The Health Upgrade Podcast

Navaz Habib (00:01.71)
Hello everybody, welcome back to the Health Upgrade Podcast. I'm here with JP, my co -host, and I'm very excited as well to have our wonderful guest for today, Andrea Donsky. Great to see you, Andrea.

Andrea Donsky, Menopause Researcher (00:13.807)
Great to see you and great to meet you, JP.

JP Errico (00:16.439)
Great to meet you.

Navaz Habib (00:18.04)
So today's topic is very relevant to the month that we're in. It is October, it is Menopause month. And so we are very excited to have Andrea on because Andrea is a wonderful researcher and a really well -known.

I don't know how we put this, but in the media with regards to women's health, menopause, perimenopause support in terms of being in Canada. And the Canadian population really does know her. We're excited to get her out to as many people as possible because I feel like a lot of the research and a lot of the insights that she can provide today are going to be relevant to women, particularly

that are going through perimenopause and menopause. So I'm really excited to chat with you about this today, Andrea.

Andrea Donsky, Menopause Researcher (01:06.819)
I am too and thank you for that sweet introduction.

Navaz Habib (01:10.252)
So we're excited to get into it, but we always want to get to know you a little bit and understand what brought you into this particular area of interest. So why don't you give us a little rundown about you and how you got into this.

Andrea Donsky, Menopause Researcher (01:25.723)
Sure. So, I mean, for me, my businesses have always been where I'm at in my life, my personal interests, and I've made it my mission to be able to help women go through what I was going through. So, like you said, I've been in the health and wellness space a long time. So it's going to be 25 years next year. And I had several companies in this space. So I basically grew up in it in my 20s and now I'm in my 50s. I grew up really understanding health, wellness, our bodies.

went back to school in my mid to late 20s and I was like, I want to understand my body so well that I want to become a nutritionist because I was having digestive issues. And I got to the point where it was so bad, I couldn't even function. I'm like, yeah, no, I need to understand this better. And then that way I can help other people who are going through that as well. And when I got into my 40s and I was 47 and I had my first hot flash, I was like, I really didn't understand what was going on. I thought, wait a second.

am I in menopause? Like I had no idea that there was a word perimenopause. I didn't even know it existed. I didn't know anything about this space. And at the time I had been in health and wellness in that space for 17 years. And I'm like, but wait a minute, if I don't understand what's going on, maybe other people don't either. Other women don't understand either. And that's when I thought, okay, I'm going to like change my vocation. And I had been in that space for so long. I'm like, nope, now I'm just going to focus on perimenopause and menopause. And

The way my brain works is I love data, like data, data, data, the more the better. And I love research and I love understanding the hows and the whys and like, why, what's happening? Why is this going on? So I just changed direction in terms of what I'm doing. I've been with the same business partner, Randy, for the 25 years next year and we, next year, and we've had, this is our third company. We started Morphist a few, you know, a few years ago in 2021. And I just thought, well,

I need to understand this space better and the more I understand, the more I can help other women who are going through it. And that's what I've been able to do. It's been amazing. Like you said, Navaz, I've been in the media for a very long time. It's about 16, 17 years that I've been doing TV segments and I was doing lots around health and wellness. And now it's literally just talking. I mean, I talk about other things as well, but primarily is perimenopause and menopause.

Andrea Donsky, Menopause Researcher (03:42.447)
We can't hear you.

JP Errico (03:42.603)
Yeah.

Navaz Habib (03:44.974)
Sorry, was muted for a moment there. I remember watching you on breakfast television like probably 15 years ago before I really got into the space myself, but I recognize your face and it was really cool for you to reach out when I had my book and for us to collaborate on your podcast. And so we're really excited to have you here. It's really interesting because it's a very common journey for people that we often have our own struggle and we create a solution or we

find that solution and then we want to share that with as many people as possible. But this is a very common journey in this health and wellness space. it's having had your own experience in here. When you started having those hot flashes, when you started experiencing those symptoms and this became that that real topic, what was that driving force to try to help people get through this? Because obviously you being in this space, you hadn't heard from many people about what

was about to happen and kind of this whole experience. Tell me a little bit about kind of that initial journey and what it was like actually experiencing.

