middle age. For some women, middle age is a renaissance where they’re most comfortable with themselves and thrive in ways they didn’t in their 20s or 30s. Kirsten Miller talks about “rebranding” menopause in her book as a time of newfound power.
Can’t get enough?
- Purchase the Mayo Clinic Press book “The Menopause Solution.”
- Purchase Kirsten’s book “The Change.”
- Want to read more on the topic? Check out our blog:
- If you’ve got ideas or book suggestions, email us at email@example.com.
- We invite you to complete the following survey as part of a research study at Mayo Clinic. Your responses are anonymous. Your participation in this survey as well as its completion are voluntary.
Dr. Denise Millstine: Welcome to the “Read. Talk. Grow.” podcast, where we explore women’s health topics through books. In the same way that books can transport us to a different time, place or culture,”Read. Talk. Grow.” demonstrates how books can also give a new appreciation for health experiences and provide a platform from which women’s health can be discussed. At “Read. Talk. Grow.” we use books to learn about health conditions in the hopes that we can all lead happier, healthier lives.
I’m your host, Dr. Denise Millstine. I’m an assistant professor of medicine at Mayo Clinic in Arizona, where I practice women’s health, internal medicine and integrative medicine. I am always reading and I love discussing books with my patients, my professional colleagues, and now with you.
I am so excited to introduce my two guests today. The first is the author, Kirsten Miller, who’s a groundbreaker and feminist author in Y.A. literature, best known for her popular “Tiki Strike” series. In addition to writing novels, Kirsten spent 25 years as a strategist in the advertising industry, which we get some insight into with her book. During that time, she worked for some of the largest agencies in the world as well as boutique agencies and an eight-person startup. She is proud to have quit at least two of those jobs over ads and incidents that are featured in the book we’ll talk about today, “The Change.” Welcome, Kirsten.
Kirsten Miller: Hi. So nice to be here. Thank you so much for inviting me.
Dr. Denise Millstine: Our second guest is Dr. Paru David. Dr. David is a consultant and assistant professor of medicine at Mayo Clinic. She works in the Department of Women’s Health Internal Medicine. She received her medical degree at the University of Missouri, Kansas City, after completing a combined B.A., M.D. program in six years.
After her internal medicine residency at Banner University Medical Center here in Phoenix, she joined Women’s Health Internal Medicine at Mayo Clinic more than 20 years ago. We won’t reveal the actual years. She’s a fellow of the American College of Physicians and she’s a certified menopause expert with the North American Menopause Society. She’s also a contributor to the Mayo Clinic book “The Menopause Solution.” Welcome, Dr. David.
Dr. Paru David: Thank you for having me.
Dr. Denise Millstine: I’ll start by telling the story of how your book, Kirsten, came onto my radar. I get together with a group of readers and one read an advance copy of your book and was on fire with it right afterward. She brought it to our meeting and she said: “This is about women in middle age who get superpowers, and she doesn’t back away from any aspect of that.”
I could not grab the book fast enough. Then I brought it to my Division of Women’s Health and asked if everybody would read it and we could talk about it, and we did. The first ever Women’s Health Internal Medicine book club happened, inspired by you and your work. But subsequent to that, I was doing an academic presentation on menopause at a conference, and we were talking about using popular reading for learning about health conditions.
The incoming president of NAMS was saying: “You know, you can read those books, but you have to take them with a grain of salt,” and I said: “Wait a second, what about reading those books when they’re in story form?”
We actually changed the narrative about how we think about the menopause transition and middle-aged women and the phase of women’s life that can be actually quite exciting and not as disastrous as the images on the internet would make it appear when you look at them searching for menopause. Tell us about how you decided to write this book and change this narrative.
Kirsten Miller: I really did want to change the script. I’m 49, and at this point in my life, I think that we all approach this and are somewhat surprised by it. Even though it’s something that happens to half the population, it’s still shrouded in mystery and secrecy and shame. My own mother, who is somebody who would have been happy talking about anything, never actually mentioned the word menopause in my presence.
