Mailbag: Talking about menopause at work, plus how to cover the cost of HRT treatments, and more.

Summary

HerMoney with Jean Chatzky: Detailed Episode Summary

Episode: Mailbag: Talking about menopause at work, plus how to cover the cost of HRT treatments, and more
Release Date: February 7, 2025
Host: Jean Chatzky
Guest: Jill Herzig, Chief Brand Officer and Co-Founder of MIDI Health

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Introduction

Jean Chatzky welcomes listeners to a special mailbag episode featuring Jill Herzig from MIDI Health. Building on their previous discussion about managing the financial aspects of menopause, Jean introduces the episode's focus: addressing listener questions related to menopause, workplace challenges, and hormone replacement therapy (HRT).

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Listener Questions and Expert Responses

1. Navigating Career Challenges During Perimenopause

Question from Trudy (01:54):
Trudy, a single mother experiencing perimenopause, faces job stagnation, isolation at work, and fears about applying for new positions amidst menopause symptoms like brain fog. She seeks advice on career advancement and whether to pursue additional certifications.

Responses:
Jill Herzig emphasizes the commonality of menopause-related challenges and encourages embracing this life stage with grace. She highlights the importance of optimizing sleep and considering HRT to combat brain fog.
Jean Chatzky advises Trudy to focus on her transferable skills rather than job titles, suggesting a market research approach to identify suitable opportunities. She supports the idea of obtaining a certificate like Project Management from Google to boost confidence, while also noting that leveraging existing skills can be equally effective. Jean underscores the value of HRT in enhancing overall well-being, which can, in turn, positively impact career progression.

Notable Quote:
Jill Herzig (03:18):
"This is not a you thing. It is an every woman alive thing. Every one of us will go through this."

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2. Understanding Hormone Replacement Therapy (HRT) Costs and Coverage

Question from Jen (07:14):
Jen is considering HRT and seeks information on its costs and the type of health plans that cover HRT treatments.

Responses:
Jill Herzig explains that HRT typically costs around $40 a month, though her personal cost is slightly lower at $32 thanks to MIDI Health's assistance in finding optimal coverage. She notes that non-hormonal alternatives, such as the newly approved Vioza, may vary in coverage based on insurance formularies. Jill emphasizes the importance of working with knowledgeable clinicians to navigate treatment options effectively.

Jean Chatzky adds practical advice on pricing HRT, recommending listeners to compare prices from different pharmacies and consider purchasing generics in bulk to reduce costs. She shares her own experience of switching generics to manage side effects and costs better.

Notable Quote:
Jean Chatzky (10:13):
"Just shopping around can significantly reduce your out-of-pocket costs for HRT."

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3. Managing Menopause Symptoms in a Demanding Senior Role

Question from Sheila (12:21):
Sheila holds a demanding senior-level position and is experiencing menopause symptoms like hot flashes, fatigue, and brain fog. She seeks advice on requesting remote work flexibility without facing ageism.

Responses:
Jill Herzig references a Harvard Business School study indicating that women who openly discuss their menopause symptoms are perceived as more confident and stable. She encourages honesty and transparency when communicating with employers, suggesting that vulnerability can project strength. Jill advises requesting specific accommodations, such as remote work days, to manage symptoms effectively.

Jean Chatzky complements this by advising Sheila to prepare for the conversation by listing her contributions and successes within the company. She suggests demonstrating how remote work can enhance productivity and retention, thereby making a strong case for her request.

Notable Quote:
Jill Herzig (12:21):
"Showing vulnerability projects confidence and authenticity, which can strengthen your leadership presence."

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4. Indicators of Perimenopause While on Birth Control Pills

Question from Heather (14:35):
Heather is currently on birth control pills and is curious about the signs of perimenopause. Her gynecologist advised tapering off the pills to better assess her menopausal symptoms, such as whether it's appropriate to transition off the contraceptives.

Responses:
Jill Herzig clarifies that birth control pills are a form of hormone therapy with higher hormone levels intended to suppress ovulation. Tapering off the pills allows Heather to accurately determine her menopausal stage by observing her natural hormonal fluctuations and the presence of symptoms. Jill explains that symptoms like irregular periods and menopause-related changes can coexist, and it's normal to experience both during perimenopause.

Notable Quote:
Jill Herzig (15:21):
"Perimenopause is a confusing time with a lot of misinformation, but tapering off the pill is the right step to understand your body's transitions."

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Insights and Recommendations

• Embracing Menopause: Both Jean and Jill emphasize the universality of menopause, encouraging women to embrace this phase with self-compassion and to seek support when needed.

• Financial Planning: The discussion underscores the importance of integrating health considerations like HRT costs into broader financial planning, especially for women navigating career changes during midlife.

