Episode 14: How to Approach Menopause More Holistically with Dr. Jen Gunter

Michelle MacDonald: Welcome to The Wonder Women Podcast, where we discuss a variety of subjects all pertaining to optimizing your physique, building strength, developing a strong mindset, and tools to help you win at life.

I'm Michelle MacDonald and I'm the founder of The Wonder Women Coaching Team. We are a community of results-driven coaches and clients who believe that we can age like never before.

Welcome back to episode two of a two-part series with Dr. Jen Gunter. In this episode, we'll be focusing on menopause, some of the interesting research Jen is seeing in this space, and also why it's important that we're having this conversation earlier as we start to look at menopause more holistically.

If you're interested in making big changes to your lifestyle, make sure to check out our upcoming 24-week transformation program. It's our signature program tailored to the individual and it provides dramatic yet sustainable results. Lifestyle continues to be one of the biggest levers we can pull when it comes to our health. At The Wonder Women, we show you how.

Okay, so I know we're going to run out of time and I want to ask a critical last question which is, most of the people following this, even though we do have all ages, we are predominantly in the 40 plus. Is there anything exciting that you're aware of that's happening in this space, any digital health technologies, anything that's happening that you think we should be looking at in seeing what's happening there?

Dr. Jen Gunter: Well, I would say that from a research standpoint, the stuff that I'm most excited about is they're working on other drugs like VEOZAH for hot flashes, the neurokinin 3 inhibitors.

I'm excited about that for two reasons. One, it's always great to have more options for people. But two, this research often tells us more about how the brain works. It's always fascinating to see then what other science can shoot off from the research.

For example, the development that went into VEOZAH told us a lot about the biology of hot flashes. So, I'm excited about that. I think the other thing that I'm excited about is people really thinking more about menopause more holistically as like the whole person, as opposed to just take this drug.

Michelle MacDonald: The symptoms.

Dr. Jen Gunter: Yeah, the conversation about menopause happening earlier, because everybody like when you're on a news show, they're like, “What's the one urgent thing women need to know about menopause today?”

I'm like, “Okay, well, what they really needed to know was in their 20s, that the best thing for longevity is actually a healthy lifestyle.” But you can turn that around at any age. I would say that whatever age you are, if you're having questions about how your body is aging in menopause, the very first thing I would say is what's your investment in the foundation?

Because medications can help with certain aspects, but they're not magic wands. They're often oversold as like cure-alls and we have to be really careful because we know that, for example, when people take a vitamin, they're actually less likely to move more. So people then think they're doing something healthy with the vitamin, so subconsciously, they actually start doing less.

We don't know if that happens when people take hormones or other medications for symptoms of menopause. People just need to be very, very mindful that they have a foundation just like your house has a foundation. The foundation for menopause is exercise, eating healthy, and not smoking. In one of the studies that was looking at these interventions, they found that only 8% of women were doing all three, 8%.

Michelle MacDonald: I'm not surprised at all because I specialize in women's health from a very practical in-the-trenches place, and when people arrive at my doorstep, it's like, “All right, let's turn this ship around, and let's do it as fast as possible in the most healthy way possible.”

Then keep going in the right direction. Don't go back because you can't go back. There's no more going back to normal. That's not how this works. It's like, “No, that way of doing things, you got to say goodbye. Goodbye.”

Dr. Jen Gunter: Yeah. I just think that the medications absolutely have their place. It's so funny, whenever I say that people are like, “Oh, you're anti-hormone therapy,” I'm like, “No, I didn't say that at all.”

Michelle MacDonald: You want choices for us.

Dr. Jen Gunter: Yeah. If for example, you want to take hormone therapy for hot flashes, which I prescribe all the time and which is the gold standard, you're going to have a better outcome for your life and your longevity if you're also doing these other things. But if you think that you can just put the patch on and it's going to take care of everything, then you're going to be disappointed.

That's why I see people start to then dose escalate and dose escalate, then you see people coming in on catastrophically high doses of estrogen because they feel better temporarily because of the placebo effect and then they keep going up and up and up as opposed to like, “Hey, we're going to think about your body holistically. Let's talk about what you're putting in. Let's talk about how you're moving. Let's talk about medications that might be able to help you.”

So you're doing those because you know what, if you're up all night with hot flashes, maybe it's going to be really hard for you to engage in an exercise program because you're really tired. So you want to think about it. I'm really excited about the people talking about menopause in a more holistic way.

Michelle MacDonald: Mm-hmm. It's for exactly that reason that I had Dr. Annice Mukherjee as my first-time menopause expert come in and talk about it because I know that she has a very holistic approach and she's been in the field practicing and dispensing medications for a very, very long time.

