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- [00:00]
Monica Lewinsky
Wondery subscribers can listen to Reclaiming with Monica Lewinsky early and ad free right now. Join Wondery plus in the Wondery app or on Apple Podcasts, or you can listen for free wherever you get your podcasts. Hi. On today's episode I spoke with the doctor and best selling author known as the queen of menopause. Dr. Mary Claire Haver is an OBGYN specialist who's been on a crusade to empower women as they go through different stages of menopause, even if you're far away from your own menopause experience. In this episode, we spoke all about women's health, hormones and how to navigate the health care system that so often lets women down. And for the men out there, please keep listening. There'll be stuff in here that will help you better support and understand the women in your life. Anyway, I hope you all find something in our chat to connect to and thanks for joining us on Reclaiming. Reclaiming is brought to you by Audible Emmy Award winner Kerry Washington returns as Dr. Virginia Edwards in Audible's heart pounding supernatural thriller the Prophecy Season 2. Picture this a mother on the run protecting her miracle child from a sinister cult leader who'll stop at nothing to find them. But Virginia Edwards is no ordinary mom. Haunted by visions and guided by an ancient prophecy, she's about to discover her true power as both protector and chosen one. With an all star cast, this supernatural thriller will keep you on the edge of your seat and wondering when everything's at stake, who can you really trust? Evil is rising. Time is running out. Don't miss Kerry Washington in Audible's Must Listen Event of the Year. Some stories change you forever. This one just might save humanity. Start listening to The Prophecy Season 2 today at audible.com the Prophecy 2 or wherever you get your podcasts.
- [02:13]
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- [02:15]
Dr. Mary Claire Haver
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- [02:47]
Monica Lewinsky
Welcome to Reclaiming Dr. Mary Claire Haver.
- [02:50]
Dr. Mary Claire Haver
Super excited to be here.
- [02:51]
Monica Lewinsky
I'm so so grateful. I was thinking about I think we met for the first time last summer at Amy Griffin's G9 Ventures summit. And you were on a panel about menopause. And like this show was just formulating in my mind and you told me, totally embodied, you know, this idea of women reclaiming their body and their health. Right. Sort of later in life in this kind of menopause phase. I mean, well, I want to get clear on all that. Which we will. And I then quickly joined your kind of posse of bajillion people on Instagram.
- [03:31]
Dr. Mary Claire Haver
The menopausy.
- [03:32]
Monica Lewinsky
The menopausy. And I love it. And it's so interesting to me because every time, I mean, you probably know this and hear this a lot, but every time I'm talking to my friends or I meet a new woman and we're having a conversation, if we're in an age range and we start talking about all the changes, your name comes up like. And everybody is just, you know, is such a fan and so grateful, so grateful for the work you're doing and how you're helping so many people, myself included.
- [04:02]
Dr. Mary Claire Haver
I wish I could tell you honestly that, you know, I woke up one day and decided this is my passion. And I was board certified obgyn, delivering babies, doing my thing. And I really thought like at 35, no way in hell would I have thought I would have become a menopause specialist. Like what on earth would I do with that? And it took experience, life changes, my patients kind of going through it with me at the same time for me to realize there's a problem with the status quo.
- [04:33]
Monica Lewinsky
Yeah.
- [04:33]
Dr. Mary Claire Haver
There's a problem with what we're teaching. There's a problem that women are being left out of the conversation. They don't have seats at the table when it comes to how we look at our health as we age.
- [04:44]
Monica Lewinsky
Yeah, yeah. When I get into all of that, I guess one of the things I read about you that was fascinating to me is that you have a culinary medical certificate.
- [04:53]
Dr. Mary Claire Haver
Right.
- [04:54]
Monica Lewinsky
And so what's so interesting to me is my dad's a radiation oncologist. He just retired after having practiced for 50 years. He is also a gourmand chef and he just endowed to UC Irvine Medical School a program, culinary medicine programs which are not normally in medical school. So he wanted to marry that. So it was just so interesting to me.
- [05:19]
Dr. Mary Claire Haver
So my undergrad is in geology.
- [05:22]
Monica Lewinsky
I know we're gonna have the crystal. Don't worry, we will have a crystal moment.
- [05:25]
Dr. Mary Claire Haver
I'm so excited. So I, you know, finished my undergrad and decided last minute to, you know, I worked for a couple of years for an Oil company. So here I was in my little corporate outfit, and then I figured out this wasn't my path, but what else could I do, you know, and start. I looked at nursing school, I looked at medical school, and I thought, well, let me take the MCAT and see what happens. And then, you know, 30 something years later, here we are. But I had zero undergrad education in nutrition, and I found myself really struggling to help patients who in their mid-30s, 40s, 50s, were really, really struggling with nuance at weight gain.
- [06:04]
Monica Lewinsky
Right.
- [06:05]
Dr. Mary Claire Haver
And the only thing I'd been taught in undergrad was calories in, calories out. And I'd give them the same, you know, tired, workout more, eat less. It has to work. There's no other way. You know, hormones don't have anything to do with it until, sadly, it happened to me. So when I realized there's a huge part of nutrition that is missing from my education, I was looking for ways to fill that gap in knowledge. And the man, Tim Harland, Dr. Tim Harland, who designed the culinary medicine program, and he was at Tulane at the time, had come as a aoa, like the Honors Society for Medical Students speaker. And I was galvanized. And so I ran up to him at the end. I was like, sign me up. How do I do this? And he was offering the online version of the course for clinicians, so physicians, practitioners, pharmacists, anyone who wanted to get a deeper knowledge of practical nutrition. Not just all the background in nutrition science, but we went to test kitchens with dietitians and learned how to cook so that we can then talk to our patients about cooking techniques or substitutions. So it was probably one of the most influential things I've done in my career, and I did it in my 40s, very late in life.
- [07:15]
Monica Lewinsky
I love hearing from you, just that you kind of had these life pivots in a way, and that you were really open to it. I don't know what it was like on the ground in your life, in the moment, but I think so often I've had to pivot many times. And I think that so often it can become really challenging to, like, to find your footing there and to not think something negative about yourself like that there's something wrong with you when. When you realize, oh, actually I need this to change, like, I need to make a change in my life. Right. I don't. Was that hard for you? Easy for you?
- [07:51]
Dr. Mary Claire Haver
I just. In my 20s and 30s, yes. But once things started crystallizing around what I want and what I really want, to do with my life and not to just follow the status quo all the time and realize I do have power. You know, I was always a yes girl and I got a lot of satisfaction on making the highest grades and seeing the most patience and winning all the awards. And so my internal validation was really set on checking all those boxes until they weren't. Until I realized they weren't serving me. I was working 100 plus hour weeks, I was trying to raise these two kids. My husband was working overseas. I was a single mom six months a year by choice.
- [08:37]
Monica Lewinsky
Right, right.
- [08:37]
Dr. Mary Claire Haver
With his job. And when he was home, my husband was amazing. Like he really took over, took the kids to the doctor, substitute taught at the school, took them to all the appointments. Right.
- [08:45]
Monica Lewinsky
But there's, you know, I think when you are the solo parent in the house, it means you're holding all the worry, you're holding all the checklists of what have to get done.
- [08:54]
Dr. Mary Claire Haver
And I still managed all the traditional stuff, like what are they going to wear? Like what kind of doctor are they going to see? You know, I just kind of sent him off on the tasks. You know, he was basically a nanny, so. But he, you know, would not change that experience. But that experience of being in crisis mode six months a year really help crystallize for me. Like what do you want? What's going to make you happy? Because I'm watching my husband just excel in his career, make all these like every two years he's in a new job, he's looking for the next thing he's working, you know, in these incredible positions and what does that mean? Sorry. So yeah, he was, his degree is in metallurgy and materials engineering and then he got an MBA in his 40s right around Hurricane Ike which wiped out our island. So a lot of things crystallized around that as well. And so he's been in oil and gas, like in an executive position, kind of moving around, working in different parts of the world and whole different fields, facilities. And it was really fun for him because every two years he gets a new challenge and I was doing the.
- [09:57]
Monica Lewinsky
Exact same thing and I interrupted you before so you were saying that you were.
