Ep. 255 Navigating Women’s Midlife Health with Kristin Johnson & Maria Claps

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Episode 12: There’s No Shame in Healthy Aging with Maria Claps

Book mentioned: 

The XX Brain by Lisa Mosconi

Transcript

Cynthia Thurlow: Welcome to Everyday Wellness Podcast. I’m your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent, is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.

Today, I had the honor of connecting with Maria Claps and Kristin Johnson. They are plain-spoken friends and practitioners who share a passion for women’s health, especially women’s health at midlife. Today, we dove deep into their backgrounds in helping to change the cultural narrative around aging for women, secrecy, and shame. We talked about some of the changes that occur in middle age including changes in metabolic homeostasis in our metabolism, muscle, immune function and brain health, the need for changes in nutrition especially increases in protein and a reduction in carbohydrates, the need for strength training as well as Zone 2 training, the role of HRT, mistakes they commonly see in navigating not only HRT, but also supplementation and the importance of testing. I hope you will enjoy this empowering podcast as much as I did enjoy recording it.

Well, ladies it is such a pleasure to have Maria back again and have you, Kristin. I know that there’s been a lot of interest in having us connect and talk about the amazing work that you both are doing to help empower women in perimenopause and menopause and beyond. So, welcome.

Kristin Johnson: Thank you.

Maria Claps: Thank you so much, I’m very excited to be back.

[laughter]

Cynthia Thurlow: Yeah. For listeners, this is a fun fact. Back when Kelly and I cohosted the podcast in 2018, we had Maria as one of our very first guests. If you go back to episode 12, that’s when Maria shared her whole story. But Maria’s story, Kristin’s story, my story are all very great examples of what most women experience, even women that are smart and articulate and are able to identify what they’re going through. The traditional narrative still negates what we experience north of 40 years old. I’d love for you both to share a little bit about your story so we can start the conversation there and then we’ll dive into what we’re just talking about before I hit record.

Maria Claps: Yeah. The story of how I came to do this work, Cynthia?

Cynthia Thurlow: Yes. Your calling, this is your calling.

Maria Claps: Yeah, it does feel like a calling. I was kind of early 40s-ish, I would say about 43. I just started to really feel very different physically, emotionally, mentally and I sought out help of what I thought was a pretty good doctor, I’m not here to put him down, in New York City. He had written several books. He was on Lower Park Avenue. I believe my doctor’s visit was December 26. If you’ve been in Manhattan on December 26 you’ll know, it’s crazy, hard to get a cab, but that’s how desperate I was. So, went to the office. It was very much an awakening and he helped in certain areas, but the big takeaway was I got like the fire hose of information. Interestingly, now remember I was 43, he ended up prescribing HRT for me, full HRT like estrogen and progesterone and ton of supplements, very little to really no education as to what was happening in my body.

I did everything he said and I got somewhat better. He mixed in some potentially really dangerous remedies in there and one of that was Klonopin and I got a little bit hooked on that. I ended up getting unhooked, I unhooked myself, I didn’t get that hooked in, but I’d probably used it for close to a year. I was able to unhook myself. Thank God, it was a really tiny dose, but still just not really great. I just came away from that thinking that there has to be a better way. That’s just when I pursued a deeper education.

Cynthia Thurlow: Yeah, I think your story is certainly so commonly expressed, probably in your DMs and my DMs, people that write about the podcast explaining their experiences in late 30s, early 40s and it’s not to suggest that there aren’t people that benefit from early progesterone therapies or things like that, but I think this traditional one size fits all mindset is hugely problematic in a lot of different ways. Kristin, I would imagine I know you were a competitive athlete, you are a high-powered attorney, so you had a lot of stress from the exercise, stress at work. I think we’re all moms of all boys, which I think is we share that in common as well. What was your process like coming to terms with the changes in your body and perimenopause?

Kristin Johnson: Yeah, so I didn’t really have any idea of what it was. The reason why is because my mom had a complete hysterectomy at 32, so I didn’t see her go through. It was honestly after my birth. She went from the cesarean to the surgical room to have the C-section. So, looking back, I can now recall some of the pains and things that she had. She actually was one of the women who was on HRT during the WHI and had it abruptly withdrawn. That cascaded in a whole bunch of problems for her, bilateral breast cancer and a few other things, but I didn’t have any hint that this was hormonal driven. As you said, I was very high achieving and I had a lot going on in my life and I started to stumble. It was the fatigue and the exhaustion, the foggy brain, I joked that I needed list to tell me where my list was for the day, I could not get through anything.

Definitely saw the libido change, sleep disruption in a way that I think I actually still have some PTSD over this sleep disruption that I went through and it didn’t help. I was getting up at [4:30] in the morning to go row and do other things, but I just went from being able to do everything to really struggle to do anything. And went to my doctor, I was living in Boston at that time. It was the epicenter of big medicine. I thought these will be the people, they’ll help me. I had a woman, and she was from India and she took a very holistic approach with various things. I was completely confident that she would be able to say, this is what’s up. Instead, she gaslit me and she looked at me and said, you’re too young. Like Maria, I was 43. We joked that 43 is like this magic age for the bottom to start falling out.

But she looked at me and she wouldn’t even do any blood testing. She wouldn’t do anything and looked at me and said, you’re too young. Even if it is, we can put you on the pill. This is not an issue. I said, “No, something’s wrong with me. I’m not the person I used to be.” Went back to her so frequently that she finally yelled at me and said, “You know, you’ve been back here four times in the last six months for blood tests, there’s nothing wrong with you.” And I was begging like, do I have Lyme disease? Is this autoimmune? Something is wrong. I got the opposite of what Maria did. I got nothing given to me, not even testing, and was sent on my merry way.

Being a bit of a questioner in terms of my personality and being an attorney, I like to research. I just started diving into this and realized, “No, there is something changing.” It’s not necessarily wrong, it’s just not optimal and it’s difficult to support the life I was living with these issues that were going on without some other intervention. That too is how I came to this. I think both Maria and I were driven by maybe a little undercurrent of anger and frustration and started to really just educate and figure out what is going on. As we started to work with clients in our nutrition and health practice, it was these women who were having the same issues over and over, and they felt heard when the two of us could say, this is okay. This is normal. It’s not optimal, but it’s normal. We continue to deepen the education piece because, like you said, every woman is different. It’s not a one size fits all, but I think we can cover all the bases probably between the three of us in terms of how it’s gone.

