You’re Not Losing Your Edge: Perimenopause, Work and the Pressure to Power Through

WEBVTT

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What happens when a highly capable woman suddenly

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can't sleep, can't focus, or can't find the right

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word in an important meeting? At work, those

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moments do not always get interpreted as health

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issues. They can be interpreted as stress, burnout,

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a lack of confidence, or worse, that she is no

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longer as sharp or capable as she used to be.

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That is why perimenopause belongs in a conversation

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about women and leadership. It often arrives

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during the exact years women are leading teams,

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running businesses, competing for promotions,

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and being expected to perform at their highest

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level. And yet, many women do not recognize what

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is happening. I know, because I was one of them.

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Today's guest, Dr. Kase Troutman, is a quadruple

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board certified physician with more than 20 years

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of clinical experience. She specializes in menopause

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care and women's midlife health. And through

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her practice, midlife remedy, she helps women

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better understand and address the changes affecting

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their sleep, energy, concentration, hormones,

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and overall health. Dr. Chapman is not only our

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guest today, she is also my doctor. In this episode,

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we talk about how perimenopause can affect sleep,

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concentration, confidence, and credibility at

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work, why so many women dismiss the symptoms,

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and why there is no metal for simply powering

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through. This is not about women becoming less

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capable. It is about understanding what is happening

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before we or everyone around us mistakes it for

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decline. Let's get into it. Welcome to loud and

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lifted Dr. Kase Troutman. I'm so happy to have

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you here. Well, I am so thrilled to be here in

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your podcast as well, Betsy. So this is, I love

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when things come full circle and this is one

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of these conversations that has come full circle

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to me because our listeners may see the topic

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of this conversation and be like, wait, this

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is a women in leadership podcast. Why are we

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talking about perimenopause? Like how is this

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connected? And the irony is, is how I got introduced

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to you was at a women in leadership networking

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event where there's a bunch of women sitting

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around the table, talking about running their

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own businesses and the struggles and the challenges

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and within. I don't know, like 15 minutes maybe

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of this conversation, suddenly we go down this

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rabbit hole of perimenopause and how it's impacting

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all these women sitting on the table who are

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various ages. And someone named you that you

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were the savior of their day. And so that's how

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we got here, right? And we'll get into a little

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bit about my conversations with you. But it's

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wild. Part of it, I know, is my age, but perimenopause

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is this word that we're hearing a lot nowadays.

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And let's start with really being very clear.

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What does that even mean? Yes. I'd love that

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we start there. But I want to say, though, that,

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of course, even if this is a business podcast,

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it will absolutely affect all women, right? 100%.

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We are our business. how healthy you are, how

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amazing you are, is how you're going to run your

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business. So if we are operating from a non -healthy

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approach, then yes, our businesses will suffer.

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Okay. I just want to say - Don't worry. We have

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a whole big topic on that. We'll get into that.

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You're right. Love that we're starting with definitions,

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right? So before we describe paramenopause, I

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think it's easier for people to know what menopause

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is. So menopause is literally one day, which

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is 12 months after our last menstrual period.

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And basically that is the outward symptom when

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we don't have periods for a year, but the cellular

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level and the biological level, what it simply

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means is the ovaries are not producing estrogen

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anymore. And then the days and years after that

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one day is postmenopause. And the years before

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that one day, is perimenopause. So literally

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perimenopause is a transition. It encompasses

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years of a woman's life. And it is... The reason

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why it's so talked about and why it's very confusing

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for a lot of women, even a lot of doctors, is

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because there is no one set definition. There

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are definitions of how we use it, of how we would

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describe it, which is irregular periods. That's

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usually the first sign. But the reality is the

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lived experience of women in paramanopause is

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they have symptoms other than irregular periods

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and heavy periods. And those symptoms happen

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way before period irregularity happens. I know

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that was a mouthful. No, that's good. No, that's

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super helpful. Well, and it's funny, again, I'm

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47, right? So this is like hot topic around every

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table and it's wild. And I think back to like

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when my mom was my age, like I remember her talking

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about menopause and it was just hot flashes and

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it was moodiness, right? Like that's all I knew

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growing up, you know, as a woman of like, this

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is this menopause thing when I don't get my period

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anymore, I have hot flashes and I'm going to

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be a little bit of a bee apparently. At least

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that was my experience as a daughter. But there's

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so much more to it. And if I go back into that

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conversation that I mentioned in the beginning

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of where these women were sitting around, it

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impacts how we show up. So if someone's sitting

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here in their 40s, even late 30s, chances are

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they're probably in perimenopause, correct? What

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do those signs or symptoms look like? Yes. So

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first of all, average age of US adults of perimenopause

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is 47, but it can start as early as 35. And for

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10 % of US women, it actually starts before 35.

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Okay, so there is early, earlier perimenopause.

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So I always like to start with that because honestly,

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before I got into what I do now in women's health,

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I thought menopause was like an old person thing,

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you know, like the 60s, like golden girls, like

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not me, right? Not 35 year old me, but 35 year

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old me was happy symptoms, right? So anyway,

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so symptoms, I love that question. So I... The

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way I would kind of answer that would be to refer

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people to a paper that came out in Menopause

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2024, a journal article came out. And the authors

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interviewed 1 ,300 women, aged 35 to 55. They

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asked them one question. In the last three months,

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how often did you not feel like yourself? Oh,

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that was your question. And almost like 300 women

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answered 50 % of the time they did not feel like

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themselves. And almost like 100 plus women said

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every day for the last three months, I did not

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feel like myself. That's so sad. That is, right?

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That is what I call the lived experience of women

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in perimenopause. So the authors went even deeper

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and asked them, what do you mean by you don't

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feel like yourself? What are the symptoms you're

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having? Just to answer your question. You know

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the number one symptom? It was fatigue. I was

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going to say tired. Yes. Oh, that's so weird.

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I wonder why I know that. And then it goes on.

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It's fatigue, anxiety, concentration, rage, kind

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of overwhelmed. So it's all those mood and energy

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and brain symptoms. Hot Flashes was on the list,

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but it was at the bottom of the list. Interesting.

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So again, perimenopause, it's not just about

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period irregularity. All of that is how we officially

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define it. Well, I think as we get to know more

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about studying women in general, because again,

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women haven't really been studied. Which is wild.

