The No.1 Menopause Doctor They’re Lying To You About Menopause! Brand New Science! (Men Need To Listen Too!) Mary Claire Haver

In this episode, Dr. Mary Claire Haver, a leading menopause expert, and the host delve into the pervasive yet often overlooked issue of menopause, affecting 1.2 billion women worldwide. Dr. Haver shares her personal journey and the systemic failure in addressing menopausal symptoms, which range from hot flashes to increased risks of cardiovascular disease, depression, and osteoporosis. Despite 85% of women experiencing menopausal symptoms, only 10.5% receive treatment, often being misdiagnosed and prescribed antidepressants instead of hormone therapy. Dr. Haver emphasizes the importance of strength training, proper nutrition, and hormone replacement therapy (HRT) as part of a comprehensive menopause toolkit. She also discusses the societal stigma and lack of research funding that contribute to women's suffering in silence. The conversation underscores the need for education, advocacy, and a more empathetic healthcare approach to support women through this inevitable life stage.

• In 2023, 85% of women report experiencing menopausal symptoms.
• Only 10.5% of these women are receiving treatment or therapy for their symptoms.
• Dr. Mary Claire Haver emphasizes the severity of menopausal symptoms by comparing it to male testicular atrophy at age 51.
• There is a disparity in treatment, with women more likely to be prescribed antidepressants than hormone therapy for menopause.

"In 2023, 85% of women are complaining of menopausal symptoms. 10.5% are receiving treatment or therapy." "But a woman is more likely to prescribed an antidepressant for her menopause than hormone therapy."

The quotes illustrate the prevalence of menopausal symptoms among women and the inadequate treatment they often receive, highlighting a need for better healthcare responses to menopause.

• Menopause is inevitable, but suffering from its symptoms is not.
• Women often suffer in silence from a wide range of menopausal symptoms, including brain fog, sexual function changes, and weight gain.
• There is an increase in mental health issues and risks for diseases such as cardiovascular disease, diabetes, and recurrent urinary tract infections during menopause.

"So here's their laundry list of symptoms. We've categorized about 70. So there's brain fog, changes in her sexual function, weight gain. But here's the scary thing, and the studies have been done. We see either a new onset or worsening of depression, anxiety, bipolar, adhd, risk for cardiovascular disease and diabetes increases recurrent urinary tract infections, which is a major cause of death for women."

This quote details the extensive list of menopausal symptoms and the serious health risks associated with menopause, emphasizing the need for awareness and proactive health measures.

• Dr. Haver recommends strength training to combat muscle mass loss during menopause.
• She developed the Galveston Diet program to address nutrition and inflammation in relation to menopause.
• The focus is on improving longevity and health quality during the aging process.

"For example, we see a dramatic loss of muscle mass. Focus on strength training. This is going to determine your longevity as you age. Strength over skinny."

The quote suggests practical advice for women undergoing menopause, stressing the importance of strength training to maintain muscle mass and overall health.

• Menopause affects 50% of society due to its prevalence among women.
• Currently, 1.2 billion women worldwide are affected by menopause.
• Understanding and supporting women through menopause is crucial for both men and women.

"Whether you're a man or a woman, menopause is going to affect you because it's going to affect 50% of our society. And there is 1.2 billion women being affected by menopause right now."

This quote emphasizes the widespread impact of menopause on society and the importance of educating both men and women about it.

• Dr. Haver's passion for OBGYN and helping people led her to specialize in menopause.
• She noticed a gap in her education regarding menopause and sought to address it through research and additional training in nutrition.
• Her social media presence and the Galveston Diet program have helped many women understand and manage their menopause symptoms.

"I want to see my grandkids one day. I want to watch these women I've raised grow up and be the women they're meant to be."

The quote reflects Dr. Haver's personal motivation and dedication to improving the lives of women going through menopause, driven by her desire to see future generations thrive.

• Approximately one-third of the female population is in some stage of menopause.
• There are estrogen receptors in every organ system, and their decline during menopause affects many aspects of health.
• Education about menopause is lacking, and women often feel dismissed and misunderstood by the medical community.