Andrea Donsky, Menopause Researcher (04:54.779)
So when I got, so what I realized now, so I had a baby, I'm gonna take it back for a second. So I had my third baby at 41 and at 42, so I had all my postpartum symptoms and at 42, things weren't getting better. So I thought that I had gone into perimenopause after my third baby. But then I'm writing a book now, it's coming out in 2026. And in doing all the research in hindsight and looking back and speaking to my doctor, I'm like, I realized that I actually started perimenopause

at 36, like somewhere around 35, 36. And it started with phantom smells. But when I turned 47 and I had my first hot flash, I didn't realize that I had been in perimenopause for all those years. And again, looking back, when I tried to get pregnant with my third, I had complications, which I didn't have with my first and I had a miscarriage. Like there were a lot more issues with my third than I had with my first two. But again, not realizing I was in perimenopause at the time. So when I had that first hot flash, was

you know, I got my first hot flash and then it went away for six months and then it came back and I was so miserable. I couldn't function. Like when I say that it took over my life, I mean, I'm not kidding. It would come every like minute and it would last for like 30 seconds. And I looked at my husband one day and it's very similar to my story of why I went back to school to become a nutritionist. I had reached my breaking point. I just couldn't do it anymore. I was like, you know what? I can't function. This is not for me.

And for now I know thousands and thousands and thousands of women, like it is so uncomfortable. And this is just one symptom, by the way, out of the hundred plus that we now know exists due to our research. So I looked at my husband and I'm like, yeah, I can't do this anymore. I need to find a solution. And that's what led me down my journey, on my journey and down the rabbit hole of how am I going to help myself? Because I had already had the nutrition and I mean, lifestyle. mean, sure, let's manage our stress. Okay. Easier said than done.

trying to do what I could do, all trying our best. That's your lane in terms of the vagus nerve and the stimulation. And now there's so many other hacks that we can do that can help, an exercise and movement, but things were changing so rapidly for me that things that worked for me before I got into this stage, they weren't working for me anymore. So I had to really understand how can I help myself? So through that nutrition, through the lifestyle, through the exercise, managing stress and supplements. And that led me down to understanding, that brought me to understanding

Andrea Donsky, Menopause Researcher (07:14.235)
how can I help myself by adding in the supplements and I found solutions for myself and I was like, okay, now I need to share this with everyone else. So again, that personal journey and finding solutions that work and then understanding that menopausal symptoms are way more than just hot flashes and the 34 recognized symptoms that we had once heard exist. We now know that there are so many more and

That was the exciting part for me is, okay, I'm gonna find a solution for myself. And at the same time, I'm gonna find solutions that help millions of women out there. that's what really gives me my drive every single day. That helps me with my passion.

JP Errico (07:52.408)
So it sounds like hot flashes were really your first sign that you in it. When you look back, you probably now recognize that there were other things that were going on even before the hot flashes. For those people who aren't yet there, or maybe are but don't even realize it, what are some of those things that are the earliest onset experiences that they should be on the lookout for?

Andrea Donsky, Menopause Researcher (08:19.141)
Sure. So some of the more common ones that, you know, are more synonymous with perimenopause would be changes in their cycle. So maybe that their periods come earlier or later, or maybe they're heavier, the flow is heavier or lighter. So that is very more, it's more that telltale, like, telltale sign of like, yeah, I'm in perimenopause. But other things like fatigue that we know now, according to our research, fatigue, exhaustion, can't get out of bed. That is the number one.

most common symptom of perimenopause and menopause. Again, not hot flashes. Hot flashes now, we now know on my list of, now we have almost 5 ,000 women have filled it out, it's 4 ,600. We now know that hot flashes is number 10 on that list of the most common symptoms in perimenopause. So fatigue, brain fog is a huge one. Sleep issues, memory loss, anxiety, loss of libido. Almost 60 % of women experience a loss of interest in libido or sex drive.

And then we have joint pain, lack of concentration, lack of focus, hot flashes, lack of patience, night sweats. I mean, the list goes on. So for me, and phantom smells was, that was like, as I mentioned earlier, that was my first symptom that I could think of. Rage, anger, emotional, weepy, weight gain, weight fluctuations. I mean, when I look back, I'm like, I had so many symptoms that I never really connected the two between how I was feeling and it being perimenopause.

And now I know that I was in peri -menopause for a total of 14 years, 11 of which I just had no idea that I was in peri. So those would be some of the more, know, some of the, but there's a lot more. Like there's also less known symptoms like itchy ears, body odor in one or both armpits, bruising. mean, bad breath. Tonight is vertigo. The list goes on.

JP Errico (10:03.48)
So let me ask you a couple of questions, because these are really triggering a whole bunch of thoughts in my head. And the first is that a lot of the symptoms you listed there, starting with fatigue, are common symptoms experienced by people with rheumatological disorders. And that is, of course, associated with heightened levels of inflammation. know, other immune diseases, you know, if you have rheumatoid arthritis, or if you have any one of a host of

of diseases that we hear a lot about associated with anti -TNF alpha therapies, et cetera. Fatigue is always a common theme through that. And of course, during menopause, there's a withdrawal of estrogen and the effects of estrogen are anti -inflammatory. So when that withdraws, you're going to see a heightened level of inflammation. But I'm really intrigued by the fact that you mentioned that symptom of itchy ears.

