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VEST Her Podcast
The VEST Her Podcast is about the real, often hidden challenges that hold women back—at work, in society, and in building wealth. It highlights the stories of women pushing for change and creating new paths forward.
We talk about the pressure to do it all, the self-doubt that creeps in, and the systems that were never built with us in mind. Each episode features honest conversations with women who are figuring it out—whether they’re switching careers, launching businesses, raising families, or learning to lead on their own terms.
This podcast is for anyone tired of being told to just “lean in” and ready to do things differently. If you want to grow, speak up, build confidence, and be part of a supportive community—you’re in the right place.
We’re here to question the rules, share what’s real, and build a better future—together.
VEST Her Podcast
Beyond Hot Flashes: Reclaiming Your Hormonal Health
The whispers about hormones, perimenopause, and menopause have remained frustratingly quiet for too long. Dr. Kristen Markell, a double-board certified OBGYN and certified menopause practitioner, breaks the silence with game-changing clarity in this essential conversation moderated by VEST Member Alison Anthony.
For decades, women experiencing brain fog, anxiety, fatigue, and mood changes during perimenopause have been dismissed or told to "just deal with it." Dr. Markell reveals the biological truth: these symptoms aren't character flaws but natural responses to dramatic hormonal fluctuations that can begin up to a decade before menopause. She expertly explains how progesterone typically declines first, while estrogen levels become erratic with extreme highs and lows—a process many healthcare providers themselves don't fully understand.
The consequences of this knowledge gap are serious. Women's highest risk of suicide attempts occurs between ages 45-49, coinciding precisely with perimenopause. Beyond mental health, these hormonal changes affect bone density, heart health, and cognitive function. Yet many women suffer silently, especially in professional settings where they fear being perceived as weak or incompetent if they acknowledge their symptoms.
Dr. Markell guides listeners through the confusing landscape of treatment options—from hormone replacement therapy and bioidenticals to supplements and lifestyle modifications. She emphasizes that finding the right provider is crucial, suggesting resources like the North American Menopause Society to locate certified practitioners. Most importantly, she frames perimenopause not as a decline but as "a portal into the second half of life"—an opportunity to refocus energy on what truly matters.
Whether you're in your 20s planning for future hormonal health, navigating perimenopause now, or supporting someone who is, this conversation provides the knowledge, validation, and practical guidance to transform how we approach this universal yet uniquely personal journey. Your hormones aren't just about symptoms—they're foundational to how you show up in every area of your life.
For our guest full bio and show notes click here.
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You help us understand the science of it a little bit.
Speaker 2:So menopause is defined as one year after your last period. At that point, obviously, you have to have uterus right. So if people have had a hysterectomy or have had some sort of ablation or an IED in place, then they may not be having regular periods or having periods at all. But for those of us with the uterus, you know, one year after the last period is now you have entered menopause and at that point the hormone levels estrogen and progesterone are very, very low, sometimes even zero.
Speaker 2:Perimenopause, which you know, I'll be honest, when I did my training in OBGYN we didn't talk about perimenopause Like this is just now. Over the last five to 10 years, people are, you know, acknowledging this sometimes decade long life, the seven to 10 years before your last period. What's happening in perimenopause is your hormones are starting to become a bit more erratic. In perimenopause what is happening there is that the progesterone is usually getting lower in that second half of the cycle. Sometimes that change in that progesterone level can lead to symptoms similar to PMS, right, some people will notice them in that premenstrual time, that week before your cycle starts, and sometimes it's physical, like breast tenderness, headaches, and sometimes it's mental or emotional. It can be more anxiety, feeling overwhelmed, irritability, brain fog, poor sleep.
Speaker 4:In this episode, we talked to Dr Kristen Markell, a double-bore certified OBGYN and certified menopause practitioner, about one of the most under-discussed and misunderstood pillars of women's health our hormones. Special thanks to Vest member Allison Anthony, ceo of Tulsa Area United Way, for moderating this session. Whether you're in your 20s, 40s or beyond, understanding hormonal health isn't just about navigating menopause or beyond. Understanding hormonal health isn't just about navigating menopause. It's about reclaiming your energy, brain function, mood, sleep, sexual drive and long-term vitality. Yet, for far too many, these conversations remain taboo, confusing or quietly dismissed, especially when it comes to professional settings, where symptoms like brain fog, fatigue or anxiety are often internalized as a personal failure rather than recognized as a psychological shift. And that's exactly why this conversation matters.
Speaker 4:Hormones aren't just a midlife topic. They're foundational to how we show up in every area of our life, from our ambition to our focus, relationships and, yes, even our leadership. If we're going to support women in their full power, we need to normalize these conversations around hormonal health so that we can equip ourselves with the knowledge and resources to rewrite the narrative, one that sees midlife and aging not as a decline but as a vital time for growth, energy and purpose. For our guest's full bio and show notes go to wwwvastherco forward slash podcast. This conversation was part of a more intimate coaching session with VAS members and has been repurposed to accommodate this episode. If you enjoyed the episode, share with a friend, leave us a review and don't forget to hit the subscribe button. And if you're ready to take your career in business to the next level, apply to join our community of powerful women eager to help you get there and stay there. Go to wwwbestherco forward slash membership.