Like you, she's not anti-HRT at all, but really looking at the whole picture and how can we optimize, how can we really optimize pulling all the levers, especially the simple lifestyle levers that we shouldn't be pulling, not just for menopause transition, but things like bone health, sarcopenia, cognitive health, cardiovascular health, and metabolic health.

I like what you said, I can't remember which interview you said, maybe it was in The Vajenda, the diet and lifestyle choices that will improve your menopause symptoms are pretty much the standard best choices for pretty much everything else.

Dr. Jen Gunter: Yeah, that's why I would say people need to be very, very wary of people saying that they have a special diet because there are no studies to say that whatever, keto is better than intermittent fasting is better than just tracking your calories.

I mean, if those things help you get into the calorie deficit that you want to be in, that's great. That's fine. They're just all different ways, but there's no superior menopause diet.

If there were, there couldn't be because then how would people who lived in Greece have the same longevity as people who lived in what's now Northern Russia? They've totally different diets. Completely different diets, or people who lived in Iceland versus people who lived in Ecuador.

Historically, we couldn't have survived in menopause with these drastically different diets if everybody needed whatever, a very specific food or very specific way of eating, the truth is humans are pretty creative omnivores. The one thing that we didn't evolve with was this overabundance of easy-to-digest food that's everywhere, that's hyper-palatable. That's a very different thing.

But the idea that there's a specific menopause diet is not borne by science, it's the same thing, and maybe it's like you need to eat a high-fiber diet, you need to get enough protein, you need to make sure you're getting all your nutrients.

Michelle MacDonald: [inaudible]

Dr. Jen Gunter: Yeah, exactly. There's nothing magical or special and there's no hack. I would say be very wary of people who have like hacks. They have the one hack or they have uncracked the code. There's no code to crack.

Michelle MacDonald: It's funny that you said that. I asked Dr. Ayesha on my interview with her, she's a neurologist and I asked her, I said, “So could you give me like a simple hack?” and she visibly went [breathes heavily]. I said, “I just like to help people get more fiber,” and then I said, “My hack is I buy these beautiful jars of French,” I don't know if you have them where you are in Canada, probably because of the Quebec thing, but the French chickpeas and lentils and I just scoop them out and I plop and they are delicious.

I plop them on my salads and put them in my ratatouille and they're just a great way to beef up the fiber and get some plant proteins in and some other goodnesses that are in legumes. But she visibly like–

Dr. Jen Gunter: Yeah, I know, but maybe we should be calling fibers the one hack you don't know about. In the office, whenever people are asking me for dietary recommendations, I just always start with, “Let's add in more fiber to your diet. Let's see how much fiber you have and let's start to add it.” Because it's not taking something away, it's not denial, you're adding. So I think there's something psychological about that.

Also, when people start having enough fiber, people see the effect right away because they don't have constipation anymore. It's like you actually can get a pretty rapid feeling better. Even though you know the effects on your lipid health and all those things are going to take a little time, everybody feels better when they're not constipated, like everybody. There's this gastroenterologist who introduced me to this fantastic term called Poophoria.

Michelle MacDonald: I get it.

Dr. Jen Gunter: Yeah, exactly. Everybody feels better when they've had Poophoria.

Michelle MacDonald: Oh, yeah, my husband and I, it's like you hear it, it's like you won an award, you won an Oscar. That's how it is.

Dr. Jen Gunter: Right. You high-five people in the hallway. Fiber is your way to Poophoria. Yeah, I try to have a list of foods in the office and I say, “Look, if you're struggling, you don't know, just start with a high-fiber cereal, just start somewhere.” High-fiber cereal makes it so easy and cereals have a lot of added micronutrients too, they’re fortified, so find a cereal that you can stick with.

Then people say, “Well, what about the added sugar?” I'm like, “Don't worry about that right now. Just get started on the fiber, make one change.” Oatmeal is another one. I make a lot of overnight oats so then I don't have to make anything in the morning.

Michelle MacDonald: Start with that one thing, make it easy.

Dr. Jen Gunter: Yeah, just make it easy, start with one thing, then you build on that. Then when you're like, “Okay, I made one change. I can make another change.” The fiber is the one I would say we need to sell as a hack. It's the one hack they don't want you to know.

Michelle MacDonald: It's the one hack. Make some really viral TikToks. My mind is thinking because I want to dent the narrative in a powerful way where this easy stuff that people spend a lot of money to work with me and it's like this should be available for everybody.

