Podcast appearances and mentions of susan dominus

In THE FAMILY DYNAMIC: A Journey into the Mystery of Sibling Success (Crown; on sale May 6, 2025), the acclaimed New York Times journalist Susan Dominus offers compelling profiles of six such families in search of the factors that led to their success—was it an inherited quality, a specific way of parenting, the influence of a sibling, or a twist of luck? Inspired by the iconic Brontë sisters, whose remarkable literary success prompted endless speculation, Dominus, the mother of twin teenagers, sought out contemporary high-achieving families who shared intimate stories of their upbringing. She introduces us to the Chens, young parents who fled their country's one-child policy to open a Chinese restaurant in Appalachia—then sent four children to elite colleges and on to careers that give back in technology and medicine; the Groffs, whose claim to fame is not just an award-winning novelist but an Olympic athlete and a notable entrepreneur; the Wojcickis, whose daughters made inroads as STEM pioneers in Silicon Valley; and the Murguias, who rose from exceptionally humble origins to become powerful jurists and civil rights champions. Woven into these and other stories is an account of centuries of scientific research into the ongoing question of nature versus nurture. Elegantly written and extensively researched, The Family Dynamic is more than a checklist of how-to's. It's a deep and moving exploration of the complexity of family life and the rewards—and burdens—of ambition.Become a supporter of this podcast: https://www.spreaker.com/podcast/arroe-collins-like-it-s-live--4113802/support.

This week, Emily Bazelon, John Dickerson, and David Plotz discuss this week's Supreme Court decision that validates Trump's firing of 2 officials without cause thus stealth-overruling a key check on presidents, the power dynamics around who benefits from Trump's attempts to destroy Harvard, and the challenges and rewards of male friendship in modern life.  Here are this week's chatters:   Emily: Emily Davies for The Washington Post: Trump's clemency spree extends to ex-gangster, artist, former congressmen; Aaron Blake for CNN: ‘No MAGA left behind': Trump's pardons get even more political   John: Jason DeParle for The New York Times: How a Generation's Struggle Led to a Record Surge in Homelessness; Malu Cursino for the BBC: Ancient human fingerprint suggests Neanderthals made art; Cara Tabachnick for CBS News: Last living grandson of 10th U.S. President John Tyler, a link to a bygone era, dies at 96; the Miller Center at the University of Virginia: President John Tyler (1790-1862); Sherwood Forest: More About Sherwood Forest and John Tyler.   David: Sarah Zhang for The Atlantic: The ‘Man Eater' Screwworm Is Coming   Listener chatter from Jody Litvak in Los Angeles: The Stamp Thief (trailer video 1:58)   For this week's Slate Plus bonus episode, Emily, John, and David discuss WilmerHale's court win this week, in which Judge Leon struck down the president's politically-motivated executive order against the law firm as unconstitutional.   In the latest Gabfest Reads, Emily talks with author Susan Dominus about her new book, The Family Dynamic: A Journey into the Mystery of Sibling Success.   Email your chatters, questions, and comments to gabfest@slate.com. (Messages may be referenced by name unless the writer stipulates otherwise.)   Research by Emily Ditto Learn more about your ad choices. Visit megaphone.fm/adchoices

This week, Emily Bazelon, John Dickerson, and David Plotz discuss this week's Supreme Court decision that validates Trump's firing of 2 officials without cause thus stealth-overruling a key check on presidents, the power dynamics around who benefits from Trump's attempts to destroy Harvard, and the challenges and rewards of male friendship in modern life.  Here are this week's chatters:   Emily: Emily Davies for The Washington Post: Trump's clemency spree extends to ex-gangster, artist, former congressmen; Aaron Blake for CNN: ‘No MAGA left behind': Trump's pardons get even more political   John: Jason DeParle for The New York Times: How a Generation's Struggle Led to a Record Surge in Homelessness; Malu Cursino for the BBC: Ancient human fingerprint suggests Neanderthals made art; Cara Tabachnick for CBS News: Last living grandson of 10th U.S. President John Tyler, a link to a bygone era, dies at 96; the Miller Center at the University of Virginia: President John Tyler (1790-1862); Sherwood Forest: More About Sherwood Forest and John Tyler.   David: Sarah Zhang for The Atlantic: The ‘Man Eater' Screwworm Is Coming   Listener chatter from Jody Litvak in Los Angeles: The Stamp Thief (trailer video 1:58)   For this week's Slate Plus bonus episode, Emily, John, and David discuss WilmerHale's court win this week, in which Judge Leon struck down the president's politically-motivated executive order against the law firm as unconstitutional.   In the latest Gabfest Reads, Emily talks with author Susan Dominus about her new book, The Family Dynamic: A Journey into the Mystery of Sibling Success.   Email your chatters, questions, and comments to gabfest@slate.com. (Messages may be referenced by name unless the writer stipulates otherwise.)   Research by Emily Ditto Learn more about your ad choices. Visit megaphone.fm/adchoices

Some families seem to have the secret code to sibling success. How else to explain how an Olympic athlete, an award-winning novelist and a successful entrepreneur could all be raised under a single roof? The journalist Susan Dominus set out to answer this puzzle.

This week, Emily Bazelon, John Dickerson, and David Plotz discuss this week's Supreme Court decision that validates Trump's firing of 2 officials without cause thus stealth-overruling a key check on presidents, the power dynamics around who benefits from Trump's attempts to destroy Harvard, and the challenges and rewards of male friendship in modern life.  Here are this week's chatters:   Emily: Emily Davies for The Washington Post: Trump's clemency spree extends to ex-gangster, artist, former congressmen; Aaron Blake for CNN: ‘No MAGA left behind': Trump's pardons get even more political   John: Jason DeParle for The New York Times: How a Generation's Struggle Led to a Record Surge in Homelessness; Malu Cursino for the BBC: Ancient human fingerprint suggests Neanderthals made art; Cara Tabachnick for CBS News: Last living grandson of 10th U.S. President John Tyler, a link to a bygone era, dies at 96; the Miller Center at the University of Virginia: President John Tyler (1790-1862); Sherwood Forest: More About Sherwood Forest and John Tyler.   David: Sarah Zhang for The Atlantic: The ‘Man Eater' Screwworm Is Coming   Listener chatter from Jody Litvak in Los Angeles: The Stamp Thief (trailer video 1:58)   For this week's Slate Plus bonus episode, Emily, John, and David discuss WilmerHale's court win this week, in which Judge Leon struck down the president's politically-motivated executive order against the law firm as unconstitutional.   In the latest Gabfest Reads, Emily talks with author Susan Dominus about her new book, The Family Dynamic: A Journey into the Mystery of Sibling Success.   Email your chatters, questions, and comments to gabfest@slate.com. (Messages may be referenced by name unless the writer stipulates otherwise.)   Research by Emily Ditto Learn more about your ad choices. Visit megaphone.fm/adchoices

The understanding that our lives are shaped by our parents is extremely ubiquitous. However, the influence of siblings is much less known. In her book, “The Family Dynamic: A Journey Into The Mystery of Sibling Success,” Susan Dominus shares her findings after spending time with multiple sets of high-achieving siblings to understand how sibling relationships affect each other. Reset sat down with the author to talk about family, define success and understand the ways siblings shape one another. For a full archive of Reset interviews, head over to wbez.org/reset.

New research suggests siblings may play a more powerful role than parents do in shaping each other's success. For more on this Susan Dominus, staff writer at the New York Times Magazine and author of The Family Dynamic: A Journey Into the Mystery of Sibling Success.

This week, Emily Bazelon, John Dickerson, and David Plotz discuss the huge House tax bill and its broad economic implications with Harvard economist Jason Furman, the DOJ's selective investigation and prosecution of officials as a method of intimidation, and the Heritage Foundation's “Project Esther” as the Trump administration's blueprint for shutting down dissent with accusations of antisemitism. In the latest Gabfest Reads, Emily talks with author Susan Dominus about her new book, The Family Dynamic: A Journey into the Mystery of Sibling Success.   Email your chatters, questions, and comments to gabfest@slate.com. (Messages may be referenced by name unless the writer stipulates otherwise.)     Research by Emily Ditto   Want more Political Gabfest? Join Slate Plus to unlock weekly bonus episodes. Plus, you'll access ad-free listening across all your favorite Slate podcasts. You can subscribe directly from the Political Gabfest show page on Apple Podcasts and Spotify. Or visit slate.com/gabfestplus to get access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

This week, Emily Bazelon, John Dickerson, and David Plotz discuss the huge House tax bill and its broad economic implications with Harvard economist Jason Furman, the DOJ's selective investigation and prosecution of officials as a method of intimidation, and the Heritage Foundation's “Project Esther” as the Trump administration's blueprint for shutting down dissent with accusations of antisemitism. In the latest Gabfest Reads, Emily talks with author Susan Dominus about her new book, The Family Dynamic: A Journey into the Mystery of Sibling Success.   Email your chatters, questions, and comments to gabfest@slate.com. (Messages may be referenced by name unless the writer stipulates otherwise.)     Research by Emily Ditto   Want more Political Gabfest? Join Slate Plus to unlock weekly bonus episodes. Plus, you'll access ad-free listening across all your favorite Slate podcasts. You can subscribe directly from the Political Gabfest show page on Apple Podcasts and Spotify. Or visit slate.com/gabfestplus to get access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

This week, Emily Bazelon, John Dickerson, and David Plotz discuss the huge House tax bill and its broad economic implications with Harvard economist Jason Furman, the DOJ's selective investigation and prosecution of officials as a method of intimidation, and the Heritage Foundation's “Project Esther” as the Trump administration's blueprint for shutting down dissent with accusations of antisemitism. In the latest Gabfest Reads, Emily talks with author Susan Dominus about her new book, The Family Dynamic: A Journey into the Mystery of Sibling Success.   Email your chatters, questions, and comments to gabfest@slate.com. (Messages may be referenced by name unless the writer stipulates otherwise.)     Research by Emily Ditto   Want more Political Gabfest? Join Slate Plus to unlock weekly bonus episodes. Plus, you'll access ad-free listening across all your favorite Slate podcasts. You can subscribe directly from the Political Gabfest show page on Apple Podcasts and Spotify. Or visit slate.com/gabfestplus to get access wherever you listen. Learn more about your ad choices. Visit megaphone.fm/adchoices

Finding happiness is no longer an abstract pursuit—there's serious science behind it, but it's research that hasn't always been held in the highest esteem. Susan Dominus, staff writer for The New York Times Magazine, joins host Krys Boyd to discuss how studying happiness became a respected field of study, what psychologists are learning about different types of happiness, and what data says about contentment. Her article is, "How Nearly a Century of Happiness Research Led to One Big Finding."  Learn about your ad choices: dovetail.prx.org/ad-choices

What makes a family tick? While parents spend lots of time and energy trying to shape their kids' lives, studies show that siblings play as significant a role in who their brothers and sisters become. We talk to New York Times Magazine staff writer Susan Dominus about her new book, “Family Dynamic: A Journey into the Mystery of Sibling Success,” and we hear from you: how did a sibling shape who you are? Guests: Susan Dominus, author, "The Family Dynamic: A Journey into the Mystery of Sibling Success;" staff writer, New York Times Magazine Learn more about your ad choices. Visit megaphone.fm/adchoices

Emily Bazelon talks with author Susan Dominus about her new book, The Family Dynamic: A Journey into the Mystery of Sibling Success. They discuss the commonalities among families that have multiple high-achieving children, what we can learn from these unique families, and more.   Tweet us your questions @SlateGabfest or email us at gabfest@slate.com. (Messages could be quoted by name unless the writer stipulates otherwise.)   Podcast production by Cheyna Roth. Learn more about your ad choices. Visit megaphone.fm/adchoices

Emily Bazelon talks with author Susan Dominus about her new book, The Family Dynamic: A Journey into the Mystery of Sibling Success. They discuss the commonalities among families that have multiple high-achieving children, what we can learn from these unique families, and more.   Tweet us your questions @SlateGabfest or email us at gabfest@slate.com. (Messages could be quoted by name unless the writer stipulates otherwise.)   Podcast production by Cheyna Roth. Learn more about your ad choices. Visit megaphone.fm/adchoices

Emily Bazelon talks with author Susan Dominus about her new book, The Family Dynamic: A Journey into the Mystery of Sibling Success. They discuss the commonalities among families that have multiple high-achieving children, what we can learn from these unique families, and more.   Tweet us your questions @SlateGabfest or email us at gabfest@slate.com. (Messages could be quoted by name unless the writer stipulates otherwise.)   Podcast production by Cheyna Roth. Learn more about your ad choices. Visit megaphone.fm/adchoices

Emily Bazelon talks with author Susan Dominus about her new book, The Family Dynamic: A Journey into the Mystery of Sibling Success. They discuss the commonalities among families that have multiple high-achieving children, what we can learn from these unique families, and more.   Tweet us your questions @SlateGabfest or email us at gabfest@slate.com. (Messages could be quoted by name unless the writer stipulates otherwise.)   Podcast production by Cheyna Roth. Learn more about your ad choices. Visit megaphone.fm/adchoices

Meera Sodha is a cook and food writer based in London. Meera's best-selling cookbooks and weekly Guardian column, The New Vegan, are some of my favorite sources of cooking inspiration, but like many people, she experienced burnout that led her to fall out of love with food. Today on the show, Meera talks about finding her way back into the kitchen and how that experience inspired her new book, Dinner, an honest and helpful guide to getting the most important meal of the day on the table. Also on the show we have a conversation with Susan Dominus. Susan is a staff writer at the New York Times Magazine the author of a terrific new book, The Family Dynamic. We talk about how parents—and siblings—shape and fuel individual success, and focus on family a story with a Chinese restaurant at the center. We also talk about some of Susan's food-related work at the Times.Do you enjoy This Is TASTE? Drop us a review on Apple, or star us on Spotify. We'd love to hear from you. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Joanna Coles talks with Susan Dominus, author of the new book, 'The Family Dynamic'. Dominus demystifies why certain families produce super successful children. Through research, she reveals how some families are able to cut through the morass of day to day life and engage their children, yielding hyper-productive siblings. Joanna is also joined by Emmy-award winning actor, writer, and producer Dan Bucatinsky. The 'Hacks' star shares what life is like in Rome with his 20-year-old daughter. Hosted on Acast. See acast.com/privacy for more information.

Parents unleash the arrow of ambition in their children, but siblings are often the ones who help guide its direction says Pulitzer Prize winning New York Times staff writer Susan Dominus. After a lifetime of curiosity about the ecosystems of families, Dominus set out to discover what families of high-achieving siblings had in common including the values, habits, and everyday rituals, like dinnertime conversations that influenced their children to hit the bullseye in their lives and work. Her book is called The Family Dynamic: A Journey into the Mystery of Sibling Success.

Parents try everything to influence their children. But new research suggests that brothers and sisters have their own profound impact.Susan Dominus, a staff writer for The New York Times Magazine, discusses the surprising ways that our brothers and sisters shape our lives.Guest: Susan Dominus, a staff writer at The New York Times Magazine covering a broad range of topics. Her recent article was adapted from her book, “The Family Dynamic: A Journey Into the Mystery of Sibling Success,” which was published by Crown on May 6.Background reading: Read Susan's article about the surprising ways that siblings shape our lives.For more information on today's episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday. Photo: Artwork by Kensuke Koike Unlock full access to New York Times podcasts and explore everything from politics to pop culture. Subscribe today at nytimes.com/podcasts or on Apple Podcasts and Spotify.

What do high-achieving families have in common, and what are some good lessons from them we can replicate in our own parenting? Susan Dominus, author of the new book THE FAMILY DYNAMIC, discusses the forces at play in families with multiple successful members and how we can encourage our kids to succeed in the ways that make sense for them. Susan Dominus is a staff writer for The New York Times Magazine. In 2018, Susan was part of a team reporting on workplace sexual harassment that won a Pulitzer Prize for public service. Susan, Amy, and Margaret discuss: How socioeconomic status informs family dynamics The role that parent expectations play in child development Why relationships outside the family are important for kids Here's where you can find Susan: @suedominus on IG @susandominus.bsky.social on Bluesky Buy FAMILY DYNAMIC: https://bookshop.org/a/12099/9780593137901 We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on our website: ⁠https://www.whatfreshhellpodcast.com/p/promo-codes/⁠ mom friends, funny moms, parenting advice, parenting experts, parenting tips, mothers, families, parenting skills, parenting strategies, parenting styles, busy moms, self-help for moms, manage kid's behavior, teenager, tween, child development, family activities, family fun, parent child relationship, decluttering, kid-friendly, invisible workload, default parent, siblings, brothers, sisters, sibling relationship, kids age gap, sibling age gap , family dynamic Learn more about your ad choices. Visit podcastchoices.com/adchoices

There is no secret sauce to raising successful children, but it sure is fascinating to understand some of the elements that result in a family filled with high-achieving siblings. And it raises lots of important questions, too, like: What even is success? When are the sacrifices to reach goals too great? And what do parents ultimately want for their children? New York Times writer and author of The Family Dynamic, Susan Dominus, helps us dive into all these complicated questions. Show Notes: Join our LESS AWKWARD ESSENTIALS Go to Quince.com/awkward for free shipping and 365-day returns Head to phyla.com and use code PUBERTY for 25% off your first order Get 15% off, plus free shipping on your first set of sheets, at BollAndBranch.com slash AWKWARD.  New customers can enjoy this special offer of only $1.99 a meal at Everyplate. Go to everyplate.com/podcast and use code AWKWARD199 to get started. Download the FREE Playbook for Getting Your Kid to Talk Order our book This Is So Awkward Check out all our speaking and curriculum at www.lessawkward.com and our super comfy products at www.myoomla.com To bring us to your school or community email operations@lessawkward.com To submit listener questions email podcast@lessawkward.com Watch the full episode on Youtube! Produced by Peoples Media Learn more about your ad choices. Visit podcastchoices.com/adchoices

In this episode of SuperPsyched, host Dr. Adam Dorsay interviews Yale Lecturer and New York Times writer, Susan Dominus, about her new book, 'The Family Dynamic: A Journey into the Mystery of Sibling Success'. The discussion delves into how family dynamics, specifically sibling interactions, play a significant role in shaping children's futures. Highlights include parental influence, the importance of family mottos, and the balance between intrinsic and extrinsic motivations. Both speakers share personal anecdotes and insights on creating environments that foster high achievement without compromising mental wellness.00:00 Welcome to SuperPsyched00:28 Introducing Susan Dominus and Her Book01:35 Susan's Personal Connection to the Topic04:16 The Influence of Siblings06:45 Parental Influence and Expectations15:29 Outsourcing Discipline and Encouraging Independence20:05 Intrinsic vs. Extrinsic Motivation24:29 Final Thoughts and Parenting Insights30:03 Conclusion and FarewellHelpful Links:Susan Dominus'The Family Dynamic: A Journey into the Mystery of Sibling Success' Book

Why are some families full of exceptionally talented and intelligent siblings? Is it nature, or nurture, or some combination? Susan Dominus, a staff writer at The New York Times Magazine, discusses her new book The Family Dynamic: A Journey into the Mystery of Sibling Success. And listeners weigh in on their own experiences and observations.

In this episode, meet children's author Antwan Eady, teacher and advocate Chasten Buttigieg, and New York Times Magazine staff writer Susan Dominus. Tune in to hear what Antwan Eady wishes he had in the recording studio with him, what Chasten Buttigieg's favorite section of his book to read (and write) was, and who Susan Dominus would cast to narrate her audiobook if she didn't read it herself. The Gathering Table by Antwan Eady: https://www.penguinrandomhouse.com/books/692628/the-gathering-table-by-antwan-eady-illustrated-by-london-ladd/audio Papa's Coming Home by Chasten Buttigieg: https://www.penguinrandomhouse.com/books/763440/papas-coming-home-by-chasten-buttigieg-illustrated-by-dan-taylor/audio The Family Dynamic by Susan Dominus: https://www.penguinrandomhouse.com/books/624531/the-family-dynamic-by-susan-dominus/audio/

What do you think of this episode? Do you have any topics you'd like me to cover?What really shapes success — nature, nurture, luck? It's a perennial question. The Family Dynamic is a brilliant, captivating exploration of families in which all of the children became high-achievers. The award-winning author, Susan Dominus, has woven academic research into a book of wonderfully engaging family stories that tease out the role played by our environment: Parents with a bold vision, community, neighbourhoods, and most enlightening of all siblings. If you've ever questioned how important your parenting really is, the impact of siblings on your child's life, the role of community, or whether our kids should do chores, this is a conversation you won't want to miss.THE BOOK: The Family Dynamic by Susan DominusCONTACT DETAILS:Website: Susan P Dominus at susanpdominus.comInstagram: @Sue DominusBlue Sky: Susan DominusFacebook: She remains active and friendly on FacebookAdditionally, the New York Times Magazine.SIBLINGS: Based on Susan Dominus's research, siblings play a crucial role in a child's success through several key mechanisms:Motivational Influence

You know those families where the kids all grow up to be remarkably successful? New York Times journalist Susan Dominus has spent the last few years getting to know some of them, looking for parenting techniques and life lessons. She's written a book about her findings called The Family Dynamic. "I thought I wrote a book about high-achieving families," she tells us, "but when I look back, it's really a book about families who did believe that the sky's the limit."

