Strong in Midlife: Advocating for Women through Menopause, Bone Health and More

[00:00:00] Welcome to Beyond The Paper Gown, I'm Dr. Mitzi Krockover. Today we're diving into a topic

[00:00:13] that touches the lives of countless women navigating midlife. So let me ask you, have

[00:00:19] you been experiencing hot flashes? Moot swings, changes in your skin and hair or even challenges

[00:00:26] in your intimate life. And are you wondering where to find reliable information or a healthcare

[00:00:32] provider who understands and can recommend solutions? Well our guest today, Claire Gill, faced

[00:00:38] the same questions and she took a remarkable step forward by establishing the National

[00:00:44] Menopause Foundation. This foundation focuses on supporting women seeking to understand

[00:00:49] the myriad changes that come with midlife, from finding help to successfully managing

[00:00:54] the transition at work. And in her dual role as CEO of the Bone Health and Osteoporosis

[00:01:00] Foundation, Claire also tackles the critical aspect of bone health, including its connection

[00:01:07] of osteoporosis to many women's menopause journey. We'll explore how these incredible

[00:01:12] organizations educate consumers, healthcare providers and policymakers about this phase

[00:01:18] of life. We'll also talk about the importance of education, programs and policy in addressing

[00:01:24] menopause and osteoporosis challenges. I am so glad you're here as we discuss how to

[00:01:30] make the most of these services offered by these organizations and what steps you can

[00:01:35] take to advocate for yourself, be it in your doctor's office or on Capitol Hill. And

[00:01:42] just a reminder that this podcast is for informational purposes only. Please consult your healthcare

[00:01:47] provider for any personal issues you may have. However, I encourage you to share this

[00:01:52] information with your healthcare provider so that you can have a robust conversation

[00:01:57] focused on your own healthcare needs.

[00:02:06] I am very happy and excited to welcome our guest today. You're going to get kind of

[00:02:19] a toofer. We're going to certainly talk about menopause, but we also are going to slide

[00:02:25] right into talking about osteoporosis. Let me welcome Claire Gill. Claire, please go ahead

[00:02:31] and introduce yourself. Hi, so nice to be here. I'm Claire Gill. I'm the founder and

[00:02:36] president of the National Menopause Foundation. And I'm also the CEO of the Bone Health

[00:02:41] and Osteoporosis Foundation. Wow, those are two big hats. So let's talk about the

[00:02:50] menopause foundation first and then we'll talk a little bit more about the osteoporosis

[00:02:56] foundation later on. And so how did you come to found the menopause foundation?

[00:03:03] Yeah, so it was very interesting and it's really very just like happens dance that this came

[00:03:12] to my attention as far as a real need in the nonprofit space. So I've been working in my

[00:03:18] background is actually marketing public relations and I have done that for more than 20 years

[00:03:23] in nonprofit and for-profit companies. And I was working in a nonprofit in the health

[00:03:30] space when it became to my attention that there was no patient advocacy education organization

[00:03:38] dedicated to menopause. And I was at the life stage where I was a parent and a puzzle and

[00:03:47] you know interested and confused about what was happening in that stage of life myself.

[00:03:54] And so did a little more background checking and worked with some of my close medical advisors

[00:04:01] and decided that this was a real gap and a real need. And so at the end of 2019 we launched

[00:04:09] the National Menopause Foundation and we've been really really pleased to see that menopause

[00:04:17] is getting much more awareness and attention these days in just a few short years.

[00:04:23] What does the foundation do? What are some of its programs and activities?

[00:04:28] Yeah, well our mission was we launched the organization was be attested in relatable

[00:04:33] resource to raise awareness and understanding of menopause through education, activism

[00:04:39] and community building. So all of our activities really center on those three areas. And basically

[00:04:46] we wanted to start with the education, providing a place where anyone can go to get information

[00:04:54] about menopause and the journey to and through menopause. And that website is the National

[00:05:01] Menopause Foundation.org. From there we also have a podcast called The Positive Pause where

[00:05:07] we take a look at one of those topics that are most important to women as they make that

[00:05:12] journey through menopause and interview experts around the symptoms of menopause but also

[00:05:18] empowering women to explore this stage of life in a very positive way. We also have a newsletter

[00:05:25] and we worked with several partners to come up with different types of programs that we

[00:05:30] felt were of most need and that could make the most difference for women as we try to improve

[00:05:37] women's health at midlife. So we last year partnered with Bank of America on a menopause

[00:05:43] in the workplace study, it's called Breaking the Stigma and it looked at what both employers

[00:05:49] and employees felt and experienced about menopause and where again were the gaps in what

[00:05:57] the people's knowledge was about menopause and also getting at what women's needs were

[00:06:02] to feel more secure and more appreciated and more understood in the workplace during this

[00:06:09] time of life. And then from there we created tools and resources that both women and employers

[00:06:15] can use to be able to have the conversation within the workplace about menopause and then

[00:06:22] again just a natural stage of life but one that does come with complications that people need

[00:06:28] to be aware of and so we were pleased to do that. We also just launched the Women's Midlife Health

[00:06:35] Policy Institute and we'll be doing a Women's Health Summit in March of this year bringing together

[00:06:41] leaders in clinical area, in business area and in the policy area to talk through not just menopause

[00:06:50] but all of women's midlife health and how can we advance it by collaborating and working together

[00:06:57] on a real agenda for what it's going to take to improve women's midlife health.

[00:07:03] So those are some of the things that we want to be on at least.

[00:07:07] Wow those are terrific and you know it really speaks to my heart because one of the things

[00:07:14] that I've always wanted to focus on is the multifactorial impact of various factors that impact

[00:07:25] on women's health and you just named a number of them. Not only you know just the physiological

[00:07:31] things that are happening to our body but also the impact at work and how that can

[00:07:37] make an impact as well as what we do know now maybe even in technicolor that policy really makes

[00:07:46] a difference in terms of how we get our health and healthcare and are able to be healthy.

