← Today, Explained
Today, Explained
The perimenopause moment
00:30:09
Women’s health and hormones have been misunderstood by the medical establishment for decades. That’s changing.
Loading summary
Transcript85 lines
- [00:02]
Jonquin Hill
Support for Explain it to Me comes from Fetch Pet Insurance. Are you a pet owner? Every six seconds a pet owner in the US gets hit with a vet bill over a thousand dollars. Always an unwelcome surprise. That's according to a study from a pet insurance company. That's where Fetch comes in. Fetch is the most complete pet insurance for dogs and cats. According to consumeradvocate.org you get paid back up to 90% of vet bills at any vet in the US and Canada with claim paid back in as little as two days. Go to fetchpet.com save right now for your free quote. That's fetchpet.com save
- [00:46]
Olivia from Olli
hey friends. Olivia from Olli. Between new routines and the ultimate group project known as parenting, you need science backed solutions that work with your life. That's where Ollie comes in. Start your mornings off right with multis made to support nutrition and immune health. Choose from our lineup of gut supporting probiotics and we've got occasional sleep support to help the fam chase their big dreams. Head back to class with the number one Gummy supplement brand. Stock up on ollie.com today. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
- [01:17]
Dr. Heather Hirsch
Oh my gosh.
- [01:18]
Elizabeth Komen
Perimenopause.
- [01:20]
Dr. Heather Hirsch
Holy jamoly.
- [01:22]
Jonquin Hill
And I'm a little bit in denial about it. I'm not gonna lie. I'm at a point that I'm starting to think maybe this is the beginning. But then I just don't know.
- [01:35]
Amy Sibel
So my name is Amy Sibel. I live in Oregon.
- [01:38]
Jonquin Hill
One day Amy looked in the mirror and noticed something was different.
- [01:43]
Amy Sibel
I started getting curly hair. I had always had long straight hair. I know.
- [01:47]
Jonquin Hill
But then some very not fun things started happening.
- [01:52]
Amy Sibel
Night sweats were the most disruptive and horrible. Cramps, heavy bleeding like oh my gosh, what is wrong with me? And then also emotional impacts like it was. I was clearly feeling more anxiety and dread, none of which were fun at all.
- [02:07]
Jonquin Hill
She had her suspicions, but she was 41, on the young side for menopause. Besides, she was still getting her period. But the symptoms kept coming.
- [02:19]
Amy Sibel
Acid reflux really bad. And went through a whole year of like endoscopy and changing diet and not eating after 5pm no red wine, no chocolate, sleeping on a slanted bed. And that was happening kind of on this side path at the same time that I was speaking with my my physician and she eventually, after about a year, put me on oral birth control. Within days my acid reflux went away. Just gone.
- [02:51]
Jonquin Hill
Turns out Amy had begun the change before the change, a nebulous period that doctors now call paramenopause. It can last for years. It impacts a ton of people, and it has a wide range of symptoms. I had random. What I thought was random panic attacks was like being run over by a truck. Brain fog, frozen shoulder, debilitating exhaustion.
- [03:16]
Elizabeth Komen
Kind of feeling like I was getting
- [03:17]
Dr. Heather Hirsch
the flu every month, really, around my cycle.
- [03:22]
Jonquin Hill
And yet, when it comes to women's health, there's a ton that modern medicine just hasn't figured out yet. Why is that? I'm Jonquin Hill, and this week on Explain It To Me from Vox, we're going to talk about it. Okay, to start, we gotta define some terms.
- [03:50]
Dr. Heather Hirsch
Menopause is technically when it's been one year where a woman hasn't had periods. And perimenopause is all the time leading up to that, which can be a decade for many women.
- [04:00]
Jonquin Hill
Heather Hirsch is an internist that specializes in treating women in midlife.