I have come into this stage blind, largely. Aside from all of those social stigma surrounding it. I think we’re all told at a certain age that when we reach our late 40’s, early 50’s, we’re going to become invisible, that we’re going to be slowly sort of ushered out of society. That’s not the case. Maybe it was at one point, ages ago, but it’s certainly not now. I looked around at all of my friends who were my age and they were more interesting than they had ever been. They had far more experience than they had ever had before.
Quite frankly I do not look back on my 20s fondly, let’s put it that way. I looked around and I’m like: “Why are we all whispering about this? Why is this a source of shame for so many people even today?” When the fact is a lot of us are really coming into our power.
We have more time, we have more resources, we have more education, we have more of everything than we did before. We actually have a chance to make use of it. I wanted to write that story. Somebody said the other day, and it was funny because I didn’t come up with this even though I was a brand strategist, she was like: “She rebranded Menopause,” and I was like: “Yes, that’s exactly what I was trying to do.”
Dr. Paru David: I love it. I’m just going to go ahead and jump in, if you don’t mind. I have been working in women’s health for the last 20 years, taking care of perimenopausal and menopausal women. I will also share that I am exactly in the same boat as you. For years I heard exactly what you said.
My mother never mentioned it. I am going into this blind. We would then talk about how menopause should not be considered a disease anymore. It is a phase of our lives that’s natural and normal. When you said that you yourself have also experienced that your own mother never even said the word menopause, that’s exactly what I experienced as well.
What I find so interesting is that as I have shepherded these women through menopause all these years, I don’t think I really understood it by living it. Now that I’m living it, it is such a different experience. I found that reading your book, I felt that this is exactly what I’m feeling. I thought: “This is so wonderful to read something that is like a firsthand experience.” I really, really enjoyed your book.
Kirsten Miller: Oh, great. I’m so glad about that. I think from a medical standpoint, my mother, when she reached her mid-forties, suddenly developed high blood pressure, and I did, too, at the same moment. I asked her: “What was it about? What was going on that made you develop a high blood pressure,” and she wouldn’t even talk about it.
I think she knew. But there’s just so much. It’s not just hot flushes. It’s not just discomfort. There’s so much medically that’s happening at this period in your lives. If you don’t talk about it and you don’t know what your family history is, you can get yourself in a little bit of trouble.
Dr. Denise Millstine: Often people think about menopause and they think about hot flashes, and it is obviously, to your point, so much more than that.
You have three main characters in “The Change.” One of whom, I realize we shouldn’t play favorites, but my favorite is Nessa and she says: “Oh, I didn’t get the hot flashes. I got the weight gain,” and I thought: “Oh, she’s so intuitive to not make them all this typical paradigm of the menopause experience that every woman’s experience is their own.”
Kirsten Miller: Yeah, I think that’s very true.
Dr. Denise Millstine: Tell us how you came up with the three characters.
Kirsten Miller: Nessa was the first character that I came up with. It’s interesting that she’s your favorite because I’ve always felt that she’s the heart of the book. She was the main character from the very beginning. Then I went back and added more backstory to the other characters. But at first it was just her. It was Nessa’s story.
I love this idea of finding the positive in things that people largely consider negatives or unpleasant aspects of life. She’s at a point in her life where things have gotten really quiet. Her daughters have gone off to college. Her husband has passed away and her world is so quiet that she realizes that she can hear the dead.
We have Joe, who describes herself as being at war with her body for 30 years. She started experiencing hot flashes a bit earlier than she thought she was going to, and she feels like this is the last straw. She can’t take it anymore. Then she realizes that she’s able to channel all of that heat and anger and rage and do something with it.
The third character, who people certainly seem to like a lot, is Harriet. She is an advertising executive like I used to be. She loses her job, her husband leaves her, and she disappears into her beautiful modern house, and everyone just assumes that she’s been eaten by cats. She hasn’t; she’s actually been undergoing a metamorphosis.