[00:07:54] One of the other things I just wanted to add to that where you talk about that area is family life.

[00:07:58] We don't talk enough about the journey that women are experiencing and how that impacts the people

[00:08:05] that not only we work with but the people we know are in our relationships and I think that's an

[00:08:09] important aspect to talk to as well so that women know it's very normal to have those changes

[00:08:14] happening within your family and your relationships as well.

[00:08:17] That is so very true. Let's go back to the Bank of America study. What were some of the headlines?

[00:08:25] The headlines were really that what the employer felt they were doing to support women at midlife

[00:08:33] was far exceeded what with a woman and the employees were experiencing. Only 8% I think of women

[00:08:41] said that they felt comfortable or able to talk about menopause within their workspace and I think

[00:08:48] something like 30% of 30% to 40% of employers said they had support for women at midlife.

[00:08:56] And so again just that differing of where the two sides were on the comfortableness,

[00:09:04] the culture to talk about menopause and menopausal symptoms was very very different.

[00:09:11] I think that was really the biggest headline for us is that it's far off and then a lot of the rest

[00:09:15] of the insights from the study focused on what women wanted as far as support within the workspace

[00:09:24] and I think the good news is that there are things that we can take advantage of that companies

[00:09:31] aren't doing but that menopause is not named as one of the reasons you can benefit from one of

[00:09:37] those accommodations that are already in place. So when we think now about telework or flexible

[00:09:43] hours those things have become a little bit more mainstream in our post-COVID, mid-COVID wherever we

[00:09:51] are you know lives and so but it's not known that or stated that if you were experiencing

[00:10:01] you know symptoms of menopause you are allowed to benefit from those accommodations that are

[00:10:07] already in place in many workforces. So really it's more of a raising awareness and education

[00:10:12] within businesses about the needs of women at menopause and again fostering a culture where they

[00:10:19] feel confident to be able to mention menopause and to not have that negatively impact them based

[00:10:28] on again well if you're talking about menopause we can get a general gauge of your age you know

[00:10:34] again unless it's surgically induced or surgically required menopause then that's something

[00:10:41] that women are concerned about these days so we have that twofold thing it's a health issue

[00:10:45] but it's also an age issue. Well but you know it's really interesting when you say that because

[00:10:51] when the symptoms are more problematic it's really perimenopause. That's right. You know and

[00:10:59] that can start as early as you know it can start earlier than 40 but you know around 40 plus so

[00:11:06] you're really not that old you know but I do resonate with your comment that there is ageism

[00:11:13] because we don't think anything for example of seeing a 70-year-old male executive but

[00:11:20] we're not really seeing the same with respect to women. But that's more of a better

[00:11:25] state. In their 70s and 80s like you said that's very normal and there's like there's just no way

[00:11:32] that a woman would be considered you know for those positions at that age so you're right that is

[00:11:38] it. And you're right too about when the menopausal symptoms start and as we have changed a little bit

[00:11:46] if you think about the demographics of this of our society and even some of the societal trends

[00:11:51] where women are having children later in life you know rather than 20s it's 30s for me and many

[00:11:57] others it was early 40s and then you immediately go into perimenopause it's very confusing. It's like

[00:12:04] I just had a baby now telling me I'm perimenopausal so they're like you said we don't feel or think

[00:12:10] that we're old but when those symptoms start and even at 45 as we say well that's not old but if

[00:12:15] you're starting to exhibit its symptoms of menopause then there is the ages and attached to that that oh

[00:12:21] she's she's reacting to that and this is you know what's happening. And so we have a lot to tackle

[00:12:26] just from a societal point because again it's a healthy perfect stage of life if it's basically saying

[00:12:34] that we're living long enough to experience this stage of life which is you know really amazing when

[00:12:39] you think that you know how far we've come as far as extending the lifespan of people these days

[00:12:47] that's all good news and we just need to make sure that these medical questions that come up and the

[00:12:53] things that we're experiencing kind of catch up with where we're going. Sure and to your point I

[00:12:59] too had my second child in my 40s and I was having all of these symptoms that I assumed were part

[00:13:05] of the postpartum period and I'm a women's health expert. Yes.

[00:13:11] quote unquote but when you're in the midst of it you just don't know that so I would assume that

[00:13:16] even just increasing awareness in the workplace for women to know that you know they're not

[00:13:22] going crazy they can manage this. And so what comes up though is that women say I don't want to be

[00:13:30] the one that out you know that raises my hand and talks about this to my employer. So what are your

[00:13:36] suggestions that I know you said you had some tools from this study about how women can advocate

[00:13:43] for themselves without kind of putting themselves on the line. Well that's a very important point

[00:13:48] and that was the other thing that came out of the Bank of America study we did the Breaking the

[00:13:53] Stigma study is that it can't be incumbent on the woman to initiate this conversation. It really

[00:14:01] needs to be a thing that the corporate you know workforce puts into place and then allows that

[00:14:10] conversation to happen. So that was really stressful too because like you said it's no woman's going

[00:14:15] to jeopardize her job or her position by raising her hand and saying oh I'm you know having a hot

[00:14:20] flash I need to step out of the room right now. We need to have that already in place where

[00:14:25] women feel comfortable to be able to make adjustments as needed so that was one of the things and the

[00:14:31] tools in place are there's several things that are coming out which is terrific because thankfully we

[00:14:37] are no longer the only nonprofit in the menopause space and not the only nonprofit in women's health

[00:14:43] who were talking about menopause as part of overall women's health. So the Bank of America

[00:14:50] and National Manopause Foundation did create a sort of guide for the managers and the women to talk

[00:14:59] about how to initiate the conversation and that's available like free to download. We also created

[00:15:06] for women a symptoms checklist, a menopause symptom checklist. I know we'll talk a little bit more

[00:15:11] about what those some of those symptoms are but when we think about it again in a society and what's

[00:15:16] joked about are those hot flashes right? Oh women are experiencing the hot flash but there are so

[00:15:21] many symptoms of menopause. We focus on 34 of the common but in a format that we can

[00:15:30] track what symptoms we're experiencing, the duration of the symptoms and the intensity

[00:15:36] and to use that to have a conversation with the healthcare providers about what we're experiencing.