Cynthia Thurlow: Absolutely. And that paints a purpose. I think for each one of us, if we reflect on, I think I was 44 or 45 when I hit the wall and I really hit a wall and I remember going in to see my GYN and her remark to me was, it just so happened that day I went there, my cycle had started, and it was very heavy. I was telling her this and she did a physical exam and she was like, “Oh my God, this is really heavy.” I said, “I’ve been telling you that.” She said, “Okay, we can fix this. We can put you on the pill. We can do an IUD, we can do an ablation and you know you’re probably not going to have any more kids, so if you want we can just do a partial hysterectomy.” I was like, “Time out, no way.”

[laughter]

I knew enough by that point that those things weren’t going to fix the problem. She was aghast that I wasn’t willing to consider one of those four methodologies. But when we think about traditional allopathic medicine, that’s really– we address symptoms, we’re not looking at the root cause. Do you suspect for all of us and I say all of us as a community of women that there’s a degree of secrecy and shame and discomfort about the aging process that probably drives some of this lack of awareness, lack of our healthcare professionals talking to us, preparing us for when this is going to happen. Because I know even practicing or training OBGYNs get very little training about menopause and very few of them go on to specialize in this area. Do you suspect that the shame and the secrecy piece is worsening or adding to this issue for women?

Maria Claps: I do. I think a lot of our worth is tied to our fertility and I think that, gosh, it’s even reinforced in Hollywood, the most beautiful of the beautiful people, they tend to stop getting roles at around 40 or 45. It’s funny, I was reading an article yesterday and well the author was, I believe, quoting a celebrity who said, “Well, that ageism in Hollywood has maybe lessened a bit.” But that’s probably because we have the ability to look younger than we are. I thought that was really very interesting, thoughtful, just something to consider. So, yeah, I absolutely do. Madison Avenue has predicated that youth and dewy skin and again, ability to be fertile to be just what we always want to aim for. That’s pretty sad, actually.

Kristin Johnson: Yeah. I think too that it’s one thing when we’re new moms, we can stand at the bus stop and talk to our girlfriends or go and have book club or play bunco or whatever, and we can share these common things that we’re going through as we’re raising children and growing in our marriages and whatnot. But when your vagina gets dry and sex becomes painful that’s not a topic that comes up at book club. It’s not a topic that comes up at the bus stop. And we do feel broken, I mean, we feel like we have failed in some way if we’re not able to love having sex with our husband, forget the fact that it’s painful and uncomfortable or that maybe we don’t have the same lubrication. We wonder, like, do I not like him as much as I used to? We start to question these things as though we are to blame.

I think that’s where the shame piece comes in is that we stop talking to these women in this community that we all share and we become very insular. It becomes whispered concern at the doctor’s office if you even raise it at all. You’re met with a variety of things which is either here’s some sleeping pills and some lube, here’s for Maria 30,000 supplements or for Kristin, nothing’s wrong with you, get over it yourself. That piece of it, I think, just absolutely feeds this very uncomfortable experience physically to be incredibly uncomfortable emotionally. And it’s hard, even our partners will be like, what’s wrong with you, because maybe you’re extra bitchy or something. You’re thinking to yourself, like, I don’t know what’s wrong with me, but you can’t say that we get defensive or we feel like we did something bad.

So, it’s tough. It’s a tough time of life and I think we’re all forgetting that at the same time most of us are raising teenagers around this time and they’re not loving us, often. [laughs] We’re not the most popular person in our households, let’s put it that way. Between changes in the bedroom, changes in our mood, changes in our appearance, and then changes in our interpersonal relationships, it’s just not a fun time.

Cynthia Thurlow: Oh, I just can’t tell you how timely that comment is. I have two teenage boys, one of whom gives me the bro hug. Like, every night I get a bro hug, which I’ve now acquiesced. So, this is my new normal. My 15-year-old is very mercurial. He’s either happy or he’s pissed at the world, I’m usually the person that gets the brunt of it, I’m not quite sure why. But last night or two nights ago, he was in the pantry and he was trying to pick out something to eat because, of course, it’s second dinner or third dinner.

Kristin Johnson: You didn’t feed him enough.

Cynthia Thurlow: Yeah, exactly. Which, I know you both understand with boys. I remember saying to him, I was like, “Okay, I’m going to bed, give me a hug” and he was like, “No, I don’t feel like giving you a hug.” I said, “Well, just give me a bro hug.” He’s like, “No, I don’t feel like giving you a hug. Why do I have to give?” And then it becomes this argument. I just said, “Buddy, every night before I go to bed, I’ve always given you a hug.” I was like, “Hug my arm, is that less offensive?” And then when we’re having this whole conversation in the pantry and for women listening, if you’ve been through this with your teenagers or your kids, boy, it is really like, you have to take it back. It’s like, okay, I need to respect the fact that he doesn’t want to do this even though it’s pretty benign, but also understanding my relationship with my boys is shifting because they’re getting more independent, they’re getting more outspoken. My poor husband is sitting back and try to watch this. He’s like, “I’m not sure if I should say anything or just stay out of it.”

[laughter]

Cynthia Thurlow: The acknowledgment that all those little snugly moments that you have when your kids are younger that doesn’t last forever. It doesn’t mean and Maria I know that your boys are a little older now, maybe it comes back around, maybe they become better huggers. It’s that oxytocin hit that you get from connecting with your loved ones that you start to realize I need to find other ways to get this because of the things, the fallback mechanisms are shifting and changing, much like everything does in parenting.

Kristin Johnson: Yeah, it feels like loss. [crosstalk]

Maria Claps: It’s an interesting journey. Yeah.

Kristin Johnson: I think Maria and I, we both have kids that are older and this weekend, for example, my middle one came home all the way from California for 60 hours. Okay, that was it. He’s in the armed forces, so he wasn’t able to take a lot of time off. I didn’t drive him back to the airport, my husband did. My husband came home and he said, “Wow.” And I said “What” and he said I was told, “I never have appreciated my family more than this weekend and I’m so thankful for all of you.”

Maria Claps: So sweet.

Kristin Johnson: Okay, A, that’s great to hear, but like B it would have killed me to hear it.

[laughter]

Kristin Johnson: I was like why can’t you say that when he was walking out the door? [laughs] Saved it for dad in the car ride. But, yeah, they do become more appreciative later on. It’s just this is a tough time and when you feel like you’re losing your body, your relationship is changing, and then you’re watching these things that you’re launching into the world start to detach from you, it’s a bit of a gut punch.