Speaker 1:I was with my primary care provider, my physician, yesterday and I told her that I was helping facilitate this conversation today and she you know she's a long time practicing internal medicine specialist and she said, oh my gosh, I wish I didn't have patients so I could attend that. She said when I was in med school and we covered women's, you know menopausal and hormonal health. I was like is that all? Is that all you're going to teach us? And she said it just, the medical community has not caught up either. So with that, I would love to ask you you know why? Why are we still, when we think about menopause and aging in our hormonal health, why are these subjects still feeling taboo, when we are half the world, you know women, and we all are going through these same things? Why? Why is this still a kind of too quiet topic?
Speaker 2:Yeah, that's such a good question. First off, thanks so much for having me. I love talking about this. I think the more awareness we have around it then, you know, the more help we can get for people.
Speaker 2:But yeah, you know, I think we could all look at the different reasons why talking about women's health is taboo, whether we're talking about menopause or we're talking about periods or we're talking about pregnancy. You know this has these have typically been taboo subjects and, just like you mentioned with your primary care provider, you know not, hasn't been the focus, right, hasn't been the focus for 50% of the population. And we could look at why, right, what, what is that? Well, first off, we don't talk about those things, right, we don't talk about Bruno, we don't talk about periods and and and aging, and and menopause. And then you know we have to look at our culture. Especially this Western culture is very, you know, anti-aging, right, you know there's a lot of people that are talking about anti-aging and I always say, well, the goal is that we want to continue to age, right, the alternative is not what we want.
Speaker 2:And when we look at people who are professional, professional women you know there have been some studies that have been done about menopause and perimenopause and aging in the workplace and some of the things that come out of these studies that are that women feel like disclosing, you know, menopausal or perimenopausal symptoms? Um could make them be seen as weak or incompetent, right, and so, um, some of these symptoms, like brain fog or fatigue or more anxious symptoms, um are not the ones that we have been talking about as much as we could. Right, I do think that's changing. We're hearing about hot flashes and night sweats and vaginal dryness, but some of these other early perimenopause symptoms that people may start to question like am I losing my edge? Am I, you know, not where I used to be? You know that can definitely affect how they feel, like they're showing up not only at work but at home and in their relationships.
Speaker 1:Well, and I'm so grateful for Erica and team to help us on the path of normalizing these conversations. I am just off track, but I have a master's thesis in my background in 17th century women's literature and sometimes I think they were more frank about their bodies in the 17th century than we are today, which is not okay. Not okay, you know. I look around the Zoom room and we have a multitude of ages here, which is one of the things I love about Vest so much. I think we help keep our edge by working across and getting the wisdom from older women and the energy and the ideas and the boldness from some of our younger colleagues. So when you think about women in their 20s and 30s many of whom are on this call, who may not be thinking about menopause yet but I know, still have to tackle issues of their hormonal health and how that sets them up for better energy, fertility and longevity, what advice would you have for how they approach those topics?
Speaker 2:Yeah, that's a topic close to my heart too. So I work with women throughout the lifespan and, you know, in the twenties and thirties, this is when I'm hoping, you know that we have have had some awareness of what's going on with our hormones, right? I want people to learn about their hormones and their teens so that, you know, as we're aging, we just build on that self-awareness and that knowledge about what's happening Right. Build on that self-awareness and that knowledge about what's happening Right, and so really understanding how your hormones support you. You know, I'm not of the belief that you can't do certain things in your cycle right. Like you, you can't do it at this time, you can only do it this time. I don't believe that.
Speaker 2:But I do believe that there are certain times things feel easier, right, and there are certain times that we may need an extra tool or more support, or we might just kill it.
Speaker 2:You know, at ovulation, because we're, you know, feeling so good and radiant, and so knowing how that is for you, knowing what your symptoms feel like during your cycle, how to support them, is going to be key. And then you know, as we progress throughout different seasons of life, into perimenopause and menopause, then we're aware of how things are changing, we're aware of, well, this is not how it used to be for me, or this symptom has become very problematic for my everyday life and you know, because I focus a lot on well-being and coach women and that I always talk about good, deep, restorative sleep, you know that can be a little tricky at certain seasons of life, depending on yourself, other people that are affecting sleep. But focusing on that deep, restorative sleep, finding a regular stress management practice, which that may include movement, it may include community, it may include something fun and joyful that really takes us into that more creative space, these are the things that I that I work with, with patients and clients on.
Speaker 1:I think all of us on this call are going to get something, and for our present and our future. So hormones just affects so many aspects of our health and whether that's mood, like you said, metabolism, sleep, energy. When I started to go I had a hysterectomy, I think 12 years ago and my symptoms were more about brain fog and anxiety and I've never had anxiety or brain fog issues and I had no idea initially that that was tied to hormonal shifts because, like you said, we hear about, you know, vaginal dryness, or we hear about and I you know, can we just celebrate being on a webinar? We would get to say vaginal, that's fun.
Speaker 1:Yay for today, I mean yay, today we got to say vaginal on a webinar. That's a good, that's, that's a win. So Jay's like oh mother.
