The Real Fix for Menopause Symptoms No One Talks About w/ Dr. Jila Senemar

[SPEAKER_00]: It is not elective to make women feel better. [SPEAKER_00]: Women need a combination of things in order to have health optimization that lead to living longer but healthier. [SPEAKER_01]: Dr. Tila Senamara, a board certified OBGYN and the founder of Gila MD, spent over two decades listening to women and translating that lived experience into hormone therapy protocols. [SPEAKER_01]: plans and mid-life hair that don't settle. [SPEAKER_00]: Listening to so many women with complaints and not have an answer that felt good. [SPEAKER_00]: That's what kept me up at night. [SPEAKER_00]: You say that hormone therapy should never be one size fits all. [SPEAKER_00]: It really depends on the patient. [SPEAKER_00]: Most women are candidates for hormone therapy,

but women need to be looked at as a whole. [SPEAKER_01]: 4% of eligible women are on hormone therapy. [SPEAKER_01]: It feels like menopause care is still decades behind. [SPEAKER_00]: We're behind. [SPEAKER_00]: We have people who want to help women. [SPEAKER_00]: Yes, most have no idea what we're even talking about. [SPEAKER_00]: Power you need to find what hormone health includes. [SPEAKER_00]: It's not just about hot flashes and mood swings anymore. [SPEAKER_01]: Expert care for menopause and sexual health now just to click away. [SPEAKER_01]: Virtual care by her MD offers longer visits, personalized treatment plans, and trusted providers all from the comfort of the home. [SPEAKER_01]: Learn more at her MD.com. [SPEAKER_01]: This episode was sponsored by

her MD. [SPEAKER_01]: Content of the disruptor podcast is for informational purposes only, and does not constitute medical advice, please consult your healthcare provider for personalized guidance regarding hormone therapy and all your medical decisions. [SPEAKER_00]: How have you been though? [SPEAKER_00]: I mean, you're a lot of moving parts, a lot of things in shift in changing, but good stuff, really good. [SPEAKER_00]: I'm excited for the fall. [SPEAKER_01]: Your clinic looks amazing. [SPEAKER_01]: It just looks gorgeous. [SPEAKER_01]: I'm so happy for you. [SPEAKER_01]: It brings back so many memories for me, but so proud of you. [SPEAKER_01]: So congrats on that. [SPEAKER_01]: I got to see that on Instagram and it's beautiful. [SPEAKER_00]: I'm excited. [SPEAKER_00]: It's

fun. [SPEAKER_00]: It was a labor of love. [SPEAKER_00]: So, you know, you can relate to how that feels when you finally have your own, and it's like, okay, I'm done. [SPEAKER_00]: I don't have to answer 21, but me and it's it's a nice feeling to have. [SPEAKER_01]: It's a duality though. [SPEAKER_01]: It's that freedom of, uh, I described it as like dumping off a cliff. [SPEAKER_01]: Like when you get like, oh my god, I'm flying. [SPEAKER_01]: Oh my god, I'm dying. [SPEAKER_00]: No, man. [SPEAKER_00]: You know where you're like, what did I just do to myself? [SPEAKER_01]: What did I do? [SPEAKER_01]: Are they going to come? [SPEAKER_01]: Yeah, you know, um, yeah. [SPEAKER_01]: So

I remember being other than when it comes to personal things, the most scared I'd ever been in my entire life. [SPEAKER_01]: So, um, but it is incredibly freeing. [SPEAKER_01]: And when you finally do it, it's like, oh, I did it. [SPEAKER_01]: And on my own boss. [SPEAKER_01]: And that's pretty cool. [SPEAKER_01]: Yeah. [SPEAKER_00]: It's exciting after so many years, right? [SPEAKER_01]: Yes, I know. [SPEAKER_01]: It takes so many years for people to ask, but why didn't you do it younger? [SPEAKER_01]: I'm like, send medical school and residency. [SPEAKER_01]: Yeah. [SPEAKER_01]: So taking my boards, doing all the things we need to do. [SPEAKER_00]: I think we were like setting the stage for this, because I

think if we did it earlier, it may not mean as much, right? [SPEAKER_01]: or feel as good when you finally get there, right? [SPEAKER_00]: Yeah. [SPEAKER_01]: But I remember when I was fundraising, they thought I was so old for an entrepreneur and I would look around the room and I was one of the oldest ones, but it is because in medicine, there is all that time spent studying and in school [SPEAKER_01]: even to the point where you're allowed to practice medicine on your own. [SPEAKER_01]: And then I feel like you have to build credibility and that experience, you've got to see a lot of patients and get that on your belt first, you know? [SPEAKER_00]:

Yes, that's how I'm for the level to make the jump, right? [SPEAKER_01]: Yeah. [SPEAKER_01]: I mean, you don't meet many 25 year-old, I mean, you meet me 25 year-old tech entrepreneurs, but you don't meet a lot of 25 year-old medical entrepreneurs, you know, that it just doesn't happen at that phase in our life. [SPEAKER_01]: After I turned 50, I realized it's not a race. [SPEAKER_01]: Like I'm doing things on my own time line, you know? [SPEAKER_01]: All right, so getting back to what you and I do for a living. [SPEAKER_01]: Midlife medicine doesn't need a makeover. [SPEAKER_01]: It needs a rebuild. [SPEAKER_01]: The Dr. Sheila and I are already doing it. [SPEAKER_01]: And today we're

going to go deep into the how and the why. [SPEAKER_01]: So you and I both started in traditional obituy and care [SPEAKER_01]: midlife was where real innovation and honestly, real need existed, what was your tipping point? [SPEAKER_00]: What did it for ya? [SPEAKER_00]: I think it was watching and listening to so many women come in with complaints and not have [SPEAKER_00]: an answer that felt good to give them. [SPEAKER_00]: I just kept kind of being like, okay, well, let's look into that. [SPEAKER_00]: Let's see what's going on with you. [SPEAKER_00]: And putting the pieces together, because remember, Perry Menopause Menopause wasn't a discussion when we were in training. [SPEAKER_00]: We were right in the midst