Cynthia Thurlow: Absolutely. Let’s talk about some of the changes that are going on in our bodies in late 30s, early 40s. I think it’s important to have context because the rest of our conversation will stem from this. This explains the symptoms. This explains why you start becoming weight loss resistant, which so many questions about weight loss resistance, which I’m sure we’ll unpack, but I think starting the conversation there will be really invaluable.

Maria Claps: So, the brain directs our hormones and so many times we just think about like, “We think about our hormones. But it’s really like that brain connection to the hormones. For whatever reason that starts to become a little bit disconnected and progesterone, I always like to say it’s probably DHEA that started falling first. We got that whole adrenal issue happening, but it’s progesterone. Let’s start with progesterone that falls and estrogen fluctuates. Kristin and I believe that estrogen fluctuates at even a lower level than say it did in your 20s, 30s like that and that has impacts. But women are often very concerned about being high estrogen and that’s very very rarely the case. We always tell women if it is the case, it’s super temporary, it’s on their way out.

[laughter]

Maria Claps: Yeah.

Kristin Johnson: Yeah. So, as these hormones are changing, I think to even go back further, we as women think of our hormones as driving our menstrual cycle, driving our fertility, but at the end of the day, they’re actually driving complete metabolic homeostasis in the body. And we don’t appreciate that. We don’t understand or anticipate that as we start to lose those hormones, we’re losing that metabolic homeostasis. How does that manifest becomes really relevant because we’ve all just shared? We feel like all this change is happening and some of it’s very obvious and some of it’s not so much. Women might not realize that maybe that anxiety you developed in your mid 40s was actually declining hormones. Maybe you lost a parent and it stemmed from that and then it escalated, but it is this loss of homeostasis. So, our metabolism is changing, our ability to metabolize carbohydrates in particular is changing, our muscle is declining, our immune system is slowing, our brain function is changing.

Like all of these things are happening driven by, as Maria just described, the declining fluctuating hormones that we’ve always just attributed to fertility. It’s not just that, so this is why we say to women it’s totally normal what is happening. Your body isn’t broken, it’s not failing you. It’s just we have the senescence on the horizon and on that horizon sits these changes and they’re going to happen. So, body composition changes. We see women really going hard with that mentality of calories in calories out, or cringed all weekend long when we’re seeing people hit the gym like, I earned my turkey and we’re like, that’s not really how we want to think about it [laughs].

So, as these shifts start to happen, even maybe before a cycle change, women in their late 30s and 40s are like, wait a minute, all of a sudden I’m getting softer. What’s happening? They start doing more cardio, and they start eating plant based, and they’re changing all these things that unfortunately are interventions that make it worse. That’s one of the things that frustrates women a lot because they’re like, I’m doing it so hard, I’m doing it so well, I’m doing it better than I’ve ever done it, and it’s not helping or it’s getting worse. That’s where we want to say to women, that’s your hormones. It’s difficult for them to think that belly fat is going to be an estrogen issue of decline, not an estrogen issue of excess.

Cynthia Thurlow: I think it’s a really important qualifier because we’ve been conditioned as women that if we restrict, so if we dial back on calories, if we work out harder and generally it’s not lifting weights, it’s the Orangetheory Fitness, sorry people CrossFit-

Kristin Johnson: [crosstalk]

Cynthia Thurlow: -really intense exercise in perimenopause and menopause and then I see a lot of women that start over restricting in terms of not only their nutrition, but they start fasting and they think if a little bit of fasting is good, then more is better. If a little bit of food is good, then less is better. If a little bit of exercise is good, then more is better. I start to see this triad and trying to explain to women that actually the overexercising and over restriction is actually making things worse and trying to dial back on all that dieting methodology, all of us are old enough to have lived through, I mean, I used to tell patients in the beginning, you just need to exercise more and eat less. Like that was the prevailing garbage nonsense that I was taught, that I talked about for years till I knew better. I think for a lot of people it’s very hard whether it’s cognitive dissonance, it’s really hard to work through. Like, “Oh, wait, you want me to walk outside and go lift weights? Wait, you actually want me to eat more protein?” These things are really different. The other side of that is that people assume one thing is going to fix it all and I just keep telling them the game has changed. All of a sudden, we’re really at the beck and call of our hormones.

Maria Claps: Yeah.

Kristin Johnson: Yeah, and the sleep disruption doesn’t help. I think that’s something that we all overlook and some of it is definitely driven by lifestyle choices. We’re on devices, we’re staying up too late, we’re not honoring this horrible early sunset, [laughs] not these things that are happening. If we started to really tap into that circadian rhythm and prioritize and optimize our sleep, women would be shocked that sometimes they don’t even need to make a whole ton of changes. If they just started sleeping, the weight loss resistance would lighten up a little bit. That’s something that we see frequently with women as the not sleeping or the waking up all night to pee and things like that. There’re ways to address it, but honestly, it’s a really low-hanging fruit that sometimes women are overlooking in exchange for all of those other things, which is the over restriction.

We’ll tell women all the time, like, “You need to eat, you need to eat more, you need to eat a lot more protein.” [laughs] They just look at us with fear, like absolute terror that if I eat more, I’m going to gain weight. We’re like, “I know that’s a theory, but we need to unlearn that.” And we’ve seen it, Maria. We’ll mump women up to sometimes 50% more calories than what they were eating and all of a sudden, they’re like, “I lost 10 pounds and we’re like shocked. That the bodies– [crosstalk] 

Maria Claps: Or they just feel overall better. We get a lot of responses– I just feel like women that are really tuned in, like, my blood sugar is balanced and my cravings are down.

Kristin Johnson: I don’t have to eat all the time.

Maria Claps: Yeah, we don’t have to eat all the time. It’s like, when they can actually trust us and break through to the other side, they have some pretty significant changes.

Kristin Johnson: Yeah.

Cynthia Thurlow: Yeah, I do find the protein thing is for many women mind blowing because I know any time my team and I create content, we get so many questions, well, how am I supposed to eat 100 grams of protein a day? I’m only eating 40. I’m like, well, you work your way up, you eat a bigger piece of steak, you put more chicken on your plate. I’ll be honest, I don’t love turkey. I don’t love turkey. It probably makes me un-American, but I don’t.

[laughter]

Cynthia Thurlow: You better believe, on Thursday I had a lot of turkey on my plate. When I finished eating all that turkey, I was like, okay, now if I decide to eat some dessert, I’m going to regulate how much I’m going to eat because I know there’s just a finite amount of more food that I can put into this body, but I’m going to enjoy every bit of this pie. So, not surprisingly, when you get women sleeping, when you better balance their blood sugar, when they’re more satiated, they sometimes will start to see improvements in body composition, how they feel, their energy levels, etc. But let’s spend a little bit time talking about nutrition because this is an area where we have to unlearn some bad habits. One of them is the lack of animal-based protein. I know all of us are on the same page about the superiority of animal-based protein, but why are carbohydrates such a triggering topic? I feel like every time we touch this, it ends up exploding.