Speaker 2:Sit with me and we talk about all the things.
Speaker 1:But while I was in the energy business we didn't say that a lot so we didn't kind of work that into most conversations. But what is actually happening? Can you help us understand what's actually happening to our bodies and our hormones in paramenopause and menopause? You know what's happening and why it matters. Why do these things matter, and can you help us understand the science of it a little bit?
Speaker 2:Yeah, oh, yeah so. So menopause is defined as one year after your last period and so at that point, obviously you have to have uterus, right? So if people have had a hysterectomy or have had some sort of ablation or an IED in place, then they may not be having regular periods or having periods at all. But for those of us with the uterus, you know, one year after the last period is now you have entered menopause and at that point the hormone levels estrogen and progesterone are very, very low, sometimes even zero. And perimenopause which you know, I'll be honest, when I did my training in OBGYN we didn't talk about perimenopause Like this is just now, over the last five to 10 years, people are, you know, acknowledging this sometimes decade long life of life is the seven to 10 years before your last period, because what's happening in perimenopause is your hormones are starting to become a bit more erratic, right? So you know, in our quote unquote, you know fertile years where we're, you know, typically having a regular cycle and if you look, you can see like, oh, the estrogen comes up here and then it, it, it comes up in the second half and then the progesterone stays low but comes up in the second half in perimenopause. What is happening there is that the progesterone is usually getting lower in that second half of the cycle, and so sometimes that change in that progesterone level can lead to symptoms similar to PMS. Right, some people will notice them in that premenstrual time, that week before your cycle starts, and sometimes it's physical, like breast tenderness, headaches, you know, and sometimes it's mental or emotional. It can be more anxiety, feeling overwhelmed, irritability, brain fog, poor sleep, right, you know, and maybe it's clustered in that time period. Right, as we progress through perimenopause, what starts happening with the estrogen? You know, we used to think like, oh, it just kind of starts coming down. Now we know that it's very erratic, it's having extreme highs and it's having extreme lows, and so we think that it's these huge shifts that are really contributing, and contributing a lot, to our perimenopause symptoms, along with the declining progesterone. And so the interesting thing about perimenopause is that it looks different at the beginning of it than it does in that year before you're going to have your last period, right, and so that's where it can get a bit tricky for people, because maybe one month they're like oh, that was a little off, I didn't feel well, I was very fatigued and, you know, more irritability and anxious. But then the next month, maybe the brain and the ovaries are communicating better that month and it feels like, oh, that wasn't so bad. It feels like, oh, that wasn't so bad.
Speaker 2:And so, you know, what I hope to do with perimenopause education is to just remind people that these are things that we're looking out for, not in a scary way, but just in a way that we don't have to get to that suffering point right when people are coming in like I thought it was nothing, but this has been going on for years and they're really very depleted. And so why it's important is for that reason for sure, because women are suffering for long periods of time sometimes and then they come in and we have to really shore them up to get them back to normal, versus having this awareness of, okay, these things might be changing. What can I do to support myself? Who do I need to check in with? You know so from a, from an everyday standpoint. That's why it's important. And then, when we think long-term, you know why is it important? Because you know these changes in hormones can affect our long-term health, can affect our longevity, because they are going to influence, you know, our heart health, our brain health and our bone health that is.
Speaker 1:you know, if anybody had drifted away that, coming back to that point that you know it's not just about I love the words you use suffering and being depleted and you know and not minimalizing the real symptoms, but also thinking about the organs in our body that need all these other parts to be healthy, and heart health that's so critical. So you're not, you're not whining ladies, you're not, you know, you're not overreacting, you're, you're taking care. We only get this one body in our life. One body, that's all we get.
Speaker 1:I had we take better care of our cars and our refrigerators you know our air conditioners than we do this one body, so take care of this right. I am dying to know gabby and sarah and jay and erica. Uh, I'm seeing, but I'm not able to keep up with it all. Do you have some comments that you'd like to tease out that have been especially interesting, that you'd like to mention, or questions that have come up in the chat?
Speaker 6:Yeah, we've had a lot, of, a lot of comments and questions in the chat to come up already. I know a lot of people are just really praising that come up already. I know a lot of people are just really praising that, again, we're having this conversation, talking about really understanding the symptoms that are going on, so they can be aware whether you know they're already experiencing it or they're, you know, just getting prepared for it. A lot of talk about how a lot of women in this group are already sharing those symptoms in their workplaces too, just to normalize the conversation in their circles as well. So, kudos to all the women here as well. And I did just see a question pop up from Kit. I don't know if, kit, you're able to unmute yourself and ask her, if you want us to just go ahead and ask for you.
Speaker 3:Hi there, yeah, good morning, I would love to. So when I figured out that I might be in perimenopause, I went to my doctor and was like, okay, I have all these questions and I understand that these are my symptoms and I feel like a crazy person. And she's like yeah, we don't have a lot of research and I had a hysterectomy eight years ago, so I have no like ability to track any kind of cycle. Um, and so I was like so what do I do? And she goes really we're gonna have to put you on a dose of birth control. And uh, I was like well, that feels really strange compared to I had a hysterectomy, so I didn't have to do that anymore. And so why would I do that? And she's like you know, it's just unfortunately. She was like this is the protocol, like this is the standard kind of procedure for what we recommend. So then of course, my phone is listening to me and so now I get all these ads for everything else and it's like here's the you know berry tea that you can take, and here's the saffron tea that you can take and here's the oil that you can rub on your body.