- [04:04]
Dr. Heather Hirsch
I think it is the biggest transition a woman will go through. And we think about puberty, and this is actually puberty in reverse. The biggest physiologic change is happening, which is that our sex hormones are declining. And so we know that there is a lot of changes in the brain at this time. The brain is changing in terms of both the sex hormones and then also the neurotransmitters. And so that can change your mood, it can change your ability to process at fast speeds, to remember multiple things. These are things that definitely frighten women when they cannot remember their neighbor's first name. But it's common because all of these changes in the brain, we know the skin's changing the heart and the bone. So we know a lot of the physiology, I. E. The anatomy and things and. And what's changing and how that's experienced clinically, what women will say and feel. You know, there is a lot of things that happen to women that seem totally unrelated. So, for example, you could get the worst headache of your life all of a sudden in your 40s, and this is a migraine, and it's sometimes triggered by the rapid loss of estrogen palpitation. So all of a sudden you feel like your heart skipping a beat. This is really anxiety provoking. The first time you feel your heart, you almost wish you never knew you felt it. Women will talk about a new onset of ratches, itchy ears, dry skin. You may end up in the dermatologist's office. Right. Joint aches and pains. Here's A funny one. If you notice before your period, like, your hips are really stiff or maybe even your fingers or your knees, and then it seems to get better once you get your period and in the first part of your cycle. Perimenopause.
- [05:56]
Jonquin Hill
Okay. A lot of these things, though, could be other things. How do you know if it's perimenopause versus any other thing that makes your body do these things?
- [06:06]
Dr. Heather Hirsch
There's two things you can think about. The first is it's really helpful to track them. If it's perimenopause specifically, and we're talking about perimenopause, which is when women are experiencing symptoms, but they're still menstruating or they're still ovulating, they might have a cyclic pattern. So if you notice hot flashes or night sweats or mood symptoms that seem to go on a cyclic pattern, this is one very strong indication that it could be hormonal, because your hormones do have this cyclic pattern of about every four to five weeks, although, again, that will change as you get into perimenopause. The other thing is that sometimes, you know it's perimenopause when we actually start menopausal hormone therapy. Because if we are to start menopausal hormone therapy in sort of a diagnostic way, sometimes that really helps. Women say, oh, wow, it was hormonal. So let me give you the example of palpitations or the joint aches and pains. If we start menopausal hormone therapy and my patients say, wow, Dr. Hirsch, they're gone. That's also how we know it is hormonal.
- [07:12]
Jonquin Hill
I think for a lot of people, this can be really isolating because, you know, you feel like something's off, you feel like maybe something's wrong, but you can't get a clear answer. Why is that?
- [07:26]
Dr. Heather Hirsch
You know, I think it has so much to do with still the taboo and the shame on the topic, whether it's, you know, aging or it's just changing how culturally you're perceived. You're no longer someone who can reproduce. You're no longer getting your periods. Maybe you're no longer youthful, and your body is changing so much. So for many women, when they start to experience these symptoms, they start to feel socially isolated because maybe you are exhausted, you get home from work. It took all of your energy to get through work. Now you just want to take your clothes off. Maybe you've gained weight, you want to sit on the couch, you want to go to bed, and you just want to veg out I talk with women all the time, they still say, often in their friend groups or among their siblings. It's still not a topic that's easily talked about. Now these are changing, but still slowly. We feel like we've made such a big change. And a lot of that I do believe has to do with social media. But there's a difference between talking to avoid and actually talking to one of your best friends or your partners. It can feel more vulnerable when it's someone that's very, very close to you. There is still this idea that we have to suffer through this. There's this idea that that's what our grandmothers did and our great grandmothers and and so we should just suffer through it. And I am here to say to anyone listening that suffering not only is unnecessary, there's no metal at the end, but it will derail your health. And so what's been exciting in the last couple years is there's more and more and more acceptance of how to treat symptoms through perimenopause that they're safe, they're effective, and they can be life changing for the vast majority of women who start them.