I've always been fascinated by how birth order shapes family dynamics, especially as we navigate this season of parenting. Penn and I are very aware that we don't have many more years “on the record” with our kids. Have we done enough to help them become their best selves? This week, we're chatting with Susan Dominus, an award-winning writer for The New York Times and a journalism professor at Yale. Her new book, The Family Dynamic, is all about what makes exceptional families tick—and since she couldn't find a book that explored this, she spent years writing it herself! It's available for pre-order now and comes out May 6th. We dig into what sets thriving families apart, what we can learn from them, and how to help our own kids succeed. Plus, we wrap up with another hilarious Top 5 list from Penn. Check out The Family Dynamic and pre-order here: https://amzn.to/4c1tAPoVisit Our ShopJoin Our NewsletterFind us on SubstackFollow us on YouTubeFollow us on InstagramFollow us on TikTok Follow us on FacebookKim and Penn are award-winning content creators known for their online videos, including original music, song parodies, and comedy sketches. Their videos have resulted in over 2 billion views and 9 million followers across their social media platforms since they (accidentally) went viral in 2013. They have a New York Times bestselling book on ADHD, best-selling book on marriage communication, a top-rated podcast, a fun-filled family card game, and most recently, they were the winners on Season 33 of The Amazing Race.The Holderness Family Podcast is produced by Ann Marie Taepke and edited and engineered by Max Trujillo of Trujillo Media and Sam Allen. Hosted on Acast. See acast.com/privacy for more information.

Dear Readers,They say in schools, February's no joke. Alongside my colleagues, I've certainly been putting in the hours in order to serve our students the best we can. But there's always still reading to be done — not only for this newsletter and our reading community, but also for my own self-care. It makes me happy that I keep getting to do this, week after week. Thank you for reading and supporting Article Club.I have a feeling you're going to like this week's issue. Instead of the regular offering (i.e., four articles), I'm switching things up and sharing with you some great writing and thinking from a variety of genres. Scroll down and you'll find:* an essay about racial appropriation and the end of an interracial friendship* an interview with Susan Dominus about IVF and her article, “Someone Else's Daughter”* an article about the care a park ranger takes in order to support unhoused people in Golden Gate Park* a podcast episode about how young people definitely don't think using generative AI is cheatingAlso, don't miss our pet photo, as well as our poll toward the end. Hope you enjoy.If you like what we're doing here at Article Club, and want to support this venture with a paid subscription, I would be very grateful. It's $5 a month or $36 a year.1️⃣ Dear White SisterI appreciate the work of Tressie McMillan Cottom, so when she recommended Don't Let It Get You Down, a collection of essays by UC Berkeley Law professor Savala Nolan, I knew I needed to check it out. I was not disappointed. As the book's subtitle makes clear, Prof. Nolan writes plainly and thoughtfully about race, gender, and the body. In the chapter, “Dear White Sister,” Prof. Nolan decides whether to approach a close and long-time white friend after an objectionable post on Instagram. In short, the friend quotes Beyoncé's song “Freedom” to celebrate her love for roller skating and progress in roller derby.Prof. Nolan writes: “I feel a peculiar sensation when white people borrow — take — something Black: it's like there's an octopus in my chest, peacefully afloat, when danger suddenly appears. The animal contracts its jellied body and expels a gush of protective ink, then darts away in panic. Don't belittle ‘Freedom,' I hissed inside. ‘Freedom' isn't for a white girl in the Midwest taking up roller derby.”By Savala Nolan • Don't Let It Get You Down • 25 min2️⃣  An Interview With Susan Dominus: “I was just so inspired by the goodness of the people involved.”Many of you read and appreciated January's article of the month, ”Someone Else's Daughter,” by Susan Dominus, which told the story of a horrible IVF mistake that resulted in two women giving birth to the other woman's genetic baby. More importantly, the piece illuminates the generosity of the human spirit, as the mothers, filled with grief and shame for an error they didn't make, embrace each other and figure out a way to raise their children together.I got to interview Ms. Dominus a few weeks back, and hope you take a listen. Over and over again in our conversation, she shared how reporting and writing the piece left her inspired and hopeful. Here's an excerpt: I would say the main thing that I really did want people to feel reading the piece was that same inspired feeling I felt in hearing their stories — that there is always a way, not always, but that when there is conflict or crisis, if you respond with openness and generosity, sometimes beautiful things come of that. That's what I took away as a human being, just being part of it. I was so inspired by the goodness of the people involved and the way that their goodness allowed them to turn something awful into something really beautiful.➡️ Listen to the interview by clicking the play button below.3️⃣ Her Job Is To Remove Homeless People From SF's Parks. Her Methods Are Extraordinary.It's easy to bewail the rise and intractability of homelessness. It's much harder to do something about it. That's why I appreciated reading this article about the efforts of Amanda Barrows, a park ranger for San Francisco Recreation and Parks. In 2015, the government agency launched a new program designed to connect unhoused people with the services they need. Since Ms. Barrows joined the force in 2021, she has helped 60 people leave Golden Gate Park and accept more permanent housing.Reporter Susan Freinkel does an excellent job following Ms. Barrows as she builds relationships with her clients, earns their trust, and listens to what they need. Having grown up in public housing, having lived in a “dodgy SRO” for five years, and having lost her father to a fentanyl overdose, Ms. Barrows says that her work feels natural. “I can relate to a lot of the people who I contact through my own lived experience.”By Susan Freinkel • The San Francisco Standard • 16 min • Gift Link4️⃣ Playboi Farti And His AI Homework MachineIn case there's any doubt: How teenagers think about using generative artificial intelligence in school is very different from how most educators think about it. In essence, we think it's cheating (or plagiarism, or whatever big word we want to use), and they don't. To them, ChatGPT is like a word calculator. Why slog away at a boring five-paragraph essay about The Great Gatsby that's been done millions of times when a robot can do you it for you?That's the essential question of this podcast episode, in which host PJ Vogt tests a theory he holds — that writing is more than answering a teacher's prompt, and that generative AI is more than just a labor-saving tool. It's thinking, he argues, and if we give away thinking to a computer, then our humanity is doomed.By PJ Vogt • Search Engine • 61 min • Apple Podcasts✅ It's time for a quick poll. I'd love to hear from you.Last week, we confirmed that there's no widespread conspiracy to keep this newsletter out of your inbox. Delivery is working well most of the time.But what about your reading habits? Do you focus on the current week's issue? Or do you like diving into the archives to check out past issues?Thank you for reading this week's issue. Hope you liked it.

Dear Readers,First things first: Let's welcome our 51 new subscribers Violet, Rae, Olga, Taylor, Joyce, Sogo, Emily, Callie, Angelina, Peter, Tya, Emily, Natalie, Christine, Heather, Mary, Hannah, Marie-Pierre, Kristy, Fernanda, Maurtini, Helen, Angelina, Colette, Ronald, Courtney, Kelley, Jaymi, Katy, Steph, Deborah, Cathy, Christina, Brenna, Megan, Jacki, Alina, Cynthia, Caryn, Brittany, Nimi, Katie, Shell, Jamie, Candice, Samuel, Leslie, and Stephanie. New subscribers, I hope you find the newsletter a solid addition to your email inbox. Welcome to Article Club. Make yourself at home.

THE WINNER—Clang! Clink! Bang! Hear that? It's the sound of all the hardware that Jake Silverstein's New York Times Magazine has racked up in his almost eleven years at its helm: Pulitzers and ASMEs are heavy, people!When we were preparing to speak to Jake, we reached out to a handful of editors who have loyally worked with him for years to find out what makes him tick. They describe an incredible and notably drama-free editor who fosters an amazing vibe and a lover of both literary essay and enterprise reporting who holds both an MA and an MFA. As one New York Times Mag story editor put it, Jake's superpower is his “vigorous and institutionally-shrewd support of skilled reporters with strong voices pursuing projects that were just a little beyond the paper's ordinary comfort zone.” Here's a theory we set out to test in this interview—one that we've floated in our newsletter, The Spread, for years now: Is The New York Times Magazine the best women's magazine out there? Yes, we're talking about the stories they produce under Jake, like Susan Dominus's ASME-winning, game-changing story about menopause and hormone replacement therapy, and Linda Villarosa's feature shining a light on the Black maternal health crisis. But we're also talking about the woman-loaded top of the Times Mag masthead, on which Gail Bichler, Jessica Lustig, Sasha Weiss, Ilena Silverman, and Adrienne Greene reign supreme—and seriously outnumber their male counterparts. And we could spend all day name checking favorite writers, like Dominus and Villarosa, but also Emily Bazelon, Danyel Smith, Taffy Brodesser-Akner, Irina Aleksander, Jordan Kisner, Azmat Khan, Pam Colloff, Nikole Hannah-Jones, J Wortham, Wesley Morris. We could go on and on—you get the idea! So, did Jake agree with our women's mag theory? And what is it like to have the deep resources it takes to make these kinds of stories these days? You'll have to listen to find out.—This episode is made possible by our friends at Commercial Type and Freeport Press. Print Is Dead (Long Live Print!) is a production of Magazeum LLC ©2021–2025

John and Craig look at three extraordinary news stories and ask, How Would this be a Movie? Stories include the United Healthcare CEO assassination, a small town's process for licensing fortune tellers, and a harrowing I.V.F. mixup. We also follow up on AI, Flightplan's source material, Craig's Belfast accent, and answer a listener question on the order of surnames for writing partners. In our bonus segment for premium members: Hey Alexa, play John and Craig's conversation about home automation. I don't think she heard– HEY ALEXA, PLAY JOHN AND CRAIG'S CONVERSATION ABOUT HOME AUTOMATION. Links: The Wheel Spins by Ethel Lina White The Conundrum of the Workshops by Rudyard Kipling OpenAI's controversial Sora is finally launching today. Will it truly disrupt Hollywood? by Wendy Lee for LA Times I Went to the Premiere of the First Commercially Streaming AI-Generated Movies by Jason Koehler A timeline of the fatal shooting of UnitedHealthcare CEO Brian Thompson and search for his killer by Michael R. Sisal and Cedar Attanasio for Associated Press How do you license a fortune teller? by Paul Debole An I.V.F. Mix-Up, a Shocking Discovery and an Unbearable Choice by Susan Dominus for NYT Magazine Monsters, Aliens, and Holes in the Ground by Stu Horvath Your Consciousness Can Connect With the Whole Universe by Manasee Wagh for Popular Mechanics Get a Scriptnotes T-shirt! Check out the Inneresting Newsletter Gift a Scriptnotes Subscription or treat yourself to a premium subscription! Craig Mazin on Threads and Instagram John August on BlueSky, Threads, Instagram, and Mastodon Outro by Matthew Chilelli (send us yours!) Scriptnotes is produced by Drew Marquardt and edited by Matthew Chilelli. Email us at ask@johnaugust.com You can download the episode here.

This episode is presented by Midi Health, a virtual care clinic dedicated to providing expert menopause and perimenopause care to women in midlife.   For so many women, menopause is a mystery. Its symptoms can be wide-ranging and last for years, and information about treatments can be confusing - where it exists at all. To make things even more challenging, healthcare providers are often less-than-helpful when it comes to finding solutions.  Our guests today are here to help: New York Times writer Susan Dominus' recent article, “Women Have Been Misled About Menopause” was an immediate viral sensation, becoming a valuable resource on the latest research and treatments. Her reporting also resonated for another reason: the symptoms women experience are finally being taken seriously. Dr. Rebecca Brightman, a gynecologist from New York City specializing in menopausal medicine, joins the conversation to share what she's learned throughout her years of treating women facing this life-altering transition. Plus: our guests answer questions submitted by you, our listeners.See omnystudio.com/listener for privacy information.

Midway through one of the booziest holiday weekends of the year, we re-examine our love-hate relationship with alcohol.Susan Dominus, a staff writer for The New York Times Magazine, gets to the bottom of the conflicting guidance on the benefits and risks of drinking.Guest: Susan Dominus, a staff writer for The New York Times Magazine.Background reading: Research has piled up debunking the idea that moderate drinking has any health benefits.For more information on today's episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday

Writer, artist, and filmmaker Miranda July has a devoted – even rabid – following, through her writing, her work on the screen, and her collaborative art projects. Her debut 2007 collection of short stories No One Belongs Here More Than You was a publishing sensation, and her debut film, Me and You and Everyone We Know, won the Palme D'Or at Cannes Film Festival. This week, she and Michael discuss her new novel, All Fours, which explores desire, intimacy, dance, and an often overlooked part of the ageing process.Reading list:BooksNo One Belongs Here More Than You, Miranda July, 2007The First Bad Man, Miranda July, 2019All Fours, Miranda July, 2024Short Stories‘Roy Spivey', Miranda July, 2009 (The New Yorker)‘The Metal Bowl', Miranda July, 2017 (The New Yorker)‘Women Have Been Misled About Menopause', Susan Dominus, 2023 (The New York Times)What Fresh Hell Is This?, Heather Corinna, 2021Long Island, Colm Tóibín, 2024You can find these books and all the others we mentioned at your favourite independent book store. Socials: Stay in touch with Read This on Instagram and TwitterGuest: Miranda JulySee omnystudio.com/listener for privacy information.

Writer, artist, and filmmaker Miranda July has a devoted – even rabid – following, through her writing, her work on the screen, and her collaborative art projects. Her debut 2007 collection of short stories No One Belongs Here More Than You was a publishing sensation, and her debut film, Me and You and Everyone We Know, won the Palme D'Or at Cannes Film Festival. This week, she and Michael discuss her new novel, All Fours, which explores desire, intimacy, dance, and an often overlooked part of the ageing process. Reading list: Books No One Belongs Here More Than You, Miranda July, 2007 The First Bad Man, Miranda July, 2019 All Fours, Miranda July, 2024 Short Stories ‘Roy Spivey', Miranda July, 2009 (The New Yorker) ‘The Metal Bowl', Miranda July, 2017 (The New Yorker) ‘Women Have Been Misled About Menopause', Susan Dominus, 2023 (The New York Times) What Fresh Hell Is This?, Heather Corinna, 2021 Long Island, Colm Tóibín, 2024 You can find these books and all the others we mentioned at your favourite independent book store.  Socials: Stay in touch with Read This on Instagram and Twitter Guest: Miranda July

Host Andrew Xu sits down with Richard Reeves, the President of the American Institute for Boys and Men. They discuss the underrepresentation of male students on college campuses, the significance of biological differences between boys and girls, and changes in the perception of feminism over time. References "Stop Pretending You're Not Rich" by Richard Reeves, The New York Times "Of Boys and Men: Why the Modern Male Is Struggling, Why It Matters, and What to Do about It" by Richard Reeves "How to Solve the Education Crisis for Boys and Men | Richard Reeves" from TED "The Men — and Boys — Are Not Alright" from The Ezra Klein Show "There Was Definitely a Thumb on the Scale to Get Boys" by Susan Dominus, The New York Times Magazine "Less than a third of American women identify as feminists" by Catherine Morris, Ipsos

How is it that menopause, something that can affect half the population, also manages to be among the most understudied and least understood bodily phenomena? This week, journalist Susan Dominus talks with host Kimberly Drew about how a landmark study on hormone therapy for menopausal women was misunderstood in the media creating panic and long-term repercussions on the way women's symptoms were treated. To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

