Episode Transcript
Speaker 0
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Speaker 1
Welcome to this is perimenopause, the podcast where we delve into the transformative journey of perimenopause and beyond. I'm one of your hosts, Michelle.
Speaker 0
And I'm your other host, Michelle. And we know firsthand how confusing, overwhelming, and downright lonely this phase of life can be.
Speaker 1
Join us as we share real life stories and expert advice to help you navigate this journey and advocate for your best health.
Speaker 0
We used to think menopause signaled an end, but really, it's just the beginning.
Speaker 1
Before menopause was trending on TikTok and celebrities started sharing their hormone stories, there was a small group of doctors quietly becoming experts in this space. Doctor Shafina Premji was one of them. She became a certified menopause practitioner in two thousand and fifteen when very few people were paying attention to women's midlife health. Fast forward ten years and she's seen it all. Every symptom combination you can imagine and every misconception that's keeping women from getting help. Doctor Frenji has insights that you can only get from helping thousands of women navigate this journey. So get ready for an incredibly informative and inspiring conversation and find out why our new mantra is WWDPD. What would doctor Premji do? Doctor Premji, welcome. Delighted to have you with us today. For our listeners who don't know you, you have an incredible background. We'd love for you to share about who you are, and in particular, how you came to be a certified menopause practitioner long before it was cool and before menopause was having a moment. I think you became certified in twenty fifteen. Is
Speaker 2
that correct?
Speaker 0
That's
Speaker 1
right. Right. So, I mean, there were crickets in twenty twenty, let alone twenty fifteen. So please take it away and tell us about your fabulous self.
Speaker 2
So I, well, first of all, I wanted to say thank you so much for the opportunity to join you on your podcast. It's always a pleasure to connect with like minded individuals talking about all things women's health, midlife, and menopause. This is, as you know, a big passion for me. It's a it's a passion project. It's no longer just a part of what I do in my job. It it really deep sits very deeply, in me, as part of who I am as my identity as a physician. So who I am, I am a family physician by training, graduated in twenty twelve from, Queen's University in Kingston, and then I did a women's health fellowship, also through Queen's University. And that is where my discovery of menopause occurred. Mhmm. I started practicing as a family physician in twenty thirteen also offering, all levels of women's health. So that included obstetrics, postpartum labor and delivery, and then, of course, contraception and menopause care. And it's been about ten years that I kinda had this very, comprehensive women's health practice. But in the last two years, I decided that I really wanted to focus on menopause care. And so, in early twenty twenty four, I passed my my patients my my panel of family practice patients to another physician. And so now my primary focus is on obstetrics, labor and delivery, postpartum care, contraception, contraception, and then a lot of menopause medicine. How this all happened for me was quite a fluke to be quite honest with you. It was never on my radar. And as you know, physicians, residents, medical students in the country get zero menopause education. So I was also part of that zero menopause education. What I think peaked my interest was my mom, her history. So my mom was forty three at the time of her menopause, which I didn't really think what that meant. I didn't understand the terminology or definitions. I just thought, like, menopause was around fifty. That's a little bit early.
Speaker 1
Mhmm.