- [09:17]
Jonquin Hill
Up. Next, we get into that life changing treatment and we bust some myths about it too. Support for Explain It To Me comes from Fetchpet Insurance. Here's something that might surprise you. Every six seconds, a pet owner in the US gets hit with a vet bill over $1,000. That's according to a study from a pet insurance company. Be prepared with Fetch pet Insurance. Fetch is the most complete coverage for dogs and cats. According to consumeradvocate.org fetch covers accidents, illnesses, diagnostics and more. Every vet in the US and Canada is in network. You can build a plan that fits your budget and once approved, claims are paid back in as little as two days. To learn more, go to fetchpet.com save that's fetchpet.com save.
- [10:27]
David Beckham (iM8 co-founder, ad voice)
Support for this show comes from iM8. Ever feel like you're cycling between whatever the hot supplement is but never sticking with one to see real results? Imaid is the way to simplify your supplement routine once and for all. Imate's Daily Ultimate Essentials can replace 16 separate supplements all in one drink for just $2.61 a day. That's 90 ingredients that can work across nine major organ systems. Imate was co founded by David Beckham and built by leading doctors and researchers. Which is to say IMAIT was designed by the world's best. 95% of people who tried it over 12 weeks felt more energy and that's from a clinical trial conducted by the San Francisco Research institute. Go to imaid.comexplained right now or click the link in the description to use Code Explain for a free welcome kit, five travel sackets plus 10% off your order. That's code explained@imadehealth.com explained. Code explained@imadehealth.com Explained. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Foreign.
- [11:42]
Jonquin Hill
I'm JQ back with more Explain it to me. And we're talking with Dr. Heather Hirsch about the pause before the pause. Paramenopause. So, Heather, to deal with their symptoms, a lot of people turn to hormone therapy. How does it work?
- [11:58]
Dr. Heather Hirsch
Well, you know, essentially what you're doing is you are replacing what you're missing. So there's lots of examples of where we do this. Diabetics, specifically, even type 1 diabetics, they don't have insulin, a hormone that helps them take, you know, carbohydrates, glucose, and utilize it well. And so we're kind of doing the same thing with menopause perimenopause, because your hormones are starting to low, get lower, and drop. We're replacing them now. We're replacing them in actually very low, low doses. And it can be extremely helpful for the places that the body is missing it. We've already talked about the brain, the heart, the bones, the pelvic floor, the skin. It can make a huge difference when we replace them.
- [12:42]
Jonquin Hill
I'd love a breakdown. Which hormones are we talking about and what are doctors looking for?
- [12:52]
Dr. Heather Hirsch
There's sort of three big ones if we think about the trifecta. And I always explain this as sort of an ice cream cone analogy when we think about estrogen. This is kind of if you're craving a Sunday, let's say, okay, it's a hot summer day. This is like the ice cream. This is the main ingredient. This is what you want to go down to the ice cream shop for. Estrogen, when it drops, can make us feel hot and dry. So that can be the hot flashes, the night sweats, the dry skin. It can make us feel like we have low mood or anhedonia or depression because estrogen actually keeps serotonin in the brain longer. It's a natural antidepressant.
- [13:31]
Jonquin Hill
Oh, okay.
- [13:32]
Dr. Heather Hirsch
And it also plays a role in keeping our heart and our bones healthy. So estrogen is kind of like the main ingredient. Now, progesterone is like the ice cream cone. It keeps the Estrogen safe or really, it's also protecting a woman if she has her uterus still. Progesterone in the brain converts to allopregnanolone, which binds to GABA receptors. And it makes you feel calm and sleepy. So many women, if they've ever had a pregnancy, will remember in their first trimester they can feel really tired. And that is the effects of progesterone. It's really, really increasing in that trimester. And then I think about testosterone as sort of the toppings of your Sunday. So maybe a little sprinkles, maybe a little cherry on top. Kind of really cinches things together. Not necessary. You could absolutely have an ice cream sundae. You don't need any toppings, Right? The ice cream is good enough. But some women like to have toppings. Testosterone helps with libido, for sure, and it can also help with reducing brain fog. It sometimes can help with reducing joint aches and pains and helping mood. More research needs to be done on testosterone. The vast majority of research in terms of these three hormones is actually on estrogen, then progesterone, and then testosterone, which actually isn't technically FDA approved for women.
