341. How To Menopause

Summary

Podcast Summary: You Are Not Broken – Episode 341: How To Menopause

Release Date: October 26, 2025
Host: Dr. Kelly Casperson, MD
Guest: Tamsen Fadal (journalist, author of “How To Menopause”)

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Episode Overview

This episode features a lively and candid conversation between Dr. Kelly Casperson—a urologist and midlife wellness advocate—and Emmy-winning journalist Tamsen Fadal. The two dig into the realities of perimenopause and menopause, using humor, personal stories, and practical advice to flip the script on aging and women’s health. The focus is on Fadal’s new book, “How to Menopause,” which aims to demystify the midlife transition and empower listeners with advocacy tools, medical insights, and a positive mindset shift.

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Key Discussion Points & Insights

1. Turning Menopause Into a “How-To”

• Tamsen reflects on coining menopause as a verb and provides insight into the origins and goals of her book.
• The need for a straightforward, actionable resource came from her own bewildering experience with perimenopause.
• Quote: “You verbed menopause—the first person to have done it. So the book is called ‘How to Menopause,’ and it’s really, really effing good.”
  — Dr. Kelly Casperson [01:19]

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2. Personal Journeys & Systemic Barriers

• Tamsen candidly details her journey through a “messy divorce,” experiencing hair loss, anxiety, brain fog, and irregular periods—all misdiagnosed as stress.
  • She highlights the lack of education and recognition of perimenopause despite access to highly qualified doctors.
  • Diagnosis was impersonal: “I got four words in my patient portal—in menopause. Any questions? That was it.” [04:43]
• Frustration at medical gaslighting and the challenge of finding supportive doctors.
  • Consulted multiple doctors (GP, therapist, endocrinologist, OB/GYN), was given hormones and contradictory guidance, and struggled with fear of hormone therapy due to family breast cancer history.

Memorable Moment

Quote: “I was given hormones…offered pellets…and then I was scared to go on hormones because my mother died of breast cancer. So I had no clue what was going on. There was like six different doctors, which is insane.”
— Tamsen Fadal [06:04]

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3. Women’s Advocacy and Medical Gatekeeping

• Rise of patient advocacy: Women now bring their own research and requests to doctor visits.
• Hostility and skepticism from some in the medical community as women “come in and advocate for perimenopause and menopause care.”
• Critique that traditional gatekeeping is being disrupted by podcasts, books, and documentaries, democratizing information.
• Impactful anecdote: An OB/GYN was transformed by reading Tamsen’s book and watching her documentary, shifting her practice to focus on midlife care.

Notable Quote

“My doctor told me…‘menopause was just trending right now, and that’s not what it was.’ And I was heartbroken.”
— Tamsen Fadal [10:09]

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4. Role of the Journalist & Building a Bridge

• Tamsen viewed her reporting as bridging the gap: asking experts the questions women wish they could.
• Importance of “brain fog proof” writing; the book is structured for clarity and accessibility for readers in the throes of perimenopause.
• Value of patient scripts: Tamsen included communication tools for patients to advocate at the doctor’s office.

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5. Ownership, Shame, and Mindset

• Both discuss feelings of personal failure associated with symptoms (“What did I do wrong?”), and the need to break these narratives.
• Acknowledge continued feelings of intimidation, even as seasoned professionals.
• The emotional undercurrents of menopause are explored; Tamsen’s lost her mother young and wonders if her advocacy is coming “full circle.”

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6. Practical Health Actions

• Discussion on bone health and body composition.
  • Kelly shares her own DEXA scan experience, diagnosis of osteopenia, and lifestyle changes focused on protein intake, strength training, and “jumping” for bone health.
  • Both emphasize practical, actionable steps for listeners: get DEXA scans, prioritize muscle, drop outdated goals of skinny set by ‘90s supermodels.
• Discussion about the landscape of medical equipment (DEXA, body composition tools), rising accessibility issues, and the need for annual monitoring.
• Tamsen reminisces about unhealthy old habits, expressing happiness that younger women focus now on strength.

Memorable Quote

“To me, I’m like, it’s muscle. Muscle is sexy as hell, too. So put on a couple of pounds and look hot, right?”
— Dr. Kelly Casperson [19:36]

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7. Market Forces and Medical Exploitation

• Both highlight danger in the commercialization of menopause (lasers, expensive non-essential treatments) while effective, affordable solutions like vaginal estrogen are neglected due to stigma or misinformation.
• Example: A woman spent $15,000 on various treatments for GSM—none of which worked as well as simple vaginal estrogen.
• Importance of education as a defense against predatory marketing.

Memorable Quote

“It’s the silence around simple stuff that works. And…the unethical, predatory behavior of selling hope and dreams in the form of lasers and expensive vibrators when they don’t work as well.”
— Dr. Kelly Casperson [36:29]

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8. Positive Shift, Mindset, and New Purpose

• Celebration of Gen X, “elder millennials,” and boomers reshaping the midlife narrative.
• Power of mindset: Emphasize opportunity, reinvention, and the surge in women launching companies and creative endeavors post-menopause.
• Tamsen credits her new career purpose—leaving TV news for menopause advocacy—to her own experience; encourages listeners to seek and embrace new opportunities.

Notable Quote

“I really felt crazy. Like, I really felt like something was wrong… And now it’s like…my purpose found me.”
— Tamsen Fadal [26:41–27:20]

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Timestamps for Key Segments

• [01:19] – Turning menopause into a verb and book origins
• [03:35] – Tamsen’s personal perimenopause journey
• [06:04] – The search for supportive medical care
• [10:09] – Doctors dismissing menopause as a trend
• [12:35] – Dr. Kelly’s commitment to menopause advocacy
• [14:29] – Scripting patient-doctor conversations
• [18:01] – Kelly’s DEXA scan/osteopenia experience and jumping for bone health
• [20:51] – Practical advice on DEXA and monitoring bone health
• [24:10] – Tamsen’s career pivot from news anchor to menopause advocate
• [29:29] – Reflections on high-profile interviews, events, and growing movement
• [32:15] – Advice for finding the right doctor for menopause
• [34:18] – Media’s role in hormone therapy misinformation
• [36:29] – Medical exploitation vs. effective, basic treatment
• [39:23] – The role of mindset in shaping the menopause experience