of the WHO, so when it came out, on the verge of my attending was like, well then, we're done with that, we're not doing that. [SPEAKER_00]: So don't worry about it, yeah, you know, it causes cancer and it causes heart disease and so we don't really need to go down that path and so [SPEAKER_00]: just tell them no and that they'll get over and they'll get better. [SPEAKER_00]: Literally, that's what we were told in training. [SPEAKER_00]: And remember, we're in our 20s at that point. [SPEAKER_00]: We're really focused on obstetrics and becoming really great surgeons and doing all of that. [SPEAKER_00]: So it really didn't seem that significant at the time. [SPEAKER_00]: You kind of

be like to kind of ask further well what if what if we weren't there I wasn't there I was more focused on being a good doctor a good surgeon doing everything I'm supposed to so I didn't it didn't click until I kept hearing it over and over again And this huge practice that we run and I was like these women I've known for [SPEAKER_00]: You know, 15, 20 years, I've been through all the reproductive life with them, you know, watch some get married, have children, get through them, get them through all of that without any issue. [SPEAKER_00]: Here we are, and they're asking me these questions, and I'm thinking to myself, yeah, it could be

a hormone changes, but what do we do about it? [SPEAKER_00]: And it was a little bit here and there, a little touch and go, do some birth control pills and things like that. [SPEAKER_00]: And it would help a couple, but not many. [SPEAKER_00]: And it was just more and more and then it started affecting me personally. [SPEAKER_00]: And I was like, there's something here that we need to know more about. [SPEAKER_00]: and I reached out to colleagues and asked you know hey what do we do about this and they're like well there are other doctors you can go to and you know they'll make basically functional medicine go to them they'll write some you know

make some creams up and do this and that and [SPEAKER_00]: just didn't sit well with me. [SPEAKER_00]: I was like, no, there's gotta be more. [SPEAKER_00]: It doesn't make their has to be more. [SPEAKER_01]: And as doctors and surgeons were fixtures, we want to fix the problem. [SPEAKER_00]: We want to have an answer for everybody. [SPEAKER_00]: We want this kind of be like, yeah, go ahead. [SPEAKER_00]: It's fine. [SPEAKER_00]: It'll be okay. [SPEAKER_00]: Um, and so that's what kept me up at night, honestly, besides my hot sweats and just waking up at 3 a.m. [SPEAKER_00]: It's what really was running in my head. [SPEAKER_00]: I was like, I don't, I don't feel satisfied. [SPEAKER_00]: I

don't feel, I'm providing the same level of care that I can in OB and GYN and Robotics Surgery and all of that. [SPEAKER_00]: I need to do better. [SPEAKER_00]: And basically it was a digging game, you know? [SPEAKER_00]: You just start digging the rabbit hole and it pops up. [SPEAKER_01]: See, they told us in residency, so I was, we must have trained right around the same time that we would not be supported if we continued to treat our patients. [SPEAKER_01]: And at that point, remember, it was treat patients with hormone therapy, shortest amount of time, shortest duration. [SPEAKER_01]: And that's before WHO. [SPEAKER_01]: And once that came out, vitally enabled. [SPEAKER_01]: off the table and

I remember being told and it's so funny now what we heard with the FDA hearings and what you and I know is menopause specialist, but why would you offer a woman a therapy? [SPEAKER_01]: that could kill her, because of all those warnings, heart attacks, stroke, for a hot flash that won't kill her. [SPEAKER_01]: And it's like hot take, menopause can actually kill you, right? [SPEAKER_01]: Hit fracture, dementia, you're a sepsis. [SPEAKER_01]: I mean, that's just to name a few. [SPEAKER_01]: So it's so ironic that here I am in a residency program and they're telling me the fix is worse than the ailment. [SPEAKER_01]: correct, right? [SPEAKER_01]: And so I felt like a really, really bad

doctor and the same thing that motivated you, patient stories and mission. [SPEAKER_01]: are what got me to take that crazy leap to and to open my practice. [SPEAKER_01]: So very interesting, and I think those are the most successful people, by the way, people who are driven, this is what I always tell founders, doctors, anyone who wants to follow their dream and their passion is the most successful people are those that are driven by mission, and not the dollar. [SPEAKER_01]: I do. [SPEAKER_01]: I think [SPEAKER_01]: Success follows so it comes it comes. [SPEAKER_00]: It's you you can't be doing this as a business move A niche of this oh jumping on a bandwagon. [SPEAKER_00]: This isn't

weird that it's not about that It's about giving what you know is the right thing and doing the right thing and It follows like you said like I have never looked at How much is this gonna cost and maybe that's a down down fall of mine You know if you ask my house when you'll say that [SPEAKER_00]: But that's okay. [SPEAKER_00]: I keep pushing forward, like, you know, nothing stops me. [SPEAKER_00]: I'm like, you know what? [SPEAKER_00]: I don't care how much it is. [SPEAKER_00]: I'm going to do it because it's going to be okay because I know. [SPEAKER_00]: Deep in my gut, I'm doing the right thing. [SPEAKER_01]: Well, and you've also done years

and years of, I didn't know this until I got into rooms with business types, field research. [SPEAKER_01]: But by listening to those patients, you know there's a need. [SPEAKER_01]: So you've already figured that out. [SPEAKER_01]: And [SPEAKER_01]: So that's why even though you might not be thinking about the dollars, you're thinking about the patients, you're mission-driven, and for those of us who care for patients and are in the rooms and listen to the stories, we understand that healthcare is a relationship that it's not transactional, right? [SPEAKER_01]: And that's why patients come to us, right? [SPEAKER_00]: They see that, so me, they see, they can see through all of it. [SPEAKER_00]: So if they know you're