Speaker 2
I didn't really understand the implications. I don't even recall her talking about hot flushes. I don't remember the women's health initiative. Like, I don't really remember any of that. All I knew was that it was early for her. And, that also meant that menopause happening earlier would mean that if I were thinking about having a family one day, I had to get the ball rolling. I couldn't sit around and wait despite me trying to get through all of my training. So, when I started my fellowship in women's health, I was around thirty, thirty one, I believe. And it was a a self made fellowship so I could really pick and do any part of women's health that I wanted to do based on my interests. So I did, a month at a breastfeeding clinic in Toronto. I worked at an STI clinic in downtown Toronto. I spent some time at a osteoporosis clinic. I also, then decided to go to Ottawa to do a clinic in Bulwer Health. So, you know, mobile vaginal health because that was something that I didn't really have a lot of exposure to. And you see some derma dermatologic conditions that may arise when you're doing public examinations for women. So I get my merry way to Ottawa and as part of my rotation, because the Vulgar Clinic was only a couple times a week, they asked me to do some other rotations, other physician clinics that might sort of make my elective a bit more comprehensive. And that is where the menopause piece came in. There was a physician doing a menopause clinic which I really had no idea what that meant. But I decided that, you know, if I'm gonna be there, I might as well just dive right deep in and and take any opportunity that I would have the opportunity to to have. And that was with doctor Elaine Jolley, who I didn't know who she was at the time, but was the president of the Canadian menopause society, which had just very, very recently come into active, like Existence. Existence. Exactly. So, spent, I think, about four weeks with her and that was about eight clinics, so two clinics per week. And that is where I realized what menopause is, why it's important, who these women are, how much help they need, and how I was totally missing out on an area of women's health that nobody had ever brought to my attention. So with her mentorship and watching her see patients and understanding the implications of what it means to go into menopause and then beyond is really where everything sparked for me. And she essentially became my mentor and guided me through to where I am today.
Speaker 0
Amazing. Wow. Tell us a little bit more about your practice. You're you're opening a new clinic. Is that correct?
Speaker 2
Yeah. So, in twenty eighteen, once I had been in practice different clinic. And I don't know where and how and why, but I have this entrepreneurial drive. Like, I I wanna always challenge myself to do things that I don't even know how to do. Where I get this from, I have no idea.
Speaker 0
I need a little bit more.
Speaker 1
It's impressive. Like, drive is an understatement.
Speaker 2
So my husband, is from the UK and has a business, marketing communications, graphic design background. So I knew that having that sort of skill set that I was missing would help me to potentially think about building and starting a clinic from scratch. So the two of us essentially decided to start a clinic from scratch, a family practice, and it was really because I wanted to ensure that the women who came into the doors of my clinic, it was an experience for them. It wasn't just going to a doctor's office, it was an experience. From the moment they walked in, the environment, the colors, the reception, the light, like, it was so important for me that women have this experience, and that's really where my drive to build clinics came from. And so the first clinic opened January seventeenth twenty eighteen. That was called Mahogany Medical Clinic in Calgary. And thinking about all the challenges and, bumps along the way that I had to go through to even build that clinic was beyond what I even imagined. But it was so amazing to go through that experience and learn and understand the business of medicine. And then the second clinic opened a year and a half later that was called the Village Medical, a smaller size clinic. And having been now providing menopause medicine, again, my sort of entrepreneurial creative, mind has taken me into a place where I want women to have another experience, not just through pregnancy, childbirth, and postpartum, but a midlife menopause experience where they come into a place where it's not just a doctor's office that they come in and they feel empowered, inspired, motivated, safe, validated, hopeful. Yes. Because that is not what women are experiencing today. And so that is really where my, drive has come in to do that. And so, yeah, I have signed a lease. It's not fully public knowledge yet, but it it will become. And
Speaker 0
It is now. Sorry.
Speaker 2
We've had three rounds of designs. So we're on the last set of the drawings, and then we're gonna move on to the aesthetic, which is gonna be, for me, my favorite part. And construction starts September with the hope to start the clinic in January twenty twenty six.
Speaker 0
Awesome. Amazing. So what kind of services will women come to you for?
Speaker 2
So, of course, we're gonna have the, menopause consultations with a health care provider like a physician who has menopause education. But we are also building a gym in the clinic. We have an entire gym with a personal trainer. We're gonna have all of the machines there. And where we're gonna be able to access a program, a strength training program. To me, that's the huge highlight. That's the first part of the clinic that they'll see. Going around the corner, we're gonna have a beverage station, sort of an area where women can sit down and talk. So it's not so much a clinical atmosphere. It's gonna be more like, a place for women to interact, to bond, to connect. We're gonna have an education wall where women can access and look at all the Health Canada approved hormone therapy products. We're hoping to have a resource book library, some different forms of vaginal moisturizers, lubricants, estrogen therapies, pessaries as well for women who have pelvic floor issues. So really a wall for information and for touching and feeling what they might be able to experience as part of their menopause care.
