Podcasts about postmenopausal

Postmenopausal bleeding can be an alarming experience, especially when you've gone years without a period. What causes this unexpected bleeding? When should you be concerned? Dr Ceri Cashell joins me to demystify this common but often distressing symptom.We dive into the definition of postmenopausal bleeding - any bleeding that occurs after 12 months without periods - and explore the various causes, from hormone imbalances to more serious conditions that require immediate attention. Dr Ceri uses a brilliant analogy, comparing the uterus to a jumbo jet where multiple hormone "switches" need perfect alignment for smooth operation.For women recently started HRT, bleeding can be a side effect, particularly in the first three to six months or after dosage adjustments. However, Dr Ceri emphasises that certain risk factors like obesity, family history, tamoxifen use, and smoking warrant prompt investigation. We walk through exactly what happens during medical assessment - from initial GP visits to ultrasounds that measure endometrial thickness and potentially hysteroscopy procedures.My own experience with unexpected bleeding after eight years without periods highlights how confronting this symptom can be. Dr. Ceri reminds us that while HRT offers tremendous benefits, it's not a perfect solution and may require personalised adjustments to find your hormone sweet spot. Most importantly, she urges women not to dismiss or normalise symptoms that could indicate something serious - "Women are far too good at sucking things up," she notes, encouraging listeners to prioritise their health concerns.Have you experienced unexpected bleeding after menopause? Don't wait - speak with your healthcare provider today and get the answers and reassurance you deserve.LinksHealthy Hormones WebsiteThank you for listening to my show! Join the conversation on Instagram

In this episode of the Grace & Grit podcast, I sit down with gerontologist and global menopause researcher Zora Benhamou for a fascinating discussion about menopause through a worldwide lens. Drawing from her interviews with over 200 women across 50 countries, Zora shares invaluable insights about how different cultures approach this significant life transition. As a self-described nomad who speaks six languages, Zora brings a unique perspective to our conversation about biohacking menopause and challenging societal stigmas around aging. We explore both the scientific and cultural aspects of menopause, while discussing practical strategies for women to thrive during this transformative phase of life. Key topics we explore: The various stages of menopause and why understanding them is crucial for every woman's journey Practical biohacking strategies for managing common menopause symptoms The connection between gerontology and menopause, and why focusing on longevity matters How different cultures around the world approach and support women through menopause Take a listen and share with the women in your life who might also benefit from the episode. You can listen here: https://graceandgrit.com/podcast-379 MENTIONED IN THIS EPISODE Hack My Age Website: https://hackmyage.com/ Hack My Age Freebies: https://hackmyage.com/freebies/ Hack My Age Instagram: https://www.instagram.com/hackmyage/ *** ⬇️ Tools to rock your second act. ✅ Start Here: https://graceandgrit.com/start-here/ ✅ Listen to the Podcast: https://graceandgrit.com/podcast ✅ Weekly Bit of Grace & Grit: https://graceandgrit.com/rumbleandrise ✅ ️Leave a Podcast Review: https://graceandgrit.com/podcastreview ✅ Rumble & Rise with Courtney: https://graceandgrit.com/readytorumble ✅ Subscribe on YouTube: https://graceandgrit.com/youtube-subscribe ✅ Visit us online: https://graceandgrit.com

In this episode of the Grace & Grit podcast, I sit down with gerontologist and global menopause researcher Zora Benhamou for a fascinating discussion about menopause through a worldwide lens. Drawing from her interviews with over 200 women across 50 countries, Zora shares invaluable insights about how different cultures approach this significant life transition. As a self-described nomad who speaks six languages, Zora brings a unique perspective to our conversation about biohacking menopause and challenging societal stigmas around aging. We explore both the scientific and cultural aspects of menopause, while discussing practical strategies for women to thrive during this transformative phase of life. Key topics we explore: The various stages of menopause and why understanding them is crucial for every woman's journey Practical biohacking strategies for managing common menopause symptoms The connection between gerontology and menopause, and why focusing on longevity matters How different cultures around the world approach and support women through menopause Take a listen and share with the women in your life who might also benefit from the episode. You can listen here: https://graceandgrit.com/podcast-379 MENTIONED IN THIS EPISODE Hack My Age Website: https://hackmyage.com/ Hack My Age Freebies: https://hackmyage.com/freebies/ Hack My Age Instagram: https://www.instagram.com/hackmyage/ *** ⬇️ Tools to rock your second act. ✅ Start Here: https://graceandgrit.com/start-here/ ✅ Listen to the Podcast: https://graceandgrit.com/podcast ✅ Weekly Bit of Grace & Grit: https://graceandgrit.com/rumbleandrise ✅ ️Leave a Podcast Review: https://graceandgrit.com/podcastreview ✅ Rumble & Rise with Courtney: https://graceandgrit.com/readytorumble ✅ Subscribe on YouTube: https://graceandgrit.com/youtube-subscribe ✅ Visit us online: https://graceandgrit.com    

JOIN VEE MINDFUL'S BRAND NEW PRIVATE COMMUNITY. Includes Monthly LIVE Calls with a Book Club - Let's Love and Learn TOGETHER: The V Spot: Love and Learn Lounge for 50 and Over: https://www.veemindful.com/VSpotCommunity (any age over 18 and sex are honestly welcomed - just be kind and an adult.. literally, that's it.) I am trying a few products that claim to help with PAINFUL SEX due to Menopause. Watch the video if you want to learn about these products and your options based on my own experience. Sharing some information about why painful sex happens, what it feels like and how I'm addressing it. TO WATCH THIS VIDEO ON YOUTUBE: https://youtu.be/Jy3S0iDtle4

We receive so many questions about labs that we wanted to take this week's episode and dive deep into some of your most popular questions! Whether you think you need you need certain lab tests drawn based on the symptoms you are experiencing or if you are just curious and thinking about your future health, we'll cover some of the most popular tests today and answer some specific questions around them. Some questions include: I can only invest in one right now… DUTCH test or GI Map? When do I take a DUTCH test if I don't have a regular cycle? What labs can I do while on birth control? If I'm trying to get pregnant, is a DUTCH test a good idea? Can I do a DUTCH test while postmenopausal and on HRT? AND What labs should I ask my doctor for? If you have questions beyond this episode, please DM us and let us know!  Time Stamps: (2:58) Investing In One Lab Test: GI Map or Dutch Test? (8:02) Giving Clients Insight Inside of Vital Spark (8:27) Dutch Test With An Irregular Cycle (12:16) Finding Your Ovulation Window (14:14) Labs On Birth Control (17:57) Dutch Test and Pregnancy (20:30) Dutch Test, Postmenopausal, and on HRT (22:19) What Labs Should You Ask Your Doctor For? (23:55) CMP Test---------------------Follow @vanessagfitness on Instagram for daily fitness tips & motivation. ---------------------Download Our FREE Metabolism-Boosting Workout Program---------------------Join the Women's Metabolism Secrets Facebook Community for 25+ videos teaching you how to start losing fat without hating your life!---------------------Click here to send me a message on Facebook and we'll see how I can help or what best free resources I can share!---------------------Interested in 1-on-1 Coaching with my team of Metabolism & Hormone Experts? Apply Here!---------------------Check out our Youtube Channel!---------------------Enjoyed the podcast? Let us know what you think and leave a 5⭐️ rating and review on iTunes!

Postmenopausal Problems - Geriatric Gynecology in the ED by Christina Shenvi

Stella Duffy is an existential psychotherapist, award-winning writer, actor, director, a campaigner for equality and diversity, and recently completed a PHD in the embodied experience of post menopause. She herself has been postmenopausal for 30 odd years following chemotherapy as a younger woman.In this chat, we get into the deep-rooted cultural stories around menopause and ageing, including Stella's mission to change the negativity younger women often hear about it. She challenges the idea that postmenopause is all about decline, instead seeing it as a transition into a new, thriving chapter.Stella shares some of the amazing stories of women she researched as part of her doctorate on post menopause, showing just how varied the experience can be—some women struggle, some breeze through, and most land somewhere in between. But society tends to focus on fear and loss, making ageing seem like something to dread. Instead, she encourages us to lean into change rather than fight it. Menopause can be tough, sure, but it's also a chance for growth, renewal, and empowerment.Our chat is a powerful reminder that menopause isn't the end—it's just the next phase of an ever-evolving life. Hope you enjoy it.Find out more about Stella's work here; https://stelladuffytherapy.co.uk/about-stella-duffy/Or if you need support with your menopause symptoms or other health issues, contact us here; https://happyhormonesforlife.com/contact

If someone dies from a heart attack or stroke, their death is typically the result of a clot. A clot can form in less than 5 seconds! Usually, your body should form a clot, fix the hole in the artery, then dissolve the clot, but this doesn't always happen.Clots can be caused by the following:•Smoking•Pollution/chemicals•Alcohol•Birth control pills •Stress•Surgery•Endurance sports•Refined starches•Infection•High blood sugar•InflammationExcess calcium in the arteries can also trigger clotting, which can lead to a heart attack or stroke. Postmenopausal women who take large amounts of calcium are at a much greater risk for blood clots. Calcium is involved in over 15 different clotting factors. Vitamin K2 prevents calcium from building up in the soft tissues and arteries. It is found in dairy, butter, and other fatty foods. Always take vitamin D with vitamin K2. Magnesium is another important calcium regulator. It helps prevent calcium from entering the soft tissues, as well as arrhythmias and atrial fibrillation. Nitric oxide can reduce clotting. Vitamin D, L-arginine, and sunlight can increase nitric oxide to help prevent heart attack. Polyphenols, vitamin C, and omega-3 fatty acids all support heart health and may help reduce your risk of clotting.Keto and intermittent fasting can help reduce clotting by reducing inflammation in your arteries. Regular moderate exercise is vital in preventing clotting. Garlic and onion are also essential. Nattokinase, serrapeptase, and bromelain can be taken as supplements to prevent clotting.

Postmenopausal women can build some serious bone AND stay safe with the right instruction and the right load. What's the right load? Dr Belinda Beck can answer that, and in today's episode, she takes us through the results of the LIFTMOR trial. With the right instruction and supervision, postmenopausal women can be lifting 85% of their 1 repetition maximum safely, and make a substantial change in their bone density, strength, and quality of life while doing it. ------------------------------ RESOURCES For more on the LIFTMOR trial: https://pubmed.ncbi.nlm.nih.gov/30861219/

When we think about ageing well, we usually focus on eating right, staying active, and keeping up good habits. But what we don't always consider is how much our emotional health affects our physical health and therefore how well we age.The truth is, in today's fast-paced world, we have become increasingly disconnected from each other, from nature and from ourselves. This disconnect touches every aspect of our lives, affecting how we relate to one another, how we interact with our environment, and even how we care for ourselves.So if we want to make the most of our next chapter and live a happy healthy life, we need to make sure these vital connections are plugged in and thriving.Connection is the 'C' in my EMBRACE formula in my book LIFE AFTER MENOPAUSE​. The book comes with a free downloadable workbook to help you implement your own action plan for your best life after menopause!Learn more here; https://happyhormonesforlife.com/life-after-menopause

In this episode, Dr. Katie Kennedy, a pathologist, discusses the intersection of aging, health, and the effects of alcohol on the body. The conversation explores how alcohol impacts various organs, particularly the liver and brain, and its connection to inflammation and cancer. The role of estrogen in women's health and the implications of aging on inflammation are also examined, providing insights into how these factors affect quality of life. In this conversation, Dr. Kelly Casperson and Dr. Katie Kennedy discuss various aspects of women's health, particularly focusing on postmenopausal issues such as bladder health, the importance of vaginal estrogen, and the role of pathology in understanding these conditions. They delve into the significance of bone health and osteoporosis, emphasizing the need for preventative measures against hip fractures and frailty. The discussion also highlights the connection between breathing, oral health, and overall well-being, advocating for a holistic approach to health that considers the entire body. Takeaways Pathology is the study of diseases and their effects on tissues. Alcohol has a significant impact on liver health, leading to conditions like fatty liver disease. Fatty liver disease can be reversed if caught early and with proper support. Alcohol is classified as a carcinogen, contributing to various cancers. Chronic alcohol consumption can lead to memory loss and increase the risk of dementia. The loss of estrogen during aging creates a synergistic effect with alcohol on brain health. Inflammation is a common response in aging and is linked to estrogen loss. Women metabolize alcohol differently than men, making them more susceptible to its effects. Inflammation can be observed in various tissues, not just localized areas. Understanding the impact of alcohol on health is crucial for making informed choices. Postmenopausal women often suffer from bladder issues that are under-discussed. Vaginal estrogen should be a standard part of women's health care. Thin vaginal mucosa can lead to increased infections and complications. Preventative measures for osteoporosis should start early in life. Hip fractures are a significant health risk for older women. Mouth breathing can lead to various health issues, including sleep apnea. Strengthening the tongue is crucial for preventing aspiration and improving swallowing. Holistic health considers the entire body and its interconnected systems. Education and awareness are key to improving women's health outcomes. Regular health evaluations should include assessments of bone and muscle strength. Dr. Kennedy's Website Dr. Kennedy's IG Order my book "You Are Not Broken: Stop "Should-ing" All Over You Sex Life" Listen to my Tedx Talk: Why we need adult sex ed Take my Adult Sex Ed Master Class: Interested in my sexual health and hormone clinic? Starts February 2025. Thanks to our sponsor Midi Women's Health. Designed by midlife experts, delivered by experienced clinicians, covered by insurance. Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care. https://www.joinmidi.com Thanks to our sponsor Sprout Pharmaceuticals. To find out if Addyi is right for you, go to addyi.com/notbroken and use code NOTBROKEN for a $10 telemedicine appointment. See Full Prescribing Information and Medication Guide, including Boxed Warning for severe low blood pressure and fainting in certain settings at addyi.com/pi To learn more about Via vaginal moisturizer from Solv Wellness, visit via4her.com for 30% off your first purchase of any product, automatically applied at checkout. For an additional $5 off, use coupon code DRKELLY5. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Jill Harris discusses the relationship between osteoporosis and kidney stones, emphasizing the importance of calcium intake and hydration. She addresses a listener's question about managing osteoporosis while preventing kidney stones, highlighting dietary choices and the role of urine calcium levels. The conversation also touches on the significance of strength training for maintaining bone health as one ages.https://kidneystonediet.com/this-will-change-how-you-see-osteoporosis/TakeawaysOsteoporosis can lead to kidney stones due to calcium loss.Dietary choices, such as lowering sugar and salt, are crucial.Natural calcium sources are preferred over supplements.Plant milks may be beneficial but require further research.High urine calcium can indicate underlying health issues.Strength training is essential for maintaining bone health.Regular urine collections can help monitor calcium levels.Consulting a doctor about parathyroid health is important.Postmenopausal women need up to 1,200 mg of calcium daily.A balanced diet and exercise can prevent bone diseases.00:00 Introduction to Osteoporosis and Kidney Stones02:54 Understanding Calcium and Its Role11:41 The Importance of Strength Training for Bone Health——HAVE A QUESTION? _Leave us a voicemail at (773) 789-8764.KIDNEY STONE DIET® APPROVED PRODUCTSProtein Powders, Snacks, and moreWORK WITH JILL _Kidney Stone Diet®Kidney Stone Prevention CourseKidney Stone Diet® Meal PlansSUPPORT THE SHOW _Join the PatreonRate Kidney Stone Diet on Apple Podcasts or Spotify——WHO IS JILL HARRIS? _For over 25 years, Jill Harris has been a kidney stone prevention nurse helping patients reduce their kidney stone risk. Drawing from her work with world-renowned University of Chicago nephrologist, Dr. Fred Coe, and the thousands of patients she's worked with directly, she created the Kidney Stone Diet®. With a simple, self-guided online video course, meal plans, ebooks, and group coaching, Kidney Stone Diet® is Jill's effort to help as many patients as possible stop making kidney stones for good.

