Is It Perimenopause or Is It Just America? Yes.

Dr. JJ and Dr. Domi try to figure out whether their brains are melting from perimenopause, post COVID fog, or the general psychological damage of reading the news in 2026. They swap midlife horror stories; frozen shoulder, mysterious body changes, and the sudden need to train like an athlete just to survive “minor” procedures. They debate hormone therapy (including the very real risks) and talk about hunting down a menopause/perimenopause specialist before the “cliffy” symptoms get worse. Along the way they cite Naomi Watts and Halle Berry’s menopause advocacy, recap The Pitt and recommend the unsettling Hulu film The Anniversary.

00:00 Show Intro Disclaimer

00:38 Weekly Check In

01:21 News Weather Whiplash

03:24 Electric Snow Shovel Hack

06:54 Perimenopause Basics

09:24 Frozen Shoulder Connection

13:22 Midlife Psychosis Risk

14:32 Brain Fog And Covid

19:09 Aging Looks Body Changes

22:05 Fitness For Surgery Prep

24:46 Use It Before You Lose It

26:13 Perimenopause Care Plan

26:50 Hormones and Specialists

29:29 Celeb Menopause Talk

32:03 The Pit Miscarriage Story

33:59 Hulu Thriller Pick

38:34 Hormone Risks in ER

40:06 Rants and Raves

43:43 Politics and TSA Chaos

45:54 Discharge Summary

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Transcript

SPEAKER_00 0:00

Welcome to No Other Skills MD, where I, Dr. JJ, a psychiatrist in desperate need of a mental break, and I, Dr. Domi, a pediatric anesthesiologist with a dusty degree in fashion design, explore the intersections of medicine, personal growth, pop culture, and surviving a dictatorship.

SPEAKER_02 0:16

From dissecting the absurdities in healthcare, navigating midlife transformations, and delving into the latest newsworthy topics.

SPEAKER_00 0:23

Join us as we share candid conversations and learn more because we have no other skills, MD.

SPEAKER_02 0:30

And just remember, although we are both doctors, we are not your doctors. So please seek out your own physicians for actual medical advice. So, how are we doing? What are our vitals? How are we really?

SPEAKER_00 0:44

Ooh, good afternoon. Good afternoon. Or morning or evening, whenever you're listening to this. Um, doing okay on my end. It's been a week where I've had a couple of interesting medical appointments, thinking about uh maybe taking on some uh uh potential procedures in the upcoming future as related to my reproductive health, for lack of a better way of putting it. So just sort of kind of thinking about a lot of stuff on my end. How about how's your week been? It's been okay.

SPEAKER_02 1:21

I think in this administration, every week is a surprise of what the United States is doing in our country, outside of our country, and none of it is encouraging. So it's a little it's a little depressing, and you you like to fantasize about all the vacations you would like to take, and then every week you gotta X off a country on that list because something is happening all the time, and and so I'm I'm slowly, you know, ex on Dubai, ex nay on this place, ex nay on Cuba for me.

SPEAKER_00 1:57

It's very challenging because it is like sort of a a change, a target, it's all consuming and it's super impactful. So I hear you. It's it's been a little bit of um a difficult week in terms of trying to stay away from the news, but also like it's spring and spring break and all that.

SPEAKER_02 2:17

It doesn't feel like spring in New York. Not at all. It's a 70-degree day like a week and a half ago, and that was a cruel preview of things not to come. It is fully back in winter, and I don't appreciate it. And I can't prove it, but I blame Trump. Can't prove it, but he's responsible. Just leaving it like that.

SPEAKER_00 2:38

I don't think you even have to provide proof at this point, you know.

SPEAKER_02 2:44

I believe I believe um he is evil incarnate, and all bad things will lead back to him.

SPEAKER_00 2:51

I know we've on Don. We had some record-breaking heat here too, like you know, 80s, 90s in March, like uh on our end. So, and it's all obviously connected, and I too blame Trump for that. Um but you know what happens on this side of the world, the ricochet effects, right? On the rest of the weather, so absurd heat here while you guys were dealing with maybe winter thunderstorms. I don't know, but I heard it was very cold and kind of scary out there.

SPEAKER_02 3:24

It is, and I had put away my electronic snow shoveler, which was a fantastic purchase, guys, because of my age, shoveling the oh natura away is just not no longer an option. I think past 40s, if osteoarthritis is in your bones, you should not be doing any manual shoveling. And I put it away, and then this past week I said, you know what, I shouldn't be so confident that there will be no more snow. I I shouldn't have put it away. Maybe that's a bad omen I did. Um, I don't have confidence that it won't snow again. It is mid-March, or it's actually it's actually late March.