Kristin Johnson: We hear it too. Women will say, I went low carb and my hair fell out, or I went low carb and my thyroid got slower, or I went low carb and these bad things happen. I would say, Maria, we could pretty much confidently say 99.99% of the time, it’s because you cut out carbs and you didn’t replace them with anything and you were too low calorie. First of all, we want to say eating low carb is not a bad thing and it’s not going to bring down this cascade of poor health problems regardless of what you’re hearing from women who claim that that was the cause of their issues. So, there’s that. But then also that we talked about as estrogen is changing, we have estrogen expressing in the lining of our intestinal tract, in the parietal cells of our stomach. As we lose that estrogen, we actually lose our tolerance for carbohydrates, it goes down.

Women don’t want to believe that. Anyone who says at 42, I haven’t changed the way I’m eating and yet I’m gaining weight, it’s well that’s your proof right there. That you just don’t have the same capacity for the same macros that you carried through your 20s and 30s. When we look at part of why that is, it has to do with the sink that is our muscle. Everyone can accept that after 30 our muscle starts to decline. It accelerates dramatically around 45 and really hard in our 50s. That is just a big depository for carbohydrate tolerance. So, when we’re in our 30s and we’re all full of muscle, we have a better tolerance for carbs. Now decline that muscle and decline the estrogen and it’s this double whammy, where carbohydrate tolerance has to shift. Women just have to accept that. It’s not a popular thing and no one has to always be ketogenic. We’re not necessarily fans of the keto diet. It’s more eating for the metabolism that you have in midlife and that means prioritizing the protein in order to optimize muscle which newsflash will actually help you handle carbohydrates better in the future?

Maria Claps: Yeah, there’re also gradations of low carb. There’s 20 grams a day, 50, under 100 could still be considered low carb. I think there’re ways to work with that and we just really do want to focus on the protein and you know Cynthia, I will often see– this used to be me and that would be like you would go out to lunch with friends and you just have this big beautiful salad with some dark leafy greens and some carrots on top and maybe just like a really small side of chicken. I don’t know if it was 4 oz that would be a fairly good amount of protein and just like maybe not a lot of fat. Yeah, there was a dressing on it.

We eat that way and we think oh, it’s so virtuous, [laughs] I’m doing so good. But then like I don’t know, two hours later I was looking for probably for some more fat and protein. I just think that to get that protein in and just to go back to something we’re about before is it can be hard to get that protein in if you are filling up with these other virtuous healthy foods and we all have different levels of and I know you know this. Can we tolerate vegetables? I can. My son can. Our level of health can dictate that.

But even if you can, say, eat vegetables, they don’t bother your gut. You don’t have IBS or anything like that. If you are focusing on that salad, on the vegetables. This is a little bit hard for me to come to grips with and I think it’s hard for a lot of people including my husband to come to grips with is, no, okay, it’s not that you can’t have those things, you can, but you have to just put them on the side counter for now, just like put them aside, focus on protein, really be intentional and prioritize that. You can add those things on more like a side dish. So, again, I know it sounds like “Oh, is that bad, what she’s saying because that stuff is healthy, right? Like, having a big old kale salad is healthy and having a raw carrot, it’s going to detox your estrogen, although there’s nothing really magical about carrots, it’s just fiber but I don’t want to hate on carrots, but it’s just like we can’t be eating copious amounts of plant foods and expect to be meeting our daily protein requirements.

Cynthia Thurlow: I think that’s a really good point. Much to your point, for every person out there, we’ve got our own bio-individuality, our own threshold. Sometimes it ebbs and flows. Three years ago, I only tolerated meat. I’m grateful that nine months later, I could start having some vegetables. But my body, even now, like, I love Brussels sprouts to a point that’s probably a little bit absurd. I had three days of Brussels sprouts and today I got up and my gut was like, nope, can’t do that again today. Really leaning into foods that make us feel good for the same reason why, as an example, kale kills my gut, too much oxalates. For me, spinach, kale, celery, yes, they’re intrinsically healthy, they don’t work for me and that’s okay. Finding what resonates, what works for our bodies is really important, but starting with that protein piece first.

When I go to restaurants, I am that person if I don’t get enough protein on my salad, I will ask, can I have a side of shrimp? Because that’s usually something that can be cooked fairly quickly. Can I have a little bit more protein. There’s no shame in asking for that. In fact, I was in Chicago a few weeks ago with a colleague and went to this one restaurant a couple of times because were staying in an Airbnb and sometimes in the evening, we didn’t feel like driving around going to different places. And True Food Kitchen has great options. True Food Kitchen has very small protein portions. It became this running joke that I would get this particular meal and I would always ask for double protein, and they graciously did it, which ended up working fine. Don’t be afraid to– when you’re at a restaurant or you’re at a family member’s home, push that protein lever because the benefits as a middle-aged woman are really important. It’s not just the protein, but it’s also the strength training piece. I think a lot of women are afraid of weight. I don’t know how else to put it or they think that those five-pound dumbbells are going to help them build strong calorie-burning muscle.

Maria Claps: They want to be toned.

Cynthia Thurlow: Yes, they want to be toned. I know this is something we all talk about, but let’s focus on this because this also impacts your carbohydrate threshold, it impacts your body composition. I mean, it impacts many things, but the physiologic piece about insulin sensitivity is why I think muscle mass and building muscle is super important.

Kristin Johnson: Yeah, I think women have an issue with strength training similar to the reason why they have an issue with animal protein. It feels masculine. A lot of people think that it’s not very appropriate to go out to a restaurant and ask for double protein. I remember when Maria and I were at a conference-

Maria Claps: I was hoping, you can tell that story.

[laughter]

Kristin Johnson: -medical conference in San Diego about three or four years ago and she was in shock and awe as I sat there ordering a la carte meats off of the menu and just saying, could I just get this? I’m not going to eat the kale salad or the baked potato or whatever, so could I just get this a la carte? We started doing it and having fun with it. This guy finally, we’re in Southern California, it’s vegan heaven and this waiter looks at us and he’s like, you ladies are so cool.

