Mary Claire Haver (on menopause)

Summary

Armchair Expert with Dax Shepard: Episode Summary – Dr. Mary Claire Haver on Menopause

In this insightful episode of Armchair Expert with Dax Shepard, hosts Dax Shepard and Monica Padman engage in a comprehensive discussion with Dr. Mary Claire Haver, a renowned menopause expert. Released on March 19, 2025, the episode delves deep into the complexities of menopause, its symptoms, treatment controversies, and the significant gaps in medical education surrounding women's health.

---

1. Introduction to Dr. Mary Claire Haver [03:26]

Dr. Mary Claire Haver is introduced as a certified menopause practitioner from the Menopause Society, a board-certified obstetrician and gynecologist, and a culinary medicine specialist. She is also a bestselling author of two books: The New Menopause and The Galveston Diet. Her multifaceted expertise positions her as a leading voice in menopause education and support.

Dr. Haver: "More than a decade of sobriety, a degree in Anthropology and four years of improv training. I will attempt to discover human 'truths' without any laboratory work." [00:24]

2. Dr. Haver's Background and Career Path [04:15]

Dr. Haver shares her journey from Louisiana, where she grew up in a family of restaurateurs, initially pursuing a degree in geology. A shift in passion led her to medical school at LSU in Shreveport, followed by a residency in Galveston. Her experience during residency, particularly her rotation in obstetrics and gynecology, solidified her desire to specialize in women's health.

Dr. Haver: "I thought I wanted to be a pediatrician. I love babies, but I don't love their parents. This is not my niche." [06:33]

3. The Gap in Menopause Education [08:34]

Despite extensive medical training, Dr. Haver highlights a critical deficiency: menopause was scarcely covered in her curriculum. With only seven hours dedicated to menopause over eight years of education, she emphasizes the lack of comprehensive training for physicians in addressing menopausal symptoms effectively.

Dr. Haver: "In eight years of medical training and education, I had seven hours of menopause. We had no menopause clinics." [08:34]

4. The Women's Health Initiative (WHI) Study and Its Impact [13:12]

Dr. Haver delves into the WHI study, a landmark NIH-funded trial that fundamentally changed the perception of Hormone Replacement Therapy (HRT). Initially promoting HRT for menopausal symptoms and heart disease prevention, the study's flawed methodology and specific estrogen formulations led to widespread hysteria and restrictive guidelines that persist today.

Dr. Haver: "The WHI study was one of the biggest projects the NIH had ever taken on... Half were placebo versus estrogen or estrogen and progesterone if they had a uterus." [13:12]

5. Understudied and Diverse Symptoms of Menopause [19:00]

Contrary to popular belief, menopause affects every organ system due to the presence of estrogen receptors throughout the body. Dr. Haver enumerates various symptoms beyond hot flashes, including cognitive challenges like brain fog, mental health issues such as depression and anxiety, musculoskeletal problems like frozen shoulder, and changes in bone density.

Dr. Haver: "We have estrogen receptors in every single organ system in this body... It is a roller coaster, and your worst symptoms tend to be the mental challenges." [19:00]

6. The Importance of Hormone Replacement Therapy (HRT) [30:43]

A significant portion of the discussion centers on HRT. Dr. Haver advocates for its use not only to alleviate menopausal symptoms but also as a preventative measure against osteoporosis and cardiovascular disease. She critiques the outdated guidelines that limit HRT usage to severe symptoms, emphasizing that modern formulations are safer and more effective when initiated early in the menopause transition.

Dr. Haver: "We can decrease your risk with HRT... It actually has a 50% per year lower risk of new heart attack, cardiovascular disease, atherosclerosis." [30:43]

7. Lifestyle Interventions: Diet and Exercise [63:01]

Beyond medical treatments, Dr. Haver underscores the importance of lifestyle modifications. She recommends a high-protein diet to preserve muscle mass, resistance training to strengthen bones and muscles, and strategies to reduce intra-abdominal fat. Her holistic approach integrates these lifestyle changes with HRT to optimize health outcomes during and after menopause.

Dr. Haver: "We're gonna work out heavy, we're gonna lift heavy, and we're gonna eat the protein... It's the most synergistic combination for preventing osteoporosis." [63:01]

8. Addressing Misconceptions and Sexism in Healthcare [76:00]

Dr. Haver confronts the prevalent sexism in healthcare that trivializes women's health issues, including menopause. She highlights how women in medicine have historically been treated as "small men," excluded from vital studies, and inadequately prepared to handle menopause in clinical practice. This systemic bias contributes to the ongoing neglect of women's health needs.

Dr. Haver: "Women in medicine have been treated as small men... So, yeah, it's a terrible problem." [76:00]

9. Psychological Impact and Mental Health [75:17]

The conversation touches on the profound psychological effects of menopause, including increased rates of depression, anxiety, and suicide among women navigating this transition. Dr. Haver calls for comprehensive mental health support and early intervention to mitigate these risks.

Dr. Haver: "We can prevent the suicides, the job loss, the brain fog... It's about educating yourself as soon as possible." [75:17]

10. Innovative Treatments and Future Directions [110:00]

Looking ahead, Dr. Haver discusses emerging treatments like GLP-1 agonists for weight management and their role in menopausal care. She emphasizes the need for personalized treatment plans that consider individual health profiles, hormonal levels, and lifestyle factors.

Dr. Haver: "We're starting to check three months out, what are her levels, how is she absorbing... If she's distressed, let's go for it." [110:00]

11. Conclusion and Call to Action [120:00]

Dr. Haver concludes by urging women to take proactive steps in managing menopause, including seeking out certified menopause specialists, advocating for better medical education, and embracing both medical and lifestyle interventions to enhance quality of life.

Dr. Haver: "Educate yourself as soon as possible... Don't wait till you start having symptoms to use vaginal estrogen. It's very safe." [120:00]

---

Notable Quotes

• Dr. Haver on Menopause Education Deficiency:

  "In eight years of medical training and education, I had seven hours of menopause." [08:34]

• Dr. Haver on WHI Study Flaws:

  "The estrogen they used wasn't the right kind... It wasn't using modern HRT formulations." [15:20]

• Dr. Haver on HRT Benefits:

  "Women who start HRT in the first 10 years have a 50% per year lower risk of new heart attack." [30:38]

• Dr. Haver on Comprehensive Care:

  "We're gonna work out heavy, we're gonna lift heavy, and we're gonna eat the protein... It's the most synergistic combination for preventing osteoporosis." [63:01]

• Dr. Haver on Mental Health Risks:

  "We can prevent the suicides, the job loss, the brain fog... It's about educating yourself as soon as possible." [75:17]

Final Thoughts

This episode sheds light on the often-overlooked aspects of menopause, emphasizing the need for improved medical education, comprehensive treatment approaches, and proactive lifestyle changes. Dr. Mary Claire Haver's expertise and candid discussions provide valuable insights for women navigating menopause, advocating for a more informed and empowered approach to women's health.

---

Note: This summary excludes advertisements, intros, outros, and non-content segments to focus solely on the substantive discussions of menopause and Dr. Haver's expertise.

Transcript

[Dax Shepard]

Wondry plus subscribers can listen to Armchair Expert early and ad free right now. Join Wondry plus in the Wondry app or on Apple Podcasts or you can listen for free wherever you get your podcasts. Welcome, welcome, welcome to Armchair Expert. Experts on Expert. We are joined today by Dr. Mary Claire Haver. Wow, this is a long time coming.

[Monica Padman]

Big time.

[Dax Shepard]

Armchair's demanded it and we have produced it. We actually leaned on armchairs to tell us who their favorite menopause expert was. And by unanimous, popular Dr. Mary Claire, she popped up and she fucking delivered. I love her.

[Monica Padman]

I thought she was so great. This is so informative and helpful and needed and I've brought this up obviously to a lot of my female friends.

[Dax Shepard]

What was the main thing you said? Because I brought it up to some people too.

[Monica Padman]

Oh, I'm. I'm just like, guys, we had a perimenopause menopause expert on. It's really intense.

[Dax Shepard]

It's very positive. It's like the most hopeful.

[Monica Padman]

It is, it is. I was overwhelmed.

[Dax Shepard]

Okay.

[Monica Padman]

In a good. In a way that I needed to be overwhelmed.

[Dax Shepard]

Where like there's a lot hear everything coming your way.

[Monica Padman]

Exactly. There's a lot coming slash here. Yeah. And. And there are real things to do and so I gotta do them.

[Dax Shepard]

I've been telling people about the topical vaginal rub.

[Monica Padman]

Sure.

[Dax Shepard]

That's what I was most interested.

[Monica Padman]

Yeah, we learned a lot, so we lear a lot.

[Dax Shepard]

Okay, so Dr. Mary is a certified menopause practitioner from the Menopause Society. She is a board certified in obstruct and obs. I said this in the.

[Monica Padman]

It's hard to say.

[Dax Shepard]

In obstetrics. Obstetrics and gynecology specialists and a certified culinary medicine specialist and a best selling author. Two of her books, the new Menopause, which is hugely successful and the Galveston Diet. I urge everyone to follow her on Instagram. She has really, really great videos that be addressing all these little things that pop up. And also you could go to her website, thepawslife.com which is a comprehensive approach to menopause education and support. This is awesome. She was rad.

[Monica Padman]

Yeah.

[Dax Shepard]

Yeah. All right, enjoy. This message is brought to you by Apple Card. Apple Card is everything a credit card should be. It's easy to manage, built to be secure and gives users up to 3% daily cash back on every purchase. The best part about Apple Card is applying is quick and easy. Apply in the wallet app on iPhone and see your credit limit offer in minutes. Subject to credit approval. Apple Card by Goldman Sachs Bank USA Salt Lake City Branch Member, FDIC terms and [e-mail] we are supported by Addi Flavanserin, the Little Pink Pill. Ask your doctor if the FDA approved Little Pink Pill. Addi is right for you. See full prescribing information, medication guide and boxed warning regarding severe low blood pressure and fainting in certain settings at a d d y I.com PI or call 844-PINK PILL. He's an out. Lingua Franca. What is it?

[Dr. Mary Claire Haver]

Lingua Franca Franca.

[Dax Shepard]

Lingua Franca.

[Dr. Mary Claire Haver]

So they hosted my book launch, my big New York, one of the deals, and she made this for me.

[Dax Shepard]

Will you wait 39 seconds?

[Dr. Mary Claire Haver]

Absolutely.

[Monica Padman]

This is so nice. I feel left out because I do indeed.

[Dr. Mary Claire Haver]

Hydro Magic. I love it.

[Dax Shepard]

I'm told it's a wicked reference.

[Monica Padman]

It is.

[Dr. Mary Claire Haver]

Yeah.

[Dax Shepard]

And the colors are wicked.

[Dr. Mary Claire Haver]

I'm going to a Mardi Gras ball that is wizard of Oz wicked themed.

[Dax Shepard]

In New Orleans.

[Dr. Mary Claire Haver]

In Galveston.

[Dax Shepard]

I love Galveston.

[Dr. Mary Claire Haver]

You've been there?

[Dax Shepard]

I have.

[Dr. Mary Claire Haver]

There's like, three people, and he's one of them. Yeah.

[Dax Shepard]

I used to work for General Motors, and we had a car show there, and our ride route ended there, and we stayed at a very cool hotel, and each room was, like, kind of unique. You know the one I'm talking about?

[Dr. Mary Claire Haver]

So that's gonna be the Galvez, more than likely.

[Dax Shepard]

Okay.

[Dr. Mary Claire Haver]

Very, very nice on the water. Old.

[Dax Shepard]

Yeah, very old. Felt like vampires would stay there.

[Dr. Mary Claire Haver]

That's it.

[Dax Shepard]

And you guys moved there. You're from Louisiana.

[Dr. Mary Claire Haver]

Yeah, I grew up in Louisiana, went to undergrad. I was a raging Cajun. So what? Usl I'm dating. That's now U, L, L. They're fancy. And then I did grad school for a little bit. Almost went the PhD geology route. Oh. My undergrad's in geology. I went to work for an oil company. Kind of had a change of heart and was like, what else can I do with this science degree? And I was moving towards a PhD, and I'm like, if I'm not gonna do this PhD, I need to do something cool and big. Let me just take the MCAT and see what happens. So then LSU for med school, which was in Shreveport, north Louisiana. And then I did residency in Galveston, and we've stayed in the Houston, Galveston area pretty much since then.

[Monica Padman]

Do people tell you you look like Courtney Cox?

[Dr. Mary Claire Haver]

Yes.

[Monica Padman]

Yes.

[Dr. Mary Claire Haver]

Like, especially back in the day. Yes. When she was on Friends. I was a resident, and we would have friends, watch parties. And now it's kind of Tina Fey. Anyone with black hair and big Glasses. It's me.

[Monica Padman]

Well, both are compliments.

[Dr. Mary Claire Haver]

Yeah.

[Dax Shepard]

And we love them both.

[Monica Padman]

Yeah, we do.

[Dr. Mary Claire Haver]

Yeah.

[Dax Shepard]

Huge fan. You're one of eight.

[Dr. Mary Claire Haver]

Yeah.

[Dax Shepard]

What did mom and dad do?

[Dr. Mary Claire Haver]

A lot of sex.

[Dax Shepard]

Well, clearly. Yeah.

[Monica Padman]

Good for them.

[Dr. Mary Claire Haver]

Yeah.

[Dax Shepard]

Yeah.

[Dr. Mary Claire Haver]

They weren't shy about it. I would walk into the parents making out in the corner.

[Monica Padman]

Really?

[Dr. Mary Claire Haver]

Stop. So mom and dad were restaurateurs?

[Dax Shepard]

Oh, yes. They owned a Cajun restaurant.

[Dr. Mary Claire Haver]

Yeah, we just called it food. You would call it Cajun. And it was a little more upscale. It was steaks and seafood. And I grew up in a big restaurant family. My grandparents, my aunts and uncles, most of my siblings.

[Dax Shepard]

That's why they couldn't keep their hands off themselves, because restaurant people party a.

[Dr. Mary Claire Haver]

Lot and they're horny a lot.

[Dax Shepard]

That's a whole lifestyle.

[Dr. Mary Claire Haver]

Lots of naps, work the lunch shift, come home, nap quotes.

[Dax Shepard]

How do you choose ob gyn? Yeah, I want to say obstetric. It's a hard word. I can say obstetrician. But obstetrics.

[Monica Padman]

Obstetrics, that is tricky.

[Dr. Mary Claire Haver]

Obstetrics and gynecology. So in your third year, in most traditional programs, first two years are just in classroom and you get a little taste of different things, but you're mostly just getting the basics down. Your last two years are out in the wards where you're in the hospital rotating and figuring out what you want to do. I remember I thought I wanted to be a pediatrician. I was president of the peds interest group, what they call pig. And I did peds first, and I realized quickly, I love babies, but I don't love their parents. The whole dynamic. This is not my niche.

[Dax Shepard]

Yeah.

[Dr. Mary Claire Haver]

So then you rotate through surgery. I really like aspects of surgery, but I didn't like surgeons. They were.

[Monica Padman]

Yeah, they're very arrogant.

[Dr. Mary Claire Haver]

ENT was cool, but super competitive. I had the grades, turns out. But my last block was OB gyn. And that first night I caught a baby. The block I happened to have first was labor and delivery. I have some awesome upper level resident who's like, we got this. Come on, get in there. And I was like. And I remember calling my mom, like, I finally figured out what I want to do. I want to deliver babies. I didn't want to have anything to do with menopause.

[Dax Shepard]

What part do you think was so rewarding?

[Dr. Mary Claire Haver]

I still could cry. It never gets old, being there for a birth. I'm assuming that's why I wanted to.

[Dax Shepard]

Dial in on it, because two of my favorite experiences on Earth are the second. Both of my daughters were born holding them, looking in their face and going, welcome to earth.

[Dr. Mary Claire Haver]

Like, there is something so crazy. And I see him before you, and.

[Monica Padman]

I just like to see, why not?

[Dr. Mary Claire Haver]

You know, it never gets a miracle. And make a big production. We lay the baby on mom's tummy and I let the daddy cut the. I let you know he gets to cut at the court, crying through the whole birth labor process. I'm hanging out. Where'd y'all meet? Let's talk. Because you don't get that connection in a 15 minute visit all through the OB stuff. So I'm there for delivery. I'm not just rolling in to catch the baby. I'm there for the whole labor.

[Dax Shepard]

You're also getting to be a part of the most intimate thing that a couple will share, or one of them for us, for sure. Like, oh, my God, we made a thing. And it's here. As opposed to a meter maid who has to give people bad news all day.

[Monica Padman]

This is like the opposite.

[Dr. Mary Claire Haver]

There's occasional bad outcomes and tragedies, and I'm trained for all the crazy stuff that could happen, but most of the time I just get to be there. And it's just such a cool experience. So that's what I fell in love with. And I'm like, and I have to do surgery and I have to do this menopause thing and do gynecology, but it's a necessary evil to do this baby thing.

[Dax Shepard]

Yeah. Yeah.

[Monica Padman]

So this menopause thing was a sector of it.

[Dax Shepard]

Yeah, but not even.

[Dr. Mary Claire Haver]

Not even in medical school. Right. We do four years, two years on the books, two years in the wards, and we had one one hour lecture in that first two years. This is menopause. Just a basic overview.

[Dax Shepard]

One one hour lecture.

[Monica Padman]

I'm not shocked. I know.

[Dr. Mary Claire Haver]

That's why I'm here. I got you.

[Monica Padman]

Exactly.

[Dax Shepard]

And you pointed out this isn't my realization, but we're gonna do one hour to address a third of a woman's.

[Dr. Mary Claire Haver]

Life that 100% women will go through. It's not optional.

[Dax Shepard]

And it's not a couple weeks or a couple months. It's a third of their life we're gonna just not worry about.

[Dr. Mary Claire Haver]

Yeah, but you know, it wasn't put to me that way. This is just a transition. And estrogen declines and off you go. And she might have some hot flashes. We've got medicine for that. Okay, then in OBGYN residency, which is women's health, probably 55, 60% of what was to do with OB getting people pregnant, staying Pregnant, unpregnating them. All the trials and tribulations, important stuff. So proud of everything I learned. And then everything else gets shoved in the box of gynecology. And we have reproductive endocrinology, which is basically endocrine stuff that happens. Weird chromosomal things and getting people pregnant. For fertility issues. We have pediatric oncology, how to take care of smaller people with the same organs who have issues and need help. We have general gynecology, well woman exams. So menopause was part of our REI block, Reproductive endocrinology, which we only did second year for six weeks. We had a one hour lecture each week. So I got six hours. So in eight years of medical training and education, I had seven hours of menopause. We had no menopause clinics. And then I was leashed onto the world. Go, be free and practice. I didn't know anything.

[Dax Shepard]

Yeah, yeah, You've come to regret how many women were basically asking for your help. And in that paradigm, you pretty much were just turning people over to different specialists.

[Dr. Mary Claire Haver]

I didn't know enough at the time to know that her palpitations, her frozen shoulder, her, you know, myriad. Oh, girl, wait, we're gonna get. Oh, no, we gotta get her laundry list of complaints. I'm the well woman examiner and I got 15 minutes to get through this. So I'm like, we're gonna send you to cardiology for your palpitations. We're gonna go to the ortho for your shoulder. So I'm giving her six referrals.

[Dax Shepard]

Sleep specialist for your insomnia.

[Dr. Mary Claire Haver]

Yeah. And a nutritionist for your weight gain. And we're good. Your pap is normal. See you next year.

[Dax Shepard]

And then you yourself started going through menopause.