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Standout Quotes

• “You verbed menopause—the first person to have done it….”
  — Dr. Kelly Casperson [01:19]
• “I got four words in my patient portal: in menopause. Any questions? That was it.”
  — Tamsen Fadal [04:43]
• “We’re fundamentally changing the world. And many—because that’s going to trickle down.”
  — Dr. Kelly Casperson [14:29]
• “It’s the silence around simple stuff that works… and the unethical, predatory behavior of selling hope and dreams in the form of lasers and expensive vibrators.”
  — Dr. Kelly Casperson [36:29]
• “It’s muscle. Muscle is sexy as hell, too. So put on a couple of pounds and look hot, right?”
  — Dr. Kelly Casperson [19:36]
• “My purpose found me.”
  — Tamsen Fadal [27:20]

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Practical Takeaways

• Education is empowerment: Listen, read, and bring resources to your doctor—knowledge is no longer locked away in medical offices.
• Be your own advocate: Ask questions, seek second opinions, and don’t accept dismissal.
• Mindset matters: Menopause is not an ending—it can be a springboard to new chapters, passions, and power.
• Prioritize basics: DEXA scans, muscle-maintenance, bone health, and simple, evidence-based treatments are key.
• Protect yourself: Stay vigilant to overpromised products and quick fixes in the menopause market.
• Community and conversation: Sharing stories publicly is crucial for dismantling shame and building informed, healthier generations.

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Conclusion

This episode is a dynamic, honest exploration of the modern menopause experience—offering solidarity, laughter, and empowerment. Dr. Kelly Casperson and Tamsen Fadal break down stigma, share mistakes and victories, and model what revolutionizing women’s midlife health can look like in 2025 and beyond.
Call to Action: “Buy the book and bring it to your doctor…doctors love reading and we love info.”
— Dr. Kelly Casperson [41:13]

Transcript

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[Dr. Kelly Casperson]

Welcome to the you are not broken podcast. I'm your host, Dr. Kelly Casperson, a board certified urologist, thought leader, and conversation starter on midlife living, hormones and sexuality. Enjoy the show.

[Tamsen Fadal]

Hey, everybody. Welcome back to the you're not broken podcast. And I'm like, literally laughing because I just told Tamsin that she can swear. And I don't know if I've even heard Tamsen swear in my life. So now I'm feeling bad about it.

[Podcast Co-host or Guest]

How dare you?

[Tamsen Fadal]

Of course you have, dude Tamsen here to talk about your book, which is called how to Menopause. You literally, like, turned it into a verb. So it's like, next level. I'm like, have other told you people told you you've turned menopause into a how. How to. You've turned it into a verb.

[Podcast Co-host or Guest]

You're like uber smart.

[Tamson Fadal]

So you're calling it a verb. I didn't even know I did that.

[Tamsen Fadal]

She verbed menopause the first person to have done it. So the book is called how to Menopause and it's really, really effing good.

[Dr. Kelly Casperson]

Thank you.

[Tamsen Fadal]

I finished it this weekend.

[Tamson Fadal]

Well, you're in it and I'm in it. I had such a good time writing it now that it's over and now.

[Podcast Co-host or Guest]

That I'm done writing it, as you.

[Tamson Fadal]

Know, that is quite the process, I think.

[Tamsen Fadal]

I think writing books is like, it's mostly torture and then you forget about it and then you want another one.

[Tamson Fadal]

But I want to do it again. I wanted something.

[Tamsen Fadal]

It wasn't that bad.

[Dr. Kelly Casperson]

Was it that bad?

[Tamsen Fadal]

It wasn't that bad.

[Podcast Co-host or Guest]

It wasn't that bad.

[Tamson Fadal]

This one was fun, though, because, you know, a journalist for 30 years, so I love interviewing people. I love asking questions. And so that's what this was. I got to ask, like a gazillion questions. And then I got to really grab everybody from social media and ask their questions of all these brilliant, brilliant doctors and experts and people from all fields, including yourself, questions that I wish I had the answers to. Like, I wish I knew this. I wish I knew I was in Perimenopause. I wish I knew what to do in menopause. And so it was really kind of this how to. And when I came up with that, you know, I struggled with the title, remember like a year plus ago, I was like, I don't know what to call it. You're at my house. I was like, people are telling me to call it like hot and like I didn't know what to do.

[Podcast Co-host or Guest]

And you're like, you can't do that.

[Tamson Fadal]

And so anyway, when I was like, this is a how to book. And then I went, oh, the most obvious answer is the right one.

[Sponsor or Advertisement Voice]

Right.

[Tamsen Fadal]

100%. I, I think a big barrier is that a lot of people still don't think that perimenopause is real.

[Tamson Fadal]

Right. Right. It's a huge burger.

[Tamsen Fadal]

It's like most people will accept menopause as a thing.

[Tamson Fadal]

Yeah.

[Tamsen Fadal]

But like, do they just think like the, you know, gets whopped on Tuesday and now you're in menopause, like there's a massive event headed up to ovarian senescence. Talk about your experience. And you do it so beautifully in the book of like making you feel because top news anchor in New York City, you kind of look like you have it all put together.

[Sponsor or Advertisement Voice]

Right.

[Tamsen Fadal]

And like, you know, we all want to feel like we have it put together, but you just, you give such a humanist picture to being like, dude, the duck that looks smooth on the surface is like paddling like crazy underneath. So share your perimenopause because I know it's going to resonate with people.

[Tamson Fadal]

I didn't even know I was going through it. You know, I went through a really messy divorce in my early 40s and everything that happened to me during that time, every doctor was like, it's stress, it's stress, your hair is falling out. Stress, can't sleep, stress, feeling anxiety and nervousness and like weird non social things that didn't make any sense to who I was. Stress, you know, irregular periods all over the place. I never had the hallmark, to my knowledge of the 12 months of not having a period in my mind because I had endometrium polyps. So I never was like, oh, I didn't get my period for a year because I thought that because I was bleeding, it was. And then I had really debilitating brain fog, but didn't have vocabulary for it. Yeah, I just knew that I started feeling really uncomfortable going on television every night, which is something I did. Like air, you know. But then I would be nervous in front of the Camera. I would feel uncomfortable. I would look at a word, couldn't remember it, skip the word. Just really, like, not me. And I couldn't wait to get off the air. You know, you do them for 30 years, you kind of have it down you. And I just. I couldn't wait to not do it, you know, every night at the end of the night. And so I realized once I hit menopause, which was I had a blood test done after I landed on the floor of the women's bathroom one night in a live broadcast, heart racing, out of control, not knowing what was going on, feeling completely anxious, I went to the doctor, and I got four words in my patient portal in menopause. Any questions? That was it. Like, literally, that was it. That was my diagnosis. That was what they told me. That's what they like. And I was like, in menopause. What does that mean? And so my husband now was my boyfriend at the time, and I was.

