Empowering Midlife Wellness with Dr. Susan

These recent times have left many of us feeling very unsettled and uncertain, and feeling like we have no agency to change things in the world. Today, I’ll share a simple way to switch our mindset from feeling like the world is “happening to us” where we have no power, to a place of agency and choice. From this place we can move forward even in difficult times and make positive changes that affect us and all of those around us, moving towards creating the optimal older version of ourselves.

Many patients ask how to find a menopause provider and how to evaluate your provider’s credentials and education. At Complete Midlife Wellness Center we are proud to have three Board Certified Ob/Gyn physicians who are certified through the menopause society, as well as nurse practitioners with menopause society certification. We are thrilled to announce that Dr. Hillary Boswell will be joining us in November to expand our services, and huge congratulations to Brandi, Hollie and Hayley who recently passed their menopause society certification exam! If you are a provider interested in joining our provider education program in 2025, please email [email protected] to be added to the first to know list. A link to our Menopause Education Platform will be provided as soon as possible, and no later than early 2025.

Reduction in bone density, which can lead to osteoporosis and increase our risk of fracture as we age is one of the most important goals of a healthy second half of life. We’ve talked extensively before about the benefit of menopausal hormone therapy for reducing the risk of osteoporosis, but today I’m going to focus on how important exercise is in the process of helping our bones to stay healthy and even to improve their strength. Traditionally as women age and develop low bone density, we were taught to stick with very low intensity exercises, but this has been shown to not only be incorrect, but also harmful. Strenuous exercise, including use of heavy weights is not only safe if monitored properly, but incredibly beneficial for improving bone density and reducing the risk of falling and fracturing, as well as improving quality of life!

MUST-WATCH VIDEO - Queensland research helping osteoporosis sufferers - The Bone Clinic https://www.youtube.com/watch?v=9EZw_wrFnmI

The LIFTMOR Randomized Controlled Trial

https://drive.google.com/file/d/1ZNh1GfV02RPVVpkGtkIwSbYvDaJ5vWlU/view?usp=sharing

While knowledge about how to be healthier is skyrocketing, our health as a country is not improving. Knowledge alone clearly doesn't work. What's missing is the motivation to put our knowledge into action consistently, so that we can truly transform into a healthier, happier way of living.

Today I'm sharing the work that I'm passionate about in the field of motivation; a passion that inspired my second book. After 25 years of helping patients create their healthiest life, I've observed 3 states of being; one of which leads to an almost effortless commitment to make healthy choices. For those of us who still feel stuck making choices that we know are not in our best interests, wondering "why did I do that again?", I'll share a system that works for both me and my patients, to finally make lasting change from a place of peace and ease.

The best news is that we get to feel better now and improve our immediate health, while create the healthiest older version of ourselves. When you live in alignment with what you deeply believe is good, you will notice healthy choices naturally falling into place. I'll be sharing more as the book progresses!

Despite the numerous well known benefits of menopausal hormone therapy, it's important to talk about some common side effects. The most common frustrating side effect that we seen our practice is a new onset of bleeding, which affects about 5% of patients. The good news this is very rarely anything to worry about. It is certainly a major annoyance that needs to be addressed.

Today I'll discuss why this happens in both menopausal and perimenopausal patients, how to evaluate it and most importantly how to make it stop!

During the last decades of confusion about menopausal hormone therapy, many well-meaning solutions were offered to patients claiming to be safer than the feared traditional HRT. These include combinations of estrogens, progesterone and testosterone in the form of topical creams and sublingual preparations. Now that we are emerging from this fog of confusion, and understand that estradiol, progesterone and testosterone are not only safe, but also provide numerous health benefits for women, it's important to reevaluate whether compounded estrogen products still have a place. Today I’m discussing the different types of estrogen that are available in compounded form, why progesterone cream is not a safe solution for patients who have a uterus, and why at the current time we need to rely on testosterone in compounded form, and how to ensure that we're getting the safe and most beneficial dose.

Managing the time leading up to menopause, known as "peri-menopause," can be particularly challenging due to fluctuating hormone levels and their often unpleasant side effects. These years can feel like an unpredictable roller coaster, making it difficult for both patients and providers to find balance.

However, understanding what's happening in your body during this period is key. With the right knowledge, we can develop a treatment plan that includes effective options to alleviate symptoms and bring your life back into balance, helping you navigate through these challenging years with greater ease.

As science progresses, it's so important to recognize when we got something wrong and tell patients that we have learned something new and better. Too often, doctors are stuck in their old ways and are not up-to-date in the latest science, and are continuing to practice out-of-date medicine without recognizing that they were wrong.

Today I'm addressing the top five things that I personally got wrong, and I told patients these things for years before learning that there was a better way based on modern science. Even what we tell patients today no doubt will change as our understanding progresses, so it's important to see medicine (and science in general) as an ever-changing growing body of knowledge. As patients it's so important for us to stay educated and advocate for ourselves if we hear that our providers are giving information that is out-of-date or incorrect. If we learned anything at all from the debacle about menopausal hormone therapy, it's that we get things wrong sometimes, and we need to accept that, learn from it and move forward with a better way of practicing to take great care of our patients.

With metabolic dysfunction on the rise (including everything on the insulin resistance/pre-diabetes and diabetes spectrum) it's critical to understand how we are metabolizing glucose and carbohydrates. When you come to the doctor's office, we typically check glucose, insulin and other markers in a fasting state, but we have no idea what happens later in the day. Until recently, continuous glucose monitors have only been approved by insurance for diabetic patients and have required a prescription. Recently Dexcom released an over-the-counter continuous glucose monitor called Stelo, which measure is your glucose every 15 minutes, 24 hours a day. Today I'm talking about my experience with Stelo and why it might be something to consider, especially if you're struggling with weight gain or if you simply want to be educated about how different foods affect your metabolism.

Now that we are all aware of the multiple health benefits of taking menopausal hormone therapy, let's dig into some of the questions regarding timing, particularly for estrogen. There's no doubt that starting estradiol as soon as possible after menopause helps keep our blood vessels healthy, and reduces the risk of cardiovascular disease as well as multiple other diseases, including Alzheimer's. But what if you were not offered hormones and you are now more than 10 years past menopause? Today I'll be talking about what studies have shown regarding the possible risks of starting estrogen later in life, and why these risks may have been overblown and don't apply to everybody. I'll also talk about the myth that hormones should be stopped at some point, and discuss why this idea ever became popular.