• Workplace Strategies: Transparent communication about menopause symptoms can enhance workplace relationships and lead to necessary accommodations without compromising professional standing.

• Healthcare Navigation: Selecting the right HRT or non-hormonal treatments involves careful consideration of costs, insurance coverage, and working with knowledgeable healthcare providers to tailor treatments to individual needs.

Notable Quote:
Jean Chatzky (05:19):
"It's taking these skills that we have and trying to apply them in other places to level up our careers alongside managing our health."

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MIDI Health's Future Initiatives

Jill Herzig discusses MIDI Health's expansion across all 50 states, aiming to provide comprehensive virtual care tailored to women's midlife health needs. The company is broadening its services to include weight management solutions and is evolving into a holistic healthcare provider addressing various aspects of women's midlife health.

Notable Quote:
Jill Herzig (16:45):
"We are becoming a holistic healthcare company that cares for everything you need in midlife in a virtual way."

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Conclusion

Jean Chatzky wraps up the episode by highlighting the valuable insights shared by Jill Herzig and encouraging listeners to engage with MIDI Health for their midlife health needs. She also promotes HerMoney's programs, such as Finance Fix and Investing Fix, aimed at enhancing women's financial confidence and power.

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Final Thoughts:
This episode of HerMoney provides a compassionate and informative exploration of menopause-related challenges, blending financial advice with health considerations. Through listener questions and expert guidance, Jean Chatzky and Jill Herzig offer actionable strategies for women to navigate midlife transitions both professionally and personally.

Transcript

[Jean Chatsky]

Hi, everybody. Welcome to Her Money. I'm Jean Chatsky and today we are bringing you an extra special mailbag with Jill Herzig. She is the chief brand officer and co founder of Midi Health. If you listened to our most recent Wednesday episode, then you know a lot about Jill, which is great. You also know how how we can get ahead of the financial burden of menopause. Check it out if you haven't had a chance to yet. We had an opportunity to ask our community what questions they had about menopause. We got some amazing responses. Before we get into that, we're going to take a very quick break.

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[Jean Chatsky]

And we're back with Jill Herzig, co founder and chief Brand officer at Midi Health. Okay, Jill, you ready for our first question?

[Jill Herzig]

Yeah, bring it on.

[Jean Chatsky]

All right. This comes from Trudy. She says, hi, Jean and Jill. I have job and age related questions I hope you can help with. So I'm a single mom, perimenopausal, stuck with no advancement options, isolated at work, and I am afraid to apply an interview for something new. I worry with menopause brain, Gen X seen and not heard habits, and not knowing how to value myself in the current job market. I don't know how to get away from the executive administrative job title I've lived with my whole career. How do people pivot to the next career level at this point in their lives? Should I leverage my soft skills or get a project management certificate from Google? I have two jobs and two teens now. What? Oh, my goodness. You've got a lot going on, Trudy.

[Jill Herzig]

Yeah, that's a lot. On your plate.

[Jean Chatsky]

And I sense in her. During. During the interview that we did for Wednesday's show, we talked about how menopause can really be a confidence zapper. I sense that is a large part of what Trudy is going through. I don't want to discount the perimenopausal symptoms at all, but I think they. They go hand in hand.

[Jill Herzig]

Yeah, that's what I'm hearing in this question is a lot of fear and a lot of shame. Maybe around her mention of menopause. Brain. Brain fog is a particularly scary and can be very embarrassing symptom. And yet it's incredibly common. I mean, I like to say to people, this is not a you thing. It is an every woman alive thing. Every one of us will go through this. So just dropping the burden of shame and embracing this life stage with everything that comes with it in that foggy brain is also so much knowledge and experience and wisdom. You've gotta give yourself some grace and some credit. The other, like, substantive things I would say is sleep. And sleep deprivation is a huge part of brain fog and menopause brain. Really optimizing your sleep. And HRT helps tremendously with that for many women. But there are other things you can do either alongside or instead of HRT if you can't or don't want to take it. And so I would really recommend focusing on this bedrock piece of your wellness, which is your sleep. Make sure that's okay. I would also recommend a book called the Menopause Brain by Lisa Moscone, who I think has been on your show.

[Jean Chatsky]

She was on our show. Yeah, in 2024.

[Jill Herzig]

I loved her book, and I felt like it really reframed brain fog for me and made me understand that what was happening during that time, and it is temporary, but it can go on for a while, is my brain was remodeling. Without that estrogen, which drains away during perimenopause and menopause, your brain is dealing with totally different situation. And it remodels just like it did when you were going through hormonal stuff during your whole adolescent period. If you remember the craziness of that after having a baby, that same thing. They talk about pregnancy brain and baby brain. Your brain's remodeling. Like, give it some respect.