If you want the one-on-one coaching, I can give it to you but this stuff should be available for everybody. On the doctor's lips, it should be as easy for them to say, “Oh, we'll try this,” the basic stuff versus I get a lot of gals coming to me and saying they've been recommended keto and IF. I think, “Gosh, of all the things, those are such specific and extreme diets and hard to sustain for the long term.” A lot of them have negative repercussions downstream if you run them for a long time.

Dr. Jen Gunter: Yeah. I mean, I think we've seen it, especially with people who do keto and have a lot of saturated fat in their diet, where they eat a lot of animal fats, and so there's obviously a concern about that.

The other thing I say is try to have more plant protein. There was a recent study looking at menopausal women finding that increasing plant protein. Guess what? It had beneficial effects. I always tell people, "Look, see if you can make like one vegan meal a week.”

You don't have to eat vegan every day but think about what are the ways you can start to increase plant protein in your diet that works for you. Then once you start doing it, it's not so hard. But yeah, these restrictive diets, man, I mean, do you really want a surgeon who's fasted for 16 hours operating on you? I don't know. I always think about that.

Michelle MacDonald: It's a good point.

Dr. Jen Gunter: Do you want a pilot who's 12 hours into a fast? I don't know. I think about those things. I don't perform the best when I haven't eaten for 12 hours. Maybe some people do and great for them, great for them. But the more restrictive and the more difficult it is, the less accessible.

What happens if you want to travel or you want to try new foods? That's the great thing about going to other countries or even just different parts of your own country, you don't find all kinds of new crazy things to eat or not crazy, but just like they're different.

You're like, “Oh, I never thought about putting those things together. Wow, I got to taste something new.” When we put people on super restrictive diets, they don't get to have those wealth of experiences and things that bring you joy. You have to have joy too.

Michelle MacDonald: You have to have joy. Joy is very crucial to longevity and loving the fact that you're going to be around longer.

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Okay, let's wrap up with, I mean, you've done so much already and your list of credentials is insane, is there anything else that's on the table coming up that you want to share with people?

Dr. Jen Gunter: Anything on the table coming up. Well, I am going to England in March on a book tour and I'm going to actually be speaking at The British Library with one of my idols Dr. Helen King who's a classicist and expert in ancient gynecology and Hippocrates. We're going to have an amazing conversation at The British Library.

Michelle MacDonald: When is that?

Dr. Jen Gunter: It's in March. I think it's on the 20th or 21st. It's on my site, The Vajenda. I am always really excited about all the posts I write for The Vajenda because I actually learn a lot too. I always make sure that my science is accurate. I'm always double-checking myself. Then also, I have a new book that I'll be working on once I recover from this book tour.

Michelle MacDonald: Are you going to write a book on pregnancy?

Dr. Jen Gunter: No, no, no, no. I did my book on prematurity. I'm good. I don't practice obstetrics anymore and there are lots of people in that space to follow. If you're not following Shannon Clark on Instagram and you're interested in the pregnancy space, I'd recommend her, her account is Babies After 35.

The book is going to be a broader about sexism in medicine and the legacy that we're still sealing from that today. I'm going to have a little bit more of a break. This probably makes you feel like I'm really excited to get back into my exercise routine because hardcore travel, it's really hard.

When you're working from 7:00 to 11:00 every day, and you have to get up at 6:00 to do hair and makeup, there isn't time to go to the gym. There just isn't because you have to sleep.

But I was like, “Wait, can you do my steps? I'm going to walk everywhere so at least I'm getting that in.” I'm actually excited to get back to my weights and get back into routines, they make us so comfortable.

Michelle MacDonald: They do and our bodies love routines. So there you have it guys. Dr. Gunter is excited to get back to her resistance training and she knows how fundamental exercise is to the human body and aging well.

Dr. Jen Gunter: Absolutely. It's the number one thing. I have to say, I find your account very motivating on days when I'm like, “I don't want to work out,” and I see your account, I'm like, “Okay, all right, okay. Michelle's out there doing it. I know she's lifting way heavier than I am. So I'm going to get out there.” I actually find you very motivating.

Michelle MacDonald: You are so sweet. Thank you so much. I've just had a fabulous interview and I promised you, I would keep this to an hour. I definitely want to have you back on the show and I hope we can figure out something where we can do some round tables, but also maybe do something in real life. I think that could be fabulous.

Dr. Jen Gunter: Oh, that would be a lot of fun. I'd love to meet in real life. Yeah, we should start thinking about what that might look like, how it might evolve.

Michelle MacDonald: We'll manifest that. I can make that happen.

Dr. Jen Gunter: Exactly.