Speaker 0
Sorry. Can I just what is pesteries? Pessary? Pessary?
Speaker 2
Yeah. A pessary is a small device for women who have any sort of, vaginal wall prolapse. So under you have a prolapse of your bladder, your rectum, or your your uterus. And so, a pessary is a device that can be placed into the vagina, and there's various sizes and shapes.
Speaker 0
And so,
Speaker 2
women need to go to a pessary clinic to get a a fitting done. And so I wanna have pessaries on on display so women understand what a pessary is and what may may their options be.
Speaker 0
That's cool. Okay. Sorry to interrupt. Please continue.
Speaker 2
My hope is that for women who come into the clinic that, you know, as you may or may not recognize, menopause care is not well funded through public insurance plans, and so there will be some form of a non insured private offering. Not because I want to make money off of this, but because I want to be able to provide comprehensive care for women. So as part of that, I would like to offer some sort of a comprehensive heart health assessment, bone health assessment, and breast health assessment so women can understand what their cardiovascular risks are, what their breast cancer risk is, and what they can be doing to optimize their bone health. Again, these are big ideas. I also am hoping to have a pelvic floor physiotherapist in the clinic, a sexual health counsellor, somebody who can offer cognitive behaviour therapy for insomnia and hot flushes. Yeah. Somebody to offer support for obesity medicine as well. So really make it very comprehensive that when a woman comes there, she can access all of these services a la carte or as part of a program, which I'm still trying to figure out.
Speaker 0
I think it's so magical, sorry to interrupt, but, like, just to have that one spot to go and have a team of people who know your you don't have to keep going in and explaining your situation and reexplain it. Like, it's exhausting.
Speaker 1
Mhmm.
Speaker 0
This is this is magical. I'm moving to Calgary, Mackell. I'm coming. Perfect.
Speaker 1
You can come and live with me, and then we can just hang out at the new
Speaker 0
clinical avatar.
Speaker 2
And all of this is based on evidence based medicine. Right? We want women to feel that they're not being sold products or services which are not based on science. And so it's really important that women are aware that this is all evidence based, that this is supported by clinical practice guidelines, and that women are get gonna get the right answers that they're looking for.
Speaker 1
Yeah. So current and nonfiction. Right? Two things that are really hard Yes. To find right now, and it's overwhelming for the majority of women trying to navigate what is going on with their bodies and how to get the help and support and care that they need. What are maybe we can talk a little bit about some of the misconceptions or or things that you see in patients who come to see you, and maybe they've been to a variety of other places to try to get the help they need or they've been dismissed or what have you. What are what is a common misconception that you see particularly for women in perimenopause?
Speaker 2
A big misconception is that you need to wait until you are in menopause to access menopause care or hormone therapy. That's a big miss misconception. The the majority of the chaos of of menopausal symptoms is actually in the perimenopause. Yeah. So it's important that women recognize that they can get help before they enter menopause. The formulations and the recommendations of treatment options vary for perimenopausal women because there is ongoing periods, there's ongoing bleeding concerns and there is technically still a risk of pregnancy. So we happen to keep those, considerations in mind as we are selecting a therapeutic option to treat her symptoms. So that's one big misconception. The other misconception is that women think that they have to stop hormone therapy after a certain period of time Mhmm. Or that that they have to use the lowest dose for the lowest amount of time. That is not based on any scientific guidelines today. Using hormone therapy is very individualized and personalized based on every individual patient's, symptoms, her risk factors, her preferences, and her overall quality of life. So we have to take that into account. There is no magic number for starting or stopping. We do have some guidelines and those guidelines recommend that women who are under the age of sixty or within ten years of her final period, the majority of women who have bothersome hot flushes and night sweats, that hormone therapy is considered very safe provided you don't have any, you know, absolute contraindications.
