but hello I'm Jennifer Blomqvist and welcome to HealthLine this Tuesday evening.

I'm so glad you joined us.

I know we have a lot of regulars we love you.

You come back every week which is great.

So you know the drill that we're live in the studio and we love it when you call in with questions.

We also have the ability now to have you text in questions.

A lot of people have been doing that the last couple of months since we started doing that.

So let me just kind of break it down for you were living here in the studio we have a guest that many of you will recognize her.

She's been here many times over the years and love to have her back tonight.

So if you want to call in you can ask your question live during the show.

I really like that because then our doctor our guest can can communicate with you.

I mean she might want to ask you some questions so she can give you a better answer.

So that's your first option.

Second option is you can call in and just talk to the call screener and relay the question to them and they'll let me know that and we'll get it answered that way.

So here's the deal with the texting.

This is totally private.

We will not show your phone number so don't have any worries about that.

But if you feel comfortable it's great if you can maybe give us your name where you're calling from and then we'll just put your question on the screen and we'll get it answered.

The phone numbers are a little different.

So if you want to call it's (969) 27 two zero if you want to call or text us it's (969) 27 three zero and we keep those numbers up for you at the bottom of the screen throughout the show.

So let's go ahead and introduce you to our guest, a familiar face for many of our long time fans.

So Dr.

Helfgot, so nice for you to come back.

It's great to be here.

Thank you.

One of my first shows I did here eighteen years ago was with you.

Yeah, we were taught and we were talking about hormones, which is what we're going to talk about tonight.

Yeah.

So for those of you who may not be familiar with Dr.

Helfgot, you had a background in OBGYN for many years and then you ended up now you specialize in integrative medicine.

Correct.

Which I'm sure a lot of women like.

You know, it's more of a natural way to resolve problems.

I don't know if you want to talk briefly about what integrative medicine is.

>> It's a relatively new specialty.

So yeah.

So integrative medicine is in just an awesome way to look at the whole patient and really try and figure out what's going on.

Look at nutrition.

We look at the pillars of health so sleep nutrition activity and then we try and put it all together to give you the lifestyle and to give you a healthy lifestyle that you can continue something that can you can be consistent with.

>> And so we see a variety of people men, women, children all ages and some people come because they want longevity.

>> Some people come because they just want to be healthy and they want to know what they should do.

>> Some people come because they have chronic fatigue, chronic pain.

Some people have want their hormones checked, thyroid checked.

>> So it's a nice potpourri of things that we do and much more geared toward doing things you know, homeopathic you know, homeopathic but not so much have but yes, more again lifestyle changes not necessarily medications for everything.

I mean if you need medicines you need to take them so that let's be clear about that but more so again lifestyles really huge diet is huge exercise sleep managing your stress is huge and we'll do supplementation and again it's integrative.

>> So we're doing it with your family Doc.

We're doing it with the other specialties and really just trying to come together in a collaborative way.

All right.

I just want to make sure everybody understands that talking about integrative medicine here but but the issue you wanted to focus on tonight, Doctor, was perimenopause versus menopause which in our culture I think a lot of people don't take it seriously.

It's it's kind of been joked about, you know and I can tell you over the years just I've met a lot of women that it's very sad some of the some of the ways that this which is supposed to be a natural transition but it can very negatively impact their life and that of their family.

>> So you know, it's it's something that should be addressed and not joked about.

Yeah.

So I wanted to come tonight to let women know as well as their partner.

I know that like Jen Jennifer said perimenopause menopause is definitely a transition that women go through and it can be very difficult.

But I'm hoping that if we educate women and their partners about what's going on and you know what to look for and you have options of what you can do to help you make you feel better and to let you know you're not alone.

So this is something normal that you go through a lot of women will say hot flashes, night sweats, trouble sleeping.

>> You think you're the only one who has that.

And what I want women to know is the majority of you have mood changes, irregular periods.

You can't sleep sweating when everybody else is freezing my night sweats you can't sleep.

>> You just want to put your head in the freezer because you're just so hot.

>> This is a normal transition unfortunately.

>> And again it is extremely common the rare woman will not have those things so the majority will have those things.

>> The minority will not and the difference between perimenopause and menopause is perimenopause.

You're still having periods they may be a regular in that you skip a month, you skip two months.

>> You may have a period for two weeks long I hope that's not the case and menopause and you have all these symptoms and menopause is no period for a year.

>> So no spotting, no bleeding, nothing for a full year and you have these symptoms perimenopause can start we're now seeing it earlier.