She has gone wild. She’s gone feral, I think actually is really a better description of it. She’s discovered that she has this ability to communicate with nature and bend it to her will. These three ladies meet each other and together discover the body of a young girl on the side of the road, and they decide to solve her murder and find her killer. That’s pretty much the story in a nutshell. It’s very crazy. There’s a lot of weirdness along the ride. It’s a lot of fun.
Dr. Denise Millstine: You definitely have to be in for it when you start it, but once you start you can’t stop because it’s just so compelling. It’s a story you could read straight through, but if you stop and pause, in addition to talking about menopause and the menopause transition, you’ve made some social commentary, definitely not just about women in middle age who become unseen, but other people who are young women who the world forgets about or dismisses. Talk about the inspiration for that.
Kirsten Miller: I think that actually that side of the story goes hand in hand with the other side. This idea that women reach a certain age and come into their power, and what do you do with it? My answer to that is really to take that power and use it to help the next generation, and the generation after that as well.
That’s something that we can do. I think it’s something that we should do because at this point there are a lot of women in our society who are considered expendable, and there are women who are of color, there women who are from disadvantaged socioeconomic backgrounds, and they disappear or something happens to them, and literally no one goes to look. Especially if somebody is stamped as prostitutes, I would call them sex workers, but anyone who’s stamped with that label, it’s almost as if they brought it on themselves. I think that women, especially this generation of women, have the power to change that. We really have the power to make sure that those girls are looked for, to make sure that justice is served one way or another.
That’s something that we forget often is that we are literally the most powerful generation of women in the history of the planet. We are. We can actually make changes that our mothers and grandmothers could never have even dreamed of. That’s something that we should start looking into.
Dr. Denise Millstine: You do bring the generational trauma into it. You have the woman in town who is abused by a prominent male figure in town. I don’t want to give too much away about the book, but you then see the downstream effect and the assumptions that are made about her child, who’s actually this wonderful young girl who’s quite responsible and was trying to do the right thing.
Kirsten Miller: I grew up in rural Appalachia, so I had a lot of experience being around people who were not well-off. I saw how they were treated, particularly the young women. There’s nothing in this book that is not somehow drawn from my experience of seeing how other people in this country are forced to live.
Look at Jeffrey Epstein, for example. He did not go to his neighborhood to find the girls that he preyed on. He went to the trailer parks and the disadvantaged neighborhoods. That’s where they found the girls they were looking for. That’s why they got away with it for as long as they did. They would have gotten away with it to this day if it hadn’t been for one woman.
Julie Kay Brown from the Miami Herald, who stuck with the story when everyone else dropped it and refused to let it go. Really he was brought to justice by one woman, in her 50’s, who just did not want to see him walk away as he had for decades.
Dr. Denise Millstine: Instead of viewing this middle part of our lives as a time to pull back, and the sunset in our careers, there’s this opportunity to use your voice and your resources and your wisdom to speak for those who hadn’t been given a voice, at least historically, hoping that will someday change. Dr. David, you have been a menopause expert for two decades now.
Tell us how your perception is of the picture of menopause from the beginning to now. Are you seeing this shift to women feeling empowered or is it still this really difficult stretch that people are going through?
Dr. Paru David: It’s definitely been a transition. I think that the narrative that’s always been told with menopause is that, like I said earlier, that it’s a disease. Slowly but surely things are changing. In fact, I give lectures on menopause and, as part of my talk, I have found this quote from a medical journal from 1887 that was published in a journal called “Alienist and Neurologist.”
It says: “The ovaries, after long years of service, have not the ability of retiring in graceful old age, but have become irritated, transmit their irritation to the abdominal ganglia, which in turn transmit the irritation to the brain, producing disturbances in the cerebral tissue, exhibiting themselves in extreme nervousness or in an outburst of actual insanity.”
That’s what women have been told. In fact, that’s where the word hysterical comes from, and hysteria. “Hyster” is the root word for hysterectomy or the uterus. That’s what women have been told over the ages.