[laughter]

You know, we just cracked up because were like, probably not the norm to be eating like this. But strength training, I think, is the same issue. Women are scared they’re going to get bulky and newsflash ladies, you don’t have the hormones to get bulky at this stage of life. It’s not going to happen no matter how hard you try and it’s not something that we’re accustomed to. Any of us can walk into a gym, see an elliptical or a treadmill or a bike and think I can do that, I know how to do that. But jumping on a hyper or knowing how to do back extensions, knowing how to do a squat rack and look at lat pulldowns and things like that, it’s intimidating. It’s intimidating, you don’t see many women doing it. I think now we have a generation of 20 and 30-somethings who are changing the script on that, which is wonderful. But for those of us 40s, 50s, and beyond, it’s not in our wheelhouse. It’s not something we’re comfortable with. In addition, we’ve got this change in hormones that actually does change our joint mobility. It changes our tendons and our ligaments, our connective tissues.

Like me, I came into this stage of life with a lot of sports injuries and so, women who do take the plunge and try and do it, often end up hurting themselves because they aren’t ready for this stuff. We’re all looking for a bit of an easy button. We’d like a quick fix. If we just walk into the gym and start lifting heavy things, that should work. And it’s not that simple. We do need to understand movement patterns to have our range of motion evaluated, maybe undertake some physical therapy if you’re not quite ready for it yet. And then we say, hire a trainer. None of us were born with a guidebook on how to strength train. That’s not something that we can expect. We all should know how to ride a bike, but that comes from early childhood. 

But that part of thinking that we have to ask for help makes it even further more uncomfortable. Getting a trainer, having what we call a planned progressive program, women will I think with the right intentions, unfortunately, take the wrong approach, which is dialing into a YouTube video and following a random workout on Tuesday and then finding another one on Thursday, that’s not going to work, ladies. It’s not going to work. We need to follow this planned progression of stressing the muscles at different loads and different volumes and working towards a goal.

If women could just accept the fact that none of us sent our kids to kindergarten and expected them to read, they had to learn their letters first. It’s the same thing with strength training. We need to go in, understand what we’re capable of, what needs a little assistance, get some guidance, be evaluated, and have a plan that we follow. Once women and Maria and I encourage our ladies to do this all the time, they do that. They’re like, “This is so much more fun.” They’re actually enjoying strength training when they understand that it’s okay to be a newbie. It’s best to start at a beginner program, but you don’t stick with those five-pound dumbbells forever or body weight, you do need to move up. That hauling heavy iron makes you feel like a superwoman. I have a 55-pound puppy, I still pick him up every day. My kids will be like, “Mum, that is so unnatural, put him down.”

[laughter]

And I’m like, but don’t you see like, I can pick him up. I can unload the car of all the salt bags and haul them down to the softener downstairs walking through two layers of my house. It’s those functional things that strength training gives us that women aren’t appreciating. Now, the fact that my body is toned or tighter and that I have a bigger carbohydrate tolerance and that my inflammation is lower and my immune system is happier that’s all-side issue with the muscle. We look at it like, “Do you want to have to grab onto a grab bar when you lower yourself to the toilet when you’re 65? Most of us probably say no.” So, learn to squat. It’s basic things like that.

Cynthia Thurlow: I think it’s really interesting because my whole background, working in hospitals, seeing people in clinic, I saw plenty of 50 somethings that in the hospital couldn’t get off a bedside commode or were so deconditioned, their quadricep or their leg muscles were so weak that they had to go to rehab for an extended period of time. I remind people that, yes, those of us that are able bodied, it doesn’t even occur to us that can happen, but if you don’t use it, you will lose it, and it really accelerates in menopause. This is why I think all of us really endeavor to make sure people understand, like, walking is great and I do encourage people to be physically active throughout their day. What is your feeling on Zone 2 cardio? The type of cardio where you can speak while you’re doing it, the more I learn about it, the more I do it, and the more I’ve started talking to patients about it. But I think it’s important for us to at least touch on that as well.

Kristin Johnson: Yeah.

Maria Claps: It’s a Kristin thing.

[laughter]

Kristin Johnson: Only because I have a very deep, competitive athlete background, and it was a part of my training for a long, long time. Zone 2 cardio, we aren’t seeing a big burn number on that calorie counter that, by the way, ladies, it’s not accurate. Neither is your fitness tracker, but we don’t appreciate what it is. What happens is that too many times we’re training at a level that’s enough to fatigue us without getting any actual benefit. You either need to be doing this hit sprint training to really stress the heart and red line things, or we need to keep ourselves in this Zone 2 place, but because you can have a conversation or you can breathe through your nose and out through your mouth the whole time, it doesn’t feel like we’re accomplishing much. Sometimes you can do Zone 2 and not even sweat, and then who wants to go to the gym and not sweat? You feel like you didn’t do anything.

Zone 2, I think, is really, really important. I think the hard thing is fitting it in or recognizing what it is and what it isn’t. It doesn’t even have to always be on a cardio machine. It could be you wear a weight vest and you go for your daily walk. It could mean that you just keep walking hills up and down. For me, I do it on a rower, which is probably one of the more difficult things for most people to maintain a Zone 2, but I had 15, 20 years of that. A bicycle is another option, but what people don’t understand is even a low-level strength training day can be Zone 2. I say to women, get a heart rate monitor, understand what this zone is for you, and try and do your workout by staying in that, that’s frequently– you don’t need to be maxing out and crushing it in the gym all the time.

Women will say, but how do I fit it in? We say, do three days of strength training, do three days of Zone 2, and at the end of one of those Zone 2 days, do a sprint session. Sprint sessions, anyone who’s going to a HIIT class that lasts 45 minutes, I want to come and hug you and say, no, no, no, no, no, that’s not the way. A true HITT session means you are gassed within about eight to ten minutes. It doesn’t have to be hard, but it does have to be intentional no differently than the nutrition piece does. We can’t go five days a week strength training and think that we’re not going to impact our cardiorespiratory system. We need to be doing both.

Unfortunately, we have some great voices in this space talking about Zone 2, but I’ll be perfectly honest, they’re dudes, they have a ton of time on their hands, and their whole platform is their body and their longevity. So, yay for you, I love you Peter Attia, but the fact that you have 7 hours a week to do Zone 2 is patently unrealistic for the average person on the street. I think that that’s the hard thing for women is we’re hearing this stuff on podcasts and in blog posts and we think, I can’t even possibly fit this in. So, they don’t do it at all. I think that if women started to realize that 30 to 40 minutes of a Zone 2 session three times a week and then recognizing that probably one of their strength training days is actually Zone 2 as well, they would be more inclined to program this in and schedule it in.