Speaker 3:And HRT testing and saliva testing and blood testing works and it doesn't work. I just I feel like there's so much conflicting information out there, um, and like when we did blood work. For me she's like your blood work looks great, like your hormone levels are right, what we would expect them to be. So we're going to do this anyway, but you might just still like try to see what you think, and I was like that doesn't feel like an answer, and I think that's my biggest frustration is nothing feels definitive. Um, like this is the real protocol that we've tested, we've tried that we know is going to be helpful. It's so speculative, um, so I would love any more insights that you have. Is it hrt? Is it birth control? Are those the same thing?
Speaker 3:I don't have a medical degree, like I have no idea right.
Speaker 1:I think those are great questions and thank you for boldly asking that. I have to say, dr Markell, I had an employee yesterday say I have indigestion, really bad this weekend. Today I think it's menopause and I was like I was thinking about you and I said, well, that's a new one, you know, and I was thinking about this conversation. I thought you must get from the internet and all the you know, just like you said, kit, all the ads and all the you know, just like you said, kit, all the ads and all that. You just have people coming so confused. So what can you tell us about confusion and fear and hormone replacement therapy, or not talk about that?
Speaker 2:Yeah, well, first off, thank you, kit, for, yes, voicing that, normalizing that. So the interesting thing is is that you know, we have we have estrogen and progesterone receptors like all over our body, all over our organ systems, different organ systems, and so this is why perimenopause will show up differently for different people and some people have different clusters, right, more anxious type symptoms are mental or emotional, some people have more physical, some people have like a lovely mix of all the different bits, and it's difficult to create a protocol when everybody shows up a bit differently. Right, and, like you mentioned, we are in the beginning of like, really talking about this, right, and so there are providers like me who have done additional training in perimenopause menopause, prescribing hormones, sexual health, like the things that maybe were, you know, just not talked about as much, and, like we talked about at the beginning, not everybody's had that training. And so when I was a, you know, traditional OBGYN, that's what I would have done. I would have said like, hey, here, let's try this birth control, right, and some people would have stayed on birth control until they probably went into menopause. But now we know more, right, and so there are some times when birth control might be indicated in the perimenopause transition for certain symptoms that people are having.
Speaker 2:But birth control is not menopausal hormonal therapy. It is a different type of synthetic hormones, right, and not the same. Synthetic is bad, right, but it's just a type of hormones that's suppressing people's hormones to help benefit symptoms, right? Some people, those big, huge fluctuations they are like please stop these now I cannot handle these. And so we do have that option for using a birth control that suppresses the hormones. But for people who maybe have had a hysterectomy and, um, you know they are having some perimenopausal symptoms, we can use, and not even for people with a hysterectomy. Let me let me be clear with that for people in perimenopause, we can use menopausal hormonal therapy to support their symptoms, and this is where you want to see someone that that knows how to do that Right, that understands that it usually is a let's try this and see how you respond. Right, because you know, for those of us that have been in medicine for a very long time, not everybody looks like the people in the studies, right? Like we could say like oh well, in this study of all these people, I don't look like the majority of those people, and some people don't respond that way. So the point of that is to say there's different options.
Speaker 2:Perimenopause is a clinical diagnosis. It's not diagnosed with labs, but I do labs, right, like this is where you have people in the social media and they're fighting it out Like don't do labs, do labs. And here's what I say Perimenopause is a clinical diagnosis and I also do labs because sometimes I'll get surprised. I'll get surprised in that, oh, wow, your FSH and your estradiol are really close to menopause, and so we are further along in this perimenopause journey than we would have expected, based on your age. And then other times I'll do labs and someone is 51, average age of menopause, but their labs look completely normal. And I will say you know what, on this day, the brain and the ovaries were communicating really well with each other, but you have all of these symptoms that are consistent with perimenopause. Let's try something to see if those symptoms improve, and then we'll go from there Right.
Speaker 2:And so it is really the practice of medicine. It's really, you know, like looking at each person personally and saying, okay, here's what we know. We're not discounting your symptoms, this is what we've got from a lab standpoint and we can continue to follow that to see you know how it changes over the next, you know, three to five years, because we did not used to do labs. This is new, right? You know some people are like, no, we don't go by labs, we just go by symptoms, and I'm like I should do labs. If we had done labs for the last 30 to 40 years, we would have more information for women, right, we would be able to say like, well, these are the trends that we notice with perimenopause and what's happening with lab work. So I am a fan of you know, having that data, watching the changes. But you're going to see people out there that are like, no, never check labs.
Speaker 1:I'm like okay, yeah, I'm thinking if men were having these symptoms, we would be doing the labs because they'd be like.