The other thing that’s happened is that life expectancy for women has increased over the years. In the early 1900s, the average life expectancy for women was about 50, which is the average age of menopause. Many women didn’t even experience menopause or maybe they’re great grandmothers didn’t go through it. Now we’ve got this cohort of women who had to go through menopause, basically blind without any support, and then had these women who are now just now going into menopause.
Still their mothers didn’t talk about it. I see that from patients. But it’s our generation, and maybe the women a decade older than me, who’ve said, ” No. This is different. This is something that I’m going through, my friends are going through, my sisters are going through,” and they’re sharing stories.
What I find is that when they share stories it really empowers them because they realize they’re not alone, that we all go through this. Like you said, half the population goes through this. It’s that shared experience that really empowers women, and that’s what I’m seeing. That’s what excited me so much about this book, is because when we read stories about experiences that other women have gone through, I think we sit back and realize I’m not the only one, but I think it took this experience one step further.
These women got their superpowers, and I remember there were a couple of quotes in the book. I think it’s when Nessa was told that when the curse left is when the gift came, and I just loved that. I just thought it was beautiful.
Kirsten Miller: Thank you. The curse is the other side of the coin. That’s the other thing that people don’t talk about a lot. There’s so much about women’s bodies that people still do not discuss as much as we should. I was in advertising and I did work for a tampon company, as Harriet did in “The Change.”
We would go around and focus group young women all across the country, and the amount of ignorance about basic female biology was just astounding to me. Even in places where the schools were excellent and everybody was college-bound, even in places like that. The misinformation was crazy for me, and it’s because we don’t talk.
It’s because we do not share information in the way that we should. I think that’s changing now. My daughter is 13 and her generation is much more open about these things, thank goodness, than mine was. But these are things that we should be talking about. It is half the population. Having your period or going through menopause should be as boring and inconsequential as oral hygiene. It should be like brushing your teeth and it’s not. I’m so glad that things are starting to change and that people are really starting to think about it and talk about it themselves.
Dr. Denise Millstine: Another topic that has been often considered taboo or at least talked about with judgment is sex. You bring up sex, at least in one instance with Nessa, where Harriette, who has found a lot of sexual freedom, tells her that she thinks she’ll be interested in one of the other characters, and Nessa says: “Oh, no, that part of my life is over.”
She challenges her that: “You think it’s over because the world told you it’s over, but it doesn’t have to be.”
Kirsten Miller: I think that we’re really in uncharted territory. We’re only a few generations away from the life expectancy being 50. Nobody really knows, has perfected the art of being a woman past menopause. We’ve accepted a lot of these stories and a lot of the stigma and a lot of this mythology as the truth, and it’s not. Look around you. There’s nothing about hitting menopause that makes you less attractive or less interesting or any of that other stuff. It’s you telling yourself that that makes all the difference. All you have to do is stop.
Dr. Denise Millstine: Or having been told that and never stopped to challenge, “Is that actually true?” Dr. David, you do some sexual health consults for women as well. Are you finding that it is starting to crack open and people are willing to talk about it more?
Dr. Paru David: I see patients who have sexual concerns, but we’re definitely breaking down barriers. We are beginning to talk about sexuality and what that means. How it’s different from when we’re younger versus when we’re in middle age. There’s just so much that we discuss that patients were like: “Well, I wasn’t even aware of that about my body,” or “I’ve never explored that.” Women walk away thinking they have some control and that they can bring their sexuality to a place that’s good for them.
Dr. Denise Millstine: Much like you’re changing the conversation, Kirsten, you should check out the Mayo Clinic store at the Women’s Health Center at Mayo Clinic. You’ll see products and devices so you no longer have to purchase those from stores with no window that you wouldn’t need to park in the back because there’s some shame associated with going into them, so it’s a pretty exciting time.
Kirsten Miller: I’m so glad to hear that because I think that it’s one thing if Goop is selling stuff like that, but the Mayo Clinic, it really does strip a lot of the stigma away and make it clear that it’s a part of your physical and psychological health. That’s great. I will check it out and see. I’m very curious to see what it does have.