I’m not a huge walker. I live in the land of snow and cold and ice, and I’m not going to get 15,000 steps in during the day. Maria can nail those out and listen and do work. [crosstalk] I have to be very deliberate about getting that Zone 2. Like I said, it’s just no different than being very deliberate about how you’re choosing your food.

Cynthia Thurlow: I think it’s really helpful to hear how real-world people were out there in the space. We’re speaking to middle-aged women, but also being very transparent. Like, I live in a pretty temperate part of the United States. During the pandemic, my husband and I get out and walk our dogs in the morning. We get to talk and connect and we’re in a very hilly part of the area we live in, and so we’re up and down hills. And my vet was actually surprised. I have a ten-year-old dog and a nine-year-old dog. She said, “Wait a minute.” You do 4 or 5 miles a day walking your dogs? I said, yeah, “But it’s good for them, it’s good for us.” But this is what came out of the pandemic. They were certainly getting walked before, they weren’t getting an obligatory dump in the backyard to do their business.

But the point being, you find ways to figure out what’s going to work for your lifestyle. Sorry Kristin, we rarely get snow and when we do, everything shuts down in this part of the world. I would love to pivot and talk about the role of HRT. I know that we’re going to talk about menopause. I want to talk about the Women’s Health Initiative and what that has done for an entire generation of clinicians and women who are both fearful of prescribing and taking medications. And I recently interviewed Dr. Amy Killen. I’m not sure if you’re familiar with her work, but she’s a female biohacker and she’s a physician. When I talked to her last week, she said, we need to start talking about menopause, about what actually menopause is. It’s a disease state when people get fearful– [crosstalk]

Maria Claps: Oh, wow. Okay, I’m impressed because very few people come to grips with that.

Cynthia Thurlow: Yeah, and I told her, I said, it really sat with me. I had to really process what she said. It makes me feel even more empowered to say to women that you might not be taking HRT as an example. You may choose not to, but understanding what’s happening behind the scenes that you may not be seeing that is really, really impactful on your health and your longevity.

Maria Claps: Well, I would say my hat is off to her because it sounds like she wanted to just wallop people with like a zinger to wake them up. To that, I actually really agree with it. Now, I don’t know if I would go so far as to say it’s a disease state, but I would say and this is just me playing with words and being stupid, it brings on disease-like states, it does. I think that’s one of the things Kristin and I have been so passionate about is educating. We still get so many women who are like, well, I don’t really have any symptoms or my symptoms went away. My symptoms went away when I started magnesium or something like that, which is awesome. I always say, “Great, we should not have to live with nagging symptoms. No one should have to endure those things.” But that is not the entirety of the yardstick when we come to measuring your health at menopause. It’s such a huge distraction. I’m fascinated with this episode, Cynthia. I’ll have to listen to that. Yeah, HRT we think is incredibly important and Kristin and I like to flip the narrative on its head and we say to people, “What are your risks of not using it?” We don’t want to talk about– What we do a little bit, talk about the risks of using it, but we like to help women. We want to just think differently not using it.

That’s where we dig into these problems. I do think that there are some people like, I bet this doctor is going to get a lot of pushbacks for saying something like that, but there are some people who like I’ve been told before, it was a while ago, you’re scary. And I’m like, I’m sorry, I don’t mean to be and I don’t even mean to be really aggressively negative or anything. It’s just that I want to wake you up. I wish someone– I was just thinking this morning as I was making my breakfast, I said I missed my muscle-building window. I was either distracted raising children, lazy, unaware in my, say, late 30s, early 40s. I missed that. I am working overtime now to correct that problem. I feel like a lot of women if they don’t wake up, are going to miss the opportunity to use HRT. So, yeah, we’re very passionate about it.

Kristin Johnson: Yeah.

Cynthia Thurlow: I wouldn’t use the term scary. I think that you’re straight forward, when I was thinking about the ways that I describe both of you, is that I think about inspiring and empowering and you’re straightforward-

Maria Claps: [crosstalk]

Cynthia Thurlow: -and to the point. I think because I grew up in New Jersey, it’s an education piece. We want people to feel empowered. Let’s be frank, the informed consent piece is so rarely discussed. I was on oral contraceptives, which covered up PCOS. I had that thin phenotype PCOS, which we didn’t find out until I was trying to get pregnant. I remember saying to my GYN a few years ago, I was like, I wonder if that impacted being on oral contraceptives with very low estradiol state for so many years and I’m osteopenic, which I’m not paranoid about it. It is what it is. My peak bone-building years, I was on drugs that kept my estrogen levels low and probably prevented me from being capable of building more bone. Did anyone talk to us about informed consent about things [crosstalk]

Kristin Johnson: Still not happened.

Cynthia Thurlow: Yeah, still doesn’t happen.

Kristin Johnson: Yeah, I think Maria and I, we just wrote, we’re fired up on the topic of HRT from the standpoint of there’s a lot of shiny objects right now entering the market to divert women’s attention from even considering HRT. It’s partly a profit model that’s being pursued within venture capital and whatnot simply because there’s, I think, what is it 100 million women right now are menopausal in the world and it’s a 600-billion-dollar market, Maria,-

Maria Claps: Yeah.

Kristin Johnson: -financially for Wall Street. So, what makes us angry is that it really is only the last couple of decades where HRT has been this no, no. What women do not understand is really at the beginning of the 20th century, when the estrogen pill was first developed, I mean, it was well accepted. This was called, it literally had a clinical diagnosis, hormone deficiency syndrome. It was recognized as being something contributing to the chronic diseases of aging of women, and that we needed interventions or we’re going to have this really sick generation on our hands.

For like 40 years, 50 years, HRT was used to literally preserve women’s health. It was considered a preventative intervention to help women age healthily. So, when [laughs] Maria and I get women who will come to us and say, I want to do menopause naturally, and Maria and I will say, “Great, because that means dying.” Like legitimately, that is what you’re asking for is to have a shortened health span with decreased longevity and decreased functional health. We look at HRT and we say, “Given that it was a hormonal deficiency syndrome, it was American College of Physicians, American College of Obstetrics and Gynecology, American Heart Association was behind it. It was literally considered all of those important things.” We don’t need to get into the WHI, but we can, I mean, it was this horrible study, it was poorly designed, it was poorly interpreted, it had a lot of flaws.

