Hi Dr. Jen, thanks so much for giving us the straight goods. I recommend The Vajenda and your books to all my friends, co-workers, random women at the gym, etc. My nurse practitioner has suggested Ashwaganda to help with sleep disruptions and hot flashes. I’d love for you to provide info on ashwaganda. Thanks so much!
Hi Dr. Gunter. I'm an ob/gyn and I read this paper too. I was taught that heavy women often have an easier menopause due to increased levels of circulating estrogen which comes from aromatase in their adipose tissues converting androgens to estrogen. This paper says the opposite. I think that's the first time I ever heard that losing weight helps HF. One of the risk factors for severe VMS is being thin.
Also, I might highlight that the super popular black cohosh had no benefit and can also cause rare liver damage. This is the worst case with many supplements. They don't work and some can cause potential serious harm!
Thank you so much for this. I get migraines with aura so estrogen is a no go for me and my estrogen levels are strangely fine; the night sweats and hot flashes still hit. The two different supplements I have tried are Amberen and Relizen by Bonafide, the latter of which is too expensive and I didn’t find helpful, but I would like to hear your thoughts on them. Amberen was recommended by a coworker and Relizen by my Menopause Specialist Gynecologist who referred me to read your stuff! Thank you for the work you do!
Dr. Stacy Sims out of Australia has been studying menopause in athletic women for years. She has lots of data to report, including tons of information on supplements, nutrition and exercise. I highly recommend everyone read both Roar and Next Level for more information.
Hi Dr. Jen, I'm a little skeptical about adaptogens but also a little curious. I keep hearing about Schiasandra as a therapy for hot flashes. So curious to know if you have found any studies about this. Also, if one pursues this kind of therapy, how to feel confident that you're getting a bonafide product? Thank you for sharing your wisdom!
Hi, thanks for responding. I’m actually a physician but not gyn ( radiology)
I’ve had 2 kids vaginally with a bad tear after delivering a macrosomic pumpkin 😝
Now I’m post menopausal and have had a worsening cystocele ( now protruding just to the introitus) without uterine or rectal prolapse. I Had some urine leakage with coughing or jumping but that resolved when I started very low dose amitryptilline for migraine prophylaxis ( 25mg q day). It also makes me incredibly constipated but I wouldn’t go off it bc of the migraines and it let’s me sleep!
Anyway …probably way more info than you needed…
I have a good friend from my work who is not my personal doctor say that she always sends her pelvic floor weakness patients to PT and has good results with this.
However when I finally scheduled an appointment with my personal doctor she said “Oh, that never really works -you need surgery “ After she examined me though she ended up just fitting me with a pessary-which is working well, at least for the last week.
I guess my question is should I go ahead and try the PT? Can it get me back to not needing the pessary? Or can it at least help to prevent progression of the prolapse, etc?
Thanks again ( and yes I understand that you are not giving me personal medical advice-I just want to know if it’s a reasonable treatment)!
I would love to have you talk about Estrovera in one of your posts (www.estrovera.com). I was advised to take this early in perimenopause six years ago by my (former) Ob-gyn. Its active ingredient is Siberian rhubarb. I was/am hesitant to take any kind of MHT because I am at high risk for breast cancer. The thing is, it seemed to help at first for my worst symptom, which was brain fog, not hot flashes. But now I am wondering if that was just placebo effect. It didn't seem to do much for my hot flashes one way or the other, but they weren't bothering me that much. The brain fog eventually went away (for the most part, lol) but it bothered me that I was only able to get Estrovera from her office, and it was costing me about $1/day because of course it was not covered by my insurance. I tried researching it but didn't come up with much. Eventually I dropped it, and her, and got a new Ob/gyn that I trust much more. My hot flashes are about the same, maybe a little less, now that I am fully menopausal.
Since you asked: please review the data on Equol. I'm actually surprised that it's not recommended, since I'd read positive things about it -- though I admit I didn't do the deep dive that you always do.
While I understand not all woman can take hormones, I wonder why they aren't considered the most "natural" remedy. Our bodies make estrogen and progesterone and we know that it's the depletion of these that are causing the symptoms we are trying to alleviate. It feels safer to me to take exogenous hormones than to try the newest thing.
Thanks so much that’s really helpful!
Hi Dr. Jen, thanks so much for giving us the straight goods. I recommend The Vajenda and your books to all my friends, co-workers, random women at the gym, etc. My nurse practitioner has suggested Ashwaganda to help with sleep disruptions and hot flashes. I’d love for you to provide info on ashwaganda. Thanks so much!