Dr. Denise Millstine: Another element of the book that I wanted to bring up is about the men in the story. There’s this tendency to feel like a story that’s empowering women, is bashing men. Certainly there are villains in the story, many of whom are men, but not all, and you’ve done such a nice job of giving us some really enjoyable, lovable, redeemable male characters as well. There must have been intention in that.
Kirsten Miller: Absolutely. It’s funny because I’ve seen a couple of people’s reviews where it was like “a man-hating book” and I’m like: “You didn’t read it. I can tell you didn’t read it because there is nothing in this book that is…” I grew up with a wonderful father and a wonderful brother and I’m very, very fond of my ex-husband even now.
There are a lot of men in my life that I really like and I really admire. Nobody’s perfect and nobody’s perfect in this book, including any of the female characters. I did not want it to be an us versus them novel. That was not what it’s about at all. I don’t think that men are out to get us.
I just simply think that we spent most of human history at home having babies because we didn’t have any other choice. We were having babies, and when we weren’t having babies, we were breastfeeding the babies, taking care of the children, burying the children, mourning the children, and there wasn’t a lot of time left for anything else than that.
While we were doing that, men went out and they built a world that fit their needs and desires. I don’t think that the people who build stadiums think: “Oh, how do we really screw over women? Let’s make let’s give them the same number of bathrooms as we do the guys.” I don’t think that there’s any intention there. I just think that it was a world that was built by and for someone else. Now that we are out there, there’s a lot of friction. It’s not a world that fits perfectly. We need to start making some changes. I don’t think it’s a matter of fighting men to get them. Most men don’t even understand that those changes need to be made.
Most men would be horrified if they heard that, for instance, if you get into a car crash as a woman, you’re far more likely to die than you are if you’re a man. Just simply because the car is built for people men’s size and not ours. There are things like that that need to change, the justice system being one of them, but I don’t think it’s a matter of us versus them. Although, as you said, there’s some really bad people in the book. But they are not all men.
Dr. Denise Millstine: Oh, I was just going to say, I think you bring up a really interesting and important point, not necessarily that, oh, these men were purposefully wanting to build some sort of narrative that was against women. But when we look at medicine, we now know there are gender based differences in all areas of medicine. Historically all of the studies were done in men. It was simply just thought that, well, if that’s the way it is in men, well, it must be that that’s the exact same way it is in women.
Now, obviously, menopause is uniquely a female experience, but let’s take sexuality, for example. We talk about this all the time with patients. The female sexual response cycle is so different than what was presented in the 1960s by Masters and Johnson. Most people are aware of that sexual response, but it’s really based on male sexual response. When I teach my patients about this and say: “Hey, you know what, we’re different, we’re built differently.”
When they understand that, I think that there’s this whole new light that’s shed upon the whole situation. Now, I have lots of patients who bring their spouses in. Even the men are like: “Oh, well, I didn’t realize that. I didn’t realize that in menopause or after menopause, or after you’ve been in a relationship for a long time, that women kind of flip from active desire to receptive desire.”
It’s there, but it’s different. You kind of pointing that out is so important because I think that understanding that men and women are different, and then having women in positions where they can bring to the table ideas, their viewpoint or our viewpoint is so important.
Kirsten Miller: The publishing world is still very much in the COVID era, so most publishers aren’t sending authors out. I’ve been doing something really wonderful, which is talking to a lot of book clubs on Zoom, which has been so rewarding because I get to talk to people all over the country.
One of the people I just spoke to is a teacher who lives in a kind of southern state. She was talking about how restricted they are in terms of what they can talk about with gender issues. She said: “So I’ve come up with ways around it to get at the subject without getting it via text book. One of the things that I like to do is ask my female students alone for a moment to talk to her about the steps you would take if you were walking to your car at night. Listening to them go through this whole litany of actions that they take to ensure their safety in a dark parking lot,
she says: “You could just watch the boys’ faces just completely…They’re shocked.”