Are Conventional Medications Hurting your Bone Health? In this episode of the Longevity podcast, I an joined by Dr. John Neustadt, a renowned expert in integrative medicine, author, and speaker to discuss actionable tips on supplements, diet, hormone replenishment, and effective exercises to help maintain strong bones and reduce fracture risks. Valuable information for anyone looking to improve their bone health and overall well-being! Dr. Neustadt has dedicated his career to advancing the field of medicine through a holistic approach. He has authored multiple books and peer-reviewed articles, and his insights have made a substantial impact on our understanding of chronic diseases and aging. Dr. Neustadt's commitment to patient care and his innovative thinking make him a leading voice in health and wellness today.   Thank you to our sponsors for making this episode possible: Timeline: Use code NAT10 for 10% your order at https://www.timelinenutrition.com/shop/nutrition SOLTEC: Visit http://soltechealth.com/longevity to learn more and save $100 off your purchase using the code LONGEVITY. Experience the difference for yourself with a 60-day risk free trial. Bioptimizers: BiOptimizers: Go to bioptimizers.com/bionat and enter the coupon code bionat to get 10% off your order.   Find more from Dr. Neustadt: Website: https://www.nbihealth.com/  Facebook: https://www.facebook.com/nbihealth/  YouTube: https://www.youtube.com/user/NBIHealth  LinkedIn: https://www.linkedin.com/in/john-neustadt-nd-1553576/  Twitter: https://twitter.com/JohnNeustadt   Find more from Nathalie: YouTube: https://www.youtube.com/channel/UCmholC48MqRC50UffIZOMOQ  Join Nat's Membership Community: https://www.natniddam.com/bsp-community  Sign up for Nats Newsletter: https://landing.mailerlite.com/webforms/landing/i7d5m0  Instagram: https://www.instagram.com/nathalieniddam/  Website: www.NatNiddam.com    Facebook Group: https://www.facebook.com/groups/biohackingsuperhumanperformance   What We Discuss: 03:07 Limitations of Bone Density Tests 08:09 Dangers of Medication for Osteoporosis 13:30 Hormone Replacement Therapy for Postmenopausal Bone Loss 25:38 Impact of Medications on Bone Health 36:08 The Role of Hormone Replenishment 40:18 Balancing Calcium Supplementation 41:17 The Role of Calcium and Vitamin D 44:02 Understanding the Safety and Dosage of Calcium Supplementation 45:08 The Different Forms of Vitamin K2 49:34 The Limited Evidence for Magnesium, Boron, and Silica 56:43 The Potential Benefits of Vibration Plates and Exercise   Key Takeaways Bone density tests have limitations and do not accurately predict fracture risk. Fracture risk reduction should be the primary focus in treating osteoporosis. Hormone replacement therapy can effectively maintain and improve bone density in postmenopausal women. Proper nutrition, digestion, and inflammation management are crucial for bone health. MK4, a form of vitamin K2, has been shown to improve bone density and reduce fractures, while MK7 has not. While magnesium is important for overall health, there is limited evidence to support its role in reducing fractures. Exercise, including resistance training and functional exercises, can help improve bone health and reduce fracture risk.  

What if life after menopause wasn't something to fear or dread but instead a vibrant, empowering chapter where you can genuinely thrive physically, mentally, and emotionally? What if your healthiest, most fulfilling, and even most pleasurable years were still ahead? Today's guest is here to help us reframe the narrative around post-menopause and unlock the potential of this next phase. This week, episode 37 of Pleasure in the Pause is about unlocking the power of postmenopausal health and wellness! Are you ready to awaken your sensuality and feel more empowered in your body? Access the FREE Pleasure Upgrade Bundle at https://www.pleasureinthepause.com/gift.Nicki Williams is a qualified nutritionist, speaker, and author of the acclaimed "It's Not You, It's Your Hormones" and “Life After Menopause.” As the founder of Happy Hormones For Life, she has been helping women since 2014 to balance their hormones, reclaim their health, and feel better than ever. With a passion for empowering women to thrive, Nicki brings her extensive knowledge and experience to guide you through life after menopause with confidence and vitality.Highlights from our discussion include:Why stress management is crucial for hormone balance and overall health during the menopausal transition and beyond.Understanding the "feisty four" hormones as key to optimizing your well-being in midlife and beyond.How adopting an 80/20 approach to diet and lifestyle allows for balance, pleasure, and sustainability.Prioritizing rest, relaxation, and connection to nature as powerful tools for healthy aging.Embracing this next chapter of life with intention and focusing on whole-body wellness.The years beyond menopause hold immense potential for growth, fulfillment, and vibrant health. By embracing the wisdom and resilience you've cultivated, you can embark on this next chapter of your life with a renewed sense of purpose and joy. Remember, the best is yet to come - embrace this transformative time with open arms and a heart full of possibility.If you're seeking to reclaim your pleasure and vitality, join Gabriella at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.CONNECT WITH NICKI WILLIAMS:InstagramWebsiteBooksCONNECT WITH GABRIELLA ESPINOSA:InstagramLinkedInWork with Gabriella! Get immediate access to practical tools that help you feel more like yourself again during perimenopause and menopause with The Menopause Reset Journal today.

We're living longer than ever before, but for many women, the years post menopause are filled with unanswered questions and unexpected challenges.How do we manage new and lingering symptoms? How do we protect our bones, muscles, and brain health? How do we hold on to our energy, joy, and sense of self in a world that often overlooks us?The truth is, this stage of life is a huge opportunity. With the right tools and mindset, it can be a time to redefine who we are, what we want, and how we choose to age. That's what Life After Menopause is all about – helping you feel empowered and equipped to live well in the years ahead.You can learn more here; https://happyhormonesforlife.com/life-after-menopause

Building muscle during menopause takes a unique stimulus compared to PRE menopause and is also unique during peri and post menopause. Of course there's more. Are you trying to lose weight, gain muscle, prevent osteoporosis, reduce or avoid medication, do you have adrenal fatigue or long haul? In this episode I'll discuss the research on protein and call back to a recent episode about exercise volume for building muscle during menopause. Questions I answer in this episode: How have protein recommendations changed over time (then and now)? [00:08:00] What are women's protein needs during menopause? [00:17:30] What are the effects of protein on building muscle during menopause? [00:11:00] As a refresher, what is the resistance training volume for pre, peri and post menopause? [00:19:50] How important is recovery—and are you doing it right? [00:30:20] Based on RDA (Recommended Dietary Allowance), protein consumption is 0.8g per kg (of body weight) per day. This is about 55 grams of protein for a 150-pound woman — but that's only enough to maintain nitrogen balance and prevent deficiency in sedentary women. It is not enough to help you build muscle. Let me explain why that is true. The reason for that recommendation is important to understand. As you age, anabolic resistance increases, meaning you need more protein and stimulus for muscle protein synthesis. More emerging research indicates “that amount may no longer be an appropriate recommendation.” That statement was the conclusion of a  2020 systematic review and meta-analysis addressing the protein needs of people who are exercising and/or trying to lose weight.  Researchers concluded, “The RDA for protein of 0.8g of protein / kg / day may no longer be an appropriate recommendation.” Scientific Research on Building Muscle During Menopause An interview with Bill Philips, PhD, in May 2024, on the What, When & Why to Exercise for Women 40+, with his primary research focus shifting to that of midlife women, he could already say that the single simplest way to support fat loss and optimal body composition is to increase protein even if you didn't change your caloric intake. A 2022 meta-analysis recommends adults should consume nearly 1.5g of protein / kg / day of protein to maintain and/or augment muscle strength along with resistance training. Small-statured women with low reserves may need even more to prevent muscle loss, strength decline, reduced activity, and increased risk of falls or disease. For active women, whether you are competing or you are intentionally exercising more than 3 times a week for a purpose of achieving fitness or reduced fatness, the 2023 International Society of Sports Nutrition recommends at least 1.5g of protein / kg / day and maybe even more. “Daily protein intake should fall within the mid-to-upper ranges of current sport nutrition guidelines (1.4–2.2 g of protein / kg / day) for women at all stages of menstrual function (pre-, peri-, post-menopausal, and contraceptive users) with protein doses evenly distributed, every 3 to 4 hours, across the day.” One thing to note is that hitting the “ballpark” is not enough. You need to meet the threshold. Whether it's reaching muscle fatigue, breathlessness during exercise, or consistent protein intake, falling short means missing the full benefits. For women in perimenopause, it requires less stimulus than for postmenopausal women with the most hormone decline and most advanced age contributing to anabolic resistance. (inability to gain lean muscle). Training and Protein:  Building Muscle During Menopause When it's recommended to have at least two total body resistance training sessions a week, that minimum may best serve: Women in perimenopause Those with adrenal fatigue or long haul Time constricted Others who require a longer recovery period And within those workouts, there needs to be adequate volume achieved with a number of muscle groups, sets, and weight to muscle fatigue. Postmenopausal women require greater stimulus to build lean muscle. You can aim for 4 HIIT sessions per week and increase resistance training volume if 2 sessions aren't enough, provided protein, sleep, and stress are optimized. The biggest obstacle to exercise is time. The second though is time for recovery. An aging muscle needs more stimulus overload. It needs greater recovery to repair the microtears that are innate to workout out intensely. If you're an active 150 lb postmenopausal woman who wants to improve lean muscle and decrease fat, to reach the upper range of protein that would be 2.2g of protein / kg body weight / day. 68 kg x 2.2 g of protein = 150 g of protein To get this, here is a sample protein consumption per day 50 g x 3 meals 35-40 g x 4 meals For strength training, 15-minute weight training sessions likely lack adequate volume in a session, unless focused on one muscle group. This is useful for beginners learning form or those with adrenal stress or special conditions but may not provide adequate stimulus for muscle growth. In a minimum, do 5-8 sets with some rest between puts you at a need for 15-20 minutes. That's no warm up and cool down. Again, that's a single muscle. Even 30-minute sessions may not allow you adequate stimulus for your muscles. Where to Find Support for Building Muscle During Menopause Personal trainers and fitness instructors, even with degrees or certifications, lack training on menopause and hormonal influences. They're entering the field with the minimum viable knowledge. But eager to help solve a problem like weight loss or earn money, they may only do as well as they know. Advice or training from a 20, or 40-something woman showing what's working for her may not work for the goal you have and the hormone status you've got. Someone trained solely in nutrition on clinical recommendations may not necessarily be up to date on contemporary needs of older women and their hormonal status. It's coming, but until we start demanding it, here's how to advocate for yourself: To determine protein and exercise needs consider: Activity level and goals Current hormone status What you've been doing and how it's working 2.2 g protein per kilogram for active and or postmenopausal women Volume of exercise – from sets of major muscle groups – increases with age Recovery from exercise is as important as the exercise itself In an upcoming podcast, I'll share how to start increasing protein, how to plan a day of protein and position it for support of muscle protein synthesis and blood sugar control. Watch for masterclasses monthly where we deep dive with our members References: https://pmc.ncbi.nlm.nih.gov/articles/PMC7231581/ https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-022-00508-w https://pmc.ncbi.nlm.nih.gov/articles/PMC10210857/ Other Episodes You May Like: My Post Menopause Workout Week Experiment | What I'm Doing: https://www.flippingfifty.com/my-post-menopause-workout/ Protein Consumption in Menopause (Revisited): https://www.flippingfifty.com/protein-consumption-in-menopause/ Resources: Stronger: Tone & Define https://www.flippingfifty.com/get-stronger/ Flipping 50 Membership: https://www.flippingfifty.com/cafe/

Did you know that up to 68% of postmenopausal women are suffering from a hidden health crisis that could be silently undermining your body's most critical functions? In this eye-opening episode of the Dr. Josh Axe Show, we're diving deep into the world of calcium – the mineral your body desperately needs but might be critically lacking. Dr. Josh Axe reveals the shocking truth about calcium deficiency and its surprising impacts on your overall health. You'll discover: Uncover the top 10 alarming signs of calcium deficiency that most people completely miss Discover why calcium is SO much more than just a bone-building nutrient Learn the best and worst forms of calcium supplements (and which could actually harm your heart) Explore natural, food-based strategies to boost your calcium levels instantly Find out which nutrients are crucial for maximum calcium absorption Understand how calcium impacts not just your bones, but your muscles, nerves, and heart Get expert insights into testing and preventing calcium deficiency Don't miss this game-changing episode that could transform your understanding of nutrition and help you prevent potential health risks. By the end of this podcast, you'll have a comprehensive roadmap to optimal calcium health, straight from one of the nation's leading natural health experts. Tune in now and take the first step towards a stronger, healthier you! #calciumhealth #naturalnutrition #wellnesstips Want more of The Dr. Josh Axe Show? Subscribe to the YouTube channel. Follow Dr. Josh Axe Instagram Twitter Facebook TikTok Website ------  Staying healthy in today's world is an upstream battle. Subscribe to Wellness Weekly, your 5-minute dose of sound health advice to help you grow physically, mentally, and spiritually. Every Wednesday, you'll get: Holistic health news & life-hacks from a biblical world view Powerful free resources including classes, Q&As, and guides from Dr. Axe The latest episodes of The Dr. Josh Axe Show Submit your questions via voice memo to be featured on the show → speakpipe.com/drjoshaxe  ------  Links:  https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/#:~:text=Postmenopausal%20women,loss%20after%20menopause%20%5B1%5D.  https://www.bmj.com/content/342/bmj.d2040#:~:text=The%20size%20of%20this%20increase,substantial%20population%20burden%20of%20disease%2C  Ads: Even if your bloodwork looks "normal," your symptoms could point to Cell Danger Response (CDR). Discover how to break free from CDR and unlock your full potential at beyondbloodwork.com.

In this episode of the NASP Podcast, Sheila Arquette, President & CEO of NASP, visits with Mary Oates, MD, US Medical Lead, Bone Franchise with Amgen, to discuss post menopausal osteoporosis and what clinical pharmacists can do to support patients.  

Drs. Bilezikian and Cosman discuss the use of anabolic agents in patients with postmenopausal osteoporosis, including the benefits and challenges of utilizing anabolic agents as well as the need for careful patient selection, education. and monitoring. They also review the mechanisms of action, clinical trial data, and rationale of treatment sequencing.

Drs. Cosman and Bilezikian discuss the optimal use of denosumab in patients with postmenopausal osteoporosis and examine how RANK ligand inhibitors differ from bisphosphonate medications. They also share insight into how they personalize therapy with denosumab in patients with postmenopausal osteoporosis.

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There is a time to bleed. And there comes a time when all bleeding should stop. Postmenopausal bleeding is not normal.Forward.

