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Navigating Perimenopause & Menopause: A Personal Journey | Georgie Kovacs


Navigating Perimenopause & Menopause: A Personal Journey with Georgie Kovacs

Episode Description:

In this special episode of Fempower Health, host Georgie Kovacs takes a break from interviewing experts to share her personal journey through perimenopause and menopause. Georgie discusses the physical, mental, and emotional challenges she faced and offers practical advice for managing symptoms. This episode is packed with insights drawn from Georgie’s experiences and the wisdom of top experts in women’s health.


 
 

Key Topics Covered:

  • Perimenopause vs. Menopause: Understanding the differences and why it matters for effective symptom management.

  • Tracking Perimenopause Symptoms: How to identify and monitor changes in your body during perimenopause and menopause.

  • Impact of Hormonal Changes on Mental Health: Exploring the connection between menopause, hormone therapy, and mental well-being.

  • Navigating Hormone Therapy for Menopause: Georgie’s personal experience with estrogen and progesterone therapy.

  • Effective Communication with Healthcare Providers: Tips for discussing menopause symptoms and treatment options with your doctor.

  • Finding Menopause Support: Resources and expert recommendations for managing menopause symptoms and finding specialized care.


"Just know your menstrual cycle, how it’s changing, how you’re feeling, what triggers a symptom... that’s way better than just showing up at your doctor’s office incredibly frustrated." Georgie Kovacs

Call to Action: If you’re navigating perimenopause or menopause, this episode is a must-listen. Don’t miss out on Georgie’s personal insights and expert-backed advice. Be sure to subscribe to Fempower Health so you never miss an episode!


Related Episodes:

  • Metabolic Health and Hormonal Changes During Perimenopause with Dr. Lara Briden – Learn about the options and considerations for hormone therapy during menopause.

  • Mental Health in Menopause with Dr. Allie Sharma – A deep dive into the mental health challenges many women face during menopause.

  • Perimenopause vs Menopause with Dr. Jerilynn Prior - Understand the difference and why it matters


Resources Mentioned:

  • Lara Briden’s Book: Hormone Repair Manual – A guide to managing perimenopause and menopause symptoms. Check out the Hormone Repair after 40 interview!

  • Dr. Jerilynn Prior: Insights on the importance of progesterone and its role in menopause management.

  • Find a Peri/Menopause Expert


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Disclaimer

The information shared by Fempower Health is not medical advice but for informational purposes to enable you to have more effective conversations with your doctor.  Always talk to your doctor before making health-related decisions. Additionally, the views expressed by the Fempower Health podcast guests are their own and their appearance on the program does not imply an endorsement of them or any entity they represent.


Transcript

Welcome to Fempower Health. This is Georgie. I'm going to change it up a bit today and rather than interviewing one of the amazing experts I get to speak to on this podcast, I'm going to share my journey through perimenopause and menopause and weave in some of the learnings from these amazing experts. 1st, let's start with terminology. It is really important to know the difference between perimenopause and menopause because as Dr. Jerilynn Prior shared in my most recent interview with her, it matters because the symptoms differ and so do the treatments. And so it's really, really important to have awareness of the stage that you're in and be able to communicate that to your provider so you can have a more effective conversation. Okay. So, menopause is defined as 12 months without a menstrual cycle.


Some have said menopause is the day that happens and then post menopause is after that. Some have been using post menopause and menopause interchangeably. What's more important to know though is the difference, in that before that time it's perimenopause. And perimenopause can last for a varying degree of time depending on the woman. And so this is where talking to your family members is really important because the way that your elders, so to speak, like your mother, your grandmother, etcetera, experienced this stage of life will be a good indicator of what you may be experiencing as well. And so for the early signs, you really just have to notice these changes in your body and everyone's going to experience it differently. So, you may have breast tenderness. You know, your mental health will change.


You may have, hot flashes, changes in your menstrual cycle. So all of these different things, you just have to notice the change and kind of keep it in the back of your mind or better yet write it down and just start noticing it. And perhaps even noticing triggers, because it may be even things that you're eating, drinking, the way you're sleeping, the way you're working out. That can also have an impact. And not to say if you stop those, it will all go away. But it's also important to be able to identify the triggers because that will also help you have a better conversation with your doctor. One of the things that's really interesting to me about this stage of life is, you know, I've been thinking about my journey is our bodies. They're complex.


