And so what's the difference between, let's say, a menopause specialist or – a menopause doctor, and where does the doula fit in?

A doula is the support person that fills in the gaps from, oh, I feel like we need to take a step back.

So we know that medicine is not great at handling menopause.

We know that there is far more requirement, far more need for support and care.

The statistics are quite grim.

Only about 7% of internal medicine residents, OBGYN residents, family medicine residents feel like they have adequate information to treat a woman in menopause, 7%.

At the same time, we have a billion women somewhere in the menopause transition.

What kind of women are they? Are they just women going through menopause themselves, want just more information, or they actually have a practice and they're like, want to take their practice to the next level and know how to help these

I'd love for you to dig into those.

Yeah, you bet.

So you're right, you know, as chiropractors, and I think you and I talked about this previously, is we have the lens of holism right from day one.

Chiropractors are never taught to just look at one part of the body.

Yes, we're spinal experts, but the spine has connections to everything in the human experience.

And so we come at this, I mean, it just makes sense, right? Yeah.

Anyways, lots of times when I'm talking to women, I remind them that what they need to look at or we need to talk about is not adding more things, but deducing the things that aren't working so well.

And I'd love to give you the opportunity to talk a little bit about the menopause doula program, because I think this is a great time to share what you're doing and what you're launching right now.

All right.

So let's talk about the brain changes at menopause.

They're vast.

In fact, menopause itself, perimenopause itself, is an almost 20-year neuroendocrine transition.

What does that mean? It means it's not just about your ovaries.

It means it's not just about your period stopping.

It's not just about hot flashes.

Now,

Yeah

... w- [laughs] we can really start to have issues with this, and it becomes what happens when mom is, doesn't remember to pick up the groceries or pick up the kid from school or the dog grooming hasn't been booked or she's the one that's getting the insurance for our travels ahead, all of that, and all of a sudden she cannot handle it anymore.

And I find that that mental, that mind-based tipping point tends to happen around that, uh, mid to late peri.

We're not so much this with our estrogen anymore.

Now we're starting the slow or the decline, right? The estrogen cliff.

We've got no progesterone left.

Our testosterone is in the tank, too.

Right.

Yes.

That number is like one in three of us.

So when we look around, we are likely to be looking at several women that have had some kind of sexual trauma, and we're just really starting to understand how trauma lasts in the body and in the mind for a lifetime.

And I'm not sure even when you go about trying to process that trauma that you can actually completely eliminate it when it is such a big T trauma as Dr. Valerie Raine would call it.

But I suspect, and again, I have not watched the show, but I suspect that the freedom that watching two impassioned human beings having a romance- And a physical experience that we as middle-aged ladies, for most of us, we've been with our partners a long time.

And yes, I realize that Susan Bratton is still having great sex, and amazing for her, but a lot of us are having pretty average sex, if not at all.

And that's a common thing across women in menopause, uh, p- in perimenopause, late perimenopause, and early menopause.

Yep.

We're

good.

Iron sharpens iron.

No, and I'm not saying I agree with this, but I think the argument is when we're talking about prescribers and medical doctors that have not been given the education around HRT and they medicine, big pharma is decades behind, research decades behind on taking care of women.

So we're just now realistically starting to open the door in medicine to say, how do we get a prescriber that knows how to do contemporary menopause prescribing? So I think the counter argument a little bit here, I agree with you, by the way, guys, I absolutely, you need to test, you need to know.

And Karen is, oh my God, so right.

Thyroid can overlie so many things.

No idea, but at least it's accessible so that if somebody can't afford or can't have access to a good practitioner, they can still get the help.

Okay, I'm going to have a tongue twister.

It is, but what I found really interesting is it actually has a fragility score that, quote, assesses bone quality beyond quantitative bone mineral density with emerging evidence supporting a five-year fracture prediction.

So again, you know what, so often I see this with, in clinic I have these thoughts of very frequently about how antiquated the screening and testing is for women's health issues beyond obstetrics.

And this is just another indicator of it.

I mean, the DEXA scan might actually, it's still the gold standard, but is it something whose time is up and we need to evolve into the next level of Actually, I love what you said, Zora, about it's not just the trabecular bone.

You want to look at the whole thing.

Bone needs to not just be strong.

And the game is just to build fast, build more than we break down.