[Podcast Co-host or Guest]

Like, I'm in menopause.

[Tamson Fadal]

Like, I couldn't believe this, like, horrible old. Like, what is this thing? And then I wound up going doctor to doctor to try to figure out what to do and just had no. No idea. But perimenopause was never mentioned to me. I was getting polyps taken out every other year. Never mentioned to me. Bleeding all the time, Bleeding through outfits, bleeding on the anchor desk, running between commercial breaks to change my tampon. No one ever said anything to me. And so when I think about all those women that are so conf. That's what wakes me up every day and keeps me up late at night.

[Tamsen Fadal]

100%. You live in New York City and you have access. And besides the fact you know a ton of people, right? And so I think of you of, like, dude, how many doctors did you have to go to to, like, get to the point where you're like, okay, I think we're good at this point. And it's like, how many did you have to go to? And then you're like, everybody else is kind of effed.

[Tamson Fadal]

I couldn't even believe I was doing it. And first of all, the problem is it's like finding a doctor, going to it, spending the time, taking time off work, if you even have that luxury, to be able to find a doctor to do that and then get there and feel, like, completely misunderstood or walking away with no answers or not even knowing what to fight for, right? So I went from a GP because I didn't really even know what was wrong with me when that happened. I went to a Therapist because I thought it was anxiety, got Lexapro, went to an endocrinologist, went to another ob, and I was given hormones. After I got that diagnosis of in menopause in equestrian, which I changed that ob, and then I was offered pellets. And then I was scared to go on hormones because my mother died of breast cancer. So I had no clue what was going on. And this was just like, over, over. There was like six different doctors, which is insane. And then I finally met a woman that said to me, oh, I met one woman that was like, oh, I can't wait to get on hormones because of how great it's going to be for my skin. Skin. And I'm like, what?

[Podcast Co-host or Guest]

They were these crazy things. And I was like, I don't care about my skin. I care about, like, I saw what.

[Tamson Fadal]

Happened to my mother.

[Tamsen Fadal]

Right.

[Tamson Fadal]

And so I finally went to a doctor. It was like, what do you. Why are you suffering? Like, let me just explain to you what it is. It's not about what's happening today. It's not about that. We don't think you're tough enough to handle the hot flashes. And though not wanting to have sex with your fiance, it's that long term, this is what it protects. And I had no idea, like, that wasn't even. I thought that you don't do medicine in the immediate or anything if you can help it. Right? If I can help it. I don't want to do that.

[Tamsen Fadal]

If you do everything else. Right, Right. You get the privilege of not needing to take medications. Menopause turns that upside down.

[Tamson Fadal]

And even vaginal estrogen was never a conversation. Never a conversation until I started talking with you all, like, literally never a conversation. I'd go back to my doctor and say, like, hey, what about vaginal estrogen? So it's just really, when we went through the years of making the documentary the M factor, it was. That was another learning curve for me, you know, like, all the things I thought I knew at that point leading up to it, I just learned all new things.

[Tamsen Fadal]

Yeah, well, because you had learned you had become the, the expert of your experience, right? And now you're making a documentary of, like, there's all these other experiences also happening. This is not a one size fits all. And yeah, that's why your book is so great. Because you're like, great. This book is called how to Menopause. I'm going to figure out the path. And then you find out, like, everybody's path is different.

[Tamson Fadal]

Everybody's path is different. When I look at all the areas, you know, and someone's like, you know, what are we going to do to get past this? And I was like, there's so many different areas, right? There's the funding, there's the research, there's the education in medical school. There's. Oh, until we do all those things, we have to educate women because that's our first line of defense, right? Like, we are our own first line of defense. And so I do feel like there's just so much to do. And so some days I can't paddle fast enough.

[Tamsen Fadal]

I'm going to dig us into a dark hole, then hopefully then take us back out. But there's a. There's a corner of the Internet where physicians are complaining that women are going in and advocating for perimenopause and menopause care. And so, you know, like, us as being part of the menopause of, like, that dude, that's how we're changing the world, is we're educating women to go advocate and listen. For better or for worse. Hormones are prescription medications. Like, the people who can prescribe are the gatekeepers to this one piece of menopause care. I know it's everything for menopause care, but it's huge. It's literally what menopause is, is low hormones. Some people, like, the medical system's already so stressed that now people are coming in asking for more. Is it like, it isn't all smooth sailing? And to the. And I. What am I doing? I'm not complaining. What I'm doing is people are actually saying, what are these women coming in thinking everything's per menopause? And we're like, oh, well, we're doing a good job then. Because the doctors are realizing women are coming in now. And the way we get information now is books, podcasts, documentaries. Medical care is no longer the gatekeeper to knowledge like it used to be.

[Tamson Fadal]

We know. It's interesting. Well, two things. I was at south by Southwest, and this woman came up to me and she goes, I just want to thank you. And I said, yeah, of course. And she goes, but my doctor told me that when I went in and I told the doctor that I have this brain fog and I'm just not feeling myself and I'm gaining weight. I just, like, alcohol's not the same way. I feel off. My periods are all over the place, that menopause was just trending right now, and that's not what it was. And I was heartbroken. I went, oh, no. Because, look, we always know this is how it works when things go one way. Now we're gonna have to be this shift for a little while till everyone's comfortable. But I do hope that there's enough in terms of telehealth out there to be able to scoo up these people that need help. And I hope that there's enough of our voices out there strong enough. The other thing I will say is I was in New Jersey at an event and this woman stood up and she said, you know, I just want you to know, I watched, I had people coming into the office like, I need hormones. I think it's perimenopause. I think I'm in menopause. And she's like, oh gosh, now what? And so she said, I've been an OB and delivering babies my whole life. And she said, and people were saying like, oh, I read this book, I saw this documentary, I keep hearing about it online. And she said, and I, so I sat down and I watched the documentary and she goes, and I got a copy of your book that one of my patients brought into me. And I just want you to know that I'm turning my practice over to treating all women in midlife and be a practitioner and learn about menopause. I was like, oh my God, like, that's amazing. That's amazing. So I think for every one of the, you know, the critics that we get, if we have somebody like that that comes over and says that that's what they're doing to help so many women.

