Tamsen Fadal: You Are Not Going Crazy… Your Hormones Are Changing! (THIS is the GUIDE to Navigate Menopause & Take Back Control of Your Mind, Body & Life)

Summary

Podcast Summary: On Purpose with Jay Shetty

Guest: Tamsen Fadal
Episode: "You Are Not Going Crazy… Your Hormones Are Changing! (THIS is the GUIDE to Navigate Menopause & Take Back Control of Your Mind, Body & Life)"
Date: September 1, 2025

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EPISODE OVERVIEW

This episode features Emmy-winning journalist and menopause advocate Tamsen Fadal, who joins Jay Shetty to break the silence around menopause. The conversation covers the realities, myths, symptoms, and social stigma of perimenopause and menopause, the impact on women’s lives and relationships, and provides a roadmap for navigating this transition. The dialogue empowers women and informs men on how to be more supportive, emphasizing that menopause is a natural phase—not the end of a woman’s best years.

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KEY DISCUSSION POINTS & INSIGHTS

1. Why Menopause is a Taboo Topic

[02:06–06:02]

• Tamsen: Menopause is taboo due to ageism and sexism—society and the medical system often treat women's post-reproductive years as their "decline."
• Quote: “We've just kind of said goodbye to women after the reproductive years... their best years are behind them.” – Tamsen Fadal [02:32]
• Even as a major news journalist, Tamsen rarely heard, let alone said, the word "menopause" on air.

2. What is Menopause? (Definitions & Timeline)

[06:13–07:45]

• Perimenopause: 4–10 years before menopause, marked by unpredictable symptoms due to hormone changes.
• Menopause: The point when a woman has had no period for 12 months.
• Post-menopause: Everything from that point onward—can represent a third to half of a woman’s life.
• Quote: “Perimenopause is the time leading up to menopause, four to ten years of struggle … All the symptoms haven't stopped yet. But that could be a third to half of your life that we're talking about.” – Tamsen Fadal [07:20]

3. SYMPTOMS: Physical, Emotional, and Cognitive

[07:45–09:33]

• Physical: Brain fog, hot flashes, joint pain, dry skin, weight gain, low libido, sleep disruption.
• Emotional: Mood swings, anxiety, depression, loss of sense of self.
• Quote: “I look in the mirror and I don't recognize myself. And that, to me, was one of the most hurtful things...” – Tamsen Fadal [08:44]
• Impacts daily functioning, work, and relationships; women often feel they're "going crazy."

4. Work, Relationships, and the Broader Impact

[09:33–12:08]

• Menopause affects performance at work and can influence divorce rates.
• Quote: “We see a lot of divorces happening in the 40s, and I don't think that's a coincidence. … Maybe their libido's low, so their partner doesn't understand what's going on.” – Tamsen Fadal [11:00]

5. Debunking Menopause Myths

[12:08–13:41]

• Myths addressed:
  • Menopause means your best years are over. False.
  • Feeling “crazy” or “not yourself” is uncommon. False; it’s widespread.
• “You are not alone and you're not crazy.” – Tamsen Fadal [13:03]
• Symptoms and timings are highly variable among women.

6. The Science: What’s Happening Biologically

[13:41–15:04]

• Declining estrogen & progesterone cause symptoms.
• Estrogen receptors are everywhere in the body, especially the brain—hence cognitive symptoms.
• Many women worry they're developing dementia or serious illnesses before realizing it's menopause.

7. Societal Messages & Misinformation

[15:46–17:09]

• Celebrities like Halle Berry believed they could “outwork” menopause—this isn’t possible.
• Young women are led to believe menopause is only a concern for the elderly.
• Health risks like bone and heart health are often ignored till symptoms arise.

8. Early Warning Signs of Perimenopause

[17:17–18:35]

• Top symptoms: Irregular periods, sleep disruption, mood/anxiety changes.
• Doctors often dismiss these as stress, compounding women’s frustration.

9. Menopause Diagnosis & Doctor Experience

[22:39–24:51]

• Many doctors are not trained to recognize or manage menopause; only 1 day of training on average.
• 75% of women report symptoms remain untreated.
• Only 2% of medical research focuses on women’s health, with menopause being a fraction of that.

10. Health Risks of Ignoring Symptoms

[29:49–31:34]

• Osteoporosis, heart disease, cognitive decline (Alzheimer’s) can all be worsened by untreated menopause symptoms, yet few are warned.
• Early prevention and awareness are crucial.

11. Differing Experiences by Ethnicity & Geography

[31:34–32:47]

• Black women often experience earlier/more intense symptoms.
• Asian women may have more joint pain, fewer hot flashes.
• Environmental, genetic and lifestyle factors play a role.

12. The Trouble with Diagnosis & Antidepressants

[32:47–35:58]

• No single test for perimenopause; diagnosis is symptom-based.
• Too often, women are misdiagnosed and prescribed antidepressants instead of real menopause solutions.
• Tamsen recounts being given antidepressants before discovering the root cause.

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SOLUTIONS & STRATEGIES FOR NAVIGATING MENOPAUSE

1. Hormone Therapy (MHT/HRT)

[36:37–39:53]

• Estrogen and progesterone (sometimes testosterone/vaginal estrogen) can dramatically reduce symptoms.
• Not every woman is a candidate; risks exist but must be weighed against suffering.
• “Hormone therapy is a very viable option for a lot of women. … It was very helpful for me.” – Tamsen Fadal [37:47]
• Past studies created fears around HRT, sharply reducing its use, but understanding and guidelines have since evolved.

2. Lifestyle Changes

[39:56–42:43]

• Sleep: Foundation for managing symptoms.
• Strength Training: Prioritize bone health, not just cardio.
• Nutrition: Watch for inflammation, eat enough protein and fiber.
• Balance: Progress over perfection; give yourself grace when symptoms disrupt routines.
• Stress Management & Community: Share experiences, build support.

3. Building Community

[42:47–43:38]

• Friends might not understand, but a community of women facing menopause provides vital support.
• “I have a core group of women right now where I can pick up the phone and say, hey, like, I am not myself... And I think that's a really important part of this process.” – Tamsen Fadal [43:01]

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WHAT MEN NEED TO KNOW

[44:10–46:10]

• Men should educate themselves ("What is menopause? How does it manifest?").
• Ask: “Is everything okay? What’s the hardest part? How can I help?”
• Presence, patience, and practical support matter more than solutions.
• “Awareness is a huge part of it… sometimes the person outside of you can see those better than you can see them yourself.” [45:06]

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IMPACT ON SEXUAL HEALTH

[47:27–49:53]

• Sex drive fluctuates, often decreases, and sex can become painful due to dryness.
• Emotional impact: Relationships suffer without understanding from partners.
• This is hormonal/chemical, not just psychological or a lack of attraction.
• “All of a sudden it doesn’t feel good anymore. … Those are really tough things to contend with.” – Tamsen Fadal [49:55]

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PREPARING FOR PERIMENOPAUSE / ADVICE FOR YOUNGER WOMEN

[61:18–62:31]

• Start healthy habits young: sleep, strength training, nutrition.
• Get a bone density test early for a baseline.
• “If you didn't make them in your 20s or 30s, it's not too late, too late to make those changes.” – Tamsen Fadal [72:23]

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BIRTH CONTROL AND PERIMENOPAUSE

[63:34–64:38]

• Birth control may mask or regulate period irregularities but is not a solution for other perimenopause symptoms.
• Not known to worsen perimenopause experience, but can make tracking onset/ending of periods tricky.

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COMMUNITY, KNOWLEDGE, AND HOPE

[65:31–67:16]

• Women who are informed and connected feel “like themselves,” empowered for their next chapter.
• Ignorance/ambiguity causes the most anguish; knowledge is liberating.

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THE IMPORTANCE OF ADVOCACY AND DOCTOR EDUCATION

[67:55–70:25]

• Doctors often dismiss symptoms as age-related due to lack of training.
• The burden is on women to self-educate and advocate.
• More research, funding, and medical training are urgently needed.
• “There's so much that can be done about this and there's so many different ways to help women.” – Tamsen Fadal [69:18]

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CLOSING THOUGHTS & MEMORABLE MOMENTS

[71:58–73:38]

• Tamsen discovered purpose through menopause: helping women and validating their experiences.
• “I do feel like a mom now. You know, I do feel like I’m helping young women ... menopause gave me a purpose.” – Tamsen Fadal [71:58]
• Hope: It’s never too late to change your health, and the conversation around menopause is starting to shift.

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NOTABLE QUOTES & MOMENTS (with timestamps)

• “We’ve just kind of said goodbye to women after the reproductive years.” – Tamsen Fadal [02:32]
• “Perimenopause is the time leading up to menopause, four to ten years of struggle… it could be a third to half of your life that we’re talking about.” [07:21]
• “I look in the mirror and I don’t recognize myself… One day I woke up and I was like, I’m a shell of who I am and I don’t know how to find the light switch in this room.” [08:44]
• “You are not alone and you’re not crazy.” [13:03]
• “If you eat perfectly, if you work out perfectly, if you do all these things perfectly, you’re gonna be okay down the line. But the truth is, we hit perimenopause and there are some real long term health concerns that you have to pay attention to.” [15:54]
• “Only 2% of all medical research goes towards women's health… a tiny sliver of that goes to menopause and perimenopause.” [24:01]
• “I wish that every couple’s counselor … would educate themselves about the changes that happen during this time in a woman’s life, because I think it would solve so many problems.” [58:43]
• “It's never too late to make these changes.” [72:23]

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TAKEAWAYS FOR NEW LISTENERS

• Menopause is a universal, natural phase—not a disease or the end of purpose for a woman.
• Symptoms are widespread, variable, and can be debilitating—but they are manageable with knowledge and support.
• Open conversations, community, and advocacy must replace silence and stigma.
• Partners, families, and workplaces should be educated and compassionate—everyone benefits.
• It's never too early or late to take charge of your health.

