How to Treat and Manage Menopause on GDLA+

Yesterday, Sunday, was World Menopause Day and we're going to get into it. We're joined by Dr. Rajita Patel, Director of UCLA Health Comprehensive Menopause Program to unpack the latest medical insights, bust some of these common myths, and share practical ways to manage the symptoms and to not suffer, to really thrive, right? Thank you for being with us. There's been a lot of talk about menopause lately, or it seems. it's become a topic where we're discussing it's having a moment so to speak absolutely as it should which yeah which is great because you know your moms and your grandmas never told you about these things right yeah i mean it's not new right but it certainly feels like it's new it kind of does weirdly enough yeah well thanks to news media outlets and social media really kind of bringing this topic to light and i really think that women are starting to feel comfortable talking about this and that's really the first step towards feeling empowered to do something about it so I think that menopause is definitely having a moment and women are starting to realize that they don't have to suffer silently and they can really talk to each other talk to their doctors talk to people that are just going through this or have gone through that they feel empowered to do that now it's a community in a way an agency is key because you feel less alone like going through anything for anybody medically or you know with our with our gender you feel less alone when you're with a community of like-minded like hormonally activated people and tell me about you know with the the progress that's being made with some of these symptoms well first of all it's you know a lot of people think it's oh it's just hot flashes right but it's so much more than that you feel like you're going crazy you don't know what's happening to your body. You don't know who you are anymore, right? It's absolutely a window of vulnerability to these symptoms and everybody's experience is so unique. There's over 60 symptoms of menopause. 60? Yeah. Six zero. Yeah. What? So what, like give us some of the most common, well, common and uncommon. I'm curious. So definitely hot flashes. Yeah. Everybody knows about those, but definitely the mood, irritability, brain fog, right? The genitourinary symptoms that people don't like to talk about but they're real yeah right um i would say those are what are those what do you mean so just feeling like vaginally having vaginal dryness oh feeling like a loss of libido right okay so some of having more frequent utis yeah yeah some of those symptoms and not being able to hold it sometimes urgency urgency yeah even incontinence yeah yeah there's so many symptoms but everybody's experiencing it differently and they definitely impact each other so like poor sleep and mood right they go hand in hand right if you're not sleeping well you're gonna be grumpy exactly if you have hot flashes that's gonna not make you sleep well that's not gonna make you feel great during the day your brain's gonna definitely take a hit for that if you're not sleeping well your brain's not gonna feel good i mean there's they're also interconnected yeah it's definitely a web of symptoms and so i feel like definitely um people learning about that and that it's not just like one thing and we also don't want to manage it that way either well with so many symptoms out there, 60 symptoms, how do you treat somebody, how do you treat all that? That's a really good question. It's not a lot of people, this is one of the misconceptions that we just need to look at labs, right? But it's not just about your blood work you do after you, so you get your lab right, exactly. But you know, during perimenopause and early menopause, the labs are all over the place. I mean, they're not the same if I checked them this morning or checked them in the evening they're going to be different so what we really want to focus on is symptoms, I think more women need to hear that, yeah, also like oh when they ask you what phase did you go get your labs, were you in your luteal phase? I mean, I'm like it's so much to keep track of, like I don't know, right? So how do you treat some of these symptoms? Yeah, so well, okay so for most women I would say that um hormone therapy is an option and it does work for a lot of the symptoms, not all of the symptoms, but for some of the most common symptoms it does really help but not everybody's eligible for it, it's not completely no risk, that's another thing is that um you know the black box warning came off of hormone therapy, rightly so, about a year ago now. And it sort of made everybody feel like, well, it's just, there's no risk. Everybody should just be on hormone therapy. And that isn't true. The risk is low for most people, but it's not no risk. And so we definitely need to talk to people about what are those risks and everybody's risk tolerances are so different. What are the risks? So there's a less than one in a thousand chance that you can get a blood clot, for example. And 1 in 1,000 for me may seem okay. For another person, maybe not so, right? Risk of breast cancer we know is low, mostly after using it for many years. And then for most people, cardiovascular risk, it's pretty neutral on that. And same thing for the brain. But it's not the same for everybody because everybody comes into this with different genetics, different health factors, different lifestyle, the way they live their life daily. So there are non-hormonal options that work really, really well. and those options didn't exist even five years ago so we're getting new treatments to help with some people that really can't use hormone