- [10:01]
Dr. Mary Claire Haver
I'm like, wait, why can't I change? Like I'm watching him do it and I'm like, what's there for me?
- [10:07]
Monica Lewinsky
Ah, that's really interesting. It's really. I was, you know, before we kind of get too into the, into the conversation, I just, I'm sure most people listening know. But I'm going to say for me, I Want to make sure I totally understand because I like when we're talking about perimenopause, menopause and postmenopausal, because I.
- [10:29]
Dr. Mary Claire Haver
Feel like what those definitions are. Yeah, great question. And probably the most common question I get because no one understands it.
- [10:37]
Monica Lewinsky
Right. Well, because I think we're similar in age. And I think for us it was, you know, it was. The only word was menopause. And it was kind of a silent sin. It was sort of this thing of you knew your mom was gonna go through it at some point. You heard about hot flashes and weight.
- [10:54]
Dr. Mary Claire Haver
Gain, and it just had a negative connotation. When we look at. Even now, if you go to AI, it's changing slowly. And you type in. Show me an image of a menopausal woman. It looks like the Golden Girls, who, by the way, were our age.
- [11:06]
Monica Lewinsky
Oh, my God.
- [11:06]
Dr. Mary Claire Haver
When they were filming it, you know.
- [11:08]
Monica Lewinsky
Thank God for Botox and filler. Yeah. But, you know, I mean, there are.
- [11:12]
Dr. Mary Claire Haver
Gorgeous extensions and it just this connotation of an elderly type.
- [11:18]
Monica Lewinsky
Right.
- [11:19]
Dr. Mary Claire Haver
I'm Grandma. Yeah, Grandma. And I really love being menopausal now. But let's go back to definitions because I think it's so important everyone's on the same page. One of the problems in medicine is that menopause is medically defined as one day in your life. Everything before it is premenopause or perimenopause. Everything after is post menopause. And that day is defined as one year after your final menstrual period.
- [11:47]
Monica Lewinsky
Okay.
- [11:47]
Dr. Mary Claire Haver
One year to the day.
- [11:48]
Monica Lewinsky
Okay.
- [11:49]
Dr. Mary Claire Haver
So every. So, boom, one year anniversary, menopausal. Everything after that is postmenopause. And then we have this perimenopause and before. So here we have. So the average age in the US of menopause, one year after the final menstrual period is 51. Normal. Under that normal curve is about 46 to 55.
- [12:07]
Monica Lewinsky
Okay.
- [12:08]
Dr. Mary Claire Haver
Okay. So we have a really wide variation of when that day might come. Perimenopause, which is the transition from normal, happy, healthy menstrual cycle. In a healthy woman, you're not thinking about menopause. You've got your cycles under control. You know, at this time of the month, you're going to feel like this or that, but you've got it managed. Yeah, you go through a zone of complete chaos. I thought, and I was kind of trained that the minute that the ovaries just kind of quietly sail off into the sunset, sailed off into the sunset until they laid down for their Final rest and never functioned again. They go out fighting, and we can get into the nitty gritty. Yeah, yeah, yeah. And so post menopause, meaning your ovaries have shut down. We have gone into ovarian failure. It sounds terrible, but this is medically what's happening. And you will never have hormones again outside of a tumor situation produced from those ovaries. So what menopause actually is, what it represents is, sadly, ovarian failure. Now, why does this happen? One of the big differences, at least embryologically, between males and females, men and women, is that men have testicles which are on the outside of their bodies, you know, wrapped in skin, and they are able to produce sperm. And I think I heard Dr. Crawford, she's a fertility specialist, say, I think it's 15,000 sperm a minute.
- [13:28]
Monica Lewinsky
Oh, my gosh. Okay.
- [13:30]
Dr. Mary Claire Haver
It's insane. So, like milk, you know?
- [13:32]
Monica Lewinsky
Yeah.
- [13:33]
Dr. Mary Claire Haver
Every day the whole system is cranking, cranking, cranking. We are born with a set amount of egg supply, and that supply lasts us until they run out.
- [13:41]
Monica Lewinsky
Right.
- [13:42]
Dr. Mary Claire Haver
Now, genetically, there's an age at which you're kind of genetically predetermined for that to run out. Average for white women in the US is 51. It's younger for African American, a little bit older for Asian descent, for Southeast Asian. So people from the Indian continent. 46. 46 is the average age of menopause. So there's a really wide genetic variation as to when this happened. Now, say you smoke, say you live in a very high stress environment. Say you've had chemotherapy, say you've had radiation, say you've had a hysterectomy, or any real abdominal surgery that has set up an inflammatory process in the abdomen. Because the ovaries are just floating around, you know, in the. In the abdomen, and the bowels slide over them, and they're not just frozen in it.
- [14:24]
Monica Lewinsky
Okay. Oh, that's interesting.
- [14:25]
Dr. Mary Claire Haver
So they have an attachment to what we call the sidewall and attach it to the uterus and fallopian tube, and.
- [14:31]
Monica Lewinsky
They kind of just like, dance around.
- [14:33]
Dr. Mary Claire Haver
Dance around in there. And so when we run out of eggs, that's the end.
- [14:39]
Monica Lewinsky
Right, Right. It's interesting. I took a comparative psychology class in college, and I remember sort of them talking about, with evolution and everything, that it was the. Because of the eggs. Because we have so few eggs in comparison to male sperm, and because pregnancy takes so long, the nine months that it was. That our eggs are expensive.
- [15:01]
Dr. Mary Claire Haver
Yes.
- [15:02]
Monica Lewinsky
And so that was sort of what always stuck with me, when you think about it.
- [15:07]
Dr. Mary Claire Haver
We only ovulate, so we're born with 1 to 2 million and then by the time we start actually ovulating, so puberty, we're already down to about half a million. So it's a little bit of survival of the fittest. And so you really want the healthiest eggs to survive. We only ovulate roughly 400 times in our lifespan and that's without suppression from birth control pills and whatever. And that by the time we're 30, we're down to about 10% of the original egg supply.
- [15:33]
Monica Lewinsky
Okay.
- [15:33]
Dr. Mary Claire Haver
By the time we're 40, we're down to 3%.
- [15:36]
Monica Lewinsky
Yeah. I froze my eggs at 37 and part of why I had even started to look at it was because I have a friend who's 10 years older who had gone into full menopause at 40 and she had not had her kids yet. And that was, and it's devastating. That was the. I didn't even know that was something that could happen. And you know, coming to, going to get tested and my fsh and I don't remember all the things, whatever they were. It just, you know, it was really interesting to me because you just start to wonder why are we not more in charge of our own health? Like, why does, why. I mean, I don't know exactly. I'm a daughter of a doctor, but I don't know all the things.
- [16:19]
Dr. Mary Claire Haver
Why do we, why do we sit around and talk about fertility as luck?
- [16:23]
Monica Lewinsky
Right, right.
- [16:24]
Dr. Mary Claire Haver
Like, oh, you got pregnant at 40, how lucky for you. That is a combination of lifestyle, genetics, planning, you know, like, you cannot take your fertility for granted.
- [16:34]
Monica Lewinsky
Right.
- [16:34]
Dr. Mary Claire Haver
And you know, in any 25 year old listening, your period is a vital sign. So if you're not having regular predictable monthly cycles, you need to get ahead of that and see what's going on because it most likely is going to have some effect on your fertility.
- [16:48]
Monica Lewinsky
Right. I mean, is there a way. This was not my idea. It was a friend of mine, but he's not a doctor. But is there a way, like once we start having our period that there's. That we are given tests to sort of more regularly understand what's happening with our fertility through, you know, so that we feel more in charge, like instead of what I was saying with my friend and what happened where it was this big surprise.
- [17:15]
Dr. Mary Claire Haver
So there are a couple of blood tests, like AMH is one of them and you likely had that done before they offered you the, the freezing. And it basically looks at. And I'm not a fertility specialist, I've Kind of left that part of, you know, OBGYN behind when I went into traditional practice and let the fertility specialist. But AMH is basically a marker of how many eggs you have left. So we can't go in and count. There's no ultrasound or MRI or anything where we can say, ooh. But this, this AMH marker can tell us what your reserve is or what the. And based on a number, they can tell you the likelih that you will have a spontaneous pregnancy.
