Ep 42 | Amanda Thebe: How to Thrive During Menopause

Kim Strobel 00:14 

Hello, everyone, and welcome back to the she finds joy podcast. I want to thank you for pushing play today. And before we get started, I just want to remind you I know you heard the little intro commercial. But I want to remind you that one of the things that's really, really helpful to me is if you can go in to your podcast app, and leave us a review that just kind of helps us circulate and get the word out and help others find us. So thanks for being here with us today. I am really excited to introduce you to our guest today. Her name is Amanda phebe. And she is a force of nature. For women who are experiencing menopause hell, and want to start feeling healthy and fit in their 40s and beyond. With over 20 years of experience in the fitness industry. Amanda is a highly regarded expert on women's fitness and health, a popular guest on podcast and online summits. She brings a refreshing humor and no nonsense approach. Y'all know, I love that. Two sub subjects usually shrouded in shame. I am so excited to have her on today's podcast. And first and foremost, I know she hears this a million times, but like you're just gonna love listening to her voice because she's from England. Welcome, Amanda. 

Amanda 01:39 

A 

I can literally say anything and people buy it, you know, it's like, it gives me like an extra step up the ladder. And it never worked in the UK, especially because I'm from the north of 

England. And I think that, you know, there was always the perception that the Northerners were more common. And I remember my dad said to me when I was young, you can have to like refine your accent a little bit because he was from the south. And I was like, well, screw you. I'm never gonna refine my accent now. And then coming over here. Like every time I speak, people go, Oh, I would say that again. 

02:11 

Yes, it's 

Kim Strobel 02:12 

awful. It's just so soothing. I have a couple of friends from England, one of which who lived in the Midwest for about 10 years. And so you're just kind of making me a little nostalgic, just hearing your voice. So the way that I found you, Amanda is actually through my good friend Alex Ellis's body nerd show. And I was listening to Alex's episodes, and you were talking about this idea of thriving during menopause. And you are giving like the best tips for strength training, and you were talking about hormones. And so I was like, I really just loved your wrongness and your realness. And so then I jumped over to your podcast, and was listening to different episodes up. I especially like the one with Courtney Townley, because she was talking about grit and grace. And you know, how we can show compassion to ourselves and kindness, but also, you know, show up and kind of do the work that we need to do. So that's for all our audience members. That's how I found you. But I want you to kind of just do your own little intro and tell us who you are and what you do. 

Amanda 03:25 

A 

That's great. Yeah, I didn't realize that because I didn't record my podcast now for 18 months, two years, but it still gets a valuable number of hits, because the content is evergreen. And it's actually why I keep it up there. Because I've had some people that know a lot more about stuff than I do. And you know, we have to be continually learning. I mean, it's part of the showing up thing that you've just said, right? You can't show up unless you're willing to evolve. That's how I feel about about everything. And so, I've been a fitness trainer since my early 20s. So it's decades now, like I just turned 50 this year, so like nearly 30 years. Yeah, I know. I'm going for colonoscopy on Friday, so yay, for being 50 

04:09 

Yes, my 

Amanda 04:10 

A 

God. And so um, so I've been in the fitness industry, and is one of those worlds where sometimes I feel a little bit jaded being in it, because there's lots of gimmicks and lots of false information out there in the wellness industry in general. But I've sort of always forge my own path and followed people that I really respect in the industry. And then I've done certifications from organizations that I feel a true to the science and to you know, what we know to work. And so I feel that when people follow me, they follow me because I come from a real genuine place. I'm not afraid to say that things have gone wrong for me. I'm not afraid to say I've made mistakes, but I always say you know what I believe to be true right now. And so, when I came into my 40s I think around about 42. I was like we were talking just prior to the show. You were saying, you know, you run 30 miles a week and you feel amazing, you feel youthful? Well, that was me going in my 40s. I was like, poster girl for the 40 year old, you know, I feel good and healthy and strong. And, and I actually just was completely content, you know that why wouldn't change much in my life I was so content. And then by the time I came to 42, I started to feel unwell. And then for two years, I struggled with vertigo, nausea. And, and it turned out that that was from migraines. And then I also had depression. And these are things I'd never experienced before. And I spent those two years having multiple numbers of tests, seeing specialist doctors who genuinely wanted to help me, but never got to the root cause of what was going on. And I literally thought I was losing my mind. In those two years, I was like, I don't feel well, I can barely function, my quality of life is disappeared. My relationship with my husband and my children, my friends is all been impacted and wasn't showing up. Because I couldn't like I was in this really low place in my life. And it was scary, frustrating, isolating. And the reason it was that bad was because not just from the symptomatic side and even just the mental health aspect. I wasn't getting any answers. I wasn't actually being informed by any of my medical team of which there was, I think, six specialists What the hell was going on? But they just kept saying we can see or not well, but we don't know why. And then I went to my annual gynecology, you know, annual checkup, and he straightaway said, You don't look okay. You okay? Bring on the waterworks, because of course, I started crying because somebody actually cared and wanted to listen and cut a long story short, he basically said, these are symptoms of perimenopause, that valid, these are not I see these every day in my workplace, and you're not alone. I can help you. And the first thing I said was, well, what's perimenopause? Like I've never heard of this before, like, and going back eight years. I hadn't heard the word before. And so that took me down this perimenopause, rabbit hole, menopause rabbit hole. And I started talking about it from a fitness and wellness perspective, not from like a clinical medical side. But from, you know, this is me, and equals one I'm doing this experiment. Like is anybody else feel the same way? And I just got flooded with women saying, I feel the same way. And I need help and what can I do? And so I created a community on Facebook and a podcast, I've just released my book in October. So I have all of these, like, different resources now. And 

the pure purpose of doing all of this was to create a community space to help women feel validated and less isolated. And then to give them the education to be able to make choice because in those two years, if I had had the information, I don't think I would have felt quite as desperate. If I could have said, this is perimenopause. And there are active things you can do to feel better, I would have done them, right. Like most of 