Speaker 0
Can I enter in with a question for a friend's mom? So I just had this conversation the other night. I think I know the answer, but she is ten years out of her having her final. She's been in menopause for ten years. She is mid mid sixties, and she's still having, like, atrocious hot flashes several times a day. And she's she's like, what can I do? Can I start HR? Like, can I start HT now? Like, is that I know that that's not recommended, but is that possibility if she's in dire stress? I know it's individualized. I told her I'd ask someone.
Speaker 2
Yeah. So what I would say again is that, obviously, if you're looking at general guidelines, you know, over sixty, there are increasing risks with clot risk when you start hormone therapy. That being said, you know, a woman who is fifty, who has a BMI of forty, smoker, high cholesterol, diabetes is metabolically worse off than a sixty one year old that runs marathons, has a normal book Right. Or in a BMI of twenty or twenty four.
Speaker 0
So it's so individualized.
Speaker 2
Biology sometimes is more important than your chronology is what I would say.
Speaker 1
Oh, that's accurate.
Speaker 2
There are
Speaker 1
yeah. Context. Yeah.
Speaker 2
Yeah. There are many non hormonal therapies that we can do to offer patients, and women also don't recognize that there's lots of non prescription therapies as well. So for example, there is level one evidence for hypnosis as well as cognitive behavior therapy for treating hot flushes. And the last thing I wanna say is that not all hot flushes is due to estrogen deprivation or withdrawal. Right? There could be other causes for hot flushes, so we need to keep in mind other causes for a woman's symptoms as well.
Speaker 1
So I think the answer is that this friend's mom, Michelle, needs to fly to Calgary Yeah. And have an appointment with doctor Benjie and get
Speaker 0
Perfect. I actually think she knows some people in Calgary, so that's perfect.
Speaker 1
There you go. There you go.
Speaker 2
Thank you.
Speaker 0
Thank you for that answer.
Speaker 2
You're welcome.
Speaker 1
The fact that your new clinic is going to have a gym, I think, is amazing for so many reasons. And you also have recent I guess, fairly recently embarked on a strength training journey. I suspect the gym is not, you know, just because, you need to keep up with this training regimen that you've embarked on. Maybe you can tell us a little bit about why you've embarked on this journey and why the gym is a a feature of your new clinic.
Speaker 2
I'll be honest with you. I am not somebody that likes the gym. I remember grade six, my last gym class that I ever had to, like, mandatory complete was, like, the happiest day of my life.
Speaker 0
I'm I'm with your sister. I hate it.
Speaker 2
My parents never really got me into sports. You know, we've got two two of us girls, so it was either ballet or brownies or gymnastics. That was the extent of my sort of exercise regimen. My parents aren't really into that kind of sports thing, so I really didn't have a lot of exposure. I didn't like getting sweaty. These are these are honest truths.
Speaker 1
Yeah.
Speaker 2
Well, I have long hair. It was too much work to wash it on a regular.
Speaker 1
Mhmm.
Speaker 2
I was scrawny. I was very small. I didn't have I didn't have any skill. I just wasn't good. It just wasn't something that I ever thought about. And then, you know, I had my second child just after forty, and I went through the whole postpartum breastfeeding journey for a year. Sleep deprived, tired, now forty plus years old.
Speaker 1
Good times.
Speaker 2
Right? And you're starting to see changes in your body.
Speaker 1
Mhmm.
