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Dr. Karen Adams
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Natalie Brennan
I'm thinking about it because I just turned 29 and a great age, a perfect age. My friends keep doing this bit that no matter how old I turn, they keep saying, a perfect age for a woman. So it was like 27, the perfect age for a woman. And I turned 28. Perfect age. Now, once again, somehow, I've turned the perfect age for a woman. But I always remember thinking, like, 28 for some reason really stood out to me as the time that I thought a lot of my life would be together. And now that I'm past that age, it's so funny to me to think that I thought that everything would magically be figured out at that time. But I find myself now just being like, 34. 34. It's gonna work out for me by 34, which I know then I'm gonna turn 34 and laugh at that and be like, what I thought was 34 is actually 42.
Yasmin Tayag
Well, I'm 37. And it's funny. When I was a kid, I thought 37, you know, like my parents, I would have it all together.
Natalie Brennan
Yeah.
Yasmin Tayag
I don't know what I'm doing.
Natalie Brennan
We're still just us at every single age. It's just gonna be me at every age.
Yasmin Tayag
Yeah. But there's something comforting in that, to think that, like, oh, nobody really has it together at any age. They're all. Everyone's just figuring it out as they go along. I'm Yasmin Tayak, a staff writer with the Atlantic.
Natalie Brennan
And I'm Natalie Brennan, producer at the Atlantic.
Yasmin Tayag
This is how to age up.
Natalie Brennan
I'm very aware of the fact that 20s, 30s aren't the typical zone that people think of when they think of aging. But we are all always aging, Right?
Yasmin Tayag
We're always aging.
Natalie Brennan
And at different life stages. Some of us are thinking about it more than others. Like, there's this big cultural hype around turning 30. And, you know, I'm a girl who spends a lot of time on the Internet. And let me just say, the Internet is not usually a space that promotes positive ideas of aging for young women.
Yasmin Tayag
Oh, really?
Natalie Brennan
Yeah. I don't know if you've heard. I'm reporting it live, but, I mean, I'm thinking about even last year, the fashion trends revolved around bows. Everything leaned very coquette in aesthetic. That in some ways, does promote an infantilization of women.
Yasmin Tayag
I totally agree. But I do actually think there's been a recent shift happening in terms of how we think about aging. You know, I wasn't excited about my 30s. When I was growing up, everyone I admired in pop culture was in their early 20s, Max. And now we're seeing celebrities who rose to fame in their 20s become even more sexy and powerful as they turn 30 or 40 or 50. Like Chloe Sevigny, Alexa Chung, even Beyonce. They're just owning their age, and they're modeling that getting older can still be sexy and powerful.
Natalie Brennan
Extremely.
Yasmin Tayag
When I turned 30, the big thing I noticed was that, like, oh, I like myself more. I'm more comfortable in my skin, and.
Natalie Brennan
I'm really grateful that in my personal life, I have so many amazing models of. Yeah. People in my life who are in their 30s who just. Yeah. Seem to be more confident and more sure of themselves.
Yasmin Tayag
I hope I'm one of those people.
Natalie Brennan
1000% one of those people.
Yasmin Tayag
Natalie. You know, as I'm approaching my 40s, I've been thinking a lot about how I'm about to enter a new stage of life.
Natalie Brennan
Yeah.
Yasmin Tayag
So I can help you through your 20s and 30s, but I'm looking for someone to help me through my 40s and my 50s and beyond.
Natalie Brennan
And does that feel exciting or does it feel scary?
Yasmin Tayag
Well, I'm hoping to go into it with a positive mindset.
Natalie Brennan
Yeah.
Yasmin Tayag
Especially the perimenopause of it all.
Natalie Brennan
Totally.
Yasmin Tayag
And someone for me who has really reframed what getting older can look like is Dr. Karen Adams. Dr. Adams is an OB GYN and she's the director of the Stanford Program in Menopause and healthy aging. Dr. Adams, tell me how you describe your profession to someone at a cocktail party.