- [17:51]
Monica Lewinsky
Okay.
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Dr. Mary Claire Haver
So that's usually where that starts. But if you're. If your life goal is to be a mother and you know, most fertility specialists will agree, and especially if there's any history of fertility issues or you don't have regular predictable cycles somewhere in your late 20s, if you haven't started, you should consider going in for an evaluation if it would be life changing for you if this opportunity was taken away from you.
- [18:17]
Monica Lewinsky
Yeah, yeah. No, it's so, it's so interesting, but.
- [18:20]
Dr. Mary Claire Haver
Right now we don't have anything standard. You know, it's just like, well, I'm. Good luck, you know. Yeah. Hope you're lucky.
- [18:26]
Monica Lewinsky
As you said, if you could sort of. I know this is a semi impossible question, but if you could give us like a brief history of sort of women's health and like how it's pretty abysmal. Right. And sort of compare to what your vision for it is and then kind of just even juxtapose men's health and women's health and the different hormone things. I'm just so curious to understand that.
- [18:53]
Dr. Mary Claire Haver
So I was brought up in a system which has so many wonderful things about it. Like, I love everything I learned. And what I think the problem is that there are gaps in our knowledge that a lot of the. When we look historically, there's like a couple of great books I can recommend Eleanor Cleghorn's book. And then Elizabeth Coleman just wrote all in Her Head.
- [19:13]
Monica Lewinsky
Okay.
- [19:14]
Dr. Mary Claire Haver
And they both look at this historical lens of female. How the medical system has dealt with females, everything from wandering uteruses.
- [19:22]
Monica Lewinsky
Thank you.
- [19:24]
Dr. Mary Claire Haver
You know, and how until like our grandmother's time, that that was standard thought process. And when you look at the hospitalization rates and the institution institutionalization rates, and so many of those women were just menopausal.
- [19:39]
Monica Lewinsky
Yeah.
- [19:39]
Dr. Mary Claire Haver
And having these mental health changes and that no one knew how to treat or what to do with. And they were getting lobotomized. They were put on tranquilizers. My own mother, I remember. So Mama is 88 and she has Alzheimer's and she fell and broke her hip. She is like, what is my worst case scenario? You know, like what I don't want for myself and why I fight so hard to change this legacy for my children. And I remember mom talking about beasol.
- [20:09]
Monica Lewinsky
Okay, I don't know what that is.
- [20:10]
Dr. Mary Claire Haver
Butasol. Butasol. Butasol. And I just remember that name. Cause mama's little helper. She would have a stressful moment now again, she had eight kids. One had leukemia, one's coming out of the closet. You know, it was a very active, stressful life. They were running a restaurant. So she goes to her doctor and she's. And now I know now she's in her 40s. I remember this distinctly. I remember how old I was. She's in perimenopause. I now realize this. And they give her a prescription.
- [20:34]
Monica Lewinsky
Uh huh.
- [20:35]
Dr. Mary Claire Haver
And it's for something called beauty salt. And I just remember her throwing that word out like, I need my beauty salt. Go get the bottle. Right. I can't handle this. Blah blah, blah, blah, blah. And when I was writing, when I was prepping for the new perimenopause and doing the research, that story bubbled up in my head. I was thinking about mama's perimenopause and what that must have been like. And like, what stories do I remember from her? And I thought, beautiful, beautiful. What is that? I look it up and Monica, it's a version of phenobarbital.
- [21:04]
Monica Lewinsky
Oh my gosh.
- [21:05]
Dr. Mary Claire Haver
It's a sedative.
- [21:06]
Monica Lewinsky
Oh wow.
- [21:08]
Dr. Mary Claire Haver
They were sedating my mother through her perimenopause and calling it beauty salt.
- [21:15]
Monica Lewinsky
But it's like the beauty in there.
- [21:16]
Dr. Mary Claire Haver
I go and I look it up on the Internet and I find all of these ads from the 60s and 70s and it's a lady in an apron flipping a pancake. Get your mom back. Get your wife back. You know, bad mo, poor moods. And for Mama, you know, give her this medication. I mean, this was common. This is not one doctor trying to hurt my mother. This was what the medical, you know, so I'm just telling you that story in my own life. I've seen how like that kind of just instills. She's had. She had a hysterectomy as birth control. Wow. Because our religion, you know, there's been some changes in the Catholic church. But you know, I grew up Catholic and birth control was kind of excommunicated for a while and they had had eight kids. And so it is enough. Eight is enough. And like she was 43 with her last baby. And all of a sudden they whisked her off to surgery and they took out her uterus. So, you know, which I never saw the pathology, maybe there was something going on there. But she just says, I couldn't have any more. They didn't want me to have more children. And so the onslaught of that post op course, she had incontinence as long as I can remember. Mom wearing pads, mom having to wash. She wore pantyhose for to make her legs look nice. And always seeing the pantyhose hanging and washing because she was struggling for with her incontinence. She had urinary incontinence. And I'm like, she had two or three procedures to try to help the incontinence. It never worked. And like also now in the nursing home, she's wearing a diaper 247 because she has no control left over her bladder. I'm like, God, we could have done so much better by her. So I think looking historically she kind of epitomizes the worst of medicine. There's nothing wrong with her heart, her brain is broken, her bones are broken, and her general urinary system is broken. And I think women deserve better.
- [23:12]
Monica Lewinsky
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- [25:02]
Dr. Mary Claire Haver
Right.
- [25:02]
Monica Lewinsky
And institutions.
- [25:03]
Dr. Mary Claire Haver
Plato, I think.
- [25:04]
Monica Lewinsky
Yeah, yeah, exactly. Plato. In the wandering womb, I think it was. And so.
- [25:09]
Dr. Mary Claire Haver
And so anytime in medicine, women have been treated as small men. Like, medicine was designed by men for men. Okay. And they're like, anything different was she's crazy or something we can't put our finger on.
- [25:24]
Monica Lewinsky
Right.
- [25:24]
Dr. Mary Claire Haver
And it still goes on to this day. There is a bias built into the system. So when I talk to my menopause friends who are urologists and cardiologists, and Vonda. Right. The orthopedic surgeon, and they trained on treating both males and females. I mean, I've been in a bubble just treating women, you know, and they talk about this huge discrepancy between when a man comes in and he's got. He's low energy and, you know, so Vonda was telling the story the other day. A man came in, he had low energy. He's popping his tendons left and right. He's gained some weight, he's kind of feeling run down. He's not sleeping that well. She said, knee jerk. Immediately, I check his testosterone, and then if it's low, she doesn't prescribe testosterone. She sends him on to whoever can take care of that for him. No questions asked, no shame, no guilt, no whatever. She said a woman comes in with the same complaint, it's an automatic psych referral.
- [26:15]
Monica Lewinsky
Wow.
- [26:16]
Dr. Mary Claire Haver
So when you look at urologists, same thing. You know, they're coming in with genital urinary complaints or, you know, males and females or low libido or dry vaginas, men immediately, you know, just check their. To check their hormone levels, see if that has anything to do with it. And let's get this problem taken care of. Not for women. You drag your feet. You talk about coconut oil, which is a great lubricant. You know, you talk about lubricants, you talk about anything other than her low hormones. And that. That has shaped how we treat women moving forward.
- [26:48]
Monica Lewinsky
Right? Right. I remember at the. At the conference last summer, you were talking about something that totally shocked me and changed my life because we have a history of breast cancer in my family. My grandma had had a double mastectomy at 40. She's no longer here. Otherwise, she'd kill me for saying that on my podcast.
- [27:07]
Dr. Mary Claire Haver
But isn't that so common for that generation to hide those things?
- [27:12]
Monica Lewinsky
Oh, my gosh. I mean, I remember because she didn't have. I mean, she was 40. They were living in Japan. My, my grandfather had just passed away six months earlier. And she didn't have reconstructive surgery. She never did. And I remember as a kid, grandma would come visit, she'd stay in my room, and it was like she hung her boobies up at night, you know, because she had these falsies.
- [27:36]
Dr. Mary Claire Haver
Oh, wow.
- [27:37]
Monica Lewinsky
And so it's. But that was, you know, that was sort of the, the first layer of the story for me, I think in, in this history of, oh, okay, hormones and cancer and you have to be careful. And my mom, I remember my mom saying, I, oh, I'm not doing hrt, which I know we're now calling mht. Right.