Speaker 2
And, you know, I'm also working in a menopause space, and I understand the body composition changes that occur as we go through our forties and then more so into our fifties as we go through menopause. And this whole discussion around strength training, and fitness had become quite, visible in the scientific literature, more so than even cardiovascular activity. And I didn't think it was fair for me to tell women to strength train when I personally had no idea what that meant or how difficult it was to actually build muscle. I couldn't practice if I didn't I couldn't preach if I didn't practice. And I was also very afraid of equipment, walking into a gym, you know. It's very intimidating. It's super intimidating. Yes. There's a fear of judgment, you know, women looking at other women. I just didn't have any confidence, but I knew that there was this was an area that I was lacking in my life. So, you know, you think about all the things that I have fortunately been able to accomplish, like, being fit was just I was just thin. I was never fit, if you know what I mean.
Speaker 1
Yeah. Yeah.
Speaker 2
I was lucky to have found, a trainer through a friend on Instagram. And I literally just picked up the phone, I think I was ten months postpartum, and I said, like, tell me a bit of more more about what you do. And it was just an instant, validation of what women are experiencing. Like, he just understood what I was talking about. So I literally said, let's let's just try a couple of times in the gym. I'm a little bit, you know, I I don't have the skills to know what to do. You're gonna have to dumb this down into a very simple way for me to understand. I don't even know how to adjust in a machine to get the seat into the Right. Right.
Speaker 1
Yeah. Yeah.
Speaker 2
Yeah. Or to get the bar where it's supposed to be to do the exercise. Like, I had no idea. I didn't know anything about form. And I have to tell you, even before seeing the body changes, it took me some time to find the time, commit to the time, have my husband understand why I was going, not get guilty about leaving the house on a Saturday when I've already been away from work at work the whole week.
Speaker 0
Yeah. Yeah. Fair.
Speaker 2
And recognizing how good it was making me feeling, how how good it was making me feel in terms of mental health, in terms of confidence, in terms of Yeah. Feeling like my body was responding to what I was feeding it. And then when I talk to a patient in the clinic and I talk about strength training, I can help her understand because I've gone through it myself and what it takes to actually build that muscle. It's a whole shift from being I wanna be skinny to I wanna be strong. And being okay with watching your body grow
Speaker 1
or
Speaker 2
watching the weight, on the scale increase. But knowing that you're fueling your body with good food versus eating, you know, I think we think we need to stop having carbs. We need to stop having sugar. We need to stop doing x y z. It's not about stopping. It's about starting. Starting to fuel your body, starting to eat protein, starting to build confidence, starting to build strength. And when we change the terminology around it and help women understand the purpose of it, it allows me to connect better with that patient.
Speaker 0
That's amazing. And and so when you come to your clinic,
Speaker 2
The new clinic, you mean?
Speaker 0
The new clinic. Sorry. Yes. So the new clinic, when I come there, because I'm moving to Calgary, can people just join as a gym or no? You beat your your you're a patient of the clinic and that's one of your benefits, or how does that all work?
Speaker 2
I'm still trying to I'm still trying to figure out the role whole model here, but how I imagine it to be is that, as you know, I have a long wait list. I have a a wait list of about a year. Women can choose to wait to see me for that full year or they can choose to begin, a program that I will have created. And in that program, they would have they would get four to six sessions with the trainer. Right? This is the purpose of this is to provide the women a taste, some confidence, some simple questions in a place that's safe. Right? We're not looking at going into a big gym where people are watching you. You might feel judged. You don't know what to wear. I didn't know what to wear to the gym either. Okay. Like, you can just come in in whatever you feel comfortable in, in whatever size you are, in whatever situation you're in, and get some confidence in movement. I think a lot of women also have a lot of injuries or joint issues, and they're afraid of injuring themselves. The trainer has skill set about how to manage, you know, a knee or hip or a back or or a shoulder. So he's we've got resistance bands that will allow more balance and mobility more so than even strength training. You can't build muscle if you don't have balance and and mobility. So working at small things like that to give him the confidence. If there is potential for more, I'm, you know, as you know, I'm I'm a creator. So I will have to see what what the ask is from patients so that I can build and create more. But right now, how I imagine it to be is sort of a a small program to get women started.