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Because it's not like perimenopause is new. It

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didn't just pop out. Right. Yeah. So fatigue,

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that's the number one symptom. But again, it

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could be head to toe. If I go from head to toe,

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I'm just gonna ramble it here. Hair changes,

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hair loss, skin dryness, skin itchiness, dry

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mouth, you have palpitations, and mood, anxiety,

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trouble sleeping, concentration, brain fog, let's

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see, joint pain, liver is affected, cholesterol

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goes up, blood pressure goes up, sugar goes up,

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I mean... And so, of course, we can't forget

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about libido changes, decreased desire, even

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if you still love your partner, like your partner,

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just the desire is gone, painful sex, frequent

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bladder infections, and so on and so forth. I

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think they have 150 symptoms or something like

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that. Oh my gosh. Yeah. That's so depressing.

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Again, we'll also show how it is a clinical diagnosis

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because if you've heard one menopause story or

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paramanopause story, you've only heard one paramanopause

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story. My story is different than other people's

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story because we all have different symptoms

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in genetics. Sure. So, you know, it's funny,

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we talk about hormones and again, I have teenagers,

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so I feel like we talk about hormones when it's

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like, oh, teenagers or, you know, raging hormones

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or whatever. But what's happening to our hormones

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during perimenopause? Like, why does this happen?

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Yeah. So again, the idea behind this is the ovaries

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start to lose steam. So we're all born with a

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certain number of ovaries, I'm sorry, of follicles.

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And as we get older, the follicle the ovary stops

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producing the follicles and hence estrogen. So

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what happens is we get those it's not producing

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estrogen and then it's like there's a surge of

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like oh my gosh we gotta make make more estrogen

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so we get those highs. And then we get those

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slow. So really, with paramanopause, it's that

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zone of chaos, we call it. Meaning, today, my

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level could be high. And one week from now, it

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could be low. And then two weeks from now, it

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could be high again. So it is the irregularity

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of the hormone swings that defines peri. And

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menopause, we don't have any more of the hormones.

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Estrogen is out the building. OK. Interesting.

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So I have no issue sharing my story around this,

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but I think it's important that we talk about

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it. And, you know, one of the reasons why I called

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you after that conversation at the at the breakfast

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table with a bunch of women is because not knowing

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that those were symptoms, number one, right.

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And I was living in like a stressful time in

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my life. Right. Things were really crazy at my

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past job. You know, I have a I have a sick dad.

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I have all these things going on. Right. Like

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there's a lot of stress and anxiety in my life

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that was just seemed normal. And I would have

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this like constant anxiety. And I had major issues.

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sleeping like I felt like a baby sleeping through

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the night I had that 3 a .m. wake up you know

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just sort of can't go back to sleep your head

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is racing your heart is racing everything is

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just you know sleep just suddenly was out the

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window and I was just like oh it's just because

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I'm it's just because I'm stressful it's just

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because I have a lot going on there's these issues

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and and I would just be very dismissive of it

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and hope that maybe the next month or two would

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be better and you know now we're like a year

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or so into this and this is still happening and

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things are calming down in my life that those

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outside influences and it's still like not sleeping

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and that constant anxiety. And I never connected

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that until sitting at this table that that was

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even an issue. So I remember the first time I

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came in and I was like, sleep, stress, anxiety.

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And you're like, so talk through that how a lot

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of times as women, because, you know, we're in

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our forties, we're under a lot of pressure and

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stress, you know, professionally and personally,

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how that impacts us and how we sort of mistake

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those signs. Yes. And I think this is where awareness

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is key. to knowing what what happens so for example

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puberty right we all know okay puberty i will

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expect my teenage daughter to be a little kind

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of annoying right like we know that but for women

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like for para menopause menopause We don't know

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that or I should say a lot of people don't know

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it because again, we just associate, oh, it's

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hot flashes and not having my period. That's

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what they associate. So in terms of like stress,

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anxiety, and sleep, again, we just talked about

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those are the more common presenting symptoms

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for women. So here's how I kind of look at it,

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right? I'm not saying paramanopause is the problem

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or hormone therapy is a solution to everything,

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but what if It's not just stress. What if it's

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not just aging? Because that is typically what

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providers who are not as well versed with perimenopause

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and menopause would tell patients that are seeking

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help, right? I would say like, we know these

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things, the external circumstances, stress, life

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and being your own boss and having your company

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and et cetera, et cetera. We know that they are

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real stressors. And so the way I was like but

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what if it's not just that right because. The

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the the the way to see and honestly the way to

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see is to try to try treatment that's. Kind of

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like the one way I would know, and that's what

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I tell my patients when they come into my office,

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right? I say, I'm not saying this will fix everything,

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but if your symptoms are because of this menopausal

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transition that, oh, by the way, it's gonna happen

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to 100 % of women who live long enough. This

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is not like a rare thing. This is not something

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that somebody will tell you, I don't believe

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in that because this is not like Santa Claus

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that you have to believe in. This is like science

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and real, right? And again, because it's... but

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it can range from 35 to 50, like 52. That's two

00:13:14.279 --> 00:13:16.940
decades of possibility. So yes, and what do we

00:13:16.940 --> 00:13:19.700
know about that time of our lives? Usually we

00:13:19.700 --> 00:13:22.500
are at the peak of our careers. Usually we are

00:13:22.500 --> 00:13:26.620
handling children and parents or elderly. We

00:13:26.620 --> 00:13:28.779
are at, we call that sandwich generation. So

00:13:28.779 --> 00:13:30.980
absolutely we will have all those stressors.

00:13:31.440 --> 00:13:33.460
And of course we will have anxiety stress. But

00:13:33.460 --> 00:13:36.210
again, what if... the symptoms you're having,

00:13:36.509 --> 00:13:38.730
the anxiety, the trouble sleeping, the trouble

00:13:38.730 --> 00:13:42.769
concentration, the anger, the, you know, overwhelm.

00:13:42.769 --> 00:13:45.250
What if it's not just a stress? What if it's

00:13:45.250 --> 00:13:48.190
because it is a biological reason? That's it.