Hi Dr. Gunter. I'm an ob/gyn and I read this paper too. I was taught that heavy women often have an easier menopause due to increased levels of circulating estrogen which comes from aromatase in their adipose tissues converting androgens to estrogen. This paper says the opposite. I think that's the first time I ever heard that losing weight helps HF. One of the risk factors for severe VMS is being thin.
Also, I might highlight that the super popular black cohosh had no benefit and can also cause rare liver damage. This is the worst case with many supplements. They don't work and some can cause potential serious harm!
Thank you so much for this. I get migraines with aura so estrogen is a no go for me and my estrogen levels are strangely fine; the night sweats and hot flashes still hit. The two different supplements I have tried are Amberen and Relizen by Bonafide, the latter of which is too expensive and I didn’t find helpful, but I would like to hear your thoughts on them. Amberen was recommended by a coworker and Relizen by my Menopause Specialist Gynecologist who referred me to read your stuff! Thank you for the work you do!
I would love for you to discuss Bonafide's Relizen!
Dr. Stacy Sims out of Australia has been studying menopause in athletic women for years. She has lots of data to report, including tons of information on supplements, nutrition and exercise. I highly recommend everyone read both Roar and Next Level for more information.
Hi Dr. Jen, I'm a little skeptical about adaptogens but also a little curious. I keep hearing about Schiasandra as a therapy for hot flashes. So curious to know if you have found any studies about this. Also, if one pursues this kind of therapy, how to feel confident that you're getting a bonafide product? Thank you for sharing your wisdom!
Hi Dr Jen. Thank you so much for this wonderful piece. I love it. Keep on with your good work 👌💕
Also just wanted to fan girl you and say I am always forwarding your articles to friends and family!
Hi, thanks for responding. I’m actually a physician but not gyn ( radiology)
I’ve had 2 kids vaginally with a bad tear after delivering a macrosomic pumpkin 😝
Now I’m post menopausal and have had a worsening cystocele ( now protruding just to the introitus) without uterine or rectal prolapse. I Had some urine leakage with coughing or jumping but that resolved when I started very low dose amitryptilline for migraine prophylaxis ( 25mg q day). It also makes me incredibly constipated but I wouldn’t go off it bc of the migraines and it let’s me sleep!
Anyway …probably way more info than you needed…
I have a good friend from my work who is not my personal doctor say that she always sends her pelvic floor weakness patients to PT and has good results with this.
However when I finally scheduled an appointment with my personal doctor she said “Oh, that never really works -you need surgery “ After she examined me though she ended up just fitting me with a pessary-which is working well, at least for the last week.
I guess my question is should I go ahead and try the PT? Can it get me back to not needing the pessary? Or can it at least help to prevent progression of the prolapse, etc?
Thanks again ( and yes I understand that you are not giving me personal medical advice-I just want to know if it’s a reasonable treatment)!
I would love to have you talk about Estrovera in one of your posts (www.estrovera.com). I was advised to take this early in perimenopause six years ago by my (former) Ob-gyn. Its active ingredient is Siberian rhubarb. I was/am hesitant to take any kind of MHT because I am at high risk for breast cancer. The thing is, it seemed to help at first for my worst symptom, which was brain fog, not hot flashes. But now I am wondering if that was just placebo effect. It didn't seem to do much for my hot flashes one way or the other, but they weren't bothering me that much. The brain fog eventually went away (for the most part, lol) but it bothered me that I was only able to get Estrovera from her office, and it was costing me about $1/day because of course it was not covered by my insurance. I tried researching it but didn't come up with much. Eventually I dropped it, and her, and got a new Ob/gyn that I trust much more. My hot flashes are about the same, maybe a little less, now that I am fully menopausal.
Since you asked: please review the data on Equol. I'm actually surprised that it's not recommended, since I'd read positive things about it -- though I admit I didn't do the deep dive that you always do.
Hi Dr. Jen,
Do you have any information on Pycnogenol for reducing hot flashes? Love your books and your Substack; thank you for all that you do!
Hi Dr. Jen
Can you please do an article about pelvic floor weakness treatments. My doctor said that she doesn’t think pelvic physical therapy works.
I also have a good friend who’s an obgyn and she says she always sends her patients for PT.
Thanks you for this.
While I understand not all woman can take hormones, I wonder why they aren't considered the most "natural" remedy. Our bodies make estrogen and progesterone and we know that it's the depletion of these that are causing the symptoms we are trying to alleviate. It feels safer to me to take exogenous hormones than to try the newest thing.