Pioneering women’s health advocate and New York Times bestselling author Dr. Mary Claire Haver chats with Zibby about THE NEW MENOPAUSE, an enlightening guide with everything a woman needs to know to thrive during her hormonal transition and beyond. Dr. Haver shares her journey to becoming a leading advocate for women’s health during menopause and then touches on her own struggles with it, including weight gain, night sweats, and joint pain. She also discusses hormone therapy, which she endorses, and then delves into the importance of better medical education and personalized healthcare for women.

Transcript:

Zibby: Welcome to Zibby's Bookshop. We are so excited to have Dr. Mary Claire Haver here. Number, this is her second week at number one on the New York Times bestseller list.

Amazing. So I'm sure she needs no introduction, but is the foremost expert on menopause, changing life for all of us who has had their lives changed already. Oh my gosh. Amazing. Okay. Dr. Haver, kick it off. What does everyone need to know and why did you decide to dedicate your life to this and write a book about it?

Dr. Haver: So I was a basic OBGYN, very happy for most of it, you know, in my practice, delivering babies and doing pap smears and, you know, taking care of us through multiple phases of life. I didn't have a ton of menopausal patients. When I was younger, getting started, you tend to have babies with your patients and we're aging together.

So we're all kind of, in general, going through this phase of life together. And I was telling them things like, Oh, just work out more and eat less. And, you know, when they'd come in complaining of weight gain, and I was really terrified of hormone therapy. I didn't understand that the Women's Health Initiative had been Walked back.

So many of the, you know, claims have been overestimated and the actual protective benefits had been, you know, undersold and I was going through a really rough time in my own life when I was going through menopause. I'd lost my brother and I was grieving and I was having horrific, horrific joint pain and night sweats and brain fog and not able to sleep and sleep disruption and pain.

I gaslit myself, so I was grieving and I just kind of attributed everything, which there was definitely a part of it, but it took me months and realizing my grief was getting better, that I was still feeling horrible and not sleeping. And, and when the hot flashes just were just unbearable, I kind of treated.

Hormone therapy. Like I treated an epidural, you know, for myself, like we'll see how we do, you know, and get the active, getting an epidural was like throwing in the towel. Like I wasn't strong enough and it was the best fricking thing I've ever done in my life. If you've ever had one. So yeah. Um, I was three centimeters, by the way.

So three, when I got my epidural, like you weren't supposed to get it till four, but we lied. The nurse lied for me and then we got it. The anesthesiologist to come in. So that was me. So. Just that whole experience and transition, you know, I really, really struggled with the 20 pound weight gain through the menopause transition.

It was all in my midsection. I had been a thin person with twin privilege most of my life, you know, most of my adult life outside of pregnancy and college stuff, you know, and could not get the weight off. And like, that was, if anybody ever read Galveston diet, you know, that was part of the initial part of my journey.

But so I kind of took to social media to talk about that experience. And then that led to more and more questions about menopause in general. So instead, I'm a curious person. So instead of being dismissive, I was curious and I would go and look things up and be like, Wait, frozen shoulder actually is related to menopause.

So I'd find an article and post about it and a million people would go crazy on the internet. So most of what is in this book, like in the toolkit in the last section, was informed by you guys. It's telling me what you were going through and the symptoms that you had that led needed to go find research to support what you were saying.

And the saddest part, you know, really the crux of why I wrote this book is no one taught me this. And I, I know a lot of stuff. I'm really smart and no one in the American Board of OB GYN that recertifies us every year was saying, Hey, this new menopause information is important. We spend a third of our lives.

as menopausal people. And it's like our value in medicine plummets after reproduction. You know, I love my children. I loved being pregnant and the whole experience and, you know, the miscarriages. And that was such a beautiful part of my life, but like, I'm not dead, you know, and I want, you know, and I thought after, as soon as Galveston Diet was like birthed, I was immediately pregnant again, trying to get this book and into the world, because that is what I felt like everyone was telling me, you know, you know.

On social, write a book, write a book. There's too many videos for me to go through. Can't you just get it all together in one section? And so, very long answer to, you know, your very simple question. 

Zibby: That's what it's for. That's good. I went through the line really quickly before and asked what the best part of this stage of life was.

And I would say 75 percent of this tiny little sample size here said not caring as much what people think. What does that have to do with menopause? Tell me what the link there. 

Dr. Haver: I think, and this is, this is opinion, but just talking to so many people and now I have a menopause clinic and like, we get to this point in our lives where if we don't take care of ourselves, we're going to fall apart.

And, and you learn how to prioritize. Like I have boundaries now that I've never had in my life and I've never had a healthier relationship. You know, like, like it's so healthy and I prioritize my own health. Like I'm not, I'm putting my own oxygen mask on for my kids can make a meal. You know, they can, whatever.