"So right now, about a third of the female population of the world is in peri full or post menopause. It's not optional. All of us go through it."

This quote highlights the prevalence of menopause among women and the need for better education and understanding of its effects on the body.

• Menopause involves the decline of estrogen and testosterone, leading to various symptoms and health issues.
• Perimenopause can start seven to ten years before menopause, with symptoms varying widely among individuals.
• Menopause is an evolutionary trait, with the grandmother hypothesis suggesting an advantage to ceasing reproduction at a certain age.

"Estrogen is a really powerful antiinflammatory hormone in most of our body systems."

The quote explains the significant role of estrogen in the body and how its decline during menopause can lead to various health problems.

• The medical system often fails to adequately support women experiencing menopause.
• Women are frequently categorized dismissively, leading to fragmented and ineffective treatments.
• Dr. Haver criticizes the lack of comprehensive menopause treatment and the tendency to address symptoms individually rather than the root cause.

"I think the medical system is letting them down. I think society is letting them down."

This quote expresses Dr. Haver's dissatisfaction with how the medical system and society handle menopause, advocating for a more holistic approach to treatment.

• Menopause leads to various physical changes including alterations in cholesterol levels, skin, hair, teeth, and inner ear, resulting in issues such as vertigo and frozen shoulder.
• Frozen shoulder, or adhesive capsulitis, is common in menopause due to the decline in estrogen's anti-inflammatory effects on bones, joints, and muscles.
• Therapy for frozen shoulder can take up to two years, as the capsule over the bone where muscles attach becomes stuck and requires extensive physical therapy to break up.

"Frozen shoulder is an adhesive capsillitis of the shoulder joint, and it is very common in menopause. So estrogen has this amazing anti inflammatory effect, especially in our bones and joints and muscles."

This quote explains that frozen shoulder is a condition that often occurs during menopause due to reduced estrogen levels, which normally act as an anti-inflammatory agent in the body.

• HRT, or menopause hormone therapy, has been observed to lower all-cause mortality in women who start it early in menopause.
• There is a "window of opportunity" early in menopause where HRT can reduce the risk of diseases like diabetes, cardiovascular disease, and dementia.
• Estrogen is more effective in prevention rather than cure, so starting HRT in perimenopause or within the first ten years of menopause is beneficial.
• The conversation about HRT is not widely held, and women are often not given the choice to start therapy during perimenopause.

"So we know that women on HRT have a lower all cause mortality."

This quote highlights the benefit of HRT in potentially reducing the risk of death from various causes for women who undergo the therapy.

• Menopause can lead to new onset or worsening of mental health conditions such as depression, anxiety, bipolar disorder, and ADHD.
• Estrogen replacement can be a powerful adjunctive tool for treating depression and may prevent new onset depression if started in perimenopause.
• There is an uptick in suicidality during perimenopause and menopause, particularly among Caucasian women in the US.

"Women who start hormone therapy in perimenopause have a lower incidence of new onset depression in their menopause suicidality."

This quote emphasizes the potential mental health benefits of starting hormone therapy during perimenopause, including a reduced incidence of depression and suicidality.

• Estrogen functions as a powerful anti-inflammatory hormone, and its decline during menopause can lead to increased chronic inflammation.
• Chronic inflammation is a low-grade, persistent state that can contribute to aging and various diseases.
• To combat inflammation, it's important to focus on anti-inflammatory nutrition, such as limiting added sugars and increasing fiber intake.

"So it turns out estrogen is a really powerful anti inflammatory hormone."

This quote explains the role of estrogen as an anti-inflammatory agent and its significance in the context of menopause and inflammation.

• Proper nutrition is crucial for managing menopause symptoms and overall health.
• Fiber intake is often insufficient in women's diets, and it's important for blood sugar regulation, feeding the gut microbiome, and overall health.
• Vitamin D deficiency is common in menopausal women and can be linked to various chronic diseases. Ensuring adequate vitamin D intake is important.
• Foods rich in fiber and vitamin D should be prioritized in the diet.

"But fiber, and that's one thing most people are not paying attention to. How much fiber are you getting in your diet per day?"