SPEAKER_00 4:04

What is happening? What is it's actually technically spring now? Like you know, weather-wise. Can I just ask, what is an electric shover shovel? Is it different than a snowblower?

SPEAKER_02 4:16

Yes, because it doesn't quite look like a shovel, it just looks like a box machine with a handle, and you go over the snow, and then it sucks in the snow and shoots it out from whichever side you choose. So you can choose straight up to the left, to the right. So it's not a blower, it just kind of sucks and redistributes.

SPEAKER_00 4:37

Oh, and it's not so cumbersome, easy to store it fits into my closet.

SPEAKER_02 4:42

Uh when I did use it for the snowstorms as of late, people on the street, um, my neighbors looked very jealous. I had to send the link to family members because everybody was very interested in what I was doing. But it's really because my body cannot do manual shoveling. And I refuse to test my body in that way. My body's been good to me. I will not test it in this manner.

SPEAKER_00 5:07

I like that. I, you know, in addition to not testing your body, you also want to be preventative at this point. I mean, to put yourself in a situation where you might fall. I um have a person in my life recently who slipped on ice and broke their elbow in their 40s, and you know, obviously has been doing the things to help kind of build up bone strength as of late. So I think that that was an a really good prognosis in terms of how they're gonna do with a broken elbow, but still, I mean, very impactful, very debilitating, and not to mention painful.

SPEAKER_02 5:47

And speaking of bone health, I haven't been doing enough about my bone health. We can get into that. That delves into our topic today. If we're doing a little peek, it's perimenopause, how it's showing up today, tomorrow, and what feels like for the rest of our lives. And you know, I don't want to be one of those people, but I too blame perimenopause on Donald Trump. Can't prove it, but I feel like he's behind it.

SPEAKER_00 6:18

A hundred percent, he has forced us into this transition phase that is only gonna lend itself to a ton of upheaval, both obviously physically, mentally, and then just in general, our auras are impacted by perimenopause. And yes, let's just blame it on the reality of Donald Trump. I agree with you.

SPEAKER_02 6:42

I like this. This is a presenting problem. This is a case report. How uh Donald Trump has induced early perimenopause in women. That's the good, the bad, the ugly. So perimenopause obviously precedes menopause. Menopause is, I believe, defined as when you go through 12, a menstruating person goes through 12 consecutive months without a period. And when that day happens, that year mark happens, you're technically in menopause. So the years prior to that, which can range, I think three to seven years before you hit menopause, and it can vary from people, I think from 30s, most of the time it's 40s. And there isn't like a single test that tells you you're a perimenopause. I think you just feel like you're losing your body and losing your mind. And I feel like I'm in it. I must be by virtue of my age. I'm 46. I'm gonna be 47 soon. But I don't also know, is it kind of the the presence of what our society is? If that's weighing down on me and causing symptoms through anxiety, low-level depression that maybe feel like perimenopause, or is it perimenopause? I have a hard time distinguishing outside factors from my body's, you know, manifestations. That makes sense, Dr. D.

SPEAKER_00 8:09

Yeah, it does. You know what? I think it's a combination. I wonder if there is that sort of baseline perimenopause creeping into a lot of the physical and mental things that occur, and then it's like exacerbated by our kind of world turmoil, for lack of a better way to put it. And so I think it's a combination. I think it's really hard to distinguish. We're just kind of the lucky ones who get to go through it at the time of this upheaval. Uh yeah. So, but you're right. I think technically it is like 12 months of no period. Um, and you know, the other part about perimenopause that's just so challenging is like, how long will it take to get there? So technically, still getting my period on a monthly basis. Um, but there's the other parts of you that I think there's a very tangible sense of change in your body that becomes really acute during perimenopause, I think, in a way where you can't ignore patterns, you can't just brush this off as a one-off, you know. Oh, my shoulder hurts today. I'll wake up and it'll be fine.

SPEAKER_02 9:23

Yeah, frozen shoulder apparently is a terrible perimetle sign. Have you ever had it? You know, I had baseline issues in my shoulders. Um, I have a torn ligament. Now I'm playing golf. So sometimes, you know, even though I stretch, I'm having shoulder issues, but then I'm paranoid. Is it just because of the activities I'm doing, or is it, you know, Donald Trump uh affecting my body? I can't tell.

SPEAKER_00 9:52

Oh gosh, I love it. Well, you know, in it's in the differential. I mean, it is part of like uh the way that we're gonna uh manage the treatment of it, right? Uh yeah, I so I've had frozen shoulder twice and both shoulders. The first time, which also like probably is an indicator of my general overall health and how inflamed I have been for like decades, likely. But yeah, the first time it manifested in my right shoulder, I was like in my 30s.