[Dr. Kelly Casperson]

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[Tamson Fadal]

That's incredible.

[Tamsen Fadal]

I changed my, I changed my career because you did. I gave up surgery to treat hormones and sex med. It's that rewarding.

[Tamson Fadal]

But your voice is that Big. Like, I was on another podcast earlier, and the woman's like, you know, I always love what Dr. Kelly Casperson says. And I'm like, me too.

[Podcast Co-host or Guest]

I'm talking to her later.

[Tamsen Fadal]

You know, I always think, like, all the menopause, like, all of us, we're all like Teletubbies or the Spice Girls or the Power Rangers. And I'm like, the no nonsense. I'm the no nonsense one.

[Podcast Co-host or Guest]

I love that. Well, we need that one. We need that one.

[Tamson Fadal]

We need those voices, though, when we need to understand. Like, I'm. I was with Dr. Suzanne Gilbert Len. She came into Los Angeles and she interviewed you. She interviewed me. It was really fun.

[Podcast Co-host or Guest]

She was like, oh, good, I can't wait.

[Tamson Fadal]

I'm like, really?

[Podcast Co-host or Guest]

Because I've never interviewed you. And I said, oh, I never thought of about it like that. She goes, you've interviewed me like 10 times.

[Tamson Fadal]

She said, you know, the truth is, is like, you're the layperson me, and you're helping women communicate with us, the doctor. And she's like, and that's what's really the bridge. And we need all of us holding hands. And I never looked at it really like that before. You know, I'm always like, oh, I'm journalist, journalist. But that's the truth, is I'm just a woman. And so I think that that was where the book was easier for me to write because I pictured what I was going through. I was like, okay, this book has to be brain fog proof. Because when I was really going through it, I still was in, out, in, out. You know, book took like two years to write. And so I was still, like, having a hard time concentrating, having a tough time sitting down and, like, picking up a thought and taking it to completion without getting distracted. So I really did write that book from a place of somebody who'd been through that. Like, I was like, what do I want when I pick up this book? I'm not feeling good. Might not have slept, kind of, like irritated with everything. Don't have a lot of patience, don't have time to go deep. Just give me the facts. And so that was. That was why I had fun with that. But, yeah, so Suzanne just kind of explained it to me how she sees that bridge. And I thought that that was. That was pretty cool.

[Tamsen Fadal]

It's so cool. And to me, I'm like, this is not just about. I think a lot of this is about hormones, don't get me wrong. But it's not like what we're doing is we're Teaching people how to advocate for themselves. We're teaching people how to ask for something at the doctor's office. We're teaching them, like, you know, the menopause is like, this is what you say to the doctor. This is how you ask for it. This is how you. You do it. And it's like, we're fundamentally changing the world. And many. Because that's going to trickle down into everything else.

[Tamson Fadal]

You're like, 100%.

[Tamsen Fadal]

The difficult conversations, like, your fiance when you're like, I'm in menopause. It's not like he's like, don't worry, honey. I got this. They can't have this, right? So it's like. It's a whole different way of being like, I've got to know what's going on because nobody else does.

[Tamson Fadal]

It was really. You know, I lived by scripts my whole life, and so I was like, oh, I'm just gonna write some scripts inside the book for people. Because it really. When you feel nervous and uncomfortable, and rightfully so, because you go into the doctor, and I don't know if you feel like this, going to. As a doctor, going to another doctor, do you feel intimidated ever, or.

[Tamsen Fadal]

I'm more like at the dentist. I have that, though, because I'm like, I don't know anything about teeth. I also feel like it's like, a personality issue. Like, if something's wrong with my teeth, it's because I was a moral failure. Like, I get that a lot.

[Podcast Co-host or Guest]

That's how we feel.

[Tamson Fadal]

Like, I'm like, hey, I'm bleeding, like, a lot. What did I do wrong? Right? My body.

[Tamsen Fadal]

Am I not meditating enough?

[Tamson Fadal]

Yeah. Did I not meditate?

[Tamsen Fadal]

Did I forget to recycle something once?

[Podcast Co-host or Guest]

So that's how we feel at the doctors.

[Tamson Fadal]

It's funny, even now, I really do have to, like, go in there and be like, okay, I was a vira. Because he's had this, like, horrible cough. And we went into the doctor, and the doctor, like, looks like. And he's like, what's she doing here? And so. Because Ira will be like, oh, yeah, whatever you want me to take. And I was like, no. Is there a contraindicator to this medicine? And I was like, who?

[Podcast Co-host or Guest]

What? What did I just say? And so I don't even know if I know what the word really means.

[Tamson Fadal]

But I've learned to, like, at least ask enough questions. Either one, they want me to leave, or two, at least I've second guessed enough where I feel. You know, I feel good, and I want I want people to feel like that, especially women in midlife, because that's the area that's just been, like, had the shrug. But I think that doctors, especially when doctors reach that age, whether it's perimenopause or menopause, have more sympathy or more awareness because they're going through it now, too, with very little answer. And so I think that that's why we're seeing that kind of change so, so rapidly.

[Tamsen Fadal]

I think especially, like, the female physicians are like, dude, the menopause belly. Yeah, yeah, yeah, I get it. Like, you know what? We're like, dude, do you just kept telling women to, like, exercise and eat less is like, that don't work. I know that's not what's going on.

[Tamson Fadal]

I had Dr. Rocio on my podcast. We did my numbers, you know, because she is my endocrinologist. And she went through my numbers, said, like, I was pre diabetic, and I'm like, what? And I couldn't. I couldn't believe it. And so then she's like, are you sure you want to go through it on the air? And I was like, I do, because I think it's important that, like, I can't pretend that, like, I'm perfect. I'm not. And, you know, be like, oh, no. I perfectly eat every bit of everything. It's really hard to get that much protein. It's really hard to, like. And so she was explaining to me, like, the grains that I was doing to try to get enough protein in the form of grains were causing a problem for me.

[Tamsen Fadal]

Sure, right?

[Podcast Co-host or Guest]

Isn't that crazy?