- [14:58]
Jonquin Hill
I would love to know more about hormone panels. I feel like I've seen more and more people bring that up online.
- [15:07]
Elizabeth Komen
What does it take to get a full hormone panel?
- [15:10]
Dr. Heather Hirsch
Flat out? Say, I want a blood test, I
- [15:12]
Amy Sibel
want a full panel.
- [15:13]
Jonquin Hill
Ask specifically for a full hormone panel.
- [15:17]
Dr. Heather Hirsch
We are becoming data junkies. We love our whoop. We love our Apple watch, We love our aura ring. And all of those are okay. They just need to be taken in context. The most important thing for women to do is really that journaling and tracking. And if you can track what symptoms you're having in correlation with either when you're bleeding or maybe when you're ovulating, this is the most helpful thing. Because perimenopause, believe it or not, is a clinical diagnosis. And all that means is the clinician decides, which can be frustrating. Right. So women are trying to sort of get support and they're looking for a diagnosis. But if their clinician doesn't know what to do, but they're thinking, maybe lab work will help me. But there is no lab that tells you you are in or not in perimenopause. It's all about how you're feeling over, you know, a period of time.
- [16:09]
Jonquin Hill
Why are we so, I don't know, prickly when we hear the word hormones? Because I've seen it when people talk about perimenopause, and menopause and hormone replacement therapy. I've seen it with discussions online about birth control. Just like, no, hormones, hormones bad. Why do we have this kind of contentious relationship with hormones?
- [16:31]
Dr. Heather Hirsch
I think the word itself is very broad, right? When I hear the word hormones, I think of like, and this is sort of silly and personal, so this probably applies to no one else, but I think of like, agriculture, where they're injecting hormones into animals, right? They're doing it unethically and they're kind of disrupting our food supply, or so they tell us. Um, and so when we think about the word hormones, it sort of has a negative connotation to it. It just does. And I think that's part of the patriarchal and sexist society that we live in. Not that we need to go deep onto that. But again, the idea that the word hormone has become negative or has become tainted or is something bad is something that should make us sort of think, like, why do we even think that? Right. Interestingly, for perimenopause, we're actually very often using plant based estrogen or plant based progesterone in very, very, very low doses. And so when we think about it as estradiol or transdermal estradiol or prometrium or progesterone that mimics our natural progesterone. It feels different, right, A little bit, than just the word hormones in general. Hormones has this idea that we're like, you know, artificially injecting things into our bodies, but we make a lot of hormones every single day. And so, you know, I think that may be why. I think it's just that our perception, the media has shaped the. What this word means to us.
- [18:03]
Jonquin Hill
And it's not just perception that shifted. Even the way we study women's health has changed. That's coming up. Support for the show comes from Quince. The summer is full of opportunities to relax, and your wardrobe should reflect that. That means no uncomfortable, thick layers. Think nice linen sets and breezy vibes. Quince has all the well made summer essentials you need. They use premium materials like European linen, organic cotton, and washable silk. Without the traditional retail markup. Quince's 100% European linen pants, dresses and tops are the pieces you can reach for all summer long. They're lightweight, effortless to style, and start at just $32. And it's not just clothing. Quince offers everything from home to travel to everyday essentials. It's all affordable, too. All their Items are priced 50 to 80% less than similar brands. Claire White is our colleague here at Box and she's tried some stuff from Quince.
- [19:06]
Claire White
Here's what she thinks Everything that I've gotten from Quints for the summer has been awesome. They've got great tanks to great button downs, things you can wear both to the beach and to dinner. It's breathable, it's really well made and I just can't stop ordering from Quints.
- [19:22]
Jonquin Hill
Make your summer wardrobe easier. Go to quince.com explain it for free shipping on your order and 365 day returns. Now available in Canada too. That's Q-U-I-N-E.com explainit for free shipping and 365 day returns. Quince.com explainit.