>> That's what I've heard.

Yeah well like early forties.

Yes yeah.

It used to be forty five average age of menopause is fifty two .

But even for some women we're seeing these mood changes these irregular periods in their thirties.

Wow.

So again I think it's really important that you know oh wait this isn't this is what I'm going through but there are things you can do you don't have to suffer.

So again nutrition is a huge part of it for a lot of women drinking wine, eating sugar, eating simple carbs will make those hot flashes and night sweats worse.

They may make your moods worse.

They may make your sleep worse.

>> So again cutting back on those eating healthier foods is often something that's helpful and then exercise is really important for that as well.

Same thing with managing stress and so trying to figure out what is going to work for you and your family is I think really important and then supplements or medications hormones are definitely options for people.

>> So again he's advocated for that because a lot of people we've talked about in the past they're a little nervous or hesitant to go down that path.

>> Correct.

Like I I really want to emphasize please don't suffer you shouldn't have to again make those changes, manage your stress, eat healthy exercise.

But if those things aren't working then yes, there are supplements that may work but hormones are definitely something that can help you.

And I know for years because of this study that came out in twenty twenty two the Women's Health Initiative, it was a big scare for women telling women that there was increased.

The study actually was done on women who were 65 and and older whereas not the average age of menopause.

Fifty two .

Yeah.

And so we saw an increase in stroke.

We saw an increase in heart attacks.

We saw a potential increase in cancer and sure enough that scared everybody which rightly so.

>> And so we told women physicians told women you need to get off hormones.

Well, fast forward twenty two years later we're now finding out that because the study was done on older women, the risks were different.

Sure.

And we're now seeing that taking hormones and hormones when I refer to that I mean estrogen progesterone for some of you testosterone.

Yes.

You want your thyroid managed.

You want it to be stable.

But the hormones I'm talking about are estrogen progesterone and for some of you testosterone really can help you and especially within the ten years of menopause.

>> So after your last period within that ten years taking hormones have huge benefits for your heart, your brain and for your bones.

>> And I would say that's great but don't forget you still have a brain bone and heart that you want to protect after that.

>> So I think it's important to consider hormones after that as well.

>> Is that normally would you say menopause?

>> Is it is it considered maybe lasting ten years or is it is that average right question so menopause is a continuum.

That's the other thing.

So thank you for that.

A lot of women think that they go through menopause like you're going to go this and it's going to be over with.

Yeah unfortunately I'm sorry to say that again the majority continue to have the hot flashes, the night sweats.

I didn't even mention vaginal dryness, painful intercourse, sleep disturbance even ten years past when they're when they are done with their period.

>> So menopause is not a lot of times you'll hear postmenopausal.

Yeah.

Yes.

It's not it's not really a continuum.

>> You're going to continue through it and that's why it's really important to take care of yourself in your 30s.

>> I like to advocate to all our teens out there even to really good nutrition exercise et cetera so that perimenopause and menopause is easier for you still are going to have symptoms but it's easier for you.

But yes you do you are not done with those things unfortunately and women are living longer and so we really need to protect our bones, our heart and our brain and hormones can help you do that.

So I really want women to understand the benefits.

Yes, there are risks and there's all different kinds of hormones.

>> There's oral, there's cream, there's patches, there's some positives that you can put inside the.

>> There's cream you can use for vaginal dryness, topical hormones more like the patch the creams they don't go through the liver.

>> They bypass the liver so risks for clotting that you see with oral are less if any with the patch as well as with the creams.

And I assume it's not a cookie cutter correct type of prescription.

>> I mean you probably have to, you know, make a specific per patient.

We really try to make it specific for patients because you all are different, your symptoms are different, your makeups are different.

How much you need is different.

So really important that you get your hormones tested.

We typically do it through blood.

There's other options saliva and urine but typically you do it through blood.

It's good to get a baseline once you take hormones it's good for you to get checked on the hormones.

>> Are you reaching the the goal that we need you to get for you to protect your bones and your brain in your heart?

Well, Dr.

Helfgot is sharing a wealth of information with us tonight and I'd hate for you to miss out on getting a question answered.

I'm sure there are a lot of women out there who or maybe it's them or a loved one that is having some issues with menopause or perimenopause contemplating hormone use.

This is your place to get free advice.

I can even even the phone call is free because if you're outside of Fort Wayne it's still a free call.

So let me just remind you we've got the phone numbers at the bottom of the screen again if you want to call it's (969) 27 two zero.