00:13:48.529 --> 00:13:51.590
So that's all, that's all I, you know, us menopause

00:13:51.590 --> 00:13:54.129
physicians, really it's just what if it's biology?

00:13:54.429 --> 00:13:56.309
Because if it's biology, I can help you. Right.

00:13:57.270 --> 00:14:00.289
No, that's so true. And because it has an impact

00:14:00.289 --> 00:14:02.029
on us, right? When we said, why are we talking

00:14:02.029 --> 00:14:03.750
about menopause and perimenopause on a Women

00:14:03.750 --> 00:14:06.289
in Leadership podcast? Because it impacts how

00:14:06.289 --> 00:14:08.190
we show up if we're not sleeping at night and

00:14:08.190 --> 00:14:09.950
we have this constant anxiety. And then we didn't

00:14:09.950 --> 00:14:12.269
even mention really the brain fog because, you

00:14:12.269 --> 00:14:13.690
know, we talk about pregnancy, right? I remember

00:14:13.690 --> 00:14:15.690
thinking that when I was pregnant and like, oh

00:14:15.690 --> 00:14:17.769
my God, the words would just literally like leave

00:14:17.769 --> 00:14:20.570
your brain. And that happens. Again, that happens

00:14:20.570 --> 00:14:22.970
here. So if a woman's going through this and

00:14:22.970 --> 00:14:25.029
she's showing up at work and she's blanking in

00:14:25.029 --> 00:14:27.350
a meeting because either A, she's exhausted or

00:14:27.350 --> 00:14:30.110
B, it's just that brain fog, that's impacting

00:14:30.110 --> 00:14:32.210
our credibility at work that people are gonna

00:14:32.210 --> 00:14:34.429
start being like, what is wrong with her? Right.

00:14:34.909 --> 00:14:40.580
Yeah, I call it the silent packs. Because if

00:14:40.580 --> 00:14:42.860
we're not, if number one, if we're not aware

00:14:42.860 --> 00:14:45.500
that those symptoms are because of this biological,

00:14:45.620 --> 00:14:47.720
I keep saying biological because it really is

00:14:47.720 --> 00:14:51.720
biological. It's a tax, right? Because we just

00:14:51.720 --> 00:14:54.840
quote unquote blame ourselves. Oh, I should just

00:14:54.840 --> 00:14:57.120
push more. I should just try this. I should,

00:14:57.120 --> 00:15:01.080
you know, do X, Y, Z. This is also, you know,

00:15:01.220 --> 00:15:03.460
for brain fog concentration. I should just, I

00:15:03.460 --> 00:15:05.399
remember one of my patients like literally has

00:15:05.399 --> 00:15:08.450
like post -its everywhere. is to try and remember

00:15:08.450 --> 00:15:11.269
kind of the things that you know that I don't

00:15:11.269 --> 00:15:13.629
know if that's your experience or just like again

00:15:13.629 --> 00:15:16.730
normally that's their superpower their superpower

00:15:16.730 --> 00:15:20.529
is doing five things at the same time right and

00:15:20.529 --> 00:15:26.580
now barely even able to do that one task So it's

00:15:26.580 --> 00:15:30.240
a big hit on our confidence as leaders and as

00:15:30.240 --> 00:15:32.379
business owners. Absolutely. I mean, if you're

00:15:32.379 --> 00:15:34.139
sitting in a meeting or even if you're presenting,

00:15:34.360 --> 00:15:36.320
even worse, right? And you just have that blank

00:15:36.320 --> 00:15:38.299
moment. And well, yes, we all do that. Men do

00:15:38.299 --> 00:15:41.500
that too. But I've had that fear and that panic.

00:15:41.559 --> 00:15:43.779
And again, I have a dad with dementia. So I have

00:15:43.779 --> 00:15:46.519
a whole other level of paranoia about having

00:15:46.519 --> 00:15:48.320
memory issues. So it's like, oh my gosh, when

00:15:48.320 --> 00:15:50.320
that was happening, it's like that. fear and

00:15:50.320 --> 00:15:52.279
that panic and not looking like an idiot and

00:15:52.279 --> 00:15:54.820
again losing that credibility at work like it

00:15:54.820 --> 00:15:57.580
absolutely can impact you professionally and

00:15:57.580 --> 00:15:59.700
people don't know what's going on whether it's

00:15:59.700 --> 00:16:03.179
men or women that are around there. So why do

00:16:03.179 --> 00:16:05.659
you think or do you see this that we have an

00:16:05.659 --> 00:16:09.159
issue like talking about it, sort of from a professional

00:16:09.159 --> 00:16:12.240
standpoint, because it's a dilemma, right? And

00:16:12.240 --> 00:16:14.259
again, a lot of these women are in leadership

00:16:14.259 --> 00:16:16.399
positions or running their own business or high

00:16:16.399 --> 00:16:20.100
up in a company. So how do we handle that stigma

00:16:20.100 --> 00:16:22.879
at work? How do you suggest handling that professionally?