SPEAKER_01 10:22

Yeah, yeah.

SPEAKER_00 10:22

And I really don't know what the you know, there wasn't an injury that I can like name, but I do recall that all the women on my mom's side, so all my aunts, my maternal aunts, my mom, my sister, mind you, all of them have had children. I've never had a child, they've all had really severe frozen shoulder. So I do think there's something genetic when it shows up in a younger person. But then I resolved recently my left frozen shoulder in my early 40s uh by never going to a physician and getting acupuncture and claw cupping. It really helped. Physician that doesn't go to the doctor, not the first time I've heard that. You haven't heard of that before? I wonder why. Um, and then uh, but but now I'm having kind of my right shoulder kind of trying to tell me that it wants to do it again, just as I've started going back to playing tennis. But I think that that was maybe a temporary issue because I can move it again. I'm very thankful for that. But yeah, that's a huge sign related to perimenopause in terms of just kind of having things work less well than they used to.

SPEAKER_02 11:30

Well, for future reference, in case you ever do want to actually see a physician for your frozen shoulder, just to let you know, as an anesthesiologist, what we can do if it's very bad, is we can do a regional block. We give some numbing medication, numbed your shoulder, and then the orthopedic surgeon can really unleash the frozen shoulder. Yes, and then you'll have mobility again, and you won't have the pain of them doing it without pain medication. So that is an option if you ever go to the doctor.

SPEAKER_00 12:00

I know both my mom and my sister had to do it under anesthesia, it was that severe. I I decided to grit and bear it. What does that say about me?

SPEAKER_02 12:09

That sounds uh like uh how doctors usually treat themselves. Yeah, I'll give you a regional block, no problem. Just fly over. I'll real quick.

SPEAKER_00 12:19

We just do it in your amazing apartment. I would love that. In your sauna, maybe infrared sauna. Yeah, that could be a side hustle.

SPEAKER_02 12:25

Just frozen perimenopausal frozen shoulder regional blocks by Dr. Domey. Oh my gosh.

SPEAKER_00 12:32

We just figured it out. Oh my god. That would be such a cute logo.

SPEAKER_02 12:40

Also, oh my gosh, me with a little needle on somebody's shoulder. Yes.

SPEAKER_00 12:44

Oh, I love it. With a uterus somewhere in the back. You would I think you would have a lot of business, and I think the line would be out the door. You could do like a just conversation. I know. Oh my god. I'm we're gonna make this work. Yeah. This could be. I mean, and I think it's a very delicate area. There could be a lot of other things that are going on. So you want to rule out anything bad that might need a surgical intervention, but I think you'll have a lot of business the whole consult team. Oh, and then can I I'll get on Zoom with them and talk to them about it, like in terms of like, tell me about your mood. I like this.

SPEAKER_02 13:22

Can I ask you a question? Because this is I feel like it might have been an episode of Law and Order, but definitely something that was made aware of probably prior to medical school is like either perimenopausal or menopausal psychosis.

SPEAKER_00 13:38

You know, we are taught often, right, that first break psychosis or first break of mania or in people with bipolar happen for women in their early 20s. But there does seem to be another kind of phase midlife, like late 40s, where we can see it. And it really, it really can strike anytime. I mean, if you think about it, it could be medication induced, it could be hormonally induced, or it could be dementia related. So I think we're prone to it at any point in our lifetime, but there does seem to be a pattern where all of a sudden it can show up in midlife. So, yes, and obviously postpartum too. So it's to be a woman. It really is because I mean, the brain is quite impacted by perimenopause. I mean, yes, we talk about this all the time. Um, like what's your brain fog like these days?

SPEAKER_02 14:36

Can I tell you who said that? And I totally forgot that I wanted to mention brain fog. There we go. Yeah, the amount of times that some a word just leaves my brain. And, you know, obviously we can do our jobs, but when I get back home, it feels like I can't remember why I walked into the room. But also, what I think is a confounding factor, and I'm wondering, is post-COVID neurologic symptoms, especially people who have had repeated exposures. To my knowledge, I've had COVID twice when I was working in the COVID ICU, and then I think a year after that. To my recollection, obviously we have asymptomatic people who are who would test positive or who were positive for COVID, but that can have long-term neurologic effects that we don't know yet. So could it be post-COVID? Is it perimenopause brain fog? Is it combination of them both? That that's something I I question. When I can remember the question, that's what I question.

