Episode Transcript
Speaker 0
The National Menopause Show is just over a month away.
Speaker 1
Two days of menopause experts in one place answering all the questions you can't get answered in that ten minute appointment. And you know what? Mikael and I are also gonna be there, so you should come. And you can find all the details for the show in the show notes below. Check it
Speaker 2
out.
Speaker 0
Leading up to the show, we're talking to some of the speakers. First up is Roberta Hill, a nurse practitioner with twenty seven years of experience, a PhD, and a virtual menopause clinic for women in Ontario and Alberta. I am a big fan of nurse practitioners. My main provider is actually a nurse practitioner.
Speaker 1
And for me, I've never actually seen one. So I've never, sorry, I've never seen one. I've never been to one, like, Cal.
Speaker 2
I think I've seen many, but no. And so I had all kinds
Speaker 1
of questions for for Verta. Specifically, what can a nurse practitioner do for me? And it turns out, like, there's a whole lot of stuff they can do. It's awesome.
Speaker 0
In this episode, we get into what you can expect at your first appointment with a nurse practitioner, how to find one who really knows about menopause, perimenopause, and why your current provider might be following outdated guidelines. Roberta also gave us a sneak peek at what she's going to be talking about from the revive and thrive stage at the National Menopause Show. One talk is going to be about hypnosis for hot flashes. So cool. So cool. The other is perimenopause in the workplace. This is a talk everybody needs to hear and probably more than once.
Speaker 1
Yeah. Absolutely. And also, like, these are just two of the incredible talks that are going to be at the National Menopause. It's so good. Ladies, you have to be there. And you know what? If you're sick of rushed appointments, then you also have to listen to this podcast. It's really great. And this is perimenopause. So let's just get right into it. Can I tell you my most favorite thing about the National Menopause Show?
Speaker 2
Yeah.
Speaker 1
It's, it's not the expert speakers and seminars on every topic related to perimenopause and postmenopause. It's when you stand in line for a coffee or you're walking through the exhibitor hall and hearing women you've never met describe the exact symptoms you're suffering with out loud. And nobody flinches. Nobody flinches. It's it's a whole thing. You walk in thinking that I'm alone. I'm the only one, and you leave knowing that you absolutely never were.
Speaker 0
Right. And let's just circle back to the more than forty experts on stage talking about all the things, hormones, sleep, sexual health, nutrition, mental wellness.
Speaker 1
It's basically a year of our podcast rolled into one weekend.
Speaker 2
How awesome is that? Pretty awesome.
Speaker 0
Whether you're curious, already know a lot about menopause, or just want to find out the latest updates in women's health, this show is truly for every woman. And there's also an incredible marketplace for shopping which is great to discover your new favorite brand and you get to meet the founders behind some amazing Canadian brands specifically and a bunch of menopause care providers.
Speaker 1
The National Menopause Show runs October seventeenth and eighteenth at the International Center in Mississauga. Tickets, guys, they're only thirty five dollars for one day or forty five dollars for both days.
Speaker 0
An amazing price for two full days of evidence based answers in a room full of women who get it. Go to national menopause show dot com.
Speaker 1
And bring your sisters, bring your mom, and bring that friend who keeps saying everything's fine. Tickets are on sale now at national menopause show dot com. We can't wait to see you there.
Speaker 0
Yay. Hi, Roberta. Welcome. Finally, we have you on the podcast.
Speaker 1
Almost in time for next year's National Menopause Show.
Speaker 2
That's alright. Hey. I really appreciate it.
Speaker 0
It'd be great. We're looking forward to it. We're looking forward to seeing you in person again, but, really happy to have you here to talk about Thank
Speaker 2
you.
Speaker 0
All of the fabulous work you do. And
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The fun stuff. It's all fun.
Speaker 0
The fun stuff. The fun stuff. How, how was summer? Is it still summer in Sudbury, or is it turning turning here in Calgary? My god.
Speaker 2
It's trying to hang on. I didn't realize you guys were in Calgary. Are you?