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For more, check out Tamsen Fadal’s book How to Menopause, her podcast The Tamsen Show, and follow her on social media for science, solidarity, and support.

Transcript

[Tamsen Fadal]

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[Jay Shetty]

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[Interviewer/Co-host]

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[Jay Shetty]

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[Tamsen Fadal]

Over half the population is going to go through menopause, yet we don't talk about it at home. We haven't learned about it at school, we don't talk about it in the doctor's office. We often feel like our body is betraying us and we don't know who we are anymore. She's a powerhouse in women's health. Tamsen Fadal is the Emmy winning journalist and New York Times best selling author of how to Menopause, Fiercely changing the conversation on women's health.

[Interviewer/Co-host]

Why is menopause still treated as such a taboo topic?

[Tamsen Fadal]

Ageism and sexism. We've just kind of said goodbye to women after the reproductive years. We look at women that are in midlife and we say, wow, their best years are behind them. And that's kind of what the medical system has done as well.

[Interviewer/Co-host]

What are the symptoms? What are women experiencing? What are they going through on a biological and chemical level, but also on an emotional level as well?

[Tamsen Fadal]

Brain fog was the most debilitating of the symptoms. Mood swings, weight changes, joint pain, itchy skin, dryness all over, low libido.

[Interviewer/Co-host]

What happens to a woman's sex drive during perimenopause?

[Tamsen Fadal]

Nearly 60% of women say that menopause has negatively impacted their sex life and I would say that number is even higher. They experience painful sex. There's dryness that happens all over your body and it didn't feel good.

[Interviewer/Co-host]

Why is it doctors still dismiss these symptoms and medical research is not investing more?

[Tamsen Fadal]

The Number One Health and Wellness Podcast Jay Shetty Jay Shetty, the one, the only Jay Shetty.

[Jay Shetty]

Hey everyone. Welcome back to On Purpose, the number one health podcast in the world. Thanks to each and every one of you that come back every week to.

[Interviewer/Co-host]

Listen, learn and grow.

[Jay Shetty]

Today's guest is going to talk to.

[Interviewer/Co-host]

Us about a subject that I've been fascinated by for a long, long time.

[Jay Shetty]

It's something that I have a lot of questions about, something that I don't know that much about, and something that every single person we love is going to go through. Today's guest is Tamsin Fadel, an Emmy Award winning journalist and the New York.

[Interviewer/Co-host]

Times best selling author of how to Menopause.

[Jay Shetty]

She's also the producer of the acclaimed.

[Interviewer/Co-host]

Documentary the M Factor and host of.

[Jay Shetty]

The Tamsin show podcast. If you haven't subscribed yet, make sure you do. Tamsen has become a leading voice in the global conversation on midlife, menop, menopause and reinvention and helping women navigate this transition with knowledge, confidence and community.

[Interviewer/Co-host]

Please welcome to On Purpose, Tamsin Fadal Tamsen. Thank you so much for being here.

[Jay Shetty]

I said this to you off camera.

[Interviewer/Co-host]

I'm going to say it again. I'm so excited for this conversation.

[Jay Shetty]

I feel so much has been lost when it comes to women's health, men's.

[Interviewer/Co-host]

Understanding of it and the ability for.

[Jay Shetty]

Women to take charge of their health.

[Interviewer/Co-host]

But also for men to be understanding, supportive and recognizing what a big thing it is. And I'm so grateful that you wrote this book, how to Menopause that I highly recommend everyone gets. But thank you so much for being.

[Tamsen Fadal]

Here, Truly, thank you. I'm so happy to be talking about this because it is so important for men to hear this conversation.

[Jay Shetty]

Yeah, I mean, I want to start off by I have A ton of questions for you. And like, usually when I interview someone, I have some understanding or some knowledge of the area. I have nothing, which is a great place for me to be in because I feel like it's gonna give a.

[Interviewer/Co-host]

Lot of people the opportunity to learn.

[Jay Shetty]

And the first question I wanted to.

[Interviewer/Co-host]

Ask you is, why is menopause still treated as such a taboo topic when it comes to everyday conversation and everyday life?

[Tamsen Fadal]

It's such a great question, and I think I have struggled with it for so long myself. Look, I think it's wrapped up in a few things. I think it's wrapped up in ageism and sexism. And I also think this is a time in life where we just kind of said goodbye to women after the reproductive years. We look at women that are in midlife and we say, wow, their best years are behind them. Society done that for a very, very long time, especially here in the US and that's kind of what the medical system has done as well. So we have put the word menopause and taboo together for so long. And my goal is to separate those two things so we're never saying those two things together.

[Jay Shetty]

It doesn't get the spotlight it deserves.

[Interviewer/Co-host]

When every woman we know is going to experience it at some point in their life and talk to us about how long it lasts.

[Jay Shetty]

Like, just. Just break down the taboo of how.

[Interviewer/Co-host]

Long is it going to last?

[Jay Shetty]

When does it happen? For everyone who' starting from scratch, like.

[Interviewer/Co-host]

Me, like, what is it?

[Tamsen Fadal]

Like, help somewhere, Right? I'll tell you what, it was really shocking to me. I spent 30 years in the news business, and I had never said the word menopause that I remember on television. Wow. And that tells you a lot. We talked about all sorts of studies. We talked about health studies, we talked about diets. We talked about everything. Menopause and women's health were not the things we discussed. And that goes to your first question about how taboo it has been for such a long time. When I actually found out I was in menopause, I got a very simple note from my doctor saying, menopause, Any questions? And no real answers after that. So I started digging into it to figure out what was going on. And I quickly learned 1 billion women across the world were going to be in menopause by this year. And I thought, okay, well, what is it? So we'll break it down really simply because I always think it's the best way to do it. Perimenopause is the time leading up to menopause, four to ten Years of struggle, of hormone changes, of not knowing exactly what's going on with your body, of all different type of symptoms, not just hot flashes. When you hit menopause, that means that you've gone one year without your period, and then everything after that is post menopause. All the symptoms haven't stopped yet. But that could be a third to half of your life that we're talking about. So when you think about how long a woman is going through this transition this next season and the fact that we have such little information about it, it was just shocking to me.

[Interviewer/Co-host]

And talk to me about, what are the symptoms? Like, what's someone experiencing at this time? Because as a man, we're so disconnected from women's health already. And then this is, like you said, this is a underspoken about area. Like, what are the symptoms? What are women experiencing? What are they going through on a biological and chemical level, but also on an emotional level as well.

[Tamsen Fadal]

I'm glad you said that, because emotional is the big thing. And I think it gets overlooked quite often because we talk about hot flashes and we talk about irregular periods, and we talk about brain fog. And I think for me, brain fog was probably the most debilitating of the symptoms because it gets wrapped up with a lot of things I had. Anxiety, mood swings. A woman can go through weight changes. When you're talking about brain fog, you could be reading a book and not remember the plot of the book. You could be having a conversation like this. I could be sitting here, Jay, across from you. Three years ago, I probably wouldn't be able to have this kind of conversation with you without feeling like, hey, can I stop and try to remember what I was talking about? You go through joint pain. You can go through itchy skin, dryness all over, low libido. So if you think about one day, you're going along just fine in life, right? You're in your 30s, you're doing great. You're maybe in the height of your career. You're on your way to wherever you want to be. You're in a relationship, and you might start to see some of these symptoms crop up. You're not sleeping as well anymore. That's a big one. You're gaining weight around the middle, but you've been eating the same and really working out. So you wake up. And what I heard over and over from women when I was researching this is that I don't feel like myself anymore. I look in the mirror and I don't recognize myself. And that, to me, was One of the most hurtful things that I could hear because I understood exactly what they were talking about. One day I woke up and I was like, I'm a shell of who I am and I don't know how to find the light switch in this room. I just am in the dark.

[Interviewer/Co-host]

I mean, that sounds like truly one of the most difficult, challenging experiences anyone could go through. And we're saying everyone's going to go through it for nearly a decade, potentially. And so the fact that every woman we know is going to go through this, the fact that it's going to affect them physically, mentally and emotionally to the point that it can be debilitating to how you just spoken about. What are we seeing a correspondence with. When we look at women's health at this age and when they're going through this process, how is that affecting their work, their career, their family, and everything else that comes with it? Like, what's happening when.

[Jay Shetty]

Because I think sometimes when we talk about health, we kind of talk about.

[Interviewer/Co-host]

It in this silo of like, here's what's happening chemically, here's what's happening with the hormones. But this is having real life impact. Is there any correlation between menopause and divorce? Break. Like, talk to me about the real life impact of it.