They never even considered that this might be something that girls have to do. They walk outside, they get in the car and they drive away. Meanwhile, the girls are looking in the backseat. They’re looking under the car. They’re making sure they’re parked under a streetlight. She said: “I’ve had more interesting discussions about gender from that conversation than I have from anything that was brought up by textbook.”
So, yes, because I think that the boys are really receptive to hearing about these things and they’re shocked and they want to find solutions for it. They just didn’t know that the problems existed. There’s so much good that we can do just by bringing a lot of this stuff up, and there’s no fighting involved.
It’s just sort of: “Hey, do you want us to help put bread on the table? Do you want us to be out there in the world living our lives? Well, we were going to have to make a few changes to make sure that it’s safe and fair and equal for half of the population.”
Dr. Denise Millstine: It requires that openness to change perspective and to look at things in a different way, even Harriet’s husband in the book has been stealing ideas from her for a long time, and he doesn’t realize that they weren’t his ideas to begin with, which I think is a very common occurrence in professional circles that a woman will be spoken over or the idea will be restated by a male colleague and attributed to them.
That unintentional bias. It’s not like Chase in the book was trying to steal Harriet’s ideas, it was happening just as part of the system. To the extent that he truly believed they were his own ideas.
Kirsten Miller: I can’t tell you how many times that happened to me. It was throughout my entire career, all the way, well into my 40’s when I was fairly a senior person at various agencies, there were still people who would be more than happy to put their name on your writing, present your ideas as their own, and it wasn’t like they were doing it in any sort of malicious way.
It was almost as if it was something that they were entitled to do. When you call somebody on it, and I think too often we don’t, and I was as guilty of that as anyone, towards the end of my advertising career, I started saying like, “No, you cannot present my ideas. No, I am not going to give you this presentation so that you can call it your own.”
Sometimes the reaction was not so nice. Most of the time it was just sort of like: “Oh, well, okay.” I think that standing up for myself was a big part of changing that. Leaving advertising was the other big part.
Dr. Denise Millstine: Sometimes you just have to change ships, right?
Kirsten Miller: Yes, you do.
Dr. Denise Millstine: I am so thrilled that you put this book into the world to change the narrative about menopause. I wonder if you both will give us a few ideas of other books that you have appreciated that are around the same topic.
Dr. Paru David: In my practice, I tend to give patients information that we have kind of covered in our discussion. What we found was that oftentimes there was misinformation, things that we wanted to be sure that we were giving them the right information to go with. That’s where the menopause solution was born. Basically my colleagues at Mayo Rochester, the Women’s Health Division at Mayo Rochester, Mayo Jacksonville, and then Mayo Arizona, under the authorship of Dr. Stephanie Fabian, we put this book together and we all contributed various portions.That’s obviously one of the books that we recommend to our patients.
But when I’m seeing patients I typically will refer them to the North American Menopause Society, which is the medical society that reviews all of the medical literature on menopause and its associated topics. They also create the position statements. Some of this information tends to change over time.
If you’re referring them to a book with facts about menopause and then the information is changing, that’s hard to keep up with, so I really like the menopause guidebook, which is a booklet that we actually give out to our patients when they come in to discuss menopause. Those two books are my go-to books.
Dr. Denise Millstine: I think you’re alluding to some of the celebrities who have written some very popular books that have been actually a disservice to many women as they go through the menopause transition, but also the number of health care professionals who are not well educated in menopause in women’s health is extraordinary.
We are lucky enough to work in women’s health, so it’s often easy to think everybody is as well informed, but some patients are going to have to advocate for themselves and the North American Menopause Society, NAMS gives you that information to take to your health care provider.
If they’re telling you things that are based on old data, like no women in their late fifties should be on hormone therapy, which is obviously wrong. There are many who are excellent candidates for being on post-menopausal hormone therapy.
Kirsten, give us a few of the books that you like to recommend to people who want to read more about menopause. Any memoirs, things like that?