- [27:56]
Dr. Mary Claire Haver
And. And there's, there's debate about that. So. Okay, you know, but hormone therapy.
- [28:00]
Monica Lewinsky
Hormone therapy. Right, hormone therapy. And so she didn't do that because the, the narrative was, oh, no, we have this risk of. Right. And so you were talking about how that has, like when that first, when the study first happened, I think you were in medical school. So I want to, you know, take me back there to what's going on and then where we are now.
- [28:22]
Dr. Mary Claire Haver
Let's walk you through. So I was a, I was a resident. So medical training is that everyone goes to a typical four year program and gets like a basic medical degree. Either D.O. or M.D. okay. And then we decide what we want to specialize in in that last year. And for me, it was OB gyn, which is a four year residency.
- [28:40]
Monica Lewinsky
Right.
- [28:40]
Dr. Mary Claire Haver
Meaning you live in the hospital. That's what resident means. So I was in a. My training program from 98 to 2002. And most of my residency, the vast majority was hormone therapy is great. It's an option. It will decrease her risk of osteoporosis. We knew that it will decrease her problems with general urinary syndrome. We knew. And it will probably decrease her risk of cardiovascular disease, which we knew from like observational studies for decades. Okay, you gotta give her progesterone if she has a uterus so she. We won't cause the lining of the uterus to overgrow from the estrogen alone. You know, we knew all the ins and outs. And she'll feel a lot better, she'll sleep better, hot flashes will go away. Great. Okay. So when we had a patient coming in, it took a few visits for us to be like, oh, yeah, hot flashes, you know, so. And yeah, let's get those treated. I wasn't looking at it as whole body health or long term healthcare. You know, it was like a quick fix for a set of symptoms that would be short term.
- [29:40]
Monica Lewinsky
Okay.
- [29:41]
Dr. Mary Claire Haver
And then 2002, the Women's Health Initiative bombshell dropped. So the WHI was a pretty amazing studies. To this day, one of the most expensive studies.
- [29:51]
Monica Lewinsky
What's the whi?
- [29:53]
Dr. Mary Claire Haver
Women's Health Initiative.
- [29:54]
Monica Lewinsky
Okay.
- [29:55]
Dr. Mary Claire Haver
So we knew from observational studies that women tend tended to have less heart attacks and less mortality. So death from any cause and death from heart attacks if they were on hrt. Okay. So remember back then, we started HRT right when women went through menopause, right. When their symptoms were the worst. We weren't starting older patients on hormone therapy. And so they devised this study. Is this true? Is it just because people who are in HRT are overall healthier, wealthier, have access to doctors who give hormone therapy? You know, is this an artifact of just patient population selection or is this a real thing? Okay. It was a new women's head of the nih National Institute of Health. Who's paying for this study? I mean, this was such a big deal. We were so excited. So they have tens of thousands of women in this study enrolled. Okay. It's a humongous study. We have, I think, 17 or 18 different universities that are participating.
- [30:46]
Monica Lewinsky
Oh, wow.
- [30:47]
Dr. Mary Claire Haver
They are pulling in patients from all over the US this is so amazing. And the outcome measured was, is she going to have a heart attack or not? Is this hormone therapy going to be protective? Now they're measuring other things, like breast cancer, like colon cancer, like osteoporosis. I mean, they're doing blood levels for different things. It's pretty fascinating study. And what they notice. So they divide the women into two groups. You have like any good randomized control study, you have an arm that has the medicine, an arm that has a fake. Okay, the placebo. And everybody remember placebo, right? So everybody's blinded, even the doctors. You don't know who's getting what. They're just taking these white pills that you don't know what's in them. And then they're measuring the outcomes. So the average age of this study was 63.
- [31:34]
Monica Lewinsky
Okay.
- [31:34]
Dr. Mary Claire Haver
Because the outcomes, heart disease. So they want to start with an older population because it takes a long time to develop a heart attack. And that would have made the study cost prohibitive. What people don't realize is that there were 70% of the patients were overweight, 40% smoked, and 30% were obese. This was not a cardio neutral cardiovascular disease neutral population. These were older, heavier, sicker patients that are most likely going to have underlying cardiovascular disease. That's already started.
- [32:04]
Monica Lewinsky
Oh, interesting.
- [32:06]
Dr. Mary Claire Haver
So off we go. They give the placebo groups getting nothing, and then we have a group that's taking the estrogen and progestin because they still have their uteruses. And then the hysterectomy ladies, which. There's a lot of hysterectomies in this country. They are getting estrogen alone. And it's cee, which is actually premarin. Okay, so not the modern estradiol that we give patients. And the reason why they did that, like, why didn't they use the body identical. You know, exactly what our ovaries would make. Because they wanted to give the patients what a prescribing doctor would actually give. And we just weren't using estradiol back then. We were using premarin.
- [32:44]
Monica Lewinsky
Okay.
- [32:44]
Dr. Mary Claire Haver
So it made sense. Like, if you think about it, off they go, they start collecting data, and within a few years, they notice that the women who were taking the combination were having an increased risk of cancer. It was never statistically significant. Let me be clear.
- [32:59]
Monica Lewinsky
Okay.
- [33:01]
Dr. Mary Claire Haver
So there's a lot of politics. Turns out who's running the study? A cardiologist. Dr. Russo. I'll go ahead and say his name. Who had already published that he didn't like HRT and thought it would cause heart attacks. So we have.
- [33:15]
Monica Lewinsky
Wow.
- [33:15]
Dr. Mary Claire Haver
The lead investigator is already biased. He's. When you start a study with a. This is what's scaring me about what's happening kind of now. When you start a study with the outcome in mind.
- [33:26]
Monica Lewinsky
Yeah, yeah.
- [33:28]
Dr. Mary Claire Haver
You know, it's a. I remember from.
- [33:30]
Monica Lewinsky
Graduate school and that it was just, you know, how desperately I wanted with my thesis. Like, I wanted my research to be significant. You know, there's that whole thing of.
- [33:41]
Dr. Mary Claire Haver
And you're spending a billion dollars.
- [33:43]
Monica Lewinsky
Right.
- [33:43]
Dr. Mary Claire Haver
You know, the weight of the world. Yeah. It's like you have all of resources for this, and you have this hypothesis, and what if you're wrong?
- [33:51]
Monica Lewinsky
Right.
- [33:52]
Dr. Mary Claire Haver
You know, so the politics and the backstory around how this was released. So when is the last time you saw a press conference around a study that has not been published yet? Yeah, it was over, like, 10 days before the study results were available for anybody to read me. And then all of a sudden, it's hitting. It was viral before we had the Internet. Yeah, it was the number one medical News story of 2002. Estrogen causes Breast cancer. That's all anyone saw. I remember Nancy Snyderman talking about it. So here I am, I can't read the study. And honestly, at that point I'm like overrun, overworked, pregnant and like, you know, okay, it's bad, don't give it anymore. Fine. You know that bomb that dropped and caused a Whipple and a wave, and it is probably the most deleterious effect on women's health in the history of medicine. Like how that was brought to the public, how there was no nuance in the discussion, and then how over the next 20 something years we had so many papers walking back those results, relooking at the data, refining it all the nuance that never got picked up by the popular press. So I blame the lead investigators, I blame the media, you know, and I blame the medical system for just saying, okay, fine, we're just not going to give it and then move on. And so what we've ended up with is an epidemic 20 years later of women whose health is less than they deserve.
- [35:22]
Monica Lewinsky
Yeah, yeah, it's. You know, I think what is interesting to me and sad to me is my background's a bit in social psychology. And so I'm thinking about not just what this means for the individual woman, but what this means to her ecosystem, what this means to her children, what this means to how she might have shown up at work if she was able to work in all those ways that then get sort of passed on. The ripple effect, you know, it's just, I think that I hadn't really thought about it that way of just how, how big the blast radius is, how far it goes.
- [36:01]
Dr. Mary Claire Haver
And I honestly didn't realize it myself until I dug into this. Like, trust me, there are incredible researchers, there's incredible people that didn't have social media platforms that were fighting so hard to like, let you know, where, where is the drama around walking this back and the health of women and health span and lifespan and. And it is just kind of now, in the last couple of years that I think the world is able to catch up.
