For World Menopause Day: Gunter's Menopause Greatest Hits

And Free Access to the Top Paywalled Posts

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Friday, October 18, is World Menopause Day, and so I thought this was a good time to dig into the vaults and re-up some valuable past content.

One of the great things about providing medical content is there is a constant source of new material in the form of new studies (or revisiting old ones), updated guidelines, medical conferences, cutting-edge technology, and even the bottomless well of snake oil. Yes, I hate that snake oil and scammers exist, but I always learn something when writing about these services or products, whether it’s what the science actually says or a new marketing trick. In fact, I’m convinced that I often spend more time researching some of these scams than the people who sell them! 

Consequently, over the past three years, I have accumulated a large library of menopause content here at The Vajenda. The thing about a large library is, well, it’s a large library! I am sure the people who have been following along for a while haven't seen every post, and of course, new people are joining all the time (hi!). Finding your way back to an older post isn’t the most intuitive on this platform. While Substack has many benefits, to me, it feels built for what’s new, meaning what was written this week or maybe even today. While I do cover breaking stories (for example, my top takeaways from the 2024 Menopause Society Meeting or the approval of fezolinetant for hot flashes in 2023 or explaining the estrogen shortage in 2023) and I debunk viral claims (for example, about harmful chemicals in tampons), most of what I write is evergreen because I am, well, trying to build a library of women’s health content. (Although truthfully, many of the “breaking stories” are evergreen). But because of how the Internet works, many of the evergreen posts, like this one about the nuances of different vaginal estrogens, might easily get lost in the shuffle unless a new product hits the market or we get a new, groundbreaking study of vaginal estrogen. Hey, a girl can dream!

With that in mind, today, in honor of World Menopause Day, I want to highlight some posts that I think are relevant or important or that you collectively think are important because they are the most viewed!

Posts I Think Everyone Should Read:

The Language of Menopause Hormone Therapy and Why It Matters. This was published in July 2022, and anyone considering hormone therapy should read this post first. So much of the content about “bioidentical” hormones is fiction, after all, it is a marketing term. Being similar or almost identical to what the body makes does not make a hormone safe! Reading this post will help you quickly distinguish between marketing and medicine. This post, Misinformation about Bioidentical and Compounded Hormones, October 2023, is a good follow-up and explains how “bioidentical” became such a buzzword courtesy of misinformation promoted by Suzanne Somers, Oprah, and Christiane Northrup.

Don’t Use Menopause to Excuse Mediocre Men. Ha! Sort of self-explanatory. We hear a lot about loss of libido and rage in midlife, but sometimes those things are justifiable, for example, if you live with a lump of a man. Women are the ones bearing a lot of the drudgery and emotional labor in heterosexual relationships, and sometimes people are quick to assume that dissatisfaction with a relationship is hormone-related when sometimes it’s just being fucking fed up. This is why studies, like SWAN, that follow women through the menopause transition into menopause and beyond are important so that we can distinguish between aging, relationships/life, and menopause. Also, if you have libido-related concerns, let me put in a plug for the fantastic book Better Sex Through Mindfulness by Dr. Lori Brotto.  

The Money in Menopause Supplements. I created my own Dr. Jen’s Menopause Taming Turmeric Supplement so people can see how easy it is and how much money is at stake for the snake oil salespeople who offer them. The research behind doctor and naturopath-branded supplements always sucks, so there’s that. But they also seem to be more expensive than products from established supplement brands, like Nature Made. It’s pretty fucking hypocritical for doctors to complain about the lack of studies in women’s health and specifically in menopause, and then turn around and sell an unstudied supplement that is primarily backed by rodent studies. That is capitalizing on gaps in medicine, not closing them. 

Can Probiotics Prevent Osteoporosis? This isn’t a groundbreaking post in the sense that you will not learn which special probiotic can prevent osteoporosis because there isn’t one. However, I really enjoyed researching and writing this one. I learned a lot about the interaction between the microbiome and bone health, and I found the studies on germ-free mice to be fascinating. 

My Most Popular Posts Behind the Paywall, FREE Until Saturday Morning

While most of my content here is free, a small percentage is behind a paywall. Many of these are very detailed and take a lot of time to research, organize, and write. To help celebrate World Menopause Day, I am removing the paywall for the four most popular paywalled posts until Saturday morning.

Menopause, Hormone, Therapy, and the Brain. This is my take on the fantastic lecture on brain health at the 2024 Menopause Society Meeting. If anyone is telling you that hormone therapy prevents dementia, know that they either have an agenda or are out of date. This post will catch you up on what you need to know.

Testosterone and Menopause. Separating Fact from Fiction. I think the title is self-explanatory.

Depression, Low Mood, and Menopause. This post discusses who is at greatest risk for depression in the menopause transition/menopause and also reviews the therapies. Sometimes hormones may be the best approach, sometimes antidepressants, and sometimes both. There is so much demonization of antidepressants, but they have actually been studied here, so all I ask is that people keep an open mind. Any provider who claims all mood issues in menopause and the menopause transition can be treated with estrogen likely doesn’t see many patients or doesn’t see those same patients returning back when they haven’t improved because they’ve gone elsewhere. Or they are ignoring what their patients are saying and are indiscriminately increasing the doses of estrogen as the simple answer to everything.

Spotlight on Brain Fog. What is the role of menopause hormone therapy? This post should answer that question and hopefully more. 

If you want more menopause hormone therapy content, you can find it in my Hormone Therapy Guide; you can scroll to find content that might appeal to you or head to the pinned post, which has the Table of Contents with links to all the posts. The few entries that don’t have links haven’t been written yet! I’m working on it. This guide is a living document, so I go back and update posts when there is new, relevant data. At some point, new science willing, many of these posts will need major updates because of new products or new data, so when that happens, I will let people know so you don’t miss any meno-news.      

And…wait! Some more menopause content!

I used to have a podcast, Body Stuff, with the TED Audio Collective. Sadly, we couldn’t get non-sketchy sponsors (only supplement companies and Pharma were interested, and I have a no-industry sponsorship policy), so that’s why I *used* to have a podcast. It was highly produced with writers, editors, and professional fact-checkers, but without advertisers, the model was sadly not sustainable. I am super proud of the work. In season one, we did an episode on menopause, where I interviewed Dr. Kristen Hawkes, a key researcher behind the grandmother hypothesis. You can find the episode here or wherever you get your podcasts. Also, we made a short menopause-explainer video that you can find here. My friends in Canada can also find my Jensplaining episode on menopause on CBC Gem. 

Menopause is having a moment, and it’s about damn time. I’ve been writing and speaking about it for a long while, and it’s great to see the world catch up.

Sometimes, menopause can feel like being dumped in a canoe without a map, and all of a sudden, without warning, someone just pushed you out into the water with a wave. You have no idea about the difficulty of the rapids or the length of the journey ahead. You may even feel like you are sinking. My hope is that I can steady the boat a little to help you catch your breath and provide you with some tools to patch your canoe, as well as a solid map to help you plan your route.

Happy World Menopause Day (a couple of days early).