[Tamsen Fadal]

It's such a good topic because it doesn't just happen in the doctor's office. You could go to the doctor's office and have the conversation, but once you leave there, you have to think about the whole 360 of it. And it really is what I get excited to talk about, because I think that we feel very lost during this time as women. We're in our career and maybe we're hit with perimenopause and going into menopause. And we could be showing up to work, not being able to have a conversation. We don't know. How do you go into your boss and say, hey, I might be in perimenopause for seven years? I think that for a lot of women, they're starting to realize that we're normalizing the conversation. We're definitely not having the silence that we had before. But it can really impact you at work. It can show up in a lot of different ways. And what I've been fighting against is making sure that it doesn't penalize women either. We don't want that to hurt women. Women at this point are at the height of their careers. We want companies to retain women. They have some of the greatest wisdom they could ever have during these times. And beyond. So I think it's really important for women to be able to get ahold and understand what's going on. So they're not going through this journey just kind of blindly, which is what's been happening. And then I think when it comes to relationships, it has a real impact. You know, we see a lot of divorces happening in the 40s, and I don't think that that's a coincidence. I don't think it's a coincidence that somebody wakes up all of a sudden and feels very differently. Or maybe their libido's low, so their partner doesn't understand what's going on. Or all of a sudden, something that didn' bother them a long time ago, they're snapping like this. And that's what's really happening out there. I think we're getting to a place, starting to get to a place where we're starting to have this conversation more and more, but it's really where we have to bring everybody into it. It can't just be women having this conversation with each other.

[Interviewer/Co-host]

What's a myth about menopause that you think's lasted too long, that people are still holding onto? And when you talk about it, that's their first reaction, because, you know, I feel really embarrassed saying this, but I know a lot of men who'd say.

[Jay Shetty]

Oh, yeah, there was just this period.

[Interviewer/Co-host]

When my wife was acting out and she was being a bit crazy and she was a bit mad, like, language like that.

[Jay Shetty]

And that's one of those myths that.

[Interviewer/Co-host]

I think people are just like, oh, just during this phase, like, oh, the kids left home and everything just went, you know, and it becomes this lifestyle thing.

[Jay Shetty]

What are some of the myths you.

[Interviewer/Co-host]

Are seeing that you are coming up against when you're talking about this?

[Tamsen Fadal]

Yeah, I mean, I've seen so many myths with this. I think the first myth is that your best years are behind you, and that's just not true. I really think that you're coming into a whole new, new period. And even if you look at some of the data and the scientific studies out there, we look at women that are post menopause, and those are some of the best years that they can have in their lives. So that's exciting. I think another big myth or something that women feel, and they've said this over and over. I don't feel like myself, and I feel like I'm going crazy. I feel like something's wrong with me, and I just can't pinpoint what it is. But I know this isn't me anymore. And so, you know, I start the book saying that you are not alone and you're not crazy. That is not what's going on. You've got something happening to you biologically, and that's affecting you in a whole bunch of different ways. And as soon as you understand that, then you can take those steps and deal with those symptoms. And I think it's important also to know that everyone doesn't have the symptoms that we talked about. Everybody goes about this differently. And I think that's what can make it so confusing to so many women.

[Interviewer/Co-host]

What's happening to the brain and body during perimenopause and menopause? What's chemically going on?

[Tamsen Fadal]

Yeah, chemically, we're losing estrogen, obviously, also losing progesterone. And so when you're going through these hormones, I mean, think about what we went through when we were in puberty. Your hormones were all over the place. I think of perimenopause as kind of this wild ride. It's sort of unexpected. You don't know what's gonna happen. And you definitely feel that in your head when you've lost that estrogen. We have estrogen receptors all over our body, and the brain is no exception. We have them everywhere. And so I remember when I was going through perimenopause, and I didn't know I was even going through it. Cause I didn't have the vocabulary for it. That I would sit there and I'd read something. I couldn't remember it. I would look at. I couldn't. I knew the word. I recognized it. I knew. I knew how to say it, but it wouldn't come out of my mouth. And those are some scary things that happen. Because you think, is something going on with me? Is this dementia? Is this Alzheimer's? Is this something very serious? And so I know a lot of women who have gone to the doctor saying, like, there's really something wrong with my head. I don't know what's happening. Or they walk into a room and don't remember why they walked into a room. I talked to one doctor in the course of doing research for the book, and she said, I forgot my medical knowledge number, which is something we say, like our Social Security number. We say it all the time for years. And I sat there and I couldn't remember it. And I actually went to the neurology department and I made them do brain scans on me. That's how serious it can be.

[Interviewer/Co-host]

Wow. Yeah. I mean, it really hit me when I was at a Time 100 health event, and I know Halle Berry, who you've collaborated with at your events and multiple other places. I remember her speaking about this, and I know she's been a big advocate from the celebrity side to talk about this topic. And she was talking about how she really believed she was just going to be too fit, too strong, too like yogaed out.

[Jay Shetty]

And, you know, she really believed that.

[Interviewer/Co-host]

She had a workout regime that would beat menopause and that it wouldn't be a reality for her. And when she said that there was.

[Jay Shetty]

No way you could outwork or out.

[Interviewer/Co-host]

Yoga or whatever, it may be that there wasn't a method to avoiding or just pushing through this.

[Jay Shetty]

What are some of the lies or.

[Interviewer/Co-host]

Things women have been told growing up that you think have tripped them up as they come into perimenopause and menopause?

[Tamsen Fadal]

Yeah, I think it's so important to realize that. And Halle Berry has been an incredible voice in normalizing this conversation and getting out there and having real honest talks about what she went through. And I think that's really helped in so many ways, because I think women see that and go, oh my gosh, if she's going through that and she can talk about perimenopause and menopause, then maybe it's okay for me to do the same thing. You know, I think that women have been told, like, if you eat perfectly, if you work out perfectly, if you do all these things perfectly, you're gonna be okay down the line. But the truth is, we hit perimenopause and there are some real long term health concerns that you have to pay attention to when it comes to brain health, when it comes to heart health, when it comes to bone health, especially the real serious things. I know you've had Dr. Vonder Wright talking to you and she talks about bone health. It's one of the scariest things. I didn't think about my bones at 20 or 30, even 40 years old. It wasn't something I was thinking about. So I think that young women have been misled in a lot of different ways to think that this is something that happens to older women and you don't have to worry about it. We see women coming into perimenopause in their late 30s and beyond, and I don't want them to be afraid. I want them to be really inspired to get a hold of it, know what's happening and be able to handle it so they don't have these bumps that I think a lot of women have had leading up to this time.

[Interviewer/Co-host]

And let's talk about some of those. What are the early signs of perimenopause that, and I know you said there's lots of different but. And everyone has different experiences.

[Jay Shetty]

But what would you say are the.

[Interviewer/Co-host]

Early signs of perimenopause that you see across women?

[Tamsen Fadal]

Yeah, I would say the three big ones that I've seen across women are irregular periods. You're going along just fine and then all of a sudden you have your period very heavy, or you don't have it at all and you don't know what's happening. A lot of times women will go to the doctor and a doctor will say, it's just stress, calm down a little bit, it'll be okay. Instead of, hey, you're 41, you know, do you have any other. These 30 plus symptoms? Maybe it's perimenopause. The other big one I would say is sleep disruption. That's huge. I was somebody that used to be able to sleep all the time. I've heard women that say, oh my gosh, at 3 o' clock in the morning I'm up and I can't go back to sleep, or I can't even get to sleep. And that again is something else. Try to go to work and you'll have five days like that of not being able to sleep. And then you start to understand what's going on. You start, you just don't feel like yourself. And you know, I think the third one is more of mood changes. There can be anxiety, there can be rage, there can be depression. And there's a lot of things like that that happen during this time. So I think those are the top three that you see in perimenopause. And the other ones come along. You know, we've all heard of hot flashes. We know a lot about, about weight gain that starts to happen. But those are three big ones. And I think that those are three very difficult ones as you're coming up against those.

[Interviewer/Co-host]

And what's the difference between perimenopause and menopause?

[Tamsen Fadal]

Yeah, so perimenopause, you're still getting your period. It's all the time leading up to menopause. When you hit menopause, that's that one day after 12 months without your period, and then you're not getting your period any longer. So these are still your reproductive years, but you're in perimenopause and those can overlap a lot of things. You know, women can get pregnant in perimenopause Once you hit menopause, you're no longer having a cycle. And then everything after that, you're considered menopause. And some people call it postmenopausal. I just say menopause. Cause it's easier for me to remember when I do have brain fog. But, you know, I think that it's important to know that perimenopause feels very unpredictable. It feels very confusing, because you've been fine up until then, and you could be in your late 30s and you're thinking, I'm too young for this. How could I be dealing with this? But when those hormonal fluctuations start, you start seeing some of these changes. And I don't think we were really ever taught that, you know, you asked earlier, what are some of the things that young women, you know, they were taught, you're gonna get your period. You know, if you decide you want to have children, you're gonna go through your pregnancy. And then we kind of fall off the map, not only in society, but also in the medical system.

[Interviewer/Co-host]

Yeah. And then what are the symptoms of menopause then?