Speaker 1:Oh my God, I'm out. You know it would be very much part of the medical mainstream to do the lab Exactly, yes, yeah, well, talk a little bit about. You use some terms there that I think is part of confusion in the among those of us that aren't medical professionals hormone replacement therapy, supplements, bioidenticals, supplements, bioidenticals we hear all these different terms and birth controls and you know, and and all these different types of protocols that might come up. Can you just do some defining and what we should be listening for? There are just a lot of confusing information out there.
Speaker 2:We could do a whole podcast on this, right, you know? Again, because we are focusing now on perimenopause and menopause, which, yay, there's a lot of things coming out of the woodwork, there's a lot of people that have something for you, and I don't think that's necessarily a bad thing. But it can be confusing and it may be a little bit tricky to discern, like, what is needed, what's indicated. And so, you know, I did additional training and integrative fellowship in supplements and herbs because I was like I don't know, like what, what should I be considering as a must have for patients in different seasons of life? And what would be a? You know, okay, we might add this in once we get these foundational pieces supported. Know, okay, we might add this in once we get these foundational pieces supported. And so when I look at perimenopause and menopause, you know I'm always thinking about like, okay, let's check some lab levels, let's look at our vitamin D, let's look at some of these inflammation markers so we can see, let's, you know, what we need to supplement with from a vitamin D perspective. You know, I love magnesium. I think magnesium is just, you know, so helpful for many women in relation to deeper sleep, helpful for mood support, you know, and so that's something that I'm always talking with people about. But once we start to get out of, like, the baseline must haves, those are typically going to be patient to patient, specific, based on what we're seeing with their labs, their symptoms, what they tolerate, what they don't tolerate.
Speaker 2:Um, when we talk about menopausal hormonal therapy, there's lots of different options wrapped up in that right options wrapped up in that right. There's different modes of ways to give hormone therapy right. There's oral, there's transdermal, there's things that you put in the vagina there, we said it again. There's, you know, injections, there's pellets, and so you want to always have someone that understands all of it right. One way that I really look at who's saying what, who's doing, what is noticing when people are like nope, this is the only way. I'm like, yeah, I wish that could be true for all of us, but that just does not, that doesn't work. So you want to have someone that understands, you know all the different options and is able to counsel you on, okay A, if we're thinking about hormonal therapy, what are the risks, what are the benefits for you, particularly, why would we want to be using this? What are we thinking from a symptom management standpoint and a long-term health standpoint. Right? If grandma and your mom both had osteoporosis and broke hips, like you know, I have patients coming in saying like I don't want that to happen. What can I do from a lifestyle standpoint? And then I want to add in hormonal therapy to keep my bones as healthy as long as possible. And then again, we talked about you know, we talked about birth control pills and we talked about hormone therapy. Those are different things, right? Those are used for different reasons and one's not good and one's not bad, right? You know, I always say, like everybody needs their own symptoms addressed and sometimes we're not going to address it with this thing over here. Sometimes we do need to bring in something that maybe not all your friends are using, right?
Speaker 2:Bioidentical is a term that we hear a lot and sometimes people mean that they say bioidentical to mean like a compounded hormone. But the way that I look at it is that bioidentical means that when you take this hormone, your body recognizes it as the hormone that you have, right, if you're still making hormones. So, if you take estradiol, then your body recognizes it as estradiol, it puts it on the estrogen receptor throughout the body and it activates that receptor as if it were your own hormone versus synthetic hormones. Don't do the exact same. They don't do that exactly the same way.
Speaker 2:Now, the great thing about bioidentical hormones is that you can get them anywhere. You can get them at the regular pharmacy. You can get them at the compounding pharmacy. Like there's not, there's not. You know, people don't just get bioidentical from compounding pharmacies, and so you know. Again, I think it can cause a little confusion, but when we talk about it that way, it helps us understand. Like, oh, we are choosing this because, you know, I want my body to function as efficiently as it has been, or even better. Right, but sometimes we're going to use different options, like birth control, or sometimes we do use a synthetic hormone option because people don't tolerate the bioidenticals, right? So just knowing that there's lots of options out there and that if you have a provider that's well-versed in it, then you will be able to find something that works for you, let's.
Speaker 1:I want to definitely come back to the provider question because I'm seeing a lot of traffic in the chat about that and I think that'd be a great point to end, a very action oriented point for us to end on. But I want to talk a little bit about something that hopefully is going to happen for all of us on this call at some point or another is happening or has happened, and that is when we get to midlife, and the question that Gabby and Sarah gave me was 40s, 50s. I'm going to say I'm 60 if I live to be 120, maybe, but I still feel in the middle, you know, thriving and thinking about how we move from surviving and feeling depleted and those types of things or put aside or the loss of, you know, the loss of some of what society tells us. That you know kind of a time when we're facing real change. I also have seen that you've talked about it as an opportunity and I definitely feel that way.
Speaker 1:I feel like I'm at some of my most creative. I've been wanting to write a book for a long time and I'm 60. And I feel it. You know, I feel that wisdom kind of bubbling up and the lack of like as I have one friend my age that says, you know, finally, our give a shit. Factors in the negative, like we're okay, like we can say the things that we need to say. And so let's talk about the habits you think for women as we come into middle age, whatever you define that for you. Um, what are some of the habits and the things that we can do right now to build a foundation for that long-term vitality and creativity and resilience?