- [36:29]
Monica Lewinsky
Right. Do you think in some way. I don't know the exact timeline. So I'm just. What's coming up for me is if, you know, part of this is you're Gen X, right?
- [36:39]
Dr. Mary Claire Haver
Yep.
- [36:40]
Monica Lewinsky
So part of this is a bit Gen X. Like we're gonna fix it, we're gonna figure out what the fuck is wrong. And, you know, I think it's exactly that. Okay.
- [36:47]
Dr. Mary Claire Haver
Yeah.
- [36:47]
Monica Lewinsky
Okay. Because I, I'm also wondering about. And. And that's it could still be that, but also this sense of whatever might have been floating in the air that we were picking up on about our reproductive rights and our bodily rights about to be taken away from us, you know, and so this whole thing of. And what I mean is from my perspective, the popularity now of having this conversation, like I feel. Does that make sense?
- [37:16]
Dr. Mary Claire Haver
Yeah.
- [37:17]
Monica Lewinsky
Okay.
- [37:17]
Dr. Mary Claire Haver
It's hard to untangle the two. And you know, unfortunately politics wraps itself into women's health and medical care way more than men.
- [37:27]
Monica Lewinsky
Yeah.
- [37:27]
Dr. Mary Claire Haver
You know, there's no political debate over whether a man should get Viagra, you know, and I'm like, where are those Viagra laden penises going, people? Yeah. You know, like, come on.
- [37:36]
Monica Lewinsky
Yeah.
- [37:36]
Dr. Mary Claire Haver
You know, chosen not to upgrade his, you know, wife and to a younger version. So, you know, like, and I'm dealing with the onslaught of it, of these women are like, it hurts, I don't want to do it. And he's running around with an erect penis and I have no, no, no interest in this, you know, and so that's kind of one aspect. But under the bigger umbrella, I think this, you know, what's happening with, with reproductive rights, specifically around pregnancy, abortion, termination, you know, it's really like women are. Whether, whether which way they vote, it doesn't matter. You know, menopause does not care who you voted for, what your politics are. She is coming for you. You know, none of us get out of this. If we're lucky to live long enough, we will become menopausal people. And I've never seen a subject unite women so fast.
- [38:27]
Monica Lewinsky
Yeah.
- [38:28]
Dr. Mary Claire Haver
So, you know, leaving and there it's intertwined with reproductive rights. But like I said this at G9, if we could galvanize women around the end of their life and their life after reproduction ends and to think about who's voting for their health long term, not just their, you know, not just their ability to reproduce and how that's all going to go down. I think we could really unite women over this topic because there's no debate here. No women who goes through menopause ends up healthier on the other side.
- [39:01]
Monica Lewinsky
Right.
- [39:02]
Dr. Mary Claire Haver
Not one. Wow.
- [39:03]
Monica Lewinsky
Yet. Right.
- [39:05]
Dr. Mary Claire Haver
Yet.
- [39:06]
Monica Lewinsky
I mean, that's really your big mission. But I want to find it because I have just a quote that I love that you said. Menopause is inevitable, suffering is not. Yeah.
- [39:20]
Dr. Mary Claire Haver
I mean, that's been my mantra of when I really thought about perimenopause. So when we look at, you know, the zone of chaos in this transition phase, the mental health and the cognitive issues tend to get better in post menopause.
- [39:35]
Monica Lewinsky
Okay.
- [39:35]
Dr. Mary Claire Haver
And where we see the increasing suicide rates, the divorce rates, the leaving your job rates are really in late perimenopause, like before the period stop. And if you're even trained to treat menopause. We were not trained to do it until one year after the final menstrual period. So we have this 7 to 10 year period of just. I think back, Monica, to I had teenagers how I would just fly off the handle.
- [40:01]
Monica Lewinsky
Oh my God. My first perimenopausal rage of, you know, going from 0 to 60 and 60. And I know I'm being crazy and.
- [40:07]
Dr. Mary Claire Haver
I still can't stop.
- [40:08]
Monica Lewinsky
Yeah, yeah.
- [40:10]
Dr. Mary Claire Haver
I was like, not myself. What was happening to this woman? Why was she talking to her daughters this way? You know, they were doing normal teenage stuff.
- [40:18]
Monica Lewinsky
Right.
- [40:19]
Dr. Mary Claire Haver
But this sort of my resilience was like.
- [40:23]
Monica Lewinsky
Yeah. Interesting. It's so fascinating to me. I mean, I think when you look at kind of how women's health has been treated.
- [40:32]
Dr. Mary Claire Haver
Yeah, right.
- [40:33]
Monica Lewinsky
And it being a microcosm for so many things that we've seen when it comes to women.
- [40:39]
Dr. Mary Claire Haver
So I'll tell you my WW story.
- [40:41]
Monica Lewinsky
Okay.
- [40:42]
Dr. Mary Claire Haver
So when I was in training, my first. So we go through blocks of training, right? So my very first block was labor and delivery night. You know, they were in delivery, delivering babies. I was like in my element, catching babies. So fun. All the adrenaline running down the hall. And then I moved into gynecology and we had gynecology clinic two days a week, and then three days a week we were in the or and we just flip flopped back and forth. So I'm in clinic and I'm gonna date myself. There were charts, paper charts, before the electronic medal, before computers. So we had a stack of charts. So the top level residents would run and go find the surgery cases because they want to operate and get their numbers, and that's fine. So then I'm the lowest on the totem pole. So I just get what's left on the bot and I pull my first chart. And it is a woman who's in her 40s and she has multiple vague complaints. She's not sleeping, she's gained some weight, she's having trouble with her libido. You know, she's bounced around. She's got some joint pain, some headaches. You know, she's just kind of. She's been to family medicine. They sent her to, you know, they sent her to neurology for the headaches. They sent her here and there. And then finally she Gets dumped into OBGYN clinic and she's still not better. Okay, so I'm presenting this to my chief resident who just happened to be male. Literally the gender didn't matter. But I'll never forget he had his long white coat, his scrubs and his cowboy boots and it's Texas, you know. And he's walking down the hall, what you got? You know, he's in charge of me to make sure I don't kill anybody. And I said, Well, I have Ms. Smith and she's a 40 year old, you know, white female and she's complaining, blah, blah, blah, blah, blah. And he goes, did you check her thyroid? Well, family medicine did. So I'm going through all the workups that she's had and everything basically looks normal. You know, she's not diabetic, she doesn't have autoimmune disease. Like they've ruled out all the big stuff. And he goes, mmm, you got a ww? And I said, what's that? And you know, I don't know what this is. I'm like, I'm like thinking through the Rolodex of all the medical terms I've learned in my mind. And he said, well, don't write this in the chart, but it's a whiny woman. And he said, this is just what women go through at this age. We're really not going to be able to help her. Tell her to get a good night's sleep. Tell her to work out more and eat less. Tell her to do all the same things. And he wasn't a bad guy. This was taught to him. He's teaching it down to me. This is how we treat women. So I've stood on stages all over the US now. I've spoken at multiple medical schools and I always ask if you had something similar. I'm like, was this unique to Texas? No, they call them whiny Gyne's on the east coast. Total Body Dolore. Total Body pain. Status Hispanicus. Like why we're dumping on the Hispanic population, I have no idea. But you didn't have to be Hispanic to have this. And you know, there were terms used all over the country for the exact same constellation of symptoms. Vague complaints, workup is normal. She's just a dun dun, dun dun dun. And we're gonna pat her on the head and tell her it's gonna be okay and let her move on. And now I know. Yeah, she was in perimenopause.
- [43:40]
Monica Lewinsky
Yeah. No, it's, it's so terrifying because I Didn't. I mean, I feel like I've just started to come to understand some of this in the last few years. But I was saying when I had my makeup done today for this show looks great. Thank you. Thanks, Nia. I was talking about how I had. I've only had a few hot flashes last five years, but one of them was right after I was a Vanity Fair Oscar dinner. Like, I had had my makeup done and I thankfully, I'd gone through the photo line and this. I don't know if you know Derek Blasberg, but he's sweetheart. And he was trying to help me.