We have these fabulous hormones and different things that happen to our bodies, really do have an impact on them. So, if you think about it, you know, if you have PCOS or thyroid disease or endometriosis, that's gonna have an impact. If you've had children, how many you've had? If you nursed them, if you've had a hysterectomy, of course, perimenopause and menopause, all of these are changes in our hormones that have an impact on our body. And so many people say that with perimenopause, it's really about symptom management and understanding what these symptoms are rather than necessarily doing blood work. And that's really, again, how your clinician can help you. So back to my story and why I brought in the complexity of our bodies is I started fertility treatments, I think, in my mid to late thirties hormones. I had obviously gone off birth control and, you know, it was quite, quite stressful. There's a lot of complex things going on in my life.


So who knows, maybe I hit perimenopause then. Maybe it was the fertility treatments. I had a perfect 26-day cycle after I went off hormonal birth control. And once I had my son, I did try for a second. So I was clearly monitoring everything about my body because I was trained to do so for 4 years prior to that And I noticed that my cycles did start to shift. I would have a long cycle, then a short cycle, and that would go back and forth for, like, 6 months. And then the longer cycles became longer.


The shorter cycles became shorter, and then it just became a hot mess. I don't know what was happening. And then I think it was so I I did start to truly monitor because in 2020, in the midst of COVID, I had the fortune of interviewing Dr. Lara Briden for a second time because second time because she had just published her book Hormone Repair Manual. And I don't think at the time I knew what perimenopause was. And reading her book and then interviewing her really helped give me some clarity. And, you know, I was really stressed out during COVID, and I was having all these, like, mental health issues, which I attributed to COVID. And I'm sure it was actually COVID plus perimenopause in one big swirl.


And for those who are in perimenopause and dealing with mental health issues, you can just imagine what that must have been like to add COVID on top of it. Or I should say the pandemic and living through that pandemic. And, you know, it was it was certainly a struggle. And I think then it was still the early stages of discussing hormone therapy. I don't even know if people were talking about it that much because, again, it was only in the past couple of years, I would say, that people have really been talking about hormone therapy and menopause more frequently and in greater detail in social media and other outlets. But nonetheless, Dr. Briden's book was so incredible. And I really just started monitoring my symptoms.


I knew to monitor my menstrual cycle. And, I had already had a mental health condition. So, we were more just monitoring that rather than trying to add hormone therapy. So, then fast forward, I think now I'm 2 years into menopause and it was Thanksgiving 2 years ago. So, almost 2 years. And I was monitoring my cycle because I had learned from Dr. Bryden how important it is to do so. And I highly recommend all of you do that because if you do have bleeding after you've hit menopause, so after those 12 months, you could be, at risk of endometrial cancer, meaning you need to figure out why you're bleeding. And so if you know that it's been over 12 months, you definitely want to go to your doctor, to be able to get checked out for that because that actually happened to me.


So, I had hit 12 months with no menstrual cycle. And then, I was on a trip to Arizona. And as soon as I got back, I started to get a menstrual cycle again. So this is now 6 months after I thought I had hit menopause. And so I had another cycle after that. And I have heard of many people who do get their menstrual cycle back. I mean, it varies so much for women. So, again, I'm not even going to try to make sense of this and tell you this is what happens for everyone.


Because generally, the rule of thumb is 12 months without a menstrual cycle. You have menopause. Some do have breakthrough. Summary is if you have breakthrough, so to speak, please go visit your doctor. So, I did. And she tested me for endometrial cancer. So, I had to get the little biopsy and await the results. And it turned out when I went to see her, I also had an ovarian cyst.


And she said it wasn't big enough to have to take out right away and to wait and see. So, we waited for the test results of the biopsy, which turned out to be negative, thankfully. And it turned out the cyst ended up going away. So then I was fine. So then time passes. I think I'm fine. I'm still really off mentally, but I attribute it to my mental health condition, stress. You know, I'd already hit menopause, and everyone talks about the brain fog and perimenopause.