Speaker 0
I I am. Michelle is still in Ontario.
Speaker 2
Yeah. Okay. There you go. Where it's
Speaker 0
glorious. Oh, shush.
Speaker 2
It's it's not terrible here, but it's it was pretty cool and rainy for a while. But, hey. You know what? There's no snow. It's no snow yet.
Speaker 0
It's not snow yet. We're gonna dive right in
Speaker 2
and Okay.
Speaker 0
Get at this and find out about you. You are a nurse practitioner. You have a PhD. You're the cofounder of Canada's first nurse practitioner led clinic, and we're getting into some of the other rock star stuff you're doing, for women's health. Maybe we could start with why you went from, a comprehensive family practice to focusing on menopausal care specifically.
Speaker 2
Okay. Well, it was not a straight path. It was very windy. Never is. Never ever is. Yeah. And to put things in perspective, I I was the cofounder of Subradistrict Nurse Practitioner like clinics, that model of MPLC, which was great, but I never worked there. And the reason was I set up the board of directors, and we had a separation of of the board from operations at the time, but I always worked. So even when I took the job at Laurentian University in the school of nursing, I always work because I tell people you know students can spot a fraud a mile away. And these I'm lucky my license. Yeah, they do. Yeah. So and I love it. I love the practice. So for years I worked in various models like community health centers and stuff and then COVID hit and I was like okay. We all kind of rearranged how we practiced, and there was a lot of virtual care. And, you know, I loved the virtual care, and I know that many, many patients loved it too. Because of accessibility and because of, you know, really the flexibility of it. Yeah.
Speaker 0
You know, take a morning off work to go and see someone about Absolutely. Yeah.
Speaker 2
You know, that's right. And, obviously, not everything can be done virtually. Obviously. I'm not foolish. But, so I remember sitting in my gazebo thinking, oh, gee. I should do something, virtually. I should have a virtual clinic. And and I thought, where will I do it on with? And then I thought, oh, well, that's okay. I'll just focus on menopause. And then I realized I knew so little about it, and then I was embarrassed and ashamed because, like, how is that possible that I work for, like, decades? I teach nurse practitioners, and I don't know about menopause.
Speaker 0
You and everybody else that you can hear that again and again. Right? Yeah.
Speaker 2
It was terrible. But I I dove in, and I remember my first few patients, my husband said to me, oh, okay. Are you sure this was the right move for you? Like, I was like, nope. These are my people. I've got the right chat space. Exactly. Exactly. Yeah. Yeah. And I this is what I've been doing ever since, and I really do love it. I feel like I can make a big difference in the lives of women. And I I I just love the opportunities it's provided for me as a practitioner, but for the women especially. So it's great.
Speaker 0
Yeah. We we need you. And am I correct? You are I don't know if licensed is the right word. You practice virtual clinic practices or can treat c patients in Ontario and Alberta. Correct?
Speaker 2
Yes. Yep. So that's another advantage of the virtual. Yeah. So is it is it that you have a team team
Speaker 1
just out I'm just curious. Do you have a team in Ontario and a separate team licensed in Alberta, or are you licensed in both provinces?
Speaker 2
I'm licensed in both provinces, and right now I'm a sole provider. I have, yeah, off the side of my desk kinda thing. Amazing. I have moved to recruitment, and there is potentially another MP joining me, which is very exciting. That's great. But, you know, it it's kind of, I won't say it's easy, but it is very fulfilling to be able to manage all of that on my own. I know what's going on. I you know what I mean? I I've got the whole my finger on the pulse of the whole thing.
Speaker 1
Yeah. Of course. Of course. But we now need, like, ten of you.
Speaker 2
So I imagine that. Thousands
Speaker 0
of you. Yeah. Exactly.
Speaker 1
Fair. Fair. Exactly.