[Tamsen Fadal]

So the symptoms of menopause, you can still have a lot of these symptoms that can go right through. And some start to wane off a little bit. And some women can have hot flashes in their 80s. And it just depends if you decide, you know, how you're going to treat them, what symptoms are important for you to treat. Hormone therapy is one of the options that has been named and deemed by the menopause society as one of the most effective treatments for hot flashes and vaginal dryness. But I think that, you know, it's important to know what works for you. Not everybody, as we said, is going to be able to do everything or want to do everything. So I think it's been important first for me to go out there to educate women, Because I'll tell you, I was clueless. I had no idea what was happening, and I really felt like I was crazy. And I would wake up in the morning and think, like, oh, my gosh, I got two hours of sleep and I've got to go to work. And I'd get to work and not remember what was going on, or remember what I was supposed to be doing. And I hear so many stories of women in different places of work, or women that are also raising children at the same time, or taking care of elderly parents, or they're in a relationship, or they're in a new relationship. So it can be really difficult. And I think it's important to Know that menopause is not just for older women. Young women go through menopause. I consider late 30s a young woman.

[Interviewer/Co-host]

To me, it's just mind boggling how women have been so resilient and strong to move in a world to that isn't aware or is not talking about what they're going through on a daily basis and just how many relationships that touches. And having so many people in your life who don't know what you're going through. Like we talk about, I feel in the wellness community around how it feels to be misunderstood. I mean, this is the deepest form of feeling misunderstood because you're going through something physically, mentally, emotionally, daily. And everyone you meet has no context of why you're behaving that way. And then you get labeled, oh, well, you know, she's just going through something or whatever it may be that that that disassociates you from the exact experience.

[Tamsen Fadal]

The truth is, is that you don't even know you're going through it yourself sometimes. It's not like you went into the doctor and they said, hey, at 35, you should start thinking about perimenopause because you might be going through some of these symptoms right now. We're trying to teach women to go to the doctor proactively and say, hey, these are my 10 symptoms. Could this be perimenopause? And that is my hope and dream that one day there will be this baseline like we talk about mammograms, like we talk about other kind of tests that people are supposed to get when it comes to health and wellness, that we say, hey, maybe this is what you're going through. Maybe it's not stress. Maybe you don't need to just go home and you know, and take a walk outside. Maybe it's something more than that. And it's not just you that's going through this. If we can get to that place, it would be just a really beautiful place. And I think it would end a lot of the suffering because I don't think women should have to suffer during this time.

[Interviewer/Co-host]

So that's really the first step. And I know in the book you give a list of 34, is it symptoms that people experience? And so I guess the first step is if you feel any of those 34 things, go and have the conversation. Because chances are your doctor or someone may not have the conversation with you proactively if you don't raise it 100%.

[Tamsen Fadal]

A lot of doctors aren't trained about this. And that was the other thing that was so shocking for me to learn. I think I was somebody who went to the doctor, this is what the doctor said. I went home and. And that's what we did. And what I realized over time is that as we looked into menopause and perimenopause, because of the fact that women's health has not been a priority past a certain age, in midlife, mostly after about 40 years old, a lot of doctors weren't trained about this into their own admission. OB GYNs, their specialty, sometimes got a day of training in medical school to talk about this. If you can imagine all those years and they've had to go out and learn for themselves. And so there are a lot of doctors that leave medical school and don't feel comfortable talking about something like this. So about 75% of women go in and their symptoms are left untreated as a result of that. And that number is staggering to me.

[Interviewer/Co-host]

That was something I saw as well. I remember at a conference I was at, and you can correct me if I'm wrong, but there was a number that said something like only 2% of all medical research goes towards women's health. Is that right?

[Tamsen Fadal]

You're right. I would never correct you on that. That's so right.

[Interviewer/Co-host]

That's right.

[Tamsen Fadal]

Yeah. It's unbeliev believable. And then if you look at that percentage, a tiny, tiny, tiny sliver of that goes to menopause and perimenopause. And I don't know about you, but I'd never heard the word perimenopause until I started saying it a few times.

[Jay Shetty]

I haven't heard it since I followed you, probably. So, yeah.

[Tamsen Fadal]

So I mean, I went, wait, what's perimenopause? And so I think that the more we can say the word, the more we can get it out there. And it doesn't sound like this scary word. When I first started talking about it, I was told, you're gonna blow up your career talking about menopause. You're gonna age right outta your career, is what we thought about when we thought about this word. And so I'm hoping that perimenopause has a little bit of a lighter context and so that women can say, okay, this is the stage I'm in. This is where I'm at. It's going to be okay. And I know what to do. And I'm not afraid to say the word out loud.

[Jay Shetty]

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[Interviewer/Co-host]

Get into some of the solutions and what women can do, what are some of the risks of not managing or not treating these symptoms? So if you just feel the symptoms but you didn't think about it, you weren't aware, no one read your book.

[Jay Shetty]

You weren't conscious of it.

[Interviewer/Co-host]

What happens? What's the worst that can happen?

[Tamsen Fadal]

Yeah, you know, I thought when I went into it, okay, I don't know. I lost my mom to breast cancer. So I was very scared of doing anything. And I think that for me, I never had that conversation where with a parent, with a mom. I've heard that from a lot of women. But I think one of the big conversations that we miss in all of this are the long term health ramifications that could come from that. When we talk about osteoporosis one of the big silent killers of women. When we talk about heart disease, we talk about so many women dying from heart disease. It's unbelievable when we look at those numbers. And then we talk about brain health, we talk about Alzheimer's. More women are diagnosed with Alzheimer's than men are diagnosed with Alzheimer's. And so we have so much more research to do on all these things. But, but some of those are long term health risks that we have to at least pay attention to. There have been studies done that say, wow, you have more hot flashes. There could be a correlation to your heart health. Pay attention to that. And I don't think those are the conversations we're having enough of. And we're all learning as we go right now and trying to get as much information out there as we can. But those are big risks that I don't wanna take when I'm older. I don't wanna live to be much, much older and be suffering during that time because I didn't know about this time. And it's also when I think of my 30s in your, that's the best time to start protecting your bones and paying attention and having great healthy habits. There's so many things I wish I had done when I was younger. Now that I understand this is a stage I'm going to go through.

[Interviewer/Co-host]

And do women of different ethnicities, does perimenopause affect them differently?

[Tamsen Fadal]

You know, there are a lot of studies that are gone on. There's a SWAN study that's gone on for a long time. There is a lot of research that has shown that black women have more intense symptoms of menopause and often can have longer symptoms and start earlier. And so there's so much more research done. There has been a lot of research done in different countries to look at things. For example, women in Asia get fewer hot flashes, but more joint pain. But the question is why? And so there's a lot that still has to be done to look at that and pull this apart and really say, okay, we're looking at menopause, but we've gotta start looking at perimenopause. Because these women went through all of these symptoms for 7 to 10 years. So what happened during that time and what was happening differently? What were we talking about? When it comes to environment, when it comes to food, when it comes to.

[Jay Shetty]

Genetics, it's so hard because it's so varied.

[Tamsen Fadal]

Yes.

[Interviewer/Co-host]

So varied by ethnicity, by what age it starts, by the symptoms you feel. And so no wonder people just call it stress. And call it a day, because it.

[Jay Shetty]

Takes so much, you'd have to be.

[Interviewer/Co-host]

Very knowledgeable to actually diagnose it effectively, I imagine. And to. To really be able to speak to what someone needs to do.

[Tamsen Fadal]

Well, that's the interesting part is, you know, a lot of people go, okay, what's the blood test I can take to figure out if I'm in perimenopause? But if you think about this, most doctors say you don't really need blood tests. You need to know what your symptoms are. And that's how you can pretty much diagnose. If you're in your 40s or thereabout and you are not able to sleep at night, you have irregular periods, you're feeling anxious, or you're feeling a little bit moody, maybe you're gaining some weight around the middle. Even though you're not doing anything differently, you can pretty much rest assured you're in perimenopause. Now. If you're dealing with heart palpitations, you're dealing with much more intense symptoms. You probably need to make sure it's not something else. But most of the time, that's what you should start looking at there. And the sad thing is, is that what I've learned from women is the band aid that a lot of them are given is antidepressants. A lot of women are given antidepressants right away when they walk into a doctor's office and say, I'm dealing with stress, I'm gaining some weight, I'm not able to sleep. And the truth is, they might need antidepressants, but they should also be talking about perimenopause or menopause. Us. Wow.

[Interviewer/Co-host]

I mean, I can't imagine. I mean, Halle tells that great story of how, yeah, you know, her doctor thought she had an std.

[Tamsen Fadal]

Yeah. Isn't that unbelievable?

[Jay Shetty]

Which is crazy.

[Interviewer/Co-host]

Like, I. When I heard that story, I was like, wow, that's one thing. But then to be told, oh, it's probably depression, and you should be on antidepressants. What does that do to men? So if you were given antidepressants when you had menopy, menopause, what does that do to your perimenopause?

[Tamsen Fadal]

I was given them. That's how I know.

[Interviewer/Co-host]

Oh, wow.

[Tamsen Fadal]

And that's what was so shocking. So I didn't know I was in perimenopause. I didn't understand all these symptoms. I just knew I was feeling really off. And then I finally landed on the floor of my studio at work in the Bathroom with my heart racing, out of control, sweating profusely, not able to catch my breath, trying to calm my body down. And I went to the doctor and I found out I was in menopause. Because once you hit menopause, you can do a blood test because now you've kind of leveled out there.