Speaker 2:Yeah, yeah, I, I love that, right. I love midlife, the um. We have so many. I did a group with perimenopause menopausal women and they were like. They were like we don't give an F, we only have so many Fs to give. But we know where we want to put that energy now, Right, like it's all going towards these things that are important to us. And I love that clarity at, uh, midlife, because you have that experience that we've drawn on through our whole life and now we know like, oh, this is where I want to really put that energy. But you know, we talked a little bit about some of these foundational practices and they still hold true in midlife, right, and perimenopause and menopause of getting deep, restorative sleep.
Speaker 2:Now, I entered into this integrative and functional world through sleep. That was my gateway. I always tell people because I was a practicing OBGYN and I was on call sometimes three nights a week, 24 hours some, and then go to you know clinic the next day for eight to 10 hours. And so my goal when I noticed that wow, I cannot bounce back from these anymore was I've got to get really good sleep when I'm not on call. And so I started digging into how can I make my sleep more deep, more restorative? Sometimes it was interrupted. I had two small kiddos under three, and so it didn't mean that, you know, I failed if I didn't get the eight hours, but I was doing the practices to make that sleep as good as it could be, right, and so I get it.
Speaker 2:When people are like, but I have the tiny people, or I work nights or you know, my schedule fluctuates I get that there's things that are, um, that are really they're just part of a season, right, that we're like we're going to do the best we can with where we are in this season. But when we look at from a long-term health standpoint, um, sleep is huge. It's huge for your brain, right. Like you know, the next day, like you know, brain fog is, it's real, when we're not getting that deep sleep. It also affects our cravings. It affects our hormone levels that affect craving and satiety, so that can affect our metabolic health. And so I always talk to people about, like, how can we get better sleep? And that is not an overnight thing, this isn't something that happens in a week.
Speaker 2:For me, it took three to six months of working with my family, first because I had little people and so I had to, like, really get them on a lovely rhythm and we were turning down the lights and all these cues that not only helped them but helped me and my body, like, just, you know, bring it down. And so once they were better supported, then I could really focus on what I could control from my standpoint. And so, looking back after that six months, you know it was a significant change and because I like to track data, I also, you know that's when I got my aura ring. This was many years ago, and so I was looking at the data, you know, throughout the week or throughout the month to say like, oh, these things really affected it. This thing, you know, really helped my sleep to get better, and using that information to adjust what I did.
Speaker 1:In short, prioritizing our health. Right, you know so that we, if, if we need other people to take, if we have other people to take care of and jobs and we all have something, we're not able to do it if we're not taking care of our health first. Great questions going on and lots of in the chat. Gabby and Sarah and Jay, anything you'd like to tease out at this point and follow up on?
Speaker 4:One of the reasons we decided to have this conversation. Kendra Lauper is on here, and I saw a message that she posted on social media recently about you know, there's so much information which we've already talked about, and also a lot of supplements and I just talked about. I personally take ashwagandha to sleep and maybe I should change to magnesium, and I think this goes back to like, how do we personalize what's right for us, based on working with the care provider that actually understands us as an individual? So, kendra, I'm going to put you on the spot and ask you to unmute yourself.
Speaker 5:I'm unmuted. Yeah, I have so many questions. Thank you for hosting this conversation because it maybe it is just for me, but I, you know, I've tried so many supplements and part of it is I I'm a little worried because supplements, as I understand it, are not regulated Right. So there's so much out there that I'm like is this even what they say it is? And how do I know? Until I spend the dollars and try it and it works or doesn't work Right. And so I've tried several things and some work, some don't, some work better than others, but it's, you know, finding a provider that can really walk me through it and understand what exactly will help and which products are, you know, the best and trustworthy, and all of those things has been really tough. So we'd love your thoughts on that.
Speaker 2:Yeah, yeah, so you know there are third-party certifications for supplements so you can always look and see if they've done the additional testing, had a third party come in and, you know, check to see that what's in there is exactly what they say it is. And you know, then I, with my training, I have certain companies that I feel more confident in and um, so a lot of times it's it's really talking to each person about. You know, what are your goals, what are your labs showing? What are your symptoms? Um, because you know I'll take creatine, for example.
Speaker 2:Creatine is out there and and you know everyone is like, should I take creatine, should I not take creatine?
Speaker 2:And, um, you know the answer is it depends, right, it depends on do you have space to bring creatine into your, into your regimen right now?
Speaker 2:If I've got somebody coming in and we're at the beginning, we're really depleted, like even adding that in is going to be too much. Then I'm like, no, we're not taking creatine. We're getting you deep sleep, we're moving our body, we're making sure you're nourished well, and maybe we take a multivitamin to fill in those gaps right now, as we're, you know, also addressing what your specific lab values were and what those specific needs are. And then, once we get those patterns and habits in, then maybe we do talk about creatine for muscle health and for brain health. But I think sometimes you know, we get, like you said, so many things coming at us that we forget that. You know, the baseline, foundational pieces is where we start and then working with someone that understands, like okay, here's our main things we're thinking about from a long-term health standpoint brain, bone, heart but also right now, from a symptom standpoint, what am I going to start incorporating to make sure that those things are affected later on?