Speaker 2
You
Speaker 1
know, I think that it's it's great that, the nurse practitioner nurse practitioners are around because our as we know, our medical system is very strange right now. There's just not enough doctors out there. So, I also know that a lot of women go to their doctor looking for support or care or some answers, and they leave their ten minute appointment feeling just as lost, confused, maybe dismissed, as they ever were. And so I think, it's really interesting your role as nurse practitioner. Can you explain for women who may not have understood what they could come to you for? How how could they benefit from nurse practitioner care?
Speaker 2
Oh, well, you know, I think it's a oh, unfortunately, a well kept secret that nurse practitioner's scope of practice is the same as doctors. I can order all the same tests. I can prescribe all the same medications. I think I mean, there's a lot of political stuff that goes along with that. But I think that part of the problem with this ten minute appointment is the hangover from the fully fee for service models that we had, where models of care were designed for payment to physicians. And it it meant that they were held to, a volume, value evaluation of the the volume that they had rather than, you know, the patient care. And, I mean, it's not individual physicians. They were this is a systems issue. Mhmm. So then we moved to different models that still kind of promote that. Yes. But in the meantime, nurse practitioner positions have been created a lot of these models, and they're salaried. And you know what? That has been a blessing because it means that we can have a lot more flexibility in what we provide in an appointment. And we don't feel necessarily the same pressure to provide, you know, the one boom, boom, boom, boom, boom. And years ago, I remember talking to one doctor who said, well, I provide care to fifty patients a day. And I said, well, okay. So you see p fifty people for one problem each. I see ten people for five problems each. So that's it.
Speaker 1
Same. And and and better.
Speaker 2
Well, different. But there are some advantages. So, I mean, let's be very clear. We need physicians. Absolutely. But I think there's space for MPs because we also bring the nursing focus. And that is the preventative care, the holistic care, the patient center, the health promotion. And it means that, like, example, I see a patient in family practice, a little kid with an ear infection. So, of course, I diagnose and treat. And then my nursing brain comes on, and I do the other things. I find out the child's in day care, the child what other environmental issues are going on that might be, might create more ear infections in the future, and we try to solve it that way. So it's more of a broader focus, and I think that we automatically go that route. We're automatically looking at a wider wider, perspective. And that means that, you know, if it's really well with the menopause care that is really complex at times, that has a bunch of different factors, it's not just, oh, here I'll give you hormones and away you go. There's a lot going on. And Yeah. I think for those reasons nurse practitioner care is can be really amazing for a lot of women.
Speaker 0
I have a nurse practitioner as my main provider, my go to. Absolutely fantastic. Absolutely
Speaker 2
fantastic. And and the the, encouraging things that many, many, many people say that. They, as a primary care providers, we're able to do quite a bit. There are issues though. Yeah. One of the problems is that currently, we aren't able to open our practice and get paid directly from the government. We have to we have no options. Positions are created by organizations and sometimes, many times, nurse practitioners are expected to do the work to fill in the gaps of the organization rather than, you know, see patients for the menopause care that they want or to bring new people on that that don't have access to primary care. It's sort of like gap care. But that's hopefully changing because the federal government put out a mandate, I think that's what you call it, about, like, a year or so ago, expecting that the provinces will create a way to fund NP so that we don't have to we can we can, you know, get remunerated by the government individually and not ask patients for pay for service fee for service. So or private pay. So I think we're looking at some changes in the landscape that I think will make nurse practitioner practice even more accessible. And hopefully that'll, help even more win.
Speaker 0
That's amazing. Go ahead, Michelle.
Speaker 1
I was gonna say, I just out of curiosity and, I've I have not been to a nurse practitioner. So if I go there for my first appointment, like, what do I how long is the appointment generally? I know it's but what, like, what kind of things are you diving into?
Speaker 2
If I have if you were part of a family practice, that'd be a different story because I have the full background on you. But from my perspective, I get the patients to complete an intake form, and that gives me the baseline of where they're coming from. Are they perimenopausal? Are they postmenopausal? Is their major issue sleep? Is their major issue something completely different. But when they come to the full appointment, I have a whole host of questions that help me determine their risks, the potential benefits, and then we have a long discussion about the, the the recommendations and the what is the best fit for them. And that takes some time for some women. It does. Because there's education that goes along. So my initial appointment is fifty minutes. And, yeah. And Yeah.