I mean, I love my children, but, you know, they, I, I just, and you're, you're like, give a shit factor. And the weight of other people's expectations just kind of like goes out the window. So, and that's really been the best part. I mean, I fit, so I'll be 56 in a couple of months. I'm the happiest I've ever been.

This is the best part of my life. And I am healthier, better relationships. wealthier, better, entrepreneur, badass, you know, like, and I couldn't have done this at 40. I wasn't in that place in my life where I could have made that happen. And I want that for everyone. And whatever that looks like for you, like, this doesn't have to be the end.

And when I realized I was menopausal, it was like the world, was dark for a minute, you know, I was not excited about it. I was like, Oh my God, Oh my God, ew, you know, I like, and I thought, and, and that was based on the old menopause. And this is the new menopause. This is a celebration. This is the best time of our lives, but it is a, this is a biopsychosocial upheaval for us, for a lot of us in multiple different ways.

And if, you know, but we can take control of this and hopefully this book will be a guidebook for you guys at this part of our lives. 

Zibby: I didn't know until I read the book that there was even such a thing called post menopause. That we should be aware of. Like, was this, was a thing. It was just perimenopause or menopause dot, dot, dot, right.

Dr. Haver: Well, menopause medically is one day. So one year, one day, the one. One year past your last menstrual period, that day is your menopause day. Happy birthday, you know. And everything after that is post menopause. And so forever, people only define menopause by having hot flashes and symptoms. But like, our bones are not doing well.

You know, our muscles are starting to deteriorate forever. And you know, part of that is aging. Yes, we're all aging. But these things accelerate in menopause. And like, Knowing this, you know, and I just think menopause should be optional. Have you figured out exactly how to do that? There's some really, like, so my daughter's here, poor Maddie.

Hi, she's 20. So, you know, it's, my ovaries are dead, and so they're not, there's no way to resuscitate them. But I'm hopeful that for this generation, that they will, they're working on pharmacology to extend the shelf life of the ovary. Not for pregnancy, I mean, if you want that, but you know, but for enough estrogen production to continue to keep your bones, your brains, and your hearts strong.

Zibby: So hormone replacement therapy, as you mentioned, got such a bad rap for a while, but in the book you extolled the benefits. Tell us why this is something we all should consider. 

Dr. Haver: So I don't think every woman will choose it and, but I think every woman deserves a conversation and that's not what's happening in most of your offices that you go to when you're looking for care.

You're being dismissed, denied, and it's really a lack of education in the medical training system and that is where on the like advocacy level, this is where the menopause is working. It's to demand that the American Board of American College of OBGYN, but. This should not be dumped in the lap of the poor, busy OB GYN.

We got to deliver babies and do pap smears and all the things. Like this is an all medicine problem. This is internal medicine and surgery and orthopedics. And, you know, so the menopause is made up of psychiatrists, cardiologists, you know, all, and all of us have bonded together saying this isn't right and that we deserve more and better and the funding and the research and the dollars and the brain power to, to come to us.

So, so hormone therapy. It's simply replacing the hormones that your ovaries used to make. And why would we do that? Well, one, the acute symptoms. The hot flashes, the night sweats, the sleep disruption, the mental health changes, that, that stuff. So, so then we tamper down the, you know, the immediate problem.

And then you feel like you get your life back. Now we're going to try to protect you, the protective benefits. for the next 30, 40 years. So to keep your bones strong so you don't fall and break that hip. And then you die. You know? So that, you have decreased your risk of dementia. But it turns out we have, and you don't have a heart attack.

You have a heart attack later than you would have otherwise. So we're all gonna die. We haven't fixed that problem yet. But the fact of the matter is, Females live longer than males, two to four years, depending on which study you look at. We all know this, but we live 25 percent of our lives in poorer health than our male counterparts.

And we're three to four times more likely to end up in a nursing home and requiring long term care. So that last 10 years tends to be marked with this. deficiency and decline and you not being able to take care of yourself. And so when I have patients in clinic, that's what we're talking about. HRT is one tool in that toolkit, but it's not for everyone.

So if that's not an option for you or you choose not to do it, then we have to double down on the other pillars of health. And that's what the toolkit is about. The nutrition, the movement, the, you know, who's got a way to vest. Yeah. 

Zibby: So, you know, little hacks and tools and things that we can do to stay healthy longer.

Is this not the time to reveal that I only walked 254 steps all of yesterday? 

Dr. Haver: We all have that, you know, we all have better days. 

Zibby: Like, did I even go to the bathroom? Oh my gosh. What did I do? Anyway. It was, it was a, it was a rough day. Anyway. But I know that exercise is one of the things that you recommend.