Hot flashes, fatigue, and vaginal dryness were some of Katie's first clues that her body was changing. Half the population will experience menopause, yet misinformation still abounds—with doctors ill-prepared to talk to patients about this major life transition. On this episode of How To!, journalist Susan Dominus joins us to share the knowledge she gained from working on her viral magazine piece, “Women Have Been Misled About Menopause.” She explains why women's pain has been ignored for so long, where to look for information, and how to connect with others during this confusing phase of life.  Resources mentioned:  “If Men Could Menstruate” by Gloria Steinem What Fresh Hell Is This?: Perimenopause, Menopause, Other Indignities, and You by Heather Corinna The Menopause Manifesto: Own Your Health with Facts and Feminism by Dr. Jen Gunter Hot Flash Sonnets by Moira Egan Alloy Midi If you liked this episode, check out: How To Make Aging Easier for Everyone.  Do you have a problem that needs solving? Send us a note at howto@slate.com or leave us a voicemail at 646-495-4001 and we might have you on the show. Subscribe for free on Apple, Spotify or wherever you listen. How To's executive producer is Derek John. Joel Meyer is our senior editor/producer. The show is produced by Rosemary Belson, with Kevin Bendis and Jabari Butler.  Slate Plus members get bonus segments and ad-free podcast feeds. Sign up now at slate.com/howtoplus. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hot flashes, fatigue, and vaginal dryness were some of Katie's first clues that her body was changing. Half the population will experience menopause, yet misinformation still abounds—with doctors ill-prepared to talk to patients about this major life transition. On this episode of How To!, journalist Susan Dominus joins us to share the knowledge she gained from working on her viral magazine piece, “Women Have Been Misled About Menopause.” She explains why women's pain has been ignored for so long, where to look for information, and how to connect with others during this confusing phase of life.  Resources mentioned:  “If Men Could Menstruate” by Gloria Steinem What Fresh Hell Is This?: Perimenopause, Menopause, Other Indignities, and You by Heather Corinna The Menopause Manifesto: Own Your Health with Facts and Feminism by Dr. Jen Gunter Hot Flash Sonnets by Moira Egan Alloy Midi If you liked this episode, check out: How To Make Aging Easier for Everyone.  Do you have a problem that needs solving? Send us a note at howto@slate.com or leave us a voicemail at 646-495-4001 and we might have you on the show. Subscribe for free on Apple, Spotify or wherever you listen. How To's executive producer is Derek John. Joel Meyer is our senior editor/producer. The show is produced by Rosemary Belson, with Kevin Bendis and Jabari Butler.  Slate Plus members get bonus segments and ad-free podcast feeds. Sign up now at slate.com/howtoplus. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hot flashes, fatigue, and vaginal dryness were some of Katie's first clues that her body was changing. Half the population will experience menopause, yet misinformation still abounds—with doctors ill-prepared to talk to patients about this major life transition. On this episode of How To!, journalist Susan Dominus joins us to share the knowledge she gained from working on her viral magazine piece, “Women Have Been Misled About Menopause.” She explains why women's pain has been ignored for so long, where to look for information, and how to connect with others during this confusing phase of life.  Resources mentioned:  “If Men Could Menstruate” by Gloria Steinem What Fresh Hell Is This?: Perimenopause, Menopause, Other Indignities, and You by Heather Corinna The Menopause Manifesto: Own Your Health with Facts and Feminism by Dr. Jen Gunter Hot Flash Sonnets by Moira Egan Alloy Midi If you liked this episode, check out: How To Make Aging Easier for Everyone.  Do you have a problem that needs solving? Send us a note at howto@slate.com or leave us a voicemail at 646-495-4001 and we might have you on the show. Subscribe for free on Apple, Spotify or wherever you listen. How To's executive producer is Derek John. Joel Meyer is our senior editor/producer. The show is produced by Rosemary Belson, with Kevin Bendis and Jabari Butler.  Slate Plus members get bonus segments and ad-free podcast feeds. Sign up now at slate.com/howtoplus. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hot flashes, fatigue, and vaginal dryness were some of Katie's first clues that her body was changing. Half the population will experience menopause, yet misinformation still abounds—with doctors ill-prepared to talk to patients about this major life transition. On this episode of How To!, journalist Susan Dominus joins us to share the knowledge she gained from working on her viral magazine piece, “Women Have Been Misled About Menopause.” She explains why women's pain has been ignored for so long, where to look for information, and how to connect with others during this confusing phase of life.  Resources mentioned:  “If Men Could Menstruate” by Gloria Steinem What Fresh Hell Is This?: Perimenopause, Menopause, Other Indignities, and You by Heather Corinna The Menopause Manifesto: Own Your Health with Facts and Feminism by Dr. Jen Gunter Hot Flash Sonnets by Moira Egan Alloy Midi If you liked this episode, check out: How To Make Aging Easier for Everyone.  Do you have a problem that needs solving? Send us a note at howto@slate.com or leave us a voicemail at 646-495-4001 and we might have you on the show. Subscribe for free on Apple, Spotify or wherever you listen. How To's executive producer is Derek John. Joel Meyer is our senior editor/producer. The show is produced by Rosemary Belson, with Kevin Bendis and Jabari Butler.  Slate Plus members get bonus segments and ad-free podcast feeds. Sign up now at slate.com/howtoplus. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hot flashes, fatigue, and vaginal dryness were some of Katie's first clues that her body was changing. Half the population will experience menopause, yet misinformation still abounds—with doctors ill-prepared to talk to patients about this major life transition. On this episode of How To!, journalist Susan Dominus joins us to share the knowledge she gained from working on her viral magazine piece, “Women Have Been Misled About Menopause.” She explains why women's pain has been ignored for so long, where to look for information, and how to connect with others during this confusing phase of life.  If you liked this episode, check out: How To Make Aging Easier for Everyone. Do you have a problem that needs solving? Send us a note at howto@slate.com or leave us a voicemail at 646-495-4001 and we might have you on the show. Subscribe for free on Apple, Spotify or wherever you listen. Resources mentioned:  “If Men Could Menstruate” by Gloria Steinem What Fresh Hell Is This?: Perimenopause, Menopause, Other Indignities, and You by Heather Corinna The Menopause Manifesto: Own Your Health with Facts and Feminism by Dr. Jen Gunter Hot Flash Sonnets by Moira Egan Alloy Midi How To's executive producer is Derek John. Joel Meyer is our senior editor/producer. The show is produced by Rosemary Belson, with Kevin Bendis and Jabari Butler. By the way, Slate Plus members get bonus segments and ad-free podcast feeds! Sign up now at slate.com/howtoplus. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hot flashes, fatigue, and vaginal dryness were some of Katie's first clues that her body was changing. Half the population will experience menopause, yet misinformation still abounds—with doctors ill-prepared to talk to patients about this major life transition. On this episode of How To!, journalist Susan Dominus joins us to share the knowledge she gained from working on her viral magazine piece, “Women Have Been Misled About Menopause.” She explains why women's pain has been ignored for so long, where to look for information, and how to connect with others during this confusing phase of life.  If you liked this episode, check out: How To Make Aging Easier for Everyone. Do you have a problem that needs solving? Send us a note at howto@slate.com or leave us a voicemail at 646-495-4001 and we might have you on the show. Subscribe for free on Apple, Spotify or wherever you listen. Resources mentioned:  “If Men Could Menstruate” by Gloria Steinem What Fresh Hell Is This?: Perimenopause, Menopause, Other Indignities, and You by Heather Corinna The Menopause Manifesto: Own Your Health with Facts and Feminism by Dr. Jen Gunter Hot Flash Sonnets by Moira Egan Alloy Midi How To's executive producer is Derek John. Joel Meyer is our senior editor/producer. The show is produced by Rosemary Belson, with Kevin Bendis and Jabari Butler. By the way, Slate Plus members get bonus segments and ad-free podcast feeds! Sign up now at slate.com/howtoplus. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hot flashes, fatigue, and vaginal dryness were some of Katie's first clues that her body was changing. Half the population will experience menopause, yet misinformation still abounds—with doctors ill-prepared to talk to patients about this major life transition. On this episode of How To!, journalist Susan Dominus joins us to share the knowledge she gained from working on her viral magazine piece, “Women Have Been Misled About Menopause.” She explains why women's pain has been ignored for so long, where to look for information, and how to connect with others during this confusing phase of life.  If you liked this episode, check out: How To Make Aging Easier for Everyone. Do you have a problem that needs solving? Send us a note at howto@slate.com or leave us a voicemail at 646-495-4001 and we might have you on the show. Subscribe for free on Apple, Spotify or wherever you listen. Resources mentioned:  “If Men Could Menstruate” by Gloria Steinem What Fresh Hell Is This?: Perimenopause, Menopause, Other Indignities, and You by Heather Corinna The Menopause Manifesto: Own Your Health with Facts and Feminism by Dr. Jen Gunter Hot Flash Sonnets by Moira Egan Alloy Midi How To's executive producer is Derek John. Joel Meyer is our senior editor/producer. The show is produced by Rosemary Belson, with Kevin Bendis and Jabari Butler. By the way, Slate Plus members get bonus segments and ad-free podcast feeds! Sign up now at slate.com/howtoplus. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hot flashes, fatigue, and vaginal dryness were some of Katie's first clues that her body was changing. Half the population will experience menopause, yet misinformation still abounds—with doctors ill-prepared to talk to patients about this major life transition. On this episode of How To!, journalist Susan Dominus joins us to share the knowledge she gained from working on her viral magazine piece, “Women Have Been Misled About Menopause.” She explains why women's pain has been ignored for so long, where to look for information, and how to connect with others during this confusing phase of life.  If you liked this episode, check out: How To Make Aging Easier for Everyone. Do you have a problem that needs solving? Send us a note at howto@slate.com or leave us a voicemail at 646-495-4001 and we might have you on the show. Subscribe for free on Apple, Spotify or wherever you listen. Resources mentioned:  “If Men Could Menstruate” by Gloria Steinem What Fresh Hell Is This?: Perimenopause, Menopause, Other Indignities, and You by Heather Corinna The Menopause Manifesto: Own Your Health with Facts and Feminism by Dr. Jen Gunter Hot Flash Sonnets by Moira Egan Alloy Midi How To's executive producer is Derek John. Joel Meyer is our senior editor/producer. The show is produced by Rosemary Belson, with Kevin Bendis and Jabari Butler. By the way, Slate Plus members get bonus segments and ad-free podcast feeds! Sign up now at slate.com/howtoplus. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode you will hear:   (15:05) Mark and Julia discuss an article that appeared in the New York Times on 9/26/2023 by Susan Dominus entitled, “There Was Definitely a Thumb on the Scale to Get Boys This Year”. Julia and I discuss the gender gap in college and how some college admission offices are prioritizing men more than ever when making admission decisions.     (38:36) Mark and Julia discuss a Speakpipe question that asked us to follow up on a previous conversation Julia and I discussed about “standard strong' students   (01:22:54) Mark interviews Rick Clark, AVP and Director of Undergraduate Admissions at Georgia Tech and Brennan Barnard, Director of the Khan Labs Academy; Brennan and Rick discuss the most challenging and controversial topics facing college admissions officers (Part 2 of 3) Part 2-Preview v Brennan and Rick have a disagreement about Early Decision, each one shares their reason for their view on Early Decision v Rick discusses the encroachment of the federal government in regulating admissions practices. v Rick talks about how the admissions funnel is being threatened by all of the challenges. v Brennan and Rick discuss legacy admissions v Rick talks about race based affirmative action v Brennan talks about how athletic recruiting is the big conversation we are not having v Rick talks about how he and Brennan do not always agree on athletic recruiting and college admissions v Rick talks about how some people are naïve about the business realities of college admissions         (01:30:00) Recommended Resource:    Speakpipe.com/YCBK is our method if you want to ask a question and we will be prioritizing all questions sent in via Speakpipe.   (01:40:54) Spotlight: University of Dayton 1 of 2  https://udayton.edu/   You can also use this for many other purposes: 1) Send us constructive criticism about how we can improve our podcast 2) Share an encouraging word about something you like about an episode or the podcast in general 3) Share a topic or an article you would like us to address 4) Share a speaker you want us to interview 5) Leave positive feedback for one of our interviewees. We will send your verbal feedback directly to them and I can almost assure you, your positive feedback will make their day. If you have a question for one of our upcoming interviews with admissions professionals, here is a list of admissions professionals who we will interview in 2023 or 2024 Confirmed interviews not yet completedBard-Mackie Siebens Rice University-Tamara Siler American University-Andrea Felder Pitzer College-Yvonne Berumen Chapman University-Marcela Meija-Martinez Connecticut College-Andy Strickler* Trinity College-Anthony Berry* College of the Atlantic-Heather Albert* Spelman College-Chelsea Holley* Scripps College-Victoria Romero* Saint Louis University-Daniel Wood-(Interview is about transfer admissions, Daniel is a transfer counselor) Colby College-Randi Arsenault* University of Georgia-David Graves* University of Minnesota-Keri Risic Cornell University-Jonathon Burdick Oberlin College-Manuel Carballo Carleton College-Art Rodriguez Swarthmore-Jim Bok Joy St. Johns-Harvard Duke-Christoph Guttentag Florida State-John Barnhill Southern Methodist University-Elena Hicks Johns Hopkins-Calvin Wise Cornell University-Shawn Felton Haverford College-Jess Lord UAspire-Brendan Williams Yale University-Moira Poe Bard College Baylor University Butler University California Institute of Technology-Ashley Pallie Colorado School of Mines Creighton University University of Puget Sound- Robin Aijian Belmont University University of Tennessee-Knoxville Law School Admissions interview-Lydia Emory University-Sarbeth Fleming   To sign up to receive Your College-Bound Kid PLUS, our new monthly admissions newsletter, delivered directly to your email once a month, just go to yourcollegeboundkid.com, and you will see the sign-up popup.   Check out our new blog. We write timely and insightful articles on college admissions:   Follow Mark Stucker on Twitter to get breaking college admission news, and updates about the podcast before they go live. You can ask questions on Twitter that he will answer on the podcast. Mark will also share additional hot topics in the news and breaking news on this Twitter feed. Twitter message is also the preferred way to ask questions for our podcast:   https://twitter.com/YCBKpodcast   1. To access our transcripts, click: https://yourcollegeboundkid.com/category/transcripts/ 2. Find the specific episode transcripts for the one you want to search and click the link 3. Find the magnifying glass icon in blue (search feature) and click it 4. Enter whatever word you want to search. I.e. Loans 5. Every word in that episode when the words loans are used, will be highlighted in yellow with a timestamps 6. Click the word highlighted in yellow and the player will play the episode from that starting point 7. You can also download the entire podcast as a transcript   We would be honored if you will pass this podcast episode on to others who you feel will benefit from the content in YCBK.   Please subscribe to our podcast. It really helps us move up in Apple's search feature so others can find our podcast.   If you enjoy our podcast, would you please do us a favor and share our podcast both verbally and on social media? We would be most grateful!   If you want to help more people find Your College-Bound Kid, please make sure you follow our podcast. You will also get instant notifications as soon as each episode goes live.   Check out the college admissions books Mark recommends:   Check out the college websites Mark recommends:   If you want to have some input about what you like and what you recommend, we change about our podcast, please complete our Podcast survey; here is the link:     If you want a college consultation with Mark or Lisa or Lynda, just text Mark at 404-664-4340 or email Lisa at or Lynda at Lynda@schoolmatch4u.com. All we ask is that you review their services and pricing on their website before the complimentary session; here is link to their services with transparent pricing: https://schoolmatch4u.com/services/compare-packages/https://udayton.edu/https://udayton.edu/

Seven percent! According to a survey that was published in Mayo Clinic Proceedings, only 7% of doctors surveyed felt prepared to discuss menopause with their patients. What in the world?? Midlife women are suffering and our health care system has completely failed us! It's October 18th and it is World Menopause Day. Let's be honest, we don't need a freaking day to be concerned about this major life change. You need to understand the current state of affairs in women's healthcare so you can learn about menopause and become your own best advocate. I'm going to keep exposing the lies and pointing out the deficiencies. It's all today on the Healthy Harmony podcast. Here are key points to listen for... • The fantastic article written by Susan Dominus in The New York Times magazine, February 2023. She does a great job. I like how she sums up perimenopause and goes on to describe deficiencies in our system. • The powerful statement made by Professor Rebecca Thurston "...we have a high cultural tolerance for women's suffering. It's not regarded as important!" • Crucial facts from the Women's Health Initiative study that is affecting women's health care to this day. • How we should have different doctors to care for us in our different phases of life. Just my opinion. I can't wait to hear your thoughts! This is all about women's empowerment. It's up to you to learn and grow. It's up to you to teach your daughters how to avoid some of the misery that you have experienced. But you have to get determined to learn. This is not a “hey, I'll listen to this podcast and then I'll know exactly what to do”. This is not as simple as me just making a recommendation to you about what doc to go to. I wish it were that way! You have to be your own best advocate and to do that, you need to learn. Knowledge is Power!! And not just knowledge but application of that knowledge. That's why I'm so excited about this upcoming course and including literally everything! Everything. I want you to have the knowledge but also be equipped with a specific action plan. Be sure and hop on the First to Know list by clicking here https://www.inspirehealthyharmony.com/first-to-know.html --- Send in a voice message: https://podcasters.spotify.com/pod/show/inspirehealthyharmony/message

Susan Dominus, staff writer for The New York Times Magazine explains why many colleges have for years been operating under an unofficial affirmative action policy...for men. Liam Knox, admissions and enrollment reporter for Inside Higher Ed talks about the changes to the U.S. News and World Report's college ranking system, and how it affected where different schools fell on the influential list.