SPEAKER_00 15:45

That you have to first remember. But no, I hear you. There it there was something that happened in the last few years where it's like very notable, right? It isn't just like, oh, I'm tired, or oh man, my word finding is off. There is, there's like a dullness, and maybe we're both very depressed and need to get on some medications, and we can think about that. Um course we could. We shouldn't. But anyway, not not, but I I don't think it's that. I do think it's like a little bit of that more of a heaviness and like a blankness that I've noticed in terms of that brain fog. And I mean, like things that are routine, and I think for both of us, some of that is work related, right? Like we could do that, it's almost autopilot, but it's the other stuff. Like I really do rely on having things written down, not on my phone, but like literally written in order to like kind of have a little bit of a better chance of remembering something or keeping track. But like I lose my keys. Exactly. It's like these, or like even remembering what I did, honestly, like last Friday. I really have to think about it. Accessing is so much harder.

SPEAKER_02 17:00

Once I get to work, usually on Monday, people will ask, What did you do this weekend? Just it takes me a minute because I can't, what did I do? I must have done something. It was three days of not working, and a minute to to recall. Yeah. Interesting and scary because you worry about, we always worry about neurologic function as we get older, because of course both you and I have seen patients, and I'm sure family members, etc., that really have had uh either dementia, close to dementia, other uh factors that decrease memory. And so you're always wondering that is that waiting for me. And if I am to be demented or have dementia, maybe that's a better way to state it, can I be pleasantly unaware of it? That's what you want. If you're gonna have dementia, you want to be pleasantly unaware of it and just living your best life, and other people have to figure you out.

SPEAKER_00 17:56

I agree. Uh pleasant dementia seems to be very uh humane in a way versus a sort of aggressive, agitated dementia for sure. Exactly, going in and out of it, or or or you know, difficulty with convincing that it something sinister or bad isn't happening. I mean, just being skeptical the whole time could be very challenging. But yeah, I think we're getting like little previews of it thanks to this sort of huge part of perimenopause, which is brain fog. And then, you know, that it there's other like obviously the physical stuff, the shift in your menses or your period, and and then also like there there does seem to be in this period of time the reality that because your physical or mental changes aren't so temporary, that they don't resolve, that they're kind of a longer uh deterioration, there's a pattern happening. I think that it's been uh just to give a little silver lining to all of this, a little bit of a reality check that you are mortal. That you're slowly dying. I call it the slow deterioration, you know?

SPEAKER_02 19:14

Which is Can I get a little superficial with it?

SPEAKER_00 19:17

Please.

SPEAKER_02 19:17

I wonder about the looks because I feel, you know, black don't crack, say Asian don't reason. We've kept up pretty well, but I feel like the factor of perimenopause menopause is just the hunt that just goes down. There are plenty of beautiful women in their 50s and 60s and 70s, but I've noticed a change. What I feel is drastic, nobody else would notice it. And just the sag factor of the face, not so much wrinkles, and and and I blame perimenopause in just aging in general, but is that just a cliff that I'm gonna go down, or is it just kind of acute steps? Am I going off a cliff that you can't come back from? Are the hormones gonna help? I don't know.

SPEAKER_00 20:04

I don't know. I don't know. I I think I think that there are certain things that feel a little cliffy, like, ooh, that's a deep dive. Um and then there are things that feel a little bit more stepwise, like that's slowly.

SPEAKER_02 20:19

You know, the jowls in your face. Yeah. I feel like, oh, once you get the gowls, it's it's a rough life, you know?

SPEAKER_00 20:26

Yeah. And this week I was having negative thoughts about one part of my body. I won't get into the specifics, but I which aren't like necessarily uncommon, but I was like, you know, this feels a little different. Like it feels like a little bit like the point of no return, kind of like the cliff, exactly what you're talking about. Just sort of like, I'm like, oh, is this what they talk about? Like that perimenopausal like body fat changing or um some of these things that can't be remedied. I mean, oh wait, there is a remedy, it's called maybe wall Pilates, I think is what I think I need to use as an intervention. I guess that's when you do Pilates but on a wall instead of on the floor. I have never done any Pilates. I'm just gonna confess now. I know you have a machine.

SPEAKER_02 21:13

You have a machine, but I put it away for a couple of months to practice my golf swing and my living room, but I had to bring it back because I'm losing muscle tone.

SPEAKER_01 21:23

Yeah.

SPEAKER_02 21:24

And if I don't see it every day, it's an excuse not to exercise every day. So as soon as I put it out, I felt the need to use it. So I am one that things have to be in my face, especially regarding fitness, to guilt myself or something of the like to force me to exercise. I don't like to exercise naturally. I know it feels good and people have endorphins and blah, blah, blah. But I just do it to fit in my clothes, to be quite honest. And to be healthy, blah, blah, blah.