Speaker 1
Fantastic. Amazing. Let's talk about your spare time and the fact that you, undertake a lot of advocacy work, and why that's why that's important to you and what you've been focusing on lately. It's it's very impressive.
Speaker 2
Thank you. When we when I think about the advocacy work that I've been focusing on, I think what I want to first say is that I have been very fortunate in that I've been a board member of the Canadian Menopause Society for the last six years. Sorry, five years. So, since twenty twenty. And I'm a regular family doctor, like the hundreds and thousands of family doctors in this country who are trying to understand menopause medicine. The only difference is I started ten years earlier than all the, all the physicians that are starting now. Mhmm. And so being on the board of the Menopause Society has really provided me a platform to reach beyond what I have otherwise felt comfortable doing to advocate. Advocate for women, advocate for residents and students, advocate in government as well. Because if we don't talk, if we don't speak up, if we don't use our voices, change won't happen. Mhmm. And today is the day to make that change. Right now is the menopause revolution. And we need to speak up for women because this generation of women will no longer accept what previous generations of women have gone through. And I think with women now living thirty to forty years beyond their menopause, they have every right to want to have better care and to age with knowledge and power. So that's why I do this advocacy work because I want women to know that, I believe in their message. I believe in validating their experience and hope that somebody will listen to me along the way.
Speaker 0
I'm we're listening.
Speaker 1
We're we're listening. Absolutely. Absolutely. And we're very inspired by you and and your work. And, certainly what we're doing has evolved. You know, when we started this, it was really born out of our own experience and frustration with, first of all, not realizing what was happening to us and taking forever to figure it out and realizing that without each other, things would not have gone as well as they did. And the fact that not everybody has someone in their life that they can talk to and who's going through the same thing at the same time. And so it was about creating information so that women could have an easier time of things, or or fathers could have an easier time of things than we did. But it's also become, a push for advocacy in the context of we can't rely just on you, doctor Primjee, and the Menopause Society of Canada and and the powers that be to make this change. We all each need to get informed and advocate for what we need because if we're all asking, we're a lot harder to ignore.
Speaker 0
Absolutely.
Speaker 1
Yeah. So thank you. Thank you for inspiring us, and thank you for what you do. What what would you say what's the what's the next big change that you think needs to happen? Maybe that's from a policy perspective or, you know, what what what do you think is the key at this juncture in this movement?
Speaker 2
I think there's two things. The first is is that we need a strong foundation of menopause clinics across the country in each individual, city, major city. Because if we have even one or two clinics in each individual city, that's going to allow some level of access, number one. And number two, it's also going to allow education so that residents and students can come and rotate in these clinics, get the volume, and get the education. That's the one
Speaker 1
Have have the experience you did. Right? Yeah. Doctor. Jolene. Yeah. Way back. Yeah.
Speaker 2
The second piece is that menopause care has to be well compensated. And that's where I come through to government, through the Alberta legislature where I was able to meet with one of the MLAs as well as the shadow minister of health to help them understand why if you put money into providing a menopause billing code for healthcare providers to use, it's going to increase the imp impotence for that impotence, sorry, for that physician to wanna provide that extra bit of care and time to understand what women are going through and then to have the time to talk about potential treatment options. So if we're not compensating physicians, no matter how much education they're gonna get, they're not gonna have the time to do this nor are they gonna want to because it takes so much effort and time. So we need to first provide a place for women to get access, but we also then need to compensate the physicians who are providing that care as well.
Speaker 0
I I just keep thinking around, like, physicians like, a lot a lot of physicians, they in order to bill for what when a woman comes in, they need to put it in some sort of box. Right? They need to be able to tick off, oh, this is anxiety. This is but there's menopause perimenopause impacts so many different areas. It's it's it's not easy to put us into that box. And so, we you're not the first, guest we've had on our show that has, indicated there's a huge need for this billing code. And, so hopefully are we are we getting closer?