Speaker 5:Yeah, thank you. I just I mentioned that, I think, in my post. I said I just want to read an article about X, Y or Z and not have 8,000 other ads show up for X, y or Z, and I'm like, how do I? I just want to, I would just want to learn, and it's so hard. There's, you know, the internet is great and the internet is terrible, right, it's like how do you find the information? And, like you know someone, like you, I think, in Oklahoma City probably I think someone said this in the chat because of all the political issues related to women's health in our state, it's hard to find providers who are really addressing the issues holistically, and so that's been a challenge. And so do you recommend looking for people online, right? Like looking for virtual providers? I think you do that too right.
Speaker 1:Yeah, I think that that is a question I'm seeing popping up a lot in the chat. Like we all know, we need to advocate. Kendra, it's a great question. We all know we need to advocate for ourselves, we know we need to inform ourselves, but there's so much misinformation. So we need to partner advocating for ourselves, but partner with great clinical experts. And so how, dr Markell, do we find them? Where do we go? Where's the best resources to guide us to our best clinical partners?
Speaker 2:Yeah, so it kind of depends on what you're looking for. There are groups that certify people in menopause and perimenopause sexual health and so you can. You can go to these certification groups. The North American Menopause Society is a groups. The North American menopause society is a is the certifying group for menopause and perimenopause, and so you'll see people listed in your area that that is something they specialize in.
Speaker 2:Now, I always say that within that there's going to be just different types of people, right, you know, and sometimes you just have to feel people out and figure out like who your person is.
Speaker 2:Uh, ish wish is the international society for the study of women's sexual health, and they are the certifying body for people that are focused on sexual health, and so you can always look up there to see if there are providers in your area and sometimes they overlap related to perimenopause, menopause and sexual health.
Speaker 2:And you know, I think, because I'm also in the integrative and functional medicine world, you know I always say take little bits of things to pull them into my programs for women because, you know, typically we can find great bits um throughout the wisdom of all of the different, uh um, ways to care for ourself over, you know, generations, even if we're just now talking about perimenopause, uh, a little bit more in depth. And so you know, I get that there's a lot of people out there that may practice quote, quote, unquote natural medicine or some of these different terms that we'll use, but I like to say that sometimes I'm a bridge in between a lot of these different types of medicine, because I understand all of it and, based on who's sitting in front of me, we're able to pull the pieces that may work for someone but for someone else is not going to be the first thing we would go to.
Speaker 1:So it's really helpful and I'm while you were talking, I was remembering a rheumatologist I went to one time who was about 70 year old, white male, who said you know, are you you're taking thyroid medication and you know hormone replacement therapy. You women this was the exact quote he said you women just need to get over it and just go ahead and get old and let that happen. And you know and at the same time the same physician was calling his you know, 50 year old nurses, my girls, my girls.
Speaker 1:So, as I was, as I was leaving and I said you know what this isn't going to work, this discussion and, by the way, your 50 year old nurse does not want to be called your girl, so you might talk to her about that. So we parted ways after a short visit, but you know you're talking about. I mean, when we hear the term, just deal with it, whether it's from a doctor in another specialty or or, or friends, or family, well meaning family, oh, just grow gracefully. Whatever you know, when we're talking about brain fog or low libido or all these things, what are some of the risks? Talk about the actual risks to us of ignoring these things. And also, can you share examples of when someone has finally been able to crack the code on all the information, find a good provider and reclaim some of their energy? Give us an example of what that swing can look like.
Speaker 2:Yeah, the risks and the swing. So yeah, we're just done with the, just deal with it, right? Everyone is so done with that and you know, I look back through my training of you know kind of what this doctor was saying to you. Like you women just need to do and how women, how women I mean.
Speaker 1:If someone says you women just run, yeah, run away. How many women have been?
Speaker 2:gaslit for this decade-long hormonal shift that's happening. And you know, if a man had a testosterone of zero, do you think he would be saying that to him Like no? You'd be like, oh, we gotta get that replaced, right? These are hormones that our body has used throughout our whole life and so, of course, these symptoms that show up in perimenopause, like the fatigue, the brain fog, the mood symptoms that people have been told to just deal with it. They've been told like, oh, you've got small kids, you're working full-time job, you're opening a new business, of course you're tired, of course, of course, of course. And now we're starting to understand that the hormonal shifts behind this are leading to this, and of course it affects us in the day to day, but it's actually a very risky thing to ignore for some women.
Speaker 2:You know there's a study out of England that says that women's highest chance of suicide attempt is in the ages of 45 to 49. And so what is happening then? Perimenopause, menopause, right? So this isn't about just sucking it up. These things can be life-threatening, right. This can really affect people's mental and emotional health, and it also can affect long-term health symptoms, right, bone health, right, people falling later on in life, breaking hips and that initially and that eventually leading to, you know, their death. I mean, I hate to be all like scary here, but this is, these are real things that are happening, right, and you know there was just a recent study I want to say it's out of Australia which you know. I'm so thankful when I see new studies out about hormonal therapy and perimenopause and menopause that showed that some of these emotional symptoms that are happening in perimenopause are actually best served with starting women on hormonal therapy.