Kim Strobel 08:10 

us would, yes, you know, that's, it's, it's the unknown, right? It's when like, our brain can't logically attach any kind of reason to why we're experiencing these symptoms. You know, I am somebody who has suffered throughout my life from panic disorder. And I said, like, the thing that's scary about panic attacks, is that, you know, it's not as if a car It has almost ran me over or someone has a knife to my throat, it's that I have those feelings. And then I'm just sitting in my home, or I'm walking through the grocery store. And so since my brain can't attach a logical reason to it, then I start to become desperate and think I'm crazy. And so it sounds like you, you just could not attach all of these feelings and symptoms to anything other than I must be losing my mind. 

Amanda 09:07 

A 

Well, I mean, in the fitness world, especially. It's, it's never spoken about ever. In fact, the opposite. It's, you hear these older men who seem to run the fitness world saying women women just need as they get older, just to keep doing the same thing. There's no difference, no physiological differences. And I'm like, screw you. They completely is and you're missing a big part of the puzzle. So um, yeah, I mean, the fact that we have to actively dig, dig, dig to find any basic information. That's not one from the pseudoscience world because the alternative health world have run with this and they're given information to them. And that's really just not valid. It's confusing. And it leaves women going, Well, what am I supposed to do? How can I balance my hormones? Well, listen, when you just need to know what's happened and you need to find a medical specialist you need to have a good grasp of what is happening and these years leading through parents menopause to post menopause. So that you can actually make choices that are relevant and, you know, active for you instead of like having to dig, dig, dig deep all the time. And then, you know, a lot of women like you who had predicted would predispose to like panic attacks, anxiety and depression, find that those symptoms just increase in perimenopause. And I've only had two anxiety attacks and literally thought I was dying. Luckily, my oldest son who is actually on the autism spectrum, who is really high functioning, like hyper intelligent, has been in therapy for years. And he saw it and recognized it and sat me down and was made me do deep belly breaths and try to you know, he, he knows cognitive behavioral therapy. So like, it sort of made me realize that, you know, maybe I can't control the panic attacks, if it's because my estrogen and progesterone are falling, maybe that's something I actually can't control. But what I can control is the outcome of where this anxiety or panic attacks. Take me. 

Kim Strobel 11:00 

Yes, yes, exactly. So I want you to take us back to the two periods, two years of a period where you were experiencing all of these symptoms, and I want you to get really specific with my audience, like, you know, I know you talked a little bit about depression, and you just couldn't hardly function. But give me examples. What, what did a typical day look and feel like to you back then? 

Amanda 11:26 

A 

Yeah, it was awful. And, you know, so prior to me feeling unwell, I just started my fitness business, right. I know, I've done it for decades. But I got to the point in time where, you know, mums at the school, were like, Sam, please train me, please start a class but and I 

had like, 70 clients By this time, so I'd only been going a year with my bit and chips business. And it was like minded women were coming to me. And so I would get up in the morning and have a few early morning clients before the children but I'd go to people's houses for personal training, then I would have to back to back group small group training classes. And then afterwards, we were very sociable, we'd go for coffee in the place within this beautiful old building with a coffee shop. So we'd spent like an hour and a half talking afterwards. And then I do afternoon clients pick the kids up from school make dinner, you know, I had one of those, like, typical work lives where I worked for myself, and I juggle lots of balls in the air. And I had a husband, I have a husband nations that haven't got rid of him. Yeah, you still have him. You haven't gotten rid of these downstairs? Yeah, I have a husband who is an executive in a bank. And he works really long hours. And so I just can't expect him to be as hands on as it as he would like to be. You know, so the dinner was down to making me and with me and my young children, like I would stop working just to you know, spend a couple of hours with them, and then work again on an evening, right, and articles and, you know, planning programs for my clients. And so I the good, I could say I was content, I was happy. And then I went, I actually remember the day it happened. I went to a boxing class because I used to do martial arts as a kid, I was a black belt in karate, and I just like hitting things. It just makes me feel good. So I went to this boxing class and it was brilliant. And I went home and I was like, 