00:16:23.440 --> 00:16:25.899
Yeah, that's a great question. And I think it

00:16:25.899 --> 00:16:31.919
all depends on is the workplace a menopause or

00:16:31.919 --> 00:16:34.620
paramenopause -friendly workplace? it's kind

00:16:34.620 --> 00:16:39.080
of you know so so meaning if in that workplace

00:16:39.080 --> 00:16:43.679
is is talking about symptoms allowable does the

00:16:43.679 --> 00:16:46.179
culture in the in the in the workplace allow

00:16:46.179 --> 00:16:49.519
her to speak number one number two is are there

00:16:49.519 --> 00:16:53.639
systems in place to get help and treatment right

00:16:53.639 --> 00:16:57.519
i think the first step really is Talking about

00:16:57.519 --> 00:16:59.899
it, and again, this is not saying talking about

00:16:59.899 --> 00:17:03.980
it in like a big meeting. You're never, you know,

00:17:04.180 --> 00:17:06.799
you're never, you should never be required to

00:17:06.799 --> 00:17:09.559
give medical information, of course. But I think

00:17:09.559 --> 00:17:12.059
it just, maybe even starting with the impact,

00:17:12.759 --> 00:17:15.180
right? I haven't slept well and this is affected

00:17:15.180 --> 00:17:18.380
blank or something like that, without divulging

00:17:18.380 --> 00:17:21.750
any kind of like medical stuff. Right. Yeah,

00:17:21.769 --> 00:17:22.970
because if you want to see a room full of guys

00:17:22.970 --> 00:17:24.910
get real quiet, I mean, I used to be in meetings

00:17:24.910 --> 00:17:26.789
where if women started talking even about like,

00:17:26.789 --> 00:17:28.369
oh, I like your hair. It looks like, you know,

00:17:28.430 --> 00:17:31.069
you can see the guys rolling back in their chairs

00:17:31.069 --> 00:17:32.789
and like, oh my God, they're talking about hair

00:17:32.789 --> 00:17:35.569
or clothes or shoes. So, I mean, that's tough

00:17:35.569 --> 00:17:38.309
for men. If you're sitting in a conference room

00:17:38.309 --> 00:17:40.049
and there's men in there, I really think it's

00:17:40.049 --> 00:17:42.269
probably not going to be super well received

00:17:42.269 --> 00:17:45.410
if you start talking about perimenopause specifically.

00:17:45.609 --> 00:17:47.670
But to your point, the sleep piece and tying

00:17:47.670 --> 00:17:49.730
it to that, I think, has a little bit of a different

00:17:49.730 --> 00:17:52.630
perspective. So you're right. It's an uncomfortable

00:17:52.630 --> 00:17:55.130
conversation for guys. But it's interesting that

00:17:55.130 --> 00:17:57.990
I think guys absolutely should still be involved

00:17:57.990 --> 00:18:00.009
and be aware of the conversation. So I remember

00:18:00.009 --> 00:18:04.569
when I was giving a talk in Alabama, and after

00:18:04.569 --> 00:18:07.640
the talk, a guy came up to me. me and said, Oh

00:18:07.640 --> 00:18:11.240
my God, it makes so much sense now. After your

00:18:11.240 --> 00:18:14.440
talk, what my wife was going through, right?

00:18:15.339 --> 00:18:17.319
Probably that was the first talk that he sat

00:18:17.319 --> 00:18:20.220
through because he was required to sit there

00:18:20.220 --> 00:18:24.740
and listen as opposed to his wife talking about

00:18:24.740 --> 00:18:26.900
the symptoms. You know what I mean? So I think,

00:18:27.220 --> 00:18:30.079
I think. Because again, even though it affects

00:18:30.079 --> 00:18:32.519
just women, which oh, by the way, 51 % of the

00:18:32.519 --> 00:18:35.920
population, right? Like we all know a guy will

00:18:35.920 --> 00:18:39.380
know a mom, a coworker, a sister, a niece, a

00:18:39.380 --> 00:18:41.720
daughter that will be going through it. Yeah.

00:18:41.920 --> 00:18:43.700
No, that's a great point. And I think I said

00:18:43.700 --> 00:18:44.920
to you the one time I was in your office, I was

00:18:44.920 --> 00:18:46.640
like, you need to start doing content on social

00:18:46.640 --> 00:18:48.859
for men that we can record little two -minute

00:18:48.859 --> 00:18:51.599
videos because they know something is going on,

00:18:51.599 --> 00:18:53.859
right? But they don't know what, and they don't

00:18:53.859 --> 00:18:55.940
really even know what questions to ask. And maybe

00:18:55.940 --> 00:18:57.779
they're going to just attach it to mood or something

00:18:57.779 --> 00:18:59.619
like that. But at the end of the day, they need

00:18:59.619 --> 00:19:03.220
to understand what's going on too. Yeah. Yeah.

00:19:04.200 --> 00:19:06.660
100%. They survived having to go through the

00:19:06.660 --> 00:19:08.140
whole, you know, having babies and everything

00:19:08.140 --> 00:19:11.990
else. This is fine. This isn't bad. If I was

00:19:11.990 --> 00:19:14.250
going to say something about that, my hope is

00:19:14.250 --> 00:19:18.089
that the men don't just say or assume it's aging

00:19:18.089 --> 00:19:21.009
or it's just stress or the same things that we

00:19:21.009 --> 00:19:23.829
get told. Like, what if this is kind of this

00:19:23.829 --> 00:19:26.269
bylaws? So maybe just having them keep that open

00:19:26.269 --> 00:19:28.549
or maybe even just asking their partners. Sure.

00:19:29.109 --> 00:19:31.890
What are you feeling? Yeah. You know, just make

00:19:31.890 --> 00:19:34.230
sure you ask on the right day. On the right day.

00:19:34.430 --> 00:19:39.059
Just kidding. Be careful how you ask that. So

00:19:39.059 --> 00:19:42.279
a lot of my patients say, this feeling of this

00:19:42.279 --> 00:19:45.319
anger, anxiety and rage, they would literally

00:19:45.319 --> 00:19:50.500
say, I know this is not right, but I see myself

00:19:50.500 --> 00:19:55.799
reacting negatively. And again, that's part of

00:19:55.799 --> 00:19:58.720
when it's not under our direct control necessarily

00:19:58.720 --> 00:20:01.220
because of hormonal changes. No, that makes sense.

00:20:02.209 --> 00:20:04.390
We laid a lot out there, but let's talk about,

00:20:04.630 --> 00:20:07.170
and you teed this up, there's solutions. So what

00:20:07.170 --> 00:20:09.349
do some of those solutions look like? And how

00:20:09.349 --> 00:20:11.329
do you even go through this process, right? If

00:20:11.329 --> 00:20:12.589
someone's listening to this and they're like,

00:20:12.589 --> 00:20:15.930
oh, this is definitely me. How do they move forward?

00:20:16.009 --> 00:20:17.829
How do they reach out? What's just kind of that

00:20:17.829 --> 00:20:20.049
process when someone has identified, I need to

00:20:20.049 --> 00:20:21.509
have a conversation with someone about this?