You can also listen to this episode on Apple Podcasts or Spotify! Kelly Casperson, MD, is a urologist, sexual medicine expert, and best-selling author. She is on a mission to empower women to live their best love lives.In her wildly popular book, You Are Not Broken, Dr. Casperson breaks down the common narratives that women have been told about their bodies such as “I shouldn't enjoy sex,” “I can't get any better at sex,” and “It is my partner's job to give me pleasure,” in order to help women play, explore, and normalize their sex lives.Combining the power of mind, body and relationships, she breaks down the societal barriers that keep women from fully embracing their sexuality and intimate experiences.On this episode of Beyond the Prescription, Dr. McBride and Dr. Casperson discuss desire mismatch, relationship communication, and tools to help put women back in charge of their health and sex life. It is time to normalize healthy, enjoyable sex worth desiring, and Dr. Casperson is here to help!Submit your question about sex (or anything else) for this Friday's Q&A right here!Join Dr. McBride every Monday for a new episode of Beyond the Prescription.You can subscribe on Apple Podcasts, Spotify, or on her Substack at https://lucymcbride.substack.com/podcast. You can sign up for her free weekly newsletter at lucymcbride.substack.com/welcome.Please be sure to like, rate, and review the show!The transcript of the show is here![00:00:00] Dr. McBride: Hello and welcome to my office. I'm Dr. Lucy McBride, and this is Beyond the Prescription, the show where I talk with my Dr. Caspersons like I do my patients, pulling the curtain back on what it means to be healthy and redefining health as more than the absence of disease. As a primary care doctor, I've realized that patients are more than their cholesterol and their weight.[00:00:31] We are the integrated sum of complex parts. Our stories live in our bodies. I'm here to help people tell their stories and for you to imagine and potentially get healthier from the inside out. You can subscribe to my free weekly newsletter at lucymcbride.substack.com and to the show on Apple Podcasts, Spotify, or wherever you get your podcasts.[00:00:57] So let's get into it and go Beyond the Prescription. Today on the podcast I have the honor of speaking with my friend who's also a doctor, a urologist, and a sexpert: Dr. Kelly Casperson. Last year, Kelly published the wildly popular book You Are Not Broken: Stop shoulding all over your sex life. It's a combination of real stories, conversation starters, and journaling prompts about how to have a better sex life. Kelly and I agree that mental health is health, that sexual health is health, and that women and men are unstoppable when we're armed with tools, facts, and the agency to be healthier from the inside out. Kelly, I'm thrilled to have you on the podcast today. Thank you so much for joining me.[00:01:53] Dr. Casperson:  Thanks for having me.[00:01:54] Dr. McBride: So let's get right after it. You are someone like me who believes that health includes many of the invisible components of our everyday life, including sexual health, mental health, a sense of agency over our everyday thoughts, feelings, and behaviors. You're someone who was trained in urology, which is a surgical field. And when people think about urologists, they typically think about male doctors treating male genitalia.[00:02:27] Dr. Casperson: That's right.[00:02:27] Dr. McBride: So, talk to me about what it's like to be a urologist in a male dominated field that people consider as a male dominated field, and then tell me how you came to understand Sexual health as a sort of a moral imperative to dispense more information about. [00:02:44] Dr. Casperson: Well, currently practicing urologists in America, 9% are female. We're getting there. We're about 30% of the residency slots. There's only like 200 residency slots a year. So it's not like we're going to change the 9% much quickly. It's been great. I kind of… It was challenging to get into urology.[00:03:01] I loved that. I loved the instant gratification of urology. And people are still surprised, you know, that there's women in urology and it's like I've been out of residency for 10 years now. So I don't know if that's gonna change in my career at this point. It's not changing fast. But the superpower that being a urologist brings to this whole sex medicine discussion is that I treat men.[00:03:22] And so I get to see every single day how men are treated, and I see how women are treated, and it just becomes so glaringly obvious that we treat these two people very differently, and I get to have a voice because of that. In contrast to the gynecologists who don't see that we don't downplay men's complaints, and we don't say, well, that's just a quality of life issue, or yeah, you're just getting old.[00:03:42] We don't treat men the same way we're treating women. And the sex meds and… I met a patient who was crying in my office, and the more I opened my eyes to what was going on, the more I said, I thought, “this is a huge problem, an absolute huge problem,” which I hadn't really seen before because I was not taking care of women's sexual health before I kind of got awakened to it. It's going to be lifelong work because we've got a lot of work to do.[00:04:11] Dr. McBride: Let's, so let's talk about that for a second. I think what I'm hearing you say is what I experience myself as a doctor and as a person is that we countenance men's sexual dysfunction with ease and there's a whole specialty built around men's sexual health. It's urology. But in reality, urology encompasses everyone's pelvic floor, everyone's sexual health.[00:04:37] It's just that men tend to go into the surgical field, men tend to treat men, and then the narrative is that it's really for men. So, it sounds like that was your professional path, and then you began noticing, like I do, that, hey, guess what? Women have sexual health as well. Women have pain with intercourse, low libido, pelvic floor dysfunction, vaginal dryness. And like men, women are entitled to pleasure, the absence of pain, and most importantly, in my mind, is access to nuanced information about their own bodies.[00:05:13] Dr. Casperson: Yeah, we do a very interesting thing… to stereotype what we do, we say all of men's problems are biological and all of women's problems are psychological. And so like, you know, he's got erections issues. That's a blood flow viagra problem. We've totally forgotten it could be anxiety, depression, all that stuff going on.[00:05:30] And conversely with a woman, we're like, oh, she's just depressed. She's just too uptight. We're like, no, she can have a hormone problem. Women are allowed to have biological issues also. And we really put them in these little containers and then forget about the humanness of everybody.[00:05:47] Dr. McBride: Yeah, I think, you know, we can walk and chew gum at the same time. We can have anxiety about performance, and that can be rooted in an experience that was traumatic. It can also just be rooted in low self esteem, or... Body image issues. You can also have low libido from not having enough estrogen because you're going through menopause.[00:06:08] In other words, human beings are the complex sum of different parts. So to assume that women have sexual dysfunction because it's all “in their heads” and to assume that men have sexual dysfunction because it's all just a blood flow problem is to reduce people to these very simple parts and then assign them by gender. And that is not our job as doctors. It's also just completely inappropriate. It's really depriving people of the deep understanding of how their body and minds work in tandem.[00:06:40] Dr. Casperson: That's right. Absolutely.[00:06:42] Dr. McBride: Okay, so you are sitting there with a patient who's crying. Who's and by the way, I tell my patients when they cry in my office, like, you know, they're sort of apologizing or “oh, sorry. I'm just emotional.” And I'm like, oh my gosh. I mean, it's not that I want you to cry. It's a sign that we're getting somewhere that we have something to talk about. Let's peel back the curtain on what that is. It doesn't always mean you're depressed, it doesn't mean you're a hot mess. It just means there's something that's going on that we need to connect to your body.[00:07:10] So what are you finding women come to you to complain about vis a vis sexual health, sexual dysfunction? What are the main issues they present to you with?[00:07:19] Dr. Casperson: The two main ones in my office would be vaginal dryness/general urinary syndrome/menopause. Right. So low estrogen in the pelvis causing pain with sex, burning, tearing, low lubrication, decreased arousal. It's kind of this umbrella cause. And then the second one is I don't really want to have sex, or a.k.a low libido. Oftentimes, that one's so fascinating, because it's often times not a low libido problem. They don't know what it is. They come in and they say, “I have low desire,” and you talk to them and you're like, that's not what's going on at all. And a lot of times with sex, they think it's about sex, but it's just a couple's communication problem. [00:07:56] You're assuming what he's thinking, he's not talking to you about what he's thinking, you think this is a sex problem. You're like, no, no, no, this is just a relationship communication problem. But like sex gets involved and like, it just all goes haywire.[00:08:09] Dr. McBride: Yeah, I think you're right. I think sex can be the final common pathway for a lot of personal and then relationship challenges. I was talking to one of my patients who is actually a family lawyer, like she helps people get divorced or helps people not get divorced. And she, not surprisingly, said the three things that people commonly fight about or have troubles with in their relationships are kids, money, and sex.[00:08:33] Those are three very vulnerable touch points in our lives. And so I think you're right, that sex can be kind of a symptom of other issues. But in and of itself, it's important. It's part of how we connect with our partners. It's how we experience pleasure. It's a part of the human experience. So to deny someone a conversation about what it is, whether it's truly like a body parts malfunctioning problem or it's an emotional challenge is really not okay.[00:09:02] And your book, We Are Not Broken, speaks to this notion. That having trouble with sex, whether it's desire or the parts not working isn't a personal failure or a commentary on your ability to perform as a human. It's—the diagnosis here is human. It's common. I've, I mean, patients come into me all the time, I'd say of all ages, but often in their middle age and they'll sheepishly say to me, “I'm really embarrassed to say this, but I just don't want to have sex. I love my partner, but I'm just not interested.” And they act like they're the only person who's ever thought that before. And I'll say, “Oh my gosh, I could feel in an auditorium full of women who feel the same way.”[00:09:47] They feel ashamed. They feel guilty. It's not a lack of love for their spouse. Sometimes it is, or their partner. It's simply that they are struggling to connect the body and mind and they need some support and they need to be given permission to have that conversation.[00:10:04] Dr. Casperson: Yeah. Or they've just been having crappy sex their whole life.[00:10:06] Dr. McBride: Well, that's also true.[00:10:08] Dr. Casperson: And I don't want to downplay… there is now an actual medical condition called hypoactive sexual desire disorder because they have to DSM this stuff to get FDA approved for meds, like the entire thing that medicine is, but a lot of this “low libido,” I never believe them anymore because it's there's oftentimes something else and so I'm like, “well, what about sex? Is sex good? Do you like it?” And either the answer is “yes, I love it.” And then I say, “well, you don't have a problem. Stop worrying about low libido. Just go prioritize that amazing sex you're having.”[00:10:38] It's not normal to have a spontaneous desire in a long term relationship. And number two, if they're like, yeah, I could take it or leave it. I'm like, well, that's how dopamine works. You're never going to desire something you could take or leave, right? Like anchovies on my pizza. I'm whatever, right? Like I don't desire it.[00:10:54] And then it's just like, go have the sex worth desiring, which is very stuck in depth. That's easier said than done for a lot of people. They've spent how many years having the exact same unsatisfying sex because they're having sex the other person's desiring. And really prioritizing desire equality and pleasure equality within a relationship. It's like, you don't actually have a low libido problem. You have a sexist man problem.[00:11:18] Dr. McBride: interesting. So to break that down a little bit, and I'm assuming you're talking more about women, are sort of subjugating their needs and not allowing themselves to experience pleasure as much as men are. And therefore they are just having bad sex, which of course they don't desire because why would you desire something that's not that great.[00:11:38] Dr. Casperson: I'm stereotyping, you know, a heterosexual relationship here. Within any partnered relationship, you're going to have somebody who wants sex more than the other person. That's just, that's desire mismatch, and it's completely normal. And we need to normalize that. Like you, you want to, you know, drink seltzer water way more than I do.[00:11:54] Why is there so much seltzer water in our house? Between two people, there's always different things going on. So just normalizing desire mismatch, normalizing it. The other thing to normalize is it's not the lower desire person's job to come up to the higher desire person's level. It's to work within the relationship, to be like, what does our relationship need sex wise to keep everybody happy?[00:12:14] You can fulfill some of your needs outside of my vagina, right? Now, I can say that very easily because I've been talking about sex for years, and you have to be a little more nuanced in a relationship where you've maybe never talked about sex before. Because couples don't talk about sex, and then there's a problem with it.[00:12:31] Well, I don't have the basics of how to talk about sex when it was good. Now it's broken and I really don't know how to talk about it. So even just communication skills about sex is important. But yeah, I think a lot of women and there's we do not have much research on this…We've got decent studies in like college students, which are not long term committed relationships of “well, that's what he wanted. He wanted to do it. I did it to keep him happy.” Kind of this like mercy sex to control another person's behavior. I don't want him to get grumpy. I don't want him to get mad. And so you're having sex for that reason instead of connection and pleasure. And then you come in thinking you're the problem for having low libido. It's not a low libido problem.[00:13:13] Dr. McBride: Well, and there's nothing like shame or guilt to crush a libido that's already low, right? If your relationship with your partner is rooted in shoulds, then… [00:13:24] Dr. Casperson: You need to have sex with me more is the least sexy thing you can say to somebody. The partner is telling the low desire person that they're broken and they need to up their game. Like it's worked zero out of one million times to approach it that way.[00:13:38] Dr. McBride: Well, it's also, it's probably less than zero of a million times in the sense that the telling someone how to feel and then promoting the sort of shame narrative is like the ultimate libido crusher.[00:13:50] Dr. Casperson: Yep. I'm inadequate and I'm supposed to love this thing that I don't love more. [00:13:54] Dr. McBride: So I think you're right, Kelly. I think at the end of the day, it's about communication. It's about shared responsibility for meeting each other's needs. And I think that's hard in the modern era. I mean, who has time to sit down and have a nuanced conversation about sex? But I think we have to.[00:14:11] Dr. Casperson: Right. And even I, I live, I work in a very traditional medical 15 minute visit, right? And now through my years of work, I have the podcast and the book because I cannot explain this to anybody in a 10 minute visit and undo the years of socialization that women are passive and women's pleasure doesn't matter as much.[00:14:30] Male orgasm is what we prioritize—penis and vagina sex for heterosexual people. That's the only sex you should be having. All of this stuff. And they come in with low libido, and then somebody's gonna slap them on a drug. And not undo all this biopsychosocial stuff. I saw a woman literally yesterday. She had a painful vulva and vagina from menopause. Painful to the touch, like even her just touching herself hurt. Somebody threw her on testosterone for low desire. And she's like, “well, what do you think about the testosterone?” And I'm like, “I'm a urologist. I love testosterone. I'm very comfortable with testosterone.”[00:15:06] But putting somebody on testosterone who has a painful vulva, who's never going to want to be touched in the first place, you're completely missing the boat on this. We have to address the pain before we can address the desire. And so it is complex, which is why I love this topic. And I get to keep talking about it for years.[00:15:22] Dr. McBride: Yeah, I think it's treating people from the inside out, right? It's like not band-aiding them with prescriptions and referrals and drugs before we understand the patient. We are not just a set of organs. We are thinking, feeling people who absorb the public narratives, who have been raised perhaps in our own families to think about pleasure and desire and sex itself in a certain way. I think deconstructing those narratives in our own lives, and then being comfortable talking about those things is key. And I think having people like you, Kelly, out there talking about these things in a very matter of fact way is gradually changing the narrative and hopefully empowering women to ask the right questions and give themselves permission to feel.[00:16:09] So it's interesting because you and I both know that doctors are hurried, doctors are rushed. No one has time anymore with their doctor, unfortunately. You've got the field of gynecology, which is tasked with doing your pap test, writing your mammogram order, you know, checking your pelvic exam, and how can they possibly fit into a 10 minute or even 5 minute visit a conversation about pleasure, desire, feelings, behaviors, your relationship. It's just a tall order for a single specialty, right?[00:16:45] Dr. Casperson: they can't. I mean, the other thing that we completely forget in this narrative is that women are 50% of the population, that we've completely ignored in this arena, talking about both menopause and sexual health. 50% of the population, there's not enough gynecologists. Even if they could spend 15 minutes, there's not enough of them.[00:17:02] This is primary care, internal medicine, psychiatry. We really all have to get on board, because, like, we're not a minority recessive gene problem. This is 50% of the world.[00:17:16] Dr. McBride: Right? Yeah, so one of the things I try to help patients navigate is the medical system, given that we have needs the medical system cannot meet. Arm people with the questions to bring to their gynecologists. Instead of being a passive recipient of like the pap test and the referral to the mammogram, make sure you're bringing your needs to them and asking for their advice and then making a separate appointment just for a conversation if needed because it's not the doctor's fault necessarily that they don't have time to talk about sexual desire.[00:17:49] Patients are conditioned not to ask about it. Doctors don't have time. It takes a whole lot more time to counsel someone on the nuances of behavioral health and pelvic floor and the nuances of hormone replacement therapy, which we'll talk about in a minute, than it does to hand someone a referral for a mammogram and say, you look great, see you next year.[00:18:07] Dr. Casperson: Totally. And that's where good resources like your podcast, my podcast, the book is like what you read it, you can consume it. And then our podcast will give you better resources. So you come in with the current menopause guidelines. You come in saying, “I've already talked to my partner about this.”[00:18:22] Dr. Casperson: You're telling us what you've already done. You're an engaged person. We actually want to help, right? And so it's like setting that person up to be successful in the doctor's office and to ask why so many, like, you know, the hormone thing. So many women will come to me and they'll be like, well, they took me off my hormones.[00:18:38] And I'm like, “why?” Why is a very natural question for me, right? And they're like, oh, I don't know. I didn't ask. So it's very okay to just ask why in a non threatening way to your doctor. Like that's my other doctor pro tip and how to talk to…[00:18:51] Dr. McBride: Ask why.[00:18:52] Dr. Casperson: Ask why so you understand![00:18:53] Dr. McBride: This is your body. This is your life. So let's talk about hormone… it used to be called hormone replacement therapy, HRT, now it's called menopause hormone therapy, MHT. Whatever the acronym, what I want to talk about, the conversation every woman should be entitled to about hormones and using hormone replacement therapy to offset the symptoms of menopause and to prevent the myriad potential downstream effects of the absence of hormones.[00:19:25] Just to frame the question and to give listeners a little bit of a sense of what I'm talking about, what is menopause? Menopause is defined as the absence of a menstrual period for a full year. The average age in the U.S. of menopause is 51 and a half years. That stretch of time of not having a menstrual cycle can occur in the mid 40s, it can occur in the mid 50s, there's a range.[00:19:46] And during the lead up to menopause, people can experience a variety of symptoms. As a result of our ovaries no longer making robust amounts of estrogen, progesterone, and some testosterone. That can be hot flashes, night sweats, vaginal dryness, urinary tract infections. Pelvic floor, pain with intercourse, mood instability, rage, although maybe the rage is just that we're pissed off, but yes, rage.[00:20:15] And then, of course, there are the less immediate and the long term effects of not having estrogen and progesterone in our bodies, which can be downstream osteoporosis, accelerated cognitive decline, cardiovascular disease, risk of heart attack and stroke, and then the accumulated... downsides of having painful sex or having urinary tract infections.[00:20:41] How many women do I see in their 80s, for example, who end up having recurrent urinary tract infections? They're not even sexually active, necessarily. And that could have been ameliorated with hormone therapy from the get go, when they went through menopause at age 50, for example. So, the question I want to ask you is rooted in the reality that since June 2002, when the Women's Health Initiative study was halted prematurely and the headlines read, “hormone replacement therapy is bad for you.” We really took a hard right turn in the public square on the narratives around hormones. People, patients, doctors included, have been loath to prescribe estrogen and progesterone for menopausal symptoms.