Speaker 2
Well, I had a meeting, and so they're waiting for a proposal from me. Oh. I'm just waiting to get through the next one to two months of craziness. I've had a lot of speaking engagements in the last four months. I've spoken widely and across the country and, you know, anywhere from five to ten speaking engagements per month. And so that's on top of all of my clinical work, and it takes time to write these letters, and I wanna make sure that it's, compelling as well. So that is on my radar to actually write a letter because now the shadow minister of health is fully aware of the the issues related to menopause and all of the health implications that come along with it. Now it's a matter of putting in my ask in a more formalized way.
Speaker 0
Thank you. You're I'm inspired now. I'm inspired.
Speaker 2
You're opening the conversation, and that's so much. Right? Just having this podcast for women to feel validated and heard, that's huge too. We are all doing our part individually. I mean, I wouldn't be able to use my voice to speak to a large number of women if I didn't have a podcast like yours to be able to share my message. So thank you as well.
Speaker 1
Well, anytime. And, if you need some, you know, people to make some noise, We should talk. We we should talk. We're good at that. We're really good at that. We'd be happy to do that. Doctor Premji, you were just featured or you are featured in a documentary that is going to be released called let me get this right. Judith, Jackie, Grace. Can you tell us a little bit about this and, what the the hope is with this, new piece of art?
Speaker 2
So the documentary was actually filmed over a year ago in June of last year. Okay. There is a, film producer, if you wanna call him, from Toronto, who received funding to create a menopause documentary that was hoped to be played within hospital settings or other healthcare organizations. The purpose of the documentary to was to provide evidence based information hearing from three menopause experts as well as three women, and what their experiences have been with respect to their menopause journeys. Judith is actually a Calgarian and a patient of mine. So it was really nice for to have her, as in one of the main characters in the documentary. And myself and two of my colleagues were interviewed and had the opportunity to provide information to women in a very, creative documentary film like way to help women understand what menopause is and why women have felt that their symptoms have been ignored and not been addressed over the last twenty years since the Women's Health Initiative. So the film and the documentary is complete. It's thirty seven minutes long, and it has been, played in film festivals. And if I'm not mistaken, has already received two awards.
Speaker 0
Congratulations,
Speaker 2
missa. So the hope is that this documentary will come to the public eye probably in twenty twenty six. We are looking to potentially have it play at a conference potentially. So that's sort of the hope and I think women need to know that it's all based on science, but hearing it through the lens of true of of real women. And so that relatability and that connection to these to these individual women is really what's so impactful about the about the documentary.
Speaker 0
Yeah. Hopefully, we can screen it someday. Absolutely. Love it. Doctor Premji, I feel like we could keep talking and talking and asking questions, but I know you've got lots on your plate. So, what is the one thing you would love every woman to know about perimenopause?
Speaker 2
I think the first thing that women need to know about perimenopause is that it's one of those things that start very insidiously. You may you may not recognize it. It's like a chameleon. And when it begins, you may not know. And I think that if you are able to recognize and really pay attention to your to your health, to your body, listen to what's going on. As women, we're so used to just like, you know, putting things under the carpet, not ignoring it, just ignoring it, saying that it's stress, you know, our children are, you know, a priority, they need our time, our parents need their time, our careers, our homes. We just sort of put everything under the carpet. And then it just starts to like, you know, bubble like a teapot waiting to waiting to explode. So I think perimenopause really is a time that women need to be able to really tune into their bodies and listen to what's going on. Whether or not you are in it or not in it, it's going to happen to all of us at some point. And premenopause can last from four to ten years. So if you are in your early third late thirties, early forties, we need to be recognizing what's going on and being on top of our health. Not just in terms of symptoms, but in terms of risk management. Right? So heart disease, blood pressure Yeah. Weight, BMI, cholesterol.
Speaker 1
Bone density, breast health.