00:20:22.009 --> 00:20:24.930
Yeah. I mean, I think the first, if you're a

00:20:24.930 --> 00:20:28.579
woman. 35 and over. And in some of the symptoms,

00:20:28.740 --> 00:20:29.960
there are the things that we talk about kind

00:20:29.960 --> 00:20:34.000
of resonate. The first step is seeking a provider

00:20:34.000 --> 00:20:37.059
that is familiar with what perimenopause and

00:20:37.059 --> 00:20:43.400
menopause is. And then from there, again, that's

00:20:43.400 --> 00:20:48.160
a loaded question, right? Because there are providers

00:20:48.160 --> 00:20:50.819
that, again, I've heard this from my own patients.

00:20:51.079 --> 00:20:56.099
They don't believe in... paramanopause, or they

00:20:56.099 --> 00:20:59.000
have their understanding of what paramanopause

00:20:59.000 --> 00:21:03.119
is, and it's slightly outdated, because again,

00:21:03.160 --> 00:21:05.640
they're just basing it on periods, irregularity,

00:21:05.660 --> 00:21:07.039
meaning if they're still having their period,

00:21:07.259 --> 00:21:10.279
oh, you don't need treatment, is kind of what

00:21:10.279 --> 00:21:13.200
my patients think. So I think find a caring,

00:21:14.019 --> 00:21:17.660
competent provider that will listen to you and

00:21:17.660 --> 00:21:21.309
help you understand what Are you in perimenopause?

00:21:21.430 --> 00:21:23.130
And the other thing too, by the way, is look

00:21:23.130 --> 00:21:25.549
for other reasons on why you could be having

00:21:25.549 --> 00:21:27.670
tiredness, right? So that's one of the things

00:21:27.670 --> 00:21:30.069
I usually do in my own practice is, okay, yes,

00:21:30.289 --> 00:21:32.509
you are in the age range of perimenopause. So

00:21:32.509 --> 00:21:34.490
yeah, this could be it, but let's do some basic

00:21:34.490 --> 00:21:37.609
labs just to make sure, hey, you're not iron

00:21:37.609 --> 00:21:41.569
deficient, your thyroid's normal. So those are

00:21:41.569 --> 00:21:44.490
again, low -lying fruit and mimickers of symptoms

00:21:44.490 --> 00:21:46.619
of perimenopause. And again, that's the... I

00:21:46.619 --> 00:21:49.740
would like to say fun part of, or I should say

00:21:49.740 --> 00:21:53.720
the, that's the art of medicine. Where it is

00:21:53.720 --> 00:21:56.539
definitely, there's that layer of possibly biological,

00:21:56.599 --> 00:21:58.279
but yeah, we need to look for other things as

00:21:58.279 --> 00:22:01.180
well. So yeah, to your point, it's finding a

00:22:01.180 --> 00:22:03.619
provider. Finding a provider that will listen,

00:22:03.759 --> 00:22:07.299
that knows what they're doing and is competent

00:22:07.299 --> 00:22:10.700
in prescribing estrogen, progesterone, and testosterone

00:22:10.700 --> 00:22:14.440
based on what your symptoms and what your goals

00:22:14.440 --> 00:22:16.930
are in your life. And I just want to reinforce

00:22:16.930 --> 00:22:18.670
the point you made about finding somebody who

00:22:18.670 --> 00:22:20.549
listens to you because, and I shared this with

00:22:20.549 --> 00:22:21.950
you, the first time I brought up some of these

00:22:21.950 --> 00:22:24.769
symptoms to a female doctor, which is surprising

00:22:24.769 --> 00:22:27.589
that she was female, a year prior to meeting

00:22:27.589 --> 00:22:30.490
you, and she was very dismissive. Like she didn't,

00:22:30.509 --> 00:22:32.069
she was just like, oh, okay, yeah, well, you

00:22:32.069 --> 00:22:34.069
know, that's normal. That's, it is normal, right?

00:22:34.089 --> 00:22:37.049
But there was no further conversation and she

00:22:37.049 --> 00:22:38.509
just... I don't know, she was dismissive and

00:22:38.509 --> 00:22:40.609
I was like, oh, okay, well, maybe I don't bring,

00:22:40.789 --> 00:22:43.230
I don't know, because I very rarely go to a doctor.

00:22:43.349 --> 00:22:45.650
So what I did and bring this up and was dismissed,

00:22:45.710 --> 00:22:48.089
I was like, oh, okay. And a female, like, I think

00:22:48.089 --> 00:22:51.289
I was just surprised. So, you know, again, somebody

00:22:51.289 --> 00:22:53.710
then had talked about you, but it is important

00:22:53.710 --> 00:22:55.470
if you go to the first person and you feel like

00:22:55.470 --> 00:22:57.529
you are being dismissed for whatever reason,

00:22:57.650 --> 00:23:00.569
then find somebody else to talk to. I think that's

00:23:00.569 --> 00:23:02.769
definitely an important point. The sad statistic

00:23:02.769 --> 00:23:06.390
I've heard is it takes a woman six to seven providers

00:23:06.670 --> 00:23:09.150
for finding someone that will help them with

00:23:09.150 --> 00:23:12.190
their perimenopause and menopause symptoms. Nobody

00:23:12.190 --> 00:23:16.690
has time for that. No, no, no. But your point,

00:23:16.829 --> 00:23:20.289
like if you ask one time and you get gaslighted,

00:23:20.390 --> 00:23:22.930
right? You ask the second time and you get, I

00:23:22.930 --> 00:23:25.289
don't know, gaslighted and dismissed. Like the

00:23:25.289 --> 00:23:28.769
desire to ask for help, I think, gets lower and

00:23:28.769 --> 00:23:31.529
lower. Sure. Yeah, you're like, oh, OK. You feel

00:23:31.529 --> 00:23:33.589
like you're just crazy and must be all in your

00:23:33.589 --> 00:23:36.910
head. you should just suffer through it. And

00:23:36.910 --> 00:23:39.490
that's the thing. Yes, it is, perimenopause is

00:23:39.490 --> 00:23:42.789
absolutely 100 % a natural transition, but there

00:23:42.789 --> 00:23:45.890
is no medal for suffering. There's no medal.

00:23:46.410 --> 00:23:49.309
What do we know? It will average last for four

00:23:49.309 --> 00:23:52.490
years, but for some women it could last 10 years.