[00:21:30] Because the narrative that came out of that 2002 press release was that we're doing harm to women. And that wasn't the narrative before 2002. In fact, hormone replacement therapy was almost standard of care. So you probably read the same article I did, the Susan Dominus article in the New York Times.[00:21:51] I cheered. I also was sort of pissed off reading it, thinking where has the New York Times been for 20 years, but we'll take it better late than never. Her article was a very beautiful explanation of why we deprive women of conversations around hormone replacement therapy. It's easier to not talk about hormone replacement therapy because it's a long conversation in the doctor's office.[00:22:18] There are risks of hormone replacement therapy, potential risks, but there are potential risks of not being on hormone replacement therapy. And you and I both know, and even the expert society for menopause has said that if given within the first 10 years of a woman's last menstrual cycle, hormone replacement therapy in most women does more good than harm.[00:22:47] In other words, protecting you from long term downsides of not having estrogen, osteoporosis, heart disease, stroke, etc., and treating the menopause related symptoms that you have right now, arguably is better for most women than it is to not be on hormones. Now, of course, there's nuance. If you have a personal history of estrogen sensitive breast cancer, that's going to be a different conversation.[00:23:15] To deprive women of that conversation and the choice, given that risk is everywhere and there's risks of hormones and there are risks of not being on hormones, that is where we need to start. Empowering women with facts and rooting their decisions. In their risk tolerance, not ours.[00:23:32] Dr. Casperson: Yeah, I mean, I'm to the point now in my journey of like you want to control women? I got a good idea. Make them afraid. Now you have complete control out of them.[00:23:41] Dr. McBride: Oh my gosh, Kelly, amen, hallelujah. And I'm not a conspiracy theorist, but sometimes I think I am.[00:23:46] Dr. Casperson: Well, you start, I mean, you just do this long enough and you're like, I see what's going on because you know what you do when you empower women and you take their fear away, you give them agency and you give them the ability to choose what they want to do with their body—you give them a hell of a lot more power. So, that's my whole thing now—I'm here to get rid of fear.[00:24:04] Dr. McBride: It's very simple. If you have fear and shame in the driver's seat… [00:24:07] Dr. Casperson: Boom. Control.[00:24:08] Dr. McBride: We are castrated, literally. If you have fearlessness and facts in the driver's seat and a good guide, like a Kelly Casperson or some other doctor who knows the data and is focused on you, not risk aversion for their own protection, liability wise, reputation.[00:24:29] I don't know what doctors are doing when they're depriving women of the conversation or gatekeeping on hormone replacement therapy. But when you put women in charge of their own health and give them tools and information, watch out world. [00:24:42] Dr. Casperson: Yeah. Totally. I mean, the other thing, the other piece I think that Western medicine's very bad at is preventative health care.[00:24:49] Dr. McBride: A hundred percent[00:24:49] Dr. Casperson: And if we look at menopause hormone therapy as preventative health care because what we're doing is we're preventing heart disease We're preventing dementia. We're preventing osteoporosis. We're preventing genital urinary syndrome of menopause. We're preventing diabetes. And you can't see that—you can't measure that especially on an individual scale. And so you're like well just come in when you've got osteoporosis and diabetes and heart disease. We know how to treat you; we've got tons of meds for those problems. But to change the paradigm and be like, I would like to actually not need to be treated for those things, so I want to choose hormones. Hormones aren't perfect, but they will certainly help prevent to a decent amount.[00:25:27] Dr. McBride: Right, I mean people get strokes, people get heart attacks, people get dementia for other reasons, age related, genetics, environment. But certainly the data are clear that again starting hormone replacement therapy within the 10 years of the last period tends to decrease those risks. I think what you're touching on, Kelly, is a really important point that Western medicine does a very poor job—arguably abysmal job—at countenancing things we cannot see, we cannot measure.[00:25:56] So, we can measure cholesterol, we can measure your pap test, we can look at your mammogram result. We can hold it in our hands and look at the number on the computer screen. It is less easy—it takes more time, it takes more conversation and it takes an appreciation of the invisible components of the human condition—to weave in the invisible components of life.[00:26:20] If you live to your 105 and you have perfect cholesterol and no stroke and you're, that's great. But if you are suffering for 50 years from pelvic pain, the absence of a healthy sex life, depression, anxiety, that's not necessarily a good thing we've done for this person. We can help them live long, but what about living well?[00:26:43] And by the way, they're not mutually exclusive, right? It's not like I'm saying, oh, let's knock 10 years off your life to give you a good sex life. I'm saying, let's give you both. Let's be greedy. Let's give you quantity of life and quality.[00:26:53] Dr. Casperson: I think the other thing is menopause is 30 years of your life. Right? Like, maybe you aren't going to decide to go on hormones this year, but go learn some more. You can start them next year, if you want to. Who do you want to be? What do you want your health to be? What do you want to be doing when you're 70?[00:27:12] And think about your future self, and think about how I can set her up. Because once you're 70, once you're 75, you can't start on hormones. The risk is… because, I mean, you can. Technically, you can. But the risk goes up if you don't start during what they call the healthy cell hypothesis. You've got to start on healthy cells, keep them healthy, not start hormones on unhealthy cells. So we're going to think, and I asked these 50 year old women, I'm like, what do you want to be doing when you're 72? What's your plan? And a lot of them see moms with dementia, moms with osteoporosis, they've got stiff joints, they can't get on off the ground with the grandkids.[00:27:49] And you don't have to be that. You can choose, as best as you can, to set yourself up for great health. But it requires making decisions in your 40s, in your 50s, to eat right, sleep well, exercise, possibly use hormones. We don't think about our future selves, and then, you know, she might be kind of miserable.[00:28:08] Dr. McBride: It's true. You know, you probably get this question, and I do too, from middle aged women. How can I age gracefully? What can I do to preserve my cognitive, mental, physical health over time? And that's a great question and oftentimes patients have gone on the internet and they've bought some supplements, they've bought some gizmos, they've bought some gadgets.[00:28:26] They've bought into, unfortunately, the sort of worshiping at the false idols of wellness. Not that I'm anti wellness. Wellness is part of our job, right? It's just that let's be real about what is evidence based and what is woo woo in a nice package. As you can tell, I have an opinion about that.[00:28:43] Dr. Casperson: A woman sent me on Instagram today, what do you think about this supplement? And I'm like, are you drinking alcohol? Stop. Are you exercising? Start. Are you working on love in your life and keeping your brain expanded? So many people, they get narrow in their brain and their flexibility to think as they get older.[00:29:03] Dr. McBride: Well, I think that we think that, not that people are not smart, but I think we start to think that agency exists in a pill. That we'll have control if we can just take the right supplement or pay enough money for some guru, right? And it's not that I know everything. I certainly don't. You can ask my children. It's that there is no vitamin, supplement, or pill for quality of life. It's an integrated sum of different components, and that includes agency. And hormone replacement therapy, arguably, is one of the things we can do to help people “age gracefully.” There's a whole industry, as you know, about treating the symptoms of menopause by nibbling around the edges of the symptoms, like giving you a little eye of newt and a tincture of whatever to treat the various symptoms.[00:29:50] And people will go, women will go to extreme lengths and extreme costs to avoid being on hormones because of the narrative. And so the industry is now promoting, look, you can do non hormonal treatment. And that's fine. I'm not saying, I don't think you are either, that every person should be on hormone therapy.[00:30:09] Not at all. It's not appropriate for everyone. It's not even necessary for everyone. It's just that we should be honest about the data and not steer people down the path of the sort of pseudoscientific wellness industry at the expense of their actual mental and physical health.[00:30:24] Dr. Casperson: Our good friend Rachel Rubin is quoted in that New York Times article: “menopause has the worst PR campaign in the history” of health problems which is just brilliant. [00:30:32] Dr. McBride: What is it about Rachel? She has these sound bites. That was such a freaking brilliant quote. I'm just cheering for her so big, like you are.[00:30:39] Dr. Casperson: mic drops, but it's true. Like we just, we think it's a hot flash and then we think it's done. I literally saw this woman this week. She's 52. She's having heart palpitations. She's having weight gain. She's having a moodiness. Her hot flashes are so debilitating. She has to pull over her car because it's unsafe to drive during her hot flashes.[00:30:56] She went to her provider. They're like, we'll run some tests, see what your hormones are. She's 52, hasn't had a period in two years.[00:31:03] Dr. McBride: smells like a duck, sounds like a duck, looks like a duck.[00:31:05] Dr. Casperson: To me, I'm like, you're in raging menopause, you need no blood work. Get this woman on some hormones. Like, it's so obvious to the people, because menopause and hormones actually isn't that hard. We just didn't get educated. It's not hard. We just didn't get educated for two decades. We've had two decades of doctors who didn't get taught how to treat menopause because of the Women's Health Initiative.[00:31:27] Dr. McBride: Right. And so people who are listening are going to think I'm making this up to make a point, but I'm really not. I spoke to a gynecologist this week who is someone I've worked with for decades. And again, like I'm not in the business of like demonizing other doctors. In fact, I am only as strong as my community of doctors I work with, but my patient is experiencing menopausal symptoms that are hard to measure.[00:31:49] Depression, some heart palpitations, anxiety, sleeplessness, and just feeling like she's a broken person when it's all menopause. So I call the gynecologist because I want to be a team player and ask the gynecologist, what do you think about putting her on fem ring and progesterone? This is a low risk person.[00:32:08] And she's a year and a half out of her last menstrual cycle, this was her response. She said, “can't you just put her on Prozac for the depression?” And I said, well, I'm not sure she's actually depressed. I think she's just experiencing menopause. And I think that the Prozac would maybe help with mood, but it's not giving her the treatment that is going to actually help, in my opinion.[00:32:34] She said, “can't you give her gabapentin for night sweats?” I said, absolutely. We can do the workarounds. But what are you worried about, if I may ask, about putting her on true hormone replacement therapy? Basically, the hair of the dog that bit you. And the answer was, “well, the FDA has really only approved hormone replacement therapy for vaginal dryness.”[00:32:55] I said, “well…”[00:32:56] Dr. Casperson: Not true.[00:32:57] Dr. McBride: Look, I believe in our federal government. I'm a registered Democrat, but the FDA does not know my patient. The FDA, as far as I'm concerned, is a gatekeeping apparatus to deprive women of these medications. So, as her doctors, you and me, I feel obligated to offer her something that would actually help with her symptoms instead of nibbling around the edges. What do you think? And she agreed with me. But it took a long conversation. She agreed.[00:33:24] Dr. Casperson: Well, it's the… hormones are this, it's this myth that they're so dangerous. It's like Zoloft has a black box warning for suicide. Is that the preferred drug? Besides the fact that it isn't treating the root cause, which is low hormones.[00:33:36] Dr. McBride: Exactly! The level of scrutiny on hormone replacement therapy is beyond any degree of scrutiny I've ever seen for any medication, right? Urgent cares are prescribing Z packs for viral colds. I mean... What are we doing by not giving people a natural hormone if they need it, if they want it, and they know the potential downsides?[00:33:57] Dr. Casperson: 100%. Like, once you, like, as you see, you see this. It's absolutely insane. If there was a drug that helped men live three years longer on average, every man would be on it. That drug is called menopause hormone therapy. Multiple studies showing decreased immortality, increased longevity, and not only living longer, but living quality of life longer.[00:34:22] And I'm like, do you, do you think the man would be on that if he had a chance to be on that? Heck yeah. And it's like, there's no other drug. What other drug is going to give you three extra years of life? None of our drugs, to my knowledge, have that kind of longevity data.[00:34:37] Dr. McBride: That's right.[00:34:37] Dr. Casperson: Estrogen has that longevity data. We blow it off. We would not blow it off if that was given to men.[00:34:43] Dr. McBride: So tell me what your advice to people listening to your audience, Kelly, is, when they are experiencing symptoms of menopause, their doctor may not be... interested, have the time or be informed with all the data to have a discussion. What do you tell patients to do? In the power dynamic in a doctor's office, patients assume that their doctor knows everything.[00:35:06] They're making a good judgment when frankly we are experts and we do know a lot, but it is not our job to tell you what to think, tell you how to feel or to gatekeep on medications. It's really to arm you with the tools you need to manage your everyday health. So what do you tell people? In your audience as a good kind of like three or four rules of thumb to bring to your doctor when you're experiencing menopausal symptoms or want to just have the conversation.[00:35:35] Dr. Casperson: Yeah, I would bring in the 2022 North American Menopause Guidelines. That's a great document. Doctors are going to respect that document. And it really downplays a lot of fears. It says how safe it is. So come in prepared with something that the doctor, they speak that language,[00:35:50] Dr. McBride: Great. And I'm going to link to that document in the show notes.[00:35:53] Dr. Casperson: Yep. And the other pro tip for talking to a doctor about something that they might not be comfortable with is to say, you know what I'd like?[00:35:58] I would like just to try this for a couple of months and then I'll come back and I'll report back and if it didn't go well, I'll stop. Does that sound okay to you? Most doctors are going to say yes to that. Because now they've got a plan, they know you're not going to follow up, right? I'm like, I just want to try this and see if it works.[00:36:17] Dr. Casperson: Because I think people get so bent out on hormones, they're like, “should I do hormones? Should I not? Should I? Should I not?” It's like, “just try them. You could stop. This is not an amputation. It's all okay.” But having that sort of plan with your doctor, I truly believe in a long term doctor patient relationship. They're going to know you. That is the best case scenario. That doesn't always exist in our current culture. And when women don't get what they need, the smart ones are going to go online. And that's where these online clinics for menopause are coming from, because they see we are underserving women.[00:36:51] Doctors do not have time. This is a nuanced conversation. And I think for better, for better or for worse, but I think for better, you can get your hormones online now, because you don't have to spend two hours on hold trying to make an appointment with somebody you might not even know anyways. The healthcare system is kind of bad.[00:37:08] We're not set up for this, right? We're not set up for the New York Times changing, like, how many millions of women are like, maybe I can consider hormones now. We're not set up for that. We're already full, right? So, I think that's the role of where these online clinics are going to come from. I think some are doing it well.[00:37:26] Certainly, I don't think it's as good as an inpatient, in your town doctor patient relationship. But we do not have capacity to start tackling these issues like we should. And so I think that's the new role for the online clinics.[00:37:39] Dr. McBride: Yeah, I think you're right. I mean, it's sort of like the sort of outcrop of mental health providers who are doing virtual care to kind of meet the demand. I don't think online virtual therapy is ever going to replace in person therapy, but it's better than nothing. And if they're doing good and people have managed expectations about what an online therapist can do, Great. Similarly, a lot of these outposts, these online businesses helping people with menopause and hormone replacement therapy are really doing good work, like MyAlloy, which was founded by a friend of mine, Ann Fullenweider. Their medical advisor has been Sharon Malone, who's a really well respected OBGYN in DC.[00:38:20] She's a friend of mine as well. And they're doing really good work trying to empower women with facts and information because not every woman, A, has a primary care doctor, B, is comfortable talking about these things with that doctor, and C, has the time and the visit to even discuss these things. So I think it's a net.[00:38:38] I just think people need to be careful about the snake oil salesmen that are telling you to just take this little eye of newton—whatever the metaphor is—because we run the risk of misinformation running rampant as it already is.[00:38:52] Dr. Casperson: Well, yeah. And people's dollars are limited and you go online and it's this supplement, that supplement, what's the new trendy thing? And at the end of the day, I want you to save your money. Like, you really don't need a lot of that crap. And hormones are pretty darn cheap. They've been around since the 60s and 70s, right?[00:39:08] If we came out today with a drug that made you live three years longer, you know how much that would cost? Right, and you can get that in estrogen for pretty darn cheap. So that's…[00:39:17] Dr. McBride: The other point I'd love to make that people don't always understand is there's a lot of brand sort of marketing lingo around hormones that in my opinion is unnecessary and make people think that there's like a right way or a wrong way to take hormones. The word bioidentical is sort of having a moment and I would just say to people you don't need to buy fancy brand name hormones.[00:39:41] CVS, Walgreens, not that I'm a big believer in chain pharmacies, but your regular pharmacy has “bioidentical hormones.” In other words, micronized progesterone, which is the safer progesterone and estrogen in the form of a tablet, a patch, a ring is as close as it can get to not being actually your tissue.[00:40:03] So, I think that people need to be educated on the fact that it doesn't have to be fancy, formal, or brand name, and to be suspicious of anybody who says that they have the best bioidenticals and someone else doesn't, because that is just made up.[00:40:20] Dr. Casperson: It's made up. Well, I mean bioidentical came because we were so freaking afraid of hormones That it was a way to help people stop being so afraid of hormones. So it was kind of like this lead in to safety But I tell people it's like you know when you like you have a granola bar and it says natural on it and I'm like, you know what the natural means like legally And they're like, no. And I'm like, it means nothing. It doesn't… [00:40:43] Dr. McBride: It's a marketing word. It's a marketing word. It's a way to deescalate fear and to make people feel like it's their own body. When... if we can just get rid of the charade and just get people what they need, we'd be a lot better off.[00:40:55] Dr. Casperson: Yeah. And most cheap FDA approved products are “bioidentical.” They're the same. [00:41:00] Dr. McBride: It is funny. I mean we're all victims of sort of messaging and narratives and we're beneficiaries of it too. But it's just you have to know what the landscape is because otherwise we get tripped up and believe things that are just sort of hoo ha. I'm a victim of that too. And do I buy soap at CVS that says lavender scented calming soap?[00:41:24] I was laughing at that the other day and I was like, as if this soap is going to calm my noisy brain down. If it did, that'd be awesome, but I'm just going to manage my expectations that this soap is just going to clean my hands.[00:41:37] Dr. Casperson: Yeah. A hundred percent. The power of the mind, man. I mean, going back to sex, placebo gives you an erection 40% of the time. So, the mind is very powerful.[00:41:45] Dr. McBride: It's true. So Kelly, as we come to the close of our conversation, I'd love to just thank you for helping change the narrative for arming people with facts and tools and for reaching people where they are, because this is where we need to be in the modern era. We need women to have truth, access to tools and to take shame and fear out of the driver's seat.[00:42:12] Thank you so much for joining me.[00:42:13] Dr. Casperson: Thanks for having me.[00:42:15] Dr. McBride: Thank you all for listening to Beyond the Prescription. Please don't forget to subscribe, like, download, and share the show on Apple Podcasts, Spotify, or wherever you catch your podcasts. I'd be thrilled if you liked this episode to rate and review it. And if you have a comment or question, please drop us a line at info@lucymcbride.com. The views expressed on this show are entirely my own and do not constitute medical advice for individuals. That should be obtained from your personal physician.  Get full access to Are You Okay? at lucymcbride.substack.com/subscribe