therapy or don't want to so what are some of those other options so one of the the biggest things that um has come out in the last three years is um you know i you know let's talk about hot flashes for a second right most common symptom so the thermoregulatory zone of the body is in the brain and there's kind of like a gas pedal and a brake to it. The brake is estrogen. It tells it, hey, shut up. Stop firing away. Stop making someone feel so hot, right? So that's why when estrogen is all over the place, we know that people can feel hot flashes. And so giving back hormone therapy puts the brake back on it. Well, similarly, there's a gas pedal. And that gas pedal, it's really controlled by neurokinin. It's a neuron. And it basically tells it to go, go, go, go, go. So these two drugs that came out in the last few years actually take the gas pedal off and so they work really really well at um kind of getting mitigating those hot flashes and they can even help with sleep and mood this is so important um i you know when you have a friend who might might be a little bit in denial and that's okay because we want it to be more accepting so she was describing something she was feeling and she's 45 and then and she goes and i thought my gosh maybe it's like perimenopause and i'm like no way i'm too young for that and i didn't say it but i was like who's going to tell her like 45 is actually a normal age to start feeling those symptoms right you're in the thick of it doesn't it start at like 30 something now it's a great question see like nobody knows the answers right but she was adamant but it was like no she was way too young for it yeah no that's not true always right so some people start feeling symptoms in their 30s when they're having regular periods and other people don't feel it at all right so the thing is is that there's this whole notion that, oh, you're supposed to have stopped your period or your periods are supposed to be skipping before you have symptoms. Actually, we're finding more and more women start to feel like they're not themselves. And they're starting to have some of these mild symptoms, even when they're regularly menstruating. And so I think the best thing I tell women is to keep track, keep a diary of symptoms. What are you feeling? When are you starting to not feel like yourself? What is it that you're feeling and how does it relate to your period? and what happens if you don't do anything about what you're feeling so that's that's also a great question so the thing is is that if you really just suffer in silence you're really taking a hit on your short-term health but also your long-term health so actually hot flashes for example they're directly correlated with long-term brain health with cardiovascular disease sorry that was the computer with bone health right so we actually want to feel good now but we also want to help shape our future trajectory for long-term health and how long are women in this period because i mean if it's 30 till menopause which is true by definition when you totally skip your period for a year right a lot happens between that and ultimately menopause so how long are people in this yeah it's not a short duration some people go through it fly through it like quickly don't even have symptoms those are the lucky ones then we have the people that are completely disabled by their symptoms they're the unlucky ones most people are in the gray zone some are all in there and for years yeah for years so the average hot flashes are seven plus years wait so once you stop having a period yeah then is it like you're out of the menopause phase so you're in menopause right you're in it for life forever but this doesn't mean that you're just suffering right so that transition time yeah is usually the worst symptoms and and the further you get into menopause the ovaries are not going they're not they're still active but they're not going crazy they're not erratic they're not like a roller coaster and so a lot of those symptoms really they chill they chill out yeah you're like you're in your 80s let's chill totally but there are nine percent of the population that has lifelong symptoms you know i think it's also important for men or your partner oh yeah to understand what you're going to because i think that's also a big topic that doesn't get discussed so true because you need that support system you 100% do when I talk to people about feeling empowered first you have to want to feel good you want to you want to you want to advocate for yourself right but then you need to have a supportive environment around you yeah and so that's like your immediate environment because they're feeling the effects too what are three things you can share that they can know and do to be supportive of the women in their lives going through it I'm gonna say number one go to the doctor with them and hear what they have to say great example is many, many women have a drop in libido and they're just there talking to me about it. Wouldn't it be nice to have the partner in the room so that we can talk together? It's not about you. It's really not about you. So just having them in a conversation, they also then feel like, okay, they're understanding. They need to understand and be educated and feel like they're part of something in order to be able to even know what to do. Yeah, that's true. That's a really good one. This is really important. Although it was World Menopause Day yesterday, I think it's a topic we can continue to talk about year-round. Thank you so much, doctor, for coming in. Really, some things to think about. And happy World Menopause Day to all who celebrate, Thank you so much. Thank you for joining us.