[Dr. Mary Claire Haver]

I was polycystic. You know, I had an endocrine condition. I didn't ovulate regularly. Why? I had fertility treatments for my kids.

[Monica Padman]

You had pcos.

[Dr. Mary Claire Haver]

Pcos. I had the toupee kids. Finally got that done. I don't want to go through another miscarriage. We're done. So I go on birth control pills to manage my condition, which I did great on. That was fine for me. And then I get to about 48 and I'm like, okay, I think we're getting close to where we're going to be. And I'm totally suppressing my period, so I'm not taking the inactive pills. So I'm totally replaced all my hormones and shut it down. I felt better that way than pcos. I was like, probably time to get off. See where we're At. So I talked to my nurse practitioner who took care of me and was like, I'm gonna get off the pill. We're gonna get some blood work in a month and see where I'm at. She's like, cool. Very same time, my brother dies. So I have six brothers from the same parents. My oldest brother died when I was 9 from leukemia. So I was a kid when that happened. And then my next brother Bob had HIV and hepatitis. The HIV is actually really under control, but it was his liver just tanking, tanking, tanking. So I've stopped the pill, see where Mary Claire's at. And I'm in the or. The phone's ringing, ringing, ringing. I'm like, get the phone. And they put it to my ear and they're like, bob' you probably should start heading home.

[Dax Shepard]

Did you know that was coming?

[Dr. Mary Claire Haver]

Eventually I'd sat the kids down and said, you know, Uncle Bob's getting sicker. But not like today.

[Dax Shepard]

It kind of was abrupt. Despite knowing it was coming.

[Dr. Mary Claire Haver]

Yeah, I thought we had a year or two.

[Dax Shepard]

Yeah, yeah.

[Dr. Mary Claire Haver]

Anyway, my partner comes down, we get to a good part in the case, scrubs me out, and I go and prepare to go home and figure all this out. So here I am grieving this horrible thing and I am in full on menopause. But I don't know it. I'm gaslighting myself. I'm attributing all the things to grief. And certainly grief was a part of it. But after like month six, I realized the grief is lifting. I'm not crying all the time on the way home, I'm like, when was your last period?

[Dax Shepard]

It must be so comforting to hear an OB be out to lunch on their own health.

[Dr. Mary Claire Haver]

I didn't like menopause. I was like, ew. I was like Samantha on Sex in the City, not the menopause. And so I was like, dora, I'm going to come get the blood work now. And so we did everything. And sure enough, I was fully, fully menopausal.

[Dax Shepard]

And that's detectable?

[Dr. Mary Claire Haver]

Yeah. Check your estrogen. Check something called fsh. One's high, one's low. That's it.

[Dax Shepard]

So it's all in the blood work?

[Monica Padman]

Yeah.

[Dr. Mary Claire Haver]

Perimenopause? No, we don't.

[Monica Padman]

Okay, that's what I was going to ask cuz I think I'm in it.

[Dax Shepard]

I know everyone your age does.

[Dr. Mary Claire Haver]

I looked up all the stats for Southeast Asia. Oh, you did? Yes, I did.

[Monica Padman]

Thank you.

[Dr. Mary Claire Haver]

Yeah, so we'll go over that. But I reluctantly go on hormone Therapy because I'm like, I cannot live like this. I was still in the impression I would get breast cancer and die. It was going to kill me.

[Dax Shepard]

Well, let's address that right now because I happen to know way more about this than I should because I love women. Well, I do love women. But Dr. Attia, I love Peter Attia and he's been such a vocal supporter of this. But so all of this, the hysteria that you probably received was based on the work of two people? Virtually.

[Dr. Mary Claire Haver]

So. The WHI study was a large multi center trial. It was one of the biggest projects the NIH had ever taken on. And for the first time they were studying women. We were so fucking happy. We knew from anecdotal evidence that women who were on HRT before the whole hormone replacement therapy. Sorry, hormone replacement therapy. 40% of women were utilizing HRT and menopause. So that was kind of the baseline rate. It was recommended by the American College of Physicians. I mean it was like everybody should consider this. We knew that women who chose it had lower heart disease, had lower certain risk. But that's not proof. That's an observational study.

[Dax Shepard]

Yeah, correlation.

[Dr. Mary Claire Haver]

If you follow ATIA, you need a randomized, controlled, blinded. So NIH billion dollar study. Let's study women. They got 37,000 women recruited. Half were placebo versus estrogen or estrogen and progesterone if they had a uterus.

[Dax Shepard]

Huge issue right there. If you're not combining the two.

[Dr. Mary Claire Haver]

Particular estrogen that they were on was Premarin, which we don't use today very often and then a very specific progesterone. It wasn't using modern HRT formulations, it was just looking at this one. But at the time in the 2000s that was the most common formulations used. Nothing weird there because they were looking for heart disease as the outcome. Is this really protective for heart disease or are just wealthier, healthier women on HRT and were getting an artifact. The average age was 63 in the study. Little late. We know it works for hot flashes. We know it'll take care of menopause symptoms, but doesn't really help with heart disease. So they wanted to start later because it's expensive to go 20 years. So if we start later, then we'll start seeing the heart attacks in a quicker timeframe. They did have younger and they had some women in their 70s start. They went up to 79. Off they go. With the trial, the women on estrogen only had a 30% decreased risk of breast cancer. And that was statistically Significant. The women on the combo saw a slight increased risk, but it never reached statistical significance.

[Dax Shepard]

Really quick. The reason it was kind of irrelevant statistically is that the control group had an abnormally low rate.

[Dr. Mary Claire Haver]

That's it.

[Dax Shepard]

Which was not even considered.

[Dr. Mary Claire Haver]

So when you compared the two groups. Whoa. This is really causing. It was four guys.

[Dax Shepard]

Schlabowski, Aragosky.

[Dr. Mary Claire Haver]

I can't even pronounce their names. And they still stand by. It's crazy.

[Dax Shepard]

Just recently they're back at it.

[Dr. Mary Claire Haver]

There were 17 centers involved in the study. There were multiple PIs, primary investigators. And these two or three guys wrote this paper and said estrogen causes breast cancer, HRT causes breast cancer. And they called everybody in the room and said take a look at it. To make changes. They rejected all the changes. And then they went to the.

[Monica Padman]

There's no peer review.

[Dr. Mary Claire Haver]

Yeah, no, they just said it and it was like letting a genie out of a bottle. Flawed interpretation and hysteria. There was no viral for Internet back then, but it was the number one medical news story of 2002. It was on the COVID of every magazine. Nancy Snyderman is on ABC saying don't give anyone estrogen. I was a chief resident. I remember the day it came out and we were like, like what? I was terrified to give people HRT. What I didn't know. In the ensuing 20 years, being board certified, getting my recertification every year, reading every article they put in front of me. I was the straight A student. They never walked it back to the OB GYNs. And the guidelines have not been changed in American College of OBGYN since 2014. And they still say only for severe symptoms, smallest amount for the shortest time possible.

[Monica Padman]

Wow.

[Dax Shepard]

And at pre study it was at 40% which you said.

[Dr. Mary Claire Haver]

And then last year in 2023 we just got this published in the Menopause society. It was 4.

[Dax Shepard]

4%.

[Monica Padman]

Wow.

[Dr. Mary Claire Haver]

4% of women who are eligible are receiving FDA approved. Now there's probably more with compounded. It's hard to track that because they don't report. So maybe seven.

[Dax Shepard]

But still there's a great bit of context around this. So you start having the symptoms. You decide you want to do some investigation in this, in your investigation you quickly find out if you were to search medical peer reviewed articles and journal entries about pregnancy.

[Dr. Mary Claire Haver]

Almost 1.2 million.

[Dax Shepard]

And if you look at menopause at that same period, 94,000 articles written.

[Dr. Mary Claire Haver]

Do you know how much brain power we're talking about? How much nih, how much private funding, how many labs? That's ten to One and more women will go through menopause than bear children.

[Monica Padman]

Exactly.

[Dr. Mary Claire Haver]

Yes.

[Dax Shepard]

And the bearing children process will last them however long you want to say that window is.

[Dr. Mary Claire Haver]

Average of two kids, nine months each, 30 years.

[Dax Shepard]

No. So pretty nuts. And maybe now's a fun time because I actually want you to explain menopause, but I think now would be a fun time to just talk about men versus women here.

[Dr. Mary Claire Haver]

Yeah.

[Dax Shepard]

Because my father, at the same time that's being published about HRT for women, my dad is being advised to be on testosterone. Cause his level's low and it improves his life. He goes off of antidepressant, it's fine.

[Dr. Mary Claire Haver]

So men have a slow decline from like 18 or 19 down till they die. But for most, it's still detectable. Now, you might function better at a higher level, and no one's gonna deny that to you. It would be as if your testicles shriveled up and died at the average age of 51. And your empty ball sack is flapping in the breeze for the next 30 years.

[Dax Shepard]

And we're not gonna do anything about that.

[Monica Padman]

Yeah.

[Dr. Mary Claire Haver]

And good luck to you, dude.

[Monica Padman]

Yeah, exactly.

[Dax Shepard]

We're never horny again.

[Dr. Mary Claire Haver]

So here's a sleeping pill. Here's something to improve your libido, maybe here's a palpitation medicine. Here's an antidepressant.

[Monica Padman]

Yeah, it's just like, get through the rest of your life.

[Dr. Mary Claire Haver]

They're talking about over medicalizing menopause, the critics. And I'm like, yeah, I'm giving her six drugs. Or I can wipe the whole thing out with just replacing her estrogen that's gone missing.

[Dax Shepard]

Yeah, right. And it'll actually increase her bone density. It'll actually have real results.

[Dr. Mary Claire Haver]

It is the longevity drug for females. Nothing's going to work better than that.

[Dax Shepard]

Wow. Yeah. So, I mean, there's a lot in.

[Dr. Mary Claire Haver]

There now you can raw dog, minibot. You know what's making you go on it?

[Dax Shepard]

You can't underestimate the layers of sexism that exist within the fact that it would take however many years before we would acknowledge, oh, yeah, women are really suffering from this. And they have a bunch of symptoms from a bunch of different issues arising from this. And better to treat those than to get to the core of what's going on.

[Dr. Mary Claire Haver]

When you look at why menopause hormone therapy was developed, it was to treat a hot flash and forever the pathognomonic, the poster child symptoms was hot flashes. What we call medicine, vasomotor symptoms. What was never taught to me ever And I learned, like, three years ago was we have estrogen receptors in every single organ system in this body. And what I also was taught is, in perimenopause, it's a slow, gentle decline. That's all I learned. One sentence. Decline until full menopause, when you lose function, it is a rocking roller coaster. And your worst symptoms tend to be the mental challenges. The brain fog, the cognitive disorders, the frozen shoulder. All of it is peri. And late peri. And early menopause.

[Dax Shepard]

That's when you're accelerating your loss of bone and muscle. And the eggs. Right.

[Dr. Mary Claire Haver]

We were born with all of our eggs.

[Dax Shepard]

A million, though. That was a shocker to me.

[Dr. Mary Claire Haver]

So 1 to 2 million at birth.

[Dax Shepard]

1 to 2 million at birth.

[Monica Padman]

But isn't this a weird. It's like that thing where you're born with all your eggs. So really, your grandma's eggs are your eggs?

[Dr. Mary Claire Haver]

Yes. When your grandmother was pregnant with your mother, the egg that made you was inside of your mother, inside of your grandmother.

[Monica Padman]

In some ways, women have always existed.

[Dr. Mary Claire Haver]

So there's always knowledge, wisdom, and drama on through a traumatic pregnancy. Okay, a million times 2 million at birth. We lose eggs two ways. One, and from the minute they form, we start losing it through atresia, which is like an aging process. And it's kind of survival of the fittest, because not all eggs are good eggs that you want to fertilize. So we want to leave the healthy ones behind to catch the sperm. So atresia is happening. Boom, boom, boom. And it accelerates. At 35, we see a big drop off. And then just from ovulating, we lose about 10,000 to get one to, like.

[Monica Padman]

Pop off every ovulation.

[Dr. Mary Claire Haver]

Every ovulation.

[Dax Shepard]

Is that in your menstrual discharge?

[Dr. Mary Claire Haver]

Where are all those e. They just kind of dissolve. So when one egg pops out, the fallopian tube picks it up, and it gets swept like a chimney through the fallopian tube, and it's fertilized or not in the fallopian tube. And then it goes into the uterine cavity. And sometimes they can pick it up in the men's, you know, when they've done studies, but sometimes it just kind of dissolves. But it's tiny. Tiny, Microscopic.

[Monica Padman]

Yeah.

[Dax Shepard]

Yeah. But I wrote it down.

[Dr. Mary Claire Haver]

By the time you're 30, you're down to 10%.

[Dax Shepard]

Down to 10%.

[Dr. Mary Claire Haver]

How old are you now?

[Monica Padman]

37.

[Dr. Mary Claire Haver]

Okay. So at 40, most women. And this is different for you. And I'm going to explain why. Don't shoot the messenger. Messenger. She already knew are down to three. This is for people who look like me. This is the average American white girl. Are you Indian or Southeast Asian? Okay. Average age of menopause is 46.5. For me it is 51. So that's average. The window, 41 is still normal for an Indian descent. And then that goes up to 51. You start younger and then perimenopause back it up 7 to 10 years before that.

[Monica Padman]

Am I in it?

[Dr. Mary Claire Haver]

Maybe.

[Dax Shepard]

I bet you have a mix of emotions, validation and depression.

[Monica Padman]

I want. Yeah, this one is not good to be validated. I don't. Oh, God. Okay, well. Well, how would I know?

[Dr. Mary Claire Haver]

That's a great question. Certainly if your cycles were starting to become irregular and if you had hot flashes, if you had the kind of cliche symptoms. But those are usually late in the game in perimenopause.

[Monica Padman]

I don't have that.

[Dr. Mary Claire Haver]

The most common symptoms, actually, now that these online telemedicine companies have developed for menopause and they are doing scoring systems on hundreds of thousands of women because everybody goes to their website, am I in menopause? And we have all these quizzes and things. You can take fatigue out of the ordinary. Nothing has changed. Your diet hasn't changed, your stresses haven't changed. New onset mental health changes. We have a 40% increase in depression and anxiety across the menopause transition with no real environmental changes. We have weight gain, so it's a steady state weight gain. But what's happening in the background with body composition is we have this acceleration of muscle mass loss and an acceleration of body fat gain, typically in the viscera, so the intra abdominal fat. So my patients used to come in and grab their tummies in their little paper gowns and be like, what the fuck is this? Mary Claire, I worked in a small town and we all went to church together. What is this? I knew her. I worked out with her. We ran together. I know this woman. I know what she eats. That's when I was like, why are all my. My friends and now me gaining weight in weird places? None of us have gone off the deep end. We're not secretly eating bonbons at night. Yeah, and then bone density is another key thing. So we're seeing acceleration of bone loss. And so I'm telling my patients, let's get early bone densities. Let's not wait till 65. Especially if you're programmed to go through younger than what's expected.

[Monica Padman]

Okay. Can you get pregnant?

[Dr. Mary Claire Haver]

You absolutely can get pregnant during perimenopause it's just a little harder. Cause your supply and the quality of the egg goes down. Which you knew, you know, the older you are.

[Dax Shepard]

She's frozen some eggs.

[Monica Padman]

I had two rounds, but it wasn't great. There's already been some telling, but it is still regular periods as you said. Maybe that's the later end of it.

[Dr. Mary Claire Haver]

Towards the end of peri. Meaning you're getting close to exhausting the whole deal.

[Dax Shepard]

Combativeness with co workers.

[Monica Padman]

Oh my God. Mental health team specific to who you're working with.

[Dr. Mary Claire Haver]

Brain fog. You know, suddenly you lose your words. We all do it from time to time, but this is consistent. Get in the car and you're like, where am I going? You walk into a room. What was I doing here? You know, everybody does that from time to time.

[Dax Shepard]

Okay, we should have done this at the beginning, but now I'm going to make you do it now. We're unique as an animal.

[Dr. Mary Claire Haver]

There's a pot of certain whales that do it. And elephants are very matriarchal. But when you look at like the anthropologist and they're like, why do women go through menopause? So from a survival standpoint, it behooves a woman to not keep being pregnant over and over again. You kind of have your batch of children and then you have better survival rates if you stop. The anthropologists also think that women served as the source of wisdom for the tribe. They were the passers on of knowledge. The dudes tended to die younger because they were getting killed by saber toothed tigers. The grandma stayed back. Now remember, these people were still very young compared to when we think of a grandmother now. We also died a lot sooner. Things that don't take people out now, like vaccines and childhood diseases, we have a reason why we live longer, right?

[Dax Shepard]

There was a very predictable role for the grandma. She was passing on all this wisdom, helping with children. Now we have all these things. We have childcare and we farm things out to strangers. And this whole role that once served.

[Dr. Mary Claire Haver]

Our genetic fitness, we've industrialized our way out of it. We've evolved past our genetics.

[Dax Shepard]

Yes.

[Monica Padman]

Wait, so we're saying the reason that human women didn't die is because of their.

[Dr. Mary Claire Haver]

Well, those who kind of ran the gauntlet of disease and being killed by accidents if they survive, they seem to take on these very wisdom creating, teaching the next generation. You know, if you look at whales, they're teaching the babies to hunt while the moms are hunting, gathering with the.

[Dax Shepard]

Dads or grandma elephants, they're very involved in the System. And I guess, too. Would I be wrong to say this? I'm assuming childbirth gets more dangerous as you're older.

[Dr. Mary Claire Haver]

Yeah, it's harder to do, and it's harder to stay healthy doing it. In general. We would lose more women to cardiovascular issues. Hypertension, preeclampsia, that kind of stuff. Before modern medicine, we had medications to help manage those conditions, diabetes.

[Dax Shepard]

So that's how we got there. We're kind of unique, as you say. There are a couple of other people. But let's talk about what physically happens during menopause. Let's talk about the endocrine system. What is it? What does it do, and how does it change?

[Dr. Mary Claire Haver]

So let's talk about what you're going through right now. In a healthy woman who has a regular menstrual cycle, nothing is ever steady state. It's an ekg, like ebb and flow of some key hormones. And ovulation starts in the brain, not in the ovary. In order to ovulate, the brain registers that our estrogen level is low. So you have your period. Estrogen, progesterone, drop off. The brain gets that signal, Whoa, we're low. The hypothalamus is testing, says, all right, it's time. Sends a signal to the pituitary, next gland underneath, and pituitary is like, all right, boss, I got it. The pituitary then sends LH and fsh. So if you've done any fertility treatments or, you know, these words or had the shots, you know, I did all that too. So those two hormones go down and bind to the ovaries to stimulate the ovulation. Around each egg are a set of cells, follicular and granulosa cells, and then produce our sex hormones, estrogen, in the first half of the cycle, which peaks at ovulation. After ovulation, we see progesterone rise. And that cycle is unbelievable and goes month after month after month in perfection. Unless you're ill or you're pregnant.

[Dax Shepard]

Crazy athlete.

[Dr. Mary Claire Haver]

There are things that we can do to mess it up, but for the average woman, the cave woman, this worked very well. Month after month after month.

[Dax Shepard]

And is testosterone going up in preparation?

[Dr. Mary Claire Haver]

That's the one steady state that we have. It might mildly fluctuate, but really testosterone high in our 20s and 30s. And then, just like a man, it.

[Dax Shepard]

Seems it would be evolutionarily advantageous if it upped your testosterone when you were.