[Jean Chatsky]

Yeah, absolutely. And from a career perspective, Trudy, I would. First of all, I do a little bit of research on the marketplace. I mean, look at yourself as. Not the titles that you've held, but the skills that you have. A lot of these skills are transitory. You can use them in a variety of jobs and opportunities. So spend some time on the job boards and see where you think that you might fit. And the idea of a certificate, I know you've already got a couple of associate's degrees, but the idea of a certificate, especially if you think it's going to give you a boost of confidence that will enable you to walk in and really kick ass in an interview, I think that's great. You may not need it, but sometimes I think we need to feel like we have something new to offer in order to step up and offer something new. It's not always true. We can take what we have and we can repackage it. Just like Jill did when she went from working as a magazine editor to co founding a health company. Right. She covered health, but she's now doing a completely different job. And I've done largely the same thing. Right. I covered personal finance and now I'm working in the financial industry in different pockets. It's taking these skills that we have and trying to apply them in other places and definitely get a little bit of medical help. I mean, as somebody who is on HRT and has been on it for many, many years, it's made a huge difference in my know that that's the answer for you, but I know that it's been the answer for a lot of people. All right, Jill, you ready for another one?

[Jill Herzig]

I am.

[Jean Chatsky]

This one comes from Jen and it is right on target with what I was just saying. She says, hi Jill and Jean. I'm considering hormone replacement therapy, but I'd love to know the positive and negatives first, namely how much does it cost out of pocket and what type of health plan should I have to cover the bulk of treatments?

[Jill Herzig]

Yeah. So HRT is if you have, I would say, decent health coverage. You do not have to have platinum health coverage to have your HRT covered. It in general costs people around $40 a month. So it's not nothing when it's covered, but it is an incredible investment in your health. Just as we've discussed. I will tell you that mine is considerably less than $40 a month. I think I clock in at 32 bucks a month. But my midi clinician has definitely worked with me to find the best coverage for the HRT that I need. When you need non hormonal alternatives and we prescribe many of them, there are newer ones and your insurance may or may not cover them. They're very exciting. They are great options for people who are cancer survivors. But you may have a harder time getting those covered. It doesn't mean they aren't worth exploring.

[Jean Chatsky]

I actually wanted to ask you about one of those. We know there's a treatment that's coming to the market that may be able to help a lot of women. It's called Vioza. I can't even pronounce.

[Jill Herzig]

Fezzolinitan.

[Jean Chatsky]

Yeah, that. It's non hormonal and it was recently approved to treat moderate to severe hot flashes. Is this cutting edge? Is it more expensive?

[Jill Herzig]

It depends on what's on your formulary. So your insurance may cover it and it may be very cheap or sad to say, they may not. But it is really exciting that there are more of these non hormonal prescription solutions coming to market. Vioza, you do need a knowledgeable clinician. They recently had a warning added to it because people were seeing some problems with liver levels. And you essentially just need a knowledgeable person to order the right tests, get your baseline, and then track you down the line. But Vioza is very effective, very, very effective drug. And getting those hot flashes under control, as you and I have discussed, can really be life changing and career changing. So it can be very worthwhile. It's worth mentioning that HRT is something that people tolerate differently and your clinician may need to dial it a little bit for you. And that can be about dosage, but also the form that you take it in. And so it can be more expensive if, for example, you find that you best tolerate a gel. There's one called Estrogel, for example, that we prescribe a lot of at midi. Again, having a clinician who will work with you to find the solution that's effective and affordable is important.

[Jean Chatsky]

Yeah. And Jen, I just want to say, like any prescription, you should really shop around. So I think I've been on every generic version of the estrogen patch and have found when I order from the online pharmacy and get three months in one shot, it's significantly cheaper than if I just go around the corner to my local drugstore and pick up one month at a time. So I try to remember to do that and to not run out and to put it on autopilot. And there have been some of the generics that did not work for me. That made me feel a little queasy and I had to call my practitioner and say, this one's not a good one, we need to switch. And there are different costs, so you may have to do a little bit of shopping around. We've got two more questions, but before we Take them, Jill. We're going to take a very quick break for a word from our sponsors.

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[Jean Chatsky]

And we are back. Jill Herzig from MIDI Health is with me. I've got a question, Jill from Sheila. She writes. Hey, ladies, I have a very demanding senior level job and recently with menopause symptoms, hot flashes, fatigue and brain fog, I feel like I need to take a step back. I love my job and the work that I do, but I'd love advice on how to ask for one or two days of remote work. What's a good script to bring to your employer? I don't want ageism to hold me back. Jill, let me let you start because I know you've talked about this as well and I'll weigh in too.

