Hello, and welcome to today's podcast. Today we're going to mix things up a little — I'm going to interview Dr. Mark. But it also needs to be a dialogue, because today's topics aren't just a male perspective; they're a female perspective on the situation, too. We've talked about these topics on our own and with patients, and we hope we can shed a little light and give people some hope about what they need for their care. Specifically, we're talking about women's health.
Just an initial disclaimer: I'll try to keep this non-political, and I'm not going to belittle or bash any specific companies, pharmaceuticals, or insurance companies. The goal is to talk to people and meet them where they are.
Why This Work Matters
Why is working with women — especially those navigating menopause and perimenopause — something you're passionate about?
This has been transforming for years, but it really started when we first met and got together, sharing a passion for healthcare, medical missions, and a general zest for life. My passion is to shed light on what's almost been a disservice to the female population. As a physician — and as a person who looks for balance and believes truth is truth — what I see is disappointing: the idea that when a woman comes into the office, she isn't truly listened to or heard for what she needs.
It's very common that I'll see patients, hear their symptoms, look at the medications they're on, and apologize to them — even though I wasn't their original treating physician — because I understand that no one truly listened to what they were saying. There are options to control or treat their symptoms, and reasons that justify why they're truly having them. It's hard to sum up in a few words, but the female clientele has not gotten as much attention as they should have. Setting the politics aside, there's simply a lack of solid research studies showing what's truly going on and what benefits women through perimenopause and into menopause.
Can a Male Physician "Get It"?
A lot of women might wonder how a male physician can truly understand what they're going through. What do you want them to know about your perspective and role in their care?
It alludes back to the first answer: you have to listen to the patient. I don't care if they're a man or a woman — you have to listen. If you have an idea, that's fine, but your treatment plan isn't a cookie-cutter for every person.
There's a story that hits me: a woman with an excruciating headache is sitting on the couch talking to her male counterpart, and he looks at her and says, "Honey, I know what's the matter with you — you need to take that nail out of your head." She has a nail sticking out of her head, but she says, "I don't want you to fix me, I just want you to listen to me." That resonates. Ninety percent of the time you don't need a lot of labs or even a physical exam — you just need to listen, because the patient will tell you what's wrong. That's the biggest part of our perspective: we take a long, extensive history, we explain things, and we listen for what their biggest goal is.
As for how a male "gets it" when a woman explains her symptoms — honestly, I understand that the symptoms she's having are real, not "in her head." They're outward expressions of systemic issues or deficiencies of hormones, vitamins, and minerals — things that aren't in balance or optimized. How do I get it? In a way, I don't — it's more intuition than anything else.
A Doctor–Nurse (and Husband–Wife) Team
One unique thing about our clinic is that we're a doctor-and-nurse team — and also husband and wife. How does that influence the way we care for patients, especially women?
I think it makes women feel comfortable. When patients come in, their blood pressure or heart rate might be up — you've heard people say, "My blood pressure's always up at the doctor." But with us being a man-woman team, we've got both sides of the fence covered, and we understand the importance of hearing it from both sides. Patients want knowledge and answers, but they also want to be heard, and they know that whoever's in the room will understand where they're coming from.
From your perspective as a woman and nurse coach, what do you think women are most looking for in a provider during the menopause and perimenopause time frame?
I think women really want someone who will listen and hear them. Too often you go to the doctor, put down a complaint for your visit, and the provider comes in so focused on that one complaint that they lose sight of the story coming out. Listening is really key. It's cognitive behavioral therapy at its finest — to hear, understand, and direct. If you go in with high blood pressure, you get diagnosed and started on medication and told, "We'll recheck in six weeks." But *why* do I have this, and what can I do to correct it? That's where we shine.
Team-Based Care and Root Causes
We often look at labs together and walk through protocols. How does our team-based model give women a different experience than a traditional doctor?
We're not just trying to treat a disease after it's present — we're looking for the root cause. And with both of us, we bounce ideas off each other. When we're speaking with patients, it's nice to have two people asking questions and bringing different perspectives.