[Dr. Mary Claire Haver]

Fertile, when you're ovulating. But we just don't really see that female male drives are a little bit different. So then what happens in perimenopausal in the background? We're losing eggs, losing eggs, losing eggs. We reach a critical egg threshold level, which is different for every human, where the signals coming from the brain no longer work. We become resistant because the quality and the quantity of the cells around the are declining. So the brain's like, where is my estrogen? The pituitary is like, boss, I sent the signal. He's like, send more. You start pounding the ovary with the GnRH to the pituitary. Pituitary is like, all right. Shoots out FSH and lh. We see the stimulating hormones start to rise much higher than they ever, ever were in a premedital.

[Dax Shepard]

This is trying to kickstart this system.

[Dr. Mary Claire Haver]

Kick it in the ass. So we see delayed ovulation, so the period starts to become irregular. And then because you were just pounding that egg, we end up with higher estradiol levels than we ever had before. That's why twins are a little bit more common towards the end of your fertility.

[Monica Padman]

Oh, interesting.

[Dr. Mary Claire Haver]

Yeah. Than they were when you were younger because you're getting your self made fertility drugs basically.

[Monica Padman]

Right, Right.

[Dr. Mary Claire Haver]

To push that egg out. And then progesterone never quite gets to where it was before. So it used to look like this gorgeous EKG Each month now is literally a zone of chaos.

[Monica Padman]

Interesting.

[Dr. Mary Claire Haver]

So you have estrogen doing this. Progesterone's like, I'm trying to keep up. FSH and LH are all over the place. And that's why we don't have a great blood test for perimenop. Do a one time blood test and say, obviously now for post, when you run out of eggs, FSH and lh, the brain is always looking, always pushing, always trying. And now we know we have FSH receptors in other areas of our body. We think the bone, we know the liver. So sometimes it's not just the loss of estrogen, but it's these high FSH levels that are leading to the cholesterol changes that we see a new study just, just, just came out two weeks ago that was looking at using a specific cholesterol marker, LDL marker, called super dense LDL as a marker for perimenopause. Like we don't have a good blood test. But would AMH be helpful, which is one of the fertility things that we check, which is a ovarian reserve hormone.

[Dax Shepard]

Would you have needed a baseline test prior to any of this for it to be relevant?

[Dr. Mary Claire Haver]

That's a great question. People ask me all the time. Okay, so if I'm going to replace my hormones in my menopausal journey, would it have been good for me to know my 30s, where they were? I'm like, where in the month would you like me to check? Probably not the high because that's when we have the breast tenderness. We worry about stimulating the uterine lining too much.

[Monica Padman]

Right.

[Dr. Mary Claire Haver]

So one of the problems with menopause treatment is we've just titrated to get rid of hot flashes. But now we know women absorb very differently and not everyone's therapeutic on our transdermal doses. So in my clinic, we're starting to check three months out, what are her levels, how is she absorbing? We know that women who start HRT in the first 10 years have a 50% per year lower risk of new heart attack, cardiovascular disease, atherosclerosis. It's very protective of the endothelium. What we don't know is what were those levels. We just know she was on it or she wasn't.

[Monica Padman]

Right.

[Dr. Mary Claire Haver]

Yeah.

[Monica Padman]

So should we be taking estrogen during perimenopause?

[Dr. Mary Claire Haver]

I think so, yeah.

[Dax Shepard]

There's quite a big.

[Dr. Mary Claire Haver]

We can decrease your risk, but it's just how do we suppress and replace, like what's in a birth control pill or do we just support give you just enough to calm the brain down and make your symptoms better, but allow the process to proceed in the background. There's tons of debate in my world about what's better.

[Dax Shepard]

Stay tuned for more armchair expert if you dare. We are supported by Addie.

[Monica Padman]

I know about Addie. The little pink pill, right?

[Dax Shepard]

Yes, that's right. Addie is the the FDA approved pink pill clinically proven to boost desire in certain pre menopausal women who are bothered by a low libido.

[Monica Padman]

I love this. It's really nice that there's an option out there for women who are dealing with low desire. And I like that. Addie's non hormonal and created by a woman for women. Addie is helping women feel like themselves again. And that's really important.

[Dax Shepard]

It really is. So arm cherries. If your libido could use a little jump start, Addie's got you you covered. Learn [e-mail] that's a--y-I.com Addy or Flo.

[Dr. Mary Claire Haver]

Bancerin is for pre menopausal women with acquired generalized hypoactive sexual desire disorder. HSDD who have not had problems with low sexual desire in the past who have had low sexual desire. No matter the type of sexual activity, the situation, or the sexual partner. This low sexual desire is troubling to them and is not due to a medical or mental health problem, problems in the relationship or medicine or other drug use. Addy is not for use in children, men, or to enhance sexual performance. Your risk of severe low blood pressure and fainting is increased if you drink one to two standard alcoholic drinks in time to your Addy dose. Wait at least two hours after drinking before taking Addi at bedtime. This risk increases if you take certain prescriptions, OTC or herbal medications, or have liver problems and can happen when you take Addi without alcohol or other medicines. Do not take if you are allergic to any of Addi's ingredients. Allergic reaction may include hives, itching or trouble breathing. Sometimes serious sleepiness can occur. Common side effects include dizziness, nausea, tiredness, difficulty falling asleep or staying asleep, and dry mouth. See full PI and medication guide including boxed warning@ addy.com PI addy.

[Dax Shepard]

That'S a d d y I.com we are supported by Quint Quint is one of our favorite apparel brands with luxury fabrics and finishes at affordable prices. Everyone I know is obsessed with quints.

[Monica Padman]

Quince is amazing. I was gifted an incredible blanket from Quince from Elizabeth and Andy.

[Dax Shepard]

Oh wow.

[Monica Padman]

And it's so warm and soft and fuzzy and cute.

[Dax Shepard]

Yeah, all their fabrics are so nice. You get the best of both worlds. Killer style at prices that don't break the bank. Quince has some great wardrobe st all at prices that are way less than similar brands. We're talking 50 to 80% less.

[Monica Padman]

This is a gift givers like paradise. Paradise, Correct.

[Dax Shepard]

Well that's because Quint partners directly with top factories so they cut out the cost of the middleman and they also make sure the factories they partner with use safe, ethical and responsible manufacturing practices so you can feel good about your purchase. Indulge in affordable luxury. Go to quint.comdax for free shipping on your order and 365 day returns. That's Q U I N C E.comdax to get free shipping and 365 day returns. Quince.comdax we are supported by better help. Support systems are so important the most. Some would say yeah, I have a just a slew of people I rely on.

[Monica Padman]

Yeah, me too.

[Dax Shepard]

Tom Hansen, I'm talking to you. In a society that glorifies hyper independence, it's easy to forget that we're all better when we have a support system behind us. Therapy can be a source of support for any area of your life. It's time to shift the focus from doing it all to knowing we're better when we ask for help. I have a very hard time asking for help.

[Monica Padman]

Yeah, therapy is great. We all, I mean, we can't really say it enough. We love it, swear by it. Yeah, look forward to it.

[Dax Shepard]

The best part about better help is it's fully online, which helps make therapy affordable and convenient. Serving over 5 million people worldwide. Access a diverse network of more than 30,000 credentialed therapists with a wide range of specialties, and you can easily switch therapists anytime at no extra cost. Build your support system with better help. Visit betterhelp.comdax today to get 10% off your first month. That's betterhelp hlp.comdax okay, so 6,000 women reach menopause every single day in the United States. And There are only 2300 providers certified in menopause medicine. So once this occurs to you and you're going through it and you start getting serious about your own reluctance to go through this, which is a great motivator, how do you approach it? What do you start looking at? How do you even begin assembling what becomes the toolkit?

[Dr. Mary Claire Haver]

I wish that I could tell you you could confidently walk into your ob gyn, your family medicine, your internal medicine doctor, and have a reasonable, logical conversation about your plan of care in perimenopause and menopause. That is not possible right now. It is not the fault of the individual doctor. They may have been excellent in your birth and your pregnancy, every aspect, but because of this six hours. So right now, they surveyed residents coming out three years ago, only 30% felt barely adequately trained to treat menopause. It's awful. So at least they're honest. Call ahead, look on the Menopause Society website, which is menopause.org and see who has passed the test and is certified there. It's not perfect. There's always people out there who aren't great doctors who took the test. But it's somewhere to start. We crowdsourced with my followers. I've got thousands of testimonials and we organized them by country, city and state to help people. They don't pay me just to go find a provider who might be able to help you. And right now it's pretty slick. There's some great telemedicine companies that have been developed, mostly female founded, who saw a gap in care and they saw a need and they developed these telemedicine companies. I have women calling me from New York, Louisiana, London, the most well connected, you would think, who have the same basic questions and the same worries and the same fears and cannot find help as the woman sitting on the couch in Iowa.

[Monica Padman]

Yeah.

[Dax Shepard]

Okay. So as you start focusing on it and kind of pledging to get competent in it and start treating women, are you yourself even shocked with the amount of symptoms? Because I wrote down symptoms and it's about the longest list of symptoms I've ever written.

[Dr. Mary Claire Haver]

I was shocked. And most of that was driven by questions I got on social as my little social media platform was exploding. When 10,000 women ask you about frozen shoulder or palpitations or vertigo, you're like, they can't all be lying. Then I'm digging and I'm like, somebody did the study. There's clinical clear data here. So I go online and I make a little video talking about the correlation between menopause and vertigo, menopause and frozen shoulder, menopause and validations. And the world goes crazy.

[Monica Padman]

Wow.

[Dr. Mary Claire Haver]

I get 10,000 comments. Why didn't my doctor know? Again, we're doing a terrible job of teaching, but I was literally learning alongside my followers, right as I learned, I'd make a video and teach. And that's what inspired me to write the book. And they were like, please write a book. I don't want to chase you all over social media. It's too complicated. Just put it all in one place.

[Monica Padman]

Frozen shoulder, that is scaring me. My mom had it, my grandmother had it.

[Dax Shepard]

One of my mother in law's has been dealing with it for the last six months.

[Dr. Mary Claire Haver]

So this is a great story and I hope I get the lore right. But the story goes, the first study on frozen shoulder and menopause, I know it came out of Duke University. I read the paper and it was the head of OB GYN and the head of orthopedics who both happened to be women. And it was something like they were sitting in the doctor's lounge or in the cafeteria and just shooting the breeze over. Can you believe all these women with frozen shoulder? You think there's a correlation? I don't know. Let's look into it. They started pulling charts and they were like, fuck me, look at this. Women who are on HRT have a lower incidence of frozen shoulder and they do better. They're getting it, but they're getting it less than women who aren't. And they're having a better course. So they go to get it published. They go to orthopedic journals first. Nobody would touch it. Nope, this can't be right. Nope. This is an artifact. Nope, nope, nope, nope. So one of the menopause journals published it. And so then I have a friend, Vonda Wright. She's an orthopedic surgeon. She does a ton of teaching, and she wrote the paper on the musculoskeletal syndrome of menopause.

[Dax Shepard]

How's that all work?

[Dr. Mary Claire Haver]

Estrogen receptors and probably progesterone here as well are all over the musculoskeletal system. We know bones. We got bones down. We've known about osteoporosis since I was a resident. I know that one really well. But what wasn't understood was tendons, muscles, and the connections between bones and muscles and how that all works together. And frozen shoulder is adhesive capsulitis. There's a capsule around the ball joint and the shoulder that gets absolutely adhesed and frozen. And it's an inflammatory condition. You can't put your arm behind you. Go to the picture. Yeah. And it's very, very painful. You need early intervention. You need physical therapy. There's needling. They have to break it up. And that we can delay the onset and the duration and probably prevent several cases for women on HRT because estrogen is protective, so it's an anti inflammatory.

[Monica Padman]

But my mom, I've never heard her once say she had that because of menopause.

[Dr. Mary Claire Haver]

Well, no, most women don't know. Most orthopedic surgeons don't know. We're working to change that. That paper was written a year and a half ago.

[Monica Padman]

Oh, wow.

[Dax Shepard]

Okay. So ringing in the ears.

[Dr. Mary Claire Haver]

Yeah. Tinnitus. Tinnitus. I still don't know how to say it correctly.

[Dax Shepard]

Yeah, I had it for a minute and I didn't know what to tell people.

[Dr. Mary Claire Haver]

I had it once, and, man, people.

[Dax Shepard]

Kill themselves from it.

[Dr. Mary Claire Haver]

Maddening.

[Dax Shepard]

Yeah.

[Dr. Mary Claire Haver]

So again, this is an estrogen receptor problem. The vertigo is that the crystals break off quicker is basically osteoporosis in the ear.

[Dax Shepard]

Oh, wow.

[Dr. Mary Claire Haver]

And the crystals break off and then float around and you're dizzy. But the tinnitus, it's the inflammation around the nerve and around some of the auricular bones that they feel like is leading to it. And that all these studies say agematch women, premenopausal women, definitely have it less than post. And women on HRT are less likely to get it.

[Dax Shepard]

Yeah. Wow. What are some other dry skin.

[Dr. Mary Claire Haver]

Yeah. In the skin and tegumentary skin. And the hair.

[Dax Shepard]

I've heard that word.

[Dr. Mary Claire Haver]

That's nice and fancy. All the follicles and oil and sweat Glands, it's the whole system.

[Dax Shepard]

Largest organ in the body.

[Dr. Mary Claire Haver]

It is most absorbent, so we lose 30% of our collagen. You don't have to tell a woman that she knows in the first five years of menopause. We can attenuate that with topical or systemic hormone therapy. Topical works better, actually, which is why I'm on my vanity cream.

[Monica Padman]

Is it a retinol?

[Dr. Mary Claire Haver]

No, it's estrogen for the face.

[Monica Padman]

Wow.

[Dr. Mary Claire Haver]

So it's compounded. Some people take the vaginal product and we'll mix it in their moisturizer and put some on their face. But you should talk to a doctor before you do. You shouldn't do that on your own.

[Dax Shepard]

Don't do any compounding at home.

[Dr. Mary Claire Haver]

So, yeah, mix it up a little more mortar and pestle. You lose oil production in the skin, you lose thinness and the trans epidermal water loss is much greater. So you're just losing all your barrier, your protection, so the skin is less healthy.

[Dax Shepard]

Dry mouth, that's the same dry mouth.

[Dr. Mary Claire Haver]

Same thing. So mucus production, the salivary glands dry up. We have tremendous dry mouth and dry eyes. Dry mouth is the same.

[Dax Shepard]

Guys, I don't want menopause. This is miserable body odor.

[Dr. Mary Claire Haver]

What's creating body odor early in menopause as the estrogen levels decline? Something that's made in the liver called steroid hormone binding globulin. Shbg, which binds our sex hormones and carries them around the blood and renders them inactive until they let loose and then they bind to go do things. When we lose the binding hormone, the activity of our androgens increases. Even though your total testosterone may not be different, but the free is higher.

[Dax Shepard]

So when I first got a panel for testosterone, testosterone, my overall numbers were like, fine, not alarming. My free was super low.

[Dr. Mary Claire Haver]

Your SHBG was high?

[Dax Shepard]

Yeah. I had the binding globula.

[Dr. Mary Claire Haver]

Yes, so you had some. But they were bound. And you could try. It's a balance because you can eat certain things, take certain things, certain supplements to increase, decrease. But then sometimes you're robbing Peter to pay Paul. And so in women, when the activity of their androgens increases, we see male pattern baldness. They start getting chin hair and their odor changes. They smell like onions. And it's a really. Kind of weird. Yeah, I hear that the onion thing a lot.

[Monica Padman]

So awful.

[Dr. Mary Claire Haver]

Monica, I am living my best life. You just stick with me, okay?

[Monica Padman]

So I like to hear that because my mom actually said the same thing. I don't think she did any hormone Therapy. But I was like, when did you hit menopause? She said, 50. And I was like, oh, man. Well, I'm nervous. I'm in perimenopause after I read this book. And she was like, well, I like it.

[Dr. Mary Claire Haver]

I smell like onions, My mouth is.

[Monica Padman]

Dry, and I'm happy as a glass.

[Dr. Mary Claire Haver]

So many women just go blindly into the night and they have no idea. And so one of my critics have said, you're just fear mongering. You want to scare people, whatever. I'm like, no, I want to educate so you're not blindsided. You know, imagine the cortisol levels that will come down where they're like, oh.

[Monica Padman]

This is what's going on.

[Dr. Mary Claire Haver]

This might be my menopause. Fine, whatever. Okay, we got this. I'm not going crazy. Especially the cognitive changes in the mental health. The divorce rates, the suicide rates are all right in there at this age.

[Dax Shepard]

They kind of peak there.

[Dr. Mary Claire Haver]

Peak suicide rates are 45 to 50.

[Dax Shepard]

Wow. And that should be the kind of transition in life where you're like, oh.

[Dr. Mary Claire Haver]

I'm gonna lean into work. We're gonna go off in the sunset here. No.

[Dax Shepard]

Wow, that's heartbreaking.

[Monica Padman]

And is that hormonal, too?

[Dr. Mary Claire Haver]

The neurotransmitters in the brain are heavily influenced by estrogen progesterone levels, and the brain doesn't like the chaos. So the real mental health that we see, the big, big problems are in Perry Post. Things tend to calm down, both cognitively and mental health. You still may need your sr, you know, whatever. But we see this wild uptick in Perry.

[Dax Shepard]

So decreased sex drive. I think this is also something that people have just taken for granted.

[Dr. Mary Claire Haver]

I learned this much about sex drive.

[Dax Shepard]

She's holding up a zero for the listener.

[Dr. Mary Claire Haver]

Holding up a zero. Sorry. I get my little diploma and I graduate, and I'm at the top of my class. I win lots of awards, and off we go. I'm gonna go be the best OB gyn. So the pregnant people come, and then these other people come. I'm like, ew. So, like, as you're walking out from the well Woman exam, I'm like, okay, we'll see you next year. She's like, can I ask you one more thing? Sure. My. I have low libido. I don't want to have sex. It's really affecting my marriage, and I was just like deer in the headlights.

[Monica Padman]

You're like, I don't know.

[Dax Shepard]

So you're old is probably what you're thinking.

[Dr. Mary Claire Haver]

Like, please. So I go out in the hallway And I find my boss who's our mentors when we first get out, keep us out of trouble. In those first couple years, I'm like, hey, so Ms. Smith, you know, everything's fine, she's healthy. But you know, sex, I can't even say it, you know, I'm deep south and taboo. And he's like, oh, tell her have some wine, she just needs to relax and it'll be fine. Just pat her on the knee. But she's gonna be okay.

[Dax Shepard]

Told her to anesthetize herself so she can get through it.

[Monica Padman]

Exactly.

[Dr. Mary Claire Haver]

Women just go through this at this age. So many people were complaining over and over again. I started looking for resources and I read Venus and Mars in the bedroom. Like that was my bible. That was the only thing I knew how to do. No one taught me. I was going back in my textbooks. Nothing was talking about sexual desire drive. I didn't even know all the causes of female sexual dysfunction. It was never a lecture. No one ever talked about it. Here I the expert going, I'll be right back. Let me see what I can find. So I ended up making little handouts for my patients on what I could dig up on desire and herbs. And I didn't know about. Well, they came out later, but addi and felici and testosterone and all these things that might be helpful to a woman and counseling and therapy and looking for orgasmic disorders and arousal disorders and pain disorders and pelvic floor dysfunction.

[Dax Shepard]

Because it's common for sex to get more painful. Right.