Its own investigators have backed away from the conclusions, all of these things, but that yanked HRT out of women’s hands about 20 some years ago. And where are we now? Well, we outnumber men 3:1 when it comes to Alzheimer’s. We outnumber men 4:1 when it comes to osteoporosis and autoimmune disorders. We catch up to men who lead the way with cardiovascular disease until we hit 50. We catch up to them and by 65, we overtake them. Are we really living well without HRT? When we look at the average 65-year-old is on, I think, 15 prescription medications.

We push back and say, okay, so HRT is the bad guy and yet with its withdrawal from the market and withdrawal from women’s lives, we’ve actually seen the greatest decline in female health that anyone could have ever imagined over the last 25 years. There’s a problem there. That is where we get really hot and passionate about the HRT piece. I already intimated my mom was on HRT. She didn’t have a uterus, so she wasn’t in the arm of the WHI that was using progestin. She just had Premarin in her system and she was thriving. I remember my mom hitting, like, 40 and being a different person than the first ten years of my life. She had it taken away from her, and it was unbelievably gut-wrenching to see how poorly her health declined and what happened to her after that.

I don’t want that for myself. This isn’t a predestination just because we’re all going to be menopausal. Newsflash women, nobody gets out of this alive without menopause. I don’t want that for myself and I don’t want it for any other woman that I know either. If we’re sitting here and we’re all working so hard on our appearance and our nutrition and our strength training and all these things, why wouldn’t we be considering HRT on top of it? That’s the piece that Maria and I just feel like we need to go to the rooftops and shout about.

Cynthia Thurlow: I think it’s so important, though, to hear that because the narrative for so long, like, I was the baby nurse practitioner when the WHI study came out, even though I was safely in cardiology, I started seeing patients who, all of their HRT was stopped. My mother, all my mother’s sisters, all my aunts, have navigated menopause 25, 30-plus years, no HRT. You better believe that I’m seeing the sequelae of all of this. I almost get emotional when I say this, but one of my aunts said to me recently, I’m so grateful that you are giving women a voice, and we are all giving women a voice so that we can make better, more informed decisions because starting them on HRT in their late 70s is not necessarily going to be of benefit, but knowing that cognition is pretty darn important to me. The hierarchy of things, like being cognitively intact is pretty darn important if you worry about nothing else.

Brain health, Dr. Lisa Mosconi has this amazing book, The XX Brain. I highly recommend every woman read this book. I have no affiliation with her whatsoever. I just really like the work that she’s doing. When you start to understand the domino effect of what happens as we’re losing estradiol, as we are losing progesterone, as we are going through adrenopause and menopause and the impact on testosterone. I definitely want to touch on testosterone because I think far too many women think if they’re going to do HRT, they just need progesterone, they just need estrogen and really talking and speaking to how important testosterone is and finding a provider that’s going to prescribe it, also a challenge. What have been your experiences when you’re working with women? I know you have a referral base. You refer out to appropriate functional integrative medicine physicians, and PAs, and NPs. Is testosterone still a taboo subject for a lot of your female clients? Are they still fearful they think they’re going to look like Arnold Schwarzenegger after [crosstalk]

Maria Claps: No, I think they’re actually pretty excited to do it, we have to slow them down because there is, in some circles, Cynthia just moved to just rush to testosterone, and it’s our training with our mentors that, yes, testosterone great. All of our providers will do testosterone, but not right away. It’s like let’s get your estrogen and progesterone in balance and that’s because there is an issue with the receptor. It can interfere and it uses the same receptor that estradiol does. And so, like estradiol that is the alpha, most important, yes progesterone is important too, but it’s more like a supporting cast. Testosterone is important, but let’s get that estrogen and progesterone, like, working well at a physiologic level, and then we can add testosterone three to six, maybe nine months later.

Kristin Johnson: So, yeah, I think, like Maria said, so many are chomping at the bit for it from the standpoint of– [crosstalk]

Maria Claps: Libido.

Kristin Johnson: Pellets are a huge thing. Too many doctors take in early 40-something who’s maybe got a little less libido, really wants to focus on the body count piece, because we’re still a little competitive with the girlfriends and how we look at the community pool and whatnot. And they get testosterone pellets, and it’s like va-va-voom. Their husband’s like, “Whoo. Who’s this? They do still have enough estrogen in the tank that when combined with this excess testosterone and some gym time it works. We’ll have women come to us being like, I want that. I want what she’s having. We have to back them down a little it and say, look the testosterone isn’t going to do all the things and like you just said, brain health, I remember when my dad was on his deathbed, the biggest gratitude he had was that God enabled him to keep his brain.

His body failed him five times sideways with cancer and all these other things. He was so happy that he was aware and cognitively intact and still doing the New York Times crossword puzzle. Guess what? We need estrogen for that brain. It’s not testosterone. All the other things that we talked about in the female body and that homeostatic regulator, that’s estrogen not testosterone. We think it’s a wonderful thing, but like Maria said, it just needs to take a second seat, step back from getting our estrogen dialed in first, and it can have its drawbacks too. We had one woman who was very resistant to letting go of her pellets and coming at us quite a bit, and this was a client and Maria jokingly suggested to her in a gentle way that “Maybe this was testosterone speaking.”

[laughter]

Kristin Johnson: There’s a certain point where testosterone cannot be the best thing for us when we’re overdoing it. Yeah, we’re huge fans, but like Maria said, we need to tell women just slow down. Whenever we hear doctors giving out a cocktail of estrogen, testosterone, and progesterone all at the same time, it’s an automatic red flag. We just– [crosstalk]

Maria Claps: They don’t know what they’re doing.

Kristin Johnson: No. Mm-hmm.

Cynthia Thurlow: And it’s interesting. I have peers that will remain nameless that have set up pellet clinics. Because we’re all entrepreneurs, they reach out because they want support. I’m always happy to support other entrepreneurs, but I just had to say we have to agree to disagree. I just don’t think this is the– maybe it works for some people, but I’ve seen women with outrageously high testosterone levels. They feel great for a few weeks and then they feel awful for three months. I just had Shawn Tassone on and he is not a fan of pellets at all. I let him rage/discuss the use of pellets. If you’re on pellets and you’re listening to this, there’s no judgment. We just like people to know there are other options.