gosh, I just don't feel right. I don't feel well. So I thought I wonder if I picked up a bug. I wonder if I just push too hard. You know, there's times when you push too hard, and you just feel a bit like exhausted because he can't work out why. So I went to bed that night when I woke up ready to get the kids in school, the room was spinning. And I tried to get out of bed and I fell over and I kept falling over. So and and then I got a wave of nausea. So I crawled on my hands and knees to the bathroom, puke my guts up. And then I and then over the next couple of days, I started losing feeling in my face feeling down one side of my body. And I literally could barely function. Someone had to pick the kids up from school, I cancelled my clients. And I was just like, What the hell's going on? Maybe it's a virus, maybe it's just done too much. I've got a virus or something and, and it eventually cleared up but then it happened again. And then again and again. And it just wouldn't stop. And it was one of those things that had no, I am really good at logging and I record everything right. So I thought I'm gonna write this down just to see if there's a pattern. There was no pattern. I couldn't even say like, Oh, this is happening like three times a month. It was just happening randomly. And I remember flying to New York to do a certification for this ultimate sandbag. It's one ama master trainer for them. And it was a two day course. And it was super intense. And I met a friend there who are still really good friends with. She's reading the book. And she said, I remember when you came to this course and you said you felt sick and you kept running to the toilet to throw up and you were falling over and they were doing fitness tests and this thing and it was just miserable. I was on the verge of tears the whole time. And then the depression that came about and I didn't actually know I was depressed and I think when you've never been depressed and it happens you You don't know. You might with that, like, 

Kim Strobel 15:02 

talk a little bit about that. So so because I think that that might be true like that, that women don't realize they're depressed. Why do you think that is? Or what what does that look like? or What are the symptoms you think to be on the lookout for? 

Amanda 15:19 

A 

It's really hard. And it's even really hard. Now, if I get those slumps. Yeah, and so so like, so we all get blue, right? And we can get depressed. It's a feeling right. But depression isn't just a feeling. And I think that that was the difference, right? It wasn't just like that I didn't feel fine, or I didn't feel happy. I had no energy. I had like a chronic fatigue that I couldn't lift. I could I wanted to sleep all the time, I lost my appetite, I lost loads of weight. I couldn't connect on a on a social level I couldn't have I actually avoided going even to like the local book club. If it was two doors down from my house and neighborhood book club, I would make excuses because I couldn't bear the idea of like one somebody me send somebody something in their book club, and then nobody listening. And then feeling rejected. Because that was something I'd started to feel as well. I had no self esteem. I felt a thought that when I was saying things that it didn't matter anymore. There was lots of things connected. It wasn't just that I felt blue, I just felt as though a whole part of me had been removed. And then I was now stuck in this personality that I didn't recognize. And I didn't think I was ever going to move out. And I thought, yes, it feels 

Kim Strobel 16:35 

it feels hopeless, doesn't it? Like I've always said, I don't think that I've ever like suffered from depression I have had, I've suffered from situational depression as a result of like my panic attacks. But you know, I was going for my gynecology appointment this last month. And I pulled up to the hospital. And I actually had remembered that I think it was like five years before that I was working as a curriculum director, because I am a former school teacher. So I was working as a curriculum director. And I had this fantastic job and everything was fine at home, like there was, there was nothing going on really big in my life. And I started having, like, I don't even know how to explain it other than, like, I just wanted to be home, I didn't want to be anywhere else. I just wanted to be home. So like when the work would be over. And then Friday night would come. I was like, Oh, it's finally the weekend, I can just be home. But then on Saturday morning, I would wake up and I would start feeling anxious about having to go back to work on Monday morning, and I would get in my car and I would drive to work on Monday morning. And I just I couldn't explain it like I, I just I cried. And I didn't know why I was crying. I didn't know why I didn't want to go to work. I didn't know why I just wanted to stay home. And I remembered when I was at my gynecology appointment a couple weeks ago. I drove by the backside of it. And I remember pulling my car in there like five years ago and just sitting there and thinking like, I don't feel right. I don't know what's wrong with me. I'm I don't know, am I mentally unstable? Like what is wrong with me because I can't again, attach anything to how I'm feeling. I just don't want to go to work every day, I want to stay home. And I thought my God, I sat in that car and just tried to talk myself into not going in those doors and being like, I don't know what's wrong with me. And you know, I'm just giving this As another example, because you're talking about how your depression kind of manifested. And when I look back now, I think like, That must have been some type of depression. I don't know exactly what was going on. But we know that this comes in many forms. But I also at the time was like so scared to even call it depression because like, that's taboo. I don't want to think that I'm someone who suffers from depression or has ever suffered in that something. You know, it's like we have these things, like you said, it's like, it's like this inner feeling of unworthiness, if we're selling that, 