This quote stresses the importance of fiber in the diet and suggests that many people do not consume enough fiber, which has multiple health benefits.

• Fasting can have benefits for systemic inflammation and insulin levels but is not for everyone and may not be effective for weight loss.
• A gradual approach to fasting, such as the 16:8 method, is recommended for those interested in trying it.
• Fasting may improve mental clarity and thought processes.

"So I recommend fasting for the systemic inflammatory benefits. And we do see some really nice lowering of insulin levels overall from fasting."

This quote discusses the benefits of fasting beyond weight loss, particularly in terms of reducing inflammation and insulin levels.

• The Galveston Diet focuses on anti-inflammatory nutrition, fuel refocus, and ensuring adequate intake of key nutrients like fiber, vitamin D, and magnesium.
• The diet aims to shift attention from calorie counting to nutrient counting, emphasizing the importance of consuming enough of the right nutrients for health and menopause management.

"So that's looking at food. We're looking at the macron micronutrients. So I'm really going hard on fiber and vitamin D and magnesium and things that we tend to, as a gender, be deficient in, especially with menopause."

This quote outlines the principles of the Galveston Diet, which is designed to address common nutritional deficiencies in women, particularly those going through menopause.

• Dr. Mary Claire Haver emphasizes the increased importance of protein intake to maintain muscle mass in menopausal women.
• Creatine supplementation, especially when combined with weightlifting, has shown to result in greater muscle mass and strength gains in postmenopausal patients.
• The increased focus on protein and creatine is a shift from Dr. Haver's earlier recommendations, which favored higher fat and lower carbohydrate intake.

"But I think if doing it again, the way I'm counseling my patients now is I'm going much higher on protein. What I've learned since that book was written was how important protein intake is to maintaining muscle mass."

The quote explains Dr. Haver's updated dietary advice for menopausal women, highlighting the newfound significance of protein for preserving muscle mass.

"And how. Creatine supplementation, just creatine supplementation on its own. Well, combined with weightlifting, we're seeing bigger gains in the menopausal patient."

This quote discusses the benefits of creatine supplementation in conjunction with weightlifting for improving muscle mass and strength in menopausal women.

• Muscle mass loss is a significant concern during menopause, with women potentially losing up to 15% of their muscle mass within the first ten years.
• Muscle mass is closely linked to insulin resistance, overall functionality, and recovery from falls.
• Low muscle mass increases the risk of osteoporosis, with 50% of females likely to experience an osteoporotic fracture in their lifetime.

"And that muscle mass is going to determine your resistance to sugars. So your insulin resistance is really tied to your muscle mass, your functionality, your ability to recover from a fall."

This quote explains the critical role of muscle mass in regulating insulin sensitivity and maintaining physical functionality and resilience against injuries.

"So when we have low muscle mass, you are dramatically increasing your risk of osteoporosis."

Dr. Haver connects low muscle mass with an elevated risk of developing osteoporosis, a condition characterized by weakened bones.

• Osteoporosis results from the decline in bone density, which accelerates after menopause due to reduced estrogen levels.
• The condition can lead to fractures, with serious consequences such as high mortality rates and debilitating pain.
• Preventative measures include hormone therapy, exercise, adequate protein intake, creatine supplementation, and vitamin D.

"So osteoporosis is when we lose the density of our bones through estrogen."

The quote clarifies the link between estrogen depletion during menopause and the loss of bone density leading to osteoporosis.

"And that year is marked by horrific pain and not being able to move and just really, really miserable people. And so much of this is preventable."

Dr. Haver highlights the severe impact of osteoporotic fractures on quality of life and emphasizes that prevention is possible through proper care and treatment.

• The WHI study initially aimed to determine if HRT could protect against cardiovascular disease.
• The study had two groups: women with and without uteruses, leading to different HRT regimens.
• A slight increased risk of breast cancer was observed in the estrogen plus progestin arm, leading to widespread concern.

"So the absolute risk went from four out of 1000 women per year to five out of 1000 women per year."

This quote presents the actual increased risk of breast cancer found in the WHI study, which was relatively small but led to significant concern due to the way relative risk was reported.