[00:15:41] And I know we've been focusing on workforce but the other big education area is with healthcare

[00:15:46] providers. There are far-shifu experts who know how to treat women at menopause. Women are experiencing

[00:15:56] these symptoms and they bring it up to their doctor and then they're dismissed. Either you're too

[00:16:01] young for this to be happening because perhaps you are in your early 40s and the doctors aren't aware

[00:16:06] about how early some of these these symptoms can happen or they get it's just menopause

[00:16:14] and they're sent on their way without any discussion about how to treat the symptoms of menopause.

[00:16:21] Some of it can be very severe and very debilitating unfortunately for women, other women

[00:16:27] have no bad experience with it. So it really is a very personal and individual thing and so we need

[00:16:33] to provide these tools for women again track what's happening in your body and as these changes

[00:16:38] are happening and then being able to take that to your you know your healthcare provider

[00:16:44] That's terrific and we will have links to all the resources that you're talking about

[00:16:48] in our podcast notes so thank you for that. Before we leave the workforce issue

[00:16:54] what would be the argument for the bottom line benefit for these employers even if they

[00:17:00] over and above it's the right thing to do? Yes, unfortunately in our society it's the right

[00:17:07] thing to do is not the impetus that we need so there is always that economic aspect to business.

[00:17:14] So it's twofold one is we do have plenty of data that shows the loss of productivity

[00:17:23] that businesses are left with when women in the workforce are experiencing a

[00:17:28] menopausal symptoms and I sort of have a love hate relationship with those statistics

[00:17:34] because what we need in addition to what the loss is that happens when women

[00:17:41] of our experiencing the menopausal journey what we don't have in data is what we bring

[00:17:47] to businesses at this stage of life and I think we need both of those to make an accurate

[00:17:53] comparison as to why businesses should pay attention to women at men life.

[00:17:58] Again when we say the average age of a woman entering menopause is 51 in the United States

[00:18:06] but those symptoms begin much earlier and we're really an oftentimes at the height of our careers

[00:18:12] then so the capacity that we bring to our employers as far as our knowledge or expertise the

[00:18:19] ability to make decisions be able to perform in a timely manner the ability to manage.

[00:18:25] We need to quantify those because what we've done is started with oh women are missing this many

[00:18:31] days of work due to these symptoms and you know some statistics are up to 30% of women leave

[00:18:38] the workforce at this stage of life and many will then say it was due to symptoms of menopause

[00:18:44] and not feeling capable of being able to perform at the level that they were performing at

[00:18:49] because of the symptoms and so we need that balance so right now we do have the look you're

[00:18:55] losing some of your best employees because they're leaving the workforce and you have to replace

[00:18:59] them and retrain them etc so retention of employees retention of some of our best

[00:19:04] and most capable employees is really the bottom line incentive I think for most

[00:19:10] companies to consider addressing this in addition to it's the right thing to do.

[00:19:16] I want to underline the importance also that I'm sure that you're addressing and that is not just

[00:19:24] to educate women but certainly all the people around them and because I do think that if

[00:19:33] everyone understands what the issues are then it makes it a lot easier. I'm going to add a little

[00:19:39] dendom because I had a guest on who from the UK who has a menopause education program she goes

[00:19:47] into the schools and teaches kids about menopause and it was a light for me that says I have two girls

[00:19:56] in their 20s. I didn't even think about talking to them about menopause you know shame on me

[00:20:01] so I think to the extent that we can increase everyone's awareness it's valuable.

[00:20:10] You brought up an interesting point about education in schools and such and it's absolutely true

[00:20:16] and I talk about this all the time we learn about puberty and we learn about reproduction

[00:20:22] in school and yet that's where it stops there's no conversation we don't even do that very well right

[00:20:28] about but there's but there's basic education and I share this often so again later in life mom

[00:20:35] as we're called my daughter is only 12 now and last year in sixth grade they were learning

[00:20:41] about puberty and so she raised her hand class and said and at the end it's menopause and this

[00:20:50] is what happens. Oh that bless her. Well that's great like we said one school with why isn't that part

[00:20:55] of the curriculum right to be able to discuss the full life spectrum and that again if we want

[00:21:00] to we get to do a whole nother podcast about oh women's value ends when our reproductive years ends

[00:21:06] and therefore why teach people about what comes at the end. I do think we will get to that stage

[00:21:12] but there's sometimes it's overwhelming let me see I have to say because I think

[00:21:18] there's just basic education that women who are experiencing menopause need to get right now

[00:21:25] about what's happening to our bodies that we don't know about so I sort of feel like that's the

[00:21:30] immediate audience and then clinical providers so that when they are if they do figure out oh this

[00:21:36] is what's happening to me and this one when they can go to a clinical provider who doesn't tell them

[00:21:40] I won't prescribe hormone replacement therapy or menopause therapy because of a study that is long been

[00:21:48] corrected the Women's Health Initiative about the risks of HRT and then there's again the immediate

[00:21:55] the workforce issue that we have to address for the women who are currently experiencing it so I