A lot of women come to us feeling dismissed or told it's just part of getting older. What's missing from the traditional approach to women's health?
There's a term called confirmation bias — the idea that "what I was taught is how it is, and that's the way it'll always be." That's the old traditional way of training. But medicine is ever-changing; we don't know everything. Half of what we know now will change in five years, so it's a process of updating our mental and decision-making circuits. Traditionally we've been taught to treat a disease process instead of treating the root cause to avoid chronic diseases like heart disease, type 2 diabetes, and dementia. If we can identify those in advance, they're often avoidable. A classic example is the old WHO/Women's Health Initiative hormone trial from the early 2000s — hormone therapy has since been shown in most circumstances not to cause cancer, and its benefits are very positive.
You Don't Have to Just "Go Through It"
What do you want every woman listening to know about her options and how we work together to support her?
You have to ask the question "why," and you can't just accept that it's part of aging or menopause that you simply have to go through. There are ways to help you go through it. Most of all, we don't want you to give up. You feel the way you do for a reason — there are causes — and you have to fight, claw, and dig to get the answers to start feeling better. But you're not alone. We don't want anyone to feel hopeless, like "I'm never going to lose this weight," or "osteoporosis is just getting older." That's not true. You need someone to help you walk through and navigate this complex system, and we do a pretty good job of that.
For women on the fence — feeling unseen, skeptical, or unsure — what would you say? Search for a provider, male or female, who will listen, direct you, give you options, and help you understand why and what you can do. While you look, ask people in similar circumstances. There are communities of women — and men — with the same symptoms. You may feel alone, but you're not; others have the same problems, and you can learn what worked for them. If people communicate better with each other, they'll find out they're not alone and that things can be done — it's not just taking a prescription and being happy, or taking metformin for type 2 diabetes and calling it done.
Everyone Is Different
It's been great to hear so much conversation lately about menopause and perimenopause — things we didn't talk about for a long time — and to open up those questions with friends and community. But as you hear "this worked for me," you have to take it with consideration, because one of the biggest things I've learned in this work is that what works for one person won't necessarily work for everyone. That's a big difference in our practice: it isn't cookie-cutter. It takes time to get the exact recipe together, but it's achievable. Don't assume you can show up, get a prescription — estrogen or a supplement — and never have it modified. Some people don't respond to the same hormone replacement or have side effects, and there are different ways to administer it: not just a cream, patch, or pill, but also pellets and other options.
How do you feel when women have questions for you? I love it. That means they're engaged and truly want to get better. They're curious and interested in improving their own health. And it's a learning process for everyone — we learn a lot from patients through their questions, their problems, the way their labs come back, and their experiences. It's a delicate dance of navigating health, not a "take this, and if it doesn't work, sorry" kind of thing.
Little Bites at a Time
There really are so many options, and you have to take it in little bites, because it can be overwhelming — like drinking from a fire hose. We listen to the patient and move as quickly or as slowly as feels comfortable to them. Change your perspective from thinking a provider will just be prescriptive — "do this and this" — to a question-and-answer process where we find out what will work for you. Everyone is so truly different, and there are so many options, so come open to learning and getting in touch with your body and your own intuition.
We can often tell by talking to someone that they're stressed, even when they say they're not — they don't feel it because they've lived it for so long. I use the analogy that your health is like a bicycle wheel with many spokes — stress, sleep, nutrition, exercise, supplements, hormone balance, gut health, and on and on. When some spokes are missing, too long, or too short, it changes how the wheel spins. We can't fix all the spokes at once, so we take little bits and pieces at a time.
Wrapping Up
To sum it up: don't give up. Your feelings and symptoms are justified, and there's a way to improve them. Not everyone is the same, and you may not get a complete resolution, but there are options out there and multiple ways to achieve health. Thanks for joining us today. If you have any questions or want to reach out, please do. We'll look forward to talking to you next time. Have a healthy day.