[Dr. Mary Claire Haver]

When we go through the menopause transition, 100% of us are going to lose, lose the protective effect of estrogen in the vagina, the vulva, the bladder, that whole what we now call the genital urinary system. Pubic bone all the way back and up to the bladder. We lose elasticity, we lose the ability to produce mucus. So if you biopsy to pre and postmenopausal vagina, premenopausal, it's this thick, velvety, full of mucous glands. Very resilient. It'll take a beating and be fine. Baby comes through there. It's traumatic, but they'll make it. And then postmenopausal looks like a desert. You went from this gorgeous thick moss, multi layered tissue to six cells laying on top of each other with no mucus, no nothing. Like a desert. All we have to do for those women is give them back estrogen in the vagina and all that tissue will grow back. Even at 70, you can absolutely prevent and reverse this condition. So I recommend lubricants for all of my patients on every sexual encounter. Just get used to it, do it proactively, normalize this. And then I'm advising not to wait until you start having symptoms to use vaginal estrogen as very safe. It's like skincare doesn't absorb much. There's very much risk free. If you have active breast cancer, you can still use it. It will save your life. I mean, it prevents UTIs. The best treatment for recurrent UTIs for a menopausal person is vaginal estrogen, not recurrent antibiotics. Yeah, they have creams, gels, they have a suppository, they have a ring. There's multiple ways, but generic and cheap. The cream works for most people.

[Dax Shepard]

Yeah.

[Monica Padman]

Wow.

[Dax Shepard]

Where's testosterone in the drive part?

[Dr. Mary Claire Haver]

So when we look at female sexual function, we have five buckets where she may not be happy. First of all, it has to bother her. Some women are like, I don't care and I'm never going to care. And I'm like, okay, then you're good. Other women are like, I used to have it, I miss it.

[Dax Shepard]

Yeah.

[Dr. Mary Claire Haver]

So you have to make sure she's not having pain. There's a pain disorder. She's not having a relationship disorder because no amount of testosterone is going to fix a bad relationship. Can she have an orgasm or is the plumbing still working? If she puts her mind to it.

[Dax Shepard]

Does that drop off?

[Dr. Mary Claire Haver]

You see, arousal disorders, it's more of a blood flow issue. I kind of had that. I was having delayed orgasm. Like, hello, everybody, everything's working. I'm ready. I was like, okay, fine. I need vaginal estrogen now. It took about eight years in menopause because I was on systemic, but I wasn't quite getting enough. And everything's fixed. Libido, which is desire. In medical we say hypoactive sexual desire disorder. Hsdd. That is a mood. It's totally in the brain. Everything's working down here, but it's the thought of it. And most women will come to say once we get going, I'm fine. So if a female has an arousal disorder, vaginal Viagra might work for her.

[Dax Shepard]

What does that do?

[Dr. Mary Claire Haver]

Increases blood flow. Vasodilator, specifically to the porpoise spongiosum. So that's the squishy part that gets erect. We have exactly the same tissue in the clitoris.

[Dax Shepard]

Well, your clitoris becomes my penis.

[Dr. Mary Claire Haver]

Same anatomy, except ours looks like Gumby and yours is like a little rocket. So we've ruled out all the things. And she's like, I love him. I'm not going anywhere. I miss it. Please help me. So we have two classes of meds that we talk about. One is testosterone. It works for great for these women. If it doesn't help her in three months, that's not the answer.

[Dax Shepard]

And the options for testosterone are.

[Dr. Mary Claire Haver]

So we don't have FDA approved option for women. So we're either having someone cook it up in a lab and a compounded cream generally.

[Dax Shepard]

So right there, red flag. Ridiculous, right?

[Dr. Mary Claire Haver]

Ridiculous. We have studies that prove safety and efficacy and all the things and she's so much happier. There is anecdotal evidence that also her stamina is better, her mood is better, muscle mass goes.

[Dax Shepard]

Decreases osteoporosis. Yeah.

[Dr. Mary Claire Haver]

So all that works together. So I don't want to say it's a chandelier. So I have low muscle mass genetically and I'm doing the things, eating the protein, working out as a full time job, wearing my weighted vest. And I was like, what if I tried some testosterone off label for myself, did not have a libido issue and no one was complaining. And then start some testosterone and I see an uptick in the area. He's a little more interested, he's not cuter, he's not pissing me off less. He's not my poor husband. But I'm just like okay a little more often. Or maybe I'm even initiating. Which had not happened in a long time and we've just reached a different level now and I think I would miss it if it was gone. So I'm like telling my patients this, certainly if you're distressed, let's go for it. But here's my experience.

[Monica Padman]

So that's a topical.

[Dr. Mary Claire Haver]

You don't want to do oral. There's no form available in the US that will not affect the liver. There's one they use in Australia and duck and know it, but it's not available here. So you're going to look at a tran non oral option. So some people are doing some compounded injectables. What we're doing in our clinic is either T stem gel or androgel. So we're doing the FDA approved gels for men. We're just using them off label for women. Interesting.

[Dax Shepard]

You can also get a capsule.

[Dr. Mary Claire Haver]

So there's troches that dissolve that are submucosal. So you put them under your tongue. Oh, I didn't know that. You mean the pellets. The pellet pellets are commercially available. They're Not FDA approved. There's a problem with pellets that we see kind of in the ethical realm. Two problems with pellets. If you go to a doctor and they are trying to talk you into pellets and they won't discuss any other form of hormone therapy that is an ethical red flock. They are financially benefiting from the sale of the pellets. And I just think you can do better because pellets are very hard to manage. You have this rapid rise. And I've seen females with testosterone levels in the four and five hundreds, and I am not kidding. They never made a female level pellet. They just give females the low level and say, you're running 200, you're fine, you're not gonna die.

[Dax Shepard]

They don't slowly dissolve at a predictable rate.

[Dr. Mary Claire Haver]

Supposed to. I've never seen a decay curve. Have you? They don't publish them. They're not FDA approved, so they don't have the same regulation. So I'm like, listen, we don't need to be doing this, and I can take it away tomorrow. If have a pellet, you are stuck until three months. Generally, or generally, I think we can do better for our patients. I don't need to make money putting pellets in people. It's a cash cow for a lot of practices. And I'm just really hesitant if your doctor is really railroading you. If they say, I only do pellets, I would probably buy.

[Monica Padman]

Interesting.

[Dax Shepard]

Okay, good tip. Okay, so back to. So we can do an injectable.

[Dr. Mary Claire Haver]

Injectable. You can do a cream. You just rub it, pick it up.

[Dax Shepard]

You get really hairy wherever you rub it. But that's fine.

[Dr. Mary Claire Haver]

You could. So I'll tell patients to put it here. Why is that real? Hair follicles here. I was studied on the shoulders.

[Monica Padman]

Okay.

[Dr. Mary Claire Haver]

We want to monitor them to see how they're absorbing, make sure we're not going over, checking their free and total testosterone levels and just seeing how they're doing.

[Dax Shepard]

I'll say I started on a cream. The only thing I didn't love about the cream is you have this dispensary for it and you click the clicky. The amount that comes out per click per day did not seem very consistent to me. It seemed a little all over the map. I much prefer just an injection. You know exactly what you're getting.

[Dr. Mary Claire Haver]

Another option to think about would be to do the T stem gentlemen gel or the androgel. It's in a pump, so a full pump is 20 grams. For women, we need 5 to 10 grams. So that's like a half pump or a pea sized amount. I tell my patients to put it on their inner arm where there's no hair follicles so they can see the pee. And then you just rub it in.

[Dax Shepard]

Do a little rub.

[Monica Padman]

Wow. Okay. So you're doing testosterone on your arm, estrogen on your vulva. What else?

[Dr. Mary Claire Haver]

I think I replaced my hormones like five way, you know. Yeah. For estrogen, there's oral and not and in non oral patches are what we usually prescribe in my clinic.

[Dax Shepard]

On your Instagram, you're a fan of those, right?

[Dr. Mary Claire Haver]

They're very inexpensive. We have multiple strains, so I have a lot of options for patients. But sometimes people have a reaction to the adhesive tape allergies. So we have gels and creams. It's just the expense goes up. The vaginal ring is great because you get two for one. You get systemic and vaginal, but they're like 2, 300 bucks. They last for three months. It's nice. You just throw it up there and forget about it.

[Dax Shepard]

Toss it in.

[Monica Padman]

Yeah, I get scared of that. Yeah.

[Dr. Mary Claire Haver]

It's not for everyone.

[Monica Padman]

Even like the diva cup. It's not for me having.

[Dax Shepard]

You don't want something in.

[Monica Padman]

Yeah, I don't.

[Dax Shepard]

You have an outsized fear of toxic shocks from this blood over.

[Monica Padman]

I have a real fear of it.

[Dr. Mary Claire Haver]

As you should.

[Monica Padman]

Yeah. It's scary and you die.

[Dr. Mary Claire Haver]

And then there's local estrogen options for the face and or the vagina and then your progesterone. So progesterone is typically given in the menopause. We're giving oral micronized progesterone. It's the safest, I believe.

[Dax Shepard]

I understand a lot about testosterone and estrogen and estradiol, but I don't know that I know a ton about progesterone. What is it doing?

[Dr. Mary Claire Haver]

So progesterone is mandatory if you have a uterus, if you're doing estrogen because. Because the inside lining of the uterus, the endometrium where the blood would be made each month, is sensitive to estrogen. If we let estrogen play in there unopposed, with progesterone, you'll develop hyperplasia and potentially malignancy.

[Dax Shepard]

This is where some of those studies were misleading, because that was in the.

[Dr. Mary Claire Haver]

Early days of hormone therapy and the like. Get your wife back. Sexy movement. With estrogen, they were doing just estrogen and women were getting endometrial cancer. So we learned that lesson. You give her a progestogen, you will negate that so if she has a uterus without the Mirena iud, which has progesterone. Progesterone in it, you must give progesterone to not potentially give her cancer. Turns out progesterone is amazing for sleep. It upregulates GABA in the brain and it is our sleep sleep hormone. So when patients are coming in in early perimenopause, still having regular cycles, but they can't sleep two or three in the morning, progesterone might be your new best friend. It's fine to start with progesterone without estrogen. We do that in a lot of cases.

[Monica Padman]

I have so many things to do.

[Dr. Mary Claire Haver]

For the eight anxiety thoughts, it's great for that. 2am, wake up. I'll just take an extra one if I still have it.

[Monica Padman]

I mainly have a hard time just falling asleep.

[Dr. Mary Claire Haver]

I mean, it's worth the trial. It's not going to hurt you. It's a natural one.

[Monica Padman]

And none of this is a problem with getting pregnant.

[Dr. Mary Claire Haver]

If you're in perimenopause, your chances of getting pregnant are lower. But if you are trying to spontaneously get pregnant, you have to make sure you're giving low enough doses where you're not going to inhibit a severe ovulation. And menopause hormone therapy really was not high enough to suppress ovulation. So the biggest difference between birth control pills and menopause hormone therapy, you think about why they were created. Birth control was formed for contraception. We need a high enough dose to shut the signal down from the hypothalamus, to tell the hypothalamus we're cool, we got enough estrogen, no signals. No signals, no ovulation. Menopause hormone therapy was developed to simply stop a hot flash. You don't need nearly as much.

[Monica Padman]

Got it.

[Dax Shepard]

So it's lower.

[Dr. Mary Claire Haver]

Formulation, though, is different because of big pharma. Formulation is tends to be ethanyl estradiol, which is cheap and easy to make, and it's a hundred times as potent as estradiol. And that's why you have those little tiny birth control pills. Whereas estradiol in its natural form, which is body identical, it's much less potent than its cousin, ethanyl estradiol, but it's got a great safety profile and you don't need much to stop the hot flash. Now, how much do we need to prevent cardiovascular disease? You don't need much to help your bones. They did study those numbers. So we're all kind of debating if we're going to check levels, what's therapeutic.

[Monica Padman]

Okay. Wow.

[Dax Shepard]

Okay. So we really covered hrt, hormone replacement therapy. I'm so glad you're an advocate for it. I think it's insane that women have been just left out of this. What I have experienced being on hormone therapy, which is made me want to work again, made me want to do my hobbies again, made me mentally and then my fitness, everything, all the things I remember, Kristen, going like, this is bullshit. You're right, it is. This is insane.

[Dr. Mary Claire Haver]

How many doctors did you go to.

[Dax Shepard]

Before they gave me to dying? I have to police them.

[Dr. Mary Claire Haver]

A woman on average has to go to six to eight doctors before her menopause is diagnosed. This is how bad the problem is.

[Dax Shepard]

Well, I'll be clear. The general pract tend to still be pretty adverse across the board, in my experience. But we have hormone clinics on every 10ft for men. Most of them don't see women. So all one needs to do is go there. You actually need to police them, I think is my tip.

[Dr. Mary Claire Haver]

Yeah. And that's kind of the pellet. It's the biot, really, that got into, whoa, let's put these in women and see what happens, you know?

[Dax Shepard]

Yeah. And you don't need to be at 1100.

[Dr. Mary Claire Haver]

Yeah. I mean, these women are coming in, they're like, I don't know why my hair is falling out of beard. And I check her level and it's 4, 450. I'm like, I might have a clue.

[Dax Shepard]

Because women, what naturally in their 30s would hover around.

[Dr. Mary Claire Haver]

So around 40 to 70.

[Dax Shepard]

Yeah. So that's a good 8X.

[Dr. Mary Claire Haver]

So, you know, most of them come in, in menopause. 12, 15, 20, 25. Let's get you up. So I'm trying to titrate my patients 60 to 70. Let's overshoot just a little bit and see if this is going to help with your libido. But there are two FDA approved medications for libido that are not testosterone. One is Vylisi and it is an injection you give yourself 45 minutes before and it causes a massive dump of melanocortin that then stimulates dopamine. And when our dopamine levels are higher, it makes us want to do things. Yeah, we want the other one. Unfortunately, most of my patients don't choose that because they're like, there's a praying mantis on the other end of this waiting the 45 minutes going, is it working?

[Dax Shepard]

Well, additionally, it's almost the wrong medicine for the arousal type that women are, which is like, that's great. For a man. Because a man's sitting around thinking about wanting to fuck in an hour, and he's like, oh, yeah, I'll do this. Whereas a woman needs to be brought into arousal type. Right.

[Dr. Mary Claire Haver]

Very romantic.

[Monica Padman]

Yeah.

[Dax Shepard]

So it's almost like a counterintuitive solution.

[Dr. Mary Claire Haver]

For the women who like it and can unlock that part of their brain. It's great.

[Monica Padman]

Is it a base dopamine? Like, don't give it to an addict.

[Dr. Mary Claire Haver]

I've not seen those studies. I've not had a patient yet who was like, yes, please. Addie is another. So Addy was studied in mood and they saw an uptick.

[Dax Shepard]

Tell us how Addy works.

[Dr. Mary Claire Haver]

Addy works, Same thing. It's gonna increase your dopamine levels, and it's something you take every day. Was studied in mood. It works by increasing happy sexual encounters a couple of more times a month or however they measure it. So the detractors of Addie are like, well, that's not enough. And the women are okay with it.

[Monica Padman]

Right, right, right, right.

[Dr. Mary Claire Haver]

If you were having none or one, go into four.

[Dax Shepard]

That's enormous.

[Dr. Mary Claire Haver]

I'm like, let the patients decide. Most of my patients choose testosterone purely because of cost and potentially the other benefits for bone and muscle. Even though we don't have great studies yet, but the anecdotal data is looking very positive. Positive in that area.

[Dax Shepard]

Right. So if you just kind of reverse engineer, as I understand, or if you believe ATIA and I do, the best way to combat osteoporosis is to not get osteoporosis.

[Monica Padman]

Well, yeah, that'd be great.

[Dax Shepard]

Is to not get it. But your bones respond immediately to muscle and strain. So if you can work out heavy, you're putting a lot of strain on your bones, and they will react, they will make themselves stronger. And for you to do a lot of strenuous and high intensity heavy lifting, you're going to benefit from testosterone with your muscles. They're all related.

[Dr. Mary Claire Haver]

The musculoskeletal unit works together. It's not like it works in isolation. So testosterone will help a little bit. We looked at one of the things from whi, from the Women's In Health Initiative, is they followed these women forever. And they followed them into nursing homes and they looked at protein intake and frailty scores. And the women who ate the most protein, like 1.6 grams for every kilogram of lean body mass, had much lower frailty scores. I'm drilling down. We're going to prevent your osteoporosis. We're going to consider Hormone therapy and estrogen we know will prevent 50% of fractures.

[Dax Shepard]

Yeah.

[Dr. Mary Claire Haver]

So she's on HRT. We're gonna work out heavy, we're gonna lift heavy, and we're gonna eat the protein, we're gonna give some creatine on board. So all of that works synergistically. I call it my nursing home prevention program. Because once I put out the fire for menopause and she's functional and she's your mom and me now, we're like, I don't want to be my mom. My mother is in a nursing home with Alzheimer's and a broken hip. She just got out of rehab. She's not doing well.

[Monica Padman]

Right.

[Dr. Mary Claire Haver]

It's gonna take a long time.

[Dax Shepard]

And all of these four horizons are metabolic disorders.

[Dr. Mary Claire Haver]

Alzheimer's is not the natural course of aging brain. There's 14 risk factors, so of course, the easy stuff. Don't smoke, eat a balanced diet, stay away from processed foods. Don't get diabetes, don't get insulin resistance, all of that. But then it's social connection. Keep your brain moving, thinking, working. Do the puzzles. When my dad died, mama had lost Bob in 2015, one of my brothers, my second birth of esophageal cancer. The third birthday. They lost the one when he was 18. When I was 9, she'd lost two kids and a husband in five years. And she was like, I'm out. She locked herself in the house and started drinking, which I can't blame her. What I've seen it do to her relationships with her kids and this long, protracted course she's gonna have until she goes and all the talking of the children on how to manage and who's doing what. I don't want that.

[Monica Padman]

Exactly.

[Dr. Mary Claire Haver]

You know, I want to die like my dad. He was great until like the last month, and then he kind of slowed down. And then we all gathered around and we sang songs and told stories and were there and sang to him, and he was sleep into a coma, and then it was over.

[Monica Padman]

Yeah, that sounds great.

[Dr. Mary Claire Haver]

That's not what happens to women. We have this nursing home. She's frail, and she breaks and. Yeah, like, no.

[Monica Padman]

Yeah.

[Dax Shepard]

Boy, that's so true. For my grandparents, the men just collapsed.

[Dr. Mary Claire Haver]

Yeah.

[Dax Shepard]

And the women just struggled for five years and got crankier, more miserable.

[Dr. Mary Claire Haver]

My patients are not interested in option B. Yeah.

[Dax Shepard]

Okay, so we have diet and I'm glad you're protein.

[Dr. Mary Claire Haver]

Top nutrition tips for aging and longevity for women in menopause. Is she limiting added sugars so the whole keto movement Sugars got Demonized. But it turns out that sugars added to stuff are much worse than found naturally in fruits and vegetables because the sugar in a fruit is wrapped in a fruit which has fiber and vitamins and minerals. And this is a doctor who sells supplements. But I think everyone should be able to get everything they need from food. That just doesn't happen. That would be amazing if it happened.

[Dax Shepard]

That's ideal.

[Dr. Mary Claire Haver]

I'm here to help you fill in the gaps where you need it. Fiber, vitamin D. 80% of my patients are deficient in vitamin D. We're checking everyone's levels. We're telling them to supplement. I'm giving prescription doses. If they're super low, we're trying to give them loading doses. Magnesium is really great for a lot of patients. I have a specific collagen product that was studied in menopausal osteoporosis that seems to have some benefit. So we're talking about that for movement. Most of my patients are walking. Minimum. You have to meet her where she is. If she's sedentary, just walking 30 minutes a day will decrease her risk of diabetes by 50%.