"The estrogen only arm continued for a few more years because the women on estrogen only, not only did they not see an increased risk of breast cancer, they had a, I think it was a 20% decreased risk of breast cancer."

Dr. Haver points out that the estrogen-only arm of the WHI study actually showed a decreased risk of breast cancer, contradicting the initial alarming reports.

• HRT has been misunderstood due to the WHI study, with many still adhering to the lowest dose for the shortest time principle.
• Vaginal estrogen is a safe and effective treatment for genital urinary syndrome of menopause, which includes symptoms like recurrent urinary tract infections and painful intercourse.
• Vaginal estrogen is not the only form of administering HRT; systemic therapy options include ingested medication, creams, patches, rings, and pellets.

"The most likely treatment to help a woman in menopause with recurrent urinary tract infections, which is a major cause of death for women, is vaginal estrogen."

Dr. Haver explains the efficacy and safety of vaginal estrogen in treating urinary symptoms associated with menopause.

"For testosterone, it's liver toxicity, and for estrogen, we see bumps in our clotting factor."

This quote addresses the potential side effects of oral estrogen, such as increased clotting risks, which can be mitigated by using non-oral forms of HRT.

• Dr. Haver's approach to treating menopausal women begins with listening to their story and assessing symptoms.
• Blood work is conducted to evaluate hormone levels, thyroid function, vitamin deficiencies, and other health indicators.
• Treatment is tailored to individual needs, including discussions around sexual wellness and potential testosterone therapy for libido issues.

"So I start by letting you tell your story."

The quote emphasizes the personalized nature of Dr. Haver's treatment approach, starting with understanding the patient's unique experience.

"So I'm doing blood work around that. Nutrition deficiencies, vitamin D, her basic labs for her blood count, and her electrolytes."

Dr. Haver outlines the comprehensive blood work conducted to diagnose and understand a patient's health status during menopause.

• A patient named Michael experienced significant improvements in weight, muscle mass, and sexual intimacy after following a personalized treatment plan.
• The case study highlights the importance of nutrition, exercise, and hormone therapy in managing menopause symptoms.
• Dr. Haver's menopause clinic has a long waiting list, indicating a high demand for specialized menopause care.

"She's lost probably about 60 pounds of body fat because we get to measure her."

This quote illustrates the measurable success of the patient's treatment plan, with a significant reduction in body fat.

"She is absolutely thriving on all aspects, and she's constantly sharing her studies, her story online so that other women can learn that they don't have to suffer as well."

Dr. Haver shares the positive outcome of the patient's journey, which serves as an inspiration and educational resource for other women experiencing menopause.

• Partners should approach the topic of menopause with understanding and support, helping to normalize the conversation.
• Dr. Haver encourages removing the stigma around menopause and suggests involving healthcare providers in the discussion.
• Partners' involvement in treatment discussions can be beneficial for understanding and managing menopause together.

"I think normalizing this conversation, removing the stigma, it might make everyone go, oh, I mean, I didn't realize it in myself."

The quote underscores the importance of open dialogue about menopause to increase awareness and reduce stigma.

"But bless him for doing it. Like we talked about a little bit earlier, there's probably a fair amount of dissolutions of relationships, because no one's talking about this process and what it could do to someone."

Dr. Haver acknowledges the challenges partners face in addressing menopause and the potential strain on relationships when it's not openly discussed.

• The concept of male menopause, or andropause, is debated, with men experiencing a gradual decline in testosterone levels rather than the abrupt hormonal changes seen in women.
• Some men benefit from testosterone supplementation, reporting improvements in cognition and energy.
• The variation in testosterone levels among men and the potential benefits of supplementation are areas of ongoing research.

"So there's a big man to man variation. And there is a lot of men who are supplementing when they come in on the low end and they're feeling a lot better."

This quote addresses the individual differences in testosterone levels among men and the potential benefits of supplementation for those on the lower end of the spectrum.

• Menopause in women is often dismissed as psychological rather than physiological.
• Women are more likely to be prescribed antidepressants for menopause symptoms than hormone therapy.
• There is an unfounded fear around hormone therapy due to the Women’s Health Initiative, affecting physicians' confidence in prescribing it.