Speaker 1
That's very impressive.
Speaker 2
Yeah. The women love it. You know, it's interesting that many other similar models for this type of menopause clinic also seem to have that kind of first intake appointment fairly long. I think it needs to be because there's a lot going on with some of these women. Maybe. Could we talk about that?
Speaker 0
I think that's, you know, one of the gaps in care that that most women experience when they're perimenopausal for sure is the ten minute appointment just doesn't cut it. What are some of the other, you know, and you mentioned, a little bit earlier in our chat, you know, it's not just about here's the hormones and off you go. Right? Even how to prescribe the right thing for the individual in front of you and the nuance, the tweaking, you know, all of the things that need to happen. What are some of the other gaps you see in perimenopausal care that a nurse practitioner is actually able to address?
Speaker 2
You know, any provider and nurse practitioners, obviously, because of the flexibility and potential length of an appointment, they have an advantage. But any provider has the potential to offer and fill in these gaps. But the problem isn't necessarily the providers. They may be following guidelines. The problem seems to be in the medical world, guidelines aren't keeping up. So for example, the Society of Obstetricians and Gynecologists of Canada, well respected, have a two thousand and twenty one guidelines that say that menopause hormone therapy is for vasomotor symptoms only and for postmenopause. So then you transition to, say, the International Menopause Society. Their guidelines indicate that there may be it may be helpful to take hormones for things like sleep disturbance and mood and, yes, perimenopause. So they use evidence because they're not flying by the seat of their pants, so to speak. Yeah. They use the research evidence to say there could be some support for some of these things. But if you are working in Canada and you don't know anything about it and you go to a well respected resource that doesn't have the information you need, and you go to Health Canada that says all these menopause hormone therapies are only approved for post menopause. Yeah. You'll you'll be following the guidelines, but they won't be correct. Yeah. So that's a huge problem. Yeah. Because we know that many women in the menopause transition, the I think hot flashes and night sweats are are one of the they're not the top thing that people come to see me for. No. And the difficulty is that when there's this gap in knowledge, common knowledge, then it's filled in by other people, by influencers or whatever. And I have patients seeing me all the time requesting treatments that I've never heard of or that there's so little evidence to support that I I just can't do it. Like, if I don't know even what the risks are or even what the non medicinal ingredients are in a thing, it's like, guys, I'm not going there. Yeah. Yeah. But, but I don't get mad at the women because they feel awful. They're not getting help. Yeah. We're desperate. We're waiting for one more thing. Yeah. This is not this is not usual. I've worked I've been a nurse practitioner for twenty seven years. Wow. I follow guidelines. I follow research. I've never had any controversy about the Canadian diabetes guidelines or, you know, congestive heart failure or anything like that. You know, but for some reason, we're just not getting it together with this really important issue that is gonna impact half of the population. It it's kinda silly.
Speaker 0
It really it really is. What do we what do you think needs to happen? And maybe that's a really silly question because, you know, it's obviously problematic for a reason. But I don't know. What what is it?
Speaker 2
I think women are making it happen. So, I but also from my perspective. For example, I'm involved with the, restructuring, changing in the curriculum of the curriculum for the nurse practitioner program in Ontario, which is a consortium of nine universities. Amazing. I'm making sure that Yeah. The menopause care is comprehensive. Yes. Thank you. Whenever I do so, anything that I'm putting together, I try to make sure, I try to, move my colleagues forward as much as possible. And I know that my physician colleagues, the pharmacy colleagues, the registered nurses colleagues, they are all trying to do the same thing. People are in who are in the menopause world are trying very hard to bring it up to, the standard that we we need to have it at.