SPEAKER_00 21:56

Yeah. I respect that because I also, I mean, again, I think we've talked. About this a few times, I've kind of fallen off the uh exercise cliff as well. Um, because I had to get like a procedure a couple of weeks ago, and I've just sort of been coming back from that, and I'm happy to talk about it here because part of the intervention is related to what I thought were perimenopause symptoms. I was having sort of abnormal bleeding, and I'm like, okay, this is just what it is, sort of went through treatment options, ended up having an intervention where the outcome now it's nothing super scary, but there's an increased risk based on the findings of coming out down the road with something like an endometrial cancer diagnosis, et cetera. So I've been recently recommended to have a hysterectomy, which is a real big deal. Interesting outcome that I don't think I was expecting. And I sort of know that if I were to even undertake that, first off, I do want to get more fit in order to recover well from a surgery, such as that, even though the surgery in general is a lot less invasive than it used to be, it can be done laparoscopically. But, you know, the other part is like I like I sort of have that motivation to start getting that exercise in. And it is because of this sort of chapter in our lives now, in terms of the um intervention of needing to just feel better through exercise, but also strengthening things because we're so much weaker.

SPEAKER_02 23:34

I think that it's a good idea because I plan to have like a small orthopedic procedure in a couple of months, but also I've fallen off the exercise wagon. But also to get myself fit for the surgery, because honestly, you never know how things are gonna turn out. So this is something I would kind of recommend for anybody. Obviously, you want to be fit all the time and eating great all the time, but you want to prepare your body for a physical stress and emotional stress that goes along with having a procedure. So I've I'm trying to mentally get myself in the game where I'm getting myself in good cardiovascular health, I'm working on my muscle tone because after I have the procedure, I won't be able to work out probably properly for a couple of months. So I have to really build up my muscle tone to counteract the lack of exercise I'm gonna have for a couple months. And we're not 20 anymore, and it matters just because this surgery's scheduled as something quote unquote minor doesn't mean it won't turn major. You never know. You never know. And everybody's a little different, so you do have to gear up, and if that's a motivating factor, I think I'm I'm on that trend as well, because you never know, and we don't bounce back when you're 20. The bounce back is quite different than when you're in your mid 40s from surgery or anything.

SPEAKER_00 24:52

Yeah, and it is really like the realization that we should use it before we lose it to a certain extent. Like muscle tone, you know, it is muscle tone, muscle tone, bone strength, joint movement, range of motion. Uh, it's it's kind of now, I think, sinking in in terms of this phase of life, just like how precious it is. It's so as much as the I'm I'm trying to be the optimist over here. I'm trying to be that like silver lining to what all of this is. Like, it is like, I guess, very motivating. And I think independent of even the physical deterioration, some of the stuff that happens mentally with us, right? Like the limitations with what we put up with to a certain extent, because our I think our stress levels or these super high, the emotional regulation associated with managing it, how precious sleep is, all of these things I think come into focus a little bit more during this phase. So I think I want to use all of this to help me be healthier, right? And so exercise is one aspect of it. And then also like kind of thinking about where and how our body feels and what can make it feel better, you know?

SPEAKER_02 26:10

I do think about that a lot. I'm trying not to be a Debbie Downer about perimenopause because it's only gonna get worse.

SPEAKER_00 26:18

Yes. Until we get to menopause, I guess.

SPEAKER_02 26:22

Until we get to menopause, and so I'm sure our listeners who have past menopause are like, oh, buckle up, buckle up. And also, I think, you know, with the WHO, I think in the last year or so has now recommended hormone therapy when prior they did not necessarily do that.

unknown 26:41

Right.

SPEAKER_02 26:41

Uh, the World Health Organization, because of supposed quote unquote associations with certain types of cancers. So I have not done a deep dive on whether it's good for me and when someone should start. So, what I'm doing right now is researching a perimenopausal specialist or a menopause specialist. So obviously, everyone who's menstruating should have a gynecologist, but there are some that specifically specialize in menopause, perimenopause. So I want to look for that kind of person, maybe also an integrative medicine physician, hopefully someone who does both, to know where I should go because I don't want to play catch up. I don't want to wait till I'm having all of the symptoms to then have things that are irreversible or kind of changes that I feel are irreversible, the superficial ones specifically that I was mentioning earlier. So to hormone or not to hormone, that's the question. But I think, like I said, we are not your actual doctors. You should talk to someone, and we will also talk to someone. And when I do find a perimenopausal menopausal specialist, I will let you guys know what my experience is.