Dr. Karen Adams
Well, I used to say that I deliver babies But I don't do that anymore. And actually people are much more interested when I tell them that I. I was recruited about two years ago to create and lead a program in menopause and healthy aging. And people's eyes light up. Right? I mean, everyone wants to age in a healthy way. And of course, you'd have to be living under a rock to not know that menopause is having not even a moment. It's a movement. People are very interested in perimenopause and menopause. Before I went to Stanford, I was in charge of training all of the OB GYN residents at Oregon Health and Science University. And one of the requirements for the training was that they get trained in care of what was called then older women. And they were coming out of training really well, well versed in delivering babies and operating and contraception and all these different things. But they actually weren't learning how to take care of women over 40. And so I established this clinic that we called the over 40 clinic. I'm doing air quotes now. Now, we know menopause can happen really at almost any age through premature ovarian failure or insufficiency or early menopause. So it isn't really age dependent. It's been 20, 25 years ago that I established that clinic, and it just became more and more my clinical focus.
Yasmin Tayag
It's shocking to hear how little focus there was in medical schools on menopause. Like, if there's a knowledge deficit in doctors, how much worse would it be culturally, like with the general public?
Dr. Karen Adams
It's one of the huge issues right now is that people with ovaries. Not everyone identifies as a woman, but I'll use that term as we're talking, simply because that's what the terms are in the research and such. But. Right. You know that women are becoming much more educated about this sometimes than their providers are. There was a lot of fear around being on hormones 20 years ago because this big study came out and said, wow, it increases the risk of heart attack and stroke and blood clots and breast cancer and all these things. And people freaked out and everybody went off their hormones. And we're still working to undo those messages. And medical students, residents, people who were in training for about 15 years, didn't get taught about hormones or menopause. So there is some catching up to do.
Yasmin Tayag
Okay, so I want to come back to the specifics of the Women's Health Initiative study on hormone therapy. But first I'm hoping to talk to you more about the misconceptions about menopause on the whole that you're hearing these days?
Dr. Karen Adams
Oh, probably most often that it is the end of something and that people feel mournful about the process and they feel like it means their best years are behind them. And the reality is there is a thing called menopausal zest and it is a real thing. And I'm here to tell you that your mother and your grandmother are pretty much having a good time. It's the transition that's hard. You know, perimenopause is hard because you're going through a lot of changes and what is your normal is now different. And so that transition is challenging. But oh my goodness, once you get through it, women rate they are happier at their work, in their relationships, with their partners, in their overall well being, their feeling of knowing who they are and being comfortable with that. You know what's funny is, you know, the decade of life when people are the most unhappy, what age would you think that would be? 50s, 20s.
Yasmin Tayag
Wow. 20s, really?
Dr. Karen Adams
Teens and 20s. And then people get happier in their 30s and kind of early 40s. And then there's kind of a little dip, late 40s to mid-50s, people kind of are struggling a little bit. People just get happier and happier. 60s people are happier. 70s people are even happier. So, you know, as long as you've made the kind of choices that you want to make to really age in a healthy way. Now, certainly some of it is our genetics, some of it we have to play the cards we're dealt. But our lifestyle choices have so much impact on how healthy we are in our 70s and 80s. And there's a real correlation between our health with our overall happiness and well being.
Yasmin Tayag
I mean, I'm in my late 30s and I'm starting to come across quite a bit of menopause content on social media. But a lot of it still seems to focus on the negative stuff. Hot flushes and mood swings will happen, brain fog, sleep challenges, anxiety. And you know, that's the stuff people hear and it gets all the attention. But what I would love to hear from you is what is good about menopause that we're missing?