- [44:27]
Dr. Mary Claire Haver
And I was.
- [44:27]
Monica Lewinsky
You're just profusely dying, dying. And it won't stop. And it just won't stop. And that feeling of you just feel so out of control, you know, and so that is. I think what's.
- [44:43]
Dr. Mary Claire Haver
So.
- [44:43]
Monica Lewinsky
What could be so frustrating is that we have all these tropes about women, you know, and sort of like hysterical and commotional and emotional women are small men.
- [44:54]
Dr. Mary Claire Haver
Small, emotional women with breasts and glasses.
- [44:56]
Monica Lewinsky
Right, Exactly. And so it just feels like I just. I don't know, I just. I'm so grateful that this is changing now. You know, I think about my niece, and it's going to be different for her.
- [45:09]
Dr. Mary Claire Haver
It really is. I also think social media has really helped to catapult this movement because it wasn't until I got on social media that I realized, you know, when I see patients, I shut the door, I'm isolated in a room, maybe a nurse there, while a woman is telling her story. I don't hear the stories of everybody else. And besides my, like, girlfriend group, who. I know what they're going through, I don't know what the world is thinking, right. And when I started talking about this on social media and getting thousands and thousands and thousands of DMs, and, oh, my God, yes, me, this happened to me. I realized this is bigger and we're just not talking about it. But social media really allowed us to leverage that collective. And I think that's what happened kind of in me too, of like, all these women who had kept these stories so secret. And so, you know, you didn't have that opportunity. The world took it away from you. But, you know, had these experiences realize how common. We all had so much of this in commonality. And so, you know, frozen shoulder and the mental health changes, the rage, the. You know, and now we can make it funny and we can make it fun and we can, like, talk about it like girlfriends. And I just love that about the Internet?
- [46:23]
Monica Lewinsky
Yeah. No, I mean, the Internet, it's like, it can be an extraordinary thing, place, whatever. It can move mountains in ways that can spread information, but unfortunately, misinformation and disinformation, you know, so, I mean, it's all the things.
- [46:42]
Dr. Mary Claire Haver
But it is.
- [46:43]
Monica Lewinsky
You know, I often think back to the ice bucket challenge, and I think about what. You couldn't have had that without the Internet.
- [46:49]
Dr. Mary Claire Haver
Right.
- [46:50]
Monica Lewinsky
And how much awareness that brought. And also, I think it can show you that there is this connective tissue and among people, even who I have different, very different beliefs. And I think that's exactly what you're saying about the community that you found online. I mean, and you have millions of followers, like your social media and. No, you must be. I know, because we talked about this little. That you trolls and.
- [47:14]
Dr. Mary Claire Haver
Oh, yeah.
- [47:15]
Monica Lewinsky
And so what's your experience like with that? And has it gotten a little better? I don't know that my advice was my.
- [47:24]
Dr. Mary Claire Haver
Yeah, so you were actually a help. When you choose to share things on social media, you have to be prepared for backlash. And when I first got into the space, I was talking about weight gain at menopause with my nutrition background and things that we can do. And it was like so many in that personal training world who had built empires around dieting and calorie restriction and obsessive cardio were all coming in to beat me up and say things. When that first happens, you're like, ah, yeah. You know, and then I, like, I think I saw Taylor Swift say something about, it's part of the job, like, taking this stuff as part of the job. But, like, as we're really pushing the envelope medically and really teaching women to stand up and demand, you know, getting pushback from some of the academic institutions and some of the organizations is tough because I was the good girl. I pass my boards every year. I do all the things. And then some people in charge are like, whoa, slow down. We need a consensus. We need a whatever. And I'm like, women are not willing to wait the 17 years it takes from new research to come out for a guideline to change. And all the egos involved in that room where the guidelines are changed and all the bias. Like, women are ready to take their health into their own hands and they're willing to. To read studies themselves, you know, so.
- [48:53]
Monica Lewinsky
Yeah, no, it's amazing. So you've. You have created these universes in a way of. So the menopause. Menopausy. Right.
- [49:05]
Dr. Mary Claire Haver
Menopause is a group of clinicians and it's really cool. And, and some thought leaders. So like Tamsen Fadal, who did the documentary on menopause. Mostly it is, is physicians, but we have nurse practitioners and they're really ranging across specialties. We have medical oncologists and it's most women, but a few good men. Medical oncology, social scientists, urology, cardiology, psychiatry, of course, obgyn, family medicine. Like we really, and it's just people and we all really bonded. So there was a medical article that came out in the Lancet, which is kind of like New England journal, but in, in Europe and the uk.
- [49:42]
Monica Lewinsky
Okay.
- [49:43]
Dr. Mary Claire Haver
They're, they're really, really revered. And it was a four part series all about menopause. And we're excited, but then we're hearing the drumbeat before it comes out and we got an advance copy and. And so we'd all been loosely talking about this menopause movement and you know, trying to stick to evidence and all the latest evidence. And then we see this come out and it, I mean I, I took to the bed for 24 hours. I thought this is going to set women's health back another generation. Like it was. So what was it?
- [50:12]
Monica Lewinsky
What did it say?
- [50:13]
Dr. Mary Claire Haver
So basically like don't over medicalize menopause. Don't even discuss treatment unless she's having severe symptoms. Ignore all, everything we know about hip fracture and cardiovascular disease and anything that is. Oh, and we can treat a hot flash with cognitive behavioral therapy. I love cbt and the studies do show that it can help your perception of a hot flash. But it doesn't stop them. No, it makes them. You not think about them as much. Hot flashes are a harbinger of increasing risk for cardiovascular disease, diabetes, stroke, visceral fat, insulin resistance and diabetes. I'm like, the worse your hot flashes are, the worse you're gonna do later in life. Like, and accusing people of over medicalizing menopause. I mean these were like, if you can imagine, the ivory tower. Yeah. With researchers who were very biased and men, women. What's the split? It's a split. Okay. Men and women, even the. I tell you what, the women who are, you know, were on that article are the most recalcitrant to anything outside of like how they've been doing things for 20 years.
- [51:17]
Monica Lewinsky
Right.
- [51:18]
Dr. Mary Claire Haver
And so I was just like, I'm not going to stand for it. I'm not going to do it. Yeah. And so, and I'm not big in the academic research world, you know, like, they tend to be a very cerebral select group of individuals. And this is their life. They publish or they perish in these, in these institutions.
- [51:34]
Monica Lewinsky
And they play the publishing game right.
- [51:35]
Dr. Mary Claire Haver
In their, in their career. And you know this, you know, from having tried to publish before. So I'm like, I'm not going to stand for this. So we start a coalition of clinicians who are like saying, and this is all over the world. We have Australia, we have the uk, we have all over Europe, all over the US South America. And we're like, no, we're not going to stand for this. So we write a rebuttal to the article. And Lancet wouldn't even talk to, like, wouldn't even publish it. Okay, fine. We're gonna take it to Popular, we're gonna take it to news outlets, and it was published in Ms. Magazine, so we had to make it where a normal person can read it. And it's not so medical, but we had over 250 signatures on it from some of the most established and well recognized clinicians in the world. And that's one of my proudest moments in this movement. It was kind of behind the scenes, like, you wouldn't if, you know, you know, okay. But it was our saying, absolutely not. We think you're wrong. We think that if you follow these principles, women are going to end up less healthy, less happy, and we can do better by women. So that's how the menopauses started. And then we all got on a group chat. It's WhatsApp, because it's all over the world. And now it is, where we bounce ideas off each other. There's respectful debate. We don't all agree on everything that's medicine. There's nuance, there's new studies. We debate studies, we, we talk about, you know, how are you managing this? What would you do with that? It is really one of the coolest things I've ever done, is be a part of that. And then I try to elevate them so I have, you know, God has gifted me in the world with this huge platform. And so I'm constantly sharing others stuff. I took off for a vacation. I went to Norway for two weeks and I let all my friends do Instagram takeovers.
- [53:14]
Monica Lewinsky
Oh, how great.
- [53:15]
Dr. Mary Claire Haver
On my page to highlight their research and what they're doing.
- [53:17]
Monica Lewinsky
Okay. Oh, so that's what was going on.
- [53:19]
Dr. Mary Claire Haver
Yeah. Okay. I was in Norway climbing mountains.