SPEAKER_00 27:58

I would love to hear about it. But you're right, even for us, we're navigating this as females who are managing all this cluster of like symptoms and the landscape of healthcare and how to navigate it. But I do think the like now there is more of an emphasis on perimenopause. And unlike I think our parents' generations, there's a lot of discussion about it, a ton of discussion. And I think we're learning like wisdom from people as they're going through it. It's not just like, oh, that's a woman's problem, or they must be going through perimenopause, and that's why they're enraged. It's a little bit more understood, and I think, at least talked about, though, still under research. So I agree. I think that there are a lot new more studies coming out, new guidelines, less concern about certain things in the past that were a huge issue. And uh to hormone or not to hormone is a good question. I think it's gonna be a topic I I bring up with my doctoral soon.

SPEAKER_02 28:59

Cause and I think we'll both report back when we have some answers about our personal journeys with it. Yes. And maybe I'll go there and they'll be like, girl, you're so young, you're not in perimenopause, you just uh you know, have COVID brain or something. Oh, that's a real shoulders just don't work because of activities. You never know. You never know. Too much charting. Exactly. But I believe once we're getting to our consult, our second opinions, we've been reading, we've been watching TV. And there's a book about perimenopause that you had read or you're aware of.

SPEAKER_00 29:35

Last year, read the Naomi Watts book that she wrote about perimenopause called Dare I Say It. And it's like lessons about her journey through perimenopause to menopause. And I think it's part of her wellness branding. I think she's doing very well in that realm. I'm forgetting the name of her wellness company, but I know I can't remember, but she would forgive me based on her book and the content. It was a little juicy because we got a little tidbit about her personal life with her husband and her current husband, Pilly Groud Up. So that was kind of fun. And there was some nice little tea that she spilled about her sex life, which is always fun, especially because it's Naomi Watts. But went through a lot of different aspects related to perimenopause. And it was it was light. It was easy to read, it was easy to access. Um, she really highlighted quite a few physicians that have helped her through navigating it. But, you know, this is somebody with a ton of resources, right? Who could access this level of care and then have the capacity to write about it. But it was, you know, I don't know if I would recommend it. I think a quick synopsis through ChatGPT would suffice. But look at you, look at you on AI. You know, I can see the positives there. Um catch our previous episode about AI. Oh, yes, you know, you can see that I've grown a lot in a week and then I'm adapting it readily. But I would say that it was just again the conversation starter about how normalizing the impact that perimenopause has on women.

SPEAKER_02 31:14

I think Halle Berry has kind of been on a menopausal tour as well as of late. I don't think she has a book uh that I can recall, but I just remember her doing kind of all of these promotional. She thought she had genital herpes, she was having so much pain with sex, or she was diagnosed with that. But when they actually did the test, it was negative. And it turns out, after all of this, that she just had symptoms of genital urinary symptoms related to menopause or perimenopause. And so since that time, she's just been an advocate for women to recognize what they're going through, talk to their doctor. And I think she has products now available, etc. Hey, make some money, girl. Oh, yeah. So, you know, I if you can, you can.

SPEAKER_00 32:00

Any other books or updates? Uh I've of course been continuing with my viewing of the pit. I actually want to give myself credit. I was able to get through like three or four episodes this week. I just, I think I uh let the first episode just numb me out so I could get through the next few, though. I mean, bringing it back to obviously uh female issues, just and this is heartbreaking, just so everybody remembers. Oh, yes. First season, I think I got up to episode nine. So it's the afternoon post-lunch shifts from like one to three. I mean heartbreaking. I mean a miscarriage while at work. Right. I mean, spoil alert. Uh, and just kind of digging through it, kind of again, the art of pushing and repressing in order to get through a shift because things are coming at you one after another. So, you know, just women especially.

SPEAKER_02 32:57

Oh, yeah. Because I've also known some friends, female physicians of mine who have had miscarriages at work and still continue to work when they're actively miscarrying. And you know, I wouldn't say it's it's good, but it's a real depiction of what a lot of women have gone through, specifically um physicians with their medical professionals where you just can't leave. Yeah, you're not dying, just can't pick up and leave, you know.

SPEAKER_00 33:27

Can't even yeah, and and the the challenge of being able to leave in the midst of obviously a thousand things going on, and then also the isolation and loneliness of as it's happening, like you're in this world of just so much like acuity, and then you yourself are going through this in a way that is just starkly upsetting. So, you know, that was kind of I I was like, I gotta, I gotta really put on the good big girl pants here and get through a few episodes. But how how about you? Any kind of good uh media this week? Any not medically related, but okay do you have Hulu?

SPEAKER_02 34:05

I do, yeah. You have a recommendation. There is this movie called The Anniversary, and it has Diane oh, what is that woman's name? Not Keaton, she's like middle-age Diane.