Dr. Karen Adams
It's really, really a part of the story that deserves a little more attention. That it really is so wonderful in so many ways. And menopause literally is one day in your life. It's that day when you have not had a period for a year and then for the whole rest of your life you are post menopausal. But that doesn't happen like flipping A light switch, right. It's not. You just have your periods every month and then all of a sudden they stop. So there's this period of time called the perimenopause, which is where things are changing and your periods become less predictable and less regular. And then you begin to space them out and then you start getting some symptoms and eventually you've had no period for a year. When your periods go away, all of a sudden, symptoms associated with your periods go away. So, buh bye pms, buh bye pelvic pain or cramping. Some people get menstrual migraines. Endometriosis is another example of a condition that is very cyclic and very related to your monthly cycles. And so once your periods are gone, those tend to go away. So that's a huge benefit that we don't talk about very much, you know, because your periods have gone away, you're not worried about getting pregnant. And people's sex lives often improve because they're just, they just enjoy that freedom. You know, maybe you end up not needing to think about your diaphragm or your cervical cap, counting your cycles if you're doing natural family planning. It's just freeing to not be thinking so much about contraception.
Yasmin Tayag
So is it just that the symptoms of menstruation suddenly lift and that's what leads to the menopausal zest, or is there something more that's gained?
Dr. Karen Adams
It's just a time in a woman's life when there's some just stepping into your power. That sense of, I know who I am and I really had a lot of the experiences and life learnings that got me to this point. And hey, you know, I've got half of my life still ahead of me. What am I going to do with it now? My kids are almost raised, you know, they're in college. It's great. You know, I can have sex in the kitchen if I want to. Which is what one of my friends said when I said, well, your last kid's going to college, what are you gonna do? And she said, have sex in the kitchen.
Yasmin Tayag
Amazing.
Dr. Karen Adams
And that is menopausal zest.
Yasmin Tayag
Amazing. Hey, go wild, right?
Dr. Karen Adams
Why not? Right?
Yasmin Tayag
Yeah.
Dr. Karen Adams
Sex is supposed to be adult play. It's supposed to be fun. It's not supposed to be a burden. You're not supposed to feel guilty that you're a crummy partner and you wish you wanted it and you don't. Sex is for as our own well being. You release endorphins, you feel happier Pain becomes less, less intense. It's a great way to manage pain. So I talk to my patients about embracing themselves as a sexual being and trying to get back in touch with what I call your erotica menu. Everyone has an erotica menu of things they like, right? Some people like porn, some people like a back rub, Some people like erotic literature. My point when I talk about that with my patients is, remember who you are, remember what you like, and stop thinking so much about what you wish you were giving to your partner. Instead, ask for what you want. Think about what works for you. Now, I'm not at all saying that someone can't have menopausal zest and have a thrilling, wonderful second half of your life and not be sexually active. That's fine. Some people are fine not having sex. I'm not worried about anyone's sex life unless it's an issue for them. But the majority of my patients over age 70 are sexually active, and they're having sex with no difficulty, no pain, no problems.
Natalie Brennan
Yasmin, I've been thinking a lot about how our beliefs about aging are often tangled up with our beliefs about appearance.
Yasmin Tayag
I can say for myself those two things feel pretty intertwined.
Natalie Brennan
And for me, too. And, you know, we don't talk that much culturally about sex in older age. Maybe because we're just inundated with this problematic idea that as you age, your sexual importance decreases. Like, I'm even thinking about how beauty products are literally being marketed as anti aging, which perpetuates this false dichotomy between aging and desirability. Like, you must not age so you can stay desirable.
Yasmin Tayag
Right. I mean, the messaging right now is how can you freeze your body in place for as long as possible to keep looking the same age forever?
Natalie Brennan
Yes.
Yasmin Tayag
It reminds me of this story I wrote for the Atlantic about baby Botox.
Natalie Brennan
Which, to clarify, is not babies getting Botox, but refers to the amount of Botox that people are getting, which is a baby dose.
Yasmin Tayag
Yes. Like, baby Botox is this idea that you start getting small doses of Botox early on when you're very young and don't have any wrinkles, and you can kind of freeze yourself in place. When I was in college, my side gig was working in a doctor's office who did Botox. And I would see all of these moms come in with their teenage daughters in Tower. The idea is that if you never move the muscles that give you wrinkles, you'll never get the wrinkles right. I wrote about this last year, and apparently the number of 20 somethings who got Botox or other injectables jumped 71% from 2019 to 2022.