Some of the worst symptoms of menopause — including hot flashes, sleeplessness and pain during sex — have an established treatment. Why aren't more women offered it?Susan Dominus, a writer for The New York Times Magazine, explains how menopause has been misunderstood both by doctors and society for years, and tells us what happened when her article about it went viral.Guest: Susan Dominus is a writer for The New York Times Magazine.Background reading: From The New York Times Magazine: Women have been misled about menopause.A selection of seven books to guide you through menopause.For more information on today's episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday.

You can also check out this episode on Spotify!Dr. Mary Claire Haver is a board certified OBGYN and women's health advocate who has helped thousands of women going through menopause actualize their health and wellness goals. Dr. Haver's goal is to empower and educate women in their mid-lives, and help women advocate for themselves in the doctor's office. On this episode of Beyond the Prescription, Dr. McBride and Dr. Haver break down the myths and facts about menopause and hormone therapy. They discuss the harms of fear-based narratives in medicine and the importance of balancing risk to help women live longer and healthier lives.So, should you or shouldn't you take hormone replacement therapy? Dr. McBride wrote a longer piece about this decision-making process here. The upshot?* Menopause is defined as having gone a full calendar year without a menstrual period. A woman's midlife decline in estrogen and progesterone levels can cause short-term symptoms (like hot flashes, vaginal dryness, and insomnia) and can increase the risk for long-term health problems (like cardiovascular disease and osteoporosis).* In general, menopausal hormone therapy (MHT) is considered safe for most healthy women when it is initiated within 10 years of menopause.* Estrogen itself does not seem to increase the risk of breast cancer for the vast majority of women.* Unless she has had a hysterectomy, a woman should take estrogen and progesterone together.* Micronized (aka “bioidentical”) progesterone does not increase the risk of breast cancer; synthetic progesterone does seem to increase the risk, but only slightly.* Dr. McBride recommends not panicking about the new Danish study suggesting an increased risk of dementia in women who take MHT. Why? It was an observational study (not a randomized controlled trial or RCT) therefore it cannot prove causation; the study population used oral estrogen and synthetic progesterone which are not the standard of care in the U.S.; myriad RCTs show the opposite finding: that MHT is likely protective against premature cognitive decline, especially when started early. * Too many women needlessly suffer through menopause because of false narratives about the safety of MHT and because discussions about quality of life often aren't prioritized.* Don't take it from her! Dr. McBride encourages you to share the latest expert statement from the North American Menopause Society with your own doctor to help guide your decision-making process.* Women are entitled to make their own decision about hormones, armed with the data, and with an understanding of their unique risks and benefits.Dr. McBride will answer your questions about menopause and HRT on Friday. Submit your question right here!Join Dr. McBride every Monday for a new episode of Beyond the Prescription.You can subscribe on Apple Podcasts, Spotify, or on her Substack at https://lucymcbride.substack.com/podcast. You can sign up for her free weekly newsletter at lucymcbride.substack.com/welcome.Please be sure to like, rate, and review the show!The transcript of the show is here![00:00:00] Dr. McBride: Hello, and welcome to my office. I'm Dr. Lucy McBride, and this is Beyond the Prescription, the show where I talk with my guests like I do my patients, pulling the curtain back on what it means to be healthy, redefining health as more than the absence of disease. As a primary care doctor, I've realized that patients are more than their cholesterol and their weight.[00:00:31] We are the integrated sum of complex parts. Our stories live in our bodies. I'm here to help people tell their story, and for you to imagine and potentially get healthier from the inside out. You can subscribe to my free weekly newsletter at lucymcbride.substack.com and to the show on Apple Podcasts, Spotify, or wherever you get your podcasts.[00:00:57] So let's get into it and go Beyond The Prescription. Today on the podcast, I'm talking with the incredible Dr. Mary Claire Haver. She's a board certified OBGYN who has helped thousands of women who are going through perimenopause, menopause, and beyond actualize their health and wellness goals. She realized after decades of practice that she hadn't learned as much as she should have about the science of menopause, aging and inflammation.[00:01:27] She really took a deep dive into the science and has created an online course called The Galveston Diet with the goal of empowering and educating women in their mid lives. Mary Claire, thank you so much for joining me today on the podcast.[00:01:41] Dr. Haver: Thanks for having me.[00:01:42] Dr. McBride: Let's talk about the fact that women have been notoriously excluded from medical studies. Women have also been deprived in many ways of access to nuanced information about their own bodies and health. And so it's interesting right now that menopause is having this moment, right?[00:02:01] It's like Susan Dominus wrote this beautiful article about how women have been misled, and I think women around the country, around the world were like, “yes. Oh my gosh. Thank you for seeing me and hearing me.” And I think it's a historic moment where women are finally recognizing that they need to be seen and heard, and that their menopausal symptoms are not just in their head and that it's time to get the facts to put ourselves in the driver's seat. So let's just start with that article. So tell me what happened when that article in the New York Times came out, did that change increase the volume of phone calls coming to you? What? What did it mean to you?[00:02:39] Dr. Haver: I think it just validated and reinforced what I was already doing on social media and that really people were sending me the article by the thousands—I was getting tagged. I was getting, “why aren't you in this article?” I didn't even know it was being written, and I just felt like it was really well done and it really was the tip of the iceberg, but it was the first meaningful publication—in such a respected area—that really was drawing attention to the problem. But women have been screaming about this for years, and I'll tell you, so I finished my OBGYN training in 2002, which was also the year the WHI stopped the study on hormone replacement therapy and basically ended any meaningful research into menopause care for at least 20 years. [00:03:36] And when I graduated from that training program, I would've sworn on a stack of Bibles based on my board scores and my level of training that I was a world-class menopause doctor. And it wasn't until 20 years of clinical practice that I realized in going through my own menopause journey that I was not a good menopause doctor, that there were serious gaps in my own education and training.[00:04:03] So when you look at an OBGYN residency, and I know this because I was a former residency program director, and over half of what we do, probably 55 to 60% of what we do is obstetrics. All important stuff. Then everything else gets shoved in the box called gynecology. And in that gynecology box we have pediatric gynecology, we have GYN oncology, we have reproductive endocrinology, which is fertility.[00:04:29] We have everything, and menopause gets a tiny sliver of that time and education. There are only 20% of residents coming out today who feel that they had any clinical menopause training, meaning went to a clinic where they were specifically addressing a woman in menopause. When multiple surveys have been done, the doctors are realizing this is important, but they didn't get the training.[00:04:56] Nothing was really focused on that. Not to say that what we learned wasn't important. It's just menopause has never been prioritized.[00:05:03] Dr. McBride: Why do you think that is?[00:05:05] Dr. Haver: So I think it's a perfect storm of societal norms of medical education, how women have been treated through the years in medicine. I don't know about you, but we had a saying, if it walks like a duck, it talks like a duck… we love a differential diagnosis.[00:05:22] We love a standard set of symptoms, and I think one of the problems is that menopause has a very diverse presentation in each woman. Even identical twins can have completely different symptomatology. We're all going through something very similarly endocrinologically as far as our ovaries beginning to lose their eggs, and the decrease of estrogen and leading to the full menopause with no estradiol. But how that presents in our bodies is very different. So unless you've been trained in the nuances of how to pick this up, then you're going to miss it unless she's just waving a flag with hot flashes and no periods. But the symptoms of menopause begin in perimenopause seven to 10 years before.[00:06:03] So we have this entire generation of women who are suffering and going to their healthcare providers with this kind of laundry list of symptoms. And if the doctor isn't trained to realize that this constellation could all have a common denominator of decreasing estrogen levels, they may get told it's all in their head, or this is a normal part of aging, or there's nothing we can do, white knuckle it, suffer through it, you'll be fine.[00:06:30] And we're just leaving them without… they're walking out feeling dismissed, feeling like maybe they're crazy and that they are going home to cry over, I can't get any help for this. [00:06:42] Dr. McBride: I couldn't agree with you more that medical school and residency, while of course I learned a ton, did not do a fantastic job at countenancing suffering that you can't see, that you can't measure in a blood test or a CAT scan, night sweats, hot flashes, vaginal dryness. Pain with intercourse, relationships, struggles because of sexual dysfunction, decreased arousal—what we call low libido.[00:07:10] Those are things you can't see. Plus, women are used to suffering. We are very comfortable in the space of suffering, right? We deliver babies. We have our nipples cracking and bleeding with these infants hanging off of our chest. And I think it's not hyperbole to say that women are pretty good at suffering.[00:07:34] And so I think it makes sense that gynecologists who only have so much time in the office to talk to patients. And who only had a certain education and that didn't encompass menopause per se. And when we aren't comfortable talking about things we cannot see and we can't measure, we can't quantify despair, that it gets brushed under the rug.[00:07:57] It reminds me a lot of, my interest is in the relationship between mental and physical health. The relevance of mental and physical health, how we all have anxieties, we all have fears, we all have moods, we all have relationships, and we didn't talk about that at all in medical school. My psychiatry rotation was about addressing patients who are in institutions and paranoid schizophrenics, which of course is relevant, but it's not speaking to the universality of mental health as a common sort of ground zero for our whole health. So I think what you and I are doing is trying to shine a light on these universal phenomena—grief, loss, anxiety, moods, relationships. And in the case of women, the fact that every single woman, if you live long enough, will go through menopause as defined by…[00:08:47] Dr. Haver: A hundred percent.[00:08:48] Dr. McBride: The gradual decrease in the production of estrogen and progesterone, and a little testosterone, and we need to talk about it. We need to be open about it. We need to empower women with the questions to ask their doctors.[00:09:03] Dr. Haver: I think the other thing to mention here, and it's really getting brought to the forefront with the political discourse going on right now, is that society in general stops valuing a woman somehow after she's done with the ability to reproduce. And we're seeing it, and I think this is manifesting in how we are not focusing on menopause care, why the research dollars are not going to menopause care.[00:09:30] When you look at women's health spending at the NIH, it's, I think it was several billion, but only 45 million was spent on anything to do with menopause, and that was like 0.3% of the funding in women's health was going to anything to do with menopause when a third of us living, breathing, functioning women are suffering right now due to their menopause journey. We're just not valuing them.[00:09:58] Dr. McBride: And then we have, of course, the headlines that came out in 2002 when the Women's Health Initiative was stopped early, and the headlines screamed things like, I mean… you put the word breast cancer out there in a headline and the fear of breast cancer. What happened in 2002 is that this enormous study, that was the first study on hormone replacement therapy powered by NIH and Bernadette Healy was the first female head of the NIH was stopped early because there was a signal suggesting that hormone replacement therapy causes breast cancer. Now, when you hear that as a woman and women are—we're smart, we're paying attention, we also are not immune to fear-based messaging. And so talk about what happened and how it has taken us so long to correct the narrative on hormone replacement therapy as a treatment for menopausal symptoms.[00:10:52] Dr. Haver: So the fanfare with which that announcement was made was pretty much unprecedented in medicine. There was a press conference called in DC and there were reporters everywhere, and one of the—it was only one person in the study who decided to release this information. This was before the study had actually even been published.[00:11:17] Healthcare providers couldn't even read the article and decide for themselves. So everyone's in their offices, I'm in residency, and we're just doing our normal day-to-day lives. And it was like a shot went off across the world in our world that estrogen causes breast cancer, hormone therapy is going to kill you.[00:11:36] And that was the take home message. And all of us were reeling. We're reading the headlines. No one can get their hands on the study for another week or two. 80% of prescriptions for hormone replacement therapy stopped immediately based on one announcement. And in the 20 years, that 22 years now that have ensued since that publication, so much of that has been walked back on multiple levels.[00:12:04] It's been reanalyzed, looked at, retracted. People have apologized who were in the study, and none of that has gotten any of the fanfare. It's been really hard. The best book that came out was Estrogen Matters, the Avrum Blooming book. He really broke that study apart so a layman could read it and understand, and the fallacies of the study and the things that it really represented.[00:12:28] So the average age in the study was 65 years old. We weren't talking about newly menopausal women in the beginning of their menopause journey and the potential benefits, the estrogen only arm had a 30% decrease risk of developing breast cancer. No one talks about that. And that women who were diagnosed with breast cancer, it was itI believe the risk went from 3.2 to 3.8% if I have the numbers correct, and that represented a 25% increase, but it was still very small. And that the women who were on hormone replacement therapy at the time of their diagnosis had a 20 to 30% higher survival rate, five-year survival rate than the women that weren't.[00:13:09] So women were not allowed to digest that information and decide for themselves what their tolerance to this risk was, and if they still, for the health benefits, for their quality of life, they were absolutely denied. So in desperation, I think practitioners began giving people antidepressants, which can be helpful, but it's never the gold standard and the gold standard for menopausal symptoms is always going to be estrogen. But doctors just were so terrified. The patients were terrified. They didn't want to get sued.I remember being fearful of being sued for giving hormone replacement therapy.[00:13:49] And the mantra, like I was taught, kind of was only give it if she's threatening suicide, like if there's no other option, you know, otherwise do anything other than giving her back the hormones she so desperately needs.[00:14:02] Dr. McBride: Yeah, it's such an example of the paternalism of medicine or maternalism because I think women doctors too were depriving women of these hormones, but it's more this sort of like sense that doctors should be the gatekeepers and we should be the arbiters of the patient's risk tolerance. It reminds me a heck of a whole lot of COVID when instead of giving the public sort of nuanced information about, you know, calibrating your risk mitigation measures to your actual level of risk, given your age and underlying health conditions and number of vaccines.[00:14:39] Instead just telling people, here's what you do. Regardless, we are going to tell you how much risk to tolerate in medicine, as you well know, first of all, patients don't trust doctors who think they know everything. I mean, I don't, and I certainly don't know everything. And I think we owe patients…We owe women the ability to make their own decisions based on the facts and the information they have, and we need to countenance the invisible suffering, just like we countenance the risk of breast cancer. Certainly there are risks of hormone replacement therapy and there are risks of not being on hormone replacement therapy. And let's talk about both and let's try to thread that needle with the understanding that life is risky.[00:15:21] There's risk everywhere you go. You could live your life not on hormone replacement therapy cuz of the fear of breast cancer that may be completely founded because of a family history, a genetic predisposition, but then you're going to have to tolerate perhaps an increased risk for cardiovascular disease, an increased risk for premature cognitive decline, an increased risk for osteoporosis, sexual side effects, etc.[00:15:42] We owe women the discussion, the conversation. But as you know, the conversation takes time. And then it takes more time when you have to undo a fixed narrative that a woman is bringing to the doctor's office saying, “oh wow. I don't want to be on hormones because that causes breast cancer. And that's not because these people are not intelligent, it's because they've been told…”[00:16:05] Dr. Haver: It's going to ake everybody being on board. It's going to take years, but I am so proud to be on… I can't believe this. I'm just a regular OBGYN. There's nothing special about me and, but I…[00:16:19] Dr. McBride: Oh, there's so much special about you. [00:16:20] Dr. Haver: I'm kicking the door down on this I feel like… And it's probably the thing I'm most proud about in medicine, and I've delivered about tens of thousand, over 10,000 babies. I've done thousands of surgeries, all good stuff. But I feel like this is the biggest impact I can make for women's health ever.[00:16:40] Dr. McBride: I think you're making a big difference. I mean, it's amazing to me how menopause is having this moment right now. My friend Sharon Malone, who's a dear friend and colleague, was just on Oprah talking about menopause. I mean, thank you Oprah, for shining a light. My friend Rachel Rubin, our mutual friend, Kelly Caspersen, I mean, we're talking about sex, we're talking about vaginal lubrication, libido.[00:17:01] We're talking about taking control of our health kind of for the first time in a long time. I don't know if you think it's related to COVID and to me COVID laid bare our vulnerability to narratives that aren't always rooted in truth. COVID laid bare the vast marketplace of sort of pseudoscience and weird stuff.[00:17:24] It also laid bare how vulnerable we are as consumers of the healthcare industry. And how we really need to know what questions to ask. And so then I think, that's where I came in. I started writing and podcasting and you started doing your messaging and it's, I think people are really glad to have people they trust without any sort of agenda.[00:17:42] Dr. Haver: Social media for me opened my eyes to how much misinformation as far as menopause care, how much disinformation and misinformation was out there. And then one of the caveats of this menopause explosion and what the New York Times touched on is the gold rush. And so my… I live in the menopause metaverse, I call it, and my social media feed is just filled with everything menopause.[00:18:13] The wackadoodle companies that are coming up with miracle cures and vitamins and promising you're getting your unrealistic expectations of what this one little herb or something can do and get your life back and lose weight and get your sex life back and all this stuff. And none of it is founded in any evidence.[00:18:32] They're marketing to a very vulnerable population. They're desperate and willing to try anything at this point because they can't get it from, most of them can't get it from their healthcare provider, and so a lot of these new companies are popping up and really exploiting this very vulnerable population, and it makes me insane.[00:18:50] Dr. McBride: I know. I feel like wellness is a word that I think MDs and medical professionals should embrace, right? Like, what else am I doing other than helping people be well? But the wellness industry is taking advantage of women's vulnerabilities, insecurities and lack of access to the truth. And then it's fleeing them and giving them false promises. Not always. I mean, there's some good actors.[00:19:16] And I believe in vitamin supplementation if you're deficient in something in addition to getting your nutrients through food. But I think we agree that there's no sort of supplement that's going to kind of fix your broken marriage and your low libido that stems from sexual trauma or… we have to do the work, we have to do the hard job of looking at these parts of our lives that doctors unfortunately haven't really countenanced and we have to understand that the treatment for menopausal symptoms and the way to prevent the downstream cardiovascular, cognitive, and bone related health problems that stem from the absence of hormones is hormone replacement therapy.[00:19:56] Women are entitled to a conversation with their provider about hormone replacement therapy. Whether or not they take it is a different story, but in general, the benefits of hormone replacement therapy outweigh the risks in women who are within that 10 year window from their last menstrual cycle[00:20:11] Dr. Haver:  Right. And when a patient leaves my clinic, now again, I have a background in nutrition. I'm certified in culinary medicine. I can do this with confidence in myself that I know what I'm doing. I give them what I call the menopause toolkit, and so the first thing we address is nutrition. I'm lucky enough that I have a body scanner where I can measure muscle mass.[00:20:34] All of this is all so intertwined, visceral fat, body fat. So I give them very direct nutritional recommendations based on their body composition. We talk about hormones—pharmacology, hormonal pharmacology, and non-hormonal pharmacology based on their symptoms. We talk about supplementation based on what their nutrition profile looks at.[00:20:56] We talk about stress reduction, we talk about sleep quality, and every single one of those things is important to turn that wheel so that you can have the best healthspan and lifespan when a patient comes to my clinic. Yes, she's suffering, but her goal is not to have a bikini. Most of them… they don't care about bikinis anymore.[00:21:14] Sure, that'd be great. But they're more looking at their parents and what themselves and their siblings are going through taking care of parents with chronic disease. When I have a patient who is caring six or 10 years for a debilitated parent or grandparent, it shapes their lives and they are so motivated. What can I do now to keep me from doing this to my children, to my loved ones, to my nieces and nephews. I want to live the most independent, healthiest life that I can. So I'm not gonna burden the people I brought into this world with my disease and illness. Now, there's no guarantees on that. They're like, “how can I stack those cards in my favor?”[00:21:55] And I said, okay, let's get started. Nutrition, exercise, pharmacology, sleep, stress. It all works together to get you where you wanna be.[00:22:04] Dr. McBride: You're absolutely right and it so dovetails with the way I talk to my own patients and the way I write that sleep is arguably the best chemical boost you can give yourself—getting good sleep. Now, it's easier said than done. I mean, just telling someone to sleep more is not the end of the story for most people. But managing stress, having brain space to be mindful about our eating, our relationships, being in touch with how we feel, sort of being in the driver's seat, if you can, of your everyday habits. I think all of that relates to symptoms of menopause. It also relates to just our everyday health.[00:22:44] I think you're right. You look at our parents, our patients in their middle age often look at their parents and they see if their mom has osteoporosis and maybe some cognitive decline. Their dad may have cardiovascular disease or vice versa. And those are not a hundred percent preventable of course, but it's pretty incredible what hormone replacement therapy will and can do if you pair it with appropriate lifestyle modifications and you pair it with someone who's a good coach and a good guide because it's not enough for me to say, eat less red meat, Exercise more, sleep eight hours, manage your stress, take hormones, Good luck. I mean, first of all, I don't do all that stuff well all the time myself. Most humans need a trusted guide. They need structure, they need support, they need follow up, and they need cheerleading, and they need data and evidence and facts to guide their behavioral changes.[00:23:36] How does your program work? Like tell me, if you have a new patient who comes in, you do an assessment, let's say you recommend hormone replacement therapy. How does that look? I mean, do you typically recommend the patch? Do you recommend the ring? Do you recommend oral hormones? Tell me about the menu of options for hormones.[00:23:54] Dr. Haver: So I do stick to the FDA approved options. Estradiol is the number one hormone that I prescribe. So there are synthetic estrogens on the market. There's the conjugated, equine estrogens on the market. There are also different compounded options because compounding is not subject to regulation. It's not subject to testing. It can be very variable. I really want to stick to—I know when I pull it off the shelf, it's what I use for myself. There's a 98% chance of what they say is in that box, is in it, and that my patient's going to get a steady state. I usually go with a transdermal option over oral for estradiol because the first pass effect of the liver, which you and I know, when that estrogen bump hits the liver, it upregulates our clotting factors. So there's about a seven out of 10,000 women increase. So not very much, but still seven women who will have a blood clot. I can negate that and put you back to your baseline.[00:24:55]  Not saying you will never have a clot, but I won't increase that risk with a transdermal option. And because of cost, affordability, and options, I usually do an estradiol patch. If we decide on progesterone as well, There's some wonderful new data that's come out looking at different progesterones, synthetic versus progesterone, which is what our ovaries make… I hate the term bioidentical because it's become a marketing term, not a medical term…[00:25:19] Dr. McBride: Thank you. Oh my gosh. Thank you.[00:25:21] Dr. Haver: Women are getting sold a bill of goods and they're being told lies and they're being told the most ridiculous marketing that, oh, buy BHRT… I'm like, I don't use that term. I talk about estradiol and I talk about progesterone. I do not pick up a phone and call another physician and talk about bioidentical. That is, I would be laughed out of… I think people meant well with it, but it's turned into this crazy marketing term to get you to buy their product. So for progesterone I do the oral micronized progesterone. It has the best safety profile for breast cancer.[00:25:57] Actually, in the latest studies, no increased risk of breast cancer. It was the synthetics. So I tend to avoid those as much as possible. So for myself, I use an estradiol patch and I take my oral progesterone at night. I still have my uterus. For me, I find progesterone sedating, which is a benefit because it helps me with sleep.[00:26:17] Now, if someone is also having severe vaginal atrophy, I look at vaginal preparations. I love a vaginal ring. Nobody can afford it. It is top tier for most insurance plans. It's a wonderful method of delivery. I think it's amazing, but again, cost is a problem. So for vaginal estrogen, I tend to stick with the vaginal estrogen cream, which is generic and is very affordable for most patients if we decide she needs testosterone.[00:26:47] And I pretty much only prescribe that in a case of hypoactive sexual desire disorder. There's not enough evidence yet for me to prescribe it for other reasons I don't. Everyone's testosterone is low, guys, everyone, you don't even need it checked if you're menopausal, half of your testosterone unless you have a tumor.[00:27:06] And so if she's suffering from HSDD, then we discuss different options, the vii, the adi, the testosterone, if she chooses testosterone, because I don't have a great FDA-approved option. And it's very difficult for my patients to get the man's version because they only need 1/10  of the dose and they have to break the packets open and it's just Complicated. I will do the local compounding pharmacy to get some testosterone for them.[00:27:30] Dr. McBride: So helpful. So I wanna ask you a couple questions and just to clarify for listeners, vaginal estrogen, in my humble opinion, I wonder if you agree topical estrogen or just vaginal estrogen in a tablet form that is not systemically absorbed, is just topical to help with vaginal dryness. It also can help with urinary continence. It can help with muscle tone in the pelvic floor if paired with PT or just Kegels. That should be in my opinion, over the counter. That should be non-prescription. It should be something women are…[00:28:01] Dr. Haver: Yes, and I believe it is in the UK now.[00:28:04] Dr. McBride: And even for women who have had breast cancer, it's, and look, talk to your primary care provider, your OBGYN. Don't take my advice on the internet, because I'm not your doctor necessarily, but I think it should be over the counter when you talk about vaginal estrogen, like a femme ring. The femme ring is the vaginal estrogen formulation. That is systemic hormone replacement therapy. The hormone replacement therapy we're talking about is to help with not only the symptoms locally, but also the sort of whole person, the bone density, the cardiovascular risk protection.[00:28:38] So yeah, you're right. The femme ring is extremely expensive, but if someone's insurance happens to cover it, the femme ring, there's a nice way to go with the estrogen, and then you have to do the progesterone. In addition, if you have a uterus, you have to take progesterone with estrogen. Those are the two train tracks, because without progesterone, estrogen alone can stimulate the uterus and cause uterine cancer.[00:29:01] So that's sort of the mantra. Testosterone, as you said, is sort of out of the box a little bit, but it is becoming clear that it's good for hypoactive sexual desire disorder. I do have patients asking me about it because they're like, “What about belly fat, muscle mass? Can I use testosterone for that?” I know you have this wonderful program you're doing on Instagram with the belly fat challenge, and you're doing this on the heels of your Galveston diet. So tell me about testosterone for women a little bit more if you could vis-a-vis metabolism muscle mass.[00:29:31] Dr. Haver: So one of the phenomena that we know about in body composition changes through the menopause transition, we see an acceleration of body fat deposition. So it's kind of steady state and then whoop goes up in perimenopause and we see an increasing of the rate of muscle loss with age. It's called sarcopenia, which is the natural loss of muscle mass with age, and you have to combat that with consistent resistance training and adequate protein intake.[00:29:57] There's no way around it. You are going to lose muscle if you don't do the thing. And that's just your body breaking down. And that muscle is so much more important than I ever learned in school. It is controlling our insulin resistance. It is controlling our strength and functionality. And so I am one of those girls who was genetically low muscle.[00:30:16] I was always lean. But lean to me means muscle. I didn't have very much growing up. I could never do a pull up. I still can't do one. And so there's some thinking, so I'm using testosterone for myself off label, and I'm very clear about that because I'm genetically predisposed to low muscle mass. I measure it every day. I'm about the 90th percentile and I wanna hang on to that. So I'm doing a very low dose of transdermal testosterone in order to help my efforts of protein intake and resistance training to hang on and possibly build some muscle. So my levels are physiologic. I check my levels every three to six months.[00:30:56] I think the last one I was 47. And so in our natural lifespan, When we're our reproductive height, when our libidos were on point, your testosterone level is never above 70, and some of these pellet companies are recommending that you be super physiologically dosed with no evidence to support it.[00:31:18] I have had patients come and say, just check my level. My pellet should have worn off six months ago. They're still out of 300. That is men start at 246. Okay, so I asked the patient, okay, let me just make this clear. Are you transitioning? I fully support that. If this is what you're doing, I'm not the right doctor to help you through this, but, and they're like, no, I'm like, your levels are at a transitioning level. [00:31:41] I don't have clinical evidence to support a super physiologic dose of testosterone for patients. And that's what's being sold to them by a lot of these camp bonding companies.[00:31:53] Dr. McBride: So you're saying the data are not there yet, but there's enough evidence in your mind to use it at a physiologic dose to combat sarcopenia, which is low muscle mass. In addition to using it off label for people with low sexual desire, low libido.[00:32:11] Dr. Haver: Yes. So we have great studies for menopausal women, and testosterone clearly showed a benefit. FDA has not picked up those studies and that work hasn't been done yet. It takes a pharmaceutical company saying, it's worth it for me to do this, and they're not doing it because it's, it's all about economics and there is ot a lot of money in it for them, which is why we don't have an option.[00:32:34] Dr. McBride: Right. Let's talk diet and nutrition and what happens to our bodies around menopause. I've just gone through menopause myself. I'm on hormone replacement therapy. Woohoo. It's fantastic. I mean, my symptoms weren't that dramatic, but I think what happened was when I went on hormone replacement therapy, I just felt like myself.[00:32:54] It wasn't like I could name what it was. I mean, I had some hot flashes, night sweats weren't bad, but I don't know, I just slept better. I felt like myself again. But nutrition, so patients commonly come into me around perimenopause in their late forties, early fifties saying, my belly fat has increased. I've never had belly fat there. And they're just, their body composition has changed and they find it harder to…[00:33:20] It's true that estrogen in the absence of estrogen makes it easier to accumulate weight in our middles typically, and then it increases our risk for insulin resistance or pre-diabetes or diabetes.[00:33:33] So what are you counseling patients? I know it's not a one size fits all prescription, but what are you counseling patients in general about how to combat that metabolic shift and the weight distribution?[00:33:44] Dr. Haver: So there are certain behaviors and patterns of eating that we know through studies that for women in their menopausal journey, are going to lead to less accumulation of visceral or belly fat. When we say visceral fat, I want to be clear. So we have the fat, we've known our whole lives, subcutaneous fat.[00:34:03] It gives us our breasts, our butts, our curves, our cellulite. We don't like it. It's cosmetically distressing, but in, in usual physiologic amounts, it's not dangerous. Okay, visceral fat is different. That's the fat inside of our abdomens and our wrapping around our organs. That at a level, at a certain level starts leading to inflammation.[00:34:21] It produces cytokines, it's linked to cardiovascular disease, stroke, diabetes, et cetera. And we see a rapid accumulation of this fat in the menopause transition due to multiple factors, but leading off with decreasing estrogen levels. So, what can we do about it? So number one, women who have 25 grams or more of fiber in their diet per day have a much lower risk of visceral fat, and there's probably several reasons for this. It slows down the absorption of glucose into our bloodstreams, which lowers our insulin levels. It keeps us full longer. You're less likely to overeat or make different choices. [00:34:55] Number two, having a diet that has less than 25 grams of added sugar in your diet per day—less visceral fat and added sugars are the sugars in cooking and processing. And I'm not talking about keto, so I'm talking about the sugars that are found naturally in fruits, vegetables, dairy, they come in a package with fiber, with other micronutrients, with other things that keep you healthy and slow down their absorption.[00:35:21] It's Very different from drinking a soda, and that's the number one source of added sugar in the United States in women's diets is beverages that sugar is instantly absorbed. It instantly goes into the bloodstream, causes a spike in glucose, and the concomitant rise in insulin levels, which then drives fat to the abdomen.[00:35:37] The whole thing happens so fast before you even realize it drives your blood sugar down. Boom, you're hungry again. And so keeping those added sugars less than 25 grams per day. Not to say you can never sip on a soda or have a cookie, but you have a budget. And if you can keep it less than 25 a day, you're going to have less visceral fat and less ensuing health risks because of it. Third, there are some supplements done, checked on, menopausal women that seem like they were helpful. Number one is eating something rich in probiotics every day. So that could be yogurt, kimchi, miso, tempe, whatever… chinese pickles, there's lots of options, but the study that was done in menopausal women was actually done on supplementation, because that's easier to control and study is give someone a pill versus have them eat a tub of yogurt.[00:36:25] So, when the study was done on obese, menopausal women with hypertension, so the weight loss was the same. They put them both on calorie restricted diets, but added in a probiotic supplement for Group B, and the supplement group had less visceral fat, so they did their visceral fat measurements, and they also had lower blood pressure.[00:36:44] So keeping the gut microbiome healthy, both through fiber, which we talked about earlier and with probiotics, restocking the pond, as I call it, can be really helpful. Turmeric supplementation or eating diets rich in turmeric, not so typical in the US. People are now drinking turmeric teas or adding it to certain things, but turmeric supplementation, especially if you add a black pepper extract, can be really helpful.[00:37:06] Zone two training. It's getting real with Peter's book, Peter Attia's book. It's getting really popular right now. Zone two training is training below the level that you can talk through, so like when you're a little bit breathless and so there's multiple, you can google different ways to calculate what that is.[00:37:22] 220 minus your age, 60 to 70% of that is one thing that patients use. I wear a heart rate monitor usually, and so I know what my maximum heart rates are and I can do the calculation from there, but 150 minutes a week of zone two training is really helpful in that, and resistance training is important as well. [00:37:40] Dr. McBride: Okay, so to summarize these pearls of wisdom we're talking about ideally getting at least 25 grams of fiber a day. Ideally less than 25 grams of added sugar a day. We're talking about supplements based on your unique profile and health issues, and we're talking about resistance training and 150 minutes of exercise a week, building that muscle mass, keeping that motor running. In addition, we talked about sleep stress management. I mean, that's a good kit. I mean, it's a lot to do. You know, when I talk to patients about these kind of lifestyle modifications, they often aspire to these things. They aspire to sleep more or drink less alcohol.[00:38:19] Eat less sugar. One of the challenges is minding the gap between our best intentions and the execution, as I say to patients all the time,even walking around your block for five minutes after work is better than nothing. While you're on the phone, maybe do a couple squats or wall sits.[00:38:38] Notice how you feel if you take a week off of alcohol. I decided to take May off of alcohol, not because I have an alcohol problem per se, but just because I feel better without it. And it really does take at least a week in my mind to kind of notice the effect. One night's not gonna do it. So my advice to patients is just small, incremental bite-sized changes. Don't try to make wholesale changes in every aspect of your everyday health because you just won't do it.[00:39:08] Dr. Haver: Exactly. I say, we have the rest of your life to figure this out. Let's take this one step at a time. Here's the ultimate plan. We're building a house here, so first we have to lay the foundation, then we're gonna put up the studs. Then we're gonna, you know, like we have to take this step-by-step. We don't want you to be overwhelmed. We don't want you to feel like these are new habits. We're building one habit at a time.[00:39:29] Dr. McBride: That's right. That's right. Mary Claire, thank you so much for joining me today. How can people find you on the internet? In your clinic, like how can people find your wisdom and expertise?[00:39:41] Dr. Haver: So we have tons of blogs packed with information on how to advocate for yourself at your doctor's visit and you know what tests to ask for. There's lots of nutrition information at our website at galvestondiet.com. You can also find me on my biggest social media channels on Instagram and TikTok. [00:40:06] Dr. McBride: Thank you all for listening to Beyond the Prescription. Please don't forget to subscribe, like, download and share the show on Apple Podcasts, Spotify, or wherever you catch your podcasts. I'd be thrilled if you liked this episode to rate and review it. And if you have a comment or question, please drop us a line at info@lucymcbride.com.[00:40:28] The views expressed on this show are entirely my own and do not constitute medical advice for individuals that should be obtained from your personal physician. Get full access to Are You Okay? at lucymcbride.substack.com/subscribe