[00:22:00] feel like we're in stages right we have the good news is we have now attention with even celebrities

[00:22:06] on Capitol Hill and celebrities on television talking about the fact that they've gone through this

[00:22:12] journey and they didn't know and why don't we know and asking all the same questions that we're

[00:22:16] talking about and then that's important that needs to be the general awareness but it's still a bubble

[00:22:25] right there's still only certain levels of women in our country who are having this conversation

[00:22:30] and we need to make sure that there's access to that information for all women and I said the

[00:22:35] same thing about our Bank of America study I love that we did the study it was so important and

[00:22:40] we're learning so much and we're hopefully going to take some really positive steps to

[00:22:43] continue to work to change that but that's really only talking about women in offices right

[00:22:49] we haven't we're not addressing hourly wages or the hospitality industry or you know all of those

[00:22:55] other women who are working moms at home you know all of that needs to be addressed as well

[00:23:01] so while you know we pat ourselves on the back for coming forward and having these advanced studies

[00:23:06] and working on these guides for the workforce which is incredibly important there's still so much

[00:23:10] work to do even within that space and so I think it'll be a while honestly before we turn our attention

[00:23:18] to getting menopause added to the curriculum of every health program and grade school you know

[00:23:25] across the country but we will get there and how are you addressing getting education to

[00:23:33] making it more accessible to women well the we right now are working on a self-directed learning

[00:23:41] program that women can get at their convenience about the symptoms of menopause because great

[00:23:52] information available you know on our website and on other websites and there's great webinars

[00:23:56] happening but many of the women that we talk to and I know even how I like to learn is a little bit

[00:24:01] more of a deeper dive into well why is this happening to my body and well what is the research that

[00:24:06] shows that this is the right treatment etc. And so we're creating that curriculum in self-directed

[00:24:12] learning modules we're going to have four initial modules we're going to work through all the

[00:24:17] symptoms of menopause that we focus on in the checklist but the first four are our basic

[00:24:22] menopause 101 vast of motor symptoms which are technical clinical term which just means hot flashes

[00:24:29] in night sweats those are the symptoms that we call vassar motor symptoms sleep disruption

[00:24:34] which another big one for as far as the number of people who experience that symptom going through

[00:24:40] menopause and then things that have to do with the pelvic floor and the things that we experience

[00:24:46] as far as urinary infections vaginal dryness sexual health issues all of the things that we don't

[00:24:54] talk about and don't help women understand so those will be the first four modules that we

[00:24:58] will launch hopefully at the end of the first quarter of this year and then we'll again start building

[00:25:04] onto all of the others and as I said the basic information is available on our website but those

[00:25:10] modules will be available and we're also partnering with other companies to do local tours

[00:25:15] local events that will be particularly focused on democratizing menopause and making the information

[00:25:25] available in communities and in places that we're not normally having these conversations so

[00:25:32] we want to go to churches and community centers and you know areas that any women can access

[00:25:37] to find out information about her journey which is also really interesting about women and our

[00:25:46] uniqueness and our power is the menopausal symptoms actually different depending on our ethnicity

[00:25:52] and so that's just right in my mind that was my next question yeah that's something really important

[00:25:57] for people to understand and so again it's really important to speak to people within their

[00:26:02] community from people they trust and provide access to local experts that they can follow up with

[00:26:08] I've been to some fantastic events and again i'm so excited that this is you know becoming

[00:26:15] something that is more mainstream and that there are these events happening both like I said

[00:26:19] there's celebrity companies that are now producing events or other great nonprofits we work with

[00:26:25] they're preventing events but you know again they think there's a cost associated with them and

[00:26:31] you know a time commitment like you know again having it during the middle of the day so

[00:26:36] that again is accessible to certain women but not all and so we're trying to work with

[00:26:41] and focus on partnerships where we can get into community and provide either free or very low-cost

[00:26:48] events where again local experts are made available to help women and so we're

[00:26:52] hope to be launching that tour this year um and so lots of really important things happening and I

[00:26:58] know it's like well they should have been been going on for years but remember we had the pandemic

[00:27:02] we were all indoors for a number of years and so we're now just able to take this from a virtual

[00:27:09] setting into live settings around the country that's very exciting you also mentioned that you do

[00:27:17] some policy work I'm very interested in that yes so again one of those gaps that we saw strategically

[00:27:25] as we thought through what do we need to do to advance women's health and particularly at midlife

[00:27:32] was um this need to both do top down and bottom up that's what we call it you need the grassroots

[00:27:39] effort from women demanding that there be attention paid to midlife women's health but then you

[00:27:45] also have to start with the federal agencies and congress and making sure that they're aware and

[00:27:50] that they too are advancing some of these so the good news there lots of activity happening as well

[00:27:57] there are several members of congress um who are enacting and putting forward legislation to address

[00:28:05] the menopausal journey and both from a research aspect but also from a access to care

[00:28:13] that the other big thing is we have treatments available many of them are generic

[00:28:19] that women have access to that should have access to and yet they they aren't getting access to

[00:28:24] and it's a very complicated situation for why that's happening as I mentioned earlier a lot of people

[00:28:32] or you know even clinicians are still confused about hormone replacement therapy and

[00:28:37] I should probably say what that confusion is just for those listening that may not be aware but

[00:28:41] the women's health initiative which was so fantastic and is fantastic and continues to this day

[00:28:47] was the first real federally funded study that looked at women's health and a fascinating fact for

[00:28:54] me is that it was only 30 years ago last year where it was federally mandated that women be included

[00:29:01] in clinical trials prior to that just for all of us to know studies were done on men and then they

[00:29:07] just applied it to women because we white men yeah we were too complicated to study too expensive