- [19:43]
Claire White
Support for this show comes from Whatnot. It's hard to follow your business dreams and not enough people talk about the time and effort you have to put in to make your dreams a reality. Whatnot is the largest dedicated live shopping platform. Whether it's beauty, collectibles, electronics, luxury, fashion, even cookies, sellers are building real, thriving businesses. Instead of uploading a listing and crossing your fingers, sellers can go live, showcase products directly to viewers and answer questions as they come in and make some sales on the spot. According to their data across Whatnot, the number of sellers making over $1 million a year has doubled and people selling on whatnot sell 10 times more than on other major marketplaces. I tried out Whatnot and I had a really great time. I bought some really fun pieces from cool auction houses, some in la, some in Texas, people selling vintage clothes or brand new handbags. All in a fun live environment where you're able to chat with the salesperson, you're able to chat with your people bidding around you. It was great. Search Whatnot wh a t n o t in the App Store download and you can start selling right away.
- [20:56]
Jonquin Hill
The estrogen patch made the world of difference. I wish I would have had that two years ago. So why are primary care providers not being trained on that of a 40 year old woman's body?
- [21:10]
Claire White
Thanks.
- [21:11]
Jonquin Hill
Bye. This is Explain it to me. I'm J.Q. modern medicine has made so many strides when it comes to healthcare. Things that felt inevitably unpleasant don't have to be. But why does it sometimes feel like doctors are still playing catch up on some pretty basic aspects of women's health?
- [21:33]
Elizabeth Komen
Because it's true. It takes a long time for medical science to catch up with the glaring gaps in our healthcare system. And the gaps are not just about the obvious women's health issues.
- [21:44]
Jonquin Hill
That's Elizabeth Komen. She's an oncologist and a professor at nyu, and she focuses on the gap between women and modern medicine.
- [21:53]
Elizabeth Komen
We focus a lot on breast cancer. We focus a lot on reproductive function or our gynecological needs. But really the gaps also exist head to toe from our neurologic care, our gastroenterology care, how our hearts function, how our immune system functions, how our joint functions. And so the gaps are real and the experiences are real.
- [22:12]
Jonquin Hill
Can you walk me through some of the history? Like what did it look like to study women's health before the 20th century? What were we dealing with for much
- [22:22]
Elizabeth Komen
of history of medicine, at least in the Western world, the idea was that at best we were small men, and at worst there were many ridiculous diagnoses like hysteria and a long legacy of dismissing women's medical needs because we were largely not taken care of by women. And those women that were caregivers in the history of medicine, whether it was the midwives or other types of healers, were largely pushed out of medicine as it became codified. And the idea of medical science really came to rise in the late 19th century.
- [22:56]
Jonquin Hill
So I'm guessing they weren't really talking about menopause at the time, let alone perimenopause.
- [23:02]
Elizabeth Komen
Perimenopause wasn't anything that was even discussed with respect to menopause. I mean, one of the famous physicians wrote a book, Feminine Forever, and referred to women going through menopause as vapid cows. And he was the one that advocated in the 60s and 70s for women to be on hormone replacement therapy.
- [23:22]
David Beckham (iM8 co-founder, ad voice)
I have seen untreated women who had shriveled into caricatures of their former selves. She is incapable of rationally perceiving her own situation.
- [23:33]
Jonquin Hill
That's just such a wild way to refer to a group of people. I mean, just about half the population will go through this at some point. And you're just dismissing all of them as vapid cows.
- [23:45]
Elizabeth Komen
Pretty much. Pretty much crazy at best.
- [23:49]
Jonquin Hill
How were these hormones marketed to people when HRT first became a thing?
- [23:55]
Elizabeth Komen
Well, that this would help you be less crazy, that you would have more vigor. I mean, it depends on which advertisements that you look at.
- [24:02]
Jonquin Hill
Husbands too. Like Premarin. The physician who puts a woman on Premarin when she is suffering in the menopause usually makes her pleasant to live with once again.