Natalie Brennan
That is a huge jump.
Yasmin Tayag
Yeah. And full stop. If it works for you, amazing, right? That's your choice. But this conversation with Dr. Adams has had me thinking that when we try to freeze our bodies or faces or what have you in a particular period of time, what benefits are we missing out on? You know, are there benefits to looking older? I remember being in my 20s, starting out in my first job, and, you know, just kind of being dismissed for looking so young and naive. I remember once a older man told me that he, like, looked at me and said, one day, when your face has more gravitas, you'd make an excellent news anchor.
Natalie Brennan
What?
Yasmin Tayag
Looking back, it was a weird thing to say, but I wasn't offended at the time. I'd taken it as a compliment. You know, he was saying I was pretty enough to be in front of the camera someday. But now I can see how. He also suggested that I. I didn't look serious enough to deliver news because I was pretty and young.
Natalie Brennan
I hate that. And unfortunately, I think so many of us can relate to that.
Yasmin Tayag
Right.
Natalie Brennan
This sense that if you're young and attractive, you can't be a serious person. But once you become older and serious looking, there's a flip side that then you aren't seen as attractive. And of course, it can be very gendered. Young men aren't dismissed as easily.
Yasmin Tayag
Nope.
Natalie Brennan
And I think it comes from women largely being seen as sexual objects until they're not.
Yasmin Tayag
Right. I mean, on some level, I imagine it would be liberating to reach an age where we aren't being evaluated primarily on our looks.
Natalie Brennan
But I don't know, it feels like you're either too sexualized or you're not seen as a sexual being. And I think both can feel really loaded.
Yasmin Tayag
Totally. And that tension is something that Dr. Adams and I spoke a lot about.
Dr. Karen Adams
So funny, right? We're either too young or we're too old. If we have been valued for our appearance and our external attributes, it can be really challenging to age and to find that part of ourselves changing. I think we have to avoid internalizing those messages. You know, it's the work of a lifetime. And I remember being a young OBGYN surgeon, and I went into the holding area to meet my patient that morning to see her, because we were getting ready to do her hysterectomy, and I met her husband for the first time, and we talked and I said, okay, this is what's going to happen. Do you have any more questions before we go back? And he said, yes, when are we going to meet the surgeon? And I said, that would be me. And he said, you, you're going to do the surgery? And I said yes. And his wife was so embarrassed. She was like, oh my gosh, I told, you know. But now I like looking older because people think I know more, right? Cause I'm a doctor. So it's like, you know, you want your doctor to be experienced and all of that. But boy, if I were an actress or if I were something where it's all about your physical appearance, that would be tough. But I think all of the messages that we get have to be shifted a little bit. We should be working out to be strong, not to be thin and focus on how the choices that you make will promote your physical and emotional well being. And if we're lucky, we have parents that teach us to listen to ourselves and trust ourselves. And we learn that from an early age. I think we're teaching people more to trust themselves and it'll be interesting to see how that changes the experience of aging for your kids, you know, because I think people are much more aware of the importance of that than we used to be.
Yasmin Tayag
After the break, Menopausal zest sounds awesome, but what about the symptoms so many women struggle with during the transition?
Natalie Brennan
If you're enjoying this podcast, you should know that you can get more from your favorite Atlantic voices. When you subscribe to the Atlantic, a subscription gives you access to all our award winning journalism and you can listen to as many articles as you want online or in the Atlantic app. Your subscription helps fuel our journalism online, in the magazine and on our podcasts. So subscribe today@theatlantic.com Podsub.
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Yasmin Tayag
Yes.
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Yasmin Tayag
Dr. Adams, we've talked a lot about the benefits of menopausal zest, but I'm curious about the transition through. It is a transition, right?