[00:29:16] to be involved in it so really it was only 30 years ago that it was federally mandated that

[00:29:20] in any federal research women be included in the clinical trials so the women's health initiative

[00:29:25] obviously then was another giant step forward where it was looking at and tracking longitudinally

[00:29:31] long-term women's midlife health well sorry women's health what happened then was when they

[00:29:36] were looking at hormone replacement therapy some big headlines came out and it's based it said

[00:29:42] that women on hormone replacement therapy had an increased risk of breast cancer

[00:29:46] and heart disease of two of many and that those were the headlines and for those of you who are

[00:29:53] my Joe Harat midlife or beyond you probably remember the big discussion about it and then again

[00:29:58] everyone went off hormone replacement therapy because oh we stopped prescribing it and I just

[00:30:03] you know and then I started feeling guilty exactly it was just a cold hard stop the good news on

[00:30:11] that is again the study continues and then we learn more and now they have come forward and made

[00:30:18] the people aware of that oh there was a flaw in that study when it was when they the announcement

[00:30:23] or the outcome of it when they said you know that hormone replacement therapy was a risk

[00:30:28] that was looking at women who were on hormone replacement therapy like when there have been

[00:30:32] 60s and beyond well for those of us who would be starting hormone replacement therapy at the

[00:30:38] onset of manopause like in the symptom time you know paramanopause manopause there was no increased

[00:30:44] risk of either of those diseases so as you said we stopped cold turkey and that whole generation

[00:30:51] of women suffered through those symptoms and like you said lost bone density other things that

[00:30:57] we would have benefited from had they been on hormone replacement therapy and now we know that this

[00:31:01] is the case but the problem is there's no big headlines there's no giant campaign telling people

[00:31:09] hey we now know this from the study she'll find both women and many clinicians still will not

[00:31:17] consider taking any type of hormone replacement therapy because of the risks that were associated

[00:31:22] with that study which we now know were not related to women actually entering manopause so that

[00:31:29] again when we talk about policy stuff and things yes policy is one aspect of it but it is not the

[00:31:34] only reason that women aren't accessing the treatments that are readily available and effective

[00:31:40] you know we have a lot of work to do again on those education but back to the policy just even having

[00:31:46] women's midlife health the menopause be mentioned in legislation is super important and one of the

[00:31:51] ones that we were very pleased to be part of with the another nonprofit that is focused on menopause

[00:31:57] called let's talk menopause we partnered to how bring forward a menopause research and equity

[00:32:06] act that to female congresswomen brought forward that Clark in New York was the spearheader of this

[00:32:15] legislation and there are many many co-sponsors and again with this podcast you can get access to

[00:32:23] you know the legislation and who's involved and that basically said directing the national

[00:32:28] institution of health to direct some of their funding towards studying research gaps for women

[00:32:34] at menopause and that's really really important since then there are several more members of congress

[00:32:43] who have put together very interesting very in-depth legislation that is also looking at other

[00:32:50] areas workplace access etc in addition to research that is so important and so all of that is very

[00:32:57] good news and we're going to kind of continue to follow that and see where that goes but part of

[00:33:02] the impetus of it starting the women's midlife health policy institute was to bring together all

[00:33:10] the organizations and stakeholders focused on women's health at midlife across the board not just

[00:33:15] menopause but heart disease bone cancer diabetes fibroids you know there's so many things that change

[00:33:24] and have an impact on us as we you know journey through midlife but that collaboration portion is

[00:33:31] really key when it comes to making a difference the whole were stronger together you know kind of

[00:33:36] motto is is really what's what's meant for that absolutely if an individual is listening today and

[00:33:45] they said god i want to do something how can i help push this forward what would you suggest to

[00:33:52] them in terms of some of this legislation should they get in touch with their congressperson yes

[00:33:57] I mean there's several ways to get involved in general in supporting and educating about menopause

[00:34:01] across the board and on the legislative side absolutely get to know your members of congress offices

[00:34:09] call them we talk about i go i'm just outside Washington DC i do spend a lot of time going doing

[00:34:14] education you know programs on the hill and i'm told by all of the staff they prioritize what

[00:34:22] they're focused on based on their constituents interest and outreach so we need to be calling our

[00:34:28] members of congress getting on their list that they know oh Claire gale is called again and she wants us

[00:34:35] to focus on this particular legislation again it really matters i mean i can bring all the best

[00:34:41] experts to Washington and to sit with them and i do but obviously the way congress works is they

[00:34:49] are responsive to their voters and so your power as a constituent from you know

[00:34:56] demoing to your senator and to your member of congress is far more influential than mine going

[00:35:02] to your member of congress and senate right so yes to do that again i mentioned let's talk menopause

[00:35:08] our colleagues in new york they actually if you go to their website they we have a sign-up sheet

[00:35:14] where you can be involved in it'll help direct you and let you directly contact your member of

[00:35:19] congress from their website but you can just google your member of congress and get both their

[00:35:26] district office information and they're Washington dc office information and i would say email and

[00:35:31] call and just let them know get on their radar and say hey i'm a woman in your district and i vote

[00:35:37] and this is what's you know important to me getting involved in other things too is really important

[00:35:42] we are um work often with medical education and training programs for health cleric professionals

[00:35:48] where they want the patient voice they want the woman's voice to be included in that training

[00:35:53] and we tap into the women that are part of our network and they volunteer or not to

[00:35:59] that's actually sometimes a paid um option where they become involved in sharing their story

[00:36:05] to help educate clinicians so again having that younger woman who said at i went through five

[00:36:13] years of suffering with these things because no doctor even mentioned to me that could be

[00:36:18] menopausal i was checked for dementia i was checked for cancer i was checked for this and then

[00:36:21] and then it turns out i was in pariamanapause and i really just needed hormone replacement therapy

[00:36:27] and so hearing that directly from women is super important so they can just email info at national

[00:36:35] menopausefoundation.org and express their interest in that and we again sort of coordinate how to

[00:36:41] share those stories with medical providers um and and get involved so like i said lots that we can do

[00:36:47] to immediately engage um and and create that space for uh raising awareness and influencing

[00:36:55] legislation that's coming down the pike. Terrific when do you sleep?