Andrea Donsky, Menopause Researcher (10:52.932)
exam.

JP Errico (10:59.058)
And so I realized that sounds like a non -secretory, I'm interested in it. Is there a specific location on the ear where that itchiness is most prominent? I mean, is it the edge of the ear? it inside the ear?

Andrea Donsky, Menopause Researcher (11:13.859)
It's the inside the ears, it's the inner ears, it's the membranes, it's the mucous membrane. So what happens when estrogen starts to decline, so estrogen keeps the skin moist and plump. So when it starts to go down, mucous membrane, including our mucous membranes and our skin becomes drier and itchier. So that's what gets affected. So a lot of women, and this was one of the symptoms I had as well is inside the ear, you're just constantly trying to itch yourself, to scratch yourself, but.

The interesting thing that works to help with that is of course hydration and anti -inflammatory foods and all that, but omega -3s work really well at keeping that itch at bay. It's amazing. It's a little hack.

JP Errico (11:53.198)
because internet is...

Navaz Habib (11:53.462)
And isn't it interesting on the omega -3 side that that is one of the strongest anti -inflammatories and one of the best for getting HRV levels elevated as well?

Andrea Donsky, Menopause Researcher (12:02.905)
I love that. Yeah, it works really well and it's not very well known. And it's also for dry eyes, dry scalp, dry mouth, mean everything. Omega -3s help to, obviously from the internal, from the inside out, helps to hydrate you. if any of you or any of your listeners have those itchy ears, dryness in your skin, please, the Omega -3s are amazing.

JP Errico (12:23.726)
So there is also on this front, in the ear, there is a branch, well, they call it a branch of the vagus nerve, but it's actually not the vagus nerve. It's called the tragus nerve. And that links in with the vagus nerve. And there are devices out there that try to stimulate the vagus nerve through the ear. And it's interesting also because the ear is fascinating and not just because it bleeds a lot, as we just found out in the last month, but...

Andrea Donsky, Menopause Researcher (12:43.83)
that's so cool.

JP Errico (12:53.676)
When you have cluster headaches, the ear sometimes gets hot right before you have an attack. people are constantly, you know, and pulling on the ear can sometimes be used as a therapy for, you know, for certain things like muscle cramps and other things that go beyond that. So the ear has a lot of interesting innervation. And so I think there's probably a link there, but.

Andrea Donsky, Menopause Researcher (13:03.151)
Mmm.

JP Errico (13:22.38)
We'll have to study it.

Navaz Habib (13:25.142)
It's interesting, this has been kind of known for a very long time. auricular acupuncture is a, yeah, it's a really interesting tool because they've essentially mapped the entire body on the ear. And there is very specific points like the Shen Men point and any specific points for those who practice auricular acupuncture, you know that like almost the entire body is somehow listed on the oracle of the ear. So this is really interesting.

Andrea Donsky, Menopause Researcher (13:29.571)
I've had it done, I love it.

Andrea Donsky, Menopause Researcher (13:51.279)
My chiropractor used to have these little acupuncture little stickers that he would put in my ear after I left and he was like, just stimulate it all day long. So I'm familiar with that.

Navaz Habib (14:00.908)
Yeah. Yeah. And that's a really interesting tool. And you've mentioned, obviously, the brain fog, the fatigue, the lack of clear, clear thinking, the cognitive deficits, like, these are what's really interesting is there's actually an interaction between estrogen levels as they decrease and acetylcholine levels follow. And acetylcholine is a neurotransmitter utilized by the vagus nerve to lower that inflammatory burden. So as estrogen starts to decrease,

acetylcholine does the same thing. And that will have an effect of allowing inflammation to increase in its symptomatic nature. And so we'll start to notice that brain fog, we'll start to notice memory issues or cognitive issues, particularly in the brain, because we use our brain for obviously everything. And so that's a really interesting interaction, something that I thought I'd bring.

Andrea Donsky, Menopause Researcher (14:56.539)
So I love that you brought up that point and I think you're gonna love this stat that we found from our research as well is you could really argue that out of the 10 top 10 most common symptoms, nine of them are related to brain health, cognitive health and mental health. Nine out of the 10. yeah.

JP Errico (15:12.846)
I bet you 99 out of the 100 are in some way or shape or form related to the autonomic nervous system.

Andrea Donsky, Menopause Researcher (15:16.226)
No.

Andrea Donsky, Menopause Researcher (15:21.455)
Well, I would love you, actually, I would love you after the podcast to take a look at it and then come back because I'd like to include that in my book if that's the case. Any type of analysis or observations, please bring them on because the more that we look at these and the more that we can come with these observations, the more we can help women and their healthcare providers. So I love that.