Dr. Karen Adams
Oh, absolutely. It's really unmistakable because it's physical. You know, there are physical changes happening and so sometimes we go through emotional changes and transitions. But boy, menopause is a physical one. It is something that ushers in this new era of your life. But I think that one of the keys for menopausal quality of life is having good healthcare that you're not suffering with hot flushes, night sweats, sleep disturbance, mood disturbance, joint pain, brain fog, vaginal dryness. And that's one of my huge missions at Stanford in our program in menopause and healthy aging is teaching other providers how to take care of these folks because a lot of people were not trained. Women deserve high quality healthcare and the state of our, of the current situation is shameful. We can't blame people for not knowing things they were not taught. But it behooves those of us who do have that expertise to share it. And one of the best resources is through an organization called the Menopause Society, which is an organization that certifies menopause experts. So you can go on their website and put in your zip code and a whole bunch of providers who have been certified in menopause will come up and you can find someone in your area who can help you get through this. Because this is not something you want to do without a roadmap. You need a roadmap.
Yasmin Tayag
What does that roadmap actually look like? What are some practical things that people can do to actually manage what they're going through?
Dr. Karen Adams
Right, right, right. Well, I can take people's hot flushes and night sweats away in about three weeks with some estrogen. So if it's to menopause, it's highly, highly, highly treatable. And the only people who shouldn't take estrogen are people who themselves have had a heart attack or a stroke, people who've had breast cancer with certain types of hormone receptors, possibly people who've had a blood clot in their leg or their lung or their brain, some types of hormone sensitive cancers. But most people can be on hormone therapy and that's estrogen. And if, if you have a uterus, you're on progesterone as well. Night sweats are part of the reason that people have difficulty with sleeping, but some of it is because of anxiety. And so we talk to our patients about some techniques for mindfulness, for mindful breathing, some different things to help you get out of your head and be able to get back to sleep. There's a thing called cognitive behavior therapy that is the most beneficial for sleep disturbers and mood disturbance in menopause. And it can also decrease the bother of hot flushes. Everyone should do it. It is such a powerful tool for dealing with all the stresses of life. And so that's something I talk to all my menopausal patients about, is find some cognitive behavior therapy resources. It will really, really help.
Yasmin Tayag
Okay, so I wanna go back to hormone therapy because there's a lot of misunderstanding about what it can do and the risks involved. So what happened with the Women's Health Initiative study and how is it reflected in the number of women on hormone treatment today?
Dr. Karen Adams
So less than 2% of people who are candidates for hormone therapy are actually on hormone therapy, which is so awful. The Women's Health Initiative was the biggest trial in women's health at that time, and I believe to date it was 165. And it's not that it was a bad study or that it was harmful. What the Women's Health Initiative did was they enrolled people between the ages of 50 and 79 and started them all on hormones. They had not been on hormones before. And lo and behold, what we found is the people over 70 were the ones who had heart attacks, strokes, blood clots, et cetera. And the people between the ages of 50 and 60 actually had benefits. And now we have 20 years of follow up data, and we found that those people have not died of heart disease more than people who were not on hormones, nor have we had increased numbers of deaths of breast cancer. So that is the part of the message that we really have to be clear on. When you're under 60 and you don't have any of those absolute contraindications, it's really a window of opportunity. And the risk of breast cancer with it is like eight extra cases per 10,000 women. The risk of breast cancer is greater with a sedentary lifestyle or alcohol intake more than one glass of wine a night, or being obese. And people worry so much about hormones when they don't even think about the fact that they're sedentary and they're overweight. So those are much Bigger risks for breast cancer. So we do talk to folks now. If they're under age 60 or less than 10 years out from menopause, they're gonna get tremendous benefits on hormones. And we're working hard to get that message out.
Yasmin Tayag
Are you worried at all that as people realize hormone therapy could be safe for them, that there's a risk, that it starts to be seen as a cure all? You know, we see that so often in the wellness space.
Dr. Karen Adams
We recognize we have so much control over our health and that rather than looking for the answer in a supplement or some pill that you take. Although there are certain, certainly values to taking pills, and I'm not saying there isn't value to that, but when people come to me and they say, if I go on hormones, will I prevent dementia? My mother had dementia, I don't want it. If I go on hormones, will it prevent me from getting dementia? I say, we don't really know. We know there's some benefit in the brain when people are on hormones, but we do know what decreases the risk of dementia, and it is, don't smoke, minimize your alcohol intake, exercise, eat mostly plants, manage any chronic health conditions you have, like high blood pressure, diabetes, things like that. And stay connected to your family and friends and your community.