[Jill Herzig]

Yeah. There is a piece of research that I think applies here. I believe it was out of Harvard Business School and they found that women who directly address their menopause symptoms when they had a hot flash, they said, that's midlife for you, having a hot flash instead of it's a little hot in here. Those women were perceived as more confident, more stable and as stronger leaders. I found that such a revelatory study, it's like any kind of vulnerability, right? You show some vulnerability, but what it projects is confidence. I'm confident enough to show up as my whole self at work. So I think what I would advise, and obviously it depends on your workplace, if there is strong evidence of ageism, if you work in an exceptionally sexist workplace. I can't speak about every workplace, but that research would embolden me to just be honest and say, look, I'm going through this thing, we all go through it. And it would really help me to be able to have some flexibility, work from home a couple days a week. But instead of beating around the bush or trying to paper it over, I would go at it directly and in a kind of forthright way and definitely leave the shame behind.

[Jean Chatsky]

Yeah, I totally agree. And the only thing that I would add is that I'd come to this conversation armed as I would if I were asking for a Raise meaning, know exactly what you're contributing to this company. Make a list of your wins over the last year. You need to be able to pull out the information about how valuable you are, should that become necessary. As well as the fact that, in fact, not having to commute might allow you to sign on a little earlier and stay on a little later, if that is something that is called for. I think just make sure that you've got your facts straight about what you contribute to this company right now. People do not want to be out in the marketplace looking to hire. It's always cheaper and better to retain the good employees that you have. So you should know that as well. And good luck. Let us know what happens. Finally, we've got one more. Jill. This one comes from Heather. I have a medical question, she writes, rather than a financial or work question. If you're on the pill, what should you look for as indicators of perimenopause? Or ask your doctor about. My gynecologist was a bit vague when I asked what to consider now that I'm 44. She said, we'll start tapering you off the birth control pills as you get older because you won't experience typical symptoms. Is that correct? Again, not financial, but such a good question.

[Jill Herzig]

Yeah. Perimenopause is a really confusing times, I gotta say. And there is some misinformation out there. But her doctor gave her the right information. The pill is essentially a form of hormone therapy. It's just a much higher level of hormones because it has to suppress ovulation entirely to protect you against unwanted pregnancy. It's just a much higher level of hormones than you get in standard hrt. So in order to know where you're at in your sort of menopause journey, she will have to taper off and see how she feels, particularly if she gets no periods at all, because many women don't. On the pill, it suppresses ovulation and they've done away with their periods. You find out whether you're still cycling, you find out if you have symptoms. And those things can be concurrent. You can absolutely be having periods and regular periods and be getting symptoms at the same time, which a lot of women don't understand. And they're in their early 40s or even their late 30s, and they don't, they don't get it. They think, like, how can I be having my period and also have these things that seem like menopause symptoms, but that's totally normal. So, yeah, her doctor gave her the right information. She will have to taper off to get a read on where she's at and then kind of go from there.

[Jean Chatsky]

Okay, well, thank you for all of this. Jill, what should we be looking for from you from MitiHealth in the coming months and years?

[Jill Herzig]

You know, Miti has spread to all 50 states, so we're providing care to women everywhere. We are growing really rapidly to meet the demand. I think what you'll see from us is, is just offering more and more services. So our patients have, over the past few years, grown to depend on us for pretty much every kind of care that you can receive virtually. So you'll see us starting to care for a much wider variety of the needs that women have in midlife. We are currently doing that, but we don't really market it. And that's something I think that we're going to wrap our arms around and own much more fully. We expanded our services to include weight care because so many women at midlife are encountering unexplained and super stubborn weight gain. It's really upsetting to people. It's not good for their health. So we offer a whole bunch of solutions for that, including the new weight loss medications. So that was kind of a first step in that direction. But we're really becoming a holistic healthcare company that cares for everything you need in midlife in a virtual way.

[Jean Chatsky]

Amazing. Congratulations. Thank you. And let me just say, you know, I know that a lot of our listeners have accessed your services in the past, and I'm sure a lot will in the future. So thank you for what you're doing for us.

[Jill Herzig]

Yeah, I appreciate every one of our patients and I want to hear from you. You can find me pretty easily and we really appreciate any feedback.

[Jean Chatsky]

Amazing. Thank you so much. Thanks for answering the questions.

[Jill Herzig]

Of course. I love them.

[Jean Chatsky]

And thanks everybody for listening. We'll see you next time. If you love this episode, please give us a five star review on Apple Podcasts. We always value your feedback. And if you want to keep the financial conversations going, join me for a deeper dive. HerMoney has two incredible programs. Finance Fix, which is designed to give you the ultimate money makeover, and Investing Fix, which is our investing club for women that meets bi weekly on Zoom. With both programs, we are leveling the playing fields for women's financial confidence and power. I would love to see you there. Her Money is produced by Hayley Pascalides. Our music is provided by Video Helper and our show comes to you through Megaphone. Thanks for joining us and we'll talk soon.