Therapy is about as much of the American experience these days as baseball, pickup trucks, and apple pie. Professional counseling is now seen as more than just a last resort for psychological distress, but as a healthy, essential path for resolving personal issues. In 2019, nearly 20% of Americans received some form of mental health treatment ranging from medication to therapy. Over 40% of Americans have seen a counselor at some point in their lives.   Recently in the New York Times, journalist Susan Dominus asked an important question, especially given that the U.S. is in the grip of an ever-worsening mental health crisis: “Does therapy really work?”   On one hand, dozens of studies confirm the value of talk-based therapy. A landmark 1977 study, for example, found that those with significant psychological distress “fared better than 75 percent of those with similar diagnoses who went untreated.” University of Wisconsin-Madison researcher Bruce Wampold put it, “the fact that you can just go talk to another human being … and get effect sizes that are measurable” is kind of miraculous.    Other research, Dominus explains, is less clear. A 2021 study found that more than half of depression patients saw little or no benefit from talk therapy, and only one third found their depression receding long term. Another study found that only 50% of patients responded to cognitive behavioral therapy regarding anxiety disorders. The uncertainty has led some to push for alternative treatments, including more prescriptions of drugs like psilocybin, the active ingredient in so-called magic mushrooms. One prominent researcher mused, “Maybe we have reached the limit of what you can do by talking to somebody.”  Of course, the results of therapy depend on a number of factors. While counseling is a powerful tool, it can only aim at the question, “What's going on inside of me?” Often missed, which is especially consequential for a culture in a crisis of mental health, are the fixed reference points outside of ourselves by which we can be known and orient who we are.   Psychology is one of the many areas of modern life that has taken what sociologists call “an inward turn,” characterized by radical individualism and reliance on self-definition. Rather than pursue healing or the restoration of relationships, counseling can devolve into endless rounds of affirmation, a sort of perpetual re-baptism in the church of self-expression. This is just one way that therapy has replaced religion for many seekers. Self-discovery is the new salvation, and therapists the new priests. The key feature of psychology as religion, however, is the self as the new deity.   This has only enabled, as Lisa Selin Davis observed recently at The Free Press, so many of the West's top schools and institutions to embrace and employ Critical Race Theory rhetoric and LBGTQ politics. The American Counseling Association now divides counselors and clients into either “privileged” and “marginalized” groups with a dedicated script for each and little mercy for those who dissent. More states have passed so-called “anti-conversion-therapy” laws, which threaten professionals who do anything other than only affirm a client's proposed gender identity.   As a result, deeper mental health issues are never addressed, and anyone who speaks up can find themselves out of a job. One therapist in training put it, “My concern is that we're not helping people heal and transcend. We're just helping people live in their victim mentality.” In a tragic irony, the inward turn has made it harder, not easier, for the struggle to know themselves.  There are some, many of them Christians, striving to rethink psychology and counsel others by looking outward as well as inward, to know themselves by first knowing what is true and good. We can only know ourselves by first knowing reality, ultimately God and the world He made. Any mental health journey without that fixed reference point is destined to harm more than it helps.  This Breakpoint was co-authored by Kasey Leander. To help us share Breakpoint with others, leave a review on your favorite podcast app. For more resources to live like a Christian in this cultural moment, go to breakpoint.org. 

As Tracy moved closer to menopause, she lost her sex drive, started to put on visceral belly fat, experienced vaginal dryness and a host of other symptoms. She went to her primary care doctor, was told there was nothing that could be done and to just "deal with it." Tracy shares her story and how finding the NYT article "Women Have Been Misled About Menopause" by Susan Dominus reinvigorated her to keep advocating for herself. Find her @fabricaerial   Teacher Training Registration closes May 31 HERE Roll It Out Registration Order your copy, ebook or audio book of UNDERSTANDING AERIAL SILKS on Amazon Get the FREE 3-Part Video Series Aerial REHAB  Register for the FREE Mini Course HERE Reach me on Instagram @kerrywee1 and kerry@wrapyourheadaroundsilks.com Greener Grass Podcast HERE Part of the Digitent Podcast NetworkSee omnystudio.com/listener for privacy information.

Menopause is the most ubiquitous experience nobody talks about. Pain, hot flashes, mental clouding — they're a constellation of symptoms that women are routinely told are “normal.” Abdul reflects on the costs, to individuals and society. Then he sits down with Susan Dominus, a staff writer at the New York Times Magazine, whose recent piece on menopause treatment has forced doctors to rethink their recommendations. 

For so many women, menopause is a mystery. Its symptoms can be wide-ranging and last for years, and information about treatments can be confusing - where it exists at all. To make things even more challenging, healthcare providers are often less-than-helpful when it comes to finding solutions.  Our guests today are here to help: New York Times writer Susan Dominus' recent article, “Women Have Been Misled About Menopause” was an immediate viral sensation, becoming a valuable resource on the latest research and treatments. Her reporting also resonated for another reason: the symptoms women experience are finally being taken seriously. Dr. Rebecca Brightman, a gynecologist from New York City specializing in menopausal medicine, joins the conversation to share what she's learned throughout her years of treating women facing this life-altering transition. Plus: our guests answer questions submitted by you, our listeners. Want to be a know-it-all? Subscribe to Wake Up Call, our jam-packed newsletter. Monday through Saturday, we break down the top news stories of the day, answer your pressing questions, and scour the internet for the best entertainment tidbits, streaming recommendations, recipes, and health and wellness tips. To sign up, go to katiecouric.com, or click here.See omnystudio.com/listener for privacy information.

Our guest this week is New York Times writer Susan Dominus. Susan has worked for the Times since 2007, first as a Metro columnist and then as staff writer with The New York Times Magazine. In 2018, she was part of a team that won a Pulitzer Prize, for public service for reporting on workplace sexual harassment issues. And her most recent piece, "Women Have Been Misled About Menopause," went viral in a big way. To support the production of the show, please join our Patreon: patreon.com/everythingisfineFor Everything Is Fine merch, head to Tee Public: https://www.teepublic.com/user/everything-is-fine-the-podcast Hosted on Acast. See acast.com/privacy for more information.

Dr. Dekel presented what Susan Dominus missed. There are natural or bioidentical solutions for the misery women are facing with perimenopause and menopause. Big PhRMA's drug options are not the answer. Physicians are not trained in this area in medical school but no one is stopping them from learning. This was recorded live at WBAI radio. We had offered Jeff T Bowles book "16 Fascinating Covid-19 & Spanish Flu Mysteries Solved!" and asked for $25 pledge for the radio station. Call 212-209-2950 to donate and email for your PDF to download bannedcovidbook@gmail.com

Menopause has a PR problem. New York Times journalist Susan Dominus shares her own experience and what the new science says about menopause.

New York Times writer Susan Dominus wrote a feature "The Vicious Cycle" about the neglect that women in menopause suffer. Unfortunately, she wrote only a part of the story. We share with our listeners that all is not so grim and that the wonderful world of bioidentical hormones have been used for decades successfully to stop the vicious cycle.

Women have suffered through hot flashes and hormone fluxes thinking there was no help for symptoms of menopause. New York Times Magazine staff writer Susan Dominus joins host Krys Boyd to talk about hormone therapy, which was once regularly prescribed but now is rarely used following a flawed study that doctors are hesitant to move past. Her article is “Women Have Been Misled About Menopause.”

The menopause world (and midlife women) have been buzzing this week about a recent New York Times article by Susan Dominus entitled “Women Have Been Misled About Menopause.” This is a truly brilliant article which brings to light a number of incredibly important issues about the lack of menopause education for both physicians and patients. Dominus digs into the details of exactly why we were fed so much misinformation after the 2002 Women's Health Initiative study was stopped prematurely due to fear of cancer and other diseases -which has since turned out to be some of the most inaccurate and misunderstood information ever published. Now over 20 years later, this article paints a picture of not only how this happened, but where we are now and how women‘s menopausal health is still not given nearly the attention that it should. This is a must-read for every woman, and gives great information that you can use to take to your own doctor to advocate for your own health. You will likely be much more educated than your doctor after you listen to this talk! Women Have Been Misled About Menopause NYT Article - https://bit.ly/40X8sUh IG Live with Stacy London - https://www.instagram.com/p/CodjWwLPiqL/ Menopause Symptom Checker - https://bit.ly/3EaarLr Learn more about the Empowering Midlife Wellness Retreat by visiting www.completemidlifewellness.com

You can also listen to this episode on Spotify!Human suffering is impossible to fully measure. It includes our core values and beliefs. It encompasses our tolerance for pain. If medical decision-making is about avoiding risk, who gets to decide what's even worth risking? If avoiding one risk means adding another, when are we doing “no harm”?Doctors can measure blood pressure, blood sugar, liver enzymes, and white cells; we can even run genetic profiles to look for elevated risks for cancer (like the BRCA gene mutations). But there is no blood test for depression, no MRI for chronic pain, no line in the sand separating worry from debilitating fear.In this episode, Dr. McBride discusses how modern medicine tends to discount things it cannot see — and how to better advocate for ourselves in the doctor's office. Join Dr. McBride every Monday for a new episode of Beyond the Prescription. You can subscribe on Apple Podcasts, Spotify, or at lucymcbride.com/podcast. Get full access to her free weekly Are You Okay? newsletter at https://lucymcbride.substack.com/welcomePlease be sure to like, rate, review — and enjoy — the show!The transcript of the show is here!Dr. Lucy McBride: Hello, and welcome to my home office. I'm Dr. Lucy McBride, and this is "Beyond the Prescription". Today, it's just you and me. Every other week this season, I'll talk to you like I do my patients, pulling the curtain back on what it means to be healthy, peeling back the layers of everyday medical problems I see. In clinical practice for over 20 years, I've found that patients generally want the same things. A framework to evaluate their risks, [00:00:30] access to the truth and the courage to face it, and tools and actionable information to be healthy mentally and physically. So, whether it's managing weight, cholesterol, cancer, or mental health issues, we all want to feel more in control of our health. Here, I'll talk to you about how to be a little more okay tomorrow than you are today, and how to be healthy from the inside out. Let's go. Today, dear listeners, I'd like to talk to you about how we do [00:01:00] such a bad job in the modern medical landscape at addressing the invisible suffering people experience. What do I mean by this? I read this article that you probably read in the New York Times, on February 1st, 2023. It was a fantastic article, written by Susan Dominus. The title, "Women Have Been Misled About Menopause." When I first read the article, I was honestly speechless. I was delighted but I was also kind of shocked that the mainstream media are finally recognizing [00:01:30] the invisible toll on women from the absence of hormones. I'm gonna get to the substance of that article in a minute. But the takeaway from that article, which I really encourage you to read, and I'll link it in the show notes, is not so much that women should be given nuanced information about hormone replacement therapy around menopause. They should. It's more that this article represents another example of modern medicine's inability to countenance things we cannot measure, [00:02:00] things we cannot see. In other words, as I talk about commonly, there are lots of things we can measure. We can measure cholesterol, we can measure blood pressure, we can measure genetics, you know, we can measure predispositions towards genetic phenomena. What is harder to quantify but no less important is the everyday suffering that people experience. And it's not just about menopause. Let's think about other subjects in which we cannot quantify suffering. Let's talk about mental health. There's no blood test, there's no MRI [00:02:30] for depression. There is no line in the sand that separates anxiety that's unhealthy from anxiety that is "normal". Let's talk about COVID-19 and our response to it. We, for good reason, protected, at all costs, against COVID-19 in 2020, when we didn't know what was going on, we saw people dying, vulnerable people in nursing homes particularly vulnerable. But we also, [00:03:00] in my humble opinion, failed to acknowledge, over time, as more information and data was collected, and as we had extraordinary vaccines, we failed to zoom out and recognize that health is about more than the absence of COVID-19. In other words, not having COVID is great. But health is also about being in the classroom, seeing the faces of your teachers, participating in social activities. Particularly for young minds and for older people, [00:03:30] social interaction is crucial. But those are not measurable. There's no PCR test for despair. In other words, it's much easier to defend against the enemy that we can see than it is to protect against the things we can't see. Here's another example of where we don't do well in this department. By the way, this is not gonna be a depressing podcast episode, although if you're depressed, you know, fine. I have lots of thoughts and ideas on how we can mitigate this problem, [00:04:00] from a societal level and on an individual level. But another area in which we see this problem where we don't countenance the invisible is in conversations about death and dying. I have the honor of being part of these conversations. My patients who have terminal illnesses, my patients who are elderly and infirm, they have accumulated medical conditions, none of which is going to necessarily take them, but we know that given their age and their comorbidities, that they have, you know, less than two years, less than five years to live. [00:04:30] The way I approach these conversations with families and the patient is not by helping them decide on a menu which medicine, which medical procedure they want, at which time and which day, because guess what? We can't predict the future. We don't have a crystal ball on how everything is going to go in the last days, months, years of life. So, instead of asking people, "Do you wanna be on a ventilator? Do you want dialysis? Do you want aggressive measures, you know, at the end of your life?" I instead frame the question in a different way. What gives you meaning in your life? [00:05:00] In other words, let's center life in the question instead of death. Let's center your values as a way to pressure-test our decisions moving forward about interventions like feeding tubes or dialysis. Let's take an example. And my friend Eleanor Tanno, who's a physician in the D.C. area, and a good friend of mine, has written me a guest post for my newsletter about this very issue. As she says, you know, when she's talking to patients and families about end-of-life decisions, how can you decide on what you want for dinner [00:05:30] when you don't even know what's on the menu? In other words, when we're thinking about end-of-life decision-making, planning ahead, we wanna ask the patient, what is it you live for? And what are the things that you consider a bare minimum for a quality of life? And if your quality of life is contingent on being able to read the New York Times, listen to Beethoven, or know your grandchildren's names, any medical intervention that we're deciding on that's not gonna restore those faculties [00:06:00] is something we should spare you. Because at the end of the day, we do harm by prolonging life that's not quality. Then this gets back to my original point that we don't do a good job of measuring things we cannot see. It is harder to measure the value someone places in the ability to identify music they hear on the radio than it is to quantify their EKG, their heart rate, their blood pressure. Whether we're talking about menopause, and the absence of hormones, [00:06:30] and the unmeasurable suffering, like hot flashes and night sweats, sexual dysfunction, low sexual desire, loss of muscle tone in the pelvic floor, or whether we're talking about the despair that existed during the pandemic and that still does, or whether we're talking about people's core values or the way they value life, we have to do better as doctors, and as a society, having those conversations. Talking about feelings, talking about values, talking about goals, [00:07:00] and talking about what gives us pain and what gives us pleasure. For every pain we experience, we have to marry that with pleasure. In other words, we need to talk about quality of life just as much as quantity. Now, quantity of life is why we go to medical school. We're there to help people live long. But I don't see it that way as I've seen patients for 22 years. Of course, my job is to help people live as long as they can. But health is about more than just not dying. [00:07:30] Health is about living. And it's about living on people's own terms. It is not appropriate for me to set the agenda for someone's life. It's not even appropriate, in my humble opinion, to help prolong someone's life if their quality of life is not what they would want. In other words, in the modern era, I can help someone not have a heart attack, not have a stroke, not get breast cancer, or detect it really early, and I can help people live to their 95, 100. That's the benefit of modern medicine. [00:08:00] But at what cost? Now, don't go home to your spouse or your partner or your child and say, "Gosh, this Dr. McBride on her podcast is advocating for premature death." Not at all. What I'm advocating for is a thoughtful zooming-out on what it means to be alive. What are the key elements that you need to feel healthy? Who are the people in your life that you trust? What are the things that feed your soul? Is it going to the opera? Is it playing bridge with your friends? Is it having a cup of tea [00:08:30] with a neighbor? Is it your cat? Is it your writing? Is it your art? Is it your profession? Is it your children? What is it that gives you meaning, and lean into those things. What is it that gives you pain? Is it your arthritic hip? Is it grief? Is it depression that has bled into fatigue, despair, and hopelessness? Those count. Those matter in a decision-making rubric when you're in the doctor's office. [00:09:00] Those should matter when you're making a decision about any medical intervention or any decision in your life, whether it's medical or not. In other words, the way I would hope medicine to evolve over time is to meet people where they are, not to use my personal risk tolerance as a doctor to inform our decisions. And certainly, not to inform a narrative in the public square, to inform a public health policy or a decision not to give someone hormone replacement therapy [00:09:30] when they deserve to have that conversation. Going back to the hormone replacement therapy for a minute, because I'm sure you'll have questions, not every woman needs to be on hormone replacement therapy. Not every woman should be on hormone replacement therapy. What the article is talking about, finally, is what doctors have known for a long time, which is that for most women, within 10 years of their last menstrual cycle, the benefits of hormone therapy generally outweigh the risks. Of course there's nuance, and that's why you need to talk to your own doctor. [00:10:00] When we're talking about COVID-19, of course we wanna protect against COVID. Of course, no one wants to get sick. No one wants to be in the hospital. No one wants to lose a loved one to COVID-19. Of course. But we can do both. We can actually protect against COVID by getting vaccinated and boosted if necessary, and by working on our underlying conditions, and by framing our risk of COVID in the context of our whole lives. In other words, yes, we wanna protect against COVID. No one wants to get sick, no one wants to miss school or work. No one wants to get very sick. [00:10:30] No one wants to end up in the hospital or die from COVID-19, of course. But in the vaccine era, that risk has been so well-mitigated that it's appropriate now, as it has been for a long time, to think about health in a broader way. Again, health includes seeing friends, socializing, and living our normal lives, to the extent life is normal at all in the modern era. And last, when we think about end-of-life care, it's less appropriate to think about what metrics and what tests and procedures we want [00:11:00] than it is to center our decisions on quality of life and values. Now, this may all sound very vague to you, and it should, because what I'm talking about is a framework. I'm not talking about specific medical advice. All I ask is that you consider for a minute what it means to you to be healthy. I talked about that a bit in my first podcast. I talked about the integrated sum of four "I"s. And now I'd ask you to think one click over, and ask yourself, when you're making a medical decision, [00:11:30] to take cholesterol medication or not, to take hormone replacement therapy or not, to decide on a more aggressive intervention or a more conservative intervention, I would make sure that you're using your North Stars, your instinct, your desires, your wants, and your tolerance for risk, as a guide, and not your doctor's or the public narrative. All decisions, in my humble opinion, should be rooted in medical evidence and facts, [00:12:00] and the patient's story. That's my public service announcement. I'll just end by saying this. I hope that my own children, and I hope that your children grow up in a medical landscape in this country where people are seen, people are heard, and when there's an acknowledgement that our stories live in our bodies, and that the best medicine happens when we marry medical evidence with a patient's own narrative. So, I might be dead before that happens [00:12:30] and before there's universal access to primary care, with behavioral and mental health woven into it. But in the meantime, I hope you'll keep listening. I hope you'll follow along with me. My passion for discussing these kinds of issues is endless. Sometimes I exhaust myself, but I think it's really important to empower people with framework around which to make complicated decisions, to give people permission to feel and to think for themselves, and to help them understand [00:13:00] where to find the data. Because look, everyone's a guru these days. We have a gururification of the public square. And I'm not saying I know everything. Please ask my children. I don't. But I just want you to be aware that it's important to have access to the facts, to people you trust, to nuanced information, and for you to be in the driver's seat of your health, and no one else. I hope that makes sense, I hope that's helpful, and I'll see you next week.  Get full access to Are You Okay? at lucymcbride.substack.com/subscribe