00:23:52.589 --> 00:23:56.549
Oh my gosh. 10 years. This is not like, oh, deal

00:23:56.549 --> 00:24:00.150
with it for 10 years. Who would say that? Nobody

00:24:00.150 --> 00:24:03.630
would want to deal with. symptoms that affect

00:24:03.630 --> 00:24:06.390
your quality of life, your quality of life personally,

00:24:06.569 --> 00:24:09.309
your quality of life at work, right? I mean,

00:24:09.490 --> 00:24:11.890
and we know, you know, statistics -wise, just

00:24:11.890 --> 00:24:14.609
because we're talking, this is a business. There

00:24:14.609 --> 00:24:20.109
is data that women with untreated symptoms of

00:24:20.109 --> 00:24:22.970
paramanopause, menopause, they, one in three

00:24:22.970 --> 00:24:25.750
women have considered cutting hours or stepping

00:24:25.750 --> 00:24:30.109
back from leadership because of untreated symptoms.

00:24:31.139 --> 00:24:35.079
Let's see here. There is two out of five women

00:24:35.079 --> 00:24:39.140
considered finding a new job due to their untreated

00:24:39.140 --> 00:24:44.500
symptoms. Oh, wow. One in four did not pursue

00:24:44.500 --> 00:24:47.660
a leadership opportunity because of their untreated

00:24:47.660 --> 00:24:51.480
symptoms. And the reality is there's like 1 .3

00:24:51.480 --> 00:24:54.240
million women going to menopause each year and

00:24:54.240 --> 00:24:57.230
perimenopause. There's a lot of us. There's a

00:24:57.230 --> 00:24:59.829
lot of us. That's why if you think of that kind

00:24:59.829 --> 00:25:03.130
of statistic and then think about the, you know,

00:25:03.289 --> 00:25:07.730
the lost productivity, the lost revenue, really,

00:25:08.250 --> 00:25:11.869
for untreated paramanopause and menopause. That

00:25:11.869 --> 00:25:15.390
is the impact. So I think the key there is treatment,

00:25:15.630 --> 00:25:19.269
right? Get treatment, get help, because you don't

00:25:19.269 --> 00:25:22.640
have to suffer. No, I love that. And I will attest

00:25:22.640 --> 00:25:24.500
that it has definitely helped. And, you know,

00:25:24.559 --> 00:25:26.420
I think HRT through the years, I think people

00:25:26.420 --> 00:25:28.339
are starting to understand that a little bit

00:25:28.339 --> 00:25:30.539
more. And again, my age, my Facebook ads are

00:25:30.539 --> 00:25:34.640
always. Facebook is listening. Facebook is listening.

00:25:34.779 --> 00:25:36.619
They're always promoting, you know, different

00:25:36.619 --> 00:25:38.720
services and hormone replacement therapy. So

00:25:38.720 --> 00:25:40.519
hopefully people are catching on like this is

00:25:40.519 --> 00:25:42.859
inside because it sounds when you say hormone

00:25:42.859 --> 00:25:45.269
replacement therapy, it sounds so. dramatic,

00:25:45.309 --> 00:25:46.890
right? Like, I don't know, it just, because replay,

00:25:47.049 --> 00:25:48.990
I don't know. So it's just, it's the education

00:25:48.990 --> 00:25:50.630
behind like, hey, it's not a big deal. It's,

00:25:50.630 --> 00:25:52.559
it's taking some pills, you know, or having a

00:25:52.559 --> 00:25:54.400
patch or whatever it is. And I do love that I

00:25:54.400 --> 00:25:56.019
keep seeing more people talk about the patch,

00:25:56.079 --> 00:25:58.500
which I think it makes it feel a little less

00:25:58.500 --> 00:26:01.480
daunting or scary. So and of course, everyone's

00:26:01.480 --> 00:26:03.579
plan is customized and individualized for what

00:26:03.579 --> 00:26:06.359
they need. But besides HRT, are there other things

00:26:06.359 --> 00:26:08.819
that we should be doing that help us get through

00:26:08.819 --> 00:26:11.640
this time? Yeah, and I think it depends. There's

00:26:11.640 --> 00:26:14.119
so many things that that we can do. So again,

00:26:14.160 --> 00:26:16.380
in my practice, I talk about what we call the

00:26:16.380 --> 00:26:20.250
four M's. So meals, movement, mind, and meds.

00:26:20.410 --> 00:26:23.150
So hormone therapy falls under the med component,

00:26:23.170 --> 00:26:25.450
right? And how you would tailor that really depends

00:26:25.450 --> 00:26:29.349
on what the symptom is. So for example, what's

00:26:29.349 --> 00:26:30.910
bothering the patient and what are their goals?

00:26:31.009 --> 00:26:33.349
So for example, if the issue, let's just say

00:26:33.349 --> 00:26:36.130
brain fog or, you know, brain fog. Are there

00:26:36.130 --> 00:26:38.809
ways that we can eat, fuel our body with the

00:26:38.809 --> 00:26:41.990
right ingredients that will help with concentration,

00:26:42.309 --> 00:26:45.309
brain fog? Yeah, omega -3. So making sure we

00:26:45.309 --> 00:26:48.130
have omega -3 sources in our diet. So usually

00:26:48.130 --> 00:26:52.390
two to three servings of like salmon, tuna, sardines

00:26:52.390 --> 00:26:55.630
per week, you'll get your recommended omega -3.

00:26:55.769 --> 00:26:57.450
That's from diet alone. Now some people don't

00:26:57.450 --> 00:26:59.730
like fish so you know consider taking an omega

00:26:59.730 --> 00:27:03.089
-3 supplement, it's fine. Movement. movement

00:27:03.089 --> 00:27:06.210
is so important, right? Whether it's cardiovascular

00:27:06.210 --> 00:27:09.529
exercise, whether it's strength training, and

00:27:09.529 --> 00:27:12.109
both of those types of exercise has been shown

00:27:12.109 --> 00:27:15.250
to actually improve brain function. There's something

00:27:15.250 --> 00:27:18.029
called VDNF, brain -derived neurotrophic factor,

00:27:18.210 --> 00:27:21.230
where basically it's like growth in a way like

00:27:21.230 --> 00:27:24.089
helps the brain cells kind of become healthy.