[00:37:01] well you know we don't sleep at midlife that's one of the symptoms.

[00:37:04] so my eyes won't put your word put it toward. we can be very productive at two o'clock in the morning

[00:37:12] that is very true so i want to talk a little bit because you know i've been immersed in this

[00:37:18] ecosystem and there's been so much going on in the last few years especially with menopause

[00:37:25] programs for profit menopause programs services devices supplements and all of that so talk a

[00:37:34] little bit about some of the things that you're really excited about then also how do consumers

[00:37:42] make sense of the quality and the effectiveness of some of these things.

[00:37:46] that's a very very good question. there are lots of um companies now interested in

[00:37:57] this particular life stage because it's been already excited on the economics being tagged as a

[00:38:04] multi-billion dollar potential industry. the first foray into it where people were really

[00:38:10] being vocal about it tended to be around skin care which i find particularly interesting and

[00:38:16] funny in another statement to our society right that that's how we we tackle what women are

[00:38:21] experiencing at midlife is you know what do we look like. i would say skin issues are an absolute

[00:38:28] symptom and dry skin is a symptom of menopause and the impact that that loss of estrogen has on our

[00:38:35] you know our physical physiology is just incredible so dry skin is an issue so you will find a lot

[00:38:40] of things out there as far as creams and moisturizers etc etc it's up to you on those

[00:38:46] instances to judge for yourself whether or not you need something specific to menopause

[00:38:50] or whether the moisturizer you generally use will also help with your dry skin so i don't see

[00:38:56] just be cautious on that. the thing i'm most excited about is and when probably the least exciting

[00:39:04] for the population though are the therapeutics i mean like i said the fact that we now know that

[00:39:08] hormone replacement therapy can address so many of these major debilitating symptoms that we're

[00:39:14] having that's really exciting to me and making more women aware of the fact that that's available

[00:39:19] and again because with hormone replacement therapies run around for so long it's almost always

[00:39:23] you know genetic and so and there's so many different delivery mechanisms for hormone placement

[00:39:29] it can be a patch it can be you know a pill it can be a topical ointment you know there's so

[00:39:34] many different ways of women getting it and then it really is up to you and your health care provider

[00:39:38] to choose what works for you best and what do you want an experiment with and that's really great

[00:39:42] but the other aspect of that is for those who really can't do hormone replacement therapy

[00:39:48] for whatever medical reasons we now have non-hormonal solutions that are on the market

[00:39:54] and that's really important and um one of the the newest ones just got approved by the FDA last year

[00:40:01] so really again there's there's so much need and we just haven't had these and the fact that

[00:40:06] that hadn't been in the you know that there's not tons of these options and the pipeline coming

[00:40:09] through is really you know disappointing and the fact that now we have those is really terrific

[00:40:14] so there are there are one that's already done just been approved by the FDA and another that is

[00:40:23] you know finishing its clinical trials with the FDA that are both again non-hormonal

[00:40:30] treatments for vascular motor symptoms and I think can really exciting as far as devices and things

[00:40:37] again new things coming on the market every day that can you know check your temperature regulate

[00:40:43] you know your your pulse you know all of those kinds of things um good and bad right I think it's

[00:40:50] going to be very individual I think some woman will really benefit from being able to have those

[00:40:55] tracking mechanisms that help them you know detect when they're having a hot flash and you know

[00:41:00] provide that opportunity to do well I think you kind of know when you're having a hot flash but this

[00:41:04] is more to help provide some relief as you're as you're starting you know to your body temperature

[00:41:09] is changing maybe and being aware of it and I think some of those are are um are interesting and useful

[00:41:15] one of my cautions would be probiotics there are a ton of probiotics and supplements that have

[00:41:23] are coming to market and are coming to market and the reason that's not that happens so often is

[00:41:29] because they're not regulated by the FDA so their process of bringing to market is a lot quicker

[00:41:36] than it would be for something that was actually regulated by the FDA and um that means there's not

[00:41:42] the oversight that there would be of um of other kind of treatments that would be you would take

[00:41:48] so you have to be very very careful with that and I would say if you're considering it it's still

[00:41:56] important that you talk to your health care provider about the type of probiotic or supplement

[00:42:00] that you're considering um and what the benefits and what the risks are I think one of the really

[00:42:07] terrific ones that again do know harm but actually can do good are sort of the wick clothing

[00:42:13] that we think about that when you're having a flat-fash or a night sweat you know pajamas that

[00:42:18] provide breathability or that that it's almost like the same um the same material that we use for

[00:42:24] sports you know to like take off the sweat as we're working out and stuff like that cooling sheets

[00:42:29] you know all of cooling pillows cases you know those kinds of things that I think were never around

[00:42:35] or never considered before and the fact that those are available to women should they need them

[00:42:42] should they be in a position to be able to get them are things worth considering

[00:42:47] sure and also I think another area that has come into its own perhaps is sexual health

[00:42:56] and so again with a lot of uh menopausal symptoms include what you talked about earlier genital

[00:43:03] urinary and let's just call it vaginal dryness yep but you know when we think about it

[00:43:08] lube has been on the market for decades right and so do we need something specific to menopausal

[00:43:15] vaginal dryness not so sure right maybe you do and if you want to do that that's terrific but also