[Interviewer/Co-host]

How many years were you struggling without knowing?

[Tamsen Fadal]

I was probably struggling about seven years. You know, I'd gone through a divorce. A lot of the stress I attributed to that. I had hair falling out. I had. I wasn't able to sleep. I went to a doctor and I went to a doctor a couple of different times. And it's funny, I ran across some of my papers recently that were about four years before I realized I was in menopause. And it said complains of moodiness and weight gain game. But no one ever said the word perimenopause to me. I was given Lexapro. That's what I was given. And I was given antidepressants. And so antidepressants, of course, can help with mood, but it's not going to help your hot flashes and it's probably not going to help your. Maybe it'll help a little bit in your sleep, but it's probably not going to help some of the other thing, irregular periods. And so I just think it's so important for all disciplines, not just obgyns, to have this conversation and be aware of it. And I'm proud of women because I think women are really, the onus is on women right now to stand up and say, hey, I'm tracking myself. I know what's going on. I've written down my symptoms. I'm aware. And I think women are more aware than ever, you know this better than anybody, of their health and what's happening in their lives to walk in and say, maybe this is perimenopause. Can you tell me if it is? And can you tell me if you're comfortable having this conversation with me? And if not, I need to find another doctor.

[Interviewer/Co-host]

Tamsin, what do we do?

[Jay Shetty]

I'm so glad that we've talked about.

[Interviewer/Co-host]

Just at least to get a basic understanding of what's going on, the, the types of symptoms to look out for.

[Jay Shetty]

But I can imagine a lot of.

[Interviewer/Co-host]

Women that are listening to this right now who are already there saying, Jim, two years into that, I've tried everything. I don't know what to do. Or you've got women who are coming up to it. Some of our audience are younger going, oh gosh, I've Seen my mum go through that, or I've seen my aunt go through that, or whatever it may be.

[Jay Shetty]

How can I help them?

[Interviewer/Co-host]

What can I do? So where do women start? What do they need to be doing after they've figured out their symptoms? They've talked to a doctor about it. What's the plan? What's the strategy?

[Tamsen Fadal]

First of all, I don't want women to be afraid. I don't want younger women to come into this thinking, oh, my gosh, for a third of my life, I'm gonna deal with that. There are some incredible things that happened during this time. I think menopause gave me purpose. I can't even believe I say that, but that is really the truth. I had no idea what was going on in my life, and I had no idea what was gonna happen after. But I found something really different in myself. So I want women to not feel afraid when it comes to what to do. As we know, everybody goes through it differently, but I think the most important thing is to be able to have that conversation with a doctor or somebody who specializes in menopause and can give you some of the options. And there are some different options. Some women opt for lifestyle changes, solely lifestyle changes. That's what they want to do. Other women say, you know what? I need something more. I'm dealing with brain fog, the hot flashes. I'm having 15 of them a day. I can't deal with this anymore. Hormone therapy is a very viable option for a lot of women. There was a study that was done in 2002 that scared a lot of women. The Women's Health Initiative headlines came out that said, estrogen causes breast cancer. That's essentially what the headlines were. That's what the media took away from it, and it scared women to death. About 44% of women in this country were on hormone therapy at the time. Literally, after those headlines came out, it dropped to about 4%, and we're right around 5% right now. That was 20 plus years ago. So that's why it's so important to get this message out. So hormone therapy is one of those options. If you are eligible for hormone therapy, there are certain women, certain risk groups that are not. That's one option. It was very helpful for me. It was also something I wasn't sure about. I went back and forth and struggled for a long time whether or not that was gonna be something I did. And at one point, my symptoms got so bad that that was what I opted to do.

[Interviewer/Co-host]

Before we go to the others, what is hormone Therapy and what does it include?

[Tamsen Fadal]

Hormone therapy is estrogen and progesterone. And both of those things have been extremely helpful for me with regard to, to mood, with regard to sleep, with regard to hot flashes. And you know, we lose so much estrogen. Our estrogen doesn't go like this. It just kind of goes all over the place and then goes down. And so that has been very helpful. Estrogen and progesterone. There's also testosterone if a woman decides to do that if she's dealing with a low libido. And for me, that was something that came about a year later. I wanted to start on the two. I was, I was a little nervous, honestly, because I didn't know what was going on and I'd never done anything like that before. And then there's also vaginal estrogen, which is a fourth component which is helpful for painful sex or for low libido. So those are hormone therapy. Menopausal hormone therapy, you can see it referred to as or hormone replacement therapy.

[Interviewer/Co-host]

Are there any side effects to hormone therapy?

[Tamsen Fadal]

It's been great for me. There's different women that have different things that, you know, some women feel like they've been more emotional on it. There's some women that feel like, like the patch, if they're on a patch that has the glue can be irritating to them. Look, there's always risk. That comes with everything. But according to the menopause society, this is the most effective way to treat these symptoms. And for some women, these symptoms are debilitating, life changing and not things that we can say, oh, get through these years and then you'll be okay. And I think that's what's happened for a long time. You know, women in perimenopause don't think that hormone therapy is an option. Option for them. And it can very well be an option.

[Interviewer/Co-host]

And then what were the other solutions? There was lifestyle choices.

[Tamsen Fadal]

Yeah. So lifestyle is so important, I think, to talk about because as we see, only 4% of the of women really are on hormone therapy. So we look at the rest and we're saying, what are they doing? Are they struggling every day? So I look at a couple of things. I look at sleep as the number one priority, no matter what. I don't think you can do any of the other things if you don't get sleep, if you don't figure out how to prioritize that. And that became something, something really important to me. You know, I had to figure out a bedtime. I hadn't done that Since I was young, but I really had to figure that out. I had to figure out a wake up time, I had to figure out what not to do before going to bed. I started taking magnesium as a supplement because that was helpful to me. Before I was doing hormone therapy, progesterone eventually really helped me get a good night's sleep. So sleep was my number one priority. And that took precedent over everything. And then after that, I looked at some of the other things. The second thing I really paid attention to was the protein I was putting in my body. I grew up as one of the ones that was like, I'll stay on the treadmill all day long, do my cardio and I guess I'll lift some weights, but I don't really wanna do that. Strength training now has risen to the top of my list. It's really, really important to protect your bone health. Like, I had no idea. And I don't think a lot of women did know that for a very long time. So that's important to figure out some type of routine. There's a lot of women that say, like, all right, I've been working out for a long time, but I think if you flip it a little bit and put strength training up there first to protect your bones, that's really. And then I think the third thing, if we look at some of the lifestyle changes that you would take, obviously we look at food and we look at inflammation, we look at trying to get control of that, because that is very, very real. And I didn't know how important that was. You know, in my 20s and 30s, I'm like, I'll eat what I want, I'll do what I want, I'll play how I want to play, and I'll worry about being older when I'm older. And so I get excited for women who are in their 30s right now that can say, all right, I'm going to look at inflammatory foods, I'm going to try to increase my fiber. I'm going to try to pay attention to what is causing bloating, because bloating is a big problem during this time. And I think also making sure that you're balanced too. Like, I don't get everything right all the time. You know, I try to establish as many healthy habits as I can, but I know it's not always going to be perfect. So you got to give yourself a little grace. And then I think the final thing would be stress management, which I know is easier said than done, but I think it's really right, really Important. And I think part of that comes with having somebody to talk to. I think it's having community, having loved ones understand. I feel very sad when I look at the decades of women who felt they didn't have anybody to share this with. They didn't share it with partners. They didn't share it with families. Maybe they whispered about it with other women. And we went to DC at the end of last year, and we sat there with one of the lawmakers who said, this is the first time that we've uttered the word menopause out loud in this building. That's unbelievable to me.

[Jay Shetty]

So, wait, so that's hormonal therapy, lifestyle choices, lifestyle changes?

[Tamsen Fadal]

Yes.

[Interviewer/Co-host]

And those are.

[Tamsen Fadal]

And then I would say lifestyle choices. I would say stress management and community. I think community is really important. I don't know that I really ever understood community. I understood friends for a very long time, understood friendship groups. I didn't understand the importance of having people that were going through something I was going through. And when I realized that, it changed everything for me. I have a core group of women right now where I can pick up the phone and say, hey, like, I am not myself, or, wow, I feel terrible, or, you know, this weight is just making me feel different, or I can't sleep anymore. And so I think that that's a really important part of this process. And I. I'm excited to see how groups are coming together. One of my friends told me she started the hottie hotline with all these women that are going through perimenopause right now from college, and they're sharing their symptoms and going back forth and having a conversation about it. And I think that's important.

[Interviewer/Co-host]

That's such a great distinction between friends and community. I love that. I don't think anyone's ever put it that way before. It's. Your friends may or may not be going through the same things as you, but your community is that chosen group of people that are going through the same thing. And therefore, you can share notes, share your heart. I mean, I think one of the biggest challenges that I can say as a man is I just feel like part of that community or your friend needs to be your partner.

[Tamsen Fadal]

Yes.

[Interviewer/Co-host]

And it's really hard as a man when you're completely unaware about this subject.

[Jay Shetty]

I want to be educated because the.