- [53:22]
Monica Lewinsky
Yeah. Yeah. Oh, good for you.
- [53:23]
Dr. Mary Claire Haver
Good for you.
- [53:25]
Monica Lewinsky
It's interesting because you were sort of catapulted right in this with the social media. And I think you and Brene Brown were talking about because she had a similar experience of sort of blossoming over it. Very different from my TED Talk.
- [53:39]
Dr. Mary Claire Haver
And it just blew her out. Oh, no.
- [53:41]
Monica Lewinsky
From an obscure.
- [53:42]
Dr. Mary Claire Haver
It's not obscure, but like, in her field, she's so well known, but like, all of a sudden the world knows about it.
- [53:46]
Monica Lewinsky
No. And she cracked open for the entire world. Conversations around shame and vulnerability. I wouldn't have been able to do my TED Talk had she not, you know.
- [53:56]
Dr. Mary Claire Haver
Yeah, so you could run.
- [53:57]
Monica Lewinsky
Exactly. And so she's just an amazing woman. I don't know her very well, but I know her a little bit, and she's special as. Yeah. What was that like for you and what's it been like for your family?
- [54:10]
Dr. Mary Claire Haver
Oh, you know. So my kids, it's interesting, most of their lives, I was not recognized in public. I wasn't famous. I didn't have a big social. I was just mom, who was also a doctor, and we lived in a very small town. Town, okay. Then all of a sudden, right before COVID was when things were starting to kind of bubble up, and then it exploded in Covid. So we're all home, and they taught me how to do tick tock. Tick Tock is where I first blew up.
- [54:35]
Monica Lewinsky
Okay.
- [54:36]
Dr. Mary Claire Haver
And so we're all home for two years, basically. So, like, I blow up on social media, starting the menopause conversation. It really, really ignited on TikTok. Like, I would wake up and there'd be another 10,000 followers.
- [54:47]
Monica Lewinsky
Oh, my gosh.
- [54:48]
Dr. Mary Claire Haver
Of course, my dopamine's popping off. Like, oh, my gosh.
- [54:51]
Monica Lewinsky
And so.
- [54:51]
Dr. Mary Claire Haver
And I'm starting to meet other people in the space who are doing things, but they were kind of in it with me in the beginning and coaching me and tell, oh, don't do this. Don't do a dance. Point at this thing. Because my very first TikToks were to music because that's what people were doing. And I'm pointing to medical on the screen, trying to dance, you know, and then once I started talking, I'm like, oh, I can talk on this thing. Okay. So they were kind of in it in the beginning and thinking it was all fun and cute, except I was talking about menopause. Who wants to talk about that when you're 16, you know, now? So I've got one who's in medical school, and it's wonderful. It's a little bit of a, you know, she wants to stand on her own two feet, you know, because, bless her heart, everybody's like, are you following in your mom's footsteps are you. You know, and she's like, I mean, Catherine would have gone to medical school if I would have been a schoolteacher. Like, she was born to do this. So she's kind of trying to find her own path here and not have people know who she, she is, you know, who her mom is. And then my youngest is doing PR and marketing.
- [55:54]
Monica Lewinsky
Okay.
- [55:54]
Dr. Mary Claire Haver
And so.
- [55:55]
Monica Lewinsky
Well, that's, that's helpful. Yes.
- [55:57]
Dr. Mary Claire Haver
You know, she's really into it now, trying to coach me and give me advice on, you know, what my feed should look like and all these. I've never think about those things. And so it's really kind of fun. But when years ago, my niece was turning 21, we all went to New Orleans and I was kind of, you know, at the 2,3 million mark and we were out and some woman walked up to us in one of the, one of the little lounges with music, and it was kind of loud. And so my daughter's there with her friends and my niece and our whole family. And this woman's like, oh my God, it's you. And you know, I was like, oh, trying to be gracious and nice, and I see my younger daughter roll her eyes in the background and I was like, please, God, don't let that woman have seen that. So I wrap it up with the lady, we take our pictures and she leaves. And so I waited till the next morning once you. We were not at the club and I sat Maddie down at breakfast and I was like, hey, you know, you rolled your eyes last night. You didn't seem too excited about. She's like, mom, we're just being family and da, da. And I was like, this is new for all of us. And I know you didn't ask for this, but I think this is our life right now. And in public, honey, you're going to have to be gracious. A little more gracious than that. And remember that this college education and your opportunities are partially being funded by this. You know, like, this is, this is kind of part of this. And I know you didn't ask for it, and I can't stop it at this point.
- [57:20]
Monica Lewinsky
Right, right.
- [57:21]
Dr. Mary Claire Haver
And you know, she ended up majoring in that, so it's all going to be okay. But I remember having that conversation.
- [57:27]
Monica Lewinsky
It's such a strange, I think, you know, anybody who's gone through puberty knows what it feels like to be awkward and self conscious. And it is a very different experience to start to be self conscious in public because people you don't know know who you are.
- [57:47]
Dr. Mary Claire Haver
And I get that now. So every airport bathroom, someone walks up to me and my husband's like, if they're brave enough to come up to you, 10 people are not. So I'm always thinking, make sure your face looks like you're happy. Like, don't, because I tend to have resting bitch face. And so, like, skew your features into one of pleasant fitness as I'm walking through an airport or something. You know, I never want people to think or.
- [58:11]
Monica Lewinsky
Or for you to feel unapproachable.
- [58:13]
Dr. Mary Claire Haver
Yeah.
- [58:13]
Monica Lewinsky
To people. Yeah. I'm not, because I'm. Sometimes I'm normal. You know, I'm just a girl who.
- [58:19]
Dr. Mary Claire Haver
I'm like, come up. Come say hi, please. You know, half the time I'm alone and I'm bored, so. And I would love to hear your story and, you know, you share with me. Just, I can't be your doctor, you know, Subway in New York City.
- [58:31]
Monica Lewinsky
Yeah. Yeah.
- [58:32]
Dr. Mary Claire Haver
So. But I can be first your friend.
- [58:33]
Monica Lewinsky
Yeah. Oh, it's really. It's lovely. I want to talk just a little bit. I. I know. I want you to tell me about in a second about your new podcast and your upcoming book, but I want to talk because anybody who's listened to the show for a while knows I am a crystal freak. And so that you were in geology. Geology. So what got you into geology? And can you say something that totally affirms why it's okay I have a crystal addiction?
- [59:04]
Dr. Mary Claire Haver
So I went to college. I didn't know what I wanted to do. Like, I was brought up to get married, have babies, and to marry well. I mean, my dad would say so. And I love my father, and he passed away and forgive me, daddy, you meant so well by this. But like, she's pretty, she'll marry well. Like, they weren't worried about me. Okay. I had, like, I was in the middle of my class in high school. I never studied, I never tried. My cheerleading was as important as my grade grades. And you know, I was popular and just kind of. They were like, go to college, don't go to college. It'll be okay.
- [59:35]
Monica Lewinsky
Mrs.
- [59:35]
Dr. Mary Claire Haver
DEGREE Right. And so. And then at the same time, they went through bankruptcy. The oil bust had happened in Louisiana, like in the, in the 80s, like, oil prices tanked. And so my parents restaurant was tied to the success of the oil business with all the, you know, wining and dining that was going on. So, like, my parents were lost their home. We had to, you know, we're living in a rental. They were working for friends Like. Like, it was a really tough time. So that was crystallizing, like. And I watched my aunts go through some pretty tough divorces and, like, have to move into subsidized housing and stuff. And I was like, I don't want that to happen to me.
- [60:08]
Monica Lewinsky
Yeah.
- [60:08]
Dr. Mary Claire Haver
So I kind of knew you need to have a career. Like, not because you need to have a career, but because you need to be able to support yourself if whatever, marriage doesn't work out despite my parents, like, get married, you know? And so I go to college. Like, what am I gonna do? I don't know. You know, I had okay grades. All my friends went off to lsu, but I couldn't afford that, so. Which is in Baton Rouge, like, an hour away.
- [60:28]
Monica Lewinsky
I had a handbag company that was.
- [60:30]
Dr. Mary Claire Haver
Oh, in Louisiana. Okay.