Speaker 1
So then just just in case some of the listeners just wanna pull something out. So not all nurse practitioners are necessarily menopause certified still. So you go through the menopause for sure. Right? So I just because I find a nurse practitioner doesn't mean that they're gonna be up to date on menopause. So are you also listed on the Menopause Society's directory for listeners who wanna find a nurse practitioner? Is that the best place to find them?
Speaker 2
You know what? I would say yes. Okay. Because it means that even even if they stray a little bit from from potential guidelines, it means that they put the time and effort in to become to have a standardized base of knowledge. And I've had patients come to see me specifically because I'm listed as a menopause care, menopause society certified clinical provider. I think that's what it's called. And I think like I I advertise that. I put it on my on my website, and I think it's really important, because I think it's a baseline. It's a starting point for making sure that you are providing the best possible care for women. And I will say that when I I was I became certified, there were three nurse practitioners in Canada that had that designation. Wow.
Speaker 0
I know. How many are there now? Do you know?
Speaker 2
Oh, woah. Last time I checked oh, there were many, many more Oh, good. From across in every province. So it's very encouraging.
Speaker 0
That is very encouraging.
Speaker 1
That's wonderful. That is wonderful. Great to hear.
Speaker 0
You're so tell us, you're gonna be at the National Menopause Show, again this year. You're also on their advisory board.
Speaker 2
Yep.
Speaker 0
Correct. Yes. Which is amazing. I always ask this of our guests on the pike on our podcast, when do you sleep? Because all of these providers who are so invested in this type of care do a lot of extra, a lot, a lot of extra. So let me know when you sleep because I'd love to know the secret. And thank you again because it's so so needed, so so needed. But you're gonna be there again this year, and you're going to be on the revive and thrive stage, I believe. Is that correct?
Speaker 2
Yes. I am. Okay. For two things. Yes. So tell us about that. Okay. Well, the first thing is, for clinical hypnosis. I can tell your little bra about that. You guys sent me the questions. It was, what do you do about women who are skeptical? Well, I'm sure there are a lot because I wasn't sure either. Right. I can tell you again, there's been a long journey.
Speaker 1
Is it hypnosis for hot flashes? Tell us everything.
Speaker 2
Okay. So I have a I've been around for a long time, and this this will tell you why I thought clinical hypnosis was potentially good. Because in about twenty fourteen, I was working in a family practice and I became very frustrated that the only thing I could give patients for pain and stuff like that were medications. So at that time, I veered away from the traditional western medicine and took a program in acupuncture. And I started providing acupuncture to patients. And some of them said to me at the beginning, like, you know, does it work? And I'm like, I don't know. Then I discovered it works very, very well. It doesn't cure every issue or solve every problem, but, wow, patients had a great response to a lot of things. So fast forward to a few years ago when I was doing the menopause certification exam. I read a meta analysis from the menopause society. It used to be a North American menopause society. And that is where a group of of scientists review all the research about a certain topic and and split it up about what is good research that shows good evidence, what is, you know, we're not quite sure, and what is not enough evidence or doesn't help. And then they created lists of, recommended, maybe would help, or not recommended. And this was for vasomotor symptoms, and they were looking at non hormonal, options for vasomotor symptoms. Under the recommended from good evidence was clinical hypnosis for vasomotor symptoms. And I thought Wow. Wow. Wow. That's interesting. My experience with how well acupuncture worked got me to thinking about trying this. And I so I took a program. I learned at that time that clinical hypnosis has been approved by the medical or endorsed by the American Medical Association since the nineteen fifties. Really? And it yes. And it can be a very powerful tool for a number of things. It's noninvasive, and there aren't huge risks related to it. And it's a tool that people can take with them and use in different parts of their lives. There are lots of different definitions of clinical hypnosis, but what I've settled on for myself and from looking at the literature is that it's a state of consciousness where you're very relaxed and you're more receptive to suggestion. And then really importantly all hypnosis is self hypnosis. So even if you're guided and it it does work better for people if they're if there's a facilitator to guide them through. But after a while, you can put yourself into a state, and the goal is to change what's going on in your brain, to change that narrative. So here's an example. If you have you ever driven home and you got to your house and you're like, I don't remember the drive at all. I don't remember anything about it.