[Dax Shepard]

Yeah.

[Dr. Mary Claire Haver]

Wow. That's it. If she's walking, let's put on a weighted vest. If she's doing that, let's get in the gym. You have to meet them where they are, all the fit fluencers they're lifting and all that. I'm like, that. Scares the shit out of most women, right?

[Dax Shepard]

Insurmountable.

[Dr. Mary Claire Haver]

So we're easing them into it. I'd love to run these challenges for my followers. We'll get 100,000 people who are lifting weights for the first time. And I'll have a fitness person in there. I didn't know either I was injuring myself.

[Dax Shepard]

Of all the ologies you didn't do, Ken is.

[Dr. Mary Claire Haver]

The ology is not on my list. So I will hire someone to come in and show my followers how to do a squat. Say you don't have to do a lot of different exercises, just the really basic push, pull.

[Dax Shepard]

There's some real key ones that are super beneficial, particularly for osteoporosis.

[Dr. Mary Claire Haver]

Osteoporosis, squats, lunges. For osteoporosis, good studies with walking with a weighted vest. Doing yoga with a weighted vest. Balance training with a weighted vest is super helpful. Vibratory plates, again. You're stimulating that musculoskeletal unit. I tell patients to brush their teeth on one foot because you're working on balance. To always be decreasing your risk of fall with balance training and then lifting. They were putting 80 year old ladies in the gym from nursing homes and they were seeing all these gains.

[Dax Shepard]

And grip strength's a big indicator.

[Dr. Mary Claire Haver]

So grip strength is a proxy for the rest of your body.

[Dax Shepard]

Right. If you do deadlifts, you will inadvertently get.

[Dr. Mary Claire Haver]

Yeah. So it's not the grip strength. It's. That's an easy thing to measure.

[Monica Padman]

I got it.

[Dr. Mary Claire Haver]

That's an indicator.

[Dax Shepard]

Stay tuned for more armchair expert if you dare. We are supported by ZipRecruiter. Oh, get recruiting. Monica. I love our job more than anything.

[Monica Padman]

We got so lucky.

[Dax Shepard]

We did. I just show up so excited to do the thing we get to do and I couldn't be more grateful. Now if you're doing what you love to do, there's nothing better than being surrounded by people who, who love it as much as you. And if you own your own business, you want to hire employees who love what they do to boost the overall success of your business. Plus make it a pretty great place to work. But how do you find passionate employees who are a good fit for all your roles? ZipRecruiter. And right now you can try it for [e-mail] Dax ZipRecruiter is the hiring site employers prefer the Most based on G2. ZipRecruiter's powerful matching technology works fast to find top talent so you don't waste time or money. Hire experienced people who are excited excited about what they do with ZipRecruiter. Four out of five employers who post on ZipRecruiter get a quality candidate within the first day. See for yourself. Go to this exclusive web address to try ZipRecruiter for free. Ziprecruiter.com Dax again that ZipRecruiter.com Dax ZipRecruiter the smartest way to hire we are supported by Prime Video. If you're looking for a way to streamline your streaming, Prime Video has got you covered. On Prime Video, you can add over a hundred subscriptions like Max, Apple TV plus and Paramount plus all in one app. Experience the convenience of having all your favorite subscriptions in your Prime Video account with one login and one password. What a dream. Everyone's watching White Lotus right now on Max. We are?

[Monica Padman]

Yeah.

[Dax Shepard]

Yeah. We are so excited about this season and we just had Walton Goggins on the show. We're inordinately excited to see his character's journey in time. And then of course, we're tuning into Severance season two on Apple TV plus with recent guest Adam Scott. Instead of toggling back and forth between different streaming platforms, you can watch both of these shows and so much more amazing content without ever leaving the Prime Video app. Unlock a world of movies, TV and sports all in one app. Check out subscriptions on Prime Video. We are supported by Happy Egg. Free range Eggs from Happy Egg are made by hens who live acres and are treated with care by family farmers. Happy hens, happy eggs. You really can taste the difference. And you can see the difference too. This is what I like the most. The yolks have that deep orange color that's packed with flavor. Eating Happy eggs are a great way to start your day or switch it up and have breakfast for dinner. Frittatas, quiches, omelets, whatever you're making with eggs, Happy Egg will elevate your dishes and make them taste even better. I love these. I'm, I'm a sucker for that deep, deep orangyo.

[Monica Padman]

I am too. And even when you scramble it, it has a beautiful color.

[Dax Shepard]

Ooh. Crack open Happy with Happy Egg. You'll find them in the yellow carton. Visit happyegg.comdax to find a store near you. So that's exercise diet. Now, where do GLP1s fit into this?

[Dr. Mary Claire Haver]

We do use them in our clinic and probably 20% of our patients end up on them. When they it's usually, hi, I'm in menopause, help me, I'm dying. Probably 50 to 60% of them now have a weight problem, have either always had it or they have new weight gain. So the first thing we do is break down where their fat is if they have it. Because some patients come in, they're just muscular and they've been told they're obese their whole life and they're crying their eyes out because, oh my God, I'm healthy. What if they have a visceral fat problem? I really don't care about subcutaneous fat. It's not metabolically that active. It's just storage. It's the intra abdominal fat that'll kill you. And so we are working on that number. And what do we know works for that starvation, but that's not why they're there. High fiber diets, low added sugar diets, rich in probiotics or a probiotic supplement, Zone two training, all of that works. So we're focusing on that and we get her start an HRT. Across the menopause transition, a woman will go from 8% of her total body fat being visceral to 23 on average just from becoming menopausal. No changes in diet and exercise. I have the unusual circumstance of most of these people. Follow me, have read the book. It's an investment to come and see me because I'm outside of this insurance model. So they've done their homework.

[Dax Shepard]

They're dedicated.

[Dr. Mary Claire Haver]

Yeah. So they're like, okay, let's do this. We start hrt, we bring them back in three months. If her cardiometabolic risk factors are still there, and she's like, I want to give it a try. I'm like, let's go for it. A GLP one needs a lot of counseling to be done.

[Dax Shepard]

Well, yeah, because you're taking on a lot of risk of muscle mass loss, which is so important for your lcd. Although there's supposed to be a new one coming out.

[Dr. Mary Claire Haver]

Yeah, that's three. So there's temiglutide, which had just the GLP one, and then tirzepatide, which is what we usually start with now, which has the GLP1 and the Glutide, glucagon agonist. And then this new one has. I forget what the third ingredient is, but I'm excited to see when it comes out. Yeah.

[Dax Shepard]

It's supposed to reduce the loss of muscle mass.

[Dr. Mary Claire Haver]

In our clinic, if the patients eat the protein and do the resistance training, we are seeing some muscle loss expected, but not this massive loss and they are able to maintain. And then it's like that first three months, if they lose 20 pounds, maybe five is muscle, maybe 20%, but then that just levels out and it's all fat loss after that. It is absolutely the coolest thing to watch because we bring em back every six weeks to check their muscle mass. We stay on top of it. We're checking in with them. They're doing this not to look great in a bikini. I mean, maybe that'll happen and that'll be great. But they're doing this to decrease their risk of all these diseases they don't want to die from or plague their.

[Dax Shepard]

Children the last 15 years of their life or 10 years of their life.

[Monica Padman]

They're so happy during those.

[Dr. Mary Claire Haver]

They're so motivated to avoid the diseases that plague their elders, as you might expect.

[Dax Shepard]

My wife, knowing that I was interviewing you, had some specific questions. Are there any ways to predict when onset will be? Kristin heard your mother's sister can be a guy.

[Dr. Mary Claire Haver]

There is a genetic component, so there's an ethnic genetic component. So I was telling Monica, for me, it's 51 is average. For her it's 46.7. African Americans is about 18 months behind. Caucasian, Asians get a little bit longer.

[Monica Padman]

Okay, interesting. Does sexual activity impact that trauma does.

[Dr. Mary Claire Haver]

So we know lots of things that speed it up. You were born with X amount of eggs, and they're gonna go before you die if you live a normal lifespan. But what do we know speeds up the process of egg loss? Smoking, chemotherapy, radiation, abdominal surgery. You have a hysterectomy, leave the ovaries behind. But we have cut a significant blood supply to the ovary. We're gonna lose average of four years off the life of the ovary. A lot of women undergoing necessary hysterectomy aren't getting that counseling. There's nothing they can do about it. But wouldn't that be nice to know?

[Monica Padman]

Yeah. I have a friend's friend who had to have a hysterectomy. She's like, I'm about to be in menopause.

[Dax Shepard]

My mom had one when she was 30.

[Dr. Mary Claire Haver]

My mom had one after baby number eight. They were like, this is your Catholic birth control time for that uterus to come out.

[Monica Padman]

So does it instig menopause?

[Dr. Mary Claire Haver]

It cuts the blood flow, so you lose the shelf life of the ovary where you may have gone through a 51. Now you back that up four years on average.

[Monica Padman]

Okay, but it's not like you have the hysterectomy and then.

[Dr. Mary Claire Haver]

No. Unless they remove the ovary. Right, exactly. Which is surgical menopause. And we have premature menopause and early menopause, so those are a little bit different animals. Premature ovarian insufficiency is usually with an autoimmune condition, so it has its own set of risks. And then surgical menopause, you don't get a trial period. It's like, boom. So whenever I had to take out ovaries for medical reasons, I was putting a patch on them in the or.

[Monica Padman]

Yeah, that makes sense.

[Dax Shepard]

Okay, so ethnic is a predictor. Ethnicity.

[Dr. Mary Claire Haver]

And then family history. You look at the women in your family, when did they go through it?

[Dax Shepard]

But on your mom's side, is she right about it?

[Dr. Mary Claire Haver]

Mom's side and sometimes dad's side. I mean, you're half genetically.

[Dax Shepard]

She compared it to male pattern baldness, which we know comes from your mom. But I was saying, well, that's because it's on the 45th chromosome and you. You can only get a chromosomal. Yeah, so it's not like that.

[Dr. Mary Claire Haver]

It's more of a general health and kind of how things are going to go. Certain tribes in Africa have A lot of twins or certain cultures are more prone to twins. That's more of a general than a chromosome thing.

[Dax Shepard]

There's a couple things happening. A, it was completely understudied, as you pointed out. It's beginning to get studied, but also we're seeing an art. What do you think about the impact of all fours?

[Dr. Mary Claire Haver]

I'm literally on 79% of the chapter. First of all, I hate the protagonist. Okay, yeah, she's not my girl. But I'm researching and writing the new perimenopause. It's not coming out till 2026. I'm in the middle of it. And so Gretchen, who's my co writer. I write like an asshole. I am so clinical. My collaborator will take my disgusting prose and spin it into something that sounds digestible. Yeah, like a human. Not a normal person could read, not geek. And Gretchen's like, read it from the perspective this is resonating. And that just flipped the switch for me. I read for entertainment. I read about fairies and dragons and lots of sex. And my daughter reads all the dystopian novels. So I read to read with her and talk about stuff. And then I read medical journal articles. So to pick up a book that is outside of my usual and not have a 15 year old little girl who turns into a princess with magical powers was, like, hard.

[Dax Shepard]

Yeah.

[Dr. Mary Claire Haver]

I'm trying to identify this and she says, stop trying to identify. Read it and figure out why the hell the world is resonating. And then I'm like, oh. So then the doctor in me is like, she's having palpitations. That's a panic attack. That's menopause. That's menopause. That's menopause. Now have an affair and redo this room in this weird hotel that's a whole nother. But I'm getting it now. It is so hard. Resonating movie rights are there.

[Monica Padman]

Oh, yeah. All my friends read it.

[Dr. Mary Claire Haver]

Did you love it?

[Monica Padman]

I loved it.

[Dax Shepard]

I haven't read it. I've been told what it's about from Monica, who loved it. To me, it's like I was prescribed a role I don't want, or I want to test or I want to shake up or I want to break because I just prescribed it and now I want to.

[Dr. Mary Claire Haver]

I don't want it anymore.

[Dax Shepard]

That's so perfectly parallel to hey, guess what? I don't want to live a third of my life in discomfort.

[Dr. Mary Claire Haver]

That. So what I'm finding, and I think why the divorce rate's so high is that Women and my. Myself included. And thank God my relationship is better than it's ever been. And we're working together. We have a small business through the supplement company and he's now running it. I've never liked him more, but yeah, she's getting to choose the last third of her life and so did I. I chose differently than her and that's okay. But women are circling the wagons around themselves. Menopause is them so hard, they are giving themselves permission to put themselves first.

[Monica Padman]

Yes.

[Dax Shepard]

To me, it's. I've had enough on all the levels.

[Dr. Mary Claire Haver]

And now it's a survival thing if I don't do this. For me, my journey was quit a job that didn't serve me. Stop serving a system that was broken. Absolutely. Get the hell out of Dodge. Figure out what the fuck I wanted to do with my life. Put my own oxygen mask on first.

[Monica Padman]

It's time for you.

[Dr. Mary Claire Haver]

And I really didn't give a shit if the kids or my husband cared, but I had to do this. Thank God it all worked out and look where I am now.

[Monica Padman]

But that's what it is. It's. I'm making choices for the first time that are for me that aren't just handed societally to you. But what's scary about that book is now is the time I get to make the choices and my body is disintegrating. That's the part that I think everyone was like, oh my God, we have to wait till then. And it's coinciding with that. What do we do?

[Dax Shepard]

How do we prevent ourselves from getting to the too late part?

[Monica Padman]

Exactly.

[Dr. Mary Claire Haver]

Too late to celebrate. Well, educate yourself as soon as possible. Yeah, that's part of my mission, is just vomiting all over social media.

[Dax Shepard]

I think a lot of people think of HRT as being what you do after you have all the symptoms.

[Monica Padman]

Right.

[Dax Shepard]

That's. That's the next wave, I think is preventative.

[Dr. Mary Claire Haver]

Where some of the hardcore old school menopause people are like, don't say prevent. Like, come after me every time I talk. Look, FDA approved for the prevention of osteoporosis, and that is enough for me. But let me tell you, the U.S. preventative Services Tax force needs to get their shit together because you have a window of opportunity for cardiovascular disease prevention. And the data coming out clearly for mental health. We can prevent the suicides, the job loss, the brain fog. Unless you're on the dementia spectrum with early and judicial hormone therapy not allowing your body to withdraw and go through.

[Dax Shepard]

Yeah, why wait till you have all the symptoms?

[Dr. Mary Claire Haver]

Why wait till your vagina's broken?

[Dax Shepard]

But there's no other condition that we don't think early detection and treatment is beneficial.

[Dr. Mary Claire Haver]

It's never been thought of like that. It's way too miserable. And then it was severe symptoms. Only a doctor's gonna tell me if my symptoms are severe enough.

[Monica Padman]

What does that even mean?

[Dr. Mary Claire Haver]

What does that even mean?

[Dax Shepard]

Why, it's like some old vestigial Protestant suffering.

[Dr. Mary Claire Haver]

Something women have been taught to minimal. The WW story.

[Dax Shepard]

Oh yeah, whiny women.

[Dr. Mary Claire Haver]

The whiny woman. This is just what women go through. They tend to whine a lot.

[Dax Shepard]

Early in her residency, they'd come to her and say, we got a WW in room 305.

[Dr. Mary Claire Haver]

The woman with a laundry list of complaints, very vague weight gain, brain fog, low libido. And they're like, check her thyroid, get these tests, make sure you're not missing anything. But you're not going to be able to help her.

[Dax Shepard]

It's just a whiny woman.

[Dr. Mary Claire Haver]

Just one of those other doctors across the country. And in California they called it Whiny Gyne's.

[Dax Shepard]

Oh, nice.

[Dr. Mary Claire Haver]

And on the east coast, around New York, it was tbd, Total Body Dolor. And in Miami, it was Madame Dolores.

[Dax Shepard]

Oh my God, what is that pain?

[Dr. Mary Claire Haver]

Oh, like she's got a lot of pain. Women who come in and complain a lot. Kind of vague libido. Go have some wine. You'll be okay? Yeah, yeah.

[Monica Padman]

Oh my God, this is wild.

[Dr. Mary Claire Haver]

I don't want to scare people, but.

[Monica Padman]

It'S good to know we don't know anything.

[Dr. Mary Claire Haver]

And your doctor, not their fault, may not know anything.

[Monica Padman]

None of us know. Even the smart people who are educated. I do. These girls dinners. And we just had one recently and we were talking about something random. We were like, why don't we know the answers to any of these questions that keep popping up about our own bodies?

[Dr. Mary Claire Haver]

Yeah, because it was never studied. Women in medicine have been treated as small men. So excluded from studies till 94 because of thalidomide. And what happened? If there's a chance in hell she might be pregnant, we need to exclude her. And oh, we probably shouldn't study them anyway because hormones are hard. Yeah, they didn't even study female rats in the lab. It was only me. Because they have estrus.

[Dax Shepard]

They too.

[Dr. Mary Claire Haver]

So they too will fuck up your study. The cardiovascular data is awful for women. You go into the ER with a heart attack. If you're a woman, you have a 50% higher chance of dying than if you're a Man. Because we have atypical chest pain. So men have the classic clutching their chest, going up their neck, sliding down their arm. You're an actor and they're like, pretend you're having a heart attack. I know exactly what you're going to do. A woman. A woman has fatigue, abdominal pain. It's very vague. Because men have the lad. The widowmaker. The very large vessels that immediately come out of the aorta to dive into the heart muscle to feed that heart. That's where the plaques happen. Women, it's way down below that. It's the diffuse microvascular disease.

[Dax Shepard]

You're always shoving it down.

[Dr. Mary Claire Haver]

Oh. Another way to speed up your menopause is trauma. So there was a study that looked at women who were sexually abused who then had kids who went on to be sexually abused, and they went through menopause nine years sooner.

[Monica Padman]

Wow.

[Dax Shepard]

My mom must have hit menopause at, like, 35 because she had a hysterectomy. She's got the trauma. Then there's kids with trauma.

[Monica Padman]

Are her libidos okay?

[Dax Shepard]

That somehow is. Well, I think it's trauma related, but yeah, that's true.

[Monica Padman]

There's a million factors.

[Dax Shepard]

Your book's a bestseller. The new menopause. You have the Mary Claire Wellness Clinic.

[Dr. Mary Claire Haver]

It's my little baby clinic in Galveston.

[Dax Shepard]

You have many millions of followers that are interested in this subject.

[Monica Padman]

You were the person that people wanted.

[Dax Shepard]

Yeah. We turned it over to America and said, who's your favorite menopause expert? And you were voted on. You were elected.

[Monica Padman]

We were like, who do you want to come on? Experts. And your name came up over and.

[Dr. Mary Claire Haver]

Over and over again. You know, it's a different audience. But is it. It's all women.

[Dax Shepard]

No, we have a lot of. A lot of women.

[Monica Padman]

Just people need to know. People don't know.

[Dr. Mary Claire Haver]

Well, I appreciate being on here, and actually, my kids now think I'm cool.

[Dax Shepard]

Oh, wonderful. Two daughters.

[Dr. Mary Claire Haver]

Two daughters, 21 and 24.

[Dax Shepard]

Okay, cool.

[Monica Padman]

Are they on? Oh, that's a question. How early can someone get on these things?

[Dr. Mary Claire Haver]

Well, it's a little early for them. So Katherine's in med school. She's tough. She has guaranteed me she's not doing obgyn. But talk about having someone hold a mirror up to you and keep you in line and double check your facts behind your back.

[Monica Padman]

Y.