SPEAKER_00 34:21

She was she in the Tuscan son?

SPEAKER_02 34:24

Yes, Diane, whatever her name is. Oh my gosh, brain fog, perimenopause. Anyway, I can see her face. Kyle Channing is the guy's name, you know the actor?

SPEAKER_00 34:37

Yes, Diane. I'm looking her up. Diane Lane. Diane Lane, thank you. Okay, you're welcome. And she did it. There is no way I would remember that. I have perimenopausal brain fog plus COVID.

SPEAKER_02 34:51

Right, right. The combination, and of course, the cost, which is Trump. So I was watching this movie, and it's basically about a family. She's a professor, her husband is a restaurateur, and I it seems like perhaps they live in the Hamptons or some suburb close to New York City, I'm assuming, and they have three grown children, and one of the children starts to date this very conservative girl, a woman, and the family is known to be liberal. Now, they don't label things as Democrat or Republican or anything like that, but the progression of not to spoil too much, the progression of what happens when this woman enters their family and then kind of how that permeates their inner circle, their outer circle, the world, and it escalates very quickly. It was so unsettling because it's not too far off when you think about today's episode. Yeah, so it's uh it was good, it was suspenseful, but it was disturbing because it's not too far off. And I think about when movies were made. This is a movie that came out, it just came on in Hulu, but came out, I guess, in 2025. I don't think a theatrical release, but honestly, I don't know what's really what made it to the movie theaters. I don't really go anymore. Versus that must have been made in 2023, if we look at I see shooting schedule. And so What's his name wasn't even elected yet for the second time around, most likely when this movie was being made, right? But it's so closely mirrors what's happening, it was disturbing, it was good, but it was disturbing. So I would recommend it.

SPEAKER_00 36:38

Oh, I like that. Okay, that does sound very intriguing. I'll take a look at that. I've been yeah, I've been watching a lot of like Fierce Women. I don't know if Diane Lane's character is that sort of taking on. Yeah. I I watched another like movie from a couple or series where uh there was just like a badass woman kicking ass, and I I I've been gravitating towards that. And so I wonder if that's part of the perimenopause as well. Like people in their late 40s, early 50s just doing it, going for it. Oh, thanks for the recommendation.

SPEAKER_02 37:11

I will definitely it does have a disturbing factor because it doesn't, it seems outlandish when you watch the movie, but given today's events, not really.

SPEAKER_00 37:24

Well, I have to say, like when things are a little bit too close to reality, it's a little bit throw it throws me off. I would say that that happened when, and I mean, obviously, part of the pit here too is when COVID started showing up in popular culture, and you're like, ooh, like I don't know, there's something something about it that is like, yeah, there's like something that's unsettling about it, right?

SPEAKER_02 37:46

So it hasn't happened yet. Obviously, I'm a little further in the pit than you are. That nothing with menopause per se has happened that I can recall. Like a frozen shoulder would be good because most women, I assume, have no idea that that's a symptom. Or other symptoms like that where menopause is in the differential. Probably you're not gonna have such an acute issue outside of a frozen shoulder that will cause you to be in the ER per se. Right. But it is in the differential for quite a lot of things, exactly. So that that would be interesting, or effects of hormone therapy or starting hormone therapy and things like that. And yeah, we'd have to obviously work with a doctor when you're going through that because different people have different risk factors, yeah.

SPEAKER_00 38:34

Interesting. Yeah, and it needs ER setting, you know, it brings up uh a friend of mine who did like try some oral hormonal medication, not a patch, but really early on in their kind of perimenopausal journey and not to scare anyone because it's really um very dependent on the individual. But she ended up having to go to the ER um and had a PE, a pulmonary embolism. And so, I mean, again, this is where please talk to your doctor about this. Don't take any advice from us. But there is a spectrum of potential outcomes depending on many factors. But I think that that could be like, why is this person in their 40s showing up with the PE? Doesn't smoke, isn't, you know, and doesn't have history, and I think was due to hormone treatment related to trying to escape some of these paramenopausal symptoms.

SPEAKER_02 39:27

And of course, whenever people take a medication, the intended effect, there's always gonna be a side effect. Not everybody has side effects with every medication that they take, but there's known side effects, and that's you know something your doctor will talk to you about. But also in the age of 2026, that's something you can look up as well. And it's always gonna be on the insert of the medication, et cetera, et cetera, or you could talk to your local pharmacist. But yeah, PE DBT is uh not a small thing, obviously.