- [24:12]
Elizabeth Komen
But if you look at advertisements of women in the 1950s, 60s and 70s, a lot of women were being just prescribed anti anxiety medicine. You know, can't manage your household at home. Don't want to take care of your kids? Here's what will sedate you and at least make you able to prepare breakfast for your husband.
- [24:31]
Jonquin Hill
Formerly nervous and tense, a Librium treated patient is better able to enjoy her family now. She can cope, thanks to Beaut, the daytime sedative for everyday situational stress.
- [24:48]
Elizabeth Komen
It's really shocking and yet not that surprising. If you look at Instagram today, are we really that far off from what gets marketed to women? Women sink billions of dollars probably into sham supplements and sham treatments because they don't feel cared for when they go to the doctor. And what fills that space? A lot of people trying to market things that have no proven evidence.
- [25:08]
Jonquin Hill
You know, I think it's, I think it's really interesting how at one point hormone replacement therapy was like this big thing. Because I feel like growing up in the 90s and 2000s, hearing women who are older than me speak, they were very kind of anti hormone. How did the pendulum swing that way?
- [25:29]
Elizabeth Komen
Well, the pendulum has swung in wildly different directions. So at first it was every woman needs to be on it. And there were, you know, wildly successful sales. And then there was the Women's Health study that over exaggerated the risk of breast cancer.
- [25:41]
Jonquin Hill
The announcement yesterday that a hormone replacement regimen taken by 6 million American women did more harm than good was met with puzzlement and disbelief by women and
- [25:50]
Elizabeth Komen
their doctors across the country.
- [25:52]
Jonquin Hill
A rigorous study found that the drugs,
- [25:54]
Elizabeth Komen
a combination of estrogen and progestin, caused small increases in breast cancer, heart attacks, strokes and blood clots. The New York Times, July 2002. Certainly during my training and up until very recently, the thought was that, that these risks were, as we were taught, over exaggerated, meaning we were taught that all these women that were getting breast cancer that I was seeing in clinic, it was secondary to their hormone replacement therapy and that simply we don't have the evidence for. And now we've become much more granular about what we know and what we don't know. But I still think we're far behind on the science. There's lots that we don't understand, such as how we can improve testosterone replacement therapy in women, how we can give potentially hormone replacement therapy to women who are very far out from their breast cancer and may have had what we call triple negative breast cancer, breast cancers that are not driven by the estrogen receptor. There's just still a lot that we need to learn. But fortunately and understanding of the prior studies and what their limitations are has come to light.
- [26:53]
Jonquin Hill
You mentioned the Women's Health initiative study from 2002. Why was that such a game changer?
- [27:00]
Elizabeth Komen
It was a game changer because it included a lot of women. There was a lot of hype around it. There was a lot of fear. Obviously, breast cancer is something that is terrifying for so many women and the landscape for how we treat it has improved. But understandably, women were terrified. I mean, they were told by the media, by reputable scientists, that these risks were significantly high and that they could not be on it. And then we didn't leave them with any alternatives. And I'll give you an example also, where we know that intravaginal estrogen, where it is not, where it's inserted into the vagina and it's not systemically absorbed, meaning it's not traveling throughout your whole body and hitting other tissues in the body, is relatively safe for even breast cancer patients. And this is something that we have not been giving breast cancer patients. And yet for years we've been telling women, oh, sex is uncomfortable. Oh, your vagina feels so dry in under many circumstances, or you're at increased risk for urinary tract infections, but we don't really have anything for you. And fortunately, that has changed in recent years.
- [27:57]
Jonquin Hill
What do you think it will take for people to trust their doctors again? Like, instead of turning to treatments, they're being sold online. That might be dangerous. Feeling good about the interactions they're having at the doctor's office.