[Tamson Fadal]

I had no idea. So it's just, like, constantly learning. But I asked her 6,000 questions about it because I just didn't understand. But, you know, you guys are patient with all my questions.

[Tamsen Fadal]

We love you. And, like, also, we're obsessed with this topic.

[Sponsor or Advertisement Voice]

Dude.

[Tamsen Fadal]

But I have to tell you, this might be the first time. This might be an announcement on this podcast right now. I got my DEXA done last week.

[Tamson Fadal]

You did?

[Podcast Co-host or Guest]

I'm going at the beginning of June.

[Tamsen Fadal]

For anybody who's listening in my town, go to. Go to, like, the private radiology clinic in town. Ask what your cash price for DEXA. Bone density. Two different DEXAs. There's a DEXA for bone density, and there's DEXA for body composition. And there's usually two different things, so ask for the one you want. They're both good. But I have an in body scanner in my clinic, so I don't need body comp.

[Tamson Fadal]

Right.

[Tamsen Fadal]

So I Got the.

[Tamson Fadal]

Is that the one that you stand on with?

[Tamsen Fadal]

That's when you stand on and it.

[Podcast Co-host or Guest]

I did that.

[Tamsen Fadal]

Yeah. Please let me. I gained like a pound of muscle over the past month that I'm like so proud of my one pound baby. One pound baby muscle. But dude, I have osteopenia. No, you don't.

[Tamson Fadal]

Then I must, I must.

[Tamsen Fadal]

So I've been processing that. Just be more of a badass. So here's the thing. You don't know if you ever built to maximum capacity. So maximum bone strength is 25. Maybe I never built. I'm a small framed person, but I'm like, also, dude, I was pretty much underweight or at the bottom of the BMI for most of my life. And so I'm like, dude, I was just freaking undernourished. So now I'm like, dude, protein, muscle, vitamin D. Now I'm starting, I've started jumping just the data online. It's like minimal jumps. It's like 20 jumps a day.

[Tamson Fadal]

It's like actually kind of fun little trampoline thing.

[Tamsen Fadal]

No, you just freaking jump. So like jump like in the air? Yeah. You do one legged jumps if you feel like good for your balance.

[Tamson Fadal]

Is it for balance or for bone strength? All right, I'll try that. Oh, no. Now I'm a little nervous, honestly.

[Tamsen Fadal]

No, no. Like this is like, get the Dexa, figure out where you are because it's like you can at least maintain if not gain. So to me, I'm like, all the hormones. I'm probably never gonna try to be skinny again in my life. Like, like to me, I'm like, it's muscle. Muscle is sexy as hell too. So it's like put on a couple of pounds and look hot, right? But it's like, dude, our generation, like the 90s, the supermodels who our role models were fricking osteopenic.

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[Tamsen Fadal]

For those who want an alternative, it.

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[Tamson Fadal]

I mean, look, I remember it's funny, I was cleaning out a bunch of stuff and I have these like file cabinets because I'm still, you know, whatever. My husband's like, how do you have paper? Every part of your life is so streamlined. How do you sell paper? But I used to keep notes of what I what I would eat. It was really bad. And I would be like half of banana grain muffin, coffee, cappuccino. And then it would be like dinner sweet potato spinach. And that was like my day of eating. And then I'd be like, work out in the, whatever the StairMaster for an hour and a half until I sweat it up. And that was literally what that time period was. And it's so screwed up and sick. So I get really happy when I see young women like strength training and paying attention and ignoring the stupidity.

[Tamsen Fadal]

To me, the Dex is a wake up call too.

[Tamson Fadal]

Of like, that is a little scary one.

[Tamsen Fadal]

I know I'm mid-40s.

[Tamson Fadal]

Can you reverse some of that?

[Tamsen Fadal]

That's, that's the goal that anything now. It's like, you know, keep an eye on it every year to make sure you're not losing ground. Yeah, biggest percentage of bone loss is the two years up to your period ending. So it's like, get the DEXA now. Even if insurance doesn't cover it. It's $80 cash and I'm in Washington state. But it's like, know where you are. Because now I'm like, dude, muscle, muscle, muscle, muscle, muscle.

[Tamson Fadal]

Well, you know what's funny about it though, is that I had an appointment for June. They're rescheduling me now. But the place that did it, they got rid of their machine. I'm like, what? You should be tripling the machine. We're sending people to it because it's one of these, like, radiology places. So I'm wondering what other kind places have that machine that is going to be accessible to people? Because the body composition machine I've done before because that was inside of a doctor's office. Seems like a lot of doctors have that now.

[Dr. Kelly Casperson]

Yeah.

[Tamsen Fadal]

So body comp doesn't require X ray. When I was in Sydney in Australia for the Sydney Opera House, I actually got my femur ultrasounded. So there's an ultrasound. That's right. Because they're like X rays. Difficult for a lot of people to build an X ray room. Right. Like, it's. This is a. I Forget. It's like 60 or $80,000 to buy this thing, but it not only shows. It not only measures density, which is what DEXA does, but it measures strength. So in Sydney, Australia, this guy did my femur, and he's like, it is showing some issues with density, but it's showing a very strong bone.

[Tamson Fadal]

Okay, so you already knew there was something maybe.

[Tamsen Fadal]

So I already knew. I was like, okay, what is this going to look like on Dexa? And so the DEXA showed osteopenia, but DEXA doesn't measure strength.

[Tamson Fadal]

Wow, that's so fascinating.

[Tamsen Fadal]

It's super interesting.

[Tamson Fadal]

Yeah. All right, I'm gonna have to start jumping.

[Tamsen Fadal]

This is our basic title of this podcast is everybody get a Dexa and.

[Tamson Fadal]

Read how the menopause get your dex.

[Tamsen Fadal]

One thing that I want to ask you about is you're. I mean, you're at the top of your game. Like, you got the Emmys, you got the New York City anchor chair, worked your way up from other states, and, like, you got to the pinnacle, and then you effing quit. But I'd be like, dude, your career now is bigger than it was as a news anchor. That's my opinion. But it's like, dude, you're producing, you are creating, you're writing, you're traveling. Like, it's bigger. And I would say influencing. Like, who watches the New York City news? People in New York now. This is the world. Did you see that coming? That you're like, I'm gonna quit this and be bigger and better than ever?