JP Errico (15:42.376)
have you done autonomic testing on people? And now that we've got things like oral rings and Fitbits and Apple watches that measure heart rate variability and other things, we can have some pretty decent markers at looking at changes. Now, obviously for a person who's not yet in perimenopause and then transitions into it, there'd be an opportunity to track that person and say, okay,

We historically know that your heart rate variability has been pretty high. You didn't change anything about what you were doing or eating and all of a sudden it's dropping. That may be a sign of heightened inflammation, reduction in estrogen levels, et cetera. That would be an interesting longitudinal look if you have any of that data or if it's available.

Andrea Donsky, Menopause Researcher (16:30.907)
So the data is N of one right now and I'm constantly measuring, I'm actually working on a big project that I wanted to bring Navas into once we actually have some go ahead on it that we can look at more longitudinal studies. But so right now the N of one, so I wear the O -ring, I love it and other wearables as well. And for me,

JP Errico (16:33.166)
Most probably.

Andrea Donsky, Menopause Researcher (16:57.753)
I'm always playing with trying to hack my sleep because that for me is a big thing and my HRV. And I always say to Navaz, I'm like, I like to flex my HRV, although everybody is so different. And what I learned from Navaz is everybody's numbers, numbers don't matter. Everybody is so unique and individual. But I didn't really know my numbers before I started wearing wearables. So I do believe it's such an important thing that we wear. And then how can we help it with the wear, like with the different devices? JP, I know what you were talking about, the Truvega and then

The Apollo I've tried as well. And it's interesting because when you wear these wearables or these devices that help to stimulate the vagus nerve, and I brought on when I was on Cityline, I think it was last year two years ago, I talked about an essential oil that you could rub behind your ear as well that could help with the stimulation of the vagus nerve. So all these things that help to stimulate it, it's amazing, and that's your area of expertise.

Navaz Habib (17:50.594)
Was that the Paris and pathetic blend from the blue bottle?

Andrea Donsky, Menopause Researcher (17:56.633)
I forget the name of the company now, but it was a company out in Collingwood and they had like this oil that I was called the Vegas nerve oil or something and literally you put it behind your ear, yeah, and then you massage it and just the massaging and the smelling of the oil. So these are all amazing to see how your body's recovering during the night. And we know, and this is probably a good segue, we know according to our research and we have, you know, that was published last month in the Menopause Society's, the journal Menopause, that

Navaz Habib (17:57.869)
Yeah.

Okay, okay.

Andrea Donsky, Menopause Researcher (18:26.395)
women as they go into perimenopause and menopause are, know, 66 % of them are more stressed now than they were before. So it's a major issue when it comes to stress and we're less able to cope with it. So, you know, we need to find ways that we can help to stimulate that parasympathetic better. and according to our research, we asked women like, what are you doing? So,

I haven't seen anyone mention the wearables, but maybe it's because they're just not as aware of it. And that's what I'd love for you to talk about on my podcast, because I think it's something that could be really cool as a topic for our listeners. But things like taking walks in nature, watching a funny movie, spending time with family, friends, people that you love, staying away from things that create that stress and anxiety for you, like perhaps the news is triggering for you. So maybe watching it less or not watching it for a little bit, right?

putting down boundaries, all of these things, waks in nature, shinrin roku. So all of these things can help, as you know, to help lessen our stress levels. So I think it's important for women to understand because anxiety, depression and stress play a massive role in this phase of life.

JP Errico (19:34.316)
Yeah, diet, diet is a huge part of being able to become more resilient to stress in general. I try to tell people when I talk to them about stress, chances are we're not going to be able to change the world and the amount of stress that the world is putting on us. What we have to change is how resilient we are physically, emotionally and mentally to that stress. Sleep is a big part of it. Exercise is a big part of it. Diet. But, you know, the part that I try to focus on for people is

that stress in short doses is actually quite healthy. Stress in long doses, it's like running. If you go out and you run five miles, great. You go out and run 500 miles, I'm pretty certain somewhere along the way you're gonna break down. And so what you need to do is recognize that we just need little five mile runs of stress and one mile runs and going on a walk.

And the way I like to, one of the tricks that I give people is something I learned actually from training for a marathon and running, which is you can go so much farther if you run for a mile and then walk for a minute and then run for a mile and walk for a minute. That one minute of recovery that you're giving your body, pays dividends a thousand times over.

twice, three times as far as you thought you could. So what I tell people is if you're at a job, you're sitting at a desk and you're working, take the last five minutes of every hour. So from 55 minutes to the end of the hour, put down the phone, push yourself away from the computer, stretch, check in with your body. Do you have to go to the bathroom? Do you have to get a drink of water? Are you hungry? Do something. Just call a friend, call your spouse, call your kids.

Andrea Donsky, Menopause Researcher (21:26.617)
I love that.