The sixth episode in the HRT after breast cancer series features Lisa Colclough and Helen Widner, two breast cancer patients who decided to go down two very different routes. Helen decided to start testosterone pellet therapy whilst being on aromatase inhibitors, whilst Lisa decided to restart her HRT soon after her breast cancer treatment. This mini-series explores hormone replacement therapy (HRT) after breast cancer, a controversial and emotive subject. The conversation focuses on the further understanding of risks and benefits of HRT (hormone replacement therapy) or also MHT (menopause hormone therapy), the emotional impact on patients, and the different views among medical professionals. The goal is to provide understanding for patients seeking HRT after breast cancer and insight for doctors on how to move forward without robust evidence. Dani Binnington, host of the Menopause And Cancer podcast, and founder of the not-for-profit organisation Menopause And Cancer has spoken to hundreds of women who feel like they are in a void and have nowhere to turn to in discussing this difficult topic. Welcome to our HRT after breast cancer series.In this episode we discuss:What was the hardest part about menopause for each of them?We explore why Helen and Lisa thought about using hormone replacement therapy after their breast cancer diagnosis.Lisa discusses not being heard as a patient and why she was made to take action without her doctor's support. Helen discusses the hurdles to accessing testosterone pellet therapy in the UK.Episode Highlights:00:00 Intro.05:13 Postmenopausal risk versus benefits of aromatase inhibitors.08:36 Difficulties with tamoxifen, switched to HRT.11:58 Brain fog impacted daily life, resembling dementia.28:47 Desire for informed discussion about medical decisions.35:45 Research led to considering testosterone implants with AI.Connect with us:For more information and resources visit our website: www.menopauseandcancer.org Or follow us on Instagram @menopause_and_cancerJoin our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

Too busy to read the Lens? Listen to our weekly summary here! In this week's episode we discuss: In this week's issue The exposure to GLP-1 receptor agonist treatment may be associated with a lower risk of developing glaucoma in those with type 2 diabetes. Refractive surgery was shown to be a viable solution to help children with neurodevelopmental challenges who struggle with glasses or contact lenses. Postmenopausal hormone therapy was shown to negatively influence the pathophysiology of glaucoma development. 

It’s Monday in America, time for The World’s Greatest Political Podcast: THE LEFT SHOW! This week, J.M. Bell,  Tiffany and JC talk Kamala Harris, boy howdy! Negative Nancy, weirdos, Project 2025, migrants, JD Vance’s negativity, and The Postmenopausal Female. #655 The World’s Greatest Political Podcast – The LEFT Show  Apple Podcasts, Spotify, and AMAZON too! THE A BLOCK COMMA […]

TIME STAMPS: 00:14 Coach Maili (IG = @healthcoachmais) is a certified keto & carnivore online coach through the Emmerich's program; certified in applied quantum biology through the Institute of Applied Quantum Biology; specializes primarily in helping women over 40 lose weight and optimize their health! She uses a meat based approach to encourage her clients to address their circadian rhythms. 01:52 YAKS - LION DIET approved! Yaks are a “primal” ruminant that still inherits all of its senses, intelligence and agility required to survive in harsh climates and able to fend off most predators that would consider a cow or calf as an easy meal. 06:01 Maili's SEASONAL meat-based diet! 14:29 Davina, from Ireland: “Early bird, owl and circadian cycle. Why people wake up at the same time every night? Do people that work shit [I think she meant to type “shift!”] - living outside the circadian cycle - how does this affect peoples lives? Can you reverse aging after shift work?” 22:22 All about SUNLIGHT and how to benefit from the full spectrum of natural light! 27:09 The impact of NIGHTTIME EATING and its affect on your sleep quality. 31:33 How the Carnivore diet restores your THYROID HEALTH. 36:06 Detrimental effects of THYROID MEDICATIONS and advice on getting off of them. 42:00 What is CIRCADIAN/QUANTUM BIOLOGY?!?! 46:02 Advice for burning stubborn fat for POSTMENOPAUSAL women.  54:34 BAD COACH BUSTED - the Carnivore Diet is not a fad! @carnivorejt, @serena.carnivore, @ryan_healthwealth, @hikmat_jwanroy, @danielleluvsher6 57:14 How to do a “FULL BODY CHECK” to start with your head and identify how every part of your body is feeling!!!  01:03:07 Kelly Hogan's CARNIVORE OOPSIE CAKE! 01:10:04 How Maili's ENDURANCE TRAINING drastically improved since embracing a proper human diet. 01:15:48 DIY SKINCARE ?! How to make your own tallow-based skincare products at home! 01:07:02 Why don't carnivores sunburn? 01:19:04 Inside scoop on Maili's CIRCADIAN METABOLIC RESET GUIDE! (details on her IG!) Looking for some mid-workout entertainment and motivation? Stream The SuperSetYourLife.Com Podcast from any platform. We publish every MONDAY and FRIDAY!

What is the single best thing we can do for our health? What is it that makes the biggest difference? What has the biggest return on investment? Biggest bang for our buck? In a study, people with arthritis who used the "Magic Pill" for 1 hour 3 times per week decreased their pain and disability by 47%. Older patients who did this decreased their progression of Alzheimers and dementia by 50%. For those patients who had diabetes, it reduced their progression by 58%. Postmenopausal women who had 4 hours a week of this treatment had a decrease in the risk of hip fracture by 41%. Right now we hear A LOT about anxiety in our culture.  Many people experience symptoms of anxiety. This treatment reduced anxiety by 48 percent. Of patients suffering with depression, 30% were relieved with a low dose of this treatment and it was bumped up to 47% relief as they increased the dose. Following a group of Harvard alumni for over 12 years those who got the treatment decreased their risk of death by 23% than those who didn't. It is the #1 treatment of fatigue. And this treatment has been shown over and over again to improve quality of life So what's the treatment?! What's the magic pill?  Exercise!!! Mostly Walking. I'm going to say just MOVEMENT! In this episode we discuss the many benefits of movement and how to get more into our day! First, start where you are!! Notice what you are doing! Second, start small! Increase by even just thinking about movement! And third, introduce some new ways to move! I talk about my new favorite: REBOUNDING! Movement is the ONE THING that impacts every aspect of our lives, physical, mental, emotional, social, and spiritual. It truly is the Magic Pill! Listen in for more and follow the links below! 23 1/2 hours DocMikeEvans Hood Fit 15 Minute Trampoline Routine Jump and Jacked 2023 Top Hits Dance Party Rebounding Hotel Maid Study  

I'm sure Carolyn Parker could have become a household name if she had wanted. In her 20s and 30s, Carolyn was one of the most talented all-around mountain athletes in the U.S. — she was one of the first women to become an AMGA certified Rock Guide, climbed 5.12 trad at altitude

Dr. Susan V. Bukata and Freda B. Hannafon, NP‑C, discuss the role of nurse practitioners and physician assistants in the care of patients with postmenopausal osteoporosis, including diagnosis, management, and collaboration with endocrinologists and orthopedic surgeons.