Natalie Brennan
Yaz. You know, it's really amazing to hear this conversation about women embracing rather than defying aging, because so much of what we hear about right now in the longevity space is focused on trying to eradicate aging altogether. And I do wonder if there is something about a very physical transition like menopause that almost forces women to reckon with aging. Like, you can't ignore what's happening to your body when it hits you all at once. It's not something you can compartmentalize or ration yourself out of. It's a part of your everyday. And maybe people who don't go through such a sudden shift miss out on.
Yasmin Tayag
Yeah, I mean, men go through changes, too. As they age, they experience things like a lack of energy, weight gain, sleep problems, sexual issues. And there's been some effort to classify these changes as menopause, the male version of menopause. But there's a lot of pushback on this idea because it's just not the same thing. What men go through isn't caused by a sudden shift in hormone levels that leads to huge transformations in their body. It's not like their testosterone suddenly nosedives the way estrogen does.
Natalie Brennan
Right.
Yasmin Tayag
It decreases a little, but very gradually over a long period of time.
Natalie Brennan
Yeah.
Yasmin Tayag
So there may not be A moment or a life period that marks or reinforces aging in the same visceral way.
Natalie Brennan
Right. I mean, I cannot see manopause going over very well right now in the current cultural zeitgeist. But regardless, I think one thing that might be important to remember right now is that these internalized ideas that Dr. Adams has been talking about in regards to aging, they affect all of us, people of all genders. So recognizing them, unpacking them, working through them, that's more of a call to everyone.
Yasmin Tayag
You know, throughout this conversation, I couldn't help but notice you've said, we know now so many times, which is amazing because it means, yes, we know now. Menopause can be awesome. So why are we so stuck on this narrative?
Dr. Karen Adams
Ah. Why are we? And I have to tell you, I would rather be 66 as I am now than pregnant. No question. No question. I mean, I wouldn't be 35 again for anything. You're trying to figure out your career. You're trying to figure out your partner. You're trying to figure out where you're gonna live. You're trying to figure out, are you gonna have kids? Where are you gonna raise em? What are you gonna do? There's so much going on in our 20s and 30s that is challenging and hard and physically, we're not getting much sleep, and we're trying to progress in our careers. And so much of that is resolved when you're in your 50s and 60s. It's so great. It's so great. Amazing.
Yasmin Tayag
Dr. Adams, thank you for the absolutely enlightening conversation. I am excited to enter my next decade in a way that I wasn't before we talked. So thank you.
Dr. Karen Adams
I'm so glad. I'm so glad. Come on in. The water is fine.
Yasmin Tayag
Natalie, as you know, I just adored this conversation with Dr. Adams.
Natalie Brennan
We are two huge fans.
Yasmin Tayag
And, you know, a thing I've been thinking a lot about is that intellectually, I understand the benefits of aging. I get that it can be great in all these ways. But emotionally, it's hard to undo all those assumptions. And I find it hard to trust that I, too, am gonna feel as awesome as she does at that age.
Natalie Brennan
Yeah. We can't know how we're gonna feel in this life stage that we're not in yet. What we do know is that we have this testimony and affirmation from older women who do know, and I do find that really comforting. You know, there's this poem by Mary Ruffley that this conversation really reminds me of in this way of acknowledging that from where you and I are at right now, we can't even really understand where we're gonna land because we just haven't gone through it yet.
Yasmin Tayag
Mm.
Natalie Brennan
And maybe that persists throughout your life. I remember sending the poem to my mom around the time she was going through menopause. And. And we both really love it and keep coming back to it.
Yasmin Tayag
Hmm. That's really sweet.
Natalie Brennan
And, you know, maybe it could be another point of reference for you, too. I'm going to read you the end of this poem.
Yasmin Tayag
I'm going to cry.