- [60:31]
Monica Lewinsky
In Baton Rouge, so. Oh, wow. So I spent a lot of time there. So.
- [60:35]
Dr. Mary Claire Haver
Both my girls went to college there, so. Yeah. So I couldn't afford it. I stayed home, walked. I was a mile away. I could walk to class and so. And tuition was $400.
- [60:46]
Monica Lewinsky
Oh, my gosh, back then.
- [60:48]
Dr. Mary Claire Haver
So I go and I'd, like. I think I picked business or something. I didn't know what I was doing. And then my first semester, I failed two classes pretty much because I didn't drop them properly. But, you know, and I quickly, like, had this come to Jesus moment. Like, you're gonna end up in a mobile home that you don't want to live in with a guy who beats you. Like, I was like, worst case scenario of what one of my aunts went through.
- [61:09]
Monica Lewinsky
Yeah.
- [61:10]
Dr. Mary Claire Haver
And if you don't get your shit together, because this is your take, you know, And I had never done well, well in school, so I took a bunch of ologies and I made myself. And I made this promise to myself that I was going to get an A in everyone.
- [61:23]
Monica Lewinsky
Wow.
- [61:23]
Dr. Mary Claire Haver
So geology, Biology. Yeah, I forget. I took, like, three or four science classes that semester, and I just buckled down, and lo and behold, I was smart. Turns out I was good at academics. I had no idea. So I was like, whoa. And all of a sudden, I'm getting this new validation. Like, people like, oh, look at you. You made 100 on this. And I'm like. I'm like, I love this feeling, you know, Like, I want to keep going in this direction. So I took another geology class because I did really well. The professors were, like, patting me on the head and telling me how smart I was, and I just kind of kept taking the classes, and they're like, why don't you change your major? I'm like, me. And you're like, we have money. And I was like, oh. So suddenly I had a full scholarship, a full rise. I'd have to worry about tuition anymore. And I'm doing something I really love.
- [62:09]
Monica Lewinsky
Yeah.
- [62:09]
Dr. Mary Claire Haver
As an undergrad, and they're taking me to the mountains, and I'm learning about rocks and crystals and all this cool, fun stuff, and I was really, really good at it. Turns out I'm just really good at science and seeing things in three dimension and picking out patterns. And so I get my undergrad, I start working for an oil company, and then realize this is not right. My path.
- [62:31]
Monica Lewinsky
Right.
- [62:32]
Dr. Mary Claire Haver
You know, did a stint in grad school in New Zealand for a semester, like, and kind of there, I kind of got away from all the, you know, my parents and everything. You have to. This actually had a PhD lined up in geology.
- [62:43]
Monica Lewinsky
Okay.
- [62:43]
Dr. Mary Claire Haver
And so all funded, paid for, and then decided if I'm going to back out, I have to do something amazing. And, like, medical school was on that list, and so took the mcat, and here we are.
- [62:55]
Monica Lewinsky
I. I admire the risks, like, the chances you've taken on yourself. That's sort of something I hear, like, throughout all of our chat, is you've taken a chance.
- [63:08]
Dr. Mary Claire Haver
It turns out I'm not afraid to pivot. Yeah.
- [63:11]
Monica Lewinsky
But, I mean, but I think, especially for women, I think that's not always easy.
- [63:19]
Dr. Mary Claire Haver
And I think the most unhappy time in my life was when I couldn't pivot. You know, those years where I was a mom and the kids were little and Chris was building his career, and I kept feeling this, like, friction of, I'm stuck, I'm stuck, I'm stuck. And that, to me, is the worst feeling in the world about being stuck and not being able to create change. And then once I got to a position in life where things were getting paid off, the kids were older, they didn't need me as much, and then I could, like, throw the wrench in and pivot. So.
- [63:46]
Monica Lewinsky
Yeah. Yeah. It's interesting. Talk to me about your new podcast, Unpaused.
- [63:51]
Dr. Mary Claire Haver
Unpaused.
- [63:52]
Monica Lewinsky
Right.
- [63:53]
Dr. Mary Claire Haver
So, you know, seems like lots of people are having podcasts now, so it feels a little bit cliche. But I felt, you know, I've been on so many now, and, you know, I'm so excited to be here. I'm like. And I thought, I think there's a message that I can help deliver, and I can bring out voices I want women to hear. And a lot in the medical space But I want bigger than that. I want to show that the woman sitting on my, my thought is always to for when I'm talking on social media, the woman on the couch in Ohio, you know, like, she's my focus. Who doesn't have the access and the resources, like what can I give her to help her make her life better? And so that's what I want to do with this podcast. Let her know there's life after reproduction ends, you know, and this life can be absolutely amazing and wonderful. And who can I bring on the show to give her tools? Whether it be, you know, an author, a researcher, a scientist or, you know, anybody really that is really taking the bull by the horns and making this the best third of their lives lives. So that's why I'm doing it. And so unpaused means we're not going to use menopause or post menopause this last 30, 40 years of our lives. And we're not going to be quiet, we're not going to be small, we're going to be big. We're going to be loud. We're going to take back control and live the best lives that we deserve to.
- [65:14]
Monica Lewinsky
Oh my God. Amen. Well, you've got your new book coming out as well next year, right?
- [65:19]
Dr. Mary Claire Haver
Yeah. April, the new Perimenopause.
- [65:22]
Monica Lewinsky
Yeah. I wish that had had been around when I was, when I was younger, but you're helping women reclaim so much and. Thank you. The question I ask everybody at the end is if, you know, like what are you working on reclaiming personally?
- [65:38]
Dr. Mary Claire Haver
Me? Yeah, me. Now that I've.
- [65:40]
Monica Lewinsky
I've.
- [65:41]
Dr. Mary Claire Haver
I'm done with, you know, I'll always be a mother but they're grown, you know, I'm solidified in my partnership. You know, like of course, course we have our moments but you know, we've been together over 30 years. Congratulations. And you know, and he's totally supportive. Like he is basically retired and is now backing me up in this business. And I am want to live my best life and I don't want at the end of the road to have the same path that you know, less way more options than my grandmother and my mother did. My grandmother spent the last 10 years years of her life in a bed.
- [66:18]
Monica Lewinsky
Yeah, mine too.
- [66:20]
Dr. Mary Claire Haver
Incontinent. Alzheimer's. We didn't know what it was Alzheimer's back then. Absolutely arthritis.
- [66:25]
Monica Lewinsky
Not my maternal.
- [66:26]
Dr. Mary Claire Haver
Completely debilitated in loss of independence and miserable. You know, and would not kept telling me I wasn't always like this. Do you remember when I used to play with you. Do you remember? And before she could, she didn't talk in the last two or three years. But, you know, and I'm. Mama's pretty much going down the same path now. It took her mid-80s, but I'm like, I want better, and I want better for my girls. I want better for our nieces and all the women coming up behind us, all these perimenopausal women, like, they deserve better. Men live shorter lives, so we live longer than men. We rent on what I see the wellness bros and longevity bros spouting their new gadget and all this stuff. I'm like, that's not gonna make my patients. They're not coming in wanting to live to 120. They don't want to live without their loved ones. I have no desire to live that way.
- [67:13]
Monica Lewinsky
Zero.
- [67:14]
Dr. Mary Claire Haver
What I want to do is not lose my independence. I want to be independent until the day I die. So take care of myself, drive, cook, whatever, but that I am not. My daughters are not interrupting their lives to come and take care of mama. So I'm trying to stack as many cards in my favor so that whatever time that period is is as short as possible.
- [67:36]
Monica Lewinsky
Wow, that's great. Thank you.
- [67:39]
Dr. Mary Claire Haver
You're welcome.
- [67:41]
Monica Lewinsky
Reclaiming with Monica Lewinsky is hosted and executive produced by me, Monica Lewinsky production services by WTF media studios. Our theme song is by Ben Benjamin and our music supervisor is Scott Velasquez. Our story producer is Elna Baker and our senior producer is Megan Donis for Wondery. Eliza Mills is the development producer. Our managing producer is Taylor Snippet. Nick Ryan is our senior managing producer. Senior producers are Candace Manriquez Wren and Emily Feldbring. And executive producers are Dave Easton, Erin o' Flaherty, and Marshall Louie.