SPEAKER_00 39:55

Yeah, but again, another female problem, uh woman problem that I think we have to all really kind of uh learn more and more about. So, you know, going into Dr. Domi, the rants and raves of the week, I mean, just to throw it out there, that lack of research and perimenopausal understanding is part of my rant this week because there is a lot more that we know uh than before, but there is still such a dearth and lack of research and long-term studies associated with the whole process and the reality of the fact that this is a phase in life that could be like 10 plus years of our lives. Like, you know, I would say that I've started in my early 40s. I don't anticipate this is gonna end anytime soon unless I get, you know, said hysterectomy. I'm gonna have some changes happening, but um, that's for me to figure out you'll probably keep your ovaries, right? Definitely look normal, so you still will have some get that hormonal influence exactly. But yeah, so I think there's more research. I'm so glad to hear there are perimenopause experts now. I mean, this is really great because it is finally being talked about.

SPEAKER_02 41:06

The only thing is, and I my gosh, I am a demi-downer. I was about to say, with this administration, anything that has to do with DEI includes women's issues, right? Yep. So funding may not be as robust as it would have been prior to, or with somebody else in charge. So it depends how RFK Jr. feels about women, I suppose. Uh, and he's got a history. Has he been that rabbit hole?

SPEAKER_00 41:38

Anything about women, I think, yeah, though, given given his past, if you want to I think so chat Chat GPT can help you out with his past, doesn't have the the best track record as far as women or caring about women is concerned.

SPEAKER_02 41:54

But aside from that, I don't know how much funding, I haven't looked this up, is really going to continue for women's specific needs.

SPEAKER_00 42:03

Because after all, like once we've hit that lack of like, you know, fertility, what's the point? Right? Yeah, just throw us in the garbage. Hey, basically, that's what's been the uh situation so far. So, yeah, very good point. You're right, because like whatever might have been happening is likely paused and or will be dismantled.

SPEAKER_02 42:22

Yay! It takes a little more work on an individual's end to kind of find the right resources for them. But as a segue, the rave is people are talking about it more. And I was just watching Married to Medicine, which is this reality show on Bravo, because you know I love my reality shows. It's about a bunch of doctors or married to doctors, that's it, in the Atlanta area. And um, someone was like age-shaming another person, like you're so old, and then three women on panel are like, I'm 50, I'm in menopause. And but back in the day, nobody was announcing that they were in menopause proudly. Do you know what I mean? Right. I was like, Oh, look at that, look at that. My people's stage of life together. Something you look forward to, and they look great. There was no sagging, there might have been some help, but we'll we'll no sagging jowls to be seen.

SPEAKER_00 43:19

I need to watch Married to Medicine, yeah.

SPEAKER_02 43:22

I think probably the early seasons are a hoot. Um but it's it's it's hilarious. Oh I would not envision myself on that show, but you could pay me and I I might I might do it. Hey, and never know. My other rant was, of course, like we had mentioned at the top of the top of the episode, that every week it's something with the administration. And part of this podcast is surviving the dictatorship, surviving what's happening politically, socially, and just the government is not paying. TSA workers appropriately. There are a growing list of countries that Americans should not be traveling to. So we should be able to travel where we can while we can. And the fact that you won't pay them, but you will pay ICE agents to go into actual airports to do what? They're already arresting people who are taking a flight somewhere that they did not have warrants for to begin with. What is the point? Just pay people whose job it is to keep our airport safe and to keep passengers safe, but instead you're bringing in this organization that will terrorize people and don't know how to do TSA's job properly. So what is the point? What are we wasting money on? We already have a war that's you know one billion dollars a day. And I know which I could have sworn the government said was over in a day and a week, and I think we're on week three. Three craps. Yeah. Anyway, so that's my rant of just well pay people appropriately to do their jobs appropriately. Yes, with not terrorizing people who live here.

SPEAKER_00 45:11

I wonder, yeah, they can fund this war that's been three weeks old, but not pay the TSA agents who, by the way, have been doing a great job. I don't know. Have you been? I've not been in a line that was three hours long ever.

SPEAKER_02 45:26

Except for this week. So this week has been, yeah, um, kind of hours, like they're saying to get to the airport four hours early. Um do you have any upcoming flights? Because I have one next month, but I have one end of April. End of April, yeah. Every week is something something new. So you never know. Just make those tickets refundable, guys, for the rest of the good point. Great advice. Always make your tickets refundable. So as we have our discharge summary, thanks again for joining us at No Other Skills MD Podcast. We hope you got something out of listening to your friendly neighborhood doctors.

SPEAKER_00 46:04

But please remember we are doctors, but not your doctors. So for actual medical advice, please reach out to your own personal physician.

SPEAKER_02 46:12

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