Meet Holly Rockweiler, CEO of Madorra. This episode explores the transformative journey of Madorra from a Stanford Biodesign fellowship project to a pioneering force in women's health aiming to revolutionize the treatment of vaginal atrophy and dryness without hormones. Holly's story is not just about groundbreaking medical devices, but also about the passion and determination that drive the quest for better healthcare solutions. Through engaging storytelling, this episode unveils the challenges and triumphs of bringing novel technologies to market, the power of female leadership in STEM, and the broader impact of MedTech on improving lives.  Guest links: www.madorra.com | https://www.linkedin.com/company/madorra-inc-/ | https://www.facebook.com/MadorraMedical | https://twitter.com/MadorraMedical Charity supported: Equal Justice Initiative Interested in being a guest on the show or have feedback to share? Email us at podcast@velentium.com.  PRODUCTION CREDITS Host: Lindsey Dinneen Editing: Marketing Wise Producer: Velentium   EPISODE TRANSCRIPT Episode 033 - Holly Rockweiler [00:00:00] Lindsey Dinneen: Hi, I'm Lindsey and I'm talking with MedTech industry leaders on how they change lives for a better world. [00:00:09] Diane Bouis: The inventions and technologies are fascinating and so are the people who work with them. [00:00:15] Frank Jaskulke: There was a period of time where I realized, fundamentally, my job was to go hang out with really smart people that are saving lives and then do work that would help them save more lives. [00:00:28] Diane Bouis: I got into the business to save lives and it is incredibly motivating to work with people who are in that same business, saving or improving lives. [00:00:38] Duane Mancini: What better industry than where I get to wake up every day and just save people's lives. [00:00:42] Lindsey Dinneen: These are extraordinary people doing extraordinary work, and this is The Leading Difference. [00:00:51] Hello, and welcome back to another episode of The Leading Difference podcast. I'm your host Lindsey, and I'm so excited to introduce you to my guest today, Holly Rockweiler. Holly is co-founder and CEO of Madorra, a woman's health company dedicated to changing the treatment paradigm for vaginal atrophy and dryness. She co-founded Madorra as a spin out of the Stanford Biodesign fellowship, where she implemented ethnographic research to identify unmet clinical needs and define user market and product requirements for solutions and women's health, urology, and infectious disease. Prior to Biodesign, she worked as a Senior Research Scientist at Boston Scientific, where she developed therapies to enable more efficient care for patients living with heart failure. Her preclinical and clinical research has led to more than 20 pending and issued patents. Holly holds an MS and a BS in Biomedical Engineering from Washington University in St. Louis. Welcome, Holly. It's so wonderful to have you here today. Thanks so much for joining us. [00:01:49] Holly Rockweiler: Thanks for having me. [00:01:51] Lindsey Dinneen: Yeah, absolutely. Well, I was wondering if you wouldn't mind starting off by telling us a little bit about yourself and your background and maybe what led you to the medtech industry. [00:02:02] Holly Rockweiler: Sure. So let's see. So my background is in biomedical engineering. I majored in biomedical engineering. Maybe I can say why, like I, I knew that I wanted to be an engineer. I felt like, well, first of all, as a woman in math and science growing up, when I did every teacher told me to be an engineer, but I didn't really know what that meant until I got to college, but I liked it. Pursued engineering and I started undecided, but very quickly found that I was, most just excited about the problems in the biomedical engineering field. I remember one of my classes was like "calculate the torque of a drill on a tooth," I was like, "Wow, that's amazing. I think I found it." [00:02:41] So majored in biomedical engineering, got my master's and bachelor's at Wash U in St. Louis, and then I went to work for Boston Scientific. And so they are a medical device company. And so that's obviously how I got into it, but I did seek that out. When I was thinking about what did I want to do, I thought about... chemistry was never an area I felt very strongly about. I liked stuff I could hold in my hands and really conceptualize. And so I think that's what led me more in the device road and then had a incredible opportunity to work at Boston Scientific. [00:03:15] And so I worked there for several years in their implantable cardiac division. So that's pacemakers and ICDs, working in the research department. So that was also really cool because we were on the front end helping to define the next generation products and was able to also work very cross functionally. So just because research conceived of an idea didn't mean it was going to be in the product development had to help it go forward, and obviously we were keyed in very closely with the marketing team to understand. What were the needs that we were solving. [00:03:45] So it was an incredible introduction to our industry. And then I decided that I wanted to try a smaller company. There was just some broader themes of working in a large company that didn't totally jive for me. And so I was like, "Well, I don't know the first thing about startups." So I had heard about the Stanford Biodesign program, which is where I went next. And the company that I started, Madorra, is a spin out of that program. [00:04:14] Lindsey Dinneen: Wow. Okay, so your path is really cool, and I love that you are an engineer, and I love your passion behind it too, just hearing you talk about that one random problem and your excitement about it. I adore that. I do. Because that is not my leaning. So whenever I hear somebody just get really excited about that kind of thing, I'm like, "Yes, tell me more." [00:04:40] Holly Rockweiler: Well, then you're in the right field too, I would say. [00:04:42] Lindsey Dinneen: Indeed. Indeed. Indeed. So, yeah. I'm just curious. Okay. So, so going back just a little bit, you started off at Boston Scientific and kind of developed this appreciation for the medical device space and innovation. And then with Stanford Biodesign, can you tell me a little bit about being a part of that and then how you were able to spin off into your own company? I mean, that's not, that's like a one sentence thing that you put in there, but I know that it took a lot of work, and I'd just love to hear about that process, and your experience. [00:05:17] Holly Rockweiler: So, absolutely. So, the Stanford Biodesign program has many different facets. I was part of the fellowship, but they also have classes they teach and books and online resources. And then other universities have kind of sister programs around the world, frankly. So I was very interested in joining the program, like I said, to kind of-- what I was telling myself was like a way to dip my toe in the water of what a smaller company would be like. Now that's not at all what Stanford pitches the biodesign program as. Really what it is a an academic training program for an innovation process. And that's what they teach you. Now there are a lot of companies that end up spinning out of it. [00:05:56] And so I thought, "Well, maybe, like I said, this is a way to dip my toe in the water, but also if I decided to come back to a larger company setting, this skill set still would be highly useful given what I want to do in my career. So that's what I set out to do. And so the program I love, I think is fantastic. It's as described initially, it's this innovation process and they teach you that in a very hands on way. So first you start with really understanding and building a list of unmet needs, and so that starts by looking for problems in Stanford Hospital. You kind of have this unfettered access as an engineer. It was the 1st time I had that, you know, observe and ask questions and talk to physicians and patients and other health care professionals and then. you end up with, obviously, a long list of problems that you can find, just like any, anywhere in the world, right? This could happen. But also this, in healthcare, it happens. [00:06:55] And then you translate those problems into what the program calls need statements, to really-- there's a lot packed into that, but once you have those, then you spend the bulk of the program actually learning how to filter that long list of problems down into a couple key top unmet needs that you're working on. And so again, this is their goal is academic. They want to teach them their product is the people. They want to teach people this process and have them go out and share this process and use it to be successful in whatever, you know, vein they end up going down. [00:07:32] And so I was like, I was just having a conversation with my husband this weekend. I was like, we were talking about something interpersonal and I said, "Well, the unmet need here really is..." So it certainly has, you know, I've drank the Kool Aid completely and love to share it. So, but anyways, so, but what happens because you're working hands on these projects you very often, which was the case for myself and my co founders, by the end of the year, you may have something that you're pretty passionate about. [00:08:00] And so what has now become my about me description is working in women's health. I had no idea how passionate I would be about. I feel like I kind of backed my way into it, but now kind of reviewing that history, it's like, "Oh, maybe I was always kind of destined for this given my interest in, in, you know, activism." So kind of combining all of this together is what led us here. So, spinning it out was a consequence of having a lot of hard work with my team throughout the year. And we had other projects too, but this became the one that kind of survived every stage gate. And we ended up spinning out. into the company, Madorra. [00:08:42] Lindsey Dinneen: Wonderful. Well, thank you for sharing a little bit about that. And also, I love the crossover into real life, not that's not real life, but I do your daily life as well. Oh my gosh. That's great. I'm going to start doing that. Okay, so can we talk now a little bit about your company and the product that you've developed and where you're kind of looking to take it in the future? [00:09:05] Holly Rockweiler: Certainly. So, again, being born out of Stanford, we started with an unmet need around creating a treatment for vaginal dryness and atrophy for postmenopausal women that didn't rely on hormones. So this is a problem that I had never heard of before we literally met patients with this problem and talk to providers about this problem. And as we started researching, "Wow, up to 75 percent of all postmenopausal women are dealing with some, you know, degree of this. How have we not heard of this before?" That is a striking number of people. [00:09:39] And so as we continued to do our research, very quickly learned the gold standard treatment here is hormone therapy, but even though this market is huge, only 7 percent of the market is using hormones today. And so that... there's a lot of reasons why, but that's really what motivated us to say, "Wow. There needs to be another option." Because if you don't want hormones right now, the only other FDA cleared product or category for treating this are over the counter lubricants and moisturizers. And those are like, both of the products that exist today are really, those categories are really great, but they're not enough. [00:10:16] And again, with 43 million women in the United States with this problem, like we need more than just those two categories. And it really felt like no one had really looked at this. I mean, hormones, again, are a good solution for the patients who want to or can use them. But for patients who can't, for example, breast cancer survivors, they're stuck with, you know, just kind of subsisting off these over the counter products that really are not enough when your case is more moderate or severe. [00:10:43] And so we said, "Well, let's look at this and see if there's a better way or, you know, something we could combine," and ended up developing the idea for what is now the main product that we're developing at Madorra, which is a home use device that uses ultrasound to really rekindle the body's natural lubricating process. And so our whole goal has been to be very supportive of the other products in this category. We think hormones should be used more often than they are, frankly, but that women shouldn't have to make a compromise. If they don't want to use hormones, then they should have other options, and that's where we come in. [00:11:21] So our product, we will, it's not on the market yet. We're working towards that, but when it's out there, what we envision is a prescription happens from the gynecologist, and then the patient uses the product at home on a regular basis to, like I said, kind of revitalize that natural process. And what patients have told us they like about this is that It is restarting their own natural lubrication rather than some exogenous hormone or chemical. And there's less of a kind of a goop ick factor, you know, than having to use these over the counter things, which again, they like say that not to say that those don't have their place because they absolutely do, but it's not enough. [00:12:01] And so, we're pre FDA clearance, but we have a breakthrough designation from FDA. So that's feather in our cap and will help us get through the agency more expeditiously. And we have done several clinical trials and look forward. We've published one of those trials in our first manuscript, and we look forward to putting more of our data out there to help really lay the foundation to say, "Yeah, ultrasound is an appropriate approach to treating this and has virtually no side effects." So this should be a great option to be available to as many people as possible. [00:12:36] Lindsey Dinneen: Oh, that is incredible. Oh my goodness. Well, yeah, first of all, again, you know, it boggles my mind and it probably shouldn't anymore, but it continues to when you tell me statistics like this, that 75 percent of women who've are in this situation or have this concern or whatnot. And you're just think, you're addressing it in a way that's so innovative. And yet that hasn't really been addressed yet and it happens again and again with healthcare for women. And I'm wondering, you know, you mentioned earlier being very passionate about this. So I'm wondering if you can speak a little bit to fem tech and women's health and how you're involved in helping to push the conversation forward 'cause I know that can be a little challenging at times. [00:13:23] Holly Rockweiler: Absolutely. Yeah. And well, it's super fascinating too, because we spun out of Stanford in 2014. So we're coming up on 10 years here and the conversation is so different today than it was just, well, just 10 years. I mean, it was a decade, but it feels like yesterday. Like a lot has changed. When we first were starting Femtech wasn't a hashtag, like that was not a conversation. And people would say like, "Ooh, that's a niche." Yeah. And that doesn't happen anymore, which is really great. So while that's, that's certainly progress, so we should acknowledge that and be proud of everyone who's worked towards creating that progress. So I think what's been interesting, though, it's like the pace of progress, maybe? [00:14:09] So it's very exciting to know that there are, for instance, obviously I spend a lot of my time fundraising, there are women's health focused venture groups now. They, that's fantastic. That we just need bigger and bigger funds to be focused on that. We just need more and more We need more of everything, right? I mean, one of many things I've been very surprised to learn is how little training physicians get on menopause specifically. And so that has to change. And so there's just like a lot. [00:14:40] And so to the point of activism, like there's a lot to say, and so I think, it's... being raised by parents who are feminists, that helps, I think, me just start by saying, "Well, no, this shouldn't be . We can do better, and we will do better." So that's helpful, and I think that's also what really keeps me going-- obviously, every job is hard, and in our startup world, this is certainly a lot emotional rollercoaster. And so when I think about when I have harder days, it's like, "Wow." We've had patients tell us, for example, "I can't believe you're even paying attention to this. I can't believe you're listening to what I have to say." And so one, that's disturbing that's, as little as it's needed to make someone feel better. Secondly, it's "Wow, we can have such an impact by just being out there." So like the fact that we exists, I always think is helpful and that we do things like this and have open conversations about vaginal health for an aging population. [00:15:39] I will also say that, a year ago at the Super Bowl last year, there was an ad for a hot flash drug. And so that's like, you know, the world stage, menopause is being discussed. That was not happening 10 years ago. There is real progress being made. The last thing I want to say is that one thing I, I have also really appreciate about working in women's health and how supportive everyone is of everyone else. Every, anytime, even like our closest competitor, when I met their CEO, she was wonderful to me and, you know, shook my hand and said, "How can I help you?" And it's like, "Where else does that happen?" That's incredible. I think 'cause we all see there's a lot of work to be done. We can't do it alone. We want to support each other. [00:16:19] Lindsey Dinneen: Oh, I love that. Yeah, that is something that I have really admired and appreciated about the medtech industry. I think because people are curious, and their mindset is very innovation problem solving, "how can I help?" It seems like even with competitors. Yes, we're maybe vying for similar people to sell to. However, there's this idea of camaraderie, which I don't find in a lot of industries. So yeah, to your point, I think it's really helpful to have those allies in the space because that's, it's a little different. [00:16:53] Holly Rockweiler: Totally. [00:16:54] Lindsey Dinneen: Yeah. So yeah. And I, I love what you were saying about these conversations are happening more and they're becoming more mainstream and less embarrassing or taboo, which sounds hilarious because it's 50 percent of the population or whatever. But anyway, the point being, it is exciting to see this continue to move forward. And I'm wondering, even as a company, obviously your next big hurdle is getting that FDA approval, going to market and whatnot. But as you continue down the road, what other kinds of problems are you looking to solve? Or are you not even there yet? This is just like, "Let's start here. We'll get into that later." [00:17:38] Holly Rockweiler: Yeah. No, it's a great question. I think like what kind of harkening back to the just the prior question about the community of women's health. It's like you can't go a day without finding five other problems that you want to solve. So absolutely. I think that yeah, I mean, like with Madorra, we are very focused obviously on this technology and developing it, but we certainly have a roadmap of where this technology could go and other ideas of where to take it. And then what I find fascinating is that there is no menopause "brand." Like no one owns menopause, which I, if I worked at Procter and Gamble or Kimberly Clark, I would be like, hopefully 15 years ago, I would have said, "Guys, let's do it." So it's very surprising to me. So I think there's a lot of opportunities. [00:18:23] So would Madorra be that brand? I would love that. We would need a lot of other products that come together with us. So what I really see is a roll up in the future of multiple women's health products together. So I think that's exciting. In terms of, also a little bit maybe more broadly speaking, and this is no surprise to you, I'm sure, or your listeners, that reimbursement is an area that needs massive... I don't know, I was gonna say like overhauling, but that sounds pretty drastic. [00:18:53] It just needs to be clearer and cleaner and simpler. In terms of a process. I'm not saying that we should be handing out reimbursement left and right, but any investor conversation I have is, we go there immediately. And it's like, "Okay, what's the path? Well, why do you think that's going to happen?" And when, you know, X, Y, Z, other company had this happen and I can, we have a good strategy. I think I have a good pitch, but, oh, just... it just is an area that is really murky, and given that's a really critical piece in any business is how are you going to get paid? That's an area that I think there's a lot of good work being done. It just moves at a pace that is painfully slow. I don't have anything insightful to say about it except that, thank you to the people who are working on it, and I support you. I think the TCEP program is a step in the right direction, but even that has been very slow, and not without its own issues, so. [00:19:53] Lindsey Dinneen: Yeah. Still work to be done, but thankful for the work that is being done. [00:19:58] Holly Rockweiler: Well said. Yes. [00:20:00] Lindsey Dinneen: So, yeah, so, okay. So obviously, listening to you speak about your background and about the industry, it's really clear how passionate you are about this. And I, I wonder if there are any moments or series of moments that stand out to you as kind of confirming that, "Yes, I am in the right place at the right time. I'm here for a reason." [00:20:23] Holly Rockweiler: Oh, good question. Yeah. I'm trying to think like, there are plenty. There's plenty of times in the moment where it's like, "Of course, yes." And then there's like quickly like, "Oh, what's the next fire I'm trying to put out?" So it's hard to really think. I wish I had a super answer right away. I'm thinking, I guess I always come back to the patient and so like hearing-- so we've done some clinical trials in Australia and various team members of ours have gone over and been able to support the trials and be a part of them. And just hearing the stories that they bring back, it's just like, "Yes, we have to keep doing this." [00:21:01] One of our employees was there and came back with a couple stories of one of them was just like after the study visit, the patient was speaking to her and was saying, "It's a conspiracy of silence. This is a huge problem. So many of us are suffering. We're so glad you're here." And then it's other things like we did, for instance, a human factors study that was really helpful to us. And we learned a lot from, and in that study, it was like patients came in to do mock use of the device so we could improve our training materials and also, you know, all parts of the user experience. And it was amazing to me. [00:21:38] So patients, you know, participants, I should say, got zero benefit theoretically about being in that study. It was all for us to learn how to do this better. I mean, we did compensate them, but marginally, right? And so many people wanted to be in that study. And even if it was the early on patient who had-- I'm going to make it up. I had like, "Oh, the user manual didn't make sense to them" or something. They were still like, "I'm so glad to be here to help you because this product needs to be out there." And so it's like, " This is incredible. Yes!" And that part is really rewarding to me. [00:22:09] For me, it's the patients and their feedback and just their enthusiasm. And then, I was gonna say also for the healthcare providers too, we have a lot of wonderful physicians that we work with and their support has been helpful. Like for instance, as I mentioned, we put a paper out there and one of our clinical advisors was highlight, or I think a couple of them highlighted to us that like, "We need to do a second paper on a specific subset of that data because it's super valuable and hasn't been out there before," which may be the clinicians do that for everything they do 'cause they, they know the scene and they know what needs to be published, but it just felt like we have a lot of people who really are rowing in the same direction and really want to make an impact like we do. [00:22:49] Lindsey Dinneen: Oh, wow. Yeah, that's incredible. Thank you for sharing those stories. I think, you know, as you alluded to earlier, because your role has so many components, because that's the space you're in and you've got so much going on, I think it's really compelling to have something to hold onto when it gets hard and go, "You know what? I remember that patient who was so thankful just to have the opportunity to be a part of it and just wait until this gets into the hands of so many more." [00:23:15] Holly Rockweiler: Totally. [00:23:17] Lindsey Dinneen: Yeah. Yeah. Yeah. And so for you, you know, you obviously have a very strong background in engineering and innovation. How was it for you going from that to also now being an entrepreneur, and having a business, and having to also learn all of those skills as well. How was that transition? [00:23:42] Holly Rockweiler: Fun. I think that-- there's a lot of personal growth, and I've learned a lot about myself and what where I find passion. So I think there's definitely a lot of hard parts too, but what, well, one thing is that I think there's also a heavy dose of naivete that was important. I didn't know what I didn't know. And so here I am 10 years later I think, you know, in the beginning too, I was not... what do I say? I wasn't convinced, yeah, I wasn't convinced that I could be a CEO, that I should be or could be. And so I think that was, and is maybe still a definitely a continuous journey to it. So why is, why did I think that? What does that mean to me? And where am I now? That's been certainly a learning process. [00:24:31] But that's also like why I said fun, because I, I get to do such a variety of, like, I get to have this opportunity to speak to you on this podcast. I get to work with our clinical advisors on a paper. And I also get to apply for grants. And there's a lot of hard things that come with all those things, but I feel like it's been a really, I don't know, just an incredible opportunity to have a job that It requires so many different things. It also requires me to do financial modeling, which I'm terrible-- well, was terrible at-- have learned and much better at, but also don't really love doing. [00:25:04] So it teaches you what, what you might look for in a future chapter of your life as well. But I'm someone who really thrives on, I have a very curious mind. So trying new things and figuring out new things. And that, I think that curiosity is well satiated by an entrepreneur's life. The managing your own psychology is really difficult, but that's why you have a great community of people around you, both within the entrepreneur community and outside of it. [00:25:36] Lindsey Dinneen: Oh my word. I think I just need to take what you just said those last couple of sentences and just make it into a quote because that was so well articulated. [00:25:45] Holly Rockweiler: Oh, thank you. [00:25:47] Lindsey Dinneen: I cannot think of a better way to describe that journey. So thank you for, but also thank you for being vulnerable and willing to share that, because it is such a journey and it is a learning curve, but kudos to you for embracing it with an attitude of fun, like, "Let's just learn something new and it might not go great the first time, but that's okay. I'll try again." [00:26:10] Holly Rockweiler: Yeah, I was thinking, I was like, "Well, if any of my investors are listening, I have gotten really good at a lot of these things, so y'all don't need to worry." But I do think that's maybe the blessing and the curse of being a first time entrepreneur. So I think, you know, there's certainly a lot of benefits for having done it before and knowing exactly what to expect. But I think with anything in maybe any regulated industry, or maybe any startup, really, there's always going to be curveballs. So that keeps you excited. [00:26:41] Lindsey Dinneen: it's never boring. It keeps you on your toes. There's at least that. [00:26:45] Holly Rockweiler: Yes, absolutely. [00:26:47] Lindsey Dinneen: Excellent. Pivoting the conversation just for fun. Imagine that you were to be offered a million dollars to teach a masterclass on anything you want. It can be within your industry, but it doesn't have to be. What would you choose to teach and why? [00:27:04] Holly Rockweiler: Oh, that's interesting too. And that's a nice paycheck. [00:27:08] Lindsey Dinneen: Right? I [00:27:10] Holly Rockweiler: Let's see. It's getting right to what do I think I'm good enough at to teach a class about. So, I mean, I think one thing that I've been thinking about a lot recently is scientific communication and how, how different voices get amplified and how the kind of stereotypical scientific persona is, it's not the one that wants to be necessarily on social media with a gazillion followers and all these TikTok videos. So I think that I would like to teach the class in concert with, I have a lot of ideas of like, who would be a great way, who would be great people to collaborate with in order to teach or really to help promote more scientific discourse in a conversation that's appropriate and approachable for anyone. [00:28:04] I think that obviously our country has faced a lot of division and I don't think that's really true. I think that a lot of that is-- well, there certainly is a lot of division. I don't mean that. I just mean that I think there's a path to human connection via communication and that, wouldn't it be cool if we could help bridge conversations. And obviously I'm, I am a scientist. I think of myself as a scientist, so I want to think about ways to provide other voices out there to be amplified as well, or perhaps amplify the right voices to help promote just a more enriched dialogue than what is often presented as the country's dialogue today. [00:28:48] Lindsey Dinneen: I love that. [00:28:50] Holly Rockweiler: It's kind of rambling. I can get back to you with my course description, but that's probably where I would go. [00:28:56] Lindsey Dinneen: Syllabi due Tuesday. No, I think that is absolutely incredible. And I love that because I think that is something that's missing and there's some translation error that occurs. And one of the things that I'm passionate about is helping to bridge that gap between-- so I'm right on board with you-- but to bridge that gap between maybe taking some what are traditionally considered complex ideas, concepts, whatever, and distilling it down to a more accessible format. And because everyone learns differently, it's just helpful to have a wider range of options. [00:29:35] Holly Rockweiler: Totally. [00:29:36] Lindsey Dinneen: So I love what you would be passionate about sharing. I mean, I would sign up for that masterclass. [00:29:41] Holly Rockweiler: You can help me teach it, I think. [00:29:43] Lindsey Dinneen: Okay. Deal. We'll get back on that. [00:29:45] Holly Rockweiler: Okay. [00:29:47] Lindsey Dinneen: Excellent. Yeah. How would you wish to be remembered after you leave this world? [00:29:53] Holly Rockweiler: You have some great questions. Yeah, let's see. You know, I've honestly never thought about that. I think that I would, what would I want people... well, I think about like what I would want my friends to think. That, like, they were loved and that they hopefully shared that love broadly. But then, well, let's see, that's not really, like, remembering. Yeah, I guess, maybe it is. So, yeah. That I'm a lover, a curious person, and that I, there is a lot of beauty in the everyday, and so there's a lot to be excited about even on the hard days, [00:30:32] Lindsey Dinneen: Yeah. I love that. And then, final question. What is one thing that makes you smile every time you see or think about it? [00:30:41] Holly Rockweiler: Certainly my family. I have a four year old son and he is, keeps me very present and cracks me up continuously. And so, my husband and I are very lucky to have him. And obviously my husband makes me laugh. A lot. And so I really appreciate them. And so even when, you know, the work day is hard, I feel really fortunate to have a very rich personal life outside of that. So my family and then my friends also. [00:31:09] Lindsey Dinneen: Oh, yes. Of course. That's wonderful. And I'm so glad you have that amazing support system to bring that smile to your face, especially on the tough days. [00:31:19] Holly Rockweiler: Absolutely. [00:31:20] Lindsey Dinneen: Well, Holly, this has been a wonderful conversation. I'm so thankful for you and what you're doing in this space and the fact that you're tackling an issue that affects so many people, and that you're just bringing all this innovation to, and you're so passionate about sharing that in a way that resonates with people. So I just want to first say, you know, thank you so much for the work that you're doing. I know it's not easy and there are probably days where you, you just kind of want to, you know, toss something in the trash, but honestly, thank you for continuing to do the work you're doing. It's not nothing. And I want to appreciate that. [00:31:59] Holly Rockweiler: Well, that is very kind. Thank you. And that means a lot. And thank you for doing what you're doing, too, to give people like me a chance to share, and also us to listen to others sharing their stories. And for asking, I will say, asking questions that are more about me as a whole person too. I think that when I've been in other conversations sometimes are really-- and there's nothing wrong with those, but it's fun to have, we can ask these questions. I'm like, "Wow, I would do some thinking this weekend about how I want to be remembered" because I've never thought about that. [00:32:30] Lindsey Dinneen: Yeah. There you go. I love it. Well, and we are so honored to be making a donation on your behalf as a thank you for your time today to the Equal Justice Initiative, which provides legal representation to prisoners who may have been wrongly convicted of crimes, poor prisoners without effective representation, and others who may have been denied a fair trial. So thank you for choosing that organization to support, and we just wish you continued success as you work to change lives for a better world. [00:32:59] Holly Rockweiler: Well, thank you. It's been a pleasure. Thank you. [00:33:03] Lindsey Dinneen: Me too. And thank you so much for our listeners for tuning in. And if you're feeling as inspired as I am right now, I would love if you would share this episode with a colleague or two, and we will catch you next time. [00:33:16] Ben Trombold: The Leading Difference is brought to you by Velentium. Velentium is a full-service CDMO with 100% in-house capability to design, develop, and manufacture medical devices from class two wearables to class three active implantable medical devices. Velentium specializes in active implantables, leads, programmers, and accessories across a wide range of indications, such as neuromodulation, deep brain stimulation, cardiac management, and diabetes management. Velentium's core competencies include electrical, firmware, and mechanical design, mobile apps, embedded cybersecurity, human factors and usability, automated test systems, systems engineering, and contract manufacturing. Velentium works with clients worldwide, from startups seeking funding to established Fortune 100 companies. Visit velentium.com to explore your next step in medical device development.