JP Errico (21:34.018)
Check in with them. Just break away for a moment, have a positive social interaction, physically change your position and move just to let your parasympathetic recovery mode kick in. Even if it's just for a couple of minutes, that can go so far in reducing your stress level, making you more resilient to the next hour's worth of trauma that's gonna hit you at work. And...

And I think it's an easy thing for people to do. And if they do it, you'll experience the dividends a thousandfold.

Andrea Donsky, Menopause Researcher (22:09.883)
That's awesome.

Navaz Habib (22:10.828)
Yeah, I think the concept of cycling through stress and recovery, stress and recovery and allowing that to occur. That's a tactic that can be used by anybody at any point, just really beneficial. And we know that those small stressors, JP, that you're talking about, those acute stressors, that's what we call hormesis or hermetic stressors, right? We have this little push into discomfort out of, out of that comfort zone and running for five miles. For me, it's like weight training.

things like that, that we push ourselves a little bit outside of what we feel comfortable with. And that, then we recover effectively from it. And that allows us to handle new stressors because we're essentially creating a new buffer, creating the opportunity to recover from and building that resilience that's required to handle stressors that are unexpected. Because if we teach ourselves to handle stressors that are expected, then we teach ourselves how to bounce back when the unexpected stressors come by.

just really interesting concept that a lot of people aren't utilizing effectively and something that we could definitely dig into. Andrea, I'd love to, sorry, go ahead.

Andrea Donsky, Menopause Researcher (23:18.595)
It reminds, sorry, I was gonna say it reminds me of like, HIIT exercises, right? So you're, yeah.

Navaz Habib (23:22.936)
Yeah, Yeah, hit is exactly that high intensity interval training on for a bit, off for a bit, on for a bit, off for a bit, right? So you need to allow for that recovery time in the middle. I'd love to dig into, exactly.

JP Errico (23:34.848)
It's like intermittent fasting. You're switching between anabolic and catabolic states. You just need to mix it up a little bit.

Andrea Donsky, Menopause Researcher (23:38.491)
Yeah, yeah.

Good point.

Andrea Donsky, Menopause Researcher (23:46.373)
Yeah, makes sense.

Navaz Habib (23:48.014)
I'd love to dig into some of your research in terms of that survey that you did and getting to know what those top 10 symptoms really are. What are some of the ones that were much more common and what are some of the more unique outliers, really interesting ones that some people may not have realized were symptoms of hairy menopause?

Andrea Donsky, Menopause Researcher (24:07.515)
Sure. So as I mentioned earlier, fatigue is number one. So fatigue and exhaustion. And that was by 72 % of the women in both perimenopause and menopause. Brain fog, 66%. Sleep issues, 65%. And what was interesting to me is we're very familiar with sleep issues as being a symptom of perimenopause and menopause, but I actually created a secondary survey. It was our second survey that we launched. The signs and symptoms was our first. And that kind of

branched out into several different surveys because I wanted to understand why women weren't sleeping and we can get into that in a minute. Memory loss, 64 % of the women. Anxiety, 59%, 59 .4 to be exact. Loss of libido, 59%. Joint pain, 58 .3%. Lack of concentration, 57 .8%. Same for lack of focus, 57 .4%, a little bit less.

hot flashes 56 .6. So that would be like the top 10. Then we go, sorry, go ahead JP.

JP Errico (25:08.962)
They differentiate between mental and physical fatigue. I know you capture a lot of mental issues in there with loss of focus, loss of concentration, brain fog, but with fatigue, I know in the research that I've done in things like Sjogren's syndrome and rheumatoid arthritis and fibromyalgia, they tend to differentiate when they test mental fatigue versus physical fatigue.

Did you see anything like that or did you differentiate that?

Andrea Donsky, Menopause Researcher (25:41.307)
So we didn't differentiate it in our questionnaire, but I would love you to actually go into the difference from what you've seen because it is a big thing. And that's why we accounted fatigue as being one of the nine that are related to brain health and cognitive health and mental health, because you can unpack a lot of things under the fatigue in terms of the brain health, but I'd love you to go into it since it's something that you're an expert at.

JP Errico (26:06.754)
Yeah, it's a function of the fact that you're probably capturing a lot of it with the other things that you're asking, because in rheumatoid arthritis studies, for example, they're not asking about brain fog as much as they're asking about fatigue. But there is a slight difference in how the immune system dysregulation is affecting those two systems, and of course, how the autonomic nervous system functions peripherally versus centrally. So for example,

We've talked a lot about when you activate the vagus nerve, you're releasing acetylcholine. Well, you're doing that in the central nervous system because there's a nucleus in your brain stem that's the primary source of acetylcholine and how that's affecting the microglial cells in your brain. that's, we talked a little bit before we went on the air about how that impacts your ability to learn and how to recall information effectively, et cetera.