- [28:12]
Elizabeth Komen
I think it's going to be really challenging. First of all, we can't blame patients because we've done them a disservice. And certainly medicine has fragmented the care of many patients, not just women, but men as well. We have to build a healthcare system that allows for time to be with patients and really hold space for them. I think that's where the trust is really going to be built. Because at the end of the day, despite all the technology that's available, medicine is about human to human care. And that is what everybody wants, to be treated as a human, to be seen and heard in the ways that you can't just reduce a body to biology.
- [28:52]
Jonquin Hill
Remember Amy, who we heard at the beginning of this episode? She started perimenopause in her early 40s. Now she's 55 and still there.
- [29:01]
Amy Sibel
I have been in perimenopause for nearly 15 years and I have still not had a year without a period. So I'm still in the technical definition for perimenopause. It's been a journey, for sure.
- [29:17]
Jonquin Hill
Amy's been able to manage her symptoms with hormone replacement therapy prescribed by her doctor and by talking with other women in the same stage of life.
- [29:25]
Amy Sibel
Not everyone has the same symptoms, not everyone has the same path. It doesn't happen at the same time. But finding other women in this same age group and actually being open and honest, finding room to discuss these things, not only complain and be curious about, but also kind of like celebrate some of the new things we find out about ourselves.
- [29:50]
Jonquin Hill
If you could give advice to, I don't know, maybe Even like your 30 year old self or your 25 year old self about this time in life and navigating it or preparing, what would you say to her?
- [30:03]
Amy Sibel
Yeah, well I love that you used a 25 year old self example because my older daughter is 25. If I could go back and tell my own self at 25, I would say to make the assumption when you're in your 40s and early 50s that any weird new thing that comes up might be hormonally related and explore that and bring that up with your caregivers and doctors. And then also know that some really good things happen with aging too. You know that you shaped life happiness curb for me has been really true. I'm. I'm still in perimenopause and yet I feel like I have a more clarified sense of purpose. I have a much stronger sense of self acceptance. I feel even more connectivity to just being a human and a woman and connecting with people that are in these same stages of life and those have been really enriching and freeing at the same time. So be well informed, pay attention to your body, talk about it with people, and then welcome the the changes just leap in, keep leaping in.
- [31:13]
Claire White
Don't.
- [31:13]
Amy Sibel
Don't become fearful of change and new things. It's hard, but it's been. It's been really.
- [31:25]
Jonquin Hill
That's it for this week. Thanks to everyone who called in and shared their story. Next up, we're working on an episode about vacations which, given the state of the world, may look a little different for you this year. Has money influenced your recent vacation plans? Do you have a great staycation to recommend? Tell us about it, call 1-800-618-8545 or email askvoxox.com if you want to support this work, consider becoming a VOX member. You get to listen to the show ad free. You can find out more by heading over to Vox.com members. This episode was produced by Ariana Aspuru. It was edited by Ginny Lawton. Fact Checked by Melissa Hirsch Engineered by Brandon McFarland Our Executive Producer is Miranda Kennedy, and I'm your host, Jonquin Hill. Thank you so much for listening. I'll talk to you soon. Bye.
- [32:32]
Olivia from Olli
Running a business shouldn't feel like surviving a software group project. One app for accounting, another for inventory, another for sales, and somehow none of
- [32:40]
Dr. Heather Hirsch
them talk to each other.
- [32:41]
Olivia from Olli
That's where Odoo comes in, an all in one business management software that brings every part of your business together, from sales and accounting to inventory and marketing, all in one powerful platform. No messy integrations, no bouncing between tabs, and best of all, no spreadsheets. Stop managing software and start managing your business with one unified system. Try for free today at odoo.com Vox that's O-O-O.com Vox that refresh you've been putting off until the right deal came along. It's here. Wayfair's Black Friday in July sale is happening now, so you can finally get the style you've been waiting for. For less. Get up to 80% off area rugs and up to 60% off outdoor and bedroom furniture. Shop Wayfair's huge selection of styles and find the piece to fit your style, budget and space, plus free shipping. Black Friday in July ends July 27. Shop today at Wayfair.com Wayfair Every style, every home.