Dr. Kristi Tough DeSapri joins us on Aging Today to discuss, understand, prevent, and treat the symptoms of perimenopause, menopause, osteoporosis, low bone density, and fractures. Every woman will reach menopause and every woman will have their own unique menopause journey. Every 3 seconds, an osteoporosis-related fracture occurs, and 1 in 5 women will experience a re-fracture within 5 years.Click AgingToday.us & listen today!

Drs. Kristi Tough DeSapri and Pauline M. Camacho share their insights into best practices for pharmacological management of postmenopausal osteoporosis in women at a high risk for fracture.

Drs. Pauline M. Camacho and Kristi Tough DeSapri share their insights into current and coming advancements in diagnosing postmenopausal osteoporosis, with a focus on identifying women at high risk for fracture.

One of the most common diagnoses we see as pelvic floor PTs is urinary incontinence. This diagnosis is surprisingly very common affecting at least 50% of the vulva owners which increases in prevalence to 75% in women over the age of 65. Unfortunately many of us have been told “that's the price of child birth” or “that's just part of getting older”. While child birth and aging has its affects on the pelvic floor, it doesn't mean that urinary incontinence has to be what you deal with. There are many treatments including pelvic floor PT that can help decrease leakage if not completely eliminate it.Follow us @thev.movementJoin our newsletter or email us info@thevmove.comOur introduction music provided by POW/Sunset Beach/courtesy of www.epidemicsound.comFind a PT near you!Resources:The V Movement's Bladder Diary HandoutNational Association for Continence Bladder Diary