That's very different from how it's affecting in the periphery that release of acetylcholine and where it's coming from, because it's actually coming from a type of immune cell as opposed to a nerve cell, and how it affects your mitochondria and how it affects energy production and how it affects glucose metabolism and all that kind of stuff peripherally. So lots to get into there and probably a little bit beyond what we're talking about right now, but there's a lot of overlap.

and the mechanisms are very similar, but they are distinct from one another, at least when you're trying to come up with solutions, they're mitochondrial solutions and metabolic solutions, that's different from what you might do in the central nervous system.

So tell me, because my father was an OB -GYN and I was fascinated by the fact that he was very intrigued by the symptoms that his patients came to him with that were very difficult for Western medicine to define or to even diagnose. And that a lot of his colleagues viewed those symptoms as sort of just, well, that's just what happens with women with their age and

JP Errico (28:17.378)
didn't really have solutions for it, but he was always conscious of the fact that his patients were experiencing something and he couldn't explain it, but that didn't mean it wasn't real. And it didn't mean that it shouldn't be addressed. So one of the things that he talked to me about was, and I've read about this and maybe you can elaborate on it, the symptoms that come during perimenopausal and premenopausal timeframes, things like the hot flashes and the

the strange smells or phantom smells, those things, the severity with which you're experiencing those can predict how severely some of the late onset symptoms like osteoporosis and dementia and cardiovascular disease that may not happen for another eight or 10 years or even longer.

how severely you're going to be affected by those. Is there anything in your research that talks about that and how we might be able to, if we attack those early symptoms and we're effective in treating those, we're actually providing some pretty important protections for the long term.

Andrea Donsky, Menopause Researcher (29:33.253)
So that's not our research. Our research more focuses on symptomatology and then women in the workplace. But I am familiar with research. And to be honest, it's scary research because we now know that there was some research done earlier this year, last year on night sweats and dementia. And we know that half lashes are connected to heart disease. So that's not something that I focus on my research in particular. It's more survey research, but I am familiar with other research that is out there. And yeah, I mean,

The research that I read on the night sweats and dementia, I was like, okay, so now we know that, but what can we do? mean, aside from the things that we know that we could do from supplements or hormones or nutrition or lifestyle changes, the research didn't go beyond that as to saying, okay, here's what we think might be connected. So it gets, that was a little bit scary for me in reading that. And I actually thought about it. I'm like, do I do a TikTok about this or do I not? And I chose not to because I didn't.

feel that it provided enough information on the solution end of it yet. So it's a great point, what you're saying, JP. It's just not something that I focus on in my research, but it is, I mean, I do talk about it in my education part of it and more research needs to be unpacked, but we are seeing how the severity of certain symptoms are relating to other things down the road.

JP Errico (30:51.714)
Yeah, it's not necessarily proven that if we could find ways to reduce those symptoms early on, that that's somehow going to carry forward. It's a hope. There's some logic behind it, but there's no mechanistic answer as to why that would work. But if it turns out to be true, then I think a lot of the research that you've done to identify what those symptoms are and then to identify things that help to...

resolve those symptoms at that time might actually turn out to be helping people in the long term really, you know, against some pretty devastating things that could happen in their lives with dementia and heart disease and osteoporosis.

Andrea Donsky, Menopause Researcher (31:34.617)
osteoporosis, like, I mean, those are the big three that we know that we're more susceptible to as we go into menopause, right? And to your point, and I think this is an important thing to mention is in speaking to thousands and thousands of women over the last six years or seven years, one of the things I hear over and over again from women and they'll say like, what do you do? Or, you know, or if I talk about something about menopause, they're like, I'm way past it. I'm way past menopause. And my answer is, and a little bit comes, a little bit of the confusion.

JP Errico (31:40.054)
It's rough.

Andrea Donsky, Menopause Researcher (32:02.959)
comes from the definition of the word. So you've got perimenopause, you've got menopause, and then you've got postmenopause. And menopause and postmenopause are the same thing. So, and that's where women are like, so menopause is actually just one day, if you think about the definition of it. And menopause equals postmenopause. Postmenopause is everything after that day. So I actually would love to rewrite the definition and be like, no, no, no, we don't need the word postmenopause because I feel it's a confusing thing for women to think, yeah, I'm already through it. I don't need to pay attention anymore.

where in fact, you need to pay attention even more now because it's like puberty. Once you're through puberty, you're always through puberty. Yeah, I'm sure I'm way past it. I'm not 12 years old anymore, but you still like it's the same logic applies is that once you're in menopause, you're always in menopause now for the rest of your life. And we are more susceptible to certain things. So now more than ever, we need to look at our nutrition. And to your point earlier, nutrition is the foundation for everything, right? So nutrition, lifestyle, movement,

Navaz Habib (32:41.602)
you

Andrea Donsky, Menopause Researcher (33:01.689)
you know, and then we look at supplements and, and hormones, hormones is out of my lane. So that's not something that I speak about openly. I've tried things, but that's not my lane. So I'm always, I'm, I'm an expert at certain things. Hormones is not one of them. leave that to the doctors and the experts, but there are so many options nowadays that don't stop taking, know, taking control of your health and how you feel just because you think you are past menopause. No, no, no, no.