[00:43:20] again the fact that we don't have that sexual health education for women anyway and men

[00:43:27] and talk about what that is and the importance of that and it's it's interesting because

[00:43:32] I would say of all the events I go to there's there's probably at least three of the sessions

[00:43:38] about sexual health as a symptom and um it's interesting to have that being discussed because

[00:43:45] you couldn't say the word vagina you still can't say the word vagina on television and in other

[00:43:49] areas in many cases and so the fact that we're talking about women's sexual health and pleasure

[00:43:56] and what that means and how how important that is to our overall health and well-being

[00:44:02] is is really fantastic and I think that's a great advancement and we need more of it as we have

[00:44:08] this conversation about what does midlife health mean and going to your point about policy

[00:44:14] and I hear this from entrepreneurs all the time especially in the sexual health area but even in

[00:44:20] just menopausal area as well when they're addressing vaginal dryness is that they get censored

[00:44:27] on social media so they can't even get their products out can't get the education to women

[00:44:34] there are things that are really like you said it's really important to to health from the

[00:44:41] sexual health aspect of it and the benefits of it and that it should be something that is considered

[00:44:46] as part of the what does healthy aging mean healthy aging also includes sexual health and being

[00:44:52] able to explore that part of our you know our journey and our needs is really important and as you

[00:44:59] said yes there's barriers put up everywhere on social media on on television as I said on things

[00:45:05] that you can't do um in can't say and so it was exciting to see a menopause as a super bowl

[00:45:11] commercial thanks to one of the new or um non-human normal placement companies talking about it

[00:45:18] that's a big stride right that's a that's a positive that that was happening and so we just need

[00:45:22] to make that more mainstream and I think that's really part of again what I hope our purpose and

[00:45:28] our journey will be at the national menopause foundation is by the time my daughter is approaching

[00:45:34] this stage of life it should be something that she completely understands and can get access to

[00:45:40] the care she needs and clinicians know how to address whatever symptoms she might be experiencing

[00:45:45] I want that for all women and all people who are experiencing menopause symptoms

[00:45:59] so shifting topics because I want to talk about your second hat and that is as the executive

[00:46:06] director of the boat health and osteoporosis foundation did I get that name you did because I

[00:46:13] know it changed the name we changed the name we branded in 2021 we were the national osteoporosis

[00:46:19] foundation and when I took over as CEO although I'd been with the organization for 10 years uh when

[00:46:25] I when I came on and uh a CEO one of the things again given my marketing and PR background was to

[00:46:32] look at what we've been doing over the past 30 years at the time 30 plus years and what people

[00:46:38] thought of us and looking landscape and it was really interesting to you know do the research and

[00:46:44] dive into all of this opinions in of all of our stakeholders including people who did not know

[00:46:50] of our organization or what we did and everybody wanted to keep osteoporosis in the name

[00:46:56] the feedback we got was they wanted prevention and bone health to be discussed as much as we

[00:47:03] discuss managing the disease of osteoporosis and so that's how we became the bone health and osteoporosis

[00:47:09] foundation so talk a little bit about what BHOF does in its mission so BHOF is the nation's leading

[00:47:17] patient advocacy education organization and bone and osteoporosis in the US and we're a hybrid

[00:47:24] organization in that we are not only the leading patient education organization but we also provide

[00:47:31] continuing medical education for healthcare providers about bone and osteoporosis and so those

[00:47:37] are our two areas of focus as well as policy we also run the National Bone Health Policy Institute

[00:47:44] again knowing that that's the third leg of the stool in what we need to do to make sure we're advancing

[00:47:51] bone health in America so when we talk about the connection between menopause and osteoporosis it's

[00:47:57] that when we go through menopause and postmenopausal women can learn of lose up to 20% of our bone density

[00:48:06] in the first five to seven years postmenopause so one of the things we truly are at greatest risk for

[00:48:13] as we approach menopause is osteoporosis and I think that's something that so many women who

[00:48:22] have osteoporosis say to me as a you know on the see as a CEO of BHOF why didn't I know

[00:48:29] why didn't someone tell me when you know at menopause that I needed to change my diet and get more

[00:48:34] calcium and vitamin D and work on these weight bearing exercises and do all of these things and

[00:48:39] we all have that same question too why don't we you know currently you can get a bone density

[00:48:46] scan as a woman at age 65 if once you're on Medicare it's free to all people on Medicare

[00:48:54] and that's terrific but by 65 you are likely you know in a matter of either already osteoporodic

[00:49:01] or in a much higher risk for osteoporosis and so we are working to change some of the

[00:49:09] the ways that we address screening for osteoporosis in bone health on the policy side lots for people

[00:49:16] need to be involved in saying you need to pay attention to the you know bone health and osteoporosis

[00:49:22] and fractures um to their members of congress but those are the things that we're working on that's

[00:49:27] what the organization does I feel like there's so many connections between that menopause again

[00:49:33] the basic education and awareness about how our bone and structural are you know skeletal

[00:49:37] health works something that many of our clinical experts have said was as osteoporosis is a

[00:49:43] pediatric disease that manifests as we age because we build the densest strongest bone we're going to

[00:49:52] get by the time we're in our mid-twenties and that's why we need to tell the tell kids

[00:49:59] that even though they may or may not listen because if you miss it by 30 then exactly then

[00:50:05] you're already deficient and then the body it's a living tissue that remodels throughout our lives

[00:50:12] you know so I think people know like your skin you know you slump the skin you get new skin

[00:50:16] it regenerates so do our bones and that remodeling process is healthy and happens throughout our life

[00:50:24] it does slow down a little bit as we age so we don't build bone as fast as we make bone and so

[00:50:30] sometimes that is why people think oh it's just a normal part of aging no that's minor it is much