00:27:24.190 --> 00:27:29.039
Those are activated by exercise. So mind is how

00:27:29.039 --> 00:27:32.000
do we handle stress? Part of a big, big part

00:27:32.000 --> 00:27:36.200
of what I do is, you know, is what are you thinking

00:27:36.200 --> 00:27:38.140
evaluating cognitive behavioral therapy? What

00:27:38.140 --> 00:27:40.160
are you thinking? Like, is that true? Right?

00:27:40.259 --> 00:27:43.720
Like kind of using the power of coaching to understand

00:27:43.720 --> 00:27:47.859
our thoughts and is that helpful? And is it serving

00:27:47.859 --> 00:27:50.640
you? Is it even true? Um, so yeah, there's so

00:27:50.640 --> 00:27:53.819
many things, right? So for sleep that, so just

00:27:53.819 --> 00:27:55.539
so you know, I'm going to just go ahead and I'm

00:27:55.539 --> 00:27:57.640
very open about my own peri -menopausal story.

00:27:57.900 --> 00:28:02.140
My crib tonight was sleep. Like for me in my

00:28:02.140 --> 00:28:05.599
late thirties, I just had trouble falling asleep.

00:28:05.980 --> 00:28:09.099
I would wake up at 3 a .m. and again, at that

00:28:09.099 --> 00:28:12.210
time I was the head of my career. Okay, so I'm

00:28:12.210 --> 00:28:14.569
like, oh, I must just be stressed. That's why

00:28:14.569 --> 00:28:16.990
I'm waking up in the middle of the night. So

00:28:16.990 --> 00:28:19.829
I went down as a physician, I have access to

00:28:19.829 --> 00:28:23.190
kind of. regular treatment. So I did counseling,

00:28:23.630 --> 00:28:26.529
I did medication for anxiety because I just thought

00:28:26.529 --> 00:28:29.849
I was anxious. I also deep go into something

00:28:29.849 --> 00:28:32.349
called cognitive behavioral therapy for insomnia.

00:28:32.670 --> 00:28:35.329
I'm a clinic, I'm trained in that. Again, that's

00:28:35.329 --> 00:28:37.529
where using the power of your mind and recognizing

00:28:37.529 --> 00:28:40.410
how to change behavior when it comes to sleep.

00:28:40.670 --> 00:28:43.710
I did the whole alternative medicine route like

00:28:43.710 --> 00:28:49.880
ashwagandha, rhodiola, lavender. So again, so

00:28:49.880 --> 00:28:52.539
I did all of that. So again, there's, I'm not

00:28:52.539 --> 00:28:55.380
saying all of, they, to a certain extent, all

00:28:55.380 --> 00:28:58.160
help, right? They're all, counseling is good.

00:28:58.279 --> 00:28:59.900
I think everybody should have counseling, you

00:28:59.900 --> 00:29:05.039
know? But for me, particularly in my case, hormone

00:29:05.039 --> 00:29:07.930
therapy really helped. me because it was the

00:29:07.930 --> 00:29:11.930
biology. And I think the other parts, coaching,

00:29:12.309 --> 00:29:14.869
CBT, cognitive behavioral therapy for insomnia,

00:29:15.269 --> 00:29:17.970
they all helped me, you know, kind of like the

00:29:17.970 --> 00:29:21.109
puzzle pieces. Makes sense. And I love the conversations

00:29:21.109 --> 00:29:23.630
and the recommendations around like eating. And

00:29:23.630 --> 00:29:25.809
it's funny so much, again, I see about lifting

00:29:25.809 --> 00:29:27.490
weights and how important it is for strength

00:29:27.490 --> 00:29:29.349
training, how, you know, cardio is great, but

00:29:29.349 --> 00:29:31.230
you need to lift weights as you get older for

00:29:31.230 --> 00:29:33.569
more than just your memory, for bone and everything

00:29:33.569 --> 00:29:35.970
else. It's like doing that stuff's not going

00:29:35.970 --> 00:29:37.869
to... be bad right like that's not going to come

00:29:37.869 --> 00:29:39.930
out 10 years or 100 years from now that oh you

00:29:39.930 --> 00:29:41.869
guys should have not been eating so well or you

00:29:41.869 --> 00:29:43.849
should not have been lifting weights right like

00:29:43.849 --> 00:29:45.329
that's that's stuff that's going to stick that

00:29:45.329 --> 00:29:48.309
has just an overarching impact on your health

00:29:48.309 --> 00:29:50.670
and and just how you feel right and we've talked

00:29:50.670 --> 00:29:52.829
about this on this podcast before if you don't

00:29:52.829 --> 00:29:54.349
feel good you don't feel your best you're not

00:29:54.349 --> 00:29:56.670
going to show up and be your best whether it's

00:29:56.670 --> 00:29:59.170
professionally or you know with your family or

00:29:59.170 --> 00:30:01.609
friends or whoever it is so it's it's eliminate

00:30:01.609 --> 00:30:03.609
controlling the things that we can control and

00:30:03.609 --> 00:30:05.190
eliminating the things that we can eliminate

00:30:05.190 --> 00:30:07.039
that impact all that, that are going to have

00:30:07.039 --> 00:30:10.039
that effect on us. Right. But I did want to say,

00:30:10.160 --> 00:30:12.339
just because we do always say that, we always

00:30:12.339 --> 00:30:16.440
say to patients, eat better, exercise, right?

00:30:16.980 --> 00:30:19.559
But if you are struggling with perimenopause

00:30:19.559 --> 00:30:23.180
and you are literally like exhausted, like making

00:30:23.180 --> 00:30:25.279
yourself, like, you know what I mean? Like making

00:30:25.279 --> 00:30:28.779
yourself exercise feels such a struggle. Oh,

00:30:29.099 --> 00:30:31.799
true. For a lot of my patients. So when we give

00:30:31.799 --> 00:30:34.589
back, hormone therapy, when we give back hormones

00:30:34.589 --> 00:30:38.049
that your body naturally produces, that's when

00:30:38.049 --> 00:30:40.049
my patients start to feel, okay, I have energy

00:30:40.049 --> 00:30:42.569
now. Oh my gosh. Oh, I can sleep now. So when

00:30:42.569 --> 00:30:44.849
I sleep, I feel more energetic in the morning.