[Dr. Mary Claire Haver]

So I'm, like, sitting out studies, and she is literally looking at that to make sure I am toe in the line. She's talked about it. She's a little freaked out and wants to Freeze her eggs now for the highest quality.

[Monica Padman]

That's the move I kind of do too.

[Dr. Mary Claire Haver]

I did a talk. I was at Reese's event. Hello, sunshine. I was the MC for the first time. That was fun of a pan. And one of the panelists started this where you go and you donate your eggs, but you get to keep some.

[Dax Shepard]

Oh.

[Dr. Mary Claire Haver]

So it's a way for the younger women with these juicy, gorgeous eggs to look forward.

[Dax Shepard]

Oh, it gets paid for by the right.

[Monica Padman]

That's nice.

[Dr. Mary Claire Haver]

She loves to keep a few for herself.

[Dax Shepard]

Oh, I like a little for you, little for me.

[Dr. Mary Claire Haver]

I'm a terrible host because I forgot the name of the company, but, you.

[Monica Padman]

Know, in the fact check. So cool.

[Dr. Mary Claire Haver]

So I went home and told Catherine about it because she's starting to think about that kind of stuff.

[Monica Padman]

Yeah, I love that.

[Dax Shepard]

I'll be whispering that to my girls.

[Monica Padman]

Oh, yeah.

[Dax Shepard]

Then the time cl.

[Dr. Mary Claire Haver]

I have a friend in Telluride who gifted his daughter with egg retrieval. Yes.

[Monica Padman]

Again, I didn't even know about this. I didn't even know about egg freezing, really. Like, you kind of hear about it and then my best friend works at Netflix. They pay for that. And so she was like, oh, I'm getting this done.

[Dr. Mary Claire Haver]

That's a covered benefit. That's amazing.

[Monica Padman]

It's amazing.

[Dax Shepard]

I mean, it's smart for them too. They have someone in the prime of their career who doesn't want to necessarily take the time at that moment.

[Monica Padman]

It's so smart. But I was like, why are you doing that? She was like, well, they're paying for it and you might as well. And I was like, interesting. So then that's when thinking about it. But my age person did not think about it at all.

[Dr. Mary Claire Haver]

Did you just do it?

[Monica Padman]

I did it at 35.

[Dr. Mary Claire Haver]

Okay.

[Monica Padman]

And then 36.

[Dax Shepard]

It's ubiquitous and common knowledge to go, like, at 35, you're officially in a.

[Dr. Mary Claire Haver]

Geriatric cliff and all that. But it is a steady state.

[Monica Padman]

But I did better the second time.

[Dr. Mary Claire Haver]

Weirdly amazing, but I wish I had.

[Monica Padman]

Known so much earlier and just done it and felt Insurance.

[Dr. Mary Claire Haver]

My 21 year old is not on the radar. She's just trying not to be pregnant and is living her best life.

[Dax Shepard]

I know you're trying not to get pregnant. It's counterintuitive.

[Dr. Mary Claire Haver]

That girl gets to college. My oldest is by the book, straight A's, pre med. I'm like, go to the party. Have fun. Come on. I'm like, so worried about her social life. My second one has rolled with 20 kids her whole life you know, she gets there within October. She's like, I'm out of money. Like, she went with her summer money and her graduation money. I'm like, what? I check her account. I'm like, bars, beers, clothes.

[Monica Padman]

About right.

[Dr. Mary Claire Haver]

Fast food. I go, you have a meal ticket. She goes, I don't like it. So I'm like, you still have an allowance. I'm not gonna let you starve. But she went and got a job, and now she's a nanny.

[Monica Padman]

Oh, that's great.

[Dr. Mary Claire Haver]

The funniest stories ever is her taking care of other people's kids. That is these Baton Rouge moms.

[Monica Padman]

Well, that will definitely not get her to freeze her eggs. Nannying.

[Dr. Mary Claire Haver]

I will say that she's not at all worried.

[Monica Padman]

Yeah. To any young people. I just really encourage it.

[Dax Shepard]

I think a lot of people get a ton on your book. It's wonderful. The new menopause book. And please follow you. What's your handle on Instagram, Dr. Mary Claire?

[Dr. Mary Claire Haver]

D R M A R Y C L A I R E. You're very.

[Dax Shepard]

Cute in your videos. I watched a hundred of them today and they're so cute.

[Dr. Mary Claire Haver]

Most, no makeup.

[Dax Shepard]

She's in her weight dress.

[Monica Padman]

Glam with me.

[Dr. Mary Claire Haver]

And I'm like, no one's going to recognize me. Who is this girl?

[Monica Padman]

Oh, my God. That's so great. And you're doing all these fun things. You mentioned Reese. I know you're doing something tomorrow. That's very cool. Love it.

[Dax Shepard]

We're grateful for you.

[Dr. Mary Claire Haver]

Thank you.

[Dax Shepard]

The women I know are so grateful.

[Monica Padman]

For you big time.

[Dr. Mary Claire Haver]

Yeah.

[Dax Shepard]

So everybody read the book. Follow you on Instagram. This was awesome.

[Monica Padman]

We're so glad we finally got you.

[Dr. Mary Claire Haver]

Stay tuned for the Fact check.

[Monica Padman]

It's where the party's at. Hi.

[Dax Shepard]

Hello.

[Monica Padman]

Cute jacket.

[Dax Shepard]

Oh, thank you. Instagram. Impulse Buy. Really got one in this color and one in blue.

[Monica Padman]

From where?

[Dax Shepard]

Marine Layer.

[Monica Padman]

We like Marine Lay.

[Dr. Mary Claire Haver]

Yeah.

[Dax Shepard]

That's a place. That's a thing.

[Dr. Mary Claire Haver]

We.

[Monica Padman]

Our sweatshirts were from Marine Layer for a little while.

[Dax Shepard]

Yeah. I like this quilted thing.

[Monica Padman]

Yeah, quilted is nice.

[Dax Shepard]

That's what we call. Well, what one's quilted for comfort? The toilet tissue.

[Monica Padman]

Oh, Charman. Charman.

[Dax Shepard]

The quilted Quicker. Well, that's a paper towel.

[Monica Padman]

Yeah, that's paper towel.

[Dax Shepard]

The Quicker picker. This is Mandela effect we've created.

[Monica Padman]

Wow.

[Dax Shepard]

People like, do you think there's a product called Charman's Quilted the Quicker Picker Upper?

[Monica Padman]

I would say yes, definitely. Because it's Bounty.

[Dax Shepard]

Bounty. The Quicker Picker upper.

[Monica Padman]

But the Bounty doesn't have the same alliteration as Charmin.

[Dax Shepard]

And quicker Charman. Quicker picker.

[Monica Padman]

Upper.

[Dax Shepard]

How's your morning?

[Monica Padman]

My morning was good. Every two weeks. I get a flower delivery on Friday from Flamingo Estate.

[Dax Shepard]

Okay.

[Monica Padman]

And it's really exciting.

[Dax Shepard]

It is. You've signed up for a bi weekly annual sitch.

[Monica Padman]

Yeah.

[Dax Shepard]

Do they spice it up? Is it a different bouquet every time?

[Dr. Mary Claire Haver]

Yes.

[Monica Padman]

So you don't know what you're gonna get.

[Dax Shepard]

So you have anticipation. What will it look like?

[Monica Padman]

Yes. And it's always from a cool like farm.

[Dax Shepard]

They find a guy who just has one flower bed in his backyard.

[Monica Padman]

Very limited.

[Dax Shepard]

Extra, extra small micro business.

[Monica Padman]

Today was ranunculus, and they're orange.

[Dax Shepard]

Oh, that's the name of something. Flower Ranunculus.

[Monica Padman]

And they're orange and they're so pretty. I did lose a little track of time because I was cutting the ends and I was, you know, cleaning up the stems.

[Dax Shepard]

Yeah.

[Monica Padman]

And Easter egg.

[Dax Shepard]

We just learned a fascinating fact from somebody. It's a. A rule in sketch comedy.

[Monica Padman]

Uhhuh.

[Dax Shepard]

It's not our rule.

[Monica Padman]

Yeah.

[Dax Shepard]

But if a man comes in to pick a woman up on a date and a sketch.

[Monica Padman]

Yes.

[Dax Shepard]

Have him bring chocolates, not flowers. So if you bring flowers, the audience starts getting very distracted.

[Monica Padman]

They gotta put them in a vase.

[Dax Shepard]

Oh, my gosh. She's gotta get those in a vase. Gotta give it in water, and you can't even pay attention.

[Monica Padman]

I know. It's so smart. These delivery services.

[Dax Shepard]

Yeah.

[Monica Padman]

They can really brighten your day. I would recommend that for a gift.

[Dax Shepard]

Yeah. That sounds like a good gift.

[Monica Padman]

Yeah.

[Dax Shepard]

Yeah.

[Monica Padman]

Unfortunately, I did try to gift this exact thing today.

[Dr. Mary Claire Haver]

Oh.

[Dax Shepard]

To just. Today.

[Monica Padman]

Today's Cie's birthday.

[Dax Shepard]

Oh. Happy birthday.

[Monica Padman]

Happy birthday, Cali. And I was going to get her this weekly bloom bundle.

[Dax Shepard]

Right. Gift that keeps on giving.

[Monica Padman]

Yeah. But it's sold out.

[Dax Shepard]

Oh, all right.

[Monica Padman]

I can't.

[Dax Shepard]

That's the problem when you go with these micro growers that only have one flower bed in their backyard.

[Monica Padman]

Run out.

[Dax Shepard]

Yeah. It's really great idea. But then in practice, part of the fun.

[Monica Padman]

It's part of the limited edition element.

[Dax Shepard]

Okay. So I don't want to say this, and I just really can't control myself to not say it.

[Monica Padman]

Okay.

[Dax Shepard]

Because I got to get out of the habit of addressing commenters.

[Monica Padman]

Yeah. I would prefer not. But that's why. That's why I don't look at them.

[Dax Shepard]

Yeah. Yeah. But I just want to make this simple point because people, you know, they'll. Jonathan Haidt will be on Sweet People like, he's so anti technology, and he doesn't know, and it brought people together. Great, great, great, great. But I was just thinking, you know what I like about our show is we have Reid Hoffman on. He's a techno optimist. You get to hear the full sales pitch for why technology's great. And then we have Jonathan Heiton, and you get to hear the full sales pitch on. On why it's bad. And instead of being, like, angry at these guests who have a different point of view, I would really wish people would be grateful that they got to hear the counterpoint to what they believe. I mean, that's what I so enjoy about the show. And guess what? I don't know which one I think.

[Monica Padman]

Yeah.

[Dax Shepard]

It's like, I half believe what Reid's saying, and I half believe what Jonathan's saying. I don't agree with Jonathan.

[Monica Padman]

Yeah.

[Dax Shepard]

But I'm so grateful to hear a very smart person we got to hear tell me the opposite point of view that I have. And I just wish people could click into, like. Yeah, that's a gift. To hear someone with a different point of view tell you what the opposite side thinks. It's not. Shut that person down and get them out of here. And I don't like what they're saying.

[Monica Padman]

Yeah, I agree.

[Dax Shepard]

Now, if we only had one sides of all these debates, I think that would be a pretty reasonable criticism.

[Monica Padman]

Yep. I agree.

[Dax Shepard]

Yeah. That was burning the hole in my. Go ahead.

[Monica Padman]

You know what I'm gonna say.

[Dax Shepard]

Yeah, I want to hear it.

[Monica Padman]

It might sound disrespectful to the audience, what I'm about to say.

[Dax Shepard]

Yeah.

[Monica Padman]

And I don't mean that. I love our audience so much. I love the armchairs. I'm so grateful that people listen to us, but I don't care.

[Dax Shepard]

Right. That's healthy.

[Monica Padman]

If they don't like an episode. I also, personally, I don't believe it. I don't believe that what you're reading is indicative of what people think and that it bums me out that you get. You get, like, ensnared.

[Dax Shepard]

Well, some woman told me I need to apologize for saying young men are disenfranchised. And I said, apologize to who? Like, who am I apologizing to?

[Monica Padman]

I know, but this is the. Like.

[Dax Shepard]

I know. I know. It's really tricky now. I'd say the good news is, like, I'm not gonna change at all what I'm doing, so it's not like I'm subject to altering how I'm going to Invite Jonathan on and invite Reid Hoffman on. It's gonna have no impact on how I do the show. I think I have a. I do have maybe an arrogant, delusional belief. I could explain the value of hearing this, and people might lock in. Into it and go like, oh, you know what? I'm gonna stop blasting everyone I disagree with. It's okay to disagree with people. You don't have to hate them. Yeah, Jonathan's a great guy. I totally disagree with a lot of.

[Monica Padman]

What he's saying, you know, So I.

[Dax Shepard]

Have this stupid belief I can encourage people to embrace this. And that's. That's my own delusion.

[Monica Padman]

It's a delusion, but you're only seeing, like, one piece of the whole puzzle.

[Dax Shepard]

You're so right.

[Monica Padman]

You don't know who you're even talking to.

[Dax Shepard]

No, you're absolutely right. And I do think about that. So, like, naturally uranized debate about men and women, obviously. Yeah, yeah, it was very polarizing. I expected that. And that's totally fine. And I get it. I get it from both. I totally understand from both sides, but yeah, it's like 50 people, you know, on either side, out of. Out of millions of people.

[Monica Padman]

It could literally be one person. This is what I'm saying.

[Dax Shepard]

Oh, that's got 30.

[Monica Padman]

Yes. This is my point. Like, to get wrapped up in it. Your strongest trigger is getting taken advantage of. But when you react like this, I think you've been taken advantage of because.

[Dax Shepard]

I got wound up about it and.

[Monica Padman]

You don't even know.

[Dax Shepard]

But what's perfect about it is it is a facet of this thing I obsess about without the comments. Yeah. Right. So I. Your big concern is women's reproductive rights, which is. Makes total sense concern. Yeah. But it's like a very paramount concern, and rightly so.

[Dr. Mary Claire Haver]

Yeah.

[Dax Shepard]

And you'll think about that a lot.

[Monica Padman]

You know, if it feels threatened, I don't think about it on a regular basis. But if it's. If it's threatened. Yes, of course.

[Dax Shepard]

And I'm regularly so scared about the inability for people to listen to one another.

[Monica Padman]

Yeah.

[Dax Shepard]

I'd, like, think about it too much, and it really frustrates me, and it scares me. I'm scared of the future where there's two camps on the planet and they don't talk to each other.

[Monica Padman]

Can. Can we deep dive?

[Dax Shepard]

Yeah.

[Monica Padman]

Why is that so scary to you? Like, of course it sounds. It sounds. It's bad, right? Like, I think it's bad too. I'm like, this is a huge problem. But it does. I don't have this reaction that you have. And I wonder. I mean, obviously we know that if anything's like, causing that much of a reaction, it's something else. It's something about us or our past or our. Like, the fear is about us.

[Dax Shepard]

Yeah, I guess. Probably dysfunction. I grew up in dysfunction. I grew up in two parents that hated each other till they got divorced. Like dysfunction.

[Monica Padman]

Yeah.

[Dax Shepard]

Not rising to one's best self to navigate these things. We have gotten embarrassingly dysfunctional. And I see the total root of the dysfunction is us against them. And I see that as such a toxic quality. And I have children that are entering a world and I care about the world for them. So, yeah, it really bothers me really deeply because my childhood was plagued by dysfunction and two people not communicating and it's winner takes all. And I hate that situation. It wasn't compromise. It wasn't working together to. It was, you know, as I always say, the paradigm everyone needs to wrap their head around is we're married. The left and the right are married. We all live in the same country. And so we have a Gottman approach through this marriage, or we have a fucking. What's the famous War of the Roses version of this marriage. And I lived through the War the Roses versions of the marriages. And so for me, I didn't want that in my life when I grew up. And then when I feel ensconced in a whole society that way. And then I put out a show and I see people saying, you know, heights are conservative. What, like they've just written him off? I think I've said this before, but it's like one time we went out to. And this is a ding, ding, ding. Because it came up on episode yesterday we recorded. But Ted Olson, you know this, he was the most successful Supreme Court. He argued in front of the Supreme Court more times and more successfully than anyone else. And he. Very confusingly, from my perspective, both won Citizens United, which is a very right cause, giving businesses personhood. But he also defeated doma, and he believed in both of those deeply. We had a dinner with him and there was three of us liberals, girls, and then him. And we started kind of hitting them him with all of our points of view. And I. I said, hold on a second. We have an opportunity to be with one of the smartest people in the world who has a different point point of view from us. Yeah, what an opportunity to hear the best version of this point of view that I disagree with.

[Monica Padman]

If you want to look at it in a way that's selfish. It's good to hear the other person's point of you so that you know how to combat it.

[Dax Shepard]

Well you'll find if you combat it some of their pushback will make some of your points fall flat and those are points you need to rethink.

[Monica Padman]

Yeah.

[Dax Shepard]

Or jettison or figure out another way. But it's as much as you can learn from them, you also learn the weaknesses of your own point of view.

[Monica Padman]

Yeah.

[Dax Shepard]

Which I like. I'm arguing with people all the time and I get to one and and I'm like yeah, that's not a good point. I got to get rid of that. And that can't really be a part.

[Monica Padman]

Of my I also think you are in a program that requires self reflection, growth, checking yourself and so I do think you're extra.

[Dax Shepard]

I'm extra.

[Monica Padman]

It bothers you more when you see people who aren't doing that or don't care to do it but there's just a lot of people who don't and I guess I respect that that bothers you. To me I think if that bothers bothered me I would die. Like that'd be too much. Like I can't take on that people don't want to change. That's not my job to make people want to change. And you know like I can only do me.

[Dax Shepard]

I just wish everyone thought I have. I'm holding all my beliefs in my hand right now and they're certainly not the best version of my beliefs. They're going to evolve. Hopefully that's what they're supposed to do.

[Monica Padman]

Yes.

[Dax Shepard]

So you don't have the complete finished version of your beliefs and your points of view in your hand.

[Monica Padman]

People really have a huge problem with wishy washyness.

[Dax Shepard]

Right.

[Monica Padman]

They see that as heard that a lot like flip flopping. Flip flopping and a lot about politician they say that a lot about politicians that oh they said this and now they're saying this.

[Dax Shepard]

If you catch them having changed their opinion.

[Monica Padman]

Right. I find that so strange.

[Dax Shepard]

Yeah. It's really disappointing.

[Monica Padman]

Why can't they should be changing their opinion. It's so weird to me. I, I, it's so much worse to me that they would have said something so long ago felt stuck in saying that and now they just have to believe that forever. That's a big problem. But both sides hate that.

[Dax Shepard]

Yes.

[Monica Padman]

Which I, I really do not.

[Dax Shepard]

Yeah.

[Monica Padman]

Understand.

[Dax Shepard]

Yeah yeah yeah.

[Monica Padman]

It feels very backwards. But, but again like I can't get that riled up about other people feeling that way because I can't change them.

[Dax Shepard]

But I think you're right. I think, I think this whole thing feels like dysfunctional family to me.

[Monica Padman]

Yeah.

[Dax Shepard]

And I hate it.

[Monica Padman]

Yeah.

[Dax Shepard]

And I want everyone to be a bigger version of themselves. Myself included.

[Monica Padman]

Yeah.

[Dax Shepard]

And it's disheartening to live in a dysfunctional family, which is this country.

[Monica Padman]

Yeah, yeah. Yeah. You know, do you think that it's because when your dysfunctional family ended in. I mean it ended in pain for you specifically and pain for your mom and involved pain for all stepdads were miserable afterwards.

[Dax Shepard]

Their children were miserable.