Amanda 19:14 

A 

yeah. And you know, exactly the same feelings I got when the gynecologist said to me, you know, you clearly have depression, and I can help you with this as well as your symptoms. I went to meet my husband afterwards for lunch. And he said, Is everything okay? And I went, apparently I'm in perimenopause. And that's why I've got depression and migrants and my migrants will with aura, like, vestibular that's why I had all of these other sensations, and no headache. Anyway, and oh, my God, thank God, I thought we were gonna leave me and I went while I was actually but I wasn't but like I actually was nearly at that point. And I think that, you know, I didn't know what was going on. How on earth could he know what was going on? How on earth could my children know what was going on? And so what we know about perimenopause is that depression and Anxiety is some of the top symptoms that happen a and so the mental health aspect of payment cause is not discussed enough. And normally women will go to the doctors and ask for help and be given antidepressants because the doctors want to treat the symptom and not the root cause, right, where the root cause is the declining hormones. And that's the route that the doctor should take. And that's not happening. And that's another another story. But, you know, I had this conversation with my oldest boy who I just mentioned earlier, who suffers from anxiety, which he manages, but has had depression in episodes as well. And he said to me, You know, I think it's really important from him from an autism spectrum disorder standpoint, that we remove the stigma around mental health, because and this is at the time when I told him, I had the patient, there's a 14 year old kid at the time. And he went, you know, and the reason is, is because he said, it's like, it's like an invisible disability. And he says, and nobody can see it. And he said, if you had your leg chopped off, and you were walking down the street with a limb, people would sympathize, or empathize with you, because they see that you literally had to, you needed a coach, right? But you don't see it with a mental health aspect. And so when I decided I was going to talk about perimenopause, that was the reason I was really open about my mental health struggles, because I thought, I can't be ashamed of this if I have a child who has it too. And I'm embarrassed that I might need antidepressants. I'm embarrassed to talk about it. So. And I do believe that even though we have made a lot of progress in removing the stigma, there's are still a lot of herbalists comments, comments out there, you know, that are harmful and hurtful. And, but we have to just it's another thing we have to keep chipping away at the conversation. 

Kim Strobel 21:48 

Yeah, you know, I and I think you're right, I think that we talk about it a whole lot more. But I still think that, and maybe this is generations of cellular makeup that have pulled us from one, you know, one generation to another, but it's like, we can talk about it. But we don't want to own it, that it's happened to us, or, like we still have shame around saying like, my life is just feels really shitty right now. And it just sucks. And I don't know what's wrong. And I don't have any answers. Like, we're still so afraid, I think to acknowledge that or to present that side of ourselves to others, and we keep it hidden. And then when we hide stuff, that's when shame comes into it all. And so I love that you know that it's an invisible disability. And it is a disability because no one can see it. But I want to know, I want you to explain Perry minimum menopause because one of the things that is a little shocking to me, and I think it's just again, a lack of knowledge, which is why I was so excited to talk to you. Is this started for you at age 42 

Amanda 22:59 

A 

as well, yeah. So it's really strange, because, obviously, going into perimenopause, I had the misconception because I didn't know what it was obviously when the doctor said perimenopause night. Yeah. Yeah, we 

Kim Strobel 23:12 

don't know what that is. Amanda, tell us what that is. 

Amanda 23:14 

A 

And so I assumed, like many that, you know, you go through menopause, like you go through other things in your life, and you may have hot flashes and your period stuff. That's what I thought would happen. And part of me was I actually can't wait for that I'm not I'm not having any more kids. I'm sick of having a period. I can cope with being hot now and again, but it's far from that. In fact, that's such a simplified version of it. It's almost an insult to like, think that way. And so perimenopause, we know can start in your late 30s. And actually, if I go back to the when I had my last child, I was 38. And I never felt good after that. As far as my menstrual cycle was concerned. I never had like any PMS or anything like that before and then I'd start getting really exhausted. And then I'd have really bad histamine problems. That's another issue with perimenopause. So from 

Kim Strobel 24:07 

left to mean, like allergy and yeah, and congestion and all of that, okay, 

Amanda 24:11 

A so with lots of women start getting histamine issues, and it can be awful. I mean, allergies are awful, but I would get them if I like touched a Christmas tree, I'd get like a rash run in my face, and my skin would break out in these itchy rashes. And, anyway, so perimenopause, we know goes from it can start in the late 30s. And it can last on average eight to 10 years. So some women go on for longer than that I was about eight years for mine. And it's when progesterone and estrogen estrogen start to decline. And estrogen doesn't decline in a linear fashion. It's sort of all over the place. I whack whack a mole crazy. And so that's why the symptoms come and go and fluctuate and feel bad sometimes, and not so bad Other times, because there's no rhyme or reason to how you're going to gonna react and then Some women still have periods. Some women stop their periods. Are they becoming irregular like this? There's no one size fits all the perimenopause. And women usually find that perimenopause is the worst part for them. It's the most symptomatic. estrogen receptors are all over the body. They're in our joints. They're in our gut, they're caught they cross our blood brain barrier, they protect our heart so that amongst other things, and so women might start getting heart palpitations, join a gut issues, and they get brain fog. think they're having, like an episode of Alzheimer's and Yes, yeah, and and and then there's all of these mental health issues that come with them. And they're, they're a direct consequence of falling hormones. And so what happens is a woman will go through these things and maybe have like one symptom like for me, it was the like, it was vertigo and nausea. And so I got sent to an ear, nose, throat doctor and a neurologist. I didn't get a central gynecologist now and the one of the reasons is his primary caregivers and GPS, as we call them, do not get any medical training at all. in medical school, it doesn't exist. Now gynecologist, ob gyn who go through their training have to actually select to do menopause management training. And only 20% of those students do that. So even if you get a referral to a gynecologist, they might have never done any menopause training. And I've spoken to some of these doctors and they'll say yeah, all of the focus is on pregnancy and puberty, pregnancy and postpartum. It's not that we don't learn about menopause. And it's a real disservice to women that this huge, there's a huge gaping gap in the 