00:30:45.150 --> 00:30:47.990
So, right? So I guess what I wanted to also say,

00:30:48.150 --> 00:30:50.289
sometimes it is not just about powering through.

00:30:50.529 --> 00:30:54.829
If there's a biological reason why XYZ is hard,

00:30:55.269 --> 00:30:58.450
yeah, maybe because you're in peri. That is such

00:30:58.450 --> 00:31:00.369
a great closer. And the powering through thing,

00:31:00.470 --> 00:31:02.009
I think, is so important to reinforce because

00:31:02.009 --> 00:31:04.849
we just think we can power through. We think

00:31:04.849 --> 00:31:07.210
we are too busy to make an appointment because

00:31:07.210 --> 00:31:09.730
we have to take everybody else's priorities over

00:31:09.730 --> 00:31:12.450
our own. And it's not powering through. And it's

00:31:12.450 --> 00:31:14.190
prioritizing yourself because if you don't feel

00:31:14.190 --> 00:31:16.289
good, you're not going to be able to take care

00:31:16.289 --> 00:31:18.289
of your family, your kids, do a great job at

00:31:18.289 --> 00:31:20.410
work, all those pieces. So hence how this all

00:31:20.410 --> 00:31:23.170
ties together so beautifully when, again, like

00:31:23.170 --> 00:31:24.589
women in leadership, yeah, we're all impacted.

00:31:24.650 --> 00:31:27.130
And those numbers that you shared are staggering.

00:31:27.019 --> 00:31:29.619
staggering. So let's take the time to prioritize

00:31:29.619 --> 00:31:32.740
ourselves first and feel better. Feel better.

00:31:32.839 --> 00:31:36.039
Amen. Thank you, Dr. Trotman, to just be able

00:31:36.039 --> 00:31:38.119
to function in your life. So I appreciate everything

00:31:38.119 --> 00:31:40.339
you have done for me. And definitely, I'm sure

00:31:40.339 --> 00:31:42.940
all your patients feel the same. So thank you

00:31:42.940 --> 00:31:44.119
for sharing. It's the best job in the world.

00:31:44.200 --> 00:31:45.960
I know. I was thinking that. I'm like, you have

00:31:45.960 --> 00:31:49.859
a cool job. You help people sleep. You help people

00:31:49.859 --> 00:31:52.660
feel better. That's so awesome. Where can our

00:31:52.660 --> 00:31:54.519
listeners connect with you and find out more

00:31:54.519 --> 00:31:58.700
information? Yes. So my medical practice is in

00:31:58.700 --> 00:32:00.900
Camp Hill, Pennsylvania. It's called Midlife

00:32:00.900 --> 00:32:05.559
Remedy, R -E -M -D -Y. And I'm on Facebook, Instagram.

00:32:06.019 --> 00:32:09.079
My website is full of information and resources

00:32:09.079 --> 00:32:12.680
that your listeners can kind of check it out.

00:32:13.019 --> 00:32:15.839
And yeah, I'm seeing patients. And for those

00:32:15.839 --> 00:32:18.740
that are very busy, right, I have openings. next

00:32:18.740 --> 00:32:22.099
week. Oh, perfect. And you start off virtually,

00:32:22.299 --> 00:32:23.960
right? So it's even easier. You don't even have

00:32:23.960 --> 00:32:25.779
to drive anywhere. As long as you're in the state

00:32:25.779 --> 00:32:27.960
of Pennsylvania. Okay. Had to be in Pennsylvania.

00:32:28.119 --> 00:32:29.740
Good to know. Good to know. No, that's awesome.

00:32:30.059 --> 00:32:32.160
Well, thank you for sharing that and we'll connect

00:32:32.160 --> 00:32:34.119
all that in the show notes. And thank you so

00:32:34.119 --> 00:32:35.539
much for being here and thank you for helping

00:32:35.539 --> 00:32:38.119
women. Thank you for having me. It is the best

00:32:38.119 --> 00:32:40.740
job in the world and I'm, you know, this is why

00:32:40.740 --> 00:32:44.519
I'm here. Love it. Thank you. Thanks. Here's

00:32:44.519 --> 00:32:46.400
what I hope you take away from this conversation.

00:32:46.599 --> 00:32:48.700
You may have real stress in your life. You may

00:32:48.700 --> 00:32:51.160
be carrying a demanding job, a family, aging

00:32:51.160 --> 00:32:54.880
parents, a business, or all of it at once. But

00:32:54.880 --> 00:32:57.359
that does not mean stress is the entire explanation

00:32:57.359 --> 00:33:00.099
of why you suddenly feel exhausted, anxious,

00:33:00.440 --> 00:33:03.619
unable to sleep, or just unlike yourself. And

00:33:03.619 --> 00:33:05.259
it certainly does not mean you're losing your

00:33:05.259 --> 00:33:08.819
edge. Perimenopause is a normal biological transition,

00:33:09.140 --> 00:33:11.599
but as Dr. Troutman said, there is no medal for

00:33:11.599 --> 00:33:14.599
suffering. You do not have to keep powering through,

00:33:14.960 --> 00:33:17.519
blaming yourself or accepting that this is just

00:33:17.519 --> 00:33:20.339
simply how you feel. Start by paying attention

00:33:20.339 --> 00:33:23.019
to what has changed. Find a provider who understands

00:33:23.019 --> 00:33:25.960
perimenopause and is willing to listen. Ask questions.

00:33:26.440 --> 00:33:29.579
Explore the options that are right for you. Prioritizing

00:33:29.579 --> 00:33:32.160
yourself is not selfish, and it is not separate

00:33:32.160 --> 00:33:34.859
from being a strong leader. When you feel better,

00:33:35.099 --> 00:33:37.039
you are better able to show up for your work,

00:33:37.339 --> 00:33:40.759
your family, and your life. You can learn more

00:33:40.759 --> 00:33:42.720
about Dr. Troutman and midlife remedy through

00:33:42.720 --> 00:33:45.180
the links in the show note. And remember, this

00:33:45.180 --> 00:33:47.839
is common. This is worth talking about, and you

00:33:47.839 --> 00:33:51.299
do not have to figure it out alone. Until next

00:33:51.299 --> 00:33:53.200
time, stay loud and stay lifted.