So, you know, I just kind of lived my life. Didn't think I needed hormone therapy because it seemed like all the discussions on hormone therapy had to do with hot flashes. Right? And I didn't I had them here and there, but it would be more like if I had a glass of red wine, I'd get a hot flash, then that was it. So I didn't think much of it. Then I did an interview with Dr. Allie Sharma on menopause and mental health and she is, by the way, a mental health professional, not a hormone therapy expert and she made that very clear in the episode. I do highly encourage you to listen to it. By the way, I'm not having my editor edit this. So, if you see me making a couple of mistakes, I'm I'm just I'm being raw here.


I'm being real. So, forgive me. But, nonetheless, that episode changed me because just the way she was talking about mental health. I had this moment and I thought, hold on a second. I wonder if I need hormone therapy because my, psychiatrist and I have been working on this, I had these, like, ADHD like symptoms. And we tried everything. We could not get them to go away. And, things would work, and then they wouldn't work.


And I was like, I'm still off. Something's just off. And, I mean, there were days I was really, really struggling and just trying to hang on. So, nonetheless, I listened telehealth visit, because I was really stressed out. Everything felt hard. And I was worried that I was gonna have to, like, hike over to her office, sit in a waiting room, get the appointment, hike back home. Oh, no. It was a quick telehealth visit.


And I shared with her, you know, what I learned on the podcast. I shared with her some of the data that I've seen. I shared with her the things that I've tried, and we agreed that I should try the estrogen patch. And because I still have a uterus, she obviously prescribed progesterone. And within a few days, I felt like a different person. And, by the way, anything that I share on this episode is not medical advice, and it is not to say this is what you should be doing because I as you can see, I have a long medical history here, and the medical history is what matters and driving the decisions that you and your provider make. So it's really all about shared decision making. And before I forget, I also wanna say, many have asked, who do you trust on social media? How do you know if what people are telling you is correct? You know, I would say this.


Leverage the information that you're hearing and use that as data points for you to think about what might be happening with you. Monitor your symptoms. Monitor changes. List out concerns that you have and then talk to your doctor about it and have a bulleted list. Don't show up with your doc at your doctor's office with like a 15 minute vent session because they're not going to be able to help you. These are short appointments. It's a really rough healthcare system. And just share the data just like I did with her. My understanding is, you know, hormone therapy could possibly help with these mental health conditions.


I have tried this, this, and this with my health care provider. The hot flashes and things like that aren't that big of a deal. But I wonder if we could give this a try. That was pretty much my conversation. So we still went into a lot of depth, but it was just the bullets that we needed to cover. And I was able to get what I needed. So then, I still wasn't sleeping that great. And I don't remember the order of events.


It doesn't really matter at this point. Long story short, I had a discussion with Dr. Jerilynn Prior, and she was saying that according to some of the, research she's done, 300 milligrams is actually the proper therapeutic dose for progesterone. And it really helps with sleep, and she actually felt that the progesterone would be made way more helpful for me than the estrogen patch, especially because I didn't really have a lot of hot flashes. So, I ended up calling my or had my upcoming appointment with a doctor because she wanted me to sit on the original dosages of the hormones for a few months before we made any changes. So I ended up having my annual exam with her recently, and we had a whole discussion about it. And she says, I hear you on the increased dose, and I agree with you. Let's try it. But let's not go from 100 to 300.


Let's try 200. Because we don't want you to zonk out by taking progesterone and not being able to function at all. So, let's slowly titrate it up. So, now I'm on 200 milligrams. The other thing I've tried is melatonin. Melatonin is something I tried when in the midst of the pandemic. And it never did anything for me. But for whatever reason now, I have noticed that it's helped with my sleep.


I also try to make sure I have a nice wind down bedtime routine. I wear blue light glasses after 7 o'clock. I really try to stay off screens. So it's not just the hormone therapy and some of these, the mental health medications that I'm on. But it's all of these different things that I've had to do to really, make sure that I feel good and don't have all the symptoms. I also monitor my diet. After 4 years of fertility treatments, and you try anything and everything to have your kid, I certainly learned a lot about what my body needs from a food perspective. And so I don't eat dairy, no gluten, except now I'm able to do sourdough bread, which is fabulous.


I've also been able to add butter back into my diet. But if I try anything else, heck no. I get so sick. I also, you know, exercise regularly. I noticed that if I go more than 2 days, I get really stressed out. So I try to do that. What other things? Those are the the main things that I've been doing. And I now just monitor the symptoms, and I feel great.