Kim Strobel 26:47 

mash up like required, I think 

Amanda 26:50 

A 

it's Yeah, it's 51% of the population are women. 80% of those will struggle with menopause symptom. And then after this, right, so then we go through perimenopause, we reach menopause, which is 12 months without a menstrual cycle, okay, you can, you can no longer reproduce, and you're menopausal. It's almost like a dead stamp. Right? I know only you never know when it basically haven't had a period. And then for anything from that time forward, you're considered to be postmenopausal menopausal, right. So you're menopausal until the day you die. It's not something that goes away. So you're in a state that's menopausal. And so your body now is without estrogen or a very low threshold, I should say, and very low thresholds of progesterone. And what we know is that these are protect especially the estrogen is a protective hormone, told you it's around the heart and the joints and the bonds. Now, what we know is that women struggle with osteoporosis wanting to women will break a bone that are postmenopausal. And that's a direct consequence of lack of estrogen. cardiovascular disease is our biggest killer, that estrogen protects the cardiovascular system. We know that Alzheimer's is a bigger problem for postmenopausal women than it is for men. And so all of these things become the diseases that killers have, usually because where we're lacking in these hormones, and so it's super important that women know that so that they can do proactive things to help their health as they're older. You know, let's, 

28:23 

let's talk about that. 

28:24 

Well, first of all, I 

Kim Strobel 28:25 

want to I know to our audience who who's who are listening to this, I think one of the most helpful things you've said is if you think you are experiencing this and you're struggling and you're not able to get any answers, see if you're gonna like the gynecologist has that training and if not, perhaps find one that does is that a good recommendation? So it's 

Amanda 28:49 

A 

um, yes, definitely. And if your audiences mainly in North America, and they're not there is a North American menopause society. And if you go to menopause.org, there is a something you can select. They're called Pathfinders specialist, I find a provider they put them in your zip code and they list all of the gynecologist and doctors that have done them and oppose training. And hopefully you'll have like someone who can help you. And then there were a couple of like telemedicine organizations out there now one which I love is called generif, which is GNNEV generif.com. Okay, you pay a fee. I don't know if it's like something like $35 for a video conference with a menopause specialist who can issue a prescription that is that you can then usually claim via your insurance. 

Kim Strobel 29:39 

You know, I'll drop those in the show notes for you all who are listening. Okay, so that's that's one of the things that they can do. But let's talk because I'm sure everybody's listening to like, okay, we need to know what the hell we can do to help ourselves. So like, what can I like, do you promote that you think getting on hormones is the answer like what what are the answers here? 

Amanda 30:00 

A 

Okay, I mean, it's a big question with lots of answers. It is a no. So I'll try and be succinct. And I'm not very good at that, because I'm a bit of a talker. But the first thing is, is if you don't feel like yourself and you're within the age range, you can probably assume that you're perimenopausal. And, and from a medical perspective, if you're over 40, and you're starting to have symptoms that you don't recognize as part of your regular life, and and a menopause specialist looks new, they can do bloodwork that can sort of give them an idea, because 40s softer tends to be on the younger side. But if you're over 45, and you go to a menopause specialist with your symptoms, they don't even need to do any bloodwork, they can diagnose you based on symptoms. And because there's an assumption that you are. Now as far as treatment options are concerned, it really is down to you choice and what's available. Now I in the book, I have a whole section that's like, well, 

Kim Strobel 31:00 

let's tell them the name of the book right now, because oh, drop that too. But 

Amanda 31:04 

A 

video, it's men Apocalypse, man. Yeah, it's like the apocalypse. And then Apocalypse, how I learned to thrive through menopause and how you can too. And so for me, the number one thing you need to do is become educated because you cannot go to a doctor's appointment without knowing what the hell is going on, because they're likely not going to know what the hell is going on. And so if you feel as though your quality of life is impacted by the sentence that you're struggling with, than the first line treatment that doctors should offer you is hormone therapy. And hormone therapy is micro doses of estrogen. And if you still have your uterus, you need to have progesterone to protect your uterus. It's if you're somebody who's ever used birth control pill, it's like 10 hundred times less than that, like it's a super small dose. And what it can do for women is it can sort of level that hormonal playing field. And I would literally avoid anyone that says it can balance your hormones, because from an endocrinology point standpoint, and I've interviewed many experts, that's not possible. The idea that you can balance hormones, which literally fluctuate every second is a misdemeanor. But what it can do is we know estrogen is going to fall, we in a fluctuating manner, we know SM progesterone is going to fall in a more linear fashion. By supplementing your body with these hormones, it can just calm shit down, right, and it can make women feel almost human again, and be able to do the things that they can control, which is you know, looking at their nutrition and their exercise and stress management and all the things that we have a little bit more of a handle on. And so the what is this a cream though? Is 

Kim Strobel 32:45 

this like a cream that you put on Amanda? 