truly there for them, they appreciate that, and you build that relationship. [SPEAKER_01]: You build that relationship, and I think for me, it's the tears of finally them feeling like they're heard and they're seen and literally when I'm exhausted, right? [SPEAKER_01]: Because I'm mothering, I'm founding, I'm doctoring, and it's like that's literally, sometimes all it takes is an email or a note from a patient saying, oh my God, you saved my life, you saved my marriage, you found my cancer early, because you took the time to listen. [SPEAKER_01]: And so that's the little bit of fuel, I think it takes for a true mission driven. [SPEAKER_01]: provider or entrepreneur. [SPEAKER_01]: So you say, and I agree,

that hormone therapy should never be one-size-fits-all, walk us through your clinical decision tree about that statement, and how do you stay true to the science and the data, but still keeping it very personal? [SPEAKER_00]: It really depends on the patient and the relationship I have with them because a lot of them like I said, I've known for many years. [SPEAKER_00]: So they really, we have built in that trust relationship. [SPEAKER_00]: So there like, whatever you say goes, I'm with you, I'm not going to listen to all the noise and I'm going to listen to you. [SPEAKER_00]: Those are the easy ones in my opinion, because you know, [SPEAKER_00]: I've we've proven to each other where

we stand and they understand that I'm driven. [SPEAKER_00]: I'm looking at the data. [SPEAKER_00]: I'm looking at all the, you know, studies that are up to date. [SPEAKER_00]: And I explained to them, this is what it is. [SPEAKER_00]: You don't have any risk factors. [SPEAKER_00]: You know, all of your tests are up to date. [SPEAKER_00]: You're basically a low risk individual to be on hormone therapy, which as we know, [SPEAKER_00]: most women are candidates for hormone therapy. [SPEAKER_00]: One more time for the people in the back. [SPEAKER_00]: I'm not going to say everybody but most women if listen to appropriately and had appropriate care are candidates for hormone therapy. [SPEAKER_00]: So, as long as we

know that and we discuss it with a patient, we go through everything and they have, you know, I have them fill the questionnaire out and we know what they're dealing with. [SPEAKER_00]: Yes, we're going to start them. [SPEAKER_00]: The question comes with the other patients who are either new to me until we need to build the relationship or or hesitant. [SPEAKER_00]: And so I will walk them through what I'll say, okay, what are the symptoms? [SPEAKER_00]: Let's go through this. [SPEAKER_00]: Is this affecting daily life, your quality of life? [SPEAKER_00]: How are you functioning? [SPEAKER_00]: Yes, okay. [SPEAKER_00]: Let's talk about [SPEAKER_00]: the wise, the pros and the cons, where are you in your journey?

[SPEAKER_00]: Are you parrymenopausal or your menopausal? [SPEAKER_00]: What's going on and how can we best address it? [SPEAKER_00]: I will always start with lifestyle modifications as we all do because those are the things that are going to pay us forward moving on, okay? [SPEAKER_00]: You're like, go hand in hand, they go hand in hand. [SPEAKER_00]: Gather, you can't just fix one thing and it's a pyramid, right? [SPEAKER_00]: You got to have a strong base in order to be able to layer everything else on top of that base. [SPEAKER_00]: And so I start with them with, okay, what's your diet like? [SPEAKER_00]: What is your exercise regimen look like? [SPEAKER_00]: How can we modify those? [SPEAKER_00]:

How can we make them better? [SPEAKER_00]: I do, you know, routine lap testing, checking for everything under the sun, basically why? [SPEAKER_00]: Because it could be their thyroid. [SPEAKER_00]: It could be an iron problem. [SPEAKER_00]: It could be hormonal, which most of the time, it's a combo of all of those. [SPEAKER_00]: Absolutely. [SPEAKER_00]: And so you have to rule that out, and it's funny, my assistant's like, but what do we, you know, she's been with me. [SPEAKER_00]: So we're evolving the practice, right? [SPEAKER_00]: And like, say, well, you're a guy, no, what are you looking at biomarkers for the heart for? [SPEAKER_00]: I'm like, well, because you know what, I'm learning, I'm evolving, and I

wanna do more. [SPEAKER_00]: I don't wanna just be standard by the book. [SPEAKER_00]: There's more out there, women need to be looked at as a whole. [SPEAKER_00]: reproductive area, you know, breast and band don't issue all that. [SPEAKER_00]: No, it's everything. [SPEAKER_00]: It's from head to toe. [SPEAKER_01]: It's way beyond bikini medicine and I just fell in love with you all over again because I nearly lost my mom at 45. [SPEAKER_01]: So I am doing all of the cardiac screenings as well because patients even with elevated cholesterol being told just come back in six months and like [SPEAKER_01]: What magic is going to happen, what if we're preventing disease and we're saying that hormones are

part of longevity, then why aren't we investigating the ideology of the number one killer of women, more than all cancers combined? [SPEAKER_01]: and then we have to take care of brain and we have to take care of bone and so we best be checking all of those things. [SPEAKER_01]: Otherwise we're doing our patients a disservice and so earlier we alluded to stigma that was really holding menopausal care back. [SPEAKER_01]: education lane, you and I were in the midst of that WHI storm that hit, but tell me why despite two New York Times best sellers that are out there on menopause and others that had been out there and celebrities like Naomi Watts and [SPEAKER_01]: Halle

Berry and Stacey London being front and center and kind of joining hands with us and saying, you know, we won't take this anymore. [SPEAKER_01]: What do you think the breakdown is still going on that only 4% of eligible women are still on hormone therapy and it feels like menopause care is still decades behind where it used to be and where other countries are. [SPEAKER_01]: Like, what do you think is going on culturally? [SPEAKER_01]: We know educationally and we know data. [SPEAKER_00]: Yeah. [SPEAKER_00]: What's going on? [SPEAKER_00]: What's why? [SPEAKER_00]: Yeah. [SPEAKER_00]: Well, it's our communities. [SPEAKER_00]: Look around, right? [SPEAKER_00]: How many of us are there? [SPEAKER_00]: They're actually looking at the data. [SPEAKER_00]: Actually

up to date and care. [SPEAKER_00]: Even the menopause society. [SPEAKER_00]: What do we have? [SPEAKER_00]: 10,000 members right now? [SPEAKER_00]: Where's everybody else? [SPEAKER_00]: where are the births of them, right? [SPEAKER_00]: We're behind our community providers, health care providers. [SPEAKER_00]: I'm not going to say doctors because there's doctors, there's practitioners, we have a slew of women out there or docs or provide health care people who want to help women. [SPEAKER_00]: Yet, most have no idea what we're even talking about. [SPEAKER_00]: We have doctors and other specialties, cardiology, fighting a fight, like Jane Morgan will tell you. [SPEAKER_00]: She's the only one who understands hormone. [SPEAKER_00]: Nobody else is helping her fight her battle with doctors.