So. I was also really taken in the book when you said, just as you were starting to talk about now, about breaking your hip, that you can die. Yeah. Within three years. 

Dr. Haver: The stats, if you're over the age of 65, which is nine years away from me, okay, and I fall and break my hip but even with surgical repair, I have a 29 percent chance of death in the first year and within the first year.

If I'm not healthy enough for surgery, which happens to a lot of women, go follow Vonda Wright, then I have a 79 percent chance of death. And that year is marked with horrific decline and horrific, you know, just a really, really tough last year of my life. So, we can prevent probably 50 percent of that with really aggressive.

You know, HRT is definitely preventative, and I don't know why the U. S. Preventative Health Task Force has not recommended it, and I think it is a crime. You know, it is preventative for your bones to, to, you know, decrease the deterioration. But there's other things, you know, the weighted vest, the resistance training, the protein, the creatine, we talk about all this in the book, you know.

These things are, we can make them much less likely with intervention, and the earlier you start, the better. 

Zibby: There are so many things, though, that are recommended for all of us. And we're all already busy doing all the things that we've been doing the rest of our lives. So, of all these things to do and to start to make sure that we don't end a horrible life.

The rest of our lives. How do you know which ones to prioritize and which to make time for? 

Dr. Haver: When I have a patient come in, we look at her, first of all, we look at her family history. What did your mom have? What did your aunts have? Like, what are, what are your, what is your, your grandmother's, what are, what is genetics pointing you towards?

And we start working on those things first because it is overwhelming. The book's filled with 9, 000 things and a hundred supplements and whatever, but like what is bothering you? What's keeping you up at night? What acute things do we need to address so you can sleep every night? So, you can mentally function at work.

So, you know, we, we fix the acute first and then we start looking down the road at what are your personal risk factors and how are we going to address those. 

Zibby: Okay. That works. We'll start there. And as you said before, you are not everyone's doctor. You are. I'm not licensed in the state of California to practice medicine, so yeah.

How does it feel at this stage in your life, which you, really at any stage in life, to become a celebrity in your field? What is that like to have, like, over a million followers hanging on your every word and knowing that you're, like, a leader in this whole thing? How do you feel? 

Dr. Haver: So, it's, to be a social media person who becomes famous on that route, it's very lonely because I am literally sitting in my bed like this.

with a research article that stimulated me that morning trying to, like, make something. So it's not like I'm in a room full of people or I'm on a stage talking. I mean, this is rare for me, really. Not this week or last week, but, you know, with the book launch. But in my everyday life on social, I am alone, doing this alone.

And I don't, I'm sending stuff out into the world and I don't know what's gonna happen to it. So it's a little bizarre, you know, to, like, all of a sudden walk into a space or walk through the airport and people recognize you. So, Annabeth probably does it She's an actress. So, you know, it's, it's just kind of really surreal.

And it's, it's funny when my husband, he tells me for all the women who were brave enough to walk up to you at the airport to say hello or, you know, wherever we are, there's 10 more who are too scared to do it. So watch what you do in public, you know, like people are watching you. So it is kind of surreal.

To have a book come out as the number one bestseller in New York Times, I was so anxious and nervous. My husband took me to Mexico. Plus we were trying to detox from New York and all the pre launch stuff we were doing. If you followed me, I was in Vegas and New York and then Chicago and then I got to go home and then I got sick.

So we, you know, I put a mask on and we went to, to, to the beach in Cancun and it was there that I found out that, and it was my friends, the Holderness family, Kim Holderness texted me the like secret list that comes out from New York Times. She's like, did you see? See it and I was sitting, you know, having sushi with my husband at a, at a hotel.

And I saw it and it was just, that was like the moment that I was like, I, it's making a difference. You know, like not, I don't care how many books we sell, but like, this is a message that this is important. This message is important. And that, you know, the, the editors of the New York times also thought it was important to put us on the list.

So, you know, but that we'd sold enough books to be able to do that. 

Zibby: It's amazing. What do you think your brother would say? 

Dr. Haver: So you know, I've lost three. So the oldest one, I was nine. And I have very cloudy memories of him. And then Bob in 2015, and then Jude in 2020, and then my dad in 2021. And, um, so a lot of this is all part of that journey as well.

And I talk to them all the time. You know, when I was in Mexico, like, sitting there like, oh my god, this happened, and wow, and you know, I could just feel them with me. And just so proud. You know, Bob, the one who was like, over the top, and he would have been fussing over my hair, my makeup, and my outfits, and you know, and you know, Jude would have just been screaming from the sidelines, and you know, my dad.

So, it just, you know, I know that they're there, and I know that they're proud, and it just, it's a little sad, so. 