[Podcast Co-host or Guest]

No, you knew me.

[Tamson Fadal]

You knew me.

[Podcast Co-host or Guest]

You knew me.

[Tamson Fadal]

Both things. I was petrified. No, I just knew that every single day that I woke up, this is the only thing I could focus on. Like, it was.

[Dr. Kelly Casperson]

It.

[Tamson Fadal]

I was. You know, I was filming the documentary while I was at work, and I was, like, at work from 2pm to 11:30 every day. During all that, most of the time you knew me. And then in between, there is when I was doing the documentary, and then I just was so obsessed with this conversation and the space, and I really. I really came into it through the midlife lens, I think, early on, like, oh, as we age. As we age. And then when I was like, what in the world? How is this the one story that I never told in being a journalist for that long? And I just couldn't get it out of my head. And then when the documentary happened, I. I mean, you know, I was like, I don't know where it's all gonn. I don't know what's going to happen, but it would really be grateful if you do an interview. I mean, really, that's how we did this. It's been very grassroots. You know that better than anybody. And then even with the book, I was like, well, I'm going to take as many questions as I can get, pull it together and do a bunch of interviews. I really wasn't. So, no, I think I still, every once in a while, get up in the morning, and I'm like, what do we have to do next? Like, in a panic, Because I feel like this conversation. There's so many women to try to help, but I had no idea where I was going when I left. A lot of people thought I was crazy, and it was scary because that's the only thing I'd ever known. But I definitely knew that. That this was that purpose thing. Everybody had. Everyone had always talked about, like, you know, your purpose. And I was like, no, I don't know my purpose.

[Tamsen Fadal]

Right.

[Tamson Fadal]

But then all of a sudden, like, that happened. I'm like, oh, I guess that's what this is. I don't know.

[Tamsen Fadal]

Never wild. Like, you're like, you know, the people who say, like, your purpose finds you when you're hard at work, or you're like, your purpose finds you when you're not paying attention to it. Why do you think this topic was, like, an obsessive topic to you? What?

[Tamson Fadal]

I mean, Kelly, I've covered so many things. Like, I've been to Afghanistan. I've been to all over the world covering, you know, war and following our troops and doing investigative journalism and, you know, helping police with things. You know what I mean? Like, I've done so much entertainment. I don't know. You know, I think because it was personal, really personal. I think because I was seeing the number of women suffering, and I think that I really felt crazy. Like, I really felt like something Was wrong, really, really wrong with me. And I often wonder not to go too far off, but I also often wonder, like, was this always going to happen? Like, I lost my mom at an early age. You know, I lost her at 51. I was 20 years old at the time. She was 51. Like, so young now. And I look at it, though I didn't realize it then. And I always wonder if, like, that was going to be my full circle thing. I don't know. It wasn't. I mean, I did a lot of breast cancer advocacy, but nothing like this. Like, nothing like this. So I don't know. I just never have written this. It's funny now if I go, you know, I used to be where I would go someplace and go to a dinner or whatever, and people be like, oh, what's the most famous person you've interviewed? Or, what's the best story you've ever told? Or whatever. And now it's like, hey, listen, I am, like, sweating. I, like, just feel awful. And then my doctor and I was like, oh, I totally changed. My husband's like, does everyone just talk to you about menopause?

[Tamsen Fadal]

Right. Right now it could be like, you've, like, identified as a safe sounding board, and people just know that for you.

[Tamson Fadal]

I hope so. I hope.

[Tamsen Fadal]

Welcome to being a doctor, my friend.

[Podcast Co-host or Guest]

I know. I was like, no, I always.

[Tamsen Fadal]

I always preface it. I'm not a doctor. That's awesome, dude. So we met at the first swell event in New York City. I was thinking about. I was thinking about this while I was reading your book because you had mentioned that event in the book.

[Tamson Fadal]

Yeah.

[Tamsen Fadal]

And so I was thinking back to it, and you wore the most gorgeous green. I'm like, looking around for the green. The most gorgeous green suit.

[Tamson Fadal]

My highlighter suit.

[Tamsen Fadal]

I'm like, oh, if you remember the suit. I remember this suit. Like, you came in because you were gonna. They're like, she's gonna interview Katie Couric. And I'm like, I just know we need to be friends. Like, you know, they scan the room and you're like, that person. I'm like, damn, that suit. It's amazing.

[Podcast Co-host or Guest]

I'm so glad you scanned for me.

[Tamsen Fadal]

So the way the book sounded like Alyssa just called you up the night before and was like, can you swing over?

[Sponsor or Advertisement Voice]

Yeah.

[Tamson Fadal]

It was like, literally the night or two before, she was like, I think she called, like, somebody on my PR person or somebody at the station or something. And she was like, could you do an interview with a panel we have for this event? And I was like, yeah, who's on the panel? She was like, Katie Couric, Naomi Watts and Natalie Nixon. And I was like, I'm interviewing Katie.

[Tamsen Fadal]

Couric and Naomi Watts tomorrow.

[Podcast Co-host or Guest]

Yeah. It was like.

[Tamson Fadal]

I don't know.

[Podcast Co-host or Guest]

It was like, literally that week.

[Tamson Fadal]

And I go, okay, do we know.

[Podcast Co-host or Guest]

What they want to talk about? Like, you know what? So I couldn't even believe it.

[Tamson Fadal]

And then they were just both, like, so kind and so, like, I know Katie, but I didn't know Naomi.

[Podcast Co-host or Guest]

So we're both like, it was great.

[Tamson Fadal]

It was great. But then, you know, honestly, because Katie is, like, ahead of me a bit from. In news. Like, you know, she was like, somebody always looked up to. So to interview her. Like, it's. It's one thing having a conversation with another thing interviewing Katie Couric. So I was like, like, oh. I was real all bold. And then I'm like, oh, crap, it's Katie Couric.

[Podcast Co-host or Guest]

I gotta really study for this and really be prepared.

[Tamson Fadal]

And then, of course, like, it totally. Every time I've ever done a panel, it totally just, like, goes away off the notes. It never. I never stick to it. So now I just, like, I don't even.

[Tamsen Fadal]

That's what makes them fun.

[Sponsor or Advertisement Voice]

Yeah.

[Tamson Fadal]

I don't even bring notes anymore because, you know, it's never gonna go that way.

[Tamsen Fadal]

I mean, you know.