Doctors James Ferriss, Linda Duska, and Jayanthi Lea discuss the promise and the challenges of targeting the immune system with immune checkpoint inhibitors, or ICIs, in cervical and endometrial cancers. They also examine emerging data that support the use of ICIs in recurrent cervical cancer, the potential for curing some patients with advanced endometrial cancer, and molecular factors that make cervical cancer a good target for immunotherapy. TRANSCRIPT Dr. James Stuart Ferriss: Hello, and welcome to the ASCO Daily News Podcast. I'm Dr. James Stuart Ferriss, your guest host of the ASCO Daily News Podcast today. I'm an associate professor of gynecology and obstetrics and the Gynecologic Oncology Fellowship Program Director at Johns Hopkins Medicine. In today's episode, we'll be discussing the use of immunotherapy in cervical and endometrial cancers to advance the treatment of these malignancies. I'm delighted to be joined by two acclaimed experts in this space, Dr. Linda Duska and Dr. Jaya Lea.   Dr. Duska is a professor of obstetrics and gynecology and serves as the associate dean for clinical research at the University of Virginia School of Medicine. Dr. Lea is a professor of obstetrics and gynecology and chief of gynecologic oncology at the University of Texas Southwestern Medical Center.  Our full disclosures are available in the transcript of this episode, and disclosures related to all episodes of the podcast are available at asco.org/DNpod. Drs. Duska and Dr. Lea, it's great to have you on the podcast today.  Dr. Linda Duska: Thanks, Dr. Ferriss.  Dr. Jayanthi Lea: Thanks, Dr. Ferriss.  Dr. James Stuart Ferriss: So, let's get started. In recent years, we've had a revolution in the treatment of advanced endometrial and cervical cancers with improved outcomes for patients treated with immunotherapy. And when we say immunotherapy, we're specifically talking about immune checkpoint inhibitors today. A few of these agents have actually been approved in the United States for the management of these diseases. In our discussion, I'd like to review the promise and challenges of targeting the immune system in patients with advanced endometrial and cervical cancers, as well as review the most recent evidence we have in these spaces.  Let's start with cervix. We've had a lot of improvements in outcomes here, Dr. Lea, and with cervical cancer, we've seen improved overall survival with the incorporation of immunotherapy along with chemotherapy and anti-angiogenic therapy for advanced and recurrent disease. Can you remind us why cervical cancer is a good target for immunotherapy?  Dr. Jayanthi Lea: Yes, Dr. Ferriss. Immunotherapy for cervical cancer is supported by several molecular factors. And I think first and foremost, it's so important to remember that the majority of cervical cancers are HPV-positive. And HPV-positive cancers can induce a high level of inflammation, but this high level of inflammation actually contributes to evasion of immune surveillance. What it also does is that it's responsible for the induction of PD-L1. And we've seen several studies that have shown that cervical cancers express PD-L1 anywhere from 50 to 90 percent of cases. Other pertinent factors to consider are that cervical cancer can be considered a tumor with a high tumor mutational burden. So, the number of somatic mutations that we see in the DNA can be considered as a proxy for neoantigens. And so the higher the level of neoantigens, the more immunogenic the tumor. And then lastly, about 1 in 10 cervical cancers present with microsatellite instability, which is an already established key biomarker for the response team in care.  Dr. James Stuart Ferriss: So, thinking about targeting PD-L1, what clinical evidence do we have that supports the use of immune checkpoint inhibitors in recurrent cervical cancer?  Dr. Jayanthi Lea: We now have several studies that have shown a benefit for immune checkpoint inhibitors. For example, KEYNOTE-158 was a phase 2 basket [trial] that investigated the antitumor activity of pembrolizumab, which is a PD-1 inhibitor, in multiple cancer types. And specifically for patients with previously treated advanced cervical cancer, we were able to see an overall response rate of about 15% in those patients who had PD-L1 positive. And similarly, the EMPOWER CERVICAL-1 study, which was a phase 3 randomized trial that investigated the efficacy of cemiplimab, which is another PD-1 inhibitor, versus investigator's choice of single agent chemotherapy, showed a significant difference in median overall survival and progression-free survival in the cemiplimab group. There are several other studies that have investigated the efficacy of PD-1 or PD-L1 inhibitors in cervical cancer. One specific PD-1 inhibitor is nivolumab. In CHECKMATE-358, nivolumab was associated with an overall response rate of 26% in women who had recurrent/metastatic cervical cancer.  Dr. James Stuart Ferriss: Dr. Duska, do you have any thoughts?  Dr. Linda Duska: I'm really interested in PD-L1 as a biomarker because in the KEYNOTE-A18 study, which we're going to get to, 95% of patients were PD-L1 positive by CPS, which is the scoring system that we use in cervix cancer. And some of the studies that you already mentioned, including BEATcc, which we're also going to talk about, reported results where PD-L1 wasn't even considered. And so it begs the question, since PD-L1 is actually – again, depending on when in the course of disease you look at it, but more recent studies suggest 95% of cervical cancers express PD-L1, and – agnostic is the word I was looking for – it seems at least in BEATcc and similar trials that PD-L1 is agnostic, but I wonder if PD-L1 is really a good biomarker for response to checkpoint inhibitor therapy and I wonder what your thoughts are.  Dr. Jayanthi Lea: I think that's an excellent question. To your point, that's correct that we saw in KETYNOTE-A18 that more than 90% of the patients had PD-L1 positivity and the result is sort of generalizable to all comers. That's still a matter of debate as to how we see PD-L1 as a biomarker to incorporate checkpoint inhibitors in the treatment of patients.  Dr. James Stuart Ferriss: So, let's talk about the use of immune checkpoint inhibitors in the frontline setting. Until recently, we haven't seen much improvement in overall survival since the introduction of anti-angiogenic therapy to the chemotherapy backbone, and that was in GOG 240. Let's talk about the changes that have recently occurred in this space.  Dr. Jayanthi Lea: So, we've had some very exciting data specifically from initially KEYNOTE-826 and its primary metastatic or first line salvage settings. So, KEYNOTE-826, which was a phase 3 randomized, controlled trial was very practice-changing for us because it showed that incorporation of pembrolizumab to the first-line treatment of patients with metastatic or recurrent cervical cancer, really changed the landscape for treatment in this group of patients. So, keep in mind that prior to the study, the standard of care was carboplatin, or cisplatin with paclitaxel plus or minus bevacizumab, which yielded a median overall survival range in anywhere from 13 to 17 months depending on whether you use bevacizumab or not. And then adding pembrolizumab to that regimen, increase the median overall survival to 24 months, which is very promising.  Dr. James Stuart Ferriss: If I remember correctly, KEYNOTE-826 allowed investigators choice, use of bevacizumab, and initially we were unsure about which regimen was best. Has there been additional data since?  Dr. Jayanthi Lea: There has been additional data since. And another study that was done in the same vein was the BEATcc trial, which also looked at the different checkpoint inhibitors, atezolizumab in combination now with bevacizumab and platinum-based chemotherapy. And the control arm for this study was the GOG 240 regimen, which included bevacizumab. And this study showed both a progression-free and overall survival difference. The median overall survival in this study was 32 months with the incorporation of the checkpoint inhibitor to the bevacizumab and platinum-based chemotherapy. So, the way that I look at it is that the BEATcc trial basically confirmed the findings of KEYNOTE-826 and highlights that it is important for us to incorporate checkpoint inhibition with immunotherapy along with bevacizumab when we're treating patients with a recurrence.  Dr. James Stuart Ferriss: Also, folks with primary advanced treatment for cervical cancer, this would be a great regimen, is that right?  Dr. Jayanthi Lea: Absolutely. Primary advance, we would want to use the same regimen for that.  Dr. James Stuart Ferriss: Okay. What about locally advanced in primary treatment? What advances have we seen?  Dr. Jayanthi Lea: So we've had some major changes in that field as well, especially with the recent KEYNOTE-A18 data where pembrolizumab was administered in combination with external beam radiation and concurrent chemotherapy. And this study showed that there was significant and clinically meaningful improvement in progression-free survival compared to chemoradiation alone. Specifically, the progression-free survival at 24 months using pembrolizumab with chemoradiation was 68%, and 57% when in the placebo group. The hazard ratio for disease progression was 0.7 and no new safety signals were observed, which is fantastic, especially given the 0.7 hazard ratio that received PFS.  Dr. James Stuart Ferriss: Yeah, absolutely. These patients with locally advanced cervical cancer often are quite symptomatic, and the prospect of adding chemo, radiation, and now immunotherapy on top of that is really encouraging to see that it was such a well-tolerated regimen. I believe that there were patient-reported outcomes recently reported at SGO.  Dr. Jayanthi Lea: Absolutely. So, the safety profile of pembrolizumab and chemoradiation was consistent with the known profile of the individual treatment components. And no new safety signals emerged in the pembrolizumab chemoradiation arm. So, you're right. It was very well tolerated.  Dr. James Stuart Ferriss: What would you say are the takeaways for folks who are seeing these patients in the community? These locally advanced cervical cancer patients that are now adding immunotherapy in a space that we have not used routinely in the past in terms of combining it with chemo radiation in gynecologic cancer. What are some things they should be looking out for?  Dr. Jayanthi Lea: Well, I think that with the hazard ratio of 0.7 and the patient-reported outcomes showing no new signal, I think we can say that there is a positive benefit-to-risk profile of adding pembrolizumab in combination with chemoradiation, and that we should feel comfortable using this regimen. Now, of course, we have individualized patient care, and be able to know when to use bevacizumab, when to use immunotherapy. So, taking the whole patient into consideration becomes important. But for those individuals who are able to receive these drugs who don't have concrete issues to not receive these drugs [then I'd say we could] incorporate them since the safety profile is set.  Dr. Linda Duska: I would add to that, Dr. Ferriss, that right now we only have FDA approval in the U.S. for stage 3-4A disease, and that's 2014 staging. Mind you, we are now in 2018, so we should be very careful in and follow the correct FIGO staging. But the FDA only gave approval for stage 3-4A disease, even though the study included patients with earlier stage disease and positive nodes.  Dr. James Stuart Ferriss: That's a great point, thank you.  So, Dr. Duska, thinking about endometrial cancer and advanced endometrial cancer, we have seen a similar revolution in the care of patients over the past few years, with major shifts in our approach. Can you remind us how we got here?  Dr. Linda Duska: Yes, I would say in the ‘90s and before, and maybe even in the early 2000s, we used a lot of radiation for endometrial cancer as adjuvant therapy following surgery. The general consensus and what we were all taught was that this was a chemotherapy-resistant disease. And then we learned from a variety of GOG at the time, Gynecologic Oncology Group trials, that this disease is actually chemosensitive. And we went through a series of chemotherapy drugs, ranging from adriamycin cisplatin to taxel adriamycin cisplatin, and finally to taxel and carboplatin, demonstrating that this disease is actually quite chemosensitive.  With this realization came the idea that maybe it would be important to combine chemotherapy and radiation particularly in high-risk endometrial cancer cases, so those with positive nodes or patients with high-risk histology such as clear cell or serous cancers. So two very important trials were done, one of them was PORTEC-3 and the other was GOG-258, which looked at combining chemo and radiation together to see if we could do better than one or the other alone. And they were very different trials, and they looked at different populations of patients and they looked at different things. For example, PORTEC-3 randomized patients to receive chemotherapy and radiation versus radiation alone, while 258 looked at chemotherapy and radiation versus chemotherapy alone. Without going into a great amount of detail, I think what we learned from both of those studies, and I think surprised many of us, that the arms that included chemotherapy, those patients did better.  In fact, the results of GOG-258 can be interpreted – and this is somewhat controversial – but can be interpreted that many of these high-risk patients don't need radiation at all, or perhaps need tumor-directed radiation. For example, chemotherapy followed by tumor-directed radiation either to the vaginal cuff, because the vaginal cuff is at risk for recurrence, or perhaps to an area of concern, maybe the cervix if there were cervical involvement or if there is a particular concern for local recurrence in a particular patient. So, I think the pendulum has swung from almost always using radiation alone to, in more modern day, using chemotherapy and using radiation much more sparingly, and then comes immunotherapy.  Dr. James Stuart Ferriss: So, update us on the results of NRG-GY018 and RUBY?  Dr. Linda Duska: So, we've already talked about the KEYNOTE basket trials, which really contributed a lot to our understanding of the importance of MMR deficiency and microsatellite unstable disease. The KEYNOTE-158 study and the GARNET study showed us how important it was for women with MMRd and MSI endometrial cancer to receive checkpoint inhibition, and actually with remarkable response rates to women who had already been pretreated. But we also learned from the GARNET trial, which included MMRp patients, that the response rates in MMRp were not that great. And that led to KEYNOTE-775, which looked to combine pembrolizumab with a VEGF inhibitor, lenvantinib, to see if we could make the cold tumor hot. And indeed, we could. And not only could we improve the response rate in patients with MMRp tumors, but we could also improve the response rate in patients with MMRd tumors. They did better with the combination than they did with pembro alone.  That led to the idea of combining checkpoint inhibitors with chemo upfront. The idea there was we were going to take paclitaxel and carboplatin, which were our backbone for advanced or recurrent endometrial cancer, and add immunotherapy to that. And to your point, GY018 and RUBY trials did just that. And they allowed MMRd and MMRp patients and combined paclitaxel and carboplatin, either with dostarlimab in the case of RUBY, or pembrolizumab in the case of GY018. These studies, both of which were reported and published in the New England Journal of Medicine last year, showed remarkable findings in the upfront setting and potentially in the curable setting. And the OS data for RUBY were presented at SGO this year and were remarkable for MMRd patients. In the whole population, in the whole group in RUBY, there was a 16.4-month improvement in overall survival with the addition of dostarlimab which is just huge.  When you look at the MMRd group, I think Dr. Powell described the overall survival improvement as unprecedented. I believe that was the word that he used. Also, he called it very robust, with a hazard ratio of 0.32 for the group that got dostarlimab, and a median OS that was not reached. So really remarkable. In addition, in the MMRp group, there was a seven-month improvement in OS that was significant. So that's really amazing in the RUBY trial. It's also of note that the RUBY trial allowed carcinosarcomas, whereas the GY018 study did not. So, I think it's fair to say that these results apply to carcinosarcomas.  It's also really important to note that many of the patients in the immunotherapy group who received placebo, 41% of them got IO in a later treatment line, and these OS data still stand. So that's really interesting and hypothesis-generating. For GY018, we don't have mature OS data yet, so we can't talk about OS. But we saw a similar improvement in PFS in both arms, in the d and the pMMR, with an OS trend in both arms that was also reported at SGO. GY018 was a little bit different though, because they unblinded at the time of the PFS reporting last year, and so those patients were unblinded a lot earlier than the RUBY patients were. So, to interpret the data in that vein, the OS data is not mature, but we anticipate looking at the PFS curves and the preliminary OS curves, that the OS data will also be statistically significantly improved in core pembrolizumab in GY018.  What's also really interesting, and we haven't talked about molecular subtypes, is that when we look at the molecular subtypes in RUBY, and I'm sure we're going to see data on the molecular subtypes in GY018 coming up, different molecular subtypes of endometrial cancer respond differently to IO. And so, there's going to be lots of really interesting data coming our way soon that we're really excited to see, and that will help us triage patients appropriately into treatment regimens.  Dr. James Stuart Ferriss: Dr. Lea, did you have a thought?  Dr. Jayanthi Lea: Yeah, I just wanted to comment that looking at the dMMR survival curve in the file that was presented recently, one thing that really strikes me is the importance of adding the IO at the time of initial treatment. The separation of the curves persists. And, like you just mentioned, Dr. Duska, I mean, some of those patients who received placebo then later on went to get an IO treatment, but at the same time, we still see a vast separation of those curves. So, I think it's really important to note that immunotherapy should be used upfront, especially in dMMR.  Dr. Linda Duska: Yeah, I completely agree with that. And I think that might be– I mean, this is just a hypothesis, but I think that that might be why we saw a difference with the addition of immunotherapy in the MMRp group, because it's possible that the chemotherapy created an immune environment that made the checkpoint inhibitor work more successfully than it would have otherwise. So, a really good point. You definitely need to include dostarlimab or pembrolizumab with the chemotherapy and then as maintenance therapy after.  Dr. James Stuart Ferriss: So, you mentioned, we're increasingly thinking about endometrial cancer in smaller and smaller buckets of patients with very prescribed molecular profiles. We don't yet have enough information to specifically tailor treatment. How are you approaching that today in patients that you see in clinic?  Dr. Linda Duska: Well, the MMR, and I'm interested in what you both are doing also, it's easy with the MMRd and MSI high patients. Those patients all should receive a checkpoint inhibitor, no question. The patients that are p53 mut, I test them for HER2, because we do have data to suggest that atezolizumab or TDX-d might be useful in those individuals, HER2 positive. And then the remaining patients, also called the NSMPs. That's a difficult group. I'm interested to know how you all manage them. I think that's the group where more clinical research is really needed to determine what the best treatment regimen for them is. But I'm interested in both of your thoughts on that.  Dr. James Stuart Ferriss: Dr. Lea?  Dr. Jayanthi Lea: I would have to say that I do exactly like you do, Dr. Duska.  Dr. James Stuart Ferriss: And I would say our approach is very similar. And we have a robust discussion always about the use of immunotherapy with chemotherapy and in patients who are proficient MMR. But I think that most of us believe that the PFS data is certainly compelling. And now the OS data from RUBY, very compelling in both groups. And so, we are routinely recommending the use of immunotherapy along with chemotherapy in these advanced patients.  Dr. Linda Duska: I've heard the argument made that GY018 required measurable disease, and so does not necessarily apply to patients without measurable disease. I'm not sure that I agree with that. I think there were clinical trial reasons why that was a requirement rather than biologic reasons. In addition, as we already discussed, RUBY included carcinosarcomas and GY018 did not. I don't think there's a reason to only use dostarlimab for carcinosarcomas, but that said, I don't know that pembrolizumab has an indication for carcinosarcomas. The devil's in the details, don't get too lost in the weeds. I think the take-home message here is that it's really important to use IO, particularly for the MMRd patients with endometrial cancer, upfront. And based on the OS that we saw in both RUBY and preliminarily in GY018, we may be curing some people with this regimen, and I think we should focus on that. The overall survival for advanced endometrial cancer is not great, and if we can improve that and potentially cure some people, that's a huge advance for our patients.  Dr. James Stuart Ferriss: Do you envision a day that we might even ask the question, “Do we need to do surgery?”  Dr. Linda Duska: So, the rectal data would support that assertion. I'm not sure that endometrial cancer and rectal cancer are the same thing. And I think that taking out a postmenopausal woman's uterus is a lot less morbid than potentially radiating or taking out somebody's rectum. I think a different question would be, is there a day when we would stop doing no dissection? We could definitely debate that, but I don't see that happening. Do you see that happening anytime soon? A stopping of hysterectomy for endometrial cancer? Dr. Jayanthi Lea: I don't see that happening anytime soon. And I think, as you said, taking out the uterus, tubes, and ovaries, it does provide us with some information about whether you're even dealing with a secondary primary. But also, it's from a quality-of-life standpoint. If a woman has a large uterus, that's uncomfortable. Postmenopausal bleeding, avoiding bleeding during the course of treatment, so many reasons why I wouldn't be in too much of a hurry to want to not do surgery for these patients. Dr. James Stuart Ferriss: So, we'll put a plug in for our fellow gynecologic oncologists that we still have a role to play in the incorporation of treatment regimens for patients with advanced uterine cancer. So it's not just medicine, there's still a role for surgery.  Dr. Linda Duska: I think that's very fair, yeah. Dr. James Stuart Ferriss: Okay. I think that's all the time we have for today.  I want to thank our listeners for their time, and you'll find the links to all the studies we've discussed today in the transcript of this episode. And finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts. Thank you.  Dr. Linda Duska: Thank you. Dr. Jayanthi Lea: Thank you. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care, and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.    Find out more about today's speakers: Dr. James Stuart Ferriss Dr. Linda Duska @LDuska Dr. Jayanthi Lea   Follow ASCO on social media:  @ASCO on Twitter  ASCO on Facebook  ASCO on LinkedIn    Disclosures: Dr. James Stuart Ferriss: Honoraria: National Board of Medical Examiners Dr. Linda Duska: Consulting or Advisory Role: Regeneron, Inovio Pharmaceuticals, Merck, Ellipses Pharma Researching Funding (Inst): GlaxoSmithKline, Millenium, Bristol-Myers Squibb, Aeterna Zentaris, Novartis, Abbvie, Tesaro, Cerulean Pharma, Aduro Biotech, Advaxis, Syndax, Pfizer, Merck, Genentech/Roche, Cerulean Pharma, Ludwig Institute for Cancer Research, Leap Therapeutics Patents, Royalties, Other Intellectual Property: UpToDate, Editor, British Journal of Ob/Gyn Dr. Jayanthi Lea: Consulting or Advisory Role: Roche

Marie Forleo joins Dr. Mindy to dig deep into how exactly women can preserve muscle mass as they age. Together they distill complex principles into actionable steps, tailored for both perimenopausal and post-menopausal perspectives. From nuanced insights to personal anecdotes, you will get a blend of depth and entertainment, courtesy of Marie's infectious humor. Whether you're scribbling notes or simply absorbing the wisdom, this episode promises invaluable insights for anyone seeking to maintain muscle through the aging journey. To view full show notes, more information on our guests, resources mentioned in the episode, discount codes, transcripts, and more, visit https://drmindypelz.com/ep230 Check out our fasting membership at resetacademy.drmindypelz.com. Please note our medical disclaimer.

BUFFALO, NY- April 1, 2024 – A new #research paper was #published on the #cover of Aging (listed by MEDLINE/PubMed as "Aging (Albany NY)" and "Aging-US" by Web of Science) Volume 16, Issue 6, entitled, “Altered brain morphology and functional connectivity in postmenopausal women: automatic segmentation of whole-brain and thalamic subnuclei and resting-state fMRI.” The transition to menopause is associated with various physiological changes, including alterations in brain structure and function. However, menopause-related structural and functional changes are poorly understood. In this new study, researchers Gwang-Won Kim, Kwangsung Park, Yun-Hyeon Kim, and Gwang-Woo Jeong from Chonnam National University not only compared the brain volume changes between premenopausal and postmenopausal women, but also evaluated the functional connectivity between the targeted brain regions associated with structural atrophy in postmenopausal women. “To the best of our knowledge, no comparative neuroimaging study on alterations in the brain volume and functional connectivity, especially focusing on the thalamic subnuclei in premenopausal vs. postmenopausal women has been reported.” Each of the 21 premenopausal and postmenopausal women underwent magnetic resonance imaging (MRI). T1-weighted MRI and resting-state functional MRI data were used to compare the brain volume and seed-based functional connectivity, respectively. In statistical analysis, multivariate analysis of variance, with age and whole brain volume as covariates, was used to evaluate surface areas and subcortical volumes between the two groups. Postmenopausal women showed significantly smaller cortical surface, especially in the left medial orbitofrontal cortex (mOFC), right superior temporal cortex, and right lateral orbitofrontal cortex, compared to premenopausal women (p < 0.05, Bonferroni-corrected) as well as significantly decreased functional connectivity between the left mOFC and the right thalamus was observed (p < 0.005, Monte-Carlo corrected). Although postmenopausal women did not show volume atrophy in the right thalamus, the volume of the right pulvinar anterior, which is one of the distinguished thalamic subnuclei, was significantly decreased (p < 0.05, Bonferroni-corrected). “Postmenopausal women showed significantly lower left mOFC, right lOFC, and right STC surface areas, reduced right PuA volume, and decreased left mOFC-right thalamus functional connectivity compared to premenopausal women. If replicated in an independent sample, these findings will be helpful for understanding the effects of menopause on the altered brain volume and functional connectivity in postmenopausal women.” DOI - https://doi.org/10.18632/aging.205662 Corresponding author - Gwang-Woo Jeong - gwjeong@jnu.ac.kr About Aging-US Aging publishes research papers in all fields of aging research including but not limited, aging from yeast to mammals, cellular senescence, age-related diseases such as cancer and Alzheimer's diseases and their prevention and treatment, anti-aging strategies and drug development and especially the role of signal transduction pathways such as mTOR in aging and potential approaches to modulate these signaling pathways to extend lifespan. The journal aims to promote treatment of age-related diseases by slowing down aging, validation of anti-aging drugs by treating age-related diseases, prevention of cancer by inhibiting aging. Cancer and COVID-19 are age-related diseases. Please visit our website at https://www.Aging-US.com​​. MEDIA@IMPACTJOURNALS.COM