[Interviewer/Co-host]

Woman I love most in the world, my wife, is going to go through this.

[Jay Shetty]

The other woman that I love most.

[Interviewer/Co-host]

In the world, my mom, has already been through this, and I probably wasn't.

[Jay Shetty]

I was maybe Too young to be.

[Interviewer/Co-host]

Helpful or supportive, but I wish I was more understanding. And then I have a younger sister who's gonna go through this.

[Jay Shetty]

So when I look at it through.

[Interviewer/Co-host]

The lens of my life, I'm thinking, wow, there are three women in my life that I love so much, and they're all going to experience this. One of them's already gone through it, and I probably have no clue what she struggled with at the time. And, you know, in one sense, it's quite hard to reflect on that. What do men need to know about menopause?

[Tamsen Fadal]

I love, first of all, that you understand all those touch points in your life. And it's pretty amazing when you think about it. So I think it's so important for men to understand what menopause is. I really think it can be that simple. And then I think it's also really important to understand what to do during this time. And I never want to say to him, a guy, you've got to solve all the problems. But I think awareness is a huge part of it. I think, hey, what's going on right now? Is everything okay? You know, what's the hardest part of this for you? Is there something I can help with? What kind of habits is your partner or your sister or your mom trying to take on to help that you can be a part of, that you can jump into? Is it walking in the morning? Is it trying to go to bed a little bit earlier? Is it just simply understanding? You know, I think that we've laughed in society about hot flashes so long. We've always made it seem this hysterical woman that's trying to cool off or can't fall asleep, or she's ragey and upset about everything. That's not the picture of menopause or perimenopause anymore. Halle Berry, Naomi Watts, you know, those are the pictures of perimenopause, menopause. So this is happening to all of us. If we're lucky enough as women, we're going to go through this stage of life. And so I think it's important for a man to know what it is, what perimenopause is, understanding how long that could last, and understanding some of these symptoms, because I think sometimes the person outside of you can see those better than you can see them yourself.

[Interviewer/Co-host]

Yeah, I think awareness is definitely the starting point. If you know your partner is going to go through this between early 40s or late 30s onwards to be mindful of it, to be present for it, be patient for it. I think the challenge is we assume that if everyone's going through it, then it can't be that bad. Right? There's a human trait of just like, well, everyone's going through it. What's the big deal? That's what I was asking. Like, what's the worst that it can get to?

[Jay Shetty]

What?

[Interviewer/Co-host]

Have you seen the worst case scenario of?

[Tamsen Fadal]

I've seen couples going through divorce not knowing what's going on. I've seen men not understanding what's happening because perhaps, perhaps his partner doesn't want to have sex and has not wanted to for a long time and he doesn't understand it. I have seen women that get osteoporosis as a result of this. Women who are not treating their heart, women who have heart issues as a result of this. You know, I, I think that we have to pay attention to our health. And I don't think that knowing that you're in perimenopause doesn't mean that you're going to prevent heart disease, but you'll start paying attention to those things. I had never had heart palpitations before as a result of that, and it turned out that it was menopause. I wound up seeing a cardiologist to just understand where my baseline was. And I think that's really, really important because the last thing that I want women to do is suffer one and two, not be aware of what's happening in their lives during this time.

[Interviewer/Co-host]

What happens to a woman's sex drive during perimenopause?

[Tamsen Fadal]

Yeah, let's talk about that. Because listen, you're still getting your period during perimenopause and so your hormones can be all over the place. And sometimes you, you can really wanna have sex, and sometimes you might not wanna have sex at all. And I think that some of it's emotional too. You know, I lost my sex drive completely toward the end of perimenopause. Like I had nothing. And I got remarried at the age of 50. So imagine I went into this brand new relationship and was like, yeah, I have no interest in it anymore. And I think that my partner, my husband was like, what happened? Is it me? What, what happened? And so I think that that can really cause some problems. And I think that can cause, cause unspoken problems. And that's the big issue with a partner not understanding what's happening.

[Interviewer/Co-host]

And it just disappears.

[Tamsen Fadal]

It disappeared. Like I was going along, we were dating, everything was great, and then it disappeared. And that was really why I took attraction.

[Interviewer/Co-host]

You want intimacy and then I love it.

[Tamsen Fadal]

I want to kiss you. I want to be with you. You know, you're amazing. I want to be close to you. But I didn't want to have sex because it was painful, quite frankly. And that's what a lot of women experience. They experience painful, sexual. There's dryness that happens all over your body, and it didn't feel good, quite frankly. And I hear women talk about it now openly, but it wasn't something we were ever told to talk about or to express or to sit with somebody. I mean, I couldn't imagine sitting here talking to you about this three years ago, five years ago. Right. But I think it's what we have to do. So young women understand it, and so that men understand that something might be going on with their partner, and it might not just be that she's lost interest.

[Interviewer/Co-host]

And I think that's the take from a man's perspective. It's like, oh, well, maybe this relationship doesn't exist anymore. Like, there isn't attraction. There isn't a desire for intimacy. And then if you don't understand that there could be this hormonal shift that's causing this desire. I think it's so interesting, isn't it? Like, we. We grew up thinking a lot of this is purely mental and not biological.

[Tamsen Fadal]

We do.

[Interviewer/Co-host]

And not hormonal and not. Not chemical in that sense. It feels like, oh, it's a choice or an attitude. And some of this is not a choice. You didn't make a choice to not want to have sex anymore. Like, it was just. It was almost like there was an off switch.

[Tamsen Fadal]

It was an off switch. And it was. It scared me to death. It scared me to death because I thought, wow, is this, like, is this it? Do I. And it made me question, do I. Do I not have desire for him anymore? What's going on? That scared me.

[Jay Shetty]

Yeah, that's a really scary, interesting to.

[Tamsen Fadal]

Yeah, it scared me. And I. And that's really why I turned and, you know, I. I started to treat these symptoms, but I really thought it was something that was going on with me. And I. And I was scared to say it because I didn't even know how to say it. How do you say, like, hey, I just. I don't want to have sex anymore, and I don't know why. And all of a sudden it doesn't feel good anymore. And so I think that those are really tough things to contend with as a woman. And I think it's really hard when a partner doesn't know what's. And they feel in the dark and so that's why I love when men want to understand this conversation. They want to hear about this conversation and they want to know what they can do. I want to tell you a quick story. You know, I was doing a book signing and it's always women in the room, you know, and so because I don't know very many men that are going to be like, I'm going to go to the how to Menopause book signing. I can't wait. And so this one man was sitting there next to who I assumed was his wife, and he was just watching me. And he didn't really have a reaction. He wasn't nodding to where you feel like, hey, is this okay that I'm talking about all these things? And he came up afterwards and he said, hi, I need to ask you a question. And I said, yes. And he said, how old is too old to be learning about this? Or how old is too young to be learning about this? And I said, women at all ages should be learning about this. This should be being taught in school. People should understand this at all ages. Doctors should be talking about this while women going into the doctor's office. There's no question. And he said, how important is it for men to understand this? He said, because I've never even heard any of this and I think it's really important. And I said, it is. He came back to me and he said, I'm going to take two of these books and I'm going to give them to my daughters and their husbands because I'm going to insist that their husbands read these books. And I was blown away. And I thought, wow, like, one man has now shared this message with two other men. And that's how the conversation starts to happen.

[Interviewer/Co-host]

Happen.

[Jay Shetty]

But first, here's a quick word from the brands that support the show. This episode is sponsored by BetterHelp. Who do you go to when life gets tough? The group chat, A late night overshare with someone you barely know. It's funny how we'll share our deepest thoughts with people who can't always give us the tools to work through them. That's where therapy is different. Therapists are clinically trained and licensed to help you see things from a new perspective and find patterns you didn't notice and create real, lasting change. BetterHelp has been helping people find the right therapist for over 10 years. With a 4.9 rating from 1.7 million client session reviews. They make it easy. You take a short questionnaire. And with over 30,000 licensed therapists worldwide, they'll match you with someone who fits your needs. And if it's not the right fit, you can switch anytime at no extra cost. It's all online, so you can start from anywhere, anytime. Over 5 million people have used BetterHelp to begin their journey toward clarity, healing and growth. As the largest online therapy provider in the world, BetterHelp can provide access to mental health professionals with a diverse variety of experiences, Expertise find the one with BetterHelp our listeners get 10% off their first month at betterhelp.com Jaystop3 that's better H-E-L-P.com Jaystop3 this back to School Season Spend less on your kids with Amazon I was talking to one of my closest friends the other day. He has two kids and every year it's the same routine. One kid wants a very specific backpack. I'm talking not just blue, but navy blue with a neon green zipper and a galaxy print. The other lost their lunchbox before the first week of school even ended. Last year. He's like, jay, I swear they get more expensive every time they grow an inch. And I get it. Kids grow, seasons change, and somehow they always need five new things they didn't need last year. But what doesn't have to change? How much you spend on them. So remember, with Amazon's low back to school prices, just spend less on your kids because every dollar you don't spend on them is a dollar you haven't spent on them. Shop back to school at Amazon and spend less on your kids. Okay, I have two questions for the guys at home there. Do you want to have nice, healthy skin and would you rather not spend.

[Interviewer/Co-host]

A ton of time getting it?