[SPEAKER_00]: So it's definitely, [SPEAKER_00]: on upon us to educate our peers, our colleagues, the ones who are open to it, there's only so much we can do. [SPEAKER_00]: By having events, by talking openly, bringing other colleagues in and saying, hey, let's talk about this. [SPEAKER_00]: Why don't we go through the information, the data, the WHO, let's break it down, that way you see, [SPEAKER_00]: This is not just a one-sided equation. [SPEAKER_00]: This is something global. [SPEAKER_00]: This is something that we all need to be on top of, that way we can address it across the board and really eradicate these walls that have been put up to prevent women from getting the care they need

and deserve. [SPEAKER_01]: And those of us with a platform and a voice and that knowledge base and the time, [SPEAKER_01]: really need to change guidelines. [SPEAKER_01]: I can't tell you how many times I'll go into a room and I'll teach physicians and then it's like, well, the guidelines say, and I'm like, if you wait for the guidelines and don't follow the data, unfortunately you're going to be waiting another 20 years and you may be doing your patients more harm. [SPEAKER_01]: than good, but for those of us who can sit on committees who can take those stages, I think we also need to really work on guidelines because a lot of doctors will depend on those

because they don't have the time to go to CME or maybe they don't have the time to become a menopause trained provider. [SPEAKER_01]: But at least they can know enough to get their patients in the hands of someone who does, or they can have accurate evidence-based guidelines. [SPEAKER_01]: And I'd like to. [SPEAKER_00]: Yep. [SPEAKER_00]: So that's the work on that. [SPEAKER_00]: There's a lot of work to be done, but you know what? [SPEAKER_00]: We're getting there slowly, but surely. [SPEAKER_01]: We're getting there. [SPEAKER_01]: You know, I won't be honest with you. [SPEAKER_01]: More has happened in my lifetime of practicing medicine that I thought there was ever going to be. [SPEAKER_01]: And the amount of

momentum we've had, I'd say in the last two to four years, I think has been pretty incredulous. [SPEAKER_01]: So I'm pretty proud to stand alongside, you know, all of these trailblazers, and it's gonna take all of us together. [SPEAKER_01]: But I agree with you. [SPEAKER_01]: I'm optimistic for the first time and a really long time for women. [SPEAKER_01]: Um, so you use words like metabolic care, emotional rhythm, cellular energy when talking about menopause. [SPEAKER_01]: How are you redefining what hormone health includes? [SPEAKER_00]: Um, it's, you know, it's more than just a hormone, it's reproductive, it's metabolic, right? [SPEAKER_00]: It's, um, mental, it's on a cellular level. [SPEAKER_00]: We know how all of these hormones specifically

estrogen, how that works to feel, to help the little mitochondria do what they need to do. [SPEAKER_00]: So they're all in a related. [SPEAKER_00]: You can't just, [SPEAKER_00]: take one and the other and kind of associate them from each other. [SPEAKER_00]: I think in a very long time, it's come to terms we're now conventional medicine and functional are kind of having a crossroads here. [SPEAKER_00]: And we're seeing a lot of the functional medicine doctors kind of come on board toward the platform as well and say, well, we've been doing this for years. [SPEAKER_00]: You know, we're have you guys been. [SPEAKER_00]: And I give them credit. [SPEAKER_00]: They're not wrong. [SPEAKER_00]: They've been ahead of

the curve with a lot of this. [SPEAKER_00]: But as you know, functional medicine was thought as woo-woo medicine. [SPEAKER_00]: And we really didn't give them the credit. [SPEAKER_00]: They deserved back then. [SPEAKER_00]: And now, we're realizing, hey, you know what, this is where it's add women need a combination of things. [SPEAKER_00]: It's not one or the other, you need to look at everything together in order for them to have health optimization. [SPEAKER_00]: And what does that lead to? [SPEAKER_00]: It leads to longevity. [SPEAKER_00]: It leads to living longer but healthier. [SPEAKER_00]: You don't want to just live to live. [SPEAKER_00]: You want to live with [SPEAKER_00]: quality of life. [SPEAKER_00]: You want to be able

to run around after those kids, and you don't want to be in a nursing home, you know, with a wheelchair or a walker, any of those things. [SPEAKER_00]: And we're living longer, we're living healthier, and we're just a different generation, and we're going to age that way as well, differently than our, you know, mothers, grandmothers, and things like that. [SPEAKER_00]: So, [SPEAKER_00]: Looking at it from metabolic standpoint, we know where estrogen plays such a big role in all the metabolic pathways, neurologic pathways, bone formation, and breakdown. [SPEAKER_00]: So we know where it is. [SPEAKER_00]: And so we need to really hone in on that. [SPEAKER_00]: It's not just about hot flashes and mood swings anymore.