Speaker 2:Now that doesn't mean that everyone will just stop there. Some people may need additional support with, you know, ssris, snris you know mental health type symptoms, type prescriptions, but that in this study the women's symptoms the brain fog, the anxiety, the depression type symptoms were improved significantly with hormonal therapy and so I think we're just going to see more and more of that over the next decade, right? So hopefully people in this call who are in their twenties are going to benefit so much from you know this time where people were like we got to learn more are going to benefit so much from you know this time where people were like we got to learn more. And you know what I see when people come in and we get them supported and we start. You know, if they want to start hormone therapy, we do that is that people get their life back.
Speaker 2:Right, you know, a common symptom is I don't feel like myself, right, there's even a acronym NFL and not feeling like myself. People come in and say I don't feel like myself, right, there's even a acronym NFLM not feeling like myself. People come in and say I don't feel like myself and so, as we, you know, support them from a lifestyle standpoint, you know, make, get those labs supported, start hormonal therapy if that's indicated. Then they come back in six months and say, wow, like this has changed everything. My fatigue has affected how I'm showing up with, you know, my work in the world, with my people, my relationships, like, like it's really, it's affecting the things that we we are here for, right To you know, live this beautiful life Right. And then, when we think about it from from a long-term health perspective, it's important for all the reasons.
Speaker 1:Yeah, yeah, that is so helpful and I think just advocating for ourselves.
Speaker 1:On the labs you talked about, you know symptoms are one thing, but when it's your own symptoms you don't really know always how to express that and what's normal. And sometimes the lab work just yesterday my lab work was showing that my thyroid I've been on thyroid medication was really low. And you know she says things like are you sleepy, are you losing some hair? Yes, yes, but I'm also, you know, 60 and work 70 hours a week so you never know what's going on with that. And so just making sure that you're advocating to actually have your providers do the lab work, so they have, just like we talk about in our businesses and our nonprofits get the data and make data informed decisions, and I love that it all ties together. So do we want to have one more question before we let Dr Markell close us out Anything? Anyone that's just dying to ask a question?
Speaker 4:I think there are so many questions on the chat that unfortunately, we're not going to get to them. So definitely, dr Markell. How can people get ahold of you or attend your practice or your workshops? I know you do a lot of those.
Speaker 2:I do as well.
Speaker 2:Yes, so, yeah, I mean, please follow me on Instagram, kristen Markell MD. Um, or my website is the same. I'll just write it in here just for my name. Um, because you know I love to answer questions. I love to, uh, you know, a lot of times I'm sending out um free guides and things like that to explore different aspects of perimenopause or health and wellbeing, um, even, you know, during different seasons of life, not just perimenopause and menopause, uh, but, yeah, I would love to connect with with y'all. I know we had a lot of questions. I wish we had more time to answer them because they're definitely these are the questions that I hear from women and what we address in my program. So, yeah, thank y'all so much.
Speaker 2:Nobody says we can't have another session right.
Speaker 1:I mean probably the topic of menopause and hormonal health could fill two sessions, I'm pretty sure. Let me ask this last question. I think I mean I'm just the reframing of so much. You said we just want to celebrate our body and celebrate aging, because the alternative is not what we want. Right, we should never feel ashamed of our.
Speaker 1:Yesterday I asked my doctor about something I was seeing on the underside of my left breast and I mean we laughed. She said Are you just seeing this? And I'm like, well, I have to throw it over my shoulder before I could really look. So you know, I mean we laugh. Enjoy our bodies they're not what we once were, maybe, but they are fabulous and celebrate that aging and that wisdom and creativity and ability to laugh at ourselves that comes with that.
Speaker 1:But also just get some damn sleep, women. Just prioritize your sleep. If you don't take away anything else when you think I have to work one more hour or you know not, take a nap. I love that. And Shaga and Monica and so many of my friends on here who build that community, build a community of women that you can talk to and you trust across generations I think the intergenerational. I keep saying that. But that's why I invest invest because I love that. I love that I continue to learn from women across generations. So last thing I would like to to ask is if you could rewrite the narrative, as you're doing, about women's health, aging and menopause. What would be your rallying cry? What would you want that to sound like? And and leave us with that, and then Erica will toss it back to you.
Speaker 2:Yeah, I always say that perimenopause is a portal, right, it's this portal into the second half of your life and, um, you know, that is really the goal, right? We're here to age and to take what we learned in the first half of our life and refine it and put our energy towards the things that mean the most to us. And so, you know, I tell people to listen to themselves, listen to what they need, to find a partner in that, so that you can really take that time period and just set yourself up for success for the second half of your life.
Speaker 4:If you enjoyed the episode, share with a friend, leave us a review and don't forget to hit the subscribe button. And if you're ready to take your career in business to the next level, apply to join our community of powerful women eager to help you get there and stay there. Go to wwwbestherco forward slash membership.