Amanda 32:48 

A 

So hormone therapy can come in lots of different applications. So remember, I'm not a doctor, right? But this chapter in my book was written with a Harvard educated menopause specialist. Right. So it isn't just my word, this is what the current medical standard is what you need to know, there are actually no prescription guidelines in the USA at all. And they probably never will be. But hormone therapy, estrogen can come in a transdermal fashion. And which means it can be applied through the skin. And that comes in gels, creams and patches. And progesterone needs to be taken orally in order for the uterus to create a line and that protects it against any sort of like uterine cancer, it can also be inserted by gently right. So you can also take oral estrogens, they're not. They're sort of maybe considered to be the older forms of HRT, but they're still valid, and they still work. And it really just depends on a lot of the times in the US what the insurance will cover you for right. Now. One of the things I like to talk about though, is regulated versus unregulated hormones. So if you're on a, I find this such a complicated topic in the US because of the way that medical system is and the fact that people don't have insurance and they're on Medicare. And so it's really important to know that there's lots of options out there. But if you're a woman who wants to have hormone therapy, the FDA has approved about 30 different types of hormone therapy that's covered by our insurance mostly, I mean, it depends on the nuances within your program. But like for example, the one I'm on cost me $6 a month, you it's not an expensive product, right and I have a patch that I put on and I take an oral progesterone pill and you may need to fiddle about with different ones with your doctor until you find something that works for you. And chances are if you have perimenopause for eight to 10 years, your dosage dosages are going to change as your symptoms change. Right. So I think you have to be flexible going into this. Now what happened is that there are lots of private clinics out there that offer unregulated products and the market them as being like bioidentical or natural, and that that's the ones that women should take. So I'll just want to sort of like break that down a little bit. So bioidentical is a marketing term, that literally means that hormones mimic the ones that are within the same as your body. And so the they usually mixed up in a compounding pharmacy. So they take regulated drugs, they separate them and mix them with sawdust or whatever, and then give you like this supposedly personalized hormone product. Now there's a couple of problems, there's First of all, the minute that you take a regulated hormone that's FDA approved, and then change the variables, it's no longer covered new for its safety and its efficacy. And you want to be taken drugs that we know are safe, right. The second thing is, is these are never covered by the insurance, and they'll usually cost women hundreds among hundreds, hundreds. And the bio identical hormones that are offered by these compounding pharmacies and private clinics are derived from yams. Okay, so these and so what happens is they go through a process in a lab, where they extract something from the arm and they break it down through a chemical process, and it mimics the estrogen in your body. The FDA regulated bioidentical hormones are exactly the same thing. They're exactly the same. So why, and this is why I get really mad about it. Because if I think that somebody is paying $500 harmons that you can get for $6 that are regulated for efficacy and safety and gone through all the testing, and even have a blackbox warning for you. And you need to take those are not the ones that. 

Kim Strobel 36:44 

So are you saying because because I don't know hardly anything about this? Are you saying that all bio identical hormones? Are all of those made in private compounding pharmacies? And you're? No, 

Amanda 36:57 

A 

so that's not what I'm saying at all. What I'm saying is bioidentical is a marketing term. Okay, a marketing term. That means that the hormones almost identical to the body and narrow, they're derived from yams. And so it's been marketed in the way that it's natural. But what I'm saying to you is, you don't need to go to a private clinic to get the unregulated version of those, you can get the exact same thing regulated from a medical professional and covered on your insurance. So I'm just trying to say, I see don't have 

Okay, hundreds of dollars when you don't, yes, 

Kim Strobel 37:32 

I do they call like the the hormones you get from your doctor, they do they call those bio identical 

Amanda 37:39 

A 

Ooh. And so I think just as a it's a, it's a super complicated field, and it's like a navigation minefield. So over here, they do call them bio identical, but they call them regulated by okay 

Kim Strobel 37:50 

by, okay, so we want you, the audience members to make sure you're getting the regulated hormones that have been approved by the FDA. And so be very cautious when 

Amanda 38:02 

A 

you go down that and I'll tell you one of the reasons why is because sometimes these compounding pharmacies will issue a progesterone and a cream version to go with estrogen that they and it's all in one package. And and what they're finding is that the progesterone that's applied transdermally through the skin is not enough to protect the woman's uterus from uterine cancer. And so there's, there's been some higher risks of cancer using those and in addition to that, women are offered pellets, hormone pellets that get injected into your book for three months. And they're they're also opposing to be a high risk of cancer risk, because the dosages are so high. And so if you're not, if you don't believe me, I'll get you're offended by anything. I'm saying, one, I've done my research. I know what's out there to go to some of the FDA sites go to the menopause society website and actually read what they've got to say about them, they sit there standing out against it, because there's a safety issue around there. And why would you put yourself in a race? 

Kim Strobel 39:00 

Yeah, and you have an entire chapter in your book that explains all of this. Is that right? Yes, I do. Yeah, that that's really helpful too. Because I think a lot of people who are listening are probably this is new information for them and so they may have a lot of questions. I love that you're calling that out because these are just things that we do not know and marketers they do they they send us down kind of this trajectory that we completely kind of buy into sometimes 