[SPEAKER_00]: It's from head to toe. [SPEAKER_01]: Oh, it's from head to toe and I even as an expert, you know, I say I'm a forever teacher, but I'm a forever student and I learned so much from my peers and colleagues and I will tell you the number one habit I have changed. [SPEAKER_01]: So I've always eaten really well, I've always exercised, I love being outside, I love moving. [SPEAKER_01]: But I have been lifting weights and I remember being so resistant because I hated it But then I read the article the musculoskeletal syndrome of menopause and then was watching all of you and I'm like All right fine. [SPEAKER_01]: I don't want to be frail. [SPEAKER_01]:

I don't want to fall [SPEAKER_01]: And I don't want to live in a nursing home or longer, but spend, you know, my last decade of life in poor health, like I want to be out there traveling the world and climbing mountains and keeping up with my grandkids, you know, not just my kids, and so that is something that I have definitely been inspired by all of you to change even for myself personally, and really make sure that I talk to, um, [SPEAKER_01]: my patients about it. [SPEAKER_01]: So you talked about community and I feel like we all know each other better than we actually do because we keep up each other on Instagram. [SPEAKER_01]: So

you threw a really powerful event down in Miami, right? [SPEAKER_01]: Tell me a little bit more about that. [SPEAKER_00]: It really came on the heels of the emfactor screening that I did in November. [SPEAKER_00]: That's kind of where it all was sparked because I went to the Manipass Society meeting in Chicago last year and met everybody and was just overwhelmed, inspired, you name it. [SPEAKER_00]: I just didn't know where to start. [SPEAKER_00]: I came home with my head exploding, you know. [SPEAKER_00]: And I was like, what do I do? [SPEAKER_00]: How do I do this? [SPEAKER_00]: And, you know, the M factor was released and you were able to screen it. [SPEAKER_00]: So I was,

you know, fortunate enough to get it down to Miami. [SPEAKER_00]: And I started planning that out. [SPEAKER_00]: And what was supposed to be a one night screening turned into a three night screening with over 500 women who came out for it. [SPEAKER_00]: And that's where I knew there was something magical happening and I saw the audience. [SPEAKER_00]: My husband was in the back and he wasn't really sold on the whole thing yet. [SPEAKER_00]: He was, you know, he's like, it's a 50, you know, six minute documentary. [SPEAKER_00]: Who's really going to sit there for that long? [SPEAKER_00]: You're going to lose people said, I watched it and I had tears in my eyes when I

first saw it. [SPEAKER_00]: I was like, no, I don't think so. [SPEAKER_00]: I think there's something here. [SPEAKER_00]: And he was witness to something that he couldn't even put a word to. [SPEAKER_00]: He was like, you, you found something. [SPEAKER_00]: This is it. [SPEAKER_00]: This is, this is the community. [SPEAKER_00]: These women have questions. [SPEAKER_00]: They, they wouldn't stop with the panel. [SPEAKER_00]: Each night, it was just a different, you know, amount of energy in the room. [SPEAKER_00]: And it just kept [SPEAKER_00]: brewing and just kind of, you know, fueled my fire. [SPEAKER_00]: So after I was done with that, I was like, okay, you know what? [SPEAKER_00]: And I would see my patients in

the office. [SPEAKER_00]: I said, what's next, doc? [SPEAKER_00]: What, what else you're going to do? [SPEAKER_00]: You know, that was so great. [SPEAKER_00]: But we want to know more in this and I wasn't even that active on social media, yet at that point. [SPEAKER_00]: Again, this is just November. [SPEAKER_00]: And that's when I started planning that empower event. [SPEAKER_00]: And I reached out to all the docs I had met at [SPEAKER_00]: and Chicago at the Menopause Society meeting and so would you be willing to come down? [SPEAKER_00]: Would you want to come to Miami for a weekend and help me out with this event? [SPEAKER_00]: And I got an overwhelming response. [SPEAKER_00]: That's not amazing.

[SPEAKER_00]: I mean, I was floored. [SPEAKER_00]: I was like fighting for five, you know, and by the end I was like, I have 18 speakers coming. [SPEAKER_00]: This is insane. [SPEAKER_00]: Like, that's what amazing. [SPEAKER_00]: I was blown away, and it's fabulous people. [SPEAKER_00]: From all across the country, you know all of them, you know? [SPEAKER_00]: And it was just inspiring to put it together, and to see the day come together. [SPEAKER_00]: And it was from nine in the morning till almost six p.m. [SPEAKER_00]: And everybody was, they were there taking notes feverishly asking questions. [SPEAKER_00]: The panel could have kept going for hours at the end. [SPEAKER_00]: And I knew it. [SPEAKER_00]: I felt

it. [SPEAKER_00]: I was like, this is it. [SPEAKER_00]: This is what I'm here for. [SPEAKER_00]: It's not really, you know, it was not to promote anything. [SPEAKER_00]: It was really to bring everyone together to educate them. [SPEAKER_00]: and to show them what's possible and we're not done. [SPEAKER_00]: Like, you know, I was, I could have been retired. [SPEAKER_00]: But I was like, you should have just retired. [SPEAKER_00]: I would have been, you know, financially more feasible that way. [SPEAKER_00]: But then to see that day evolve, he was like, I see your passion. [SPEAKER_00]: I see the road in front of you and I'm here to support. [SPEAKER_00]: So what can we do next? [SPEAKER_00]: So,

you know, that's where it's all coming from, but that event really touched upon all aspects of women's midlife health, you know, psychological mental wellbeing, journaling, fitness, nutrition, you know, hormone therapy and cancer survivors. [SPEAKER_00]: I mean, who name it? [SPEAKER_00]: We had it. [SPEAKER_01]: and it just goes to show the power of what happens when all of those collective voices are together. [SPEAKER_01]: I've said this from day one whether it's politicians, researchers, providers, celebrities, if we all stand together and so women don't have to be competitive, we can be collaborative. [SPEAKER_01]: There is such an [SPEAKER_01]: unbelievable need for this type of care and this type of education and frankly community because women start to

feel so alone when they are turned away from doctor after doctor told it's all in their head you know told or just denied hormone therapy and so [SPEAKER_01]: Yeah, that's what moved me so many years ago and when they asked me to be part of the film, it was supposed to be such a small thing because they were told over and over again There's no market for this movie and the first time I saw it Number one I learned that menopause was not only coming for our hair [SPEAKER_01]: But also our teeth, which, you know, I knew about the hair and the vagina, but I did not know about the teeth, so I learned from

the movie, which I thought was really cool. [SPEAKER_01]: But I remember watching people's response to the film, because I had seen bits and pieces of it while filming, and I was blown away, because you definitely see, you know, we've thrown events for years as part of her MD, but to see that reaction in that format, because that was the first time that I was a part of the project like that. [SPEAKER_01]: I can't even put it in words and my husband was at the screening with me and he as a cancer doctor and he was almost moved to tears. [SPEAKER_01]: He's like, this is incredible what you all are doing together for these patients, you