[Jay Shetty]

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[Interviewer/Co-host]

I've been having a lot of conversations about it with my male friends who are older than me, whose partners are probably in that space right now and just helping them become conscious of how it could affect them. Because it's a human trait again, that when you haven't experienced something, you have no idea how it impacts someone. And that applies to anything, whether it's your parents getting divorced, whether it's visiting certain countries when you were young, whatever it may have been like. As humans, we're bad at knowing how something can affect someone else. And, you know, even. Even to the point of, you know, me and my friend were just talking the other day. We have three friends in our generation who have cancer right now. And, you know, and it's. And. And you're having this conversation, you're thinking about it, and you have so many friends who don't understand how hard it is for that person because you're like, oh, it's stage two. Oh, it's stage one. Like, you'll be okay. But then when you really think about it, that word is so loaded. It's so heavy.

[Jay Shetty]

It's so hard.

[Interviewer/Co-host]

Whatever stage it's at, it's. It's tragic to go through.

[Jay Shetty]

And I think that's partly the challenge.

[Interviewer/Co-host]

Here as well, that when it comes to menopause, I'm talking to my male friends about it a lot because I think looking at it as the source of some of the struggles in a relationship and the challenges that they're going through, communication challenges with their partner is.

[Jay Shetty]

Helpful to both of them because otherwise.

[Interviewer/Co-host]

Like you said, you were thinking it was all your fault, that there was something wrong with you. And that person, if they're not understanding, could feel the same way. Oh, it's all your fault.

[Jay Shetty]

How did your husband help you?

[Interviewer/Co-host]

Like, how did. What did that process look like? Because I'm assuming. Assuming you weren't this well versed at the time either.

[Tamsen Fadal]

When you talk about that, you talk about cancer that's life altering, whatever stage it's in, just to hear those words. My husband helped me in a lot of ways. And it was really interesting when I got the first, you know, was told I was in menopause. We were boarding a plane, and I said, oh, my gosh, I just got a note in my patient portal that says, I'm in menopause. I'm too young for menopause. I was 48, the average age is 51. I wasn't too young for menopause. I was just clueless. I just had no idea, and I couldn't believe it. And to me, I associated that word with old age and like, somebody whose best years were behind them. And I realized it was anything but. And as I continued to learn, I would talk to him about it, and I'd say, hey, listen, I found out that, like, there's not just three symptoms, there's 30 plus symptoms of menopause. And now they're in the hundreds. You know, we're counting more and more. As we learn more, we're learning more and more symptoms of menopause. And then eventually, when it came to sex, I had a real conversation, you know, because I went on my honeymoon to Hawaii and I had no sex dropped. It was really awful. It felt emotionally awful for me, but also I felt for him. And then, you know, that feeling where you're going, oh, my gosh, what's he thinking? What's she thinking? I had to have the conversation, though, with him through the process, and I was really grateful that he was open to listening to it. And it wasn't like, hey, you get that taken care of, and, you know, then let's talk, because what's going on? And I talked about it with him through everything, with weight gain, with not being able to sleep at night, with sleeping on the couch, you know, for almost a month at one point, because I couldn't fall back, back to sleep. And I was tossing and turning and tossing and turning, and then eventually decided that hormone therapy was going to be the choice for me. And it really changed everything. And my lights kind of came back on, and it felt very, very different. But we go back and we look at that time now, and I said, gosh, I was a shell of myself, wasn't I? And he said, you were really different from the girl I met. You were totally different. And I felt so sad because I didn't know what to do, and I didn't know what I had done. And that's really what I want. I wish that every couple's counselor, anybody, any coach, anybody that people are going to for help or advice, would educate themselves about the changes that happen during this time in a woman's life, because I think it would solve so many problems.

[Interviewer/Co-host]

It really would. I feel like there's a lot of trends inside that are changing. Like women are having children at an older age. What happens when perimenopause and fertility kind of, you know, overlap, those periods that you're experiencing it. What does that look like?

[Tamsen Fadal]

Like we're starting to have that conversation a little bit more and I'm, I'm excited about it because I think it's important. I don't think that any of us, or I certainly didn't as, as just a regular woman, you know, I, I'm not a doctor, I'm a journalist. I didn't understand that it started in these early years. I didn't understand in your 40s you would be dealing with any type of symptoms of perimenopause because I didn't know the word. But there have been some women that said, like, I didn't know the difference between having my child. And then all of a sudden I, I was postpartum. And then the crossover between perimenopause, what was it? What was going on in my life? I didn't even know what was happening. And then obviously in perimenopause you can still get pregnant. So, you know, some women think that their period's gone away for six months. Then all of a sudden, you know, they realize that they can still have children. And so then we have children. You know, they're having children later in life. So there is definitely, I think, more of that crossover than we, than we've ever seen before because we're having, seeing women having children later in life.

[Interviewer/Co-host]

Are there any implications, what should people be aware of if that's what they're going through?

[Tamsen Fadal]

I think to be aware of the symptoms of both, because I know there's a lot of women that are like, I didn't know what was happening. I didn't know if it was after I had a child that I wasn't able to, to get the weight off or I was feeling this like very. A lot of emotions going on and not going back to sleep. And some of those same things that I was dealing with when I was pregnant in my reproductive years are the same symptoms of perimenopause. So which is which. And I think that that's where you really have to have that relationship with your doctor. I really believe that we've done a disservice to women because we've kind of said like here, when you're in your pre reproductive years, here's what your obgyn. OBGYN looks like. And then after that you can go to the doctor and have your appointments and everything. But there's a real crossover in Those years from 35, 38 years old to, to when you hit menopause. And I think you have to be having both of those conversations. At the same time, you could get pregnant. Some of those symptoms could also be perimenopause.

[Interviewer/Co-host]

If there are younger women listening right now, how would you best recommend that they plan for perimenopause? Is there a way you can plan or prepare?

[Tamsen Fadal]

If I were a young woman right now, the best thing could be to pay attention to some of the health habits. You don't have to be perfect. I'd pay attention to the strength training. I'd pay attention of how to get habits to. To sleep. Well, now you can go have a good time. I promise, it's great. Go have a great time. But pay attention to some of these things that I think you need to put into place. Protein, adding that to part of what you have going on, and figure out a way to manage stress. I think all those are so important. And I would also do this. I'd also get a bone density test, which was nothing I'd ever heard of before or anything I thought I should get. Most women wait till they're 60 years old to get something like this, but I'd want. Want to know what my baseline is for my bones, because that's really important. And the last thing you want to do is break one.

[Interviewer/Co-host]

Yeah. So it's. It's amazing to me how the habits do help, like getting good sleep, your nutrition. These things do matter.

[Tamsen Fadal]

They do matter.

[Interviewer/Co-host]

It's just that it's not gonna. It's not gonna stop this from happening. Right.

[Tamsen Fadal]

It's not gonna cure it.

[Interviewer/Co-host]

It's not gonna cure it, Right? Yeah.

[Jay Shetty]

You can't avoid it.

[Interviewer/Co-host]

It won't cure it, but it will help you. You. Yeah, it will help you move through it.

[Tamsen Fadal]

I think it'll help you manage your symptoms, and that's the most important. You know, perimenopause and menopause, this isn't a disease. This is a transition that we're going through. And I think it's really important to know, you know, I. I wish that when I were younger, I was thinking a little bit older. I wish that I was thinking that, oh, I have time to do all those things. If I had established some of those habits when I was in my 20s or my 30s, then it wouldn't have been so hard to. In my 40s and 50s to try to figure it all out so quickly. And I think that's the advantage that younger women have today. And I feel really inspired by that. I feel really motivated for them that they're going to get a hold of this. And I don't think that perimenopause and menopause is going to look like this in five or ten years?

[Interviewer/Co-host]

Yeah, I definitely think that, especially all of our listeners. But there's such a culture now of trying to get into those healthy habits earlier and it's good to know that that will fare people well as they move through this transition. What's the impact of the pill and birth control drugs on perimenopause?

[Tamsen Fadal]

It's interesting. Some women have said to me, oh, gosh, I went to the doctor, they said it was in perimenopause according to my symptoms and I was given a birth control pill. Well, the birth control pill oftentimes is given because you had irregular periods. If you went in there saying, like, my periods are irregular, then the birth control pill is there to kind of regulate those. And so someone, some women will be on that for quite some time. They'll be eventually weaned off of that if they're in perimenopause and then they can start hormone therapy. And any of the doctors I've talked to say that, you know, both of those things are possible options depending on what, what your symptoms are. If you go into the doctor and you're saying, hey, I've got hot flashes and I can't sleep and my, my joints hurt right now and I'm just feeling a little bit of brain fog, they're probably not going to give you birth control. They will start you on a low dose hormone therapy most likely and tell you to add in those lifestyle practices to be able to help you. But birth control pill, with regard to doing anything to perimenopause, I think more often will help regulate your period.

[Interviewer/Co-host]

You're saying there's not a negative impact between younger women being on birth control and then how they experience perimenopause?

[Tamsen Fadal]

Not that I know of, except that some women say, oh, wow, I don't know if my period has stopped or started. I don't know where I am. So a lot of times if a woman is a little bit older, a doctor will oftentimes wean them off of that so they can figure out kind of where they are in their, in their cycle. Because again, if you've gone 12 months without your period, now you're menopausal and then you would be doing hormone therapy. You wouldn't be doing birth control because you wouldn't need it any longer.