Amanda 39:30 

A 

and stuff you didn't you didn't ask about like I was really an answer. We got sidetracked you did ask about like other things. So I just go like through it. So we also know that like antidepressants are usually over prescribed for menopause. But in some cases, hormone 

therapy might not be applicable, but not every woman. Not every woman can take it and not every woman likes it. I like the way it feels. And there are other pharmaceutical options that have off label benefits that anti seizure and antidepressants. That off level benefits help with some of the symptoms. And, and there are also some alternative therapies out there like ashwagandha and shandra, and black Koolhaas. And these are all like herbal alternatives. The problem is, is that they're not highly tested. And so they might work for you they might work, they might not work at all. And they're not rigorously, rigorously tested. And so right now, there isn't a real great alternative out there. Some women might try these herbal options and feel a little bit of benefit. I mean, it's a little bit like that's an again, another unregulated business, the supplement business well, and then, so what So basically, so we have the symptoms, and we have the medical options that are available, but then you're sort of still left with a whole lot of things that you can sort of tangibly do yourself. And so there might be times where, like me, we sat on the sofa for four hours a day, and you don't do anything. And that's fine. But there's going to be moments of glimmers of light moments where you can sort of take action, that are going to sort of like proactively bulletproof you for hedging and for postmenopause. Right. And that's sort of what I did in the book, I talked about the, you know, what's happening, and we this is what we know, and, and then I then I tell people in the second part of the book, some strategies that they can do to sort of take hold and do things, do things that are just going to make them feel better improve their mental health, their physical health, without confusion, right, because there's a lot of confusion out there about what you should do. 

Kim Strobel 41:35 

And you give nutrition options, and as well as exercise options, is that right? 

Amanda 41:41 

A 

I broke it down into four parts, I have a what tip and how to eat and what to eat is one of the chapters I had. And so I talked about, like what the body needs to, to function and 

how to nourish the body and how to recognize body and signals and cues so that you don't overeat. And, and you recognize what real hunger is, try to move away from the late diet culture type message that's out there. Because we know that eating disorders peak in menopause, again, like they do in teenage girls is definitely a hormone relation. In the exercise, the second chapter is about exercise. And I talked about the benefits of daily movement, not just like strength working out, but like getting outside and walk in mental health and get you know, your physical health markers. And then I have a 12 week strength training program in that because aging and menopause need us to do strength training, we can talk about that if you want later. And then the third part is stress management and sleep. And we already talked about our mental health struggles, but estrogen is intrinsically connected with other hormones in the body. And two of those that insulin and cortisol. And so when a lot of women really struggle to get down from that late high cortisol level and feel stressed all the time and don't have coping mechanism mechanisms and, and it also impacts their sleep. And so they might be doing everything else, right. But if they're not sleeping, and they're highly stressed all the time, they're never going to feel great. They're never going to be able to get their weight management, like under control and, and just like actually feel like energized. Right? Yeah. And then the last chapter is how to think and I call it shift happens. And I wanted to, like really find, I thought it was good. I thought I saw this on a roadside poster when I was driving in the car once and I'm like, I'm gonna use that because it made me laugh. But I worked for the psychologist on this one. And it literally is trying to change the narrative about aging, how we age, what it means to us, and why women put themselves on the back shelf all the time when it comes to like the workplace, the family, society. And so I'd like to change that stalling to Oh, 

Kim Strobel 43:50 

I love that I have a quote that I use all the time. That's like you're, it's you're not selfish for putting yourself first, like you're not. So I love that you're addressing that piece too for women 

Amanda 44:00 

A 

self preservation, and I think that it's not something that's woowoo. Like when I used to hear self care all the time, I'd like throw up a little bit in my mouth and go, Oh, God, I hate that term. But I think if like if we consider it as something that's essential, and not something that's frivolous, or like luxurious, or taking somewhere, 

Kim Strobel 44:20 

yeah, you know, I'm one of my friends calls itself loyalty. 

Amanda 44:26 

A 

Yeah, that's a great way of putting it. I like that. Yeah, but think the message for me through menopause is it's hard, right? But we will and we can do hard things and there is a sort of light at the end of the tunnel. You know, things start to come down and late menopause, post menopause. And it's an opportunity if you start making these small changes that by the time you come to the stage where things are calming down a bit. You've already got these good habits in place. You've already got the mindset nailed. And like your podcast you said it's called she finds joy. Like if you're not doing stuff that fills you with joy yuja. Agen you miss thing, a big part of the puzzle. It's literally the thing you should be aiming for, like should be our goal. 

Kim Strobel 45:06 

See, and I love that I think you're right, I think we do get the societal messages like, and I don't know if this is maybe going off topic a little bit. But like one of the things that is like a, I know it sounds silly, but it really is like a deep fear of mine is oh, you know, well, once 

you hit 40, you're going to pack on the pounds, and you're going to get all that belly fat. And that's just part of the aging process. And so it's like, I have fear around that I don't I don't want to have a lot of belly fat. But I also struggle like I'm great at the exercise thing, Amanda, I've got that sucker down. I mean, I, I do I run 3540 miles a week I do spin class, I do yoga, I'm going to check out your book, because I would like to add the strength training in there more, I need to do a better job of that. But it's the nutrition side of things that I need to do a much better job with. And I don't want to just be like, you know, oh, I'm just you know, this is what this is what happens when it's 40. It's just part of the life thing. You're just going to start feeling sore all the time and your body is going to hurt and you're going to have belly fat, and you're not going to be able to do the things you I can't I hate that storyline. I hate that narrative. 

