And that way I. Welcome to Horizonte, a show that takes a look at current issues through a Hispanic lens.

I'm your host, Catherine.

Aniya.

Are we talking enough about menopause?

Research shows menopause hits Latinas early with symptoms that are typically longer and worse than others.

Joining me to talk more about what Latinas need to know is Scottsdale ObGyn Doctor Erica montes, who specializes in menopause.

She's known on Instagram as the Latina gynecologist, where she creates relatable videos to help women cut through the noise when it comes to menopause.

Take a look.

I love it.

Serious issues, but really, she's having fun with making sure that we're educated.

Please welcome Scottsdale board certified ob gyn doctor Erica month is so good to have you here.

Thank you.

Catherine.

Finally meeting in person on Instagram.

Thank you so much for having me.

I'm happy to be here.

I love how you're able to connect with your audience, like I said, on these very serious issues, but in a relatable way.

So we're talking about menopause, which, you know, we're starting to normalize the conversation.

But a lot of misinformation is still out there.

So let's just start from the very beginning.

What is menopause exactly?

So menopause as far as the textbook definition is, when a woman no longer has a period for 12 consecutive months, and on average in the United States, it's about 51 years of age.

I always tell patients not every woman will experience pregnancy, but if we live long enough, all of us will go through menopause, right?

It's not anything that's preventable, but it is treatable.

And that's the most important thing to know.

Absolutely.

Research shows that race can play a role in how women experience menopause, and Latina women may experience those menopause symptoms earlier and differently than other women.

So with that, what causes racial differences in that menopausal experience?

What what exactly is that?

Yeah, there was a study that was done or started in the 1990s.

It was called the Swan Study.

And they wanted to look at different races and kind of how they experienced menopause and what were the reasons behind it.

And they did find that Latina, as were actually going through menopause sooner than non-Hispanic whites.

And they also found that they actually had a longer duration of symptoms.

And I think what they ended up finding was it actually wasn't purely a biological issue.

It was more so things like socio economic factors, their diet, environmental exposures, and it even came down to things like cultural beliefs and a long historic, kind of time frame of where we see that women or Latinas in general have had medical, mistrust in the system.

So, for example, if you think of, Latina woman, which I've had patients like this myself, plenty of them.

Latinas usually are the decision makers in the family, but we also sometimes are bad and kind of think about others before ourselves.

And so, for example, if we have a patient who is Latina, she has two jobs, she has a few kids, you know, she's always going to put them before herself.

And with just kind of growing up in certain, families, family members giving you little things about, you know, this is normal, this isn't normal.

And then along with the medical mistrust, I think we find that these women and, forgetting about themselves and not knowing what perimenopause or menopause is, and then that is what leads to them having this longer duration of symptoms.

Or sometimes you don't know anything at all.

The only thing I knew was that my mom was going through menopause at 50, but I didn't know what that was in my age at the time, I didn't care.

You know, it just wasn't affecting me.

But studies suggest that black and Latina women may begin pairing menopause early, about two years more intensely and for longer periods.

So to explain for our audience what is the difference between perimenopause and menopause and what are the signs and symptoms?

Are they the same?

Sure.

So perimenopause is kind of this transition between pre menopause and menopause.

It's some sometimes people call it the zone of chaos because our hormones are fluctuating drastically.

Estrogen is up and down.

It's difficult to do hormone labs on patients during this time because one morning it can be a certain level and by the afternoon it's a different level.

And those hormone fluctuations are basically what's causing a lot of the problem.

The number one thing that I find that my perimenopausal patients tell me is that they just don't feel like themselves.

You know, they'll come in, they'll say I'm doing pretty good, I'm working, I'm taking care of my kids doing this and that.

But something's just a little bit off or a little different.

A lot of people think that you are in perimenopause.

If you have symptoms of, like, hot flashes and night sweats, which are the cardinal symptoms of menopause, and that is due to the very low, low estrogen levels that tend to happen with menopause.

As we get to that ovarian decline.

But with perimenopause, it's more things that I tend to see, such as the start of irregular periods.

But you still can have regular periods, but definitely more irregularity.

There's low libido, brain fog, vaginal dryness, bladder symptom changes.

So those just kind of sometimes subtle changes that are starting.

And then as you progressed to menopause, they can worsen.

The other thing too is that a lot of women, you know, they kind of take a step back and think, you know, I'm just getting older, but they don't know why these symptoms are happening.

And that's that's the key point is we need to understand why.

And again, it is a lot of it is hormonal changes.

Well and it's frustrating to I think I was in menopause for at least 2 to 3 years before I actually even knew what was happening, but I knew something was happening.

I had brain fog like you were talking about.

Yeah.

Weight gain, I couldn't sleep.

Hot flashes, but didn't understand.

Well, I'm not 50 yet, like my mom.

Why is this happening?

Right.

So can you talk a little bit about.

Because we know the physical symptoms, right?

But we don't talk enough about the emotional and the mental symptoms that go along with it.

Yeah, sure.

You know, our brain actually has a lot of hormone receptors.

They're doing a lot more research on that.

And what we're seeing is that as your estrogen and progesterone levels decline, which are our sex hormones that come from our ovary, basically that affects serotonin, which we know is a feel good hormone or a hormone that helps us feel good, not depressed, not anxious.