Natalie Brennan
If you are young and you are reading this, perhaps you will understand the gleam in the eye of any woman who is 60, 70, 80, or 90. They cannot take you seriously. Sorry. For you are just a girl to them. Despite your babies and shoes and lovemaking and all of that. You are just a girl playing at life. You're just a girl on the edge of a great forest. You should be frightened, but instead you are eating a lovely meal. You are cooking one. Or you are running to the florist, or you are opening a box of flowers that has just arrived at your door. And none of these things are done in the great spirit that they will later be done in. You haven't even begun. You must pause first, the way one must pause before a great endeavor, if only to take a good breath. Happy old age is coming on bare feet, bringing with it grace and gentle words and ways which grim youth have never known.
Yasmin Tayag
That's all for this episode of how to Age Up. This episode was hosted by me, Yasmin Tayag, and co hosted and produced by Natalie Brennan. Our editors are Claudine Abade and Jocelyn Frank. Fact check by Enna Alvarado. Our engineer is Rob Smerciak. Rob also composed some of the music for this show. The executive producer of Audio is Claudina Baker, and the managing editor of Audio is Andrea Valdez.
Natalie Brennan
Next time on how to Age Up.
Yasmin Tayag
So I would say, yes, protein is essential, but also it's a trend, and trends come with noise. How to make sense of fueling our bodies and what to tune out. We'll be back with you on Monday.
David Frank
To preserve democracy, one has to believe in it. To believe in democracy, one has to understand it, where it came from, how it works, what's true, what's not true, what others did before you, how it could be better, how to make a difference. I'm David Frank, a staff writer at the Atlantic. I'm starting a new show where each week I'll dig deep into the big questions people have about our politics and our society. I'll explain progress that the peoples of the democratic world have made together and remind you that the American idea is worth defending. Listen to or watch the David Frum show wherever you get your podcasts.
Podcast Summary: How to Age Up
Episode: How to Wish You Were 66 Instead of 35
Host: Yasmin Tayag and Natalie Brennan, The Atlantic
Release Date: April 14, 2025
In the How to Age Up episode titled "How to Wish You Were 66 Instead of 35," hosts Yasmin Tayag and Natalie Brennan delve into the evolving science of aging and question whether our cultural narratives are keeping pace. Through personal anecdotes, expert insights, and thoughtful discussions, the episode challenges conventional views on aging, particularly focusing on women's experiences with menopause and societal expectations.
Navigating Perceptions of Age
Natalie Brennan opens the conversation by reflecting on societal notions of the "perfect age" for women:
Natalie Brennan [00:59]: "I'm thinking about it because I just turned 29 and a great age, a perfect age... 34. It's gonna work out for me by 34, which I know then I'm gonna turn 34 and laugh at that and be like, what I thought was 34 is actually 42."
Yasmin Tayag shares a similar sentiment, expressing the disconnect between expectations and reality:
Yasmin Tayag [01:54]: "Well, I'm 37. And it's funny. When I was a kid, I thought 37, you know, like my parents, I would have it all together."
The hosts emphasize that aging is a continuous process, often misunderstood and influenced by cultural hype, especially around milestone birthdays like 30.
From Infantilization to Empowerment
Natalie highlights the negative portrayal of aging women on the internet and in media:
Natalie Brennan [02:52]: "There’s this big cultural hype around turning 30... the Internet is not usually a space that promotes positive ideas of aging for young women."
Contrarily, Yasmin observes a positive shift in how aging is perceived, citing celebrities who embrace their age gracefully:
Yasmin Tayag [03:39]: "We’re seeing celebrities who rose to fame in their 20s become even more sexy and powerful as they turn 30 or 40 or 50. Like Chloe Sevigny, Alexa Chung, even Beyoncé. They’re just owning their age..."
Both hosts acknowledge that increased self-confidence and self-acceptance often come with age, leading to greater personal and professional fulfillment.