"And so much of what women were going through in menopause were dismissed as psychological, and really, at multiple times in their life. It's all in her head. We never said, it's all in his head." "I mean, a woman right now, in 2023, is more likely to be prescribed an antidepressant for her menopause than hormone therapy."

The quote illustrates the tendency to view menopause symptoms as psychological issues and the current preference for prescribing antidepressants over hormone therapy, reflecting biases in medical training and the impact of past studies on present-day treatment practices.

• Dr. Mary Claire Haver found meditation and therapy beneficial, especially during challenging times.
• She emphasizes the importance of self-care and putting oneself first.
• The practice of gratitude and meditation has significantly improved her well-being.

"Carving out that it's just five or ten minutes in the morning to think of what I'm grateful for, focus on that gratitude... That's really made a huge difference for me."

The quote highlights Dr. Haver's personal experience with the benefits of meditation and gratitude, and how dedicating time to these practices has positively impacted her life.

• Sleep disruption is a significant issue during perimenopause and menopause.
• Lack of sleep worsens symptoms, increases cortisol levels, and insulin resistance.
• Dr. Haver prioritizes improving sleep and nutrition in her patients.
• She refers patients with non-hormonal sleep disruption to sleep specialists.
• Sleep apnea is increasingly correlated with menopause, even in patients without weight issues.

"We need to get you sleeping, because nothing's going to work until your body is able to restore itself."

This quote emphasizes the critical role of sleep in overall health and the need to address sleep issues as a primary concern in menopausal women's care.

• Dr. Haver has shifted her exercise focus from being smaller to being stronger.
• She engages in resistance training for bone density and muscle mass.
• She regrets not focusing on building muscle mass earlier in life and advises younger women to prioritize strength over thinness.

"So I'm doing this for bone density. I'm doing a lot more lifting than I ever, ever did in my life because I have a body scanner in my office."

The quote explains Dr. Haver's current exercise regimen, emphasizing the importance of resistance training for bone density and muscle mass, especially as it relates to aging and menopause.

• Dr. Haver practices intermittent fasting, breaking her fast around noon.
• Her diet is rich in protein, green vegetables, fruits, nuts, and seeds.
• She focuses on protein-centric meals and healthy fats for anti-inflammatory benefits.
• Dr. Haver packs her meals and snacks to maintain her dietary routine.

"I'm loading up on protein. I'm doing something green, some kind of a green veggie. I'm doing lots of fruit."

The quote outlines Dr. Haver's personal dietary habits, highlighting the importance she places on protein and a variety of healthy foods to support her health goals.

• Dr. Haver believes that menopause is inevitable, but suffering is not.
• She encourages women to advocate for themselves as the medical system often fails menopausal women.
• Dr. Haver provides resources to help women advocate for their health.
• She emphasizes the importance of exercise, nutrition, stress reduction, and sleep.

"Our medical system is built to fail the menopausal woman. And there is good help out there. You're going to have to do the legwork."

This quote underscores the need for self-advocacy among menopausal women due to systemic shortcomings in the medical system and the availability of resources to support them.

• Dr. Haver's family history of health complications influences her perspective on health and self-care.
• She has lost family members to various illnesses, which motivates her to make healthier choices.
• Dr. Haver's approach to health is driven by a desire to live a long and fulfilling life.

"I know that these choices that I make with my nutrition, my exercise, my sleep, my stress reduction, what I call the menopause toolkit and my choice for HRT, are all, I want to see my grandkids one day."

The quote reflects Dr. Haver's personal reasons for prioritizing her health and the impact of her family's health history on her lifestyle choices.

• There is a growing conversation around menopause and a shift toward dismantling the stigma.
• Education on menopause is lacking, and many individuals are unaware of its impact.
• Dr. Haver's work aims to make complex scientific information accessible and empathetic to individual circumstances.

"I didn't really understand what any of this stuff meant until I started doing this podcast."

The quote from the host acknowledges the lack of widespread understanding about menopause and the importance of conversations like the podcast to educate and raise awareness.