know, who have basically felt invisible for decades. [SPEAKER_01]: All right. [SPEAKER_01]: Yeah. [SPEAKER_01]: I love that so much. [SPEAKER_01]: So we're going to do some rapid fire. [SPEAKER_01]: Are you ready for some rapid fire fun? [SPEAKER_01]: Let's do it. [SPEAKER_01]: Let's do it. [SPEAKER_01]: Let's do it. [SPEAKER_01]: What's your go to analogy when explaining hormone therapy to skeptical patients? [SPEAKER_00]: Hmm, good fun. [SPEAKER_00]: Let me see. [SPEAKER_00]: Let's look at it like, so I, you know, I have a bunch of depends on who I'm talking to. [SPEAKER_00]: I think it's like, okay, so are you somebody who's very nature-based or if you're a health person or a techie person? [SPEAKER_00]: Things, I really, you know,

[SPEAKER_00]: tweak it per se for them and if I let's have a patient who's on thyroid medication I throw it at him that way. [SPEAKER_00]: I said you have hypothyroidism You were told you need to be on synth word for the rest of your life. [SPEAKER_00]: How do you feel about that? [SPEAKER_00]: Oh, well, that's what I need to do That's what I need to do. [SPEAKER_00]: I said but then look at the ovary as another organ It was true. [SPEAKER_00]: Yes, okay. [SPEAKER_00]: It's providing your hormones and now it doesn't want to anymore You just need to replace it. [SPEAKER_00]: That's it [SPEAKER_00]: And they're like, sorry, that's it. [SPEAKER_00]: I'm like, yeah, because

that's the honest truth of it. [SPEAKER_00]: It's not, you know, it's hormone management therapy, optimization, whatever term you want to give it. [SPEAKER_00]: And I'm like, well, how long do I need to be on this? [SPEAKER_00]: 10 years to start and then we'll see how it goes after that. [SPEAKER_00]: But, you know, there is no endpoint deadline, there's none of that, as long as you have a healthcare provider that you follow up with and you have an open, you know, dialogue with or another good one, I think that gets them is Wi-Fi hormones or your Wi-Fi signal. [SPEAKER_00]: If you have shoddy Wi-Fi happening and things are not downloading, [SPEAKER_00]: What's going on? [SPEAKER_00]: You're

low on estrogen and progesterone, maybe with testosterone. [SPEAKER_00]: So the signals aren't happening from the brain to the body to the other parts So we need to correct the Wi-Fi. [SPEAKER_00]: We need to buffer you better. [SPEAKER_01]: So I'm like girl that one I really like that one because I feel like a lot of people would lock on to that one They get it. [SPEAKER_00]: They good Wi-Fi. [SPEAKER_00]: They're like, oh, yeah, okay. [SPEAKER_00]: That makes sense. [SPEAKER_00]: Okay What do you think the most misunderstood menopause symptoms? [SPEAKER_00]: the mood once and the anxiety. [SPEAKER_00]: Yes. [SPEAKER_00]: They're not expecting it. [SPEAKER_00]: They think it's life. [SPEAKER_00]: They think it's them because remember, Perry menopause

is late 30s early 40s, right? [SPEAKER_00]: Who's there? [SPEAKER_00]: All these young moms with little kids running around, going from school drop off to soccer, this, that after school activities, and we managed it usually very well. [SPEAKER_00]: I was a mom, three kids, you know, all year apart. [SPEAKER_00]: So I was in it. [SPEAKER_00]: We start doing everything and then also things start falling through the cracks and you're like, what happened? [SPEAKER_00]: Why am I not remembering or why am I more anxious or why am I more testy all of it sudden? [SPEAKER_00]: I think that's where they're not connecting the dots and they think it's them and that's where they go to the primary.

[SPEAKER_00]: Oh, maybe you just have a lot of anxiety. [SPEAKER_00]: Let's put you on some, you know, and anxio litics or anti-depressants or things like that to calm it down and [SPEAKER_00]: we're missing that puzzle puzzle piece and so we need to really hone in. [SPEAKER_01]: And don't you think this is where a side-from-way gain is the number one place I see women blame themselves? [SPEAKER_01]: They literally, the chief complaint will be, I'm going crazy. [SPEAKER_01]: And it's like, why are you calling yourself crazy? [SPEAKER_01]: Like, this is a symptom of what's going on with you, of honestly estrogen deprivation. [SPEAKER_01]: But they'll be so quick to log on or lock on to that, I'm

going crazy. [SPEAKER_01]: And that's part of the [SPEAKER_01]: talking to them and treating them and saying, okay, no, you're not the reason you're feeling this way. [SPEAKER_01]: And better yet, there's treatments available that you will probably like and will benefit of their body parts. [SPEAKER_01]: And so speaking of that, what part of the body do we under talk about in hormone care? [SPEAKER_00]: Hmm, two of them that I feel is not discussed enough and they're still taboo around the firstosexual health. [SPEAKER_00]: Yeah, complete. [SPEAKER_00]: It doesn't happen. [SPEAKER_00]: You don't talk about it. [SPEAKER_00]: Doc, why you're asking me that? [SPEAKER_00]: I'm like, well, I'm your kind of collegeist. [SPEAKER_00]: If you can't tell me,

I don't really know who you can tell and so it takes them back a little bit. [SPEAKER_00]: Oh, well, I think it's fine. [SPEAKER_00]: I don't know. [SPEAKER_00]: What do you mean you think? [SPEAKER_00]: It should be great, your past having to worry about having babies, your financial stable and your relationship with your husband at your partner, whatever have you. [SPEAKER_00]: So this is where it should be taking off. [SPEAKER_00]: You, you know, respond well, these are less kids are older. [SPEAKER_00]: You should be having an amazing sex life. [SPEAKER_00]: You should be intimate with your partner. [SPEAKER_00]: You should be great. [SPEAKER_00]: No, well, I just do it because I need to do it.