Navaz Habib (33:26.2)
you

Andrea Donsky, Menopause Researcher (33:26.883)
now is the most important time to actually pay attention to everything that you're doing.

Navaz Habib (33:33.07)
And the reason for that, in a lot of the research that's popped up, is the fact that as those levels of estrogen decrease and we get into the situation where progesterone estrogen are not having their cyclic patterns anymore, what's actually happening is increased activation of FSHLH, which are other hormones secondarily, but increased activation of the immune system into a more hyperactive, immune -activated state.

JP Errico (33:35.846)
Thank

Navaz Habib (34:02.05)
and the conditions that are associated are literally what we've outlined. The osteoporosis, because now we have osteoclast activity that's increased and that's breaking down the bone a little bit more quickly. Or we have increased microglial activation and that's leading to dementia and memory issues and cognitive challenges. Or heart disease and that's because of the macrophages in the blood vessels not being able to lower the burden of inflammation in the vessels themselves.

immune system becomes hyper activated. It's almost like as soon as those hormonal cyclic patterns change, those the acetylcholine that follows and the signals that go to those immune cells decrease and so those immune cells become ready to attack, ready to fight all the time. And so that accelerates the pace of these disease progressions that we're talking about.

JP Errico (34:55.534)
Yeah, a couple of things. One, to tack onto what you just said. We've talked several times on this podcast about the effects of inflammation on neurotransmitter expression. a lot of the top 10 symptoms you were talking about have to do with the central nervous system in the brain and mood and stress and resilience and all of those things and motivation.

You know, fatigue is mental fatigue especially, but even physical fatigue has both an energy component, but it also has a motivation component to it. And we know that neurotransmitters associated with mood, like serotonin, and motivation, dopamine, are affected by inflammation. And that's a really important point that I don't think people realize. They think, you know, they've got depression, perimenopausal depression, the blues.

things like that, there's medications that they can use. And there are, and I'm not suggesting that those medications can't be beneficial at times, but understanding what's really happening is what matters so that you can take a stand yourself. just to put a fine point on it, when that inflammation level goes up in the cells in your body, and every cell in your body makes serotonin, it's not only those...

those serotonergic neurons in your brain, but those are important. But every cell in your body is making serotonin. And when inflammation goes up, serotonin levels go down. That your tryptophan, the amino acid from which serotonin is derived, is shunted into a different direction, which starts to create more free radicals and promote mitochondrial dysfunction. Melatonin's involved because serotonin is the precursor for melatonin. And so

when you have inflammation levels going up because estrogen is withdrawing and as a result, inflammation goes up. You not only have the autonomic nervous system, acetylcholine changes that Dr. Havid was talking about, but you also have these changes in neurotransmitter expression. We talked about serotonin dopamine is the same thing. Those start to drop. And so things that you can do naturally to increase serotonin levels and

JP Errico (37:15.766)
norepinephrine, not norepinephrine, dopamine levels is really helpful. I think tryptophan supplementation is great. I think melatonin supplementation is great. I mean, it helps with the sleep. mean, so.

Andrea Donsky, Menopause Researcher (37:29.731)
I'm a massive fan of, yeah, I'm a massive fan of melatonin. And I heard, it was on Carrie Jones's podcast, actually, Navaz. I heard her talk about somebody, a doctor that coined the term melatoninopause. So once we get into our 50s or menopause, we're not making our own melatonin and getting it from an external source can be very helpful. And because we know sleep is the third most common symptom for women with

Navaz Habib (37:30.158)
That's something we want to get in.

Navaz Habib (37:37.762)
Yes.

Andrea Donsky, Menopause Researcher (37:58.843)
Over 65 % of women who are experiencing it hacks like, know, stimulating the parasympathetic nervous system before you go to sleep and taking melatonin, which is why I formulated our product called Sleep Us. You know, like these are things that we could do to help us sleep better. And I am a big fan. I'm happy you mentioned it, JP, because I am a big fan of melatonin for women in this phase of life.