[Tamson Fadal]

You know how it goes.

[Tamsen Fadal]

Yeah. I love it. When. When we did that event, that was like, 22. Yes. I want to say, were you already, like, where were you in the. The grip of the menopause culture and, like, knowing your calling at that event?

[Tamson Fadal]

Well, I was still working, for sure. And I think at that point, I had just sold the book, if I'm not mistaken. Like. Or I just, like, started going out there with it and then with the documentary. I think we were just starting to have the conversation about what it was going to look like. But I hadn't even partnered with Denise yet. My other partners in la, we were still shooting on our iPhones. We're going out in Times Square, like, shooting on our iPhones.

[Tamsen Fadal]

I, like, I'm meaning to ask you this anyways, but where are you with. We talked about the documentary a while ago. You're. We're working on international rights.

[Tamson Fadal]

I'm actually thinking of maybe doing something where we do, like, a big, huge event to show it. So I'm thinking of that for.

[Tamsen Fadal]

Is it in Canada? Has Canada seen much of this? Some of Canada has, like, shout out to the Canadians. Like, Canadians are, like, amazing. 10% of my following, it's like. Which probably means all of the women in Canada.

[Tamson Fadal]

I know, I love it.

[Tamsen Fadal]

Let's do a Toronto and a Vancouver.

[Tamson Fadal]

I would love that. Toronto. I've got a huge. A ton of people asking, so, yeah, I'm with you.

[Tamsen Fadal]

It'd be super fun.

[Advertisement Voice]

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[Tamsen Fadal]

What advice would you give people on how to. And this is like your journey. And then in writing the book, how do you find the right doctor for perimenopause slash menopause?

[Tamson Fadal]

Well, first of all, it's obviously, if it's somebody that is telling you that it's trending, trending, that's a.

[Tamsen Fadal]

That's a warning that.

[Tamson Fadal]

Isn't that ridiculous? It's so insulting.

[Tamsen Fadal]

Well, when people are like, everything's perimenopause, it's like, well, it does happen to every single woman, so it does need to be considered. Yeah.

[Tamson Fadal]

10 things. You know, we're blaming your hormones. Everything's perimenopause. You're too young for it. Any of those. And, you know, listen, I'm a big advocate of telemedicine, like a telehealth. I think it's. It's great. But I also think that you've got to find a doctor and you know this better than anybody that is committed to this space too. I think it's really important. I think it's important to be up on what's next. I think it's important to know what research is going on. I think it's important that you don't feel like you always have to know more, because I think that can make you not feel quite so confident. And so I think that's important. I think I want to go in there and know that that doctor knows more than I do about the this.

[Tamsen Fadal]

Yeah, sometimes it's easier. It's kind of like sex. You see, everybody know what you want with sex, but you know what you don't want with sex. But it's like with doctors, it's like. Like this is what we always do. Like for people to have enough expertise to be like, no, sometimes we got to use this and sometimes we got to use that, and sometimes you need different dose.

[Tamson Fadal]

They can talk to me about all these different things. I want them to work with me on stuff. Not that this is it.

[Tamsen Fadal]

It's it.

[Tamson Fadal]

Because we know that it's not, like, just sheerly from the research, just sheerly from the lack of information and education, we know that nobody has all the answers.

[Tamsen Fadal]

Yeah, totally. So in your research for the book, for your podcast, for the documentary, was there anything that, like, shocked you or made you, like, specifically angry about the whole situation?

[Tamson Fadal]

Oh, I mean, I think, you know, what happened with the women's health study, and I, you know, really. I think the big part that the media plays in a lot of this, that the media, you know, with misinterpretation of a lot of the data, and then the headlines never got big again. You know what I mean? Even when we walk back a lot of that data, the headlines never got big. And so I feel like when I see that, maybe that's a little bit reason why this kind of of dug into me, too.

[Tamsen Fadal]

It's kind of like me being a doctor and realizing how shitty it is if it's for you. Like, dude, your media played a huge part in this.

[Tamson Fadal]

A huge part in this. And so I think that that part was also, like, I'm not solely responsible for the media landscape, but. But I do feel like, how was that possible? And that made me really angry. And then I. I think what also made me really angry is the fact that we haven't seen any numbers tick back up of women getting help. And then I know there were a lot of doctors during that time that were still trying to pres. And one of them said to me, and she wasn't in the documentary, but she said to me that, like, that they had a. Like, the patients actually had to sign something that said, like, yes, I understand the dangers or whatever of hormone therapy. And they had to do. And I had no idea that any of that was going on. So I think that really pissed me off. And I think what also made me really mad is the fact that women felt so ashamed. And so we had, you know, so many stories that we couldn't put it in because it was only an hour long. But it may be a. I guess, like, when I think about, like, wow, my mom never said anything. My mom was going through chemo and everything at the same time, so obviously went into a medical menopause, and she never said a thing. I don't even know if she knew. I actually don't know if she knew. That's the truth. So that makes me really sad. And so I think, like, I Always do all these things in name of, in honor of, in hope of that if there's another Tamson out there who's, you know, 14 years old watching their mom go through that, that, that, that there are some answers.

[Tamsen Fadal]

That's super sweet. I got a message from a woman this week. She's spent $15,000 on lasers, radio frequency ablation, the O shot, very expensive vibrators, trying to fix her general urinary syndrome of menopause. She's triple negative breast cancer. We know vaginal estrogen is completely safe. We actually have pretty good data to say that systemic hormone doesn't increase risk of recurrence over baseline for triple negative. Like we have. I'm like, she has spent 15. It's one thing if you spend 15 grand and you get something good for it, sure. Not if you're still suffering, not if it's done nothing. And to, to me, I'm like, dude, number one, low hanging fruit, vaginal estrogen. Number two, you could probably be on like, for how bad her situation sounds, she could probably be on systemic hormones with no increased risk. And I'm like, number one, it's the silence around simple stuff that works. And number two, the unethical predatory behavior of selling hope and dreams in the form of lasers and expensive vibrators when they don't work as well.