Testosterone, I think, is so misunderstood because I feel, based on what I’ve read, that testosterone sometimes is that missing piece that can really be impactful for changes in body composition, that when you’re working with a provider and they say, “Oh, I don’t give women testosterone.” I always say, I think if you’re optimized otherwise, there can be a lot of benefits and it can help with libido and it can help with bone and muscle integrity and can help with brain health, and it can help with body composition and not in extreme amounts. We don’t need a lot of testosterone but certainly testosterone can be very beneficial. Before we end our discussion today, I would love to touch on some of the common pellets or one of them, some of the common things you see women utilizing, whether it’s supplements or medications in this stage of life that you think maybe they should have a pause about and then also considering testing. I know we all use the DUTCH and the GI map, and we’re huge proponents of it. Let’s end the conversation there because one thing that I find as an example is there are well-meaning practitioners out there that love DIM. And I’m like, “DIM is great.”

Kristin Johnson: I knew you were going to say DIM. It was like on the tip of my tongue.

Cynthia Thurlow: Yes, exactly. I was like DIM is a great supplement with the proper individual. Let’s talk about some of the things that people will come to me, I’ve inherited patients and I look at their list of supplements. I’m like, you don’t need DIM, why are you on DIM?

Maria Claps: Or they’re taking it for too long. It’s like I had one woman, she was taking it for over a year. Gosh, well, I would say would be just your hormone balance-type supplements that have these proprietary formulas where you don’t necessarily know the amounts in it, or even if you do know the amount, some proprietary will list the amounts. There is a formula that I like, I think it’s like probably good to take in perimenopause or even good to take if women are not going to do HRT. It’s not like I dislike all proprietary formulas or hormone balance-type supplements, but I think the way they’re marketed is very disingenuous. Like, they literally say there’s one company that says what if HRT wasn’t the default choice? Well, it’s definitely not the default choice, something lab, I won’t say what the name is.

[laughter]

Maria Claps: We’ve got them saying things like, it’s just like, this is good for all of your hormonal imbalances. Most of them have DIM in them. That is like the last thing a woman who is in a late-stage perimenopause needs or something like that.

Kristin Johnson: Yeah, I think another one is vaginal hormones. Women can get first of all, they can get their own progesterone. Ladies, we’re telling you progesterone is like testosterone. It works until it doesn’t. It’s not where you should put your money. We’ll get women one of these suppositories or vaginal creams or vaginal little pearls. What women do not understand and again, no judgment, it’s just for lack of informed consent, really to be honest, is that vaginal applications of these things are not a systemic expression. That is a huge thing that women are missing, is they’re coming to us and they’re like, well, I’ve been on this hormone regimen, and so Maria and I are always eager to see what some other providers’ HRT regimen was. She lays it out and we’re like, you’re not even on HRT. You’re literally just lubricating your vaginal tissues and clitoris that’s it.

That is one that we see frequently, these midlife women thinking that because they were given some vaginal application that is actually doing anything for their bones, their brain, their heart, it’s not. DIM obviously is a big one. The other one that we see too often is, unfortunately, botanical or herbals that are antimicrobial. Because so many people think that they’re estrogen dominant, which again, you’re not estrogen dominant or that they need to detox all their estrogen. You might have a functional medicine provider with IFM after their name who thinks, well, it’s in the gut. We’re just going to clean up your gut. They stick these women on these gut regimens that they’re still on nine months later. Meanwhile, they’ve wiped out their microbiome and they come to us and they can’t figure out why everything’s gone haywire. It’s like, holy buckets, we need to dial this back. These were short-term interventions. They should be very targeted. You should have known why you were on it. Hopefully, you knew exactly what you were addressing, whether it was Giardia or a parasite or some H. pylori or something like that. 

But that extended supplementation and these incredibly broad-spectrum protocols are really problematic to women’s health. Nobody wants to age having to take your pill popper and put 15 things in it every day, that’s just not normal. We would say to women, aside from the hormones, if you’re on this extended supplement regimen, you cannot out-supplement hormonal deficiency. And there’s a good potential that many of the things that you’re on are actually doing harm.

Cynthia Thurlow: I think that’s such an important point. Again, with good intentions, I think some of these antimicrobials and I think about berberine as being one of them. Berberine has a lot of benefits. I took a bit of berberine around Thanksgiving and I have to remind myself what berberine does to my gut is it gives me digestive upset because it’s a potent antimicrobial. Yes, it helps with blood sugar, taken every once in a while, is not a big deal. For the same reason that you’re saying that we forget that some of these supplements, they are multifaceted. They have the ability to treat and address multiple things. So, again, for full transparency took a little bit of berberine and two days later my gut was like, “Time out, no more, just don’t tolerate it.”

But I would love for you to let listeners know how to connect with you. I know you both have an amazing program. You’re both active on social media with a little bit of snark, which I appreciate because I do that to myself. [crosstalk]

Kristin Johnson: Hopefully not too much.

Cynthia Thurlow: No, no, no, I always think it’s a good amount. Like I always say, finding the appropriate amount of snark that’s not directed at anyone, except I did poke fun of a male physician the other day, but that’s okay in the context of waking is a normal function of aging. That made me very angry. With that being said, let my listeners know how to connect with you both outside of the podcast.

Maria Claps: Yeah, so they can just find us @wise_and_well_ on Instagram and then that’s the name of our website as well is wiseandwell.me. And then we have a Mighty Networks Group. Kristin can talk about that.

Kristin Johnson: Yeah, we have a standalone community that’s open and free and you can find it in our profile and our Instagram profile and the links in that, but it’s hosted on Mighty Networks, which if you’re not familiar with, there’s no feed so to speak, there’s no friending, there’re no advertisements, there’s no nothing. It’s really just a place for Maria and I to put some long-form content, be able to engage with women that’s not Instagram comments and DMs. We haven’t categorized the topic. It’s very very robust. I think people come in and they don’t realize how much is there. We’re right now releasing our very snarky, not too snarky but frustrated series-

Maria Claps: A little bit, yeah,

Kristin Johnson: -on how menopause has become big business. Ladies, you are the prey and there are predators out there and we want women to have that informed consent. If you’re going to choose supplements and oils and things like that, just understand what it is that you’re then not choosing. You’re not choosing to protect yourself with HRT. That’s perfectly fine if that’s your choice. We just want women to understand that. Don’t get distracted by shiny objects. Your algorithm is probably bombarding you with new products in Instagram and Facebook, they’re not all what they’re made out to be, and we just want women to understand why. Our Mighty Networks community is one of those things where we really just get into the depths of that stuff.

Cynthia Thurlow: Well, thanks ladies. It’s really been a pleasure to connect with you both. Thank you for your advocacy. Thank you for your transparency. It really makes a difference in the space.

Kristin Johnson: Thank you.

Maria Claps: Well, thank you for having us. We enjoyed it.

Cynthia Thurlow: If you love this podcast episode, please leave a rating and review, subscribe and tell a friend.