Speaker 0
Pretty much every day. So My candidate, I feel like that means I'm a good candidate.
Speaker 2
You might be. So you're not asleep at the time. And if something happened, you would be react an emergency, but it it's just shows you that you can have a different type of your brain can do different things other than be fully conscious or fully asleep, because you're not asleep during hypnosis. Okay. So if I say to you, who let the dogs out? Who? Who? Who? What do you think? Yeah. Right. Right. Actually, Mikael. Sue. So we're Sue. Sorry, please. There's there's an inside joke
Speaker 0
about explain to you in person at the National Medvedev Show. Yes. Yep.
Speaker 2
Sorry. I digress. I'm okay. So no. That's okay. So that it showed it shows you how our brains are conditioned to respond to certain triggers. Yeah. So for me, one of the one of the problems I had when I started the hypnosis course was that, training was that I every night, every evening, I wanted to eat. I want to eat eat eat eat eat chocolate. And it was like ruminate, ruminate, ruminate, ruminate. And I mean, I didn't eat necessarily, but it just didn't leave my head. It was driving me crazy. So I asked in the practice sessions if somebody could address that with me. And that was a few months ago. And I don't think about food all the time at night anymore. And I, you know, I think for me, it was a huge relief. And it's it's almost like now I can put my that energy that I was spending thinking about food to other stuff.
Speaker 0
Right. Right.
Speaker 2
So isn't I don't get you to bark like a dog. I you will not have a pulse like regression.
Speaker 1
I'm picturing you with a a a a wristwatch.
Speaker 2
No. No. That's what my husband wants me to do. But I said, it's I again, I dove in a little bit more, and I learned that hypnosis works well in groups. It works well online. So I've had a group. I did a pilot test with a group of of people, and I originally was gonna focus on weight management. So it's not weight necessarily weight loss. You have to be doing the work other ways, but it can help change these things in your brain, increase your motivation to exercise, that sort of thing. And you know what? They did really well. They told me that they slept better. They had better motivation to exercise, that they felt like they had could walk away from the table. So that they really got good benefit from it. And of course part of that is to make sure that they could, have the tools to do this on their own moving forward. They might come back for a little tune up once in a while. But anyway, I was so impressed. And now I'm doing, it clinically with, patients. I'm so glad I decided to just kinda look a little bit beyond this traditional, clinical guideline and and see if there's other stuff that will help patients. Because ultimately, that's what I want. But, so the literature about being hypnotized. Of course, there's a range. Twenty percent are very hypnotizable, I guess that's the word. Twenty percent are not very hypnotizable and there's a whole range in the middle. But again the research shows that pretty well everybody gets some benefit from it. So, I mean, what's wrong? What's what's so terrible about relaxing a little bit more? You know?
Speaker 1
So how long was your group, program?
Speaker 2
The program for weight loss and for I was trying to go with, again, research because, I mean, I don't know. There are some things apparently that, you can get benefit from fairly quickly with few sessions, but weight loss is a is a difficult one. Weight management. Because I'm not sure that weight loss would be the goal for with with, hypnosis because you're working on that outside. But to help you with the motivation to exercise, help you with the motivation to, like, leave the chocolate alone in the evening.
Speaker 0
Right. The food noise. Trying to
Speaker 2
manage the food. Oh my goodness. Yeah. So, that was is six weeks. And, it's once a week for six weeks. I found that was kind of the sweet spot and I'm finding that the group that I have now are telling me that it's really going well. So I'm I'm excited. It's That's exciting. It's opening up a whole new, whole new group of options for women that maybe they haven't had, and it's not necessarily something accessible, otherwise. So, again, the virtual piece is really nice.