Amanda 46:18 

A 

Well, the fact that you've already seen that, it's probably means that you're going to do stuff practically to stop it happening, right. But I was on Instagram the other day, and I saw a post I loved and it was from somebody who said along the lines of you know, I'm tired of hearing about women who have people, it wasn't just women, but in our conversation, it's quite often women who lose belief in their athletic ability, that once 

they're 30 4050, they stopped because they consider themselves over the hill. And the fact is, if you're stopping at 1314, you're probably only halfway through your life. And you've given up like and so you know, the showing up bait matters, right? And like that I've had conversations with women. And it's like, I can't, I can't, I can't, and they're stuck in this narrative of like, a no progress, they will never ever have progress. If they don't shift from that negative mindset. Yeah, I know. It's hard, right? I've been there like I'm now postmenopausal. I've been in the crappy, ugly part of it. And I felt desperate. And I felt like I'm never going to be fit and healthy again. But there are definite ways you can make changes that can shift the way that your mind thinks. And I also think, Kim, that it's okay to hold on to a little bit of vanity like, I know that it's really hard for you to admit, I don't want to get a fat belly. And it's like, we don't we're not actually I'm in and anywhere. But it's actually just that, you know, I'm quite happy to where I am. I don't want it to change. 

47:48 

Yeah, yeah. But but I think it is changing a little bit because I need to do a better job this my eating? Yeah, 

Amanda 47:54 

A 

I know. And so there's two things you can do that you can do things proactively to help with like the physical side of that. But then there's also the conversation you have as well as that if it does happen, how hard Are you going to be on yourself, and you can never have like this negative conversation that makes you hate yourself normally. So it's like, it's, that's what that's when I wrote the book, I was trying to write it in a holistic manner, meaning I want all of the bits of the jigsaw puzzle to build this really solid picture that you don't just look at exercise, you don't just look at nutrition, you also have the conversation about self worth. 

Kim Strobel 48:29 

Yeah, it's that holistic. And I'm chuckling inside because you wouldn't know this. But Amanda, as we're talking about the whole belly thing, I reached down this is one of the things I've noticed I've done is I reached down and I like pull my underwear up because I can't stand if my underwear falls below, like where there is a little more cushion, it feels much better if it's just encompass like within like the band, or I'm just laughing because as we're talking about it, I'm becoming self conscious of it. But I love your holistic approach, I definitely want to get your book, we will we will put the book in the show notes. But it sounds like it's a you've done your you're heavily invested in research. So you come from a 

scientific background, which I appreciate, I think we can blow fluff up people's asses all day long. And I'm not into fluff I'm into, you know, let's make sure that we're choosing to do things that we know are backed by science, but also that we can create that belief within ourselves that this does not have to be our narrative 

Amanda 49:32 

A 

things is that you know, like nutrition science and exercise science, when it gets down to the nuts and bolts gets a little bit confusion confusing. People don't need to know about the ATP energy system and the Krebs cycle and things that will make the eyes roll. But what they do want is they want to know they're like the why. And so I offer that but I offer that in a way that's really palatable. Like I really struggled in menopause to read the heavy medical notes. I really did and I used to I have to get somebody else to read them with me because I couldn't return it and I couldn't resolve it. So I wrote the book that I would want to have read when I was in the worst part of my perimenopause was something that was easy to read. 

Kim Strobel 50:12 

Yes, in and I have this thing with books. As you can see behind me here, I am a total book lover, but I have to have I'm gonna have to get a signed copy. Because I have this thing that if I know the author didn't 

Amanda 50:24 

A 

tell you, I thought you were sent a copy. So I'm going to send you an after the show, for sure. Wait 

Kim Strobel 50:27 

a minute. Well, one of my podcasters send me a copy of 

50:33 

a book. 

Kim Strobel 50:35 

Well, I'm gonna have to look, make sure because I'm a book scene. I'm pretty. So I'll look and let you know. You better have signed it. If you did. 

Amanda 50:43 

A 

No, I'm quite sure I didn't. Because I have to send them out personally. So But no, I am, I will get you a signed copy anyway, that's fine. Um, but yeah, and I think that what I the one of the things in my whole overall message, and it's obviously similar to yours is that I want to give women hope, right? I don't want them to be like, yes, you may get a fat belly. And there's actually a scientific reason for that happening. And so some belly fat isn't such a bad thing. When is too much a problem, though, when it becomes a problem for your house. And so, but if like, if you have an idea of what's happening, and you actually understand the physiological processes of menopause, then maybe you won't be so hard on yourself when you do that. Right. You know, 

Kim Strobel 51:28 

I love that. And I do I feel that just in this interview here today, I feel that you are on such a mission minded, you know, trajectory here with really wanting to help give women who are suffering and in the throes of this, like, you know, there's hope and there's light, and there's 

things that you can do to proactively be involved in this and not just chuck it up to the doctor who said, This is what it is, and that's not working. So I'm going to drop all of your social links in the show notes. But I do want you to just for the listeners to tell people where they can find more information and connect with you. 

Amanda 52:07 

A 

I would just tell them to head to my website, which is fittin chips calm which is fit n chip fit, chips calm and then they can access everything from there. My social my metaphors, community, etc. Yeah, 

Kim Strobel 52:20 

perfect. Thank you so much this conversation. I feel like this needs to be like a four or five part series To be honest, because I know I made you rush through pieces. And I want to dig deeper on some of that, but the book is going to be super, super helpful, too. So thank you so much for sharing your story and your vulnerability and just kind of giving us some hope with how we can navigate this as women. 

Amanda 52:45 

A 

Yeah, thank you, Kim, and thanks for having me on the show. Keep doing it. 

Kim Strobel 52:48 

I love what you're doing. You're welcome.