Introducing Dr. Karen Adams
The conversation takes a scientific turn with the introduction of Dr. Karen Adams, an OB-GYN and director of the Stanford Program in Menopause and Healthy Aging. Dr. Adams provides valuable insights into menopause and its broader implications on women's health and well-being.
Misconceptions and Medical Gaps
Dr. Adams explains the historical lack of focus on menopause in medical training:
Dr. Karen Adams [05:39]: "...before I went to Stanford, I was in charge of training all of the OB GYN residents at Oregon Health and Science University... they actually weren't learning how to take care of women over 40."
She highlights the significant gap in medical education regarding menopause, leading to widespread misconceptions and inadequate patient care.
The Women's Health Initiative Study
A pivotal topic is the Women's Health Initiative (WHI) study and its impact on hormone therapy awareness:
Dr. Karen Adams [28:19]: "The Women’s Health Initiative was the biggest trial in women's health at that time... we found that the people over 70 were the ones who had heart attacks, strokes, blood clots, etc., while those between 50 and 60 actually had benefits."
Dr. Adams emphasizes that hormone therapy is highly beneficial for women under 60 without contraindications, countering the fear-mongering effects of the WHI study.
Beyond the Negatives
The concept of "menopausal zest" is introduced as a positive outlook on post-menopausal life:
Dr. Karen Adams [13:24]: "It’s a time in a woman’s life when there’s some just stepping into your power... my friends rate they are happier at their work, in their relationships, with their partners, in their overall well-being..."
Benefits of Menopause
Dr. Adams outlines the numerous benefits that come with the cessation of menstruation:
Dr. Karen Adams [14:17]: "Sex is supposed to be adult play. It’s supposed to be fun... It’s a great way to manage pain."
Holistic Health and Lifestyle Choices
Emphasizing the role of lifestyle in healthy aging, Dr. Adams advocates for:
The Anti-Aging Industry
Natalie and Yasmin critique the pervasive anti-aging trends that prioritize perpetual youth over healthy aging:
Yasmin Tayag [16:58]: "The messaging right now is how can you freeze your body in place... What benefits are we missing out on? Are there benefits to looking older?"
They discuss the rise of "baby Botox" and its implications:
Yasmin Tayag [17:20]: "Baby Botox is the idea that you start getting small doses early to freeze yourself in place... The number of 20-somethings who got Botox jumped 71% from 2019 to 2022."
Double Standards in Aging
The hosts explore how societal expectations differ for men and women, highlighting the lack of a cultural counterpart to menopause for men:
Yasmin Tayag [32:35]: "Men go through changes, too... but it’s not the same as women’s menopause."
They argue that internalized messages about aging affect all genders and advocate for a broader cultural shift.
Developing a Roadmap
Dr. Adams provides actionable strategies for women to manage menopausal symptoms effectively:
Dr. Karen Adams [26:26]: "I can take people’s hot flushes and night sweats away in about three weeks with some estrogen..."
She stresses the importance of:
Balancing Hormones and Lifestyle
Dr. Adams cautions against viewing hormone therapy as a cure-all and underscores the importance of a balanced approach to health:
Dr. Karen Adams [30:32]: "What decreases the risk of dementia is... don’t smoke, minimize alcohol intake, exercise, eat mostly plants, manage chronic health conditions..."
The episode culminates with a poignant reflection on embracing aging as a positive and empowering journey. Yasmin and Natalie share their transformed perspectives, inspired by Dr. Adams' insights. A moving poem underscores the beauty and grace that come with age, encouraging listeners to look forward to the future with optimism.
Natalie Brennan [37:08]: "Happy old age is coming on bare feet, bringing with it grace and gentle words and ways which grim youth have never known."
The hosts leave listeners with a sense of hope and encouragement to redefine aging beyond societal pressures and embrace the opportunities that each new decade brings.
Notable Quotes:
This episode of How to Age Up serves as an enlightening exploration of aging, particularly addressing the female experience with menopause. By blending personal narratives with expert advice, Yasmin Tayag and Natalie Brennan provide a comprehensive and empowering perspective on aging that challenges existing cultural narratives and encourages listeners to embrace the natural progression of life.