[00:50:37] more impacted by people who have both controllable and uncontrollable rexpectors and so like you said

[00:50:45] really important to pay attention to if you're you know at a life stage where you have grandchildren

[00:50:51] your grandchildren need to be getting calcium and they need to be doing weight bearing exercise

[00:50:56] jumping running all the things that we did you know before we got on computers and just played on

[00:51:00] iPads or games and stuff you know they had to do that to be that and then again we built

[00:51:05] throughout our lifespan and then bringing it back to our menopause discussion the reason people think

[00:51:10] bone and osteoporosis is a woman's disease is because it happens more rapidly and more frequently

[00:51:18] to women due to the loss of estrogen at menopause for men it it's absolutely a men's condition as

[00:51:24] well it just happens a little bit later in life because they don't have a huge drop off in progesterone

[00:51:29] the way we do of estrogen and so those are the kinds of things that we need to pay attention to

[00:51:35] and another reason why again I think the collaborative look at women's health is so important

[00:51:41] because all of these things play from on one another if women were getting the estrogen they needed

[00:51:47] at the onset of menopause they would be continuing to build their bone strength and maintain

[00:51:53] their bone strength for a lot longer then we currently have it because women aren't taking any

[00:51:59] estrogen replacement and so it really is important that we work together to figure out how do we

[00:52:05] advance all women's health at midlife and make sure women are aware of all of these different

[00:52:11] conditions that play such an important role in active healthy aging and then there's other things

[00:52:19] too as far as what we know is good for our overall health and I say this too I need to practice

[00:52:27] what I preach but exercise movement healthy eating all of those things play such an important role

[00:52:37] in our health and adjusting to every stage of life including menopause they'll really have to pay

[00:52:45] attention to it and I think if we do again if we do those things there are many many ways that we can

[00:52:52] address the menopausal symptoms that we're having it doesn't mean it's going to clear them up entirely

[00:52:58] but it will help you manage and that's what it's all about right you know being productive and healthy

[00:53:04] and living through it and being able to manage whatever it is you're experiencing so I would

[00:53:09] encourage women to first look at all of those those habits those healthy habits things that we maybe

[00:53:15] have let slack or that we just like me need to put into practice and do those things and then again

[00:53:25] if there's you know continuing of symptoms that are just really debilitating to please please seek out

[00:53:33] experts who can help you to address them because there's no first look there's no prize for suffering

[00:53:40] and there's no need to suffer so as we're wrapping up what did I not ask you that you wanted to make

[00:53:49] sure our listeners were aware of well we covered a lot menopause and we could probably do several more

[00:53:58] obviously on these topics so I would say there's nothing that you didn't ask I would just like to

[00:54:03] reinforce for women that you know menopause is a natural stage of life it is not something to be

[00:54:09] embarrassed or shamed by regardless of whatever society tells us about aging it is a spectacular

[00:54:16] time of life and you will hear more and more from women talking about which I love to see and I've

[00:54:21] just was watching so many influencers and celebrities talking about man how great they feel at this

[00:54:30] stage of life I think Jody Foster just did it Michelle Obama just did it really recently talking

[00:54:34] about this is an amazing life stage and so try to keep that in mind as you approach this stage of

[00:54:41] life that it is again there are there are so many positives that come with it in addition to the

[00:54:48] symptoms that we keep talking about and then you know again to try to find a trusted healthcare advisor

[00:54:56] who is you know really will listen to you about your symptoms and help you address them if you are

[00:55:02] suffering again there's no need to suffer and becoming aware in general of what's happening

[00:55:09] to your body at this stage of life and again on our website you can see those symptoms checklist

[00:55:14] and know that you're not alone we didn't cover so many of the things that you know women talk

[00:55:20] about when we talk about brain fog or anxiety and depression where you've never had it in your life

[00:55:25] you're not that type you know you never been an anxious or depressed person and all of a sudden

[00:55:29] you're having these feelings and wondering what's happening to me and all that's happening is

[00:55:35] you're going through the next life stage um so I think just knowing what to expect knowledge is power

[00:55:43] right we talk about that all the time in so many things and it's the same with this learn to

[00:55:48] know your body and what's different in your body and then being able to address that and I hope

[00:55:53] women will reach out for all of the great resources that are available to help them with their journey

[00:55:59] well Claire Gill who is the UN Founder of the National Menopause Foundation as well as the executive

[00:56:07] director of the Bone Health and osteoporosis Foundation I can't thank you enough for

[00:56:14] this conversation as well as what you're doing for women thank you so much for covering this

[00:56:20] topic i'm so delighted to have been here

[00:56:28] the transition to menopause can be a significant change for a woman but as you heard from Claire

[00:56:34] Gill today it is not all doom and gloom it can be a wonderful new phase of life with many possibilities

[00:56:41] the challenge for all of us is to manage our symptoms so that they don't get in the way of our

[00:56:46] enjoyment and that means finding solutions and recommendations through our health care providers

[00:56:52] and through other resources such as the National Menopause Foundation and the Bone Health

[00:56:56] and osteoporosis Foundation I encourage you to check out both of these organizations

[00:57:02] and the resources we've provided you in the podcast notes you can also check out our website

[00:57:08] at beyondthepaparegound.com for articles and other resources and while you're there please subscribe

[00:57:14] to our newsletter we not only alert you to our latest podcast but you'll also find information

[00:57:19] on resources articles events and news focused on the health of women you can also tell us what

[00:57:27] topics you want to hear about next by sending an email to infoatwomencenter.com or just ping us on

[00:57:33] the website thank you for joining me today and please take good care

[00:57:50] our episode was produced by Patrick Shabayati and myself and our associate producer is

[00:57:55] Kyla McMillion