I will say the one thing I did notice too is carbs. And I am so not about to go on this discussion on no one should eat carbs or carbs are amazing. This is again, not medical advice. I'm just telling you what I noticed. For me, I noticed that if I eat a lot of carbs, I just feel kind of heavy. And so I found what worked for me is eating lighter. Like, I could eat protein in the morning. And I know that in Dr. Lara Bryden's recent book on metabolic health for women, I just did an interview with her.


She talks a lot about how we women don't eat enough protein. And so I definitely work on getting my protein in in the morning. And if I do carbs, I find I feel less icky if I do it at night. But if I eat too many, then I feel icky no matter what. However, now I'm training for a marathon. Oh my gosh. I am carbo loading like nobody's business. So yay carbs.


But, again, that's just me. And, again, I've had the honor of interviewing so many experts on nutrition and health as well. And so, I take all their advice to try to figure out what's gonna work for me. Okay. So, I think I covered it all. I think I covered how it's complex. You have to monitor your symptoms. Some of the experts I speak to say don't even bother with even the at-home hormone tests, that you can purchase, because it's really all about symptom management.


So however it is that's gonna work for you to track what's going on, please track it. It doesn't have to be this laundry list. Just know your menstrual cycle, how it's changing, how you're feeling, what cycle, how it's changing, how you're feeling, what triggers, a symptom, what makes it get better, what makes it get worse, what possibly makes it go away. If you just kind of keep track of this stuff and have a little note thing on your phone and just jot down these things, that's way better than just showing up at your doctor's office incredibly frustrated and the doctor not knowing where to begin. The more specific and the more clear you are, the more they are there to help you or the more effectively they can help you. The other thing is, I know there's been a lot of discussion on social media about frustration with doctors. I think it's important to know that once the Women's Health Initiative study was published about 20 years ago, because of the way those results were analyzed, it's been really challenging to find clinicians trained on menopause because once that data came out, they pretty much just didn't really teach it the way that they used to if at all in medical school. And recent reports showed that way less than 50% of med schools are even training on perimenopause and menopause.


So, if you understand this, then you will understand that it's really important to not just rely on any OBGYN to help you with something very, very specific. It's important to find a clinician who has been trained on this. One thing I will say you may ask, what about the coaches? I don't know the type of training that the menopause coaches go through. So, I will not speak for that. If they're not, you know what? I'm not even going down this road because I am not an expert. And I am analytical. I would want to read about their training. And then I can give you a proper assessment. I would just say my presumption is that they've been, they've come to life because of the challenges with the healthcare system and the 10-minute appointments with our doctors.


If you do wanna find a menopause trained expert, one of the places you can go is the Menopause Society's website. I will say I have heard some challenges in this in the sense that you will know the doctor and you will know their location. But what you will not be able to gather from that site is whether or not they take insurance. So, I had a friend share with me that she looked at maybe 10 websites or 15 websites and everyone was cash pay. And so, she couldn't find anyone who took insurance. And honestly, this is not a surprise because with our healthcare system and the long appointments that are required to properly, help someone in this stage of life, I'm not surprised that that is the case. However, please don't lose hope because there, you know, there there are clinicians who are in network. And I think the clearer that you are about what's happening with you and the more succinct you are, I think you can, I should hope, that you can get the help you need or at least guidance on where to go next? But so, anyways, I hope that helps.


Okay. So, a couple of episodes that I would like for you to consider listening to that I think are very helpful and unique. So I've already talked about Dr. Lara Briden's episode on metabolic syndrome. And I think a lot of that information can be useful for women in this stage of life or really all women. Dr. Prior, again, talking about perimenopause and menopause. And she also talks about progesterone versus estrogen. Progesterone is one of those hormones where people it it's like estrogen took over. Everyone talked about estrogen.


And finally, over the past few years, we've been hearing more and more people talking about progesterone. But I call that episode out because when it was first published, and then every time I republish it, it performs extremely well. So I'll just tell you about it too because everyone wants to talk about it. I spoke about Dr. Allie Sharma's episode with me on mental health and this stage of life, definitely a great one. There are several episodes on sexual health, that I think are really important. I know the sober curious movement is hot.

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