[SPEAKER_00]: I mean, I'm better, you know, I could care less. [SPEAKER_00]: And that's where I'm like, okay, well, and you and I are on the lot of same page with that one because [SPEAKER_00]: I love Addy. [SPEAKER_00]: Addy and I, we get along and my patients, they have been my anecdotal trial in front of me. [SPEAKER_00]: I've had, I want to say almost a hundred patients on it now and [SPEAKER_00]: No one, not a common one, has had a negative effect. [SPEAKER_00]: And what I've noticed with that is, between a month, it was with the quickest response and five months, was the longest response. [SPEAKER_00]: But none of them, they're like, why does nobody tell

us about this? [SPEAKER_00]: Because number one, we don't talk about women's sexual health because it's taboo. [SPEAKER_00]: And number two, we don't talk about FDA-approved options that we have out there. [SPEAKER_00]: So it's [SPEAKER_01]: No, I had an intern who worked at Herm D is in medical school now, was having a sexual health lecture, and the professor told her there are no FDA-approved medications for sexual health for women, and so she didn't raise her hand during the lecture because she didn't want to be that person, but she actually came up to the professor and said, there's both Addy and [SPEAKER_01]: And the professor was actually very nice about it and said, how do you know

this? [SPEAKER_01]: He's like, well, I worked at her MD and actually, you know, I learned under Dr. Javade. [SPEAKER_01]: So I've gotten multiple published posters with ADV, because I became so passionate about it, because I was so tired of telling women, well, I don't know what to do. [SPEAKER_01]: You know, your husband just got the blue pill and, you know, this was before I was prescribing testosterone and before I had learned about sexual health and then, [SPEAKER_01]: I started prescribing Adi and treating people to testosterone and was told I've saved marriages and saved lives because people were afraid they were going to lose their relationships and their self-identity and their confidence because we know book

goes on in the bedroom effects so many other aspects of your life. [SPEAKER_01]: And so for me, very passionate about Addy have seen a men's success. [SPEAKER_01]: I've started to see a difference in two weeks, and that's not with maybe the number of sexual encounters or the English libido or the decreased distress, but the little subtle signals I'll see in two weeks are less avoidance, instead of not wanting to go to bed at the same time because you don't want to say no, [SPEAKER_01]: spontaneous sexual thoughts, right? [SPEAKER_01]: If there's something suggestive that they're reading or something raceier, sexy on TV, rather than feeling dead or nothing, they're like, hmm, there's some tingling is going

on, you know, so those are, and then the funniest one is sexual dreams. [SPEAKER_01]: Yes. [SPEAKER_01]: Yes. [SPEAKER_01]: And they tell you, and so [SPEAKER_01]: I'm a girl from Cleveland, Ohio. [SPEAKER_01]: I'm now in Cincinnati, Abbott Abbott Sports fan. [SPEAKER_01]: And I remember this patient being so happy to tell me the story because she knew this. [SPEAKER_01]: And she goes, Dr. David, I am dreaming about sex again. [SPEAKER_01]: I go, ooh, tell me more. [SPEAKER_01]: She was like, I didn't dream about LeBron James. [SPEAKER_01]: And I looked at her and I said, are you from Cleveland? [SPEAKER_01]: And she's like, [SPEAKER_01]: No, and I was like the bronjame. [SPEAKER_01]: She goes, hey, man. [SPEAKER_01]: I'm

just so happy that I'm dreaming about sex again I go, no, he's totally adorable and brought me a championship, but I just thought it was hysterical. [SPEAKER_01]: So yeah They started dreaming about sex again. [SPEAKER_01]: So those are the some some of the changes that I've noticed with Addy and we actually Have data and breast cancer patients post-mata puzzle patients. [SPEAKER_01]: So hopefully, you know, the FD is Master acting. [SPEAKER_00]: Yes, hopefully we'll get that next. [SPEAKER_00]: That'll be me [SPEAKER_01]: Yes, because you and I, maybe willing to write it off label, but I think it's really being withheld for a lot of women who struggle in those menopausal years with low libido. [SPEAKER_01]: And

I think that if we removed that another barrier, [SPEAKER_01]: that we'll be able to treat, you know, the 40% of women that struggle with sexual dysfunction and that number is probably higher when you look at the menopausal population. [SPEAKER_01]: Under percent. [SPEAKER_01]: So we've both seen women after they've been dismissed diagnosed and told us to wait it out or come back in six months. [SPEAKER_01]: What's one thing you wish every provider set out loud to their patients in midlife? [SPEAKER_00]: That is not all in your head. [SPEAKER_00]: And that I hear you, and I'm here to help you. [SPEAKER_00]: Oh, I love that. [SPEAKER_01]: Because even that just makes them seen and hurt, right? [SPEAKER_00]:

I've been hurt. [SPEAKER_00]: I had a patient here two weeks ago. [SPEAKER_00]: And she canceled the appointment a few times. [SPEAKER_00]: So I knew something was off. [SPEAKER_00]: And she finally came from up north, so about an hour away. [SPEAKER_00]: And she sat down and she told me her story because that's how I do it. [SPEAKER_00]: I'm like sit down and let's just talk. [SPEAKER_00]: Like it's not, you know, it's very comfy, inviting safe. [SPEAKER_00]: So I just want to hear what's going on. [SPEAKER_00]: Because this has been going on for seven years. [SPEAKER_00]: I've been going from doctor to doctor to doctor. [SPEAKER_00]: And the last one wrote in my chart that I need

a psych evaluation from, yeah, a very reputable center. [SPEAKER_00]: And she didn't want to come today because she figured I was just going to do the same thing [SPEAKER_00]: And by the time she left, she said, even though you haven't done anything for me yet, you listened to me. [SPEAKER_00]: And I'm so glad that I came all the way down here. [SPEAKER_00]: I love that. [SPEAKER_00]: I love it, you feel so good. [SPEAKER_00]: I said, I was like, my day is made. [SPEAKER_00]: I don't need to do anything else today. [SPEAKER_00]: I feel amazing. [SPEAKER_00]: And I told her, I said, you made my day. [SPEAKER_00]: If you feel good, you don't know what that

just did for me. [SPEAKER_00]: as a provider and as okay you know what i'm gonna keep going i'm gonna do more stuff tomorrow so it's that that's where it's at just listening half the time you know we don't even have to do a lot we tweak a little hormone patch here and there and they think we're amazing in real life savers and we are in a way but i don't feel that i feel this is our duty [SPEAKER_01]: It's our absolute duty, and I think it's because women have just been settling for so long with so little that it doesn't take much to make a huge difference in their day, and their self-confidence. [SPEAKER_01]: So