Zibby: It's amazing what you're doing, so. Yeah. It's amazing. So then how do you know, how do you know that it's not grief? I mean, I know this goes back to the beginning of the book, but you know, grief and trauma therapists would say that a lot of these things that you described are also grief.

So how did the rest of, how do we take it all apart? 

Dr. Haver: So when my patients come in, so for me, it was sorry. I am so sorry for your loss. It's okay. My, I knew the grief was getting better. But I was not getting better. Do you know what I mean? Like I could finally, it took six months to realize that I wasn't crying every day on the drive home from work.

And I didn't get therapy and I didn't do all the emotional work throughs that I did later. But I didn't do the work I needed to do. But I was getting, you know, I could feel the grief lifting and I was still feeling so terrible. So, you know, when patients come in, the first question I'm like, when's the last time you felt good?

You know? And, and when's the last time you felt, because a lot of the times they're like, I just don't feel like myself. I just, I can't put a finger on it, but I just don't feel like myself. And, or I'm just not as resilient or I'm more anxious or more irritable or whatever. I'm like, let's go back to when you felt good.

And when you had the world by the horns, you know, and like you, you could handle the stress, all the things were okay. And so we walk back to that moment and I'll tell me what's happened since then. And we go through, has anything changed? You know, I have the usual stress, nothing new. Or sometimes they have had something tremendous happen in their lives, and we kind of work through that.

Hot flashes are pretty diagnosis, you know, diagnostic. And that's kind of why we've always defined the severity of your menopause by your hot flashes, because we really can't blame it on anything else. A fever you'll have a hot, you know, you'll get hot. And tuberculosis, and we can rule that out pretty easy.

So, but, you know, there's very few things that give you the very characteristic hot flashes at this age. And that is why we've really defined menopause. By that in all, uh, 90 percent of the, of the very small amount of research that we had has been in pharmacology. To stop a hot flash and nothing else. 

Zibby: I wrote this book blank about a menopausal woman who is not exactly me, but we are very similar.

And in it, there's a store that she wants to open called flash where she would just hand out like chunky necklaces and like waistless dresses and towels. So if anybody wants to start that store, go ahead. You can take it. Flash. That's cute. What is your vision for the future? of a life where menopause is something we control, where we don't all have dementia and need that extra care being taken, that 30 percent of our lives or whatever.

Paint a picture of that sort of Barbie esque alternate world. 

Dr. Haver: I, I, I dream about a time when everyone is menopause informed. Your partners, your loved ones, your whatever. We know much about menopause as we do about puberty. And everyone is prepared and they know what to look for because what's happening now is that The gaslighting and the blind being blindsided.

And how many of you said, or who have read the books that I wish I would have known, I wish I would have had this at 35 so that, that there's this, everyone is not scared and ready and you know, it's not hitting you like a truck and you're so scared and you go through months or years of questioning yourself and your, your motivation and, and is this really real or am I going crazy?

Which is what's happening now, and so you have you get start getting screened at 35 at your health care provider. Are you having these symptoms? Just check these boxes. These are little sheets all that we fill out. We know the doctor. I have to fill it out, too. You know what? There should be a perimenopause menopause screening.

Check, check, check, check, check. Easy, you know, because we don't have good blood work to diagnose perimenopause. 

Zibby: And you have it in there. We can, we can what, just like rip it out. Yeah, rip it out. You'll have to get another book for every doctor appointment. 

Dr. Haver: We have them online. 

Zibby: Which is very smart too. Why not just like kick it?

Why not just say, okay, I'm done. I'm going to just go back to being like, why, what is driving you to do all this? 

Dr. Haver: Because I can make a difference in the world and it's so powerful. And I, I just feel like this is where I'm meant to be. I mean, I loved delivering babies and I swear to God, if they came between eight and five, I would probably still be in the hospital.

And my babies came in the middle of the night. So, you know, my doctors were as victim as much as anyone, but this is, I'm more effective as a healer. now than I think I've ever been. I'm touching more lives now. And, and this is a generation that has been dismissed medically for most of our stuff, unless you have a heart attack or you break a leg, you know?

And so just being able to have any influence in this space and realize I'm not smarter than I'm very smart, but I'm not, you know, like there's way smarter people getting PhDs and all that, you know, but like the, this is my gift. This is my unique set of gifts. I didn't predict it. I did not see it coming, but this is what happened.

And I'm, I'm going to go with it. I'm going to run with it. So. 

Zibby: And we are all going to follow. Except maybe we're not going to go so fast. We're going to, we're going to be in there with our weighted vests, dragging ourselves by. Anyway. Does anybody feel better than when they got here? Yes? Okay thank you so much.