Speaker 0
Yeah. And I think really speaks to, you know, we've been hosting this podcast for a while now and actively working on our own menopausal journeys for some time now. And it really comes down to the habits and consistency. Right? Yes. Medications are a big part of both of our journeys, but they are not a magic bullet. There are a lot of things that we each have had to do in different ways and finding a way to start a habit, apply it consistently, and have it stick, like, that is that is a superpower.
Speaker 2
Yeah. It it really is. And I'm sure it's not gonna work for everybody, but much like medication, they don't work for it doesn't work for everybody. But Right. As a tool, it's got a lot of potential. Right.
Speaker 0
And can be applied to
Speaker 2
A whole bunch of different things. Yeah, exactly.
Speaker 0
Yeah. Oh, that's exciting. So are you gonna hypnotize this?
Speaker 2
I wasn't planning to do a hypnosis session. I think it's kind of I I think people would be a little bit taken aback if I decide to do that. But there is a, a test if you will to see how well you would respond to it, which is not hypnosis.
Speaker 1
That's fascinating because I always went at the bars in university when they had the guy.
Speaker 2
I was like, I would love to do this, but I don't know. I feel like I'm
Speaker 1
I feel like I'm very hypnotizable, and therefore, I would, like, be the person that doing the really weird stuff on stage at the bar. So
Speaker 2
I I don't have those skills, but I don't want anybody to feel concerned. And I think that's why having it online is really helpful, having my actual program, because women feel very vulnerable. Like, people are Mhmm. They feel very vulnerable if you are putting them into a hypnotic hypnosis trance while you are while they're with you, and they're worried that you're gonna make them do stuff. And, apparently, you can't make people do stuff they wouldn't normally do, but I don't I don't know. I haven't been able to do that yet. That's a mistake.
Speaker 1
Did you say that you were also doing a second talk at the National Landaupoche Show?
Speaker 2
Yes. And it it goes along with my world my academic world at Laurentian University. Okay. I liked to combine things, so I'm not spinning my wheels. And one of the big concerns I had, was the number of women that I saw in my clinic who told me that things like, if you hadn't given me treatment, I would have had quit my job. Or telling me that, you know, they have a private practice in some in some capacity, psychotherapy or lawyers or whatever, that they have to cut down on their work because they can't manage it. And my response was you shouldn't have to give up your best earning years because of menopause. You know this is a time when you should be ramping things up. When you should be getting your you know your full, full potential salary because this is gonna sustain you for the rest of your lives. So not only that, women women deserve to feel half decent, you know, so far. Yes. There is that. Yes. So So I got a little bit of funding, and I used it to create a survey for women. Because I wanna find out what is the landscape like? What are the key issues that are bothering women? What are the big concerns? And I it's been live since about, or I should say it's been approved by Laurentian University Research Ethics Board. So it's not It's good research. It's not just something I made up. Some of the key things that I've learned since in the first round of, assessment was that the biggest issue is fatigue, bar none. And it may be related to hot flashes. It may be related to sleep disturbance, but the outcome is the big deal for for work. If you are dragging into work every day, if you can't concentrate the brain fog and everything, it's so much harder to maintain and to stay at your job. Many, many women have indicated that they used vacation time for menopausal symptoms. They use vacation time. I think people need to understand this. No. And we know that ten percent of women leave their jobs because of perimenopause and menopause. It's just terrible. So my talk will be a little bit about that. We'll talk about the survey, and I hope that women are still interested in taking it because it'll be live until December, I believe. Certainly till after the menopause show. But also some strategies on what they can start to look at and do to help with their own, situation because, I mean let's face it there's a big difference between working corporate world and working in a mine in Sudbury. So
Speaker 0
Yeah. No kidding.
Speaker 2
Yeah. And I hope that that is, to leave them with some resources and some maybe some strategies and maybe some thoughts about moving forward with their own lives because it's huge. Oh and I should add the other thing that I found with my preliminary analysis was just like you were saying, Michal, it isn't women who receive treatment are not significantly more able to cope at work. That there are obviously other things that have to be in place. And they'd be different depending on the workplace. But at least they at least we're getting a sense that treating women with hormones is not gonna solve the whole problem. There have to be other things. Right. So So I'm really hoping that women find it really beneficial to start thinking about what's going on with them and maybe some things they can do to help them their situation.
