Not Feeling Like Yourself Is Enough: Dr. Kamilia Smith on Perimenopause and Comprehensive Women’s Healthcare

So if we talk about just like how this is trending in general, why we're here, why we're talking about this, I think.

So perimenopause in general is our most popular topic because the women that listen.

Why do you think it's so

popular

right now? What do you think was the big takeoff? I know you've been a part of so many like media and TV production opportunities around it.

Do you feel like there was something in your expertise that you're like, wow, I feel like that year or that thing like really set it off?

It feels like it's all of a sudden to you guys, but the momentum, I mean, we've been trying for years.

And that's why I asked, because I know it looks different from a different light.

And I honestly don't know that it's perimenopause.

I don't know that we have a name for it.

I don't know what it is because they're not all perimenopause walking through the door, but they're still having these subset of symptoms.

And I always tell my patients, when I figure out the name, I'm going to let you know.

And so I don't know what that is, this constellation of symptoms that are occurring even before menstrual dysregulation.

you know if you look at the textbook definition of none of us are a textbook but if you look at the textbook definition of perimenopause it's the four years leading up and if menopause is a diagnosis in hindsight i look behind me and i go oh i just went a year without a period and perimenopause is the four years leading up to it one of those years is perimenopause right well nobody's following that and now you've got women that are 38 or 9 going hey i'm in perimenopause well the textbook definition doesn't really support that so if you look at the straw staging have you guys ever heard of the straw i'm not okay well Look it up, it'll make your eyes like cross looking at it.

So look at the straw staging and we've even edified that, but it shows you this stage because there's premenopause, right? There's menopause and then there's postmenopause and they can be divided into early and late and there's just straw staging.

And before that now, we've even backed it up before the perimenopause and we see that circadian rhythm disruption.

And I told you that last fall, the menopause society meeting was all about peri because we're like, well, if we've missed the boat with women on menopause, we surely are not going to do that and miss it with perimenopause.

And so you'll see that circadian rhythm disruption precedes any of these perimenopausal, even the textbook definition of perimenopause disruption.

So

circadian disruption occurs well before.

So like in your late 30s, early 40s, you're waking up at 4 a.m. like, what's going on? Why am I awake? Why am I online shopping all of a sudden at 3.50? I don't even need to turn and look and see what time it is.

My body is going to tell me to wake up at 3.45. 3.50 a.m. And so that is all happening.

And there's some really cool things in the brain called candy neurons, which you're going to hear more and more about.

I'd love to come back and talk about candy neurons in the brain.

And so we've got drugs targeted towards these candy neurons now.