[Tamson Fadal]

Well, and that's the other thing. And I think that we've got to pay attention to, right, of what's going on out there because we're going to see more and more and more and more and more. And I think that that always worries me, you know, that really it does worry me. I'm very aware of it. I'm aware of what I get fed on a daily basis and. But I go, oh, what? Okay, wait, Tamsen, you know better. Like, you know, I, I'm very aware of that. I'm very aware of the hope and dream, the hope and dream of, of everything being fine and of one magic quick fix. And we know that's not the case. And so I think that's probably why it's so important. The education part of that is so important. It's why that's what I love what you do, is that education is so necessary for a hundred different reasons, but for the symptoms of it, for just feeling better overall, but also for the management of all those incoming. Because we're only gonna see it get more and bigger and bigger and bigger in terms of people realizing the money to be made.

[Tamsen Fadal]

Yeah, yeah, I think, I mean, it's the Good and the bad of like, hey, menopause is a huge market.

[Tamson Fadal]

Great. Yeah.

[Tamsen Fadal]

But there's like, the sharks are going to come as well. Right. Like, there's blood in the water, there's a lot of suffering, and that's what the education is. I mean, I, you know, I had. This was down. This was at south by Southwest. At one of Elisa's events, a woman had said she had built a special cabinet in her kitchen for her supplements, trying to solve, basically, GSM and painful sex, amongst other things. And she was so afraid of vaginal estrogen. And so she's basically like, what else. What other supplements are there? And I'm like, vaginal estrogen. Right, right, right. It's like the education, but then it's. It's literally, you know, and this is how brains work is like, once people are convinced of something, we told them to be afraid of this, it's very hard to undo that.

[Tamson Fadal]

We tell them over and over and over and over to be afraid of this. That's the problem for years. And then any walk back was like, hey, it's not so bad. So as much as we think we talk about it, it could never be enough. You know what I mean? It's got to be over and over and over again because we have year, we have decades to make up. Yeah.

[Tamsen Fadal]

Not just say, like, the definition of an expert is somebody who's okay saying the exact same thing over and over and over again. It's like, all right, we figured out the calling. Yeah, we figured out my career to wrap up. I love. You know, in the book you prioritize Mindse that. Because again, it's like, just like people told us to be afraid of hormones. People told us that menopause is shitty. And. And physically, it's not a great time. But, like, when people figure out, I get to make this what I want to make of this, I get to use this up as an opportunity to, like, look at what you do with your career. Like, it's insane.

[Tamson Fadal]

Right?

[Tamsen Fadal]

The amount, by the way, the amount of women who've told me they've started companies after starting testosterone is not zero.

[Tamson Fadal]

It's really awesome to see, though, right? It's like one example after another of women, like, going, oh, ye. Yeah, I'm not done yet.

[Podcast Co-host or Guest]

What are you talking about?

[Tamson Fadal]

And I do think that a mindset is super important. I don't think we can pull anything away from each other. I really think that this time in Life is a 360. And I think that it all kind of comes Together. So I look forward to a day where it's not all separated because I do really believe there's all of it. And that's why I couldn't stop writing with the book.

[Podcast Co-host or Guest]

The publishers were like, okay, okay, we got enough chapters.

[Tamson Fadal]

But I really did think that we couldn't separate, obviously, sex and brain and movement and sleep, but we also couldn't separate mindset and workplace and what happens next in that next season, which I think is just so incredible. And we can't just tell women that, hey, it's gonna be better on the other side. We have to show them, you know? And so I really wanted to, like, find, like, I could have written a whole other book about that. Like, there's all these different examples. And so I just think that it's encouraging to see, and I think we're going to see so much more. And I believe that some of the answers that we're looking for are gonna come out of those women that are on the other side of this in that season. And that's what gets me excited. It.

[Tamsen Fadal]

Yeah, I absolutely love it. Like, I could combine what, like, what's happening with, like, the badassery of the Gen X and like, the elder millennials are coming on board now. And it's just like. And then the boomers are like, oh, can I get. Can I get my piece too? And we're like.

[Podcast Co-host or Guest]

And we're all like, yeah, that's a cool thing.

[Tamson Fadal]

Like, I feel like there really is a respect, right, with all these different generations. And I don't know that there's been that for a long time.

[Sponsor or Advertisement Voice]

Ever.

[Tamson Fadal]

You'd be like, oh, it's them. I'm gonna be like my parents. Well, I want somebody to be like, I'm gonna be like my parents. Like, that's pretty awesome, you know, to be. Oh, I want to be k. Like my mom or my aunt or my sister. That's pretty cool.

[Dr. Kelly Casperson]

Yeah.

[Tamson Fadal]

So for the kick ass ones.

[Dr. Kelly Casperson]

I think so. I think so.

[Tamsen Fadal]

How to menopause. Brilliant book. So glad it's out there. Buy the book and bring it to your doctor is my advice, because it sounds so cheesy. But, like, doctors love reading and we love info and like, when people bring us stuff, we actually do read it.

[Tamson Fadal]

I love that.

[Tamsen Fadal]

So thank you so much for coming on the podcast today.

[Tamson Fadal]

Thank you.

[Tamsen Fadal]

It's lovely to chat with you. I know soon we have some fun stuff planned. We do this fall.

[Tamson Fadal]

This fall.

[Tamsen Fadal]

Coming soon. All right, everybody, thanks. And until next time, you are not broken. Love you.

[Dr. Kelly Casperson]

Thank you. For listening to this week's episode of you Are Not Broken. If you want to dig deeper with me, sign up for my Adult Sex Education Masterclass where you learn adult things like communication skills, anatomy lessons and desire types, and how to talk to your doctor about sexual health concerns. If you want the Adult Sex Education Masterclass for free, join my monthly membership for more in depth exclusive content, more time with yours truly. A private podcast, coaching and educational empowerment and you can watch my interviews live and get them immediately without advertising. Head over to www.kellycaspersonmd.com for the membership and Adult Sex Ed Masterclass members. Get the Masterclass for free.

[Sponsor or Advertisement Voice]

Free.

[Dr. Kelly Casperson]

This podcast is presented solely for educational, entertainment and informational purposes only. I am a doctor, but not your doctor in this format and all of my platforms and guests including on this podcast are not giving individual medical advice or practicing medicine. See in Consult with your own care team for your individual needs and concerns. This podcast is not intended as a substitute for the care and advice of a physician, therapist or other qualified professional. This podcast does not constitute the practice of medicine, in case you were curious about that and no doctor patient relationship is formed. But I still love you. Using the information on this podcast or any of my platforms is at your own risk. Until next time, Remember you are not broken.