It is a free call if you're outside of Fort Wayne just put an 866- in front of there and the texting has been really popular and that's a really quick and easy way to get your question answered.

The number is a little different.

(969) 27 three zero.

Unfortunately we only have our friend here for another ten twelve minutes or so so please call sooner or text sooner rather than later.

>> So one other thing I do want to say is for women years ago we didn't recommend hormones for women in perimenopause because they were still having periods and we were concerned that it would affect their periods and cause issues that way.

And I just want women to know who they are in perimenopause having symptoms that you can use hormones and we can work around the periods and typically it's estrogen progesterone again some for testosterone and that's good and I think this study that the new studies that have come out have really it's been a blessing and a liberation for women because women have really suffered for a long time because of this WHV study that came out in 2002 and now it's the fact that we know there are benefits.

We knew there were benefits all along we did it just was because of the increased risks that we saw with the study and then they put a black box warning on the hormones and that recently has been taken off which is great.

That was done in twenty twenty four.

It's been taken off and that again is just reassurance that hormones are good for you and if you need them consider taking them.

Well should I take them if I'm not having symptoms?

Well if you have a bone density test which women should get at age fifty and you have loss of bone then progesterone, estrogen and testosterone are great ways to support the bone.

Now are these when you talk about hormone replacement therapy?

I know everybody's busy and so you know, is this something you do daily?

I know you said there are different options when there's topical or is is there even an infusion?

>> Is that in in other ways for osteoporosis?

>> There is but I didn't know for hormone replacement therapy not not an injection per say or no, no, no.

>> So like the other things is that yeah.

Make it more like the patches twice a week you change it twice a week the progesterone if you take oral or use a cream it's nightly vaginal creams are a few times a week so for the most part we try to make it convenient.

But yes, for the most part it's something that you need to take or apply for the most part every night.

>> Well, and if you're suffering I mean you don't mind doing it.

You know, it's almost like when you've got strep throat and you you know, at the beginning of the ten day, you know, antibiotic you get every dose in and that it's like toward the end when you start to feel better then you forget or you're not as concerned about it.

>> But if you're having the symptoms I would think, you know, people would would be on top of that.

Yeah, And that's why the patch and the oral produce the patch which is the estrogen and then the oral progesterone is the easiest for women because you just put the patch on like I said twice a week you change it and in the oral progesterone you take at night.

>> But yes, you do need to remember to take it at night so do you find that it tends to be genetic?

You know, because hopefully people are talking to their moms, aunts or grandmas to see maybe what their experiences were especially to prepare so do you find that is there any correlation with genetics like if your mom had a really difficult time transitioning for sure the age that your mom was menopausal typically is when you will go through menopause that for sure and yes I do see a correlation.

I wouldn't say it's every person but a good majority if they have a hard time through perimenopause and menopause then you can again very rarely do people breeze through menopause.

>> Well and I was going to say it was interesting we had three women come last fall that were, you know, gynecologic oncology .

I saw that.

Yeah.

And it was really interesting because one of them one of the doctors after the show said she had a patient come in who was eighty early eighties and she was asking her when did you start going through menopause?

>> She's like well I don't think I ever did because I'm still having cycles.

The cycles never stopped and she thought that was perfectly normal.

She you know because that had been she said well that's just how it is in my family but that's the doctor said no, no that's more so that's something again.

>> Yeah, she didn't even think twice about it.

>> Yeah that's that's another great point.

I'm sixty two so we not far behind you we talk a lot about it but nowadays hopefully moms are talking to their daughters about what's going on and giving them some ideas of hey this is when I stop my period this is what I went through and just help them with that.

And I don't know if they're educating them in school about some this as well.

>> I don't know.

I mean I have children in school and not that I know of .

I mean there's really it's really different.

You know, even when we were growing up I feel like it was kind of an abbreviated subject.

But now you know that I feel like my children you have the option to opt out of any type of reproductive that's at least you know, I don't know if that's statewide or just in our area but every year when I register my children it's like do you know will you give us permission to cover reproductive health or do you opt out of it because something I think some families still feel more comfortable but yeah, they don't cover things like they do.

I think they cover a lot of the things like you know, vaping and drinking and you know, substance abuse, things like that but not for women's health .

It's very it's pretty abbreviated, you know, for this has been our experience.

>> So with the if you do go the route of using hormones, is that something that you would expect having to change what you're taking as years go by and how do you like with your symptoms maybe you know, at some point would would maybe you're using a cream or the patch and then you feel like after a few years it's not giving you the relief that once did.