[Interviewer/Co-host]

What else? There was, there was a funny video I saw on TikTok. It was, it was funny, it was comedic, but it was making A really big point. And it was showing how men's hormones, how to stay steady and how women's hormones go, you know?

[Tamsen Fadal]

Yeah.

[Interviewer/Co-host]

And. And just the amount of cycles that women have to go through and the experience of it all. And what have you heard from your community that's given you strength, hope, encouragement? What. What have you noticed about people who have transitioned effectively?

[Jay Shetty]

What.

[Interviewer/Co-host]

What are the success stories?

[Tamsen Fadal]

Almost the success stories of women who have gone into this stage successfully are. I feel like myself again. I feel really bold, and I can't wait for this next chapter. I'm feeling good about my body, and I think what they feel more than anything else is knowledgeable, and they feel like, wow, I know what journey I'm on. I understand what's happening to me now, and now I can tackle these different things as they come along. I never understood that knowledge and community were so important to something like this. And I think it means everything when a woman hears, hey, this is what you're going through versus, oh, my gosh, could I be dealing with dementia? Could I be dealing with Alzheimer's? Why is my heart racing out of control? Why am I gaining weight? When you are in the dark and you don't understand what is going on, I think that can be the scariest thing happening. And I think that's what so many women have been dealing with for so long, which makes me really sad. I go back and I think about my mother. I lost my mother to breast cancer when she was 51 years old, and she had a surgical menopause, meaning that as a result of her surgery and chemotherapy, she went through menopause early. She was 44 years old when she was diagnosed, so it was pretty early. And we used to go into restaurants, and we'd have to leave the restaurants because sweat would be literally pouring down her face. Like, she just. She couldn't stay there, and her heart was racing out of control, and she'd be throwing water on herself, and she'd laugh along with the rest of the family. We'd be like, oh, mom's hot again. Ha ha. And it wasn't. This was years ago. My mom died in 1990, and it wasn't until maybe three, four years ago, when I really started researching this, I realized that that was my. What was my mother was going through. It made me so sad to go back and say, oh, my gosh. She was laughing with all of us trying to play it off, and she was really suffering on the inside.

[Interviewer/Co-host]

That's the hardest part for me.

[Tamsen Fadal]

Yeah.

[Interviewer/Co-host]

Is knowing that There are so many women that I care about and that I love, that I would have been. It would have been useful if I had this context that I could have shared that with the them. They would have found better support and help in their journey, whether it's lifestyle changes or hormonal support or stress management, as you rightly said. And. And I would have been, you know, understanding and empathetic to. To the change that they were going through. I think it would. It would change so much. Why is it that despite everything we've talked about, doctors still dismiss these symptoms and medical research is not investing more? I just can't wrap my head around.

[Tamsen Fadal]

I can't either, honestly. I think part of it is societal. I think part of it is that we think women in midlife are kind of best years behind them. I think that, sadly, when it comes to research, we did a lot of research. We do a lot of research about reproductive years, about what happens when you're older, even what happens when you're younger. All ends of the spectrum. And then there's this kind of chunk of women in a time in our lives that we're just sort of. We've kind of fall off the radar. We're just not there. And so that happens when it comes to research. And then I think with doctors not being educated about it, you know, it's not the doctor's fault. They're there to help. That's what they want to do. Doctors have good intention, but unfortunately, if they didn't learn about it, if you've got a woman coming in there and you've got a woman saying like, oh, I'm tired. I'm not able to sleep. I'm gaining weight. You know, a doctor will often be like, oh, okay, it's a part of aging, or it's, you know, take this and call me. Take an antidepressant or try to get some more sleep or practice winding down. And so sadly, you know, we've got doctors that are dismissing women, women feeling they leave a doctor's office and don't know what to do. And I've heard from so many women every single day, Jay, I get messages saying, my doctor told me it was because of my age, or my doctor said I couldn't possibly be perimenopause yet, or if your symptoms aren't bad enough, you don't really need to do anything. And I think that's the one that bothers me the most. I really get upset when I hear your symptoms have to be so much worse for you. To do something about it. Because that's not true. It's just not true. And there's so much that can be done about this and there's so many different ways to help women. And so my hope is that we start getting this training and we start making sure it's mandatory and we start making sure, making sure that all disciplines, not just OB GYNs, learn about perimenopause and menopause. If you go to your cardiologist, they should be talking to you about perimenopause and menopause. We know doctors can't know everything, but that's where it comes upon the woman to be educated about this too. And right now I think it's the best thing we can do. We're not going to be able to get a whole bunch more studies right now in a short amount of time. We're not going to be able to get tons of money poured into, into women's health all the time, specifically perimenopause and menopause. And we're not going to be able to get all doctors trained so quickly. But what we can do is get this message out to all women, young women, older women, daughters, mothers, sisters, aunts, anybody that could be going through it or has somebody that they know going through it. And now especially men.

[Interviewer/Co-host]

Yeah. Well said. Well, I'm happy to be a part of that. And, and, and have this conversation because it's what you said also just about if you're, if you care about someone, you know, it's so important to be aware of what they're going to go through.

[Tamsen Fadal]

Yeah.

[Interviewer/Co-host]

And, and to me, that's especially something that, is something they can't control, you know, something that they don't have that influence over.

[Tamsen Fadal]

I have to say I'm so grateful to you for this because I know it's not an easy conversation because it's like, I don't know, where do we even start?

[Interviewer/Co-host]

It's easy talking to you about it.

[Tamsen Fadal]

Thank you.

[Jay Shetty]

Yeah, you've like just given us a masterclass. I feel so much more well versed.

[Interviewer/Co-host]

I'm so glad that's what I'm speaking to you because you make it so simple. You make it so understandable. I'm glad that people have the book so they can check the 34 symptoms. I'm glad that people have the book so that they can actually figure out where in the course they are so that they can turn to the doctor or turn to their partner, find their community. I mean, the way you laid out the three really simple steps people can take, whether it's, it's lifestyle changes, stress management, hormonal therapy. It makes it feel manageable. It doesn't make it feel like this is something insurmountable. It feels like something that we can at least grasp and know what we need to do to take the next step. So thank you for being such a great messenger for it and having the courage to do it. I'm sure it's hard being you to. As you heard your career was going to go nowhere if you became the, the, the poster child for this, but I, I actually think it, it's going to help so many people who are unaware, unconscious men or women, and people are just struggling and suffering with it.

[Tamsen Fadal]

Thank you. You know, I, I didn't have children of my own and I, I always, for a long time, I went back and forth about that and I realized going through this and having this conversation and talking to so many young women about it and trying to help them help their moms or help them help their self, I was like, wow, I do feel like a mom now. You know, I do feel like I'm helping young women. And so I figured out a purpose through menopause, how menopause gave me a purpose. But, you know, it really did change my life. So it did a lot. It did a lot for me. It let me trust myself more and it let me realize that there are some changes and it's never too late. And I think that's the most important thing of all, that it's never too late to make these changes. If you didn't make them in your 20s or 30s, it's not too late, too late to make those changes.

[Interviewer/Co-host]

I love it. Tamsin, Fidel, thank you so much for.

[Jay Shetty]

Writing this book, how to menopause, take.

[Interviewer/Co-host]

Charge of your health, reclaim your life, and feel even better than before. That's my favorite part about it, is hearing you say that. We've got to get over this belief that women are past their best years and your best years are behind you and you've already lived in. It's that part of feel even better than before. That's a message that I love. So thank you so much for writing this book. I highly recommend everyone goes and grabs a copy, men included. It's so important for us to be informed. And I really hope that this saves your relationships, helps your careers, helps your purpose and your passion, your children, and ultimately helps yourself. Thank you so much and thank you, Tamsin. Again, please follow Tamsen, subscribe to our podcast follow her on social media platforms and we will put all the links in the bio and in the comment section for you to follow along. Thank you so much again, Tamsen for joining me.

[Tamsen Fadal]

Thank you.

[Interviewer/Co-host]

Thank you for writing this book.

[Tamsen Fadal]

Thank you so much. It's wonderful.

[Jay Shetty]

If you love this episode, you will enjoy my conversation with Meghan Trainor on breaking generational trauma and how to be confident from the inside out.

[Tamsen Fadal]

My therapist told me stand in the mirror naked for five minutes. It was already tough for me to love my body, but after the second C section scarf with all the stretch marks, now I'm looking at myself like I've been hacked. But day three when I did it I was like, you know what? Her thighs are cute.

[Jay Shetty]

This episode of On Purpose is brought to you by Chase Sapphire Reserve. I believe that travel is one of the greatest gifts that we've ever been given and Chase Sapphire Reserve has been my gateway to the world's most captivating destinations. When I use my Chase Sapphire Reserve Card card, I get eight times the points on all the purchases I make through Chase Travel and even access to one of a kind experiences. Experiences like music festivals and sporting events. And that's not even mentioning how the card gets me into the Sapphire Lounge by the club at select airports nationwide. Travel is more rewarding with Chase Sapphire Reserve.

[Interviewer/Co-host]

Trust me.

[Jay Shetty]

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