Speaker 2
Yeah. All of these things are so valuable. And even the day to day, choices that we make in terms of our sleep, stress, alcohol, smoking, it's really easy to get away with things Yeah. When we're younger. Perimenopause to me is sort of like
Speaker 0
Hey. Hey. It's a rude awakening. Yeah. Or a reckoning maybe. I
Speaker 1
don't know.
Speaker 2
It's it's an opportunity. Right?
Speaker 0
An opportunity. Yes. Much better.
Speaker 2
And one of my wonderful, coaches, you know, there's this thing there's this acronym. It's w t o h. What's the opportunity here?
Speaker 1
And
Speaker 2
I think about that in any difficult life circumstance, what's the opportunity here? And so what is the opportunity here for perimenopause is that we wake up and tune into our bodies. It's okay to want to know and and and understand what's happening and to seek out that knowledge and get that information from credible sources.
Speaker 1
We're gonna create a new acronym, and it's gonna be WWDPD, which is what would doctor Primjee do? Yes. We have. Our new mantra.
Speaker 2
No one's ever heard no one's ever said that to me. And, like Well,
Speaker 0
it's gonna become making it a thing. We're making
Speaker 1
it a thing. Where can our listeners find you?
Speaker 2
So I have an Instagram page, doctor Shafina Premji. My clinic website milestone menopause centre dot c a. And those are the two places that you can find me. I also do have a LinkedIn account as well, and I do manage the social media platforms for the Canadian Menopause Society as well.
Speaker 1
Amazing. We'll include all of that in the show notes.
Speaker 2
Thank you.
Speaker 0
Perfect. Yep. I have one question that I've been thinking. It's been bubbling since the very beginning. You said earlier your mother went through menopause really young in her forties. Is there something her like, is there any value in looking towards our mother's menopause and finding out what their experience was like? Will it mirror possibly or are they completely unrelated? Is
Speaker 2
Yeah. So early menopause is defined as confirmed menopause under the age of forty. So my mom went into menopause at forty three, which is characterized or defined as early menopause. And that is there is a genetic link there.
Speaker 0
Okay.
Speaker 2
So if your mother or sister went into menopause early, then there is a higher chance that you will as well. And these women who are in premature or early menopause, need to take high doses of hormone replacement therapy, not only to treat symptoms, but actually because it's an endocrine deficiency with the absence of estrogen at an earlier age and need to take hormone therapy at high doses if they have no contraindications until fifty one to prevent the long term consequences of this of this condition. So osteoporosis, dementia, heart disease, and even early mortality. Those are for women in confirmed menopause under forty five.
Speaker 0
Five. Thank you. That's amazing. Thank you.
Speaker 1
Great information. Doctor Premji, thank you so much. This has been fabulous, and we really appreciate you taking time out of your schedule to, spend it with us and
Speaker 2
our listeners. Thank you. Thank you so much for the opportunity. You're doing amazing work, and thank you for all of the advocacy that you're doing using your platform to help advocate and be a voice for women, in Canada. So thank you.
Speaker 1
Happy. Thank you. And we'll we will happily take that very big conference.
Speaker 0
Thank you again. Thanks so much for listening to the show. If you like what you hear, please take a moment to rate and subscribe to our podcast. When you do this, it helps to raise our podcast profile so more women can find us and get a little better understanding of what to expect in perimenopause.
Speaker 1
We also read all the reviews, the good, the bad, and the ugly to help us continuously improve our show. We would love to hear from you. You can connect with us through the podcast, on social media, or through our website. Our information as well as links and details from our conversation today can be found in the show notes. This podcast is for general information only. It's designed to educate, inspire, and support you on your personal journey through perimenopause. The information and opinions on this podcast are not intended to be a substitution for primary care, diagnosis, or treatment. The information on this podcast does not replace professional health care advice. The use of the information discussed is at the sole discretion of the listener. If you are suffering from symptoms or have questions, please consult a qualified health care practitioner.