>> Is that is that what can happen?

It can happen usually not the case.

Usually the hot flashes, the night sweats, the vaginal dryness improve OK?

They don't totally go away but they definitely improve.

So we're constantly monitoring and constantly adjusting to help with the bones because that's what we can measure.

>> We we do a bone density.

You should have a bone density I should say every two to three years depending on your insurance.

So we're constantly adjusting and some women the patch can cause irritation or they don't want to put the cream on it's they forget they get into bed and they forget and they don't want to or they put it on during the day and they just got busy and they forgot.

So we're constantly changing new things are coming out so we're constantly trying new things to just to really make it so that it's convenient for you easy for you so lifestyle doesn't get in the way.

>> Sure.

Well they just showed me the car that we are five minutes out so that's still enough time to squeeze in questions.

So please don't hesitate only takes a second to I know all of you out there can text pretty fast.

I'm probably the slowest texter there is but if you want to quickly shoot us a text message or call us again, the phone number is at the bottom of your screen.

Please do so we just have a few minutes left but I'd love to hear from you.

So one thing I wanted to ask to just acknowledge I guess is I think a lot of women feel guilty because they have a lot on their plate and especially when you're talking about, you know, some some of these issues impacting women who are younger in their thirties.

They're probably having younger children at that point.

And I can tell you from being a mom of six it is overwhelming raising raising children today.

I can't even begin to tell you what our mornings are like.

I mean it's used to be I just took a bag and a pencil case, you know, my sack lunch and now it's do you have your electronics?

You you know is your phone turned off gave you a water bottle?

Do you have this?

It's it's overwhelming and they they're they're probably thinking, you know, I just don't have time for myself.

I just don't have you know and you you put up with a lot of discomfort you do which can make people miserable too.

>> Yes.

Yes again and again it's easier said than done but you shouldn't put up with it.

>> And again I just really want you all to know that it's it's not something it's common but it common doesn't mean that it's normal and that you should have to live with it.

>> Yeah.

So it's just like on the airplane when they say you know you put your mask on first before you help the person next to you and if you're no good what are you going to do for a person you care about next to you?

>> So yes.

Well Dr.

Helfgot, we did get a texta.

Thank you so much.

OK, so this caller is saying I am 70 years old and wanted to know if menopause can cause bladder discomfort.

Yes, yes.

Yeah, I guess I never thought about that.

>> Yes.

So for women as we did due to dryness due to dryness that's OK.

>> So yes, as we get older the becomes extremely dry and that can lead to more urinary tract infections, more vaginal infections, even if you're not sexually active and it can cause bladder discomfort and so we often will give estrogen cream for you for women to use over the urethra where the urine comes out and then inside the the opening of the and on the outside and that's a cream that we start off using several times a week and then we'll decrease to the the amount that's really good for you.

But yes, definitely that is something that can happen.

>> And again it can happen when you're fifty.

It can happen when you're sixty.

It can happen when you're eighty.

So there are definitely options.

That's something that you can talk to your family Doc about.

You don't necessarily depending on the family doc you don't necessarily have to see a specialist which would be a urologist or if you have a gynecologist that's somebody else you can talk to about that and they can prescribe the cream as well and UTIs are no you I didn't realize how serious those can be for an older person too.

>> Yeah.

I mean they can get into your blood.

>> Yes.

Yes, yeah.

That happened to my father in law and so you just have to think about your body differently when you're older.

>> I am learning that myself but you know me too.

Yeah.

>> So well we are only down to about thirty seconds so we're going to have to wrap up the show but such wonderful information I like Dr.

Helfgot has said, you know, don't be afraid to to look into the hormone therapy and don't try and navigate it yourself.

>> I would say no talk to him you know don't use chat.

>> Yeah that's you can learn about it.

There's definitely lots of articles out there that you can read.

Barbara Levy is a OBGYN physician who wrote an awesome summary in twenty twenty four if you just look up her name.

>> So great article for you to read.

In fact she talks about this bladder discomfort a lot so that's that's a great book.

Estrogen Matters is a great book.

There's lots out there so definitely look into it but then come prepared to talk to your guy on PCP.

>> All right.

Great advice.

Thank you.

Dr.

Michelle Helfgot comeback's we you come on.

I'm Jennifer Blomquist.

Take care everybody have a great night and we'll see you back here next week.

Bye bye.