Speaker 1
And some of those being lifestyle.
Speaker 2
Should be. But I think it's sort of, like, we have to not blame the victim for everything. The women who come to see me, they're doing everything. They're they're, exercising. They're lifting weights. They're counting their macros. They're cutting down on alcohol. They're not smoking. They're trying to get some sleep. They're doing the sleep hygiene. The work that they do is like a full time job on the side just to feel normal. And, I mean, it's not okay that, I mean, we need to be able to address that. So there are lots of ways for a workplace to accommodate women depending on the situation, how does closer to the bathroom, have, more flexible sick time benefit. Like paid days off. Have, oh, I don't know, benefits to cover menopause care. You know? Maybe we don't have that.
Speaker 0
That's a big one, I think.
Speaker 2
It's true. It's so there's a lot that can be done in those spheres as well. And we can't, you're right. I mean, obviously, they're doing the work, they need to continue to do that. But I think we need to support them as a society, and give them some supports and ideas and resources to to make things change to make changes. And we're a big group. We can do it. Yes we are.
Speaker 1
About, sorry. Roberta what is the one thing you would love every woman to know about perimenopause?
Speaker 2
I think that every woman's symptoms are different, but that that can be the most chaotic and difficult time. Post menopause I can I can tell you? It's not it's nowhere near what what perimenopause was for me anyway.
Speaker 1
For me as
Speaker 0
well. I agree. We hear that a lot.
Speaker 1
Yeah. Yeah.
Speaker 2
It's it's so difficult, especially when there's so many other things you're managing. But what I would encourage women to know is that there is help. You can feel better. Please continue to search for the best options for you because you shouldn't have to feel this way. You should enjoy this part of your life and move on to feeling even better.
Speaker 0
Any day now. Actually, it's not any day now for me. It's been a while. But, thank you. We'll include, your clinic, link in the show notes.
Speaker 2
Oh, good.
Speaker 0
For anybody who is looking for In Ontario or Alberta. Practitioner And in Ontario or Alberta. And the link to the survey as well will try to encourage as many of our followers too and listeners to, to complete that because it's important. We need we need this information, right, so that we can make changes that are needed.
Speaker 2
You know, it's true. It's like I think this is a tiny little drop in the bucket. We need so much more research about women in midlife. It is ridiculous. I even talk about to my patients and to nurse practitioners. Just look at diagnostic testing for example. It's so primitive. I mean I can't I tell women, there's no point in me doing your estradiol level because I kinda know what's going on already. You're postmenopause and you have no estrogen. For your perimenopause and it's all over the place kinda thing. And and it's really frustrating for women that we don't have something. And why don't we? Why don't we have a something that will show us what your risk of mood changes with estrogen changes? What your risk of hot flashes are? Why don't we have these things? It's very frustrating, when you offer women stuff and and the range of things is growing, and it's great, but it's still not enough. We need answers. And I think, hopefully, this is one tiny little piece that can help move the needle a little bit towards, optimal care for women in this time.
Speaker 1
Thank you. Another great, piece of that puzzle is the National Menopause Show. So if our listeners don't have their tickets yet, they really should go get them. And Roberta will be there. It's gonna be an amazing day. So two days. So, yeah, we're looking forward to seeing you there.
Speaker 2
Yeah. Come by to the revives and frives. We will. Come by to the blues. We will be there
Speaker 0
for sure. For sure. Wonderful. Thank you so much.
Speaker 2
Well, thank you so much for having me. I love talking about menopause.
Speaker 3
Thanks so much for listening
Speaker 0
to the show. If you like what you hear, please subscribe and write a review
Speaker 1
so more women can find us and get a better understanding of what to expect in perimenopause.
Speaker 3
This information is not intended as medical advice. The intent of this information is to provide the listener with knowledge to support more efficient and effective communication with their medical provider.