Kirsten Miller: I read a number of books on menopause, and one of the reasons that I wrote my book was because the books that I read largely depressed the hell out of me. I’m not going to name any names, but there was one in particular that came out not that long ago, and I’m reading this and I’m thinking: “I feel so bad for this woman. She’s obviously very, very unhappy.” That’s why I wanted to write my book, was because I was not having that experience, and I wanted to show people that it’s not all doom and gloom, and that a lot of it is about how you approach the subject.
Books specifically about menopause I would really recommend people read are books like “Invisible Women,” by Perez and “Unwell Women” by Elinor Cleghorn. Basically they discussed the subject that I was referencing earlier, this fact that we live in a world that was not built for us, that includes the medical system, which, to your point just a moment ago, there are a lot of doctors out there who do not know very much at all about the experience of menopause.
There are a lot of doctors out there who do not know how the female body differs from the male body in terms of everything; from heart attack symptoms to medication side effects, to anything and understanding, reading those two books in particular, and really understanding how little is still known about our bodies and our experiences. It’s very, very important for us to understand that there’s so much work that still needs to be done.
I don’t mean to be sexist at all, obviously, but I do think that going through menopause, it helps to have a doctor who has experienced that herself. You see things very differently when you’ve had the experience. It helps deliver compassionate care.
Dr. Paru David: I definitely agree. I kind of chuckle when Nessa had said: “I got the weight gain” and I remember, my mother, of course, had a little bit of weight gain around menopause, and I thought to myself: “I am never going to let that happen to me,” and here I am. I thought: “Wow!” Even that small aspect of it, I agree.
I think I can relate to my patients. With these encounters where you deliver patient centered care with empathy, you share a little bit, and I think patients appreciate that. I agree that when you are experiencing it firsthand you kind of have a different viewpoint.
Kirsten Miller: I didn’t experience the weight gain or really the high flashes, but I have very, very severe mood swings, especially throughout perimenopause, just violent mood swings. I did not know that that was part of the experience. I could make a lot of assumptions about my mental health. But because I know that that’s part of the process, I’m able to cope with it and deal with it and handle it.
That’s one of the reasons that I know that is because I have a female gynecologist who’s like: “Honey, it happens to all of us.” I don’t know how somebody who had never had that experience might react.
Dr. Denise Millstine: There was actually a recent editorial by the current president of NAMS, Dr. Stephanie Fabian, who’s also the head editor for the Menopause Solution, talking about middle aged women being the group that is getting the most prescriptions for the mood medications because there’s such a lack of recognition of the hormone shifts and their role in mental health at this age, and that you actually often have treatment that goes to the root of the change versus treating the symptoms of the change by giving people antidepressants.
There are a lot of efforts to at least shift the medical community to start to think about that. But your book helps anybody start to think about how they consider that transition and different ways to think about it. I just want to restate how bold and really incredible it is. I want to express extreme gratitude for putting it into the world and then, of course, for coming on the podcast and talking to us today.
Thank you, Dr. David, as well for sharing your insight as a longtime menopause expert, it’s just been so lovely to have you both today on the episode.
Kirsten Miller: Thank you so much. It’s been a joy. So nice to meet you both. I love talking to doctors.
Dr. Paru David: Thank you for inviting me and it’s been a pleasure being on this and also talking to you, Kirsten.
Dr. Denise Millstine: Thank you for joining us to talk books and health today on “Read. Talk. Grow.” to continue the conversation and send comments, visit the show notes or email us at firstname.lastname@example.org.
“Read. Talk. Grow.” is a production of Mayo Clinic Press. Our producer is Lisa Speckhard Pasque and our recording engineer is Rick Andreasen.
The podcast is for informational purposes only and is not designed to replace a physician’s medical assessment and judgment.Information presented is not intended as medical advice. Please contact a healthcare professional for medical assistance with specific questions pertaining to your own health if needed. Keep reading everyone.
The New Rules of Menopause
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