I started her MD got 10 years ago, and one of the younger entrepreneurs called me the OG, and I was like, a Santa compliment, or is that a he? [SPEAKER_01]: It's like, I don't know if I want to be the OG, but now let's jump ahead another 10 years, because even where we're now, I'm so happy, compared to where we were 10 years ago, and we've hopefully fixed a lot of the problems in the system. [SPEAKER_01]: So maybe insurance now supports mental puzzle care, data drives, access, and women actually get the full spectrum support. [SPEAKER_01]: What do we have to burn down to get, oh my god. [SPEAKER_00]: Yeah, there's so many things. [SPEAKER_00]: We

have a lot of barriers. [SPEAKER_00]: We need to burn down to get there. [SPEAKER_00]: Um, I think the first thing would be to, you know, outdated, take out that outdated belief that midlife symptoms are just in our head, number one, that's got to go. [SPEAKER_00]: The misinterpreted studies need to go, like just throw them out the window, burn them, okay? [SPEAKER_00]: Yes. [SPEAKER_00]: medical training. [SPEAKER_00]: The gap has to be filled. [SPEAKER_00]: Yes. [SPEAKER_00]: To teach in medical school in residency. [SPEAKER_00]: And you know what? [SPEAKER_00]: If we need to divide the residency into two, OB and GYN, let's do it. [SPEAKER_00]: Let's go for work. [SPEAKER_01]: I love that. [SPEAKER_01]: Then let the people

who wanted to live for babies, which is amazing, but let them do that. [SPEAKER_00]: Let them do that. [SPEAKER_00]: Yes. [SPEAKER_00]: And let us do the gynecology and the surgery and this, the menopause, Perry menopause care and be amazing at it. [SPEAKER_00]: Because you know what? [SPEAKER_00]: Not everybody wants to be an obstetrician and that's okay. [SPEAKER_00]: Okay. [SPEAKER_00]: We've done it. [SPEAKER_00]: We've delivered thousands of babies and we have it under our belt and we feel great about it. [SPEAKER_00]: But. [SPEAKER_00]: It's okay, there's plenty of amazing obstetricians. [SPEAKER_00]: We have a imbalance in our subspecialty, where OV is outweighing, GYN. [SPEAKER_00]: So we need to fix that imbalance. [SPEAKER_00]: And I think the

way to do it is to separate them. [SPEAKER_00]: Let's do that. [SPEAKER_00]: We need to do that. [SPEAKER_01]: Let's save the world. [SPEAKER_01]: One vagina at a time. [SPEAKER_00]: Let's go and talk about it. [SPEAKER_00]: I'm all for it. [SPEAKER_00]: And I think if that happens, then insurance, right? [SPEAKER_00]: Insurance will start to see. [SPEAKER_00]: This is not elective to make women feel better. [SPEAKER_00]: This is health longevity. [SPEAKER_00]: This is keeping them healthier, longer, therefore in the long run, you pay less. [SPEAKER_00]: So let's do that. [SPEAKER_01]: And the data will support that by preventing disease will actually save not only patient's money, but the entire system money. [SPEAKER_01]: And so I think what

we've learned today is that we don't just track hot flashes, we track clarity, strength, sleep, sex drive, it's all hormonal data. [SPEAKER_01]: You can ask your provider for data, I believe, like you, giving people information, giving them data, giving them metrics, whether it's about their brain health or their cardiac health or their cholesterol or their hormonal labs, give women the data so that you can get a curated treatment plan for you because hormone therapy is nuanced and then partner [SPEAKER_01]: not at you. [SPEAKER_01]: And I would say my one final takeaway from today is if it doesn't serve us, go ahead and burn it down. [SPEAKER_01]: So I want to thank you so much for

being here with me today. [SPEAKER_01]: Can you tell the listeners, because you are such a disruptor, where to find you and what you're up to next? [SPEAKER_00]: So I'm in Miami, Florida. [SPEAKER_00]: My next big step is going to be to go [SPEAKER_00]: Full time in my private practice at GLA MD, so that I've done a soft launch to the actual physical, you know, gran opening will be later this year. [SPEAKER_00]: And you can find me on social media on my Instagram, you know, Dr. Gila Senamar and on my podcast where I talk to people about all things women's health related. [SPEAKER_00]: And your podcast name, her time, her health with Dr. Gila. [SPEAKER_00]: love

it. [SPEAKER_01]: We've both seen the arrows heard the myths. [SPEAKER_01]: We've watched women walk away from appointments, more confused than when they first walked in, but it doesn't have to be this way. [SPEAKER_01]: Menopause isn't a mystery. [SPEAKER_01]: It's just been misrepresented. [SPEAKER_01]: And when you finally find a provider who listens like Dr. Gila, you stop just trying to survive and you start building. [SPEAKER_01]: Thank you so much for joining today and continuing to be a strong voice in the field and disrupting healthcare [SPEAKER_01]: This is more than a conversation. [SPEAKER_01]: It's a call, a call to build something better. [SPEAKER_01]: Subscribe, share, and bring more disruptors into this room. [SPEAKER_01]: For unfiltered insights and

bold ideas, go to DrSomeet.com to sign up for the monthly disruptor newsletter and follow us on social at DrSomeet. [SPEAKER_01]: We're not waiting for a seat at the table. [SPEAKER_01]: We're building our own table.