I do tend to see a lot of patients start having these kind of mood swings or emotional changes, especially in what we call the luteal phase of the cycle, which is the cycle or the time of the cycle right before you're going to get your period.

And so what we tend to see with that is that can be due to low progesterone levels.

And so hormones we have basically we have hormone receptors in every organ.

But the brain is one that we haven't been able to study much.

But we know now that there's a huge, huge issue with, women having these changes.

And then also the sleep disturbances that we tend to see.

I think those kind of it's kind of like the chicken in the egg, you know, is it sleep disturbances causing the, the changes or is it the other way around?

I think we, I think it could be one or the other, depending on the woman.

But sleep disturbances are key.

Especially we know if we're not sleeping well, that leads to more anxiety.

That leads to more, overeating that changes our way.

There's so many issues with with sleep disturbances.

So I think all of that goes hand in hand.

But some some patients do need medication to help with more like the general depressive and anxiety symptoms, not necessarily just hormone therapy.

And if you've had a history of depression and anxiety, we know that the perimenopause, a menopausal time frame, makes you more vulnerable to those symptoms.

Right.

And so I think it's important to talk to your ObGyn about these symptoms.

But sometimes if you have to see someone who's more specialized in those symptoms, such as anxiety or depression, it's okay for that because sometimes they can work hand in hand to help you.

Are you noticing that women are hitting perimenopause?

A lot earlier than before?

That's a great question.

You know, I was talking about that with my partners recently.

I think overall the the studies, the large studies are showing that the average age of menopause and perimenopause are still about about the same age.

For the most part, I think what what the differences are, what the changes is that the awareness that openness, the conversations like me and you are having about these things are making women more keen to look and see, am I having these symptoms or things changing within my body?

I still think that there could be a factor as far as these forever chemicals that were exposed to these endocrine disrupting chemicals, pesticides, smoking is not as much of a issue.

Women don't smoke as much as they used to, but it's still something that is there.

And so I think overall, it's maybe not so much that we're they're going through it earlier per se.

And as far as like studies are showing.

But I do think that in the long term, as we are more exposed to these environmental exposures, that number could change potentially.

So once you start having these symptoms, whether it's perimenopause or menopause, you want to talk to your doctor about what's happening to you.

What are the options there?

Because I know that menopause hormone therapy is one option for a lot of patients, but not for everyone.

Right, right.

You know, I think I think aside from menopause, hormone therapy, there's four things that I always tell patients that are always very important and key factors to make sure that you are living your best and most healthy life.

And there are easy things that we always hear.

And it's easier said than done, but it's still something important to just keep in mind.

And, you know, that includes things like, well balanced diet, regular exercise, stress management and again, improving your sleep any way you can.

We know that women who are healthier before perimenopause actually do better and potentially have less side effects than a woman who who isn't as healthy or isn't taking care of themselves as much as they should.

So I think if you focus on those four key areas of lifestyle change and in addition to getting the correct hormone therapy, I think you'll I think you'll do great.

And and you'll have a, have good success with your symptoms.

I know there are some women out there who probably like me, have often felt dismissed by their doctor when they present some of these symptoms.

Oh, you know, it's normal or oh, you're probably just exhausted.

How do we go about finding a gynecologist who is well versed in menopause?

Yeah, thank you for that.

I love this question because, you know, unfortunately there's not there's not too many of us out there.

And not all OB gyns know about menopause.

A great place to start is menopause.

Dot org.

They have a directory, even if your physician or provider aren't on the directory, though, that doesn't mean that they aren't well equipped or qualified enough.

It just means that they haven't, they haven't done the test to be on the directory, so keep that in mind.

But I think also word of mouth, you know, if you talked to friends, you talked to family members and they have a they have a physician who's doing great work with them as far as menopause and managing their symptoms.

I think it's good to consider that as well.

Okay.

And then real quickly, because, you know, there are so many things out there right now about menopause.

There's a lot of misinformation.

Right.

How do you go about cutting through the noise?

Yeah.

You know, I think I think it's important to look at the resources, talk to your physician.

There's some great books out there that are that have excellent evidence based information.

That's the key.

There's a lot of companies and even practices that are kind of using menopause as a way to make profit off of women who are vulnerable and who just want to feel better, who want answers to their symptoms.

And I think we have to just basically focus on who we can trust, learn, do your research, do so a lot of self-education, be your own advocate.

And once you kind of put it all together, share it with friends and family members.

So they kind of have a little guidebook to help them along the way as well.

Is there, one resource or maybe a couple that you would recommend for people who are wanting more information about perimenopause and menopause?

Yeah.

So so menopause.org has a lot of information.

They have some guidebooks that are great.

There's also a couple books.

There's one called The Menopause Manifesto by Jen.

Gunter.

Great book evidence base, which is excellent.

And what we need to see and hear.

And there's also the, am generation by Doctor Jessica Shepherd as well.

Okay.

And then, of course, I have to refer to your gynecologist.

You do such a great job with connecting with women.

And like I said, just a very informative but fun way.

Thank you.

You keep our attention, that's for sure.

Thank you so much.

So nice to meet you.

Thank you for joining us.

And really just empowering us with education and information.

Thank you Catherine, I appreciate it.

And that's our show for tonight for us on and Arizona PBS.

I'm Catherine and I have a great night at man.

I can't wait to.