[Monica Padman]

Because I think every. Not everyone. I'm sure. I'm sure some people are spared this. But there's a fair amount of dysfunction that happens in a lot of families. And I think I also grew up with some dysfunction. Dysfunction amongst the adults. But they didn't split up over it. Obviously. For me, having grown up and seeing things I didn't like, I think, well, I can't do that like for my life. That I don't want to replicate that. But I also am kind of like, eh. Like it sort of worked out and it's kind of fine. And I don't, I don't know.

[Dax Shepard]

If I were you, I might want to challenge me by saying maybe every. Everyone's happy with this. Which is also possible. You know, maybe right now the right's super pumped and they're pigs and shit and the left is vindicated and validated and feeling even more self righteous. Maybe everyone's getting exactly what they want out of this. And so that's an interesting thing for me to consider. Like you're trying to fix something that people will like as much as that's true. They might not want to say they like this. Maybe they do.

[Monica Padman]

Yeah.

[Dax Shepard]

Maybe the person that's like, Jonathan Height's a monster. Felt awesome.

[Monica Padman]

Yeah.

[Dax Shepard]

And told nine of their friends they did that and they love it.

[Monica Padman]

Yeah.

[Dax Shepard]

It's hard for me to.

[Monica Padman]

I also think people, I mean again, the generous offering is that they want their opinion to be heard and seen and they want to feel. People just want to feel like a person.

[Dax Shepard]

Yeah.

[Monica Padman]

Who's. Who's. Who exists. I mean we all just want proof that we exist.

[Dax Shepard]

Yeah. Yeah, yeah.

[Monica Padman]

And that is a version of it.

[Dax Shepard]

I will watch them exist and validate them without that approach. They don't need that approach.

[Monica Padman]

Yeah.

[Dax Shepard]

Yeah. But I know I sound like. And that's why I said I didn't want to say anything. I, If I were not to be like, just, hey, shut the up about the counters. Just stop reading. I fully get that criticism. And it's. It's true. It is true. But yes, it is this. It is a perfect little encapsulation of this other thing I spend too much time obsessing about. And if I were really working my AA program, I would just accept this.

[Monica Padman]

Yeah.

[Dax Shepard]

I would accept that. That's how it is.

[Monica Padman]

There's nothing you can do if someone's.

[Dax Shepard]

Attracted to my approach that'll be appealing to them.

[Monica Padman]

Exactly.

[Dax Shepard]

More so than me saying someone should have this approach.

[Monica Padman]

Yes, I agree.

[Dax Shepard]

And I should just have faith in that. Yeah. Yeah.

[Monica Padman]

Well, it's funny that you brought up hating, because on my ride here, I was listening to a podcast and they were talking about Megan Markle, and they were. They weren't saying that they hated her, but they were saying, like, there is this, like, vitriol around her and there is. And it was. It was interesting because it did make.

[Dax Shepard]

Me think people really dined out they like, on her show.

[Monica Padman]

Oh, yeah. But people, like, really hate strangers. Like it. To me, that is so interesting. And then I was thinking, I was like, who do I hate?

[Dax Shepard]

Well, I think we're hardwired to do it, right? It. We're hardwired to extremely punish someone who has values and morals outside of our in group and make a. Make a emblem of them. Right. So I do think when someone represents some, you know.

[Monica Padman]

Yeah.

[Dax Shepard]

I don't even know how they articulate why they hate her, but yeah, she's interesting, though. I have a story about this, but I. I want you to expound more.

[Monica Padman]

No, I was just going to ask if you hated anyone.

[Dax Shepard]

When? May 1st. When. When you were gonna ask if I hate her?

[Monica Padman]

Hated anyone.

[Dax Shepard]

Oh.

[Monica Padman]

Cause I was like, I don't act when I really think about it. I mean, I don't hate any strangers. And even people in my life who I like, who, who I. I do have, like, friction or cause stress. I don't hate them. Like, I don't think I hate anyone. Actually.

[Dax Shepard]

I hate a couple people in public. I hate Tucker Carlson.

[Monica Padman]

Right.

[Dax Shepard]

I just think he a smug bully. I don't even really give a about his politics. It's just this smug bulliness about it.

[Monica Padman]

Yeah.

[Dax Shepard]

Is there anyone else? Like, I'm trying to imagine. And if you're saying you hate them, you have to take it to the, like, literally, you hate them to the degree. If you saw him in person, you'd go, you're a. Yeah.

[Monica Padman]

Yeah.

[Dax Shepard]

And so I think the only person I. I can think of him that if I met him real life, I go, you're a piece of shit. Right? Would be him.

[Monica Padman]

Yeah. I feel like I remember one time, years and years and years ago, probably babysitting and we were playing games and stuff. Catan. I think I said something like, ugh, I hate this. And you said, you say, you say hate a lot.

[Dax Shepard]

Uh huh. We've talked about this before.

[Monica Padman]

Well, it's been a minute. Probably I was, was saying it just as a random word, really.

[Dax Shepard]

As an adjective.

[Monica Padman]

Yeah. It didn't, it didn't carry the weight that it was caring for you. But then I was like, yeah, that is a big word to be sort of throwing around. And I think I don't really say it as much.

[Dax Shepard]

No, not at all.

[Monica Padman]

Yeah.

[Dax Shepard]

Yeah, I think I used to say it too. I think that's one of the aspects of my point of view, shifting of moving to California that I liked a lot.

[Dr. Mary Claire Haver]

Yeah.

[Dax Shepard]

I think when I was in Michigan, I had a very long list of enemies, you know, people we hated.

[Monica Padman]

All right.

[Dax Shepard]

A lot of, lot of people we were against. Against.

[Monica Padman]

Interesting. Wait, back to.

[Dax Shepard]

Okay, back to Meghan Markle.

[Monica Padman]

Yeah.

[Dax Shepard]

So I saw, I didn't even see it, but I saw some of the Oprah thing, their very first interview, right. And a friend of mine from England, like, let it rip on her, like, can you fucking believe this? Blah, blah, blah. Like just outrage, right. And so. And this friend I ripped. Really respect their intelligence, their empathy, the whole thing. This person's a very admirable person.

[Monica Padman]

Yes, I agree.

[Dax Shepard]

And so I had to really force myself to imagine how could he have this strong of a reaction.

[Monica Padman]

Yeah.

[Dax Shepard]

And the scenario I painted in my head was, and I think I've already told you this. When Obama was in office, a Russian kid comes to the dc, Falls in love with Malia, takes her to Moscow. He and her go on their biggest television show and shit all over Obama and accuse him of being racist and just trash the country under the guise of this Russian dude. And I was like, yeah, I would fucking hate that guy. I would absolutely hate him. And there's a layer of patriotism that has to be acknowledged.

[Monica Padman]

Yeah.

[Dax Shepard]

That we all carry. And if I do think of that scenario, I just know I would hate the Russian guy who took Malia to Russia for the rest of her life and they go on TV all the time and shit on America. I would hate that guy. I don't understand the Americans who hate her so much, but I do understand the British backlash. They took the prize, son. They all liked him more than the other one.

[Monica Padman]

Right. But he taking his. So, like. Like, he didn't have a mind of his own.

[Dax Shepard]

Oh, I know.

[Monica Padman]

I mean, that's.

[Dax Shepard]

But then I'd be saying Malia doesn't have a mind of her own. But if Malia left with this Russian dude, made the Never Return, I mean.

[Monica Padman]

Yeah.

[Dax Shepard]

And then went on Russian television and on America. But I hate the whole scenario, I guess.

[Monica Padman]

I don't know. I don't know that I would. I think I would be like, yikes. She like.

[Dax Shepard]

No, but you got to evaluate him. You got to evaluate the.

[Monica Padman]

That's the part I actually can't relate to. Do. Like, for me, Harry made a choice about his life and his family.

[Dax Shepard]

Yeah.

[Monica Padman]

And I don't see it as this woman, like, took him away.

[Dax Shepard]

A siren who called him to the rocks of America.

[Monica Padman]

Exactly. I see it as. As a man who made a choice based on a lot of things, including the death of his mother. And so I don't have a problem with him being like, there's a lot of up over there. And I had to leave it.

[Dax Shepard]

But we have. We have clarity on that one because we don't have the ingroup patriotic bias.

[Monica Padman]

True. But I think if Malia left and married this Russian person.

[Dax Shepard]

Yeah.

[Monica Padman]

And then they went on Russian TV and they were talking about it, and she was saying, like, look, the White House was horrible and the media in America was horrible, and this is what they did, and this is what happened really quick.

[Dax Shepard]

If that. So I'm not talking. No. I'm not talking about Harry and Meghan.

[Monica Padman]

Right.

[Dax Shepard]

I'm talking about this theoretical Malia.

[Monica Padman]

Yeah, I know. Yeah. Yeah.

[Dax Shepard]

I would go, oh, you hate the media. You're on the biggest fucking show in Russia. You can't hate the media and then willingly participate in their biggest media outlet.

[Monica Padman]

Well, they hate.

[Dax Shepard]

You're such a fucking hypocrite. Well, no, that's what I would say to this imaginary people who's on the biggest media outlet in Russia complaining about media attention.

[Monica Padman]

But I'm saying meet. They. They speak specifically about British media tabloids. Yes. And we have had enough people on. Who have corroborated that. The British.

[Dax Shepard]

I want to be clear. I understand why I am not. None of this opinion is about those.

[Monica Padman]

No, I know. This is my.

[Dax Shepard]

I have. But I do have strong knee jerks about this theoretical defecting of Malia to Russia and being on tv.

[Dr. Mary Claire Haver]

Tv.

[Dax Shepard]

Complain about being on tv.

[Monica Padman]

I guess I don't. I just don't. Like. I think if they were if they were like. Because we have to make it equal. I don't. Because I don't. I mean, look, we have obviously media issues, but it's not the same.

[Dax Shepard]

Well, let's just say it's the, the scenario I painted is actually less impactful than the one that really happened because Malia was never going to inherit the presidency.

[Monica Padman]

Yeah.

[Dax Shepard]

Well, you know, Harry could inherit the, the kingship.

[Monica Padman]

No.

[Dax Shepard]

Yeah. His brother would have to die.

[Monica Padman]

No. Then it goes to the son, William's son. Harry can't be the king.

[Dax Shepard]

Okay.

[Dr. Mary Claire Haver]

What?

[Dax Shepard]

The son dies. He could be the king.

[Monica Padman]

Okay. It's a, it's, there's a long list. Yeah.

[Dax Shepard]

Okay.

[Dr. Mary Claire Haver]

I would.

[Dax Shepard]

They give the Kingship to a 7 year old, I don't think.

[Monica Padman]

Yeah.

[Dax Shepard]

Like do a little digging on this. Joffrey, there's no inheritance in the presidency, so the, the scenario I'm painting is even less important.

[Monica Padman]

I agree. I mean that's why we don't, it's like hard to make this.

[Dax Shepard]

Yeah.

[Monica Padman]

Equivalency. But, but also like why should he possibly stay in this thing that he sees is fucked up?

[Dr. Mary Claire Haver]

Oh yeah. Yeah.

[Monica Padman]

Like I, I, I don't know.

[Dax Shepard]

I just commend an outsider came in and then the beloved person left. And that's easy correlation to get upset about.

[Dr. Mary Claire Haver]

I mean, look, I, I, maybe Harry.

[Dax Shepard]

Would have defected on his own without a woman. Wife. That was American. That's possible.

[Monica Padman]

Yeah.

[Dax Shepard]

But we don't really know because it didn't happen that way.

[Monica Padman]

But we also, we also, you know more than anyone that like if someone, if you're in love with someone and people around you are not treating that person well.

[Dax Shepard]

Yeah. You got to protect them.

[Monica Padman]

You're going to protect them and you're going to say ultimately say this like this is a problem. Problem. We're gonna go now.

[Dax Shepard]

Yes. But yeah, so I already agree. I understand why he left and I would have left.

[Monica Padman]

Yeah.

[Dax Shepard]

A thousand percent.

[Monica Padman]

You're just saying you understand why people don't like it.

[Dax Shepard]

And I totally understand why people don't like her. That are English.

[Monica Padman]

Right.

[Dax Shepard]

I don't. It's not hard for me to understand.

[Monica Padman]

It's not hard for me to understand. I do wish they would take a second look at it. Like it doesn't affect them. It really doesn't.

[Dax Shepard]

Well, they lost their cutest royal family member over it. It like, I mean, and I, I hate royalty.

[Monica Padman]

Yeah.

[Dax Shepard]

But I understand something you value getting quote taken from you. Don't even say taken. I understand losing something you value. So it's like, they do value that. I, I, I can't understand it.

[Monica Padman]

No, sure.

[Dax Shepard]

The notion of, like, I actually can understand that.

[Monica Padman]

Weirdly, I buy into the royal family and thinking that's cool and that's a part of your history. And, like, I, I do get that. Even that, like, I even feeling that way, I don't think I would feel personally injured by one of them going to live their life. I think differently. I think people don't like her because they think she's fake. People think she's fake. People think she's mean, but she pretends to be nice. Like, there's a lot of. And then with the new show, they're like, what is this? She's just moving pretzels from one bag to another bag. This is stupid.

[Dax Shepard]

I don't know that reference, but I'm laughing right now because the description was really funny. I just. Megan. Marco. I didn't see that. So I'm not laughing at.

[Monica Padman]

I, you know what? I'm not laughing either, because it's clear that she does like it. She. It. It's not. I don't think it's fake. It may seem ridiculous to someone who's, like, living a life, going to work.

[Dax Shepard]

Yeah.

[Monica Padman]

And having to come home and then.

[Dax Shepard]

On living paycheck to paycheck.

[Monica Padman]

Exactly. Turning it on and seeing that her day is spent moving pretzels from one bag into another bag.

[Dax Shepard]

Well, now I really want to watch this episode.

[Monica Padman]

She. It's like, that's a very simple, simple explanation. She's having a guest over, and she's going to put together this, like, cute little tray by the bed for the guest. It has, like, flowers and stuff. And then she, like, buys these pretzels, I think, with peanut butter. They look delicious. And she put them in another. She took them out of the bag. She put them in another cute little bag and put, like.

[Dax Shepard]

So you've watched it?

[Monica Padman]

Yeah. Oh, yeah, yeah, yeah, yeah. And put them, like, you know, wrote peanut butter pretzels and, like, tied it up, made it cute.

[Dax Shepard]

Cute font.

[Monica Padman]

Yeah, she made it cute.

[Dax Shepard]

Yeah.

[Monica Padman]

And I think that does bring her joy.

[Dax Shepard]

Yeah, sure.

[Monica Padman]

I don't think that's a lie.

[Dax Shepard]

Right.

[Monica Padman]

And, and so it's kind of what we talked about before with the, with the, you know, podcast. The, like, men's podcast and stuff.

[Dax Shepard]

Yeah.

[Monica Padman]

If you don't like it, just don't watch it. If, if you think this is sort of offensive because your life, it's not reflective of your life.

[Dax Shepard]

Stay tuned for more Armchair Expert if you dare. We are Supported by Drunk Elephant. All my. My father would be so happy at the name Drunk Elephant.

[Monica Padman]

It's a great brand.

[Dax Shepard]

Yeah. You may have already heard me talking about my new favorite facial moisturizer. The proteiny polypeptide cream by Drunk Elephant. Oh, my skin is so silky. Silky but not shiny, Monica.

[Monica Padman]

I know. Not too oily. That's a huge thing in a moisturizer.

[Dax Shepard]

Yeah. It's lightweight gel cream which delivers daily moisture with nine signal peptides. That means nine active ingredients to help skin look firmer and smoother by supporting the natural, natural production of collagen. They work by communicating with your skin cells, encouraging them to produce more of the collagen your skin needs to maintain a youthful appearance while also protecting against collagen loss. The result is stronger, younger looking skin that's more resistant to aging. Who out there doesn't want that? Re energize your skin with Drunk Elephant Discover Proteini Polypeptide cream at Ulta Beauty stores and also@untra ulta.com. i bet the core thing that people are triggered by is like, why does this woman get a show about the things she likes?

[Dr. Mary Claire Haver]

Yes.

[Dax Shepard]

Why don't I have, like, why would I actually build bird houses?

[Monica Padman]

Right, right, right, right.

[Dax Shepard]

I actually do X, Y or Z. Yeah. And I do think it's easy to think in some abstract way she got something that you deserved more.

[Monica Padman]

Right.

[Dax Shepard]

As if her thing took from you.

[Monica Padman]

Yeah.

[Dax Shepard]

And that in general, people who don't deserve things are taking opportunities.

[Monica Padman]

Yeah.

[Dax Shepard]

That should go to deserving people.

[Monica Padman]

Right? Yeah.

[Dax Shepard]

Quickly get into some very large moral imperative stuff.

[Monica Padman]

Well, yes. Because who deserves anything? Like we do. We inherently. I mean, we deserve like dignity.

[Dax Shepard]

Uh huh.

[Monica Padman]

But to me, other than that we as people don't like come out deserving of money or. I don't know. It's a weird thing.

[Dax Shepard]

I'm. Yes and no.

[Monica Padman]

Yeah.

[Dax Shepard]

Yes and no. There's like a nihilist version of me that I can tap into pretty easily, which is like, who's kidding who? We're all staying busy on this circular globe until we die.

[Monica Padman]

Yeah.

[Dax Shepard]

There's no God. There's no one is evaluating what should and shouldn't and better and worse. Like we're just all distracting ourselves in the most entertaining fashion we can manage until we're dead.

[Dr. Mary Claire Haver]

Yeah.

[Dax Shepard]

So there's that version. It's like. Yeah. What are you talking about? You don't deserve. You deserve for 300,000 years. You deserve to come out without clothes on and be ill equipped for this world. In the best case Scenario you ate and had a kid. So the notion that you. At some point, a TV show was a human right.

[Monica Padman]

Exactly.

[Dax Shepard]

Or a cell phone's a human right. Or I hate to say it, that health care is a human right. These are all really, really incredible modern privileges.

[Dr. Mary Claire Haver]

Yeah.

[Monica Padman]

They're advanced privileges. Yes.

[Dax Shepard]

Okay. And now also on the other side, yes, Brene Brown deserves a podcast more than a lot of people because she has spent a good chunk of her life acquiring knowledge that is useful to other people.

[Monica Padman]

Yeah.

[Dax Shepard]

And yes, she does. I would. I would have to be lying to say that the guy in front of 7:11 who's repeating the same sentence over and over again isn't. Should have the same level of success on a podcast that Brene Brown has. I can acknowledge some people do deserve the success more than other because they've put more effort into it and they have more dedication and they have more skill. Jordan deserves his six titles.

[Monica Padman]

Yeah.

[Dax Shepard]

More than a lot of the players. It's not like everyone who entered the NBA deserves six titles.

[Monica Padman]

Right. I just mean we don't all deserve to be a basketball that. I mean, like, that's the whole. My whole point. We don't come out deserving everything. We have different skills and. And privileges and things that. That allow us to, like, live the life we're gonna live. But I don't know that we deserve, like. I don't know that. I don't know that. Brene. I mean, of course I love her, so I. I think she deserves.

[Dax Shepard]

Yeah, we're biased.

[Monica Padman]

Yeah. But the 711 guy, if.

[Dr. Mary Claire Haver]

If.

[Dax Shepard]

If his one sentence repeated over and over again, if.

[Monica Padman]

If his one sentence repeated over and over and over again has a massive impact on people and it changes their life and it, like, makes them think about the world differently. He deserves it.