Menopause doesn't have to mean the end of fulfilling sexual experiences. The post menopausal orgasm is real! You may just need to take some steps to make sure it's in tiptop shape. In the second part of this podcast, we continue to explore the most common reasons for the decline of the post menopausal orgasm. Maintaining good overall health is the first step to a healthy sex life. Blood flow to the clitoris is paramount; vaginal estrogen and certain vasodilators can help. PRP (platelet-rich plasma) can be used to stimulate nerve and blood vessel growth in the clitoris and vagina. Maintaining a strong pelvic floor is the key to fabulously strong orgasms. Working with your sexual health expert, you should be able to individualized a plan tailor to your needs. Key moments in this episode are: 00:00 Summary of Part 1 of Postmenopausal Orgasms 00:25 Improving clitoral blood flow 01:49 How to improve clitoral blood flow with vaginal estrogen 03:15 Other medications to improve clitoral blood flow 04:57 When blood flow alone is not enough 05:23 Uses of PRP (platelet-rich plasma) 07:09 How PRP is performed 08:22 A strong pelvic floor 09:46 Electrical stimulation vs electromagnetic stimulation 11:22 How electromagnetic stimulation is performed 13:08 Summary Learn more about platelet-rich plasma here: https://www.foundationsfl.com/prp Learn more about electrical stimuation to the pelvic floor with vTone here: https://www.foundationsfl.com/empower Learn more about electromagnetic stimulation to the pelvic floor with BTL Emsella Chair here: https://www.foundationsfl.com/emsculpt-neo Follow us! Instagram foundationskristinjacksonmd Website www.foundationsfl.com FB https://facebook.com/advancedurogynecology Loved this episode? Share with a friend

Postmenopausal women can and do experience orgasms! This podcast episode explores the changes and challenges that occur with orgasms after menopause and offers strategies to improve them. It debunks stereotypes that suggest women lose interest in sex after menopause and highlights the importance of addressing sexual concerns for both women and men. Why are physicians not discussing healthy orgasms with women The 4 main areas to focus on to improve a postmenopausal orgasm Improving arousal with hormone or other prescription medications Off label use of arousal medications Providing proper clitoral stimulation Use of vibrators as a medical device Where to shop for the best vibrator Types of vibrators Having an open conversation with your partner A happy and fulfilling sex life does not end with menopause! Key moments in this episode are: 00:26 Do women still desire sex after menopause? 01:18 Many solutions for male sexual issues 02:16 Challenges with the postmenopausal orgasm 03:15 Arousal for orgasm 03:32 Medications that decrease arousal 4:04 Hormone replacement for improving arousal 4:34 Addyi for female sexual dysfuction 05:22 Vylessi for female sexual dysfunction 07:10 Clitoral stimuation for orgasm 07:57 Using a vibrator as a medical device 09:58 Where to get a vibrator 11:19 Types of vibrators 13:01 Vibrators for both partners 13:30 Having an open conversation with your partner 14:36 Stay tuned for part 2 of this conversation! https://www.lovehoney.com/

Which route is right for you? Nonoral delivery systems of estradiol bypass the first pass effect. While oral estrogen therapy has been associated with increased factors the cause blood clots, transdermal estrogen appears to have a suppressive effect on these markers. Postmenopausal estrogen therapy involves a nuanced understanding of the mode of administration, individual risk factors, and the latest research findings. Seek a menopause society certified practioner (MSCP) in your area. **This is not medical advice, just medical education. Please ask your doctor medical questions as they pertain to your specific situation. Educational purposes only. .......................................................................... Welcome to the Sky Women community where we are all stronger together. COME SAY HI!!! Instagram: https://www.instagram.com/skywomenshealth https://www.instagram.com/drcarolynmoyers Facebook: https://www.facebook.com/skywomenshealth Email: hello@skywomenshealth.com Sky Women's Health: Https://www.skywomenshealth.com 1125 S Henderson St, Fort Worth, TX 76104 To become a patient: email hello@skywomenshealth.com or call 817-915-9803. #EstrogenSafety #HormoneTherapyInsights #BloodClotRisk #TransdermalvsOral #MenopauseHealth #HormoneDeliverySystems #ACOGGuidelines #WomenHealthPodcast #skywomenshealth --- Send in a voice message: https://podcasters.spotify.com/pod/show/skywomen/message

There are so many conversations about the benefits of fasting - but what does that mean for someone after cancer? Is there any data to support that fasting has a benefit on someone's overall health, menopausal symptoms or even better, cancer survival rates?In today's episode, I speak to cancer survivor, nutritional scientist and integrative oncology practitioner Toral Shah. Toral will dive deep into the understanding of metabolic health, insulin resistance and how that links us back to fasting.Attached are the scientific papers we mentioned in the conversation and a link to Toral's course:Fasting and chemo:https://oncologypro.esmo.org/meeting-resources/esmo-congress/effects-of-short-term-fasting-on-quality-of-life-as-an-add-on-option-during-chemotherapy#:~:text=Growing%20pre%2D%20and%20clinical%20evidence,reducing%20toxicity%20and%20adverse%20effects.Fasting and cancer:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938162/#:~:text=At%20the%20molecular%20level%2C%20fasting,%2C29%2C56%2C124.Integrative breast cancer course: https://www.theurbankitchen.co.uk/courses Episode Highlights:00:00 Introduction08:02 Fasting benefits explained.12:19 Challenges women face with menopause and periods.15:45 Metabolic health is defined by 5 key markers.22:21 Menopausal insulin resistance leads to weight gain.23:25 Postmenopausal body struggles with metabolic health, fasting.31:22 Fasting reduces breast cancer risk, and promotes health.39:18 Intermittent fasting benefits gut health and repair.43:21 Body health beyond appearance: focus on essentials.47:26 Fasting may improve cancer treatment and outcomes.About Dani:The Menopause and Cancer Podcast is hosted by Dani Binnington, menopause guide, patients advocate for people in menopause after a cancer diagnosis, and founder of the online platform Healthy Whole Me. There is lots of information out there about the menopause but hardly any if you have had a cancer diagnosis as well. Many people say to me they have no idea what their options are, who to ask for help, and that they feel really isolated in their experiences. I started this podcast because there was nothing out there when I was thrown into surgical menopause at the age of 39, which followed on from my cancer diagnosis aged 33.Through the episodes, I want to create more awareness, share information from our fabulous guest experts, doctors and other specialists in the cancer and menopause field. And of course, I will share stories from the people in our community.So that together we can work towards a better menopause experience. For all of us.More educated, better informed and less alone.Connect with Dani:Instagram @healthywholeme Facebook: @healthywholeme Website: menopauseandcancer.org Join Dani's private Facebook group:

Many women want to lose weight. To lose weight for active women over 40, they also don't want performance to deteriorate. There are a few things to consider. First, it's not the eat less, exercise more dogma that will get you what you really want.  Most women want energy, tone and definition, and strength for now and later. Better blood sugar control that supports reductions in belly fat and overall insulin sensitivity.  Am I right? But eating less and exercising more - if successful at all during menopause and post - will generally cause the opposite. Less energy, worse mood, poor sleep, less muscle tone, and spirals down from there with long term ramifications to health.  Being active, whether sports performance level or just athletic active, requires energy. There is still a way to juggle goals of maintaining or improving performance while still dropping a few pounds of extra cushioning.  Eating to Lose Weight Active Over 40 Close to the beginning and/or after completion of exercise, peri- and postmenopausal athletes should aim for a bolus of high EAA-containing (~10 g) intact protein sources or supplements to overcome anabolic resistance. Anabolic resistance is the status of muscle loss being more likely than muscle gain and it requires more intense exercise stimulus (strength training), quality protein stimulus, and recovery to overcome it.  An ACSM review of literature stated 20 g protein pre-exercise (and 40 after) for older adults to boost Muscle Protein Synthesis similar to that of a 20 yr old when workout conditions were comparable.  Time pre-exercise fuel for optimal digestion. Within 30 minutes of a workout the easier to digest fuel must be. It's not only a comfort factor, but also the diverted energy for digestion competing with the need for blood flow to deliver oxygen to working muscles. Both digestion and performance will suffer. A “simple shake” with protein powder and unsweetened almond milk or water may be the easy way to go.  If you want carbs, add a half a banana to the shake or have half cup oatmeal with protein powder. Pre-workout, avoid fiber and fat. A mixed meal eaten pre-workout should allow at least 2 ½ - 3 hours to be fully digested. Some will feel most comfortable if this is longer than that (4 hours) if it's following recommendations for high fiber, high protein and high fat.  Given recommendations range from at least 10 to 20 grams of protein pre-workout, below are some examples of protein sources. The more challenged you are with gaining lean muscle (and or are attempting to lose weight while retaining muscle) the higher end of the range you want to be. Lose Weight for Active Women: Women's Guide to Exercise Nutrition High EAA examples of 10 g protein:  Small half a simple shake including protein powder and unsweetened almond milk  Dairy (which does by the way include whey protein) generally pre-exercise wouldn't be recommended due to its influence in mucus production, even if you tolerate which a lot of women don't later in life (but Greek yogurt or cottage cheese are sources of protein- again I don't recommend pre-exercise). ·      2 eggs equal 12 grams of protein (if you tolerate eggs)  ·      ½ cup steel cut oats with protein stirred in ·      Quinoa  Choices vary as to whether you want carbohydrate prior or not to avoid early fatigue during exercise sessions. Overcoming Anabolic Resistance:  A study in the European Journal of Sports Science found higher protein intakes (2-3 times the protein Recommended Dietary Allowance (RDA) of 0.8 g/kg/d) during periods of energy restriction can enhance fat-free mass (FFM) preservation, particularly when combined with exercise. Athletes [and let's include, the very active] aiming to reduce fat mass and preserve FFM should consume protein intakes in the range of ∼1.8-2.7 g kg(-1) d(-1) (or ∼2.3-3.1 g kg(-1) FFM) in combination with a moderate energy deficit (-500 kcal) and the performance of some form of resistance exercise.  What does that look like for you?  Say you weigh 130lbs. Rounding Kgs up to 60.  Based on body weight: 162 g protein  Using the FFM example:  Say you weigh 130lbs and are 25% body fat. Subtracting the fat weight in lbs (32.5) from bodyweight leaves 97.5 Fat Free Mass.  224 g  Using the high range number for each of body weight and FFM-based protein recommendations, the daily protein recommendation then would be 162 – 224 grams of protein daily. That is with the goal of losing weight while resistance training with a moderate calorie deficit.  Taking a median number of 180 g protein with each gram of protein offering 4 kcals means you'd be taking in 720 kcals/day from protein.  Fat = 7 kcals, Carb = 4 kcals.  Prepare to be confused.  Health Organizations Weigh in (Not necessarily on losing weight) Prestigious Organizations Offer These Calculations for a 130lb active woman:  American Dietetic Association (ADA): at least 59 - 106 grams/day. The Centers for Disease Control and Prevention (CDC): 48 - 169 grams/day (10-35% of daily caloric intake). World Health Organization safe lower limit: 49 grams/day. Keep in mind these recommendations vary in goal. The least amount of protein to avoid death or illness is not the same to thrive and add lean muscle, strength and energy. We have a gap.  So, it is of course confusing. We also have emotional relationships to food and beliefs we've held for a long time. Those too are likely factors in your reaction to this episode. You're nodding or shaking. Even though the science is the basis of the content, we don't as humans adopt it readily.  Say You Don't Want to Lose Weight You Want to Maintain Daily protein intake should fall within the mid- to upper ranges of current sport nutrition guidelines (1.4-2.2 g·kg-1·day-1) for women at all stages of menstrual function (pre-, peri-, post-menopausal, and contraceptive users) with protein doses evenly distributed, every 3-4 h, across the day. Eumenorrheic athletes in the luteal phase and peri/post-menopausal athletes, regardless of sport, should aim for the upper end of the range. Let's do the math.  130lb woman  Convert to kg: 59 129 g protein    150lb woman  Convert to kg: 68 149 g protein  This is the equivalent of 1 g protein per lb of body weight. You can keep it easy by remembering that is your daily AND that a “dose” of protein needs to be at least 30gm at a meal. However, if you go higher as suggested for your first meal of the day, the next meal may not need to be as high if you eat within 3-4 hours to keep that muscle protein synthesis up. The alternative is muscle protein breakdown. You're in one or the other. There's really not a neutral.  To Lose Weight for Active Women, Examples of a day of high protein meals:  Pre-Workout: 20 gm protein in a simple shake pre-workout  Or minimally, 12 gm protein in two eggs pre-workout Meal Examples:  45g protein in a post- workout smoothie  51g Salmon (35) + quinoa (6) + Greek-style yogurt (10) with berries  43g Taco Salad with ground Bison (35) + Black beans (8)  46g 6 large Sauteed Scallops (29) + Three-bean salad (8) + Black Bean Brownie (9)  I'm not an advocate of calorie counting. However, a snapshot of the number of calories you take in can be helpful. Many women are too far below what they need, AND too low in protein, AND not lifting weights with adequate intensity or sleeping. Those will add up to muscle loss. You may temporarily think you're successful at the weight loss game, but unless you mitigate it, muscle loss will result in you feeling weaker, less energetic and having a slower metabolism  Weight loss with an on-target activity plan means having a slight caloric deficit with an increased amount of protein from a maintenance phase. Other research I've shared suggests increasing protein by 10-15% above maintenance along with a reasonable deficit if weight loss is needed.  So, let's challenge that.  Do you need weight loss? Or do you need to gain lean muscle? Get very clear. You may need both but someone listening needs to hear this: you don't need weight loss; you need fat loss. That will come with an increase in lean muscle and a decrease in inflammation.  Additionally, to Lose Weight While Active Over 40 Creatine supplementation of 3 to 5 g per day is recommended for the mechanistic support of creatine supplementation with regard to muscle protein kinetics, growth factors, satellite cells, myogenic transcription factors, glycogen and calcium regulation, oxidative stress, and inflammation. Postmenopausal females benefit from bone health, mental health, and skeletal muscle size and function when consuming higher (5g) doses of creatine. References:  Murphy CH, Hector AJ, Phillips SM. Considerations for protein intake in managing weight loss in athletes. Eur J Sport Sci. 2015;15(1):21-8. doi: 10.1080/17461391.2014.936325. Epub 2014 Jul 11. PMID: 25014731. Hector AJ, Phillips SM. Protein Recommendations for Weight Loss in Elite Athletes: A Focus on Body Composition and Performance. Int J Sport Nutr Exerc Metab. 2018 Mar 1;28(2):170-177. doi: 10.1123/ijsnem.2017-0273. Epub 2018 Feb 19. PMID: 29182451. Sims ST, Kerksick CM, Smith-Ryan AE, Janse de Jonge XAK, Hirsch KR, Arent SM, Hewlings SJ, Kleiner SM, Bustillo E, Tartar JL, Starratt VG, Kreider RB, Greenwalt C, Rentería LI, Ormsbee MJ, VanDusseldorp TA, Campbell BI, Kalman DS, Antonio J. International society of sports nutrition position stand: nutritional concerns of the female athlete. J Int Soc Sports Nutr. 2023 Dec;20(1):2204066. doi: 10.1080/15502783.2023.2204066.  Science:  PMID: 37221858; PMCID: PMC10210857. Resources:  5 Day Flip: https://www.flippingfifty.com/5dayflip Flipping 50 Cafe Membership: https://www.flippingfifty.com/cafe/ Flipping 50 Protein: https://www.flippingfifty.com/store/protein-powders/paleo-protein-powder-vanilla/ Other Episodes You Might Like:  How Much Collagen Counts Toward Protein Needs?  https://www.flippingfifty.com/how-much-collagen/ Protein Supplements for Muscle Building: What, When & Why to Exercise for Women 40+  https://www.flippingfifty.com/protein-supplements-for-muscle-building/ Midlife Weight Loss: Burn Body Fat, Balance Your Hormones  https://www.flippingfifty.com/midlife-weight-loss/