This week, David Plotz, John Dickerson, and Emily Bazelon discuss the raucous State of the Union; the spy balloon and U.S.-China relations; and Susan Dominus's reporting on missed opportunities in treating menopause. Here are some notes and references from this week's show: Zolan Kanno-Youngs, Katie Rogers and Peter Baker for The New York Times: “Kamala Harris Is Trying to Define Her Vice Presidency. Even Her Allies Are Tired of Waiting.” Susan Dominus for The New York Times Magazine: “Women Have Been Misled About Menopause”  Stephen I. Vladeck for The New York Times: “Don't Let Republican ‘Judge Shoppers' Thwart the Will of Voters” Here are this week's chatters: John: Andor; Kialo.com  Emily: Sabawoon Samim for Afghanistan Analysts Network: “New Lives In The City: How Taleban Have Experienced Life In Kabul” David: City Cast DC live; The Brothers Ashkenazi, by I. J Singer. Join David Plotz for a live taping of the City Cast DC podcast at the Politics & Prose Union Market location, Wednesday March 1 at 6:30 pm. You can register here for a free ticket.  Listener chatter from Ryan Clements: The Outlaw Ocean: Journeys Across the Last Untamed Frontier, by Ian Urbina; The Outlaw Ocean podcast For this week's Slate Plus bonus segment David, John, and Emily discuss the use of “judge shopping”—picking a preferred judge by suing in a single-judge district—to invalidate legislation nationwide.  Tweet us your questions and chatters @SlateGabfest or email us at gabfest@slate.com. (Messages may be quoted by name unless the writer stipulates otherwise.) Podcast production by Cheyna Roth and Tori Dominguez.  Research by Bridgette Dunlap. Make an impact this Black History Month by helping Macy's on their mission to fund UNCF scholarships for HBCU students. Go to macys.com/purpose to learn more. Learn more about your ad choices. Visit megaphone.fm/adchoices

This week, David Plotz, John Dickerson, and Emily Bazelon discuss the raucous State of the Union; the spy balloon and U.S.-China relations; and Susan Dominus's reporting on missed opportunities in treating menopause. Here are some notes and references from this week's show: Zolan Kanno-Youngs, Katie Rogers and Peter Baker for The New York Times: “Kamala Harris Is Trying to Define Her Vice Presidency. Even Her Allies Are Tired of Waiting.” Susan Dominus for The New York Times Magazine: “Women Have Been Misled About Menopause”  Stephen I. Vladeck for The New York Times: “Don't Let Republican ‘Judge Shoppers' Thwart the Will of Voters” Here are this week's chatters: John: Andor; Kialo.com  Emily: Sabawoon Samim for Afghanistan Analysts Network: “New Lives In The City: How Taleban Have Experienced Life In Kabul” David: City Cast DC live; The Brothers Ashkenazi, by I. J Singer. Join David Plotz for a live taping of the City Cast DC podcast at the Politics & Prose Union Market location, Wednesday March 1 at 6:30 pm. You can register here for a free ticket.  Listener chatter from Ryan Clements: The Outlaw Ocean: Journeys Across the Last Untamed Frontier, by Ian Urbina; The Outlaw Ocean podcast For this week's Slate Plus bonus segment David, John, and Emily discuss the use of “judge shopping”—picking a preferred judge by suing in a single-judge district—to invalidate legislation nationwide.  Tweet us your questions and chatters @SlateGabfest or email us at gabfest@slate.com. (Messages may be quoted by name unless the writer stipulates otherwise.) Podcast production by Cheyna Roth and Tori Dominguez.  Research by Bridgette Dunlap. Make an impact this Black History Month by helping Macy's on their mission to fund UNCF scholarships for HBCU students. Go to macys.com/purpose to learn more. Learn more about your ad choices. Visit megaphone.fm/adchoices

This week, David Plotz, John Dickerson, and Emily Bazelon discuss the raucous State of the Union; the spy balloon and U.S.-China relations; and Susan Dominus's reporting on missed opportunities in treating menopause. Here are some notes and references from this week's show: Zolan Kanno-Youngs, Katie Rogers and Peter Baker for The New York Times: “Kamala Harris Is Trying to Define Her Vice Presidency. Even Her Allies Are Tired of Waiting.” Susan Dominus for The New York Times Magazine: “Women Have Been Misled About Menopause”  Stephen I. Vladeck for The New York Times: “Don't Let Republican ‘Judge Shoppers' Thwart the Will of Voters” Here are this week's chatters: John: Andor; Kialo.com  Emily: Sabawoon Samim for Afghanistan Analysts Network: “New Lives In The City: How Taleban Have Experienced Life In Kabul” David: City Cast DC live; The Brothers Ashkenazi, by I. J Singer. Join David Plotz for a live taping of the City Cast DC podcast at the Politics & Prose Union Market location, Wednesday March 1 at 6:30 pm. You can register here for a free ticket.  Listener chatter from Ryan Clements: The Outlaw Ocean: Journeys Across the Last Untamed Frontier, by Ian Urbina; The Outlaw Ocean podcast For this week's Slate Plus bonus segment David, John, and Emily discuss the use of “judge shopping”—picking a preferred judge by suing in a single-judge district—to invalidate legislation nationwide.  Tweet us your questions and chatters @SlateGabfest or email us at gabfest@slate.com. (Messages may be quoted by name unless the writer stipulates otherwise.) Podcast production by Cheyna Roth and Tori Dominguez.  Research by Bridgette Dunlap. Make an impact this Black History Month by helping Macy's on their mission to fund UNCF scholarships for HBCU students. Go to macys.com/purpose to learn more. Learn more about your ad choices. Visit megaphone.fm/adchoices

When New York Times Magazine staff writer Susan Dominus began reporting her cover story on menopause, she was surprised by the number of women she met who had resigned themselves to a life of hot flashes, poor sleep, brain fog and depression, all of which are common symptoms of menopause. There was a near universal acceptance that this was their new reality. But in fact, there are medically accepted therapies, like hormone treatment, to address these symptoms. Yet few women seem to be offered this relief. Why is menopause, a normal biological condition that over a million women in the U.S. will enter each year, so misunderstood? And are women conditioned to tolerate suffering such that they don't seek help for menopausal symptoms? We'll talk to Dominus and experts about menopause and hear from you: What have you been told about menopause that you have come to question? Guests: Susan Dominus, staff writer, New York Times Magazine - Dominus wrote the recent New York Times Magazine article "Women Have Been Misled About Menopause" Dr. Stephanie Faubion, medical director, North American Menopause Society; director of the Center for Women's Health, Mayo Clinic Omisade Burney-Scott, creator of the "Black Girls Guide to Surviving Menopause"

Women have suffered for centuries from the worst symptoms of menopause, which include hot flashes, depression, pain during sex, and insomnia. So why don't we have better solutions? Susan Dominus, staff writer at The New York Times Magazine, joins us to discuss her new piece "Women Have Been Misled About Menopause," which examines how women have been denied potentially helpful menopause treatments for decades. She'll also take your calls on the subject.

In the first episode of five of season four of the Lunch Break podcast, we discuss The Rwandan Genocide through a conflict resolution lens and discuss the country's process of reconciliation. Sources used: Hugo, Pieter and Susan Dominus. “Portraits of Reconciliation (Rwandan)”. The New York Times. 2014. Staub, Ervin. 2014. “The Challenging Road to Reconciliation in Rwanda: Societal Processes, Interventions and Their Evaluation.” Journal of Social and Political Psychology. Vol. 2(1), 505–517, doi:10.5964/jspp.v2i1.294. 100 days of terror The Rwandan Genocide America's secret role in the Rwandan genocide | Rwanda | The Guardian As We Forgive: Can Mercy Restore What Genocides Destroyed?” (Rwanda). A Documentary Film. The Rwanda Genocide | Holocaust Encyclopedia (ushmm.org) The United Nations (UN) Definition of Genocide - Public Health Breaking the cycle of violence conflict with Johan Galtung Reconciliation: https://www.beyondintractability.org/essay/reconciliation The Lunch Break podcast centers on conversations about social matters and innovations related to the environment, world conflicts, and the internet. Follow us on Instagram for updates on future podcast episodes: @lunchbreakig.

This week, Quinta and Scott were joined by RatSec 1.0 host emeritus Benjamin Wittes to talk through the week's big national security news stories, including: “Sharing is Caring.” Earlier this week, an unnamed senior U.S. official indicated that the United States is providing targeting information to Ukrainian forces–only to have other officials walk back that assertion almost immediately. What is actually happening? And why is the Biden administration so paranoid about discussing it openly?“The Chief's Thief.” Recent revelations have shown that former Chief of Staff Mark Meadows played an integral role in leading efforts to overturn the results of the 2020 elections in the lead up to the Jan. 6 insurrection. But the Justice Department still has taken no steps toward prosecuting him for contempt of Congress for refusing to fully comply with the Jan. 6 committee's investigation. What should we make of Meadows? And what should be done about him?“Trolling Alone.” Incidents of harassment and hostility are an increasingly commonplace feature of our political discourse, particularly for public officials working on hot button issues. What should we make of this breakdown in civility? What causes it? And where may it lead?For object lessons, Quinta passed along Susan Dominus's eye-opening piece on “The Nightmare of Being a Surrogate Mother in the Ukraine War.” Scott recommended NASA's amazing virtual tour of the solar system to all his fellow stargazers (as well as astronomer Paul Byrne's amazing Twitter account). And Ben announced a new podcast experiment he is launching: live discussions with Ukrainians living on the front lines.Plus here are a few other stories we mentioned or recommended:Politico's piece on the Jan. 6 committee's focus on junior aides and staff;Frank Michelman's classic law review article “Law's Republic”;Radiolab's piece on Israel and the global surrogacy industry, “Birthstory”Be sure to visit our show page at www.lawfareblog.com and to follow us on Twitter at @RatlSecurity. We lightly edited and re-posted this episode to eliminate an offensive term that one of our co-hosts used inadvertently. For an explanation and apology, see his Tweet thread here. See acast.com/privacy for privacy and opt-out information.

Over the last year, our national dialogue about the Jan. 6 Capitol attack has become ever more focused on politics, congressional investigations and criminal prosecutions. But what about the people who were actually on the front lines on Jan. 6?Natalie Orpett sat down with Susan Dominus and Luke Broadwater, who recently published an article in The New York Times Magazine called, “The Capitol Police and the Scars of Jan. 6.” The article tells the stories of some of the law enforcement officers who were there that day, many of whom continue to experience the impact of Jan. 6 in profoundly personal ways. They talked about what they learned through their reporting and what it means for ongoing efforts to respond to the attack.Support this show http://supporter.acast.com/lawfare. See acast.com/privacy for privacy and opt-out information.

Over the past decade, Eric Coomer has helped make Dominion Voting Systems one of the largest providers of voting machines and software in the United States.He was accustomed to working long days during the postelection certification process, but November 2020 was different.President Trump was demanding recounts. His allies had spent months stoking fears of election fraud. And then, on Nov. 8, Sidney Powell, a lawyer representing the Trump campaign, appeared on Fox News and claimed, without evidence, that Dominion had an algorithm that switched votes from Trump to Joe Biden.This is the story of how the 2020 election upended Mr. Coomer's life.This story was written by Susan Dominus and recorded by Audm. To hear more audio stories from publications like The New York Times, download Audm for iPhone or Android.

Emily, John and David discuss Republican allegiance to Trump, schools during COVID-19, and they're joined by guest Jonathan Cohn to look back on Obamacare and to explore the current state of COVID-19 vaccinations. Here are some notes and references from this week’s show: Susan Dominus for the New York Times Magazine: “Rhode Island Kept Its Schools Open. This Is What Happened.” Shawn Hubler for The New York Times: “Vaccinating Oregon’s Teachers Might Not Be Enough to Reopen its Schools.” The Ten Year War by Jonathan Cohn Here’s this week’s chatter: Emily: Anna Holmes for the Atlantic: “The Magazine That Helped 1920s Kids Navigate Racism” John: Radio Garden David: Pick of The Litter Listener chatter from Ming Richie: Cathy Free for the Washington Post: “This Man Mistakenly Left his Wallet in Antarctica. Some 53 Years Later, He Got it Back.” Slate Plus members get great bonus content from Slate, a special segment on the Gabfest each week, and access to special bonus episodes throughout the year. Sign up now to listen and support our show. For this week’s Slate Plus bonus segment, Emily, David, and John discuss the legacy of Rush Limbaugh. You can tweet suggestions, links, and questions to @SlateGabfest. Tweet us your cocktail chatter using #cocktailchatter. (Messages may be quoted by name unless the writer stipulates otherwise.) The email address for the Political Gabfest is gabfest@slate.com. (Email may be quoted by name unless the writer stipulates otherwise.) Podcast production by Jocelyn Frank. Research and show notes by Bridgette Dunlap. Learn more about your ad choices. Visit megaphone.fm/adchoices

Emily, John and David discuss Republican allegiance to Trump, schools during COVID-19, and they're joined by guest Jonathan Cohn to look back on Obamacare and to explore the current state of COVID-19 vaccinations. Here are some notes and references from this week’s show: Susan Dominus for the New York Times Magazine: “Rhode Island Kept Its Schools Open. This Is What Happened.” Shawn Hubler for The New York Times: “Vaccinating Oregon’s Teachers Might Not Be Enough to Reopen its Schools.” The Ten Year War by Jonathan Cohn Here’s this week’s chatter: Emily: Anna Holmes for the Atlantic: “The Magazine That Helped 1920s Kids Navigate Racism” John: Radio Garden David: Pick of The Litter Listener chatter from Ming Richie: Cathy Free for the Washington Post: “This Man Mistakenly Left his Wallet in Antarctica. Some 53 Years Later, He Got it Back.” Slate Plus members get great bonus content from Slate, a special segment on the Gabfest each week, and access to special bonus episodes throughout the year. Sign up now to listen and support our show. For this week’s Slate Plus bonus segment, Emily, David, and John discuss the legacy of Rush Limbaugh. You can tweet suggestions, links, and questions to @SlateGabfest. Tweet us your cocktail chatter using #cocktailchatter. (Messages may be quoted by name unless the writer stipulates otherwise.) The email address for the Political Gabfest is gabfest@slate.com. (Email may be quoted by name unless the writer stipulates otherwise.) Podcast production by Jocelyn Frank. Research and show notes by Bridgette Dunlap. Learn more about your ad choices. Visit megaphone.fm/adchoices

C4 and Bryan Nehman heard weekdays from 5:30-10:00am ET on WBAL Newsradio 1090, FM101.5, and the WBAL Radio App.

NY Times staff writer Susan Dominus reports on their success See omnystudio.com/listener for privacy information.

In this week's episode of Fiction/Non/Fiction, co-hosts Whitney Terrell and V.V. Ganeshananthan are joined by former U.S. Poet Laureate Tracy K. Smith and novelist Kawai Strong Washburn, who talk about what the Biden administration owes the BIPOC and women voters who got them elected. First, Smith discusses building bridges as a nation, and shares excerpts of her award-winning collection, Wade in the Water. Then, Hawaii-born Washburn talks about the power of community organizing, and reads from his acclaimed debut, Sharks in the Time of Saviors. To hear the full episode, subscribe to the Fiction/Non/Fiction podcast through iTunes, Google Play, Stitcher, Spotify, or your favorite podcast app (include the forward slashes when searching). You can also listen by streaming from the player below. And check out video excerpts from our interviews at LitHub's Virtual Book Channel and Fiction/Non/Fiction's YouTube Channel. This podcast is produced by Andrea Tudhope. Selected readings: Tracy K. Smith The Cancer Journals Life On Mars: Poems Wade In The Water: Poems American Journal: Fifty Poems For Our Time Ordinary Light: A Memoir Duende: Poems “Poet Tracy K. Smith Pays Tribute to Kamala Harris,” Vogue Kawai Strong Washburn Sharks in the Time of Saviors “What the Ocean Eats,” McSweeney's   Others: “Biden's First 100 Days: Here's What To Expect” by Elena Moore, NPR America Amplified: Election 2020, a six-episode national talk show from the CPB public media initiative America Amplified “Portraits of Reconciliation: 20 years after the genocide in Rwanda, reconciliation still happens one encounter at a time,” by Pieter Hugo and Susan Dominus, New York Times “Kama'āina: Kawai Strong Washburn Interviewed by Kathryn Savage,” BOMB Magazine Malcolm X Biography Senator Ted Cruz on Twitter: "By rejoining the Paris Climate Agreement, President Biden indicates he's more interested in the views of the citizens of Paris than in the jobs of the citizens of Pittsburgh. This agreement will do little to affect the climate and will harm the livelihoods of Americans." “The Lawyer Who Became DuPont's Worst Nightmare” by Nathaniel Rich, The New York Times Sunday Magazine Learn more about your ad choices. Visit megaphone.fm/adchoices

Susan Chira, senior correspondent for gender issues, and Susan Dominus, a Times Magazine writer, talk about men, women and coverage of their changing roles.

Susan Chira, senior correspondent for gender issues, and Susan Dominus, a Times Magazine writer, talk about men, women and coverage of their changing roles.

Both Hillary Clinton and Donald Trump are full-blown stars in their own right, and have spawned and inspired television characters and shows. We talk to the chief television critic at The New York Times, James Poniewozik, about how television and film characters past and present inform our views of both candidates. We also chat with Susan Dominus, of The Times Magazine, about the surprising ways that gender is playing out in pop cultural depictions of Mr. Trump and Mrs. Clinton in this campaign.

Both Hillary Clinton and Donald Trump are full-blown stars in their own right, and have spawned and inspired television characters and shows. We talk to the chief television critic at The New York Times, James Poniewozik, about how television and film characters past and present inform our views of both candidates. We also chat with Susan Dominus, of The Times Magazine, about the surprising ways that gender is playing out in pop cultural depictions of Mr. Trump and Mrs. Clinton in this campaign.

Susan Dominus is a staff writer at the New York Times Magazine. She’s written about everything from higher education to organizational psychology. She also writes celebrity profiles. The most recent focused on Daniel Radcliffe of Harry Potter Fame. The other was about Stephen King and family of writers. The Radcliffe piece — "Daniel Radcliffe's Next Trick is to Make Harry Potter Disappear" — followed the Harry Potter star as he promoted the independent film "Kill Your Darlings." The story shows just how much life as Harry Potter has affected the young actor. "Stephen King's Family Business" centered around a family get-together in Maine, where the King family of writers got together to discussion the early days of Stephen's career and the new generation of writers he raised.

Susan Dominus is a staff writer at the New York Times Magazine. "A lot of reporting is really just hanging around and not going home until something interesting happens." Thanks to TinyLetter for sponsoring this week's episode. Show notes: @susandominus Dominus on Longform [7:00] Longform Podcast #31: Emily Nussbaum [9:45] "Santa's Little Helper" (New York Times • Dec 1999) [10:00] "The Allergy Prison" (New York Times Magazine • Jun 2001) [11:00] "Shabana is Late for School" (New York Times Magazine • Sep 2002) [16:00] "Everybody Has a Mother" (New York Times Magazine • Feb 2003) [17:30] "What Happened to the Girls in Le Roy?" (New York Times Magazine • Mar 2012) [25:15] "Eve Ensler Wants to Save the World" (New York Times Magazine • Feb 2002) [30:15] "He Could Be Cranky, But He Was Her Neighbor" (New York Times • Mar 2008) [32:00] "Susan Dominus is the Best" (Hamilton Nolan • Gawker • Jul 2009) [33:15] Longform Podcast #87: Amanda Hess [33:46] "It's All Sweetness and Light, Until the Snowballs Fly" (New York Times • Feb 2010) [35:00] "Could Conjoined Twins Share a Mind?" (New York Times Magazine • May 2011) [35:15] Longform Podcast #28: Joel Lovell (live) [43:00] "The Woman Who Took the Fall for JPMorgan Chase" (New York Times Magazine • Oct 2012) [49:00] "Daniel Radcliffe's Next Trick is to Make Harry Potter Disappear" (New York Times Magazine • Oct 2013) [53:30] "Why Isn't Maggie Cheung a Hollywood Star?" (New York Times • Nov 2004) [54:00] "Dangerous When Interested" (New York Times Magazine • Aug 2007) [58:00] "Life in the Age of Old, Old Age" (New York Times Magazine • Feb 2004)