[Dax Shepard]

Absolutely. But what I think is even more interesting is. So I feel that way about that topic. But what I can admit and acknowledge is there's another scenario you could paint that is the same principle at hand. And I'll go the other way.

[Monica Padman]

Yeah.

[Dax Shepard]

I think that's what's much more fascinating and more fun to pay attention to is this illusion that I have a consistent policy.

[Monica Padman]

Yeah, exactly.

[Dax Shepard]

And I don't.

[Monica Padman]

Yeah. None of us do.

[Dax Shepard]

And what really happens is I look at the person and generally I like them or I don't like them on some weird gut level. And I'm generally accepting of the things that people do that I like. And I'm critical of the things from people I don't like.

[Monica Padman]

Yes.

[Dax Shepard]

And I Frame it under this well thought out logic I have, and it's just so inconsistent that I have to acknowledge.

[Monica Padman]

Yeah.

[Dax Shepard]

There's a lot of going on.

[Monica Padman]

I do think so much of Disney dislike, though, is jealousy.

[Dax Shepard]

Oh, yeah.

[Monica Padman]

In general. And for all of us, if we dislike a lot. Not always, of course. There's like, people who do horrible to other people. Yeah, you're gonna dislike that, but, like, when. When you're just, like, irked by someone who you don't know.

[Dax Shepard]

Yeah.

[Monica Padman]

It's probably because there's something that you're triggered that you wish you had or. I mean, again, this. This thing she's presenting is. Is perfection. Right. Like, she has. She's able to make her own honey. She has this beef.

[Dax Shepard]

She has her own bees.

[Monica Padman]

Yeah. She has her own bees and she makes her own honey. And then she makes these, like.

[Dax Shepard]

Bees have rebounded.

[Monica Padman]

Really?

[Dax Shepard]

Yeah. Really great news. Remember that panic we were all. Yeah, they totally rebounded because of her, perhaps.

[Monica Padman]

Oh, my God.

[Dax Shepard]

So we all heard that a great.

[Monica Padman]

Wow. That's. That is good news. Yeah, but, like, she makes her own, like, raspberry preserves and, like. Cause she has a raspberry bush. And so people are like, I want a raspberry bush and I want to.

[Dax Shepard]

I want to spend my day doing this nice, fun stuff.

[Monica Padman]

Exactly.

[Dax Shepard]

Well, there's probably that. And then there's also Martha Stewart. Yeah, there's Martha Stewart, who has spent her entire life really becoming a master at all these things.

[Monica Padman]

Yes.

[Dax Shepard]

And then she has a show, and by God, it's very, very helpful and useful to people. Because she's a master.

[Monica Padman]

Yes.

[Dax Shepard]

And so if you're comparing these two people and they both have a similar size show, I can understand people being a little frustrated.

[Monica Padman]

Right.

[Dax Shepard]

It would appear that one person really is now benefiting from their dedication and love for their whole life.

[Monica Padman]

Yeah.

[Dax Shepard]

To something. That's a good story.

[Monica Padman]

Yeah, yeah, yeah, yeah, yeah.

[Dax Shepard]

Versus, like, and I could do this. I'm not a good woodworker, but I bet your ass I could sell a show to Netflix tomorrow about me with a wood shop building things.

[Monica Padman]

Yeah.

[Dax Shepard]

And if I was a master woodwork, I'd be like, this is why is it? And that would be fair. And also if I want to do a show about woodworking and I think it's fun and people are interested in it. Why?

[Monica Padman]

Why can't I do that? Exactly.

[Dax Shepard]

So I think all these things are true. So Kristin came home to me and she said, oh, my God, I got like, five texts from people. Like, I could they were salvating to share this news about Meghan Markle's show. And she started calling people out like it seemed a little too excited about what you determined was a failed attempt by somebody. If you're taking a lot of joy out of a failed attempt on somebody, is that who you want to be? Yeah, bigger question.

[Monica Padman]

Exactly.

[Dax Shepard]

And I also think it's worth delineating because I'm critical. As you know, I'm trying to shut the fuck up about it, but I am critical of people that are allowing someone to make them miserable, as I've said, circles back to what I'm saying to now. If you've been miserable for nine years or an hour of your day is spent in anger, I just think that's a rough use of your life. Now. If you're seeing the thing, the Megan thing, and you're excited and you share it with your friends and you all gossip and you all have a good time doing that at dinner, I guess I'm not critical of that. In a weird way, I feel bad for the subject of the ridicule, but I also can just, again, in a utilitarian way, go look at, oh, these five people had a really fun dinner for two hours gossiping, which is a. Which is an adaptation of social primates. Like we're wired to do it. Yeah, I guess I also can go. Yeah, okay. You guys had fun shitting on somebody. Everyone felt better for some reason about themselves.

[Monica Padman]

I mean, that's the part that's a bummer. Yeah.

[Dax Shepard]

But if the end result was you all did that, versus you all got together and you like this motherfucker, and I can't believe this. Yes. Outrage and feeling defeated and overwhelmed and all that. I weirdly have a distinction between those two.

[Monica Padman]

Yeah. One's harmless and the other one is causing harm, personal harm to them, the people who are doing it. And I mean, I do think it's. It's a privilege to be Kristen or be me. And I'm like, watching this, you know, I'm just watching the show and I'm like, oh, yeah, like, I want that part. It's not.

[Dax Shepard]

Yeah.

[Monica Padman]

I'm like, oh, my God. God. Like I should order some of those tomatoes and make that.

[Dax Shepard]

Cuz you're not frustrated with the outcome of your life.

[Monica Padman]

Exactly. I am not. Like, well, why does she get to have that? I think I have plenty.

[Dax Shepard]

That's right. That's right.

[Monica Padman]

I have more than I should have.

[Dax Shepard]

That's right. And, and, and I do too. And I'm not as bothered By a lot of things that people are bothered by. And I know it's a privilege. What is so tempting to tell. Try to tell people is it is a product of your own. You think this person's objectively one thing.

[Monica Padman]

Yeah.

[Dax Shepard]

And it's helpful to understand. No. If my cup was full actually and shockingly, I wouldn't feel the same way.

[Monica Padman]

I know.

[Dax Shepard]

And you kind of want people to know that because I think it is helpful for development. Which is like my opinions of things are dramatically impacted by how I feel about my own self and my own.

[Monica Padman]

Yes.

[Dax Shepard]

Outcome.

[Monica Padman]

Yeah.

[Dax Shepard]

And I would probably be best served trying to love this version of myself enough that I don't feel anger when other people are doing well.

[Monica Padman]

Real quick facts. This is for Mary Claire Haver. Great episode.

[Dax Shepard]

Solid.

[Monica Padman]

My assumption is it's get that topical vaginal cream, everybody.

[Dax Shepard]

Buddy, go out right now and just start smearing it all over.

[Monica Padman]

She already. She posted about it.

[Dax Shepard]

She did?

[Monica Padman]

Uhhuh. It was really sweet and cute because it was out early and she said it was really. She had a good time with us.

[Dax Shepard]

Can I Easter egg that I got the text of my life last night that I shared with you guys.

[Dr. Mary Claire Haver]

Yeah.

[Monica Padman]

We can't say anything else.

[Dax Shepard]

I urge people to hang on to the show a little longer. I know a lot of people are thinking about quitting, but just. Just hang out for a long.

[Monica Padman]

A couple more months.

[Dax Shepard]

Wow. Wow, wow, wow.

[Monica Padman]

I'm gonna have to get a facial. Hard as a. Have to.

[Dax Shepard]

I'm gonna have to jerk off before the interview so I can last. During the interview.

[Monica Padman]

Yeah, same.

[Dax Shepard]

Yeah.

[Monica Padman]

I have to wear really strong pants. Not ones that can explode.

[Dax Shepard]

You're gonna have to be in steel trousers. Might want to go short skirt. I say you go all the way. If ever there was a time to take the biggest shot of your life is you might want to go skirt, bra, top. Braless, see through top.

[Monica Padman]

I do have a new top that is pretty see through.

[Dax Shepard]

Oh my God. If you. If you did. If. And this person's a fashion icon. So they would just be like, oh, yeah, fashion. Oh my God.

[Monica Padman]

I could maybe get away with it.

[Dax Shepard]

I think you should go.

[Monica Padman]

You'd have to blur it, Rob.

[Dax Shepard]

Oh, they could. Yeah, they could.

[Monica Padman]

On YouTube.

[Dax Shepard]

Yeah. No problem.

[Monica Padman]

For. For.

[Dax Shepard]

For him.

[Monica Padman]

For him.

[Dax Shepard]

Or her.

[Dr. Mary Claire Haver]

Or her.

[Dax Shepard]

Whoever our guest is. Wow. I can't wait for. That's a. That's an even more fun element to think about is coming.

[Monica Padman]

How I'm going to show up.

[Dax Shepard]

Yes. Yes. And how aggressive you'll be. And I Just want you to know that I am encouraging you to go above and beyond the realm of what you think is tasteful. And you'll be sitting directly across from this person.

[Monica Padman]

Yeah, but, you know, my instinct is. Can you CR plays a lot.

[Dr. Mary Claire Haver]

No.

[Dax Shepard]

Go for it.

[Monica Padman]

I know I don't.

[Dax Shepard]

On your deathbed. On your deathbed.

[Monica Padman]

I think this person might be more intrigued by someone playing it so cool.

[Dax Shepard]

I don't think so. Let me just. Let me give you some inside baseball on guys.

[Monica Padman]

Yeah.

[Dax Shepard]

There is no guy who's gonna see a Rockin Bot on display and. And think. Not for me. I mean, there'll be no straight guy, right, who thinks that.

[Dr. Mary Claire Haver]

Yeah.

[Monica Padman]

Jess says he's starting to turn the more he hangs out with me.

[Dax Shepard]

Oh, my God. So you guys might end up.

[Monica Padman]

Might end up together after all.

[Dax Shepard]

What a great time. And then you guys bring back Monty and Jess love boys, but it's like Mani and Jess are married.

[Monica Padman]

Oh, that would be more boring. That'd be boring.

[Dax Shepard]

Well, no, you'd be fighting. All this fun you're having would quickly turn to fighting. So that could be entertaining, man.

[Monica Padman]

Anyway. Okay, well, that's TBD for people.

[Dax Shepard]

Yeah. That's exciting.

[Monica Padman]

Okay. Some facts. Okay. Rob, can you help me? What did you type in to get the names of those guys who did the WIH study?

[Dax Shepard]

I looked at Dax's notes for the episode.

[Dr. Mary Claire Haver]

Oh.

[Dax Shepard]

And saw what he wrote down.

[Monica Padman]

That is I. I for the life. I was trying so many ways of typing this into Google and I can't.

[Dax Shepard]

It won't.

[Monica Padman]

It's. That's not going to bring it up. Yeah.

[Dr. Mary Claire Haver]

Do you want me to spell it?

[Dax Shepard]

Yeah.

[Monica Padman]

Let me find it again.

[Dax Shepard]

Splowski and Travowski. C H, L, E B, O, W, S, K, I. Chlowski.

[Monica Padman]

And A, R, A G, A, S, K, I. Okay, so these are for the Women's Health Initiative. This is who you say was a part of the study.

[Dax Shepard]

And this is who I could be conflating. I. I just want to be clear. The stuff I was saying that both AA and Lane Norton are all over.

[Monica Padman]

Yeah.

[Dax Shepard]

Is Chowski and eras. They're the ones that keep doubling down on this bad dad.

[Monica Padman]

Okay, so maybe they've doubled down, but they, I don't think, are part of the original, original study.

[Dax Shepard]

Okay.

[Monica Padman]

Dr. Bernardine Healy. This is in 91. She was the female director of the NIH and she announced her plan for the Women's Health Initiative. There was a ton of people involved in this, and it was a 15 year study. I mean, and it was wrong.

[Dax Shepard]

Yeah. Not right.

[Monica Padman]

It was not right.

[Dax Shepard]

Led to a mass panic.

[Monica Padman]

Okay. Now, peak suit suicide rates for women. Female suicide is concentrated in the 35 to 64 year age group. That's 64.8%.

[Dax Shepard]

I don't know why that's so weird for me.

[Monica Padman]

I mean, I get it. I get why it's weird. I wouldn't.

[Dax Shepard]

It's weird, but obviously we were just given the explanation, which is menopause. But it is. Yeah. It's just not the time you're. You think that's the time of your life. You start fully accepting who you are and what reality is and start transitioning.

[Monica Padman]

Yeah, but it's those hormones, brain changes. Scary, but good to know. Like if you're starting to feel.

[Dax Shepard]

Yeah. That know you're. When you're in the danger zone.

[Monica Padman]

Yeah, exactly.

[Dax Shepard]

Hi to the danger zone.

[Monica Padman]

Okay, now, male pattern baldness.

[Dax Shepard]

Mpb. I say one thing.

[Dr. Mary Claire Haver]

Yeah.

[Dax Shepard]

I was eating at a restaurant this morning with Nate. He left. I paid woman came over to the counter or to my table and she said, I just wanna thank you for the Blaze episode. Oh, I have bpd.

[Monica Padman]

Oh my gosh.

[Dax Shepard]

And I think that episode probably saved me like two years of my trajectory to dealing with this.

[Monica Padman]

Great. So she realized she had it because of.

[Dax Shepard]

No, I think she already knew. But she hearing from him something he did, you know, she's like. It just kind of like fast forward her two years in the process. And it was very good for me to meet her because I think a lot of times you're like bpd. They fuck up the person's life who loves them and you villainize them. And it was very helpful to look at this young woman who's so grateful for help for this thing she doesn't want. Yeah, I was very happy to.

[Monica Padman]

That's lovely.

[Dax Shepard]

Yes.

[Monica Padman]

Yeah, I like.

[Dax Shepard]

So good luck. Bpd. Survivors.

[Monica Padman]

Yeah.

[Dax Shepard]

Yeah. Wow.

[Monica Padman]

It's first time you've ever said survivors. You don't say survivors.

[Dax Shepard]

I don't like that term.

[Monica Padman]

I know.

[Dax Shepard]

Yeah.

[Monica Padman]

Feels like the most PC you've ever been.

[Dax Shepard]

Yes. Yes, yes, yes, yes, yes, yes.

[Monica Padman]

Okay. Male pattern baldness doesn't exclusively come from the mother's side. It can be influenced by genes from both parents. The AR gene is located on the X chromosome, which men inherit from their mothers. However, other genes and environmental factors also play a role. If your mother's father has male pattern baldness, you're more likely to have it too. If your father is bald, you're twice as likely to have it. Hormonal Fluctuations, nutritional habits, stress level, and lifestyle choices can impact the onset. Onset and progression of baldness. Yeah. Genetic factors from both parents significantly influence the likelihood.

[Dax Shepard]

I fight for my life.

[Monica Padman]

You're doing fine.

[Dax Shepard]

I think I'm. I'm doing fine in the battle, but I'm fight. I'm fighting with all I got.

[Monica Padman]

I see. I see.

[Dax Shepard]

It's morning and night. That topical that I hate. Hate how it makes my hair feel.

[Monica Padman]

Yeah.

[Dax Shepard]

I gotta hold my head back so it drips back. It's. I. It's. It's embarrassing to see me at night in the mirror dealing with trying to keep my hair.

[Monica Padman]

Do you want to do that thing that Ike did?

[Dax Shepard]

What did he do?

[Monica Padman]

Crp.

[Dax Shepard]

Oh, I don't believe in it.

[Monica Padman]

Okay.

[Dax Shepard]

Yeah. What I really want more than anything is for them to figure out how to clone hair. And I want to go in and get my hair cloned and have massive surgery. Oh, and get the thickest lion mane, head of hair and have long braided hair.

[Monica Padman]

Oh, my God.

[Dax Shepard]

Like a Viking. Maybe I'll be in my Viking outfit for our guest, and you'll be in your outfit, and we'll let the chips fall where they may.

[Monica Padman]

Well, both. Maybe I'll be wearing topless.

[Dax Shepard]

I'll be in a kilt, crossing and uncrossing my legs repeatedly.

[Monica Padman]

Okay.

[Dax Shepard]

Yes.

[Monica Padman]

Oh, we're going to be competing.

[Dax Shepard]

Oh, this is great. So 1970. We're doing the river dance. I know this poor guest. Oh, my God.

[Monica Padman]

Okay, and then. Oh, real quick. So she. She said that there are. There are places that you can donate your eggs for free and keep some.

[Dax Shepard]

Yeah.

[Monica Padman]

Like so. That's cool. And there's one place called Co Fertility that does this. I don't know if this is the one she was talking about. I can't endorse this. I don't know much about it, but it is one of the places.

[Dax Shepard]

It is something that came up in a Google search.

[Monica Padman]

Yeah.

[Dax Shepard]

Yes.

[Monica Padman]

If you'd like to look into it, that's a place. All right. That's it for Mary Claire. Thank God she came in that. She really rattled me.

[Dax Shepard]

I'm going to use another word I don't like.

[Monica Padman]

Say it.

[Dax Shepard]

I'm on a roll. She's a rock star.

[Monica Padman]

You don't like that?

[Dax Shepard]

No.

[Monica Padman]

I feel like you say it.

[Dax Shepard]

Oh, no.

[Monica Padman]

Oh, yeah.

[Dax Shepard]

Sorry. This is. The list is long. It's hard to keep track of all the things atelier. Artisanal.

[Dr. Mary Claire Haver]

Oh, my God.

[Monica Padman]

Atelier. This past weekend.

[Dax Shepard]

I hate the word cuck. Oh, that's a thing. That, like, aggro dudes use to try to emasculate other men. They call them a cuckold.

[Dr. Mary Claire Haver]

Cuckold.

[Dax Shepard]

Yeah.

[Monica Padman]

Oh, weird.

[Dax Shepard]

Yeah.

[Monica Padman]

Last weekend I was doing a long walk. I walked down Sunset, I was doing this whole thing, and I passed a new coffee shop and I went in and I tried it and I texted Rob and I asked if he had tried it yet. And then he went the next day and he reminded me there was a merch there that said atelier on it. Did you buy it?

[Dax Shepard]

No, I almost did.

[Monica Padman]

Yeah.

[Dax Shepard]

To put in here.

[Monica Padman]

Yeah, I know. I considered it too.

[Dax Shepard]

She has a T shirt that says Armchair Atelier.

[Monica Padman]

I've been saying that.

[Dax Shepard]

Yeah, I was just repeating what you said, doubling down on what a great idea that you had.

[Monica Padman]

Saying that. Okay.

[Dax Shepard]

All right.

[Dr. Mary Claire Haver]

Love you.

[Dax Shepard]

Follow Armchair Expert on the Wondry app, Amazon Music or wherever you get your podcasts. You can listen to every episode of Armchair Expert early and ad free right now by joining one Wondry plus in the Wondry app or on Apple Podcasts. Before you go, tell us about yourself by completing a short [e-mail] survey.

[Monica Padman]

Imagine this.

[Dr. Mary Claire Haver]

You help your little brother land a great job abroad.

[Monica Padman]

But when he arrives, the job doesn't exist.

[Dr. Mary Claire Haver]

Instead, he's trapped in a heavily guarded compound, forced to sit at a computer and scam innocent victims, all while armed guards stand by with shoot to kill orders. Scam Factory, the explosive new true crime podcast from Wondery, exposes a multi billion dollar criminal empire operating in plain sight. Told through one family's harrowing account of sleepless nights, desperate phone calls and dangerous rescue attempts, Scam Factory reveals a brutal truth. The only way out is to scam their way out. Follow Scam Factory on the Wondery app or wherever you get your podcasts. You can binge all episodes of Scam Factory early and ad free right now by joining Wondery Plus.