Welcome to another episode of "The Scrumptious Woman"! In this episode, we dive deep into embracing life's challenges and unlocking the power of your own sexuality with the incredible Penelope Neckowitz, an experienced therapist and erotic blueprint coach. Join us for an inspiring conversation filled with wisdom and insights.In this episode, Juliette welcomes Penelope Neckowitz, a seasoned therapist and erotic blueprint coach, who shares her journey of embracing a new direction in her career, focusing on eroticism and sexuality after 40 years of practice. Penelope's story is one of resilience and transformation, particularly after overcoming breast cancer. She emphasizes the importance of saying "yes" to life, especially in the face of uncertainty and aging. The conversation delves into redefining pleasure beyond traditional notions, teaching women to reconnect with their bodies, and finding sources of pleasure unique to each individual.Key Takeaways:1. Embracing Challenges as Gifts: Penelope encourages viewing life's challenges as opportunities for growth and expansion. They have the potential to make us larger, allowing us to live a more fulfilling and enriched life.2. Reconnecting with Lifeforce Energy: Understanding and harnessing the lifeforce energy within us is a birthright, regardless of age. It's essential to embrace your own sexuality and recognize it as a fundamental aspect of your being.3. Titrating Sensations: Start by exploring sensations in your body, even if they may initially be numb or unfamiliar. Use descriptive language to identify these sensations, gradually building a vocabulary for your unique bodily experiences.4. Community and Sisterhood: Building a supportive community of women can be transformative. It offers a safe space to explore, share experiences, and celebrate the individual journey towards self-discovery and pleasure.5. Facing Aging and Mortality: Embracing aging means acknowledging that life is transient. It prompts deep introspection about legacy, intention, and the essence of one's existence.Remember, there's no age limit to feeling vibrant, sexy, and alive. Embrace your own journey, and tap into the incredible well of energy and pleasure that resides within you.Thank you for joining us on this enriching episode of "The Scrumptious Woman." Don't forget to connect with Penelope Neckowitz through her website and social media platforms for further inspiration and guidance on your own journey of self-discovery. Find out more about Juliette Karaman here: https://feelfullyyou.com/free-resources/ https://www.instagram.com/juliettekaraman/https://www.facebook.com/juliette.karamanvanschaardenburgDon't forget to Rate and Subscribe to stay updated with all of the latest shows and resources. Please leave a review so more people can tune in and the ripple effect spreads further. Take a screenshot of your review and send it to me on https://www.instagram.com/juliettekaraman/ and you will be given access to a free group Spinal Attunement session. These have been life-changing for my clients!

It's pretty standard of an evaluation… TVUS for postmenopausal bleeding. It's well accepted that an endometrial thickness of 4 mm (5 mm in some studies) should trigger further endometrial tissue analysis in women with postmenopausal bleeding. But is there a cut-off endometrial thickness at which endometrial tissue should be evaluated in a postmenopausal patient WITHOUT bleeding, where this was found incidentally? There is definitely an evidence-based recommendation, and we will cover that in this episode.(With a special guest host

In this episode, I'll review the latest hormonal health research, including exciting findings for menopausal and men's hormonal health.  Join me to stay up to date on the latest research in hormonal health. Featured Studies  https://pubmed.ncbi.nlm.nih.gov/36732722/ https://pubmed.ncbi.nlm.nih.gov/34536053/ https://pubmed.ncbi.nlm.nih.gov/35873404/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9415500/pdf/medicina-58-01047.pdf https://pubmed.ncbi.nlm.nih.gov/37084590/ https://pubmed.ncbi.nlm.nih.gov/37101856/ https://pubmed.ncbi.nlm.nih.gov/35904028/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9188729/pdf/223_2022_Article_991.pdf    Related Resources A previous podcast episode about the EMST150 sleep device:  https://drruscio.com/clinically-proven-breath-device-for-sleep-speech-and-more/  Healthy Gut, Healthy You: https://store.drruscio.com/products/healthy-gut-healthy-you  Courses, free guides, and more: https://drruscio.com/resources?utm_source=youtube&utm_medium=link&utm_campaign=drruscio.com_resources   Timestamps 00:00 Intro  01:16 Low testosterone and sleep quality  06:05 What are normal and low testosterone levels? 07:12 Symptoms of low testosterone  08:47 Diets that may increase testosterone 13:02 Does longjack improve testosterone?  14:32 Longjack vs. Ashwaghanda 16:30 Can HCG injections improve testosterone? 19:15 Can diet reduce menopausal symptoms? 22:38 Does exercise improve hot flashes?  23:20 Postmenopausal symptoms & herbal therapies 24:39 What is the best exercise for postmenopausal bone health? Get the Latest Updates Facebook - https://www.facebook.com/DrRusciodc Instagram - https://www.instagram.com/drrusciodc Pinterest - https://www.pinterest.ca/drmichaelrusciodc DISCLAIMER: The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment.   Music featured in this video: "Modern Technology" by Andrew G, https://audiojungle.net/user/andrew_g    *Full transcript available on YouTube by clicking the “Show transcript” button on the bottom right of the video.

Jess is working with a patient who has sustained a low-energy hip fracture. These types of fractures are MOST common in which population? A. High-performance athletes during intense training. B. Postmenopausal women with osteoporosis. C. Children between the ages of 5-10 years. D. Middle-aged men during heavy weightlifting sessions. LINKS MENTIONED: Did you get this question wrong?! If you were stuck between two answers and selected the wrong one, then you need to visit www.NPTEPASS.com, to learn about the #1 solution to STOP getting stuck. Are you looking for a bundle of Coach K's Top MSK Cheatsheets? Look no further: www.nptecheatsheets.com --- Support this podcast: https://podcasters.spotify.com/pod/show/thepthustle/support

Today, I am blessed to have here with me Megan Ramos, a renowned Canadian clinical educator and expert in the field. With her extensive experience, having guided over 14,000 individuals worldwide, Megan is an authority on the transformative power of fasting and its impact on overall health. Co-authoring the New York Times Bestseller, "Life in the Fasting Lane," and co-founder of The Fasting Method alongside Dr. Jason Fung, Megan brings her expertise to unravel the myths and misconceptions surrounding women and intermittent fasting. She shed light on the profound effects of modern agriculture and the processed food industry, leading to widespread obesity and the development of inflammatory and metabolic disorders. As Megan firmly believes, fasting is a powerful tool to combat these problems and regain control over our health. The specific concerns include polycystic ovary syndrome (PCOS), the influence of fasting on thyroid health, weight loss plateaus, and troubleshooting while fasting. She aims to equip women with the knowledge and understanding that fasting is a temporary solution and a sustainable lifelong strategy for achieving and maintaining optimum health. In this episode, we explore the evolution of the agricultural processed food industry and its detrimental impact on our well-being. She also addresses leptin resistance, the intricate connection between stress and hormonal balance, the significance of different types of body fat, and the varying effects of fasting on women in different stages of life, including those still cycling and those in menopause.  Prepare to have your preconceptions challenged as we dive into the depths of therapeutic fasting and its immense potential for transforming lives. Join us on this enlightening journey as we unravel the truth behind fasting and empower women to reclaim their well-being.   Purchase Megan Ramos's new book The Essential Guide to Intermittent Fasting for Women: Balance Your Hormones to Lose Weight, Lower Stress, and Optimize Health: https://amzn.to/3oAKG23 Order Keto Flex: http://www.ketoflexbook.com -------------------------------------------------------- Download your FREE Vegetable Oil Allergy Card here: https://onlineoffer.lpages.co/vegetable-oil-allergy-card-download/ / / E P I S O D E   S P ON S O R S  Wild Pastures: $20 OFF per Box for Life + Free Shipping for Life + $15 OFF your 1st Box! https://wildpastures.com/promos/save-20-for-life-lf?oid=6&affid=132&source_id=podcast&sub1=ad BonCharge: Blue light Blocking Glasses, Red Light Therapy, Sauna Blankets & More. Visit https://boncharge.com/pages/ketokamp and use the coupon code KETOKAMP for 15% off your order.  Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list. [04:59] What significance does being aware of and committed to maintaining a safe environment have? ·       After Megan married and planned to start a family, unexpected environmental toxin issues caused health problems, delaying their plans and requiring a crash course in environmental toxins. ·       The couple moved to the Bay Area due to career opportunities. However, the relocation and the subsequent pandemic added further obstacles to their journey to parenthood, making it logistically challenging to conceive conventionally. ·       The discovery of low ovarian reserves due to PCOS led the couple to pursue IVF intentionally to bank embryos, ensuring options for future pregnancies. Multiple rounds of embryo collections were required, reflecting their challenges while striving to expand their family. ·       Megan shares their experience of overcoming metabolic illnesses, insulin resistance, and weight loss, only to face a severe setback due to exposure to environmental toxins. Their health suffered, almost costing them everything, including their marriage and professional endeavours. ·       Despite maintaining a healthy lifestyle, including proper nutrition, fasting, and utilizing various tools, constant exposure to environmental toxins caused significant cellular inflammation. The resulting health issues required thyroid medication and high doses of T3 to function. · The move to a healthier environment demonstrated the immediate impact of environmental changes on Megan's health. It highlighted the importance of thoroughly investigating potential properties for toxins before purchasing and being prepared for the associated costs. Megan emphasizes the need for awareness and commitment to creating a safe environment.  [20:25] A Guide to Navigating Hormonal Differences in Women with Metabolic Disease ·       Recognizing the role of insulin resistance in driving hormonal imbalances, including PCOS, emphasizes the importance of prioritizing its management to achieve better health outcomes. ·       Women experience hormonal fluctuations throughout their lives, which can influence their ability to fast and affect their health goals. By acknowledging the impact of hormones on fastings, such as the suppression of certain hormones and potential metabolic complications, women can adapt their fasting strategies to align with their hormonal cycles. ·       The menstrual cycle consists of distinct phases with varying hormone dominance. Women can optimize their fasting experience and support hormone production by modifying fasting approaches and adopting time-restricted eating strategies. Recognizing the importance of changing fasting protocols during different phases allows for improved hormone balance and metabolic outcomes.  [30:51] Acknowledge and Honor Your Unique Hormonal Cycle ·       Every woman's hormonal cycle is unique, and it's important to recognize and honour those variations. By observing how fasting and nutritional choices align with personal hormonal fluctuations, women can tailor their approach accordingly and find a balance that works for them. ·       Women can use the moon cycle as an illustrative guide to adapt their fasting and eating patterns. Just as the moon waxes and wanes, adjusting the dial on fasting intensity based on how it feels can provide a flexible and intuitive way to navigate hormonal changes and individual needs. ·: In a society inundated with external influences and societal expectations, reconnecting with one's body and intuition is crucial. Regularly checking in with oneself, listening to the body's signals, and adjusting fasting and nutrition strategies can lead to a more intuitive and sustainable approach to health and well-being. [41:42] How can your overall health outcomes be maintained and improved? ·       When starting a fasting and keto journey for individuals with insulin resistance or type 2 diabetes, strictness may vary based on personal circumstances and goals. Tailoring the approach to each individual's needs and preferences is crucial for long-term success. ·       A more strict and therapeutic fasting approach may be initially recommended to address severe insulin resistance and metabolic issues. This can involve longer fasting periods, time-restricted eating, and cutting out snacking and late-night eating to promote improved blood sugar control and insulin sensitivity. ·    Once significant improvements are achieved, adjustments can be made to incorporate variations and explore different strategies, such as including more carbohydrates or modifying fasting durations. Finding a balance between therapeutic protocols and sustainable long-term practices is important for maintaining progress and optimizing overall health outcomes. [47:10] How can women Manage their Hormonal Changes and Fasting Strategies? ·       Ovaries are crucial in producing sex hormones throughout a woman's childbearing years. As they retire, estrogen levels decline, leading to symptoms like sleep disturbances and hormonal imbalances. The adrenal glands step in to compensate, but chronic stress and age-related factors can further impact hormone production. ·       Postmenopausal women can benefit from a proactive approach to fasting. Hormonal imbalances like estrogen dominance can be reduced by addressing insulin resistance and emphasizing fat loss. Aggressive fasting protocols, similar to those used for diabetes management, are often implemented while also considering individual variations and the impact of stress. ·       Supporting women through hormonal fluctuations during fasting involves adopting a compassionate mindset and allowing for self-compassion during challenging times. Time-restricted eating and a more ketogenic approach can be incorporated during certain phases. Carb cycling remains beneficial for overall hormonal balance and metabolic health. AND MUCH MORE! Purchase Megan Ramos's new book The Essential Guide to Intermittent Fasting for Women: Balance Your Hormones to Lose Weight, Lower Stress, and Optimize Health: https://amzn.to/3oAKG23 Resources from this episode:  Website: https://www.thefastingmethod.com/ Follow Megan Ramos Facebook: https://www.facebook.com/TheFastingMethod Twitter: https://twitter.com/meganjramos YouTube: https://www.youtube.com/@TheFastingMethod Instagram: https://www.instagram.com/meganjramos/ ●  Join the Keto Kamp Academy: https://ketokampacademy.com/7-day-trial-a Watch Keto Kamp on YouTube: https://www.youtube.com/channel/UCUh_MOM621MvpW_HLtfkLyQ Order Keto Flex: http://www.ketoflexbook.com -------------------------------------------------------- Download your FREE Vegetable Oil Allergy Card here: https://onlineoffer.lpages.co/vegetable-oil-allergy-card-download/ / / E P I S O D E   S P ON S O R S  Wild Pastures: $20 OFF per Box for Life + Free Shipping for Life + $15 OFF your 1st Box! https://wildpastures.com/promos/save-20-for-life-lf?oid=6&affid=132&source_id=podcast&sub1=ad BonCharge: Blue light Blocking Glasses, Red Light Therapy, Sauna Blankets & More. Visit https://boncharge.com/pages/ketokamp and use the coupon code KETOKAMP for 15% off your order.  Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list. Some links are affiliate links  // F O L L O W ▸ instagram | @thebenazadi | http://bit.ly/2B1NXKW ▸ facebook | /thebenazadi | http://bit.ly/2BVvvW6 ▸ twitter | @thebenazadi http://bit.ly/2USE0so ▸ tiktok | @thebenazadi https://www.tiktok.com/@thebenazadi Disclaimer: This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast including Ben Azadi disclaim responsibility from any possible adverse effects from the use of information contained herein. Opinions of guests are their own, and this podcast does not accept responsibility of statements made by guests. This podcast does not make any representations or warranties about guests qualifications or credibility. Individuals on this podcast may have a direct or non-direct interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician.

Dr. Mindy fills in some gaps from her Fast Like a Girl book for those of you out there with complicated cycles. Specifically, you Postmenopausal, Menopausal Transition, Perimenopausal, and Fertility Years women out there. To view full show notes, resources mentioned in the episode, discount codes, transcripts, and more, visit https://www.drmindypelz.com/ep176 Check out our fasting membership at resetacademy.drmindypelz.com. Please note our medical disclaimer.

We have better tools for prevention, but let's talk! Should we be offering hormone therapy for primary prevention in postmenopausal patients?  Dr. Carol Mangione (UCLA) talks us through the potential benefits and harms, and explains how this can be a jumping off point for important conversations about preventive care. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producers, Hosts: Elena Gibson MD and Paul Williams MD, FACP Writer, Infographic, and Cover Art: Elena Gibson MD Show notes: Paul Williams MD, FACP Reviewer: Molly Heublein MD Production team: Podpaste Guest: Carol Mangione MD