JP Errico (38:20.504)
So, yeah, you know, it's funny, just a couple of episodes back, we had the opportunity to speak with one of the leaders of the ITP program, which is all about aging and doing studies on animals of various different drugs. And one of the drugs that was, one of the, I guess it's not a drug, but it's a compound that they've tested and showed really remarkable longevity benefits.

for males with 17 alpha estradiol. So it's different from estrogen, it's an estradiol, it's related. And women have high levels of estrogen compared to males and women live longer. so estrogen is really something that if you can maintain the benefits of estrogen, and I'm not suggesting necessarily hormone replacement therapy versus not, but if you can...

if you can increase or enhance the benefits that women get from that and maintain them, I think it's gonna be beneficial from a longevity standpoint. And of course, anything that benefits you in longevity naturally will also benefit you in terms of preventing the onset of longevity conditions like dementia and heart disease and stroke and things like that, cancer. it's all connected.

Andrea Donsky, Menopause Researcher (39:40.271)
exactly.

Navaz Habib (39:48.206)
To dig into the sleep topic a little bit, you mentioned in one of the white papers that there was a very particular pattern that sleep disturbance occurred in. Go ahead and do that. Let's elaborate on that sleep disturbance and that kind of that two to four AM like clockwork concept.

Andrea Donsky, Menopause Researcher (40:09.731)
Yeah, I'm very excited because our sleep issue survey was also published in the journal Menopause. had four of them, which another one was doctors visits and our stress and anxiety survey. So I do want to get into our doctors visits survey after. this was a published, this is a published survey, which very exciting because now we're published researchers, which is amazing. So we know according to our sleep survey,

report is that women are waking up. So the top four reasons women are waking up in perimenopause and menopause, number one is they're waking up between 2 and 4 a and that was 63 % of the women. Now there are several reasons why women could wake up between 2 and 4 a with cortisol rising at the wrong time being a major one. So what we know that that is related to, that's your area, what is that related to? Thank you.

JP Errico (41:00.302)
stress and

Andrea Donsky, Menopause Researcher (41:03.259)
Stress, exactly, stress and anxiety. So that's number one. So you could argue that waking up between two and four a is number one reason is stress. Number two is bathroom visits with 54 % of the women. Number three is night sweats or hot flashes at 49%. And then number four was anxiety and stress and heart palpitations at 49. So in my opinion, the number one reason we're waking up during the night is because of stress. Like if I was gonna go and give my own, you know, not the scientific report, but my own interpretation, it's because of stress.

So I do think that it's really important that we do something to stimulate that vagus nerve, which is why Navaz, I love interviewing you because everything is so interconnected to what we do and sleep is such a big issue. So how do we relax ourselves before bed? Well, whether that's deep breathing, whether that's meditation, journaling, gratitude, just watching a...

YouTube video on sound baths. I love sound baths because of the vibration, the frequency and the sound. just really, it'll stimulate your vagus nerve so quickly. Like I know you've shared gargling, like all the tips that you always share on my podcast. So anything that we could do to help relax before we go to sleep will obviously help. And then bathroom visits, that's a big one. Vasopressin, which is an antidiuretic hormone. It goes down during the night as we age. So how do we bring that up? Again, our Sleep Us product,

Navaz Habib (42:03.768)
Mm

Andrea Donsky, Menopause Researcher (42:24.345)
does address that with our lactin, which is an ingredient in there. And then obviously night sweats and hot flashes. So sleeping in a cool room, maybe you need a supplement like Pycnogenol or DIM, like there are things that can help with that. And making sure that again, stress is connected to that because when you're stressed, it can trigger a hot flash or night sweats and so can nutrition. So for example, for me, if I eat ultra processed sugar before bed,

I will get more night sweats than if I didn't. Even chocolate, which is very interesting. I'm exploring a little bit now with chocolate because chocolate for me, when I eat it and I love it and I eat it all the time, it actually triggers half lashes and night sweats for me. So I'm trying to experiment now with a little, I mean, I've heard from some experts that it could affect the liver, but I haven't seen the science on it and I'm trying to find the science on it because everything right now is like, it's an antioxidant, it's amazing.

but I'm wondering how it affects women in perimenopause and menopause, but for me, it'll trigger night sweats for me.

JP Errico (43:24.376)
Just a couple of thoughts on chocolate. Do you tend to eat milk chocolate or dark chocolate? And there's a fair amount of caffeine that oftentimes is associated. Do things like coffee and tea also trigger night sweats?

Andrea Donsky, Menopause Researcher (43:28.283)
No, no, no, no, no. It's like 70, 80 % dark.

Andrea Donsky, Menopause Researcher (43:41.423)
So I'm not a big coffee drinker or caffeinated tea drinker. But if I do have coffee now, like during the day, it used to trigger hot flashes for me, but the supplements helped me. I don't really have them so much anymore. So to answer your question, no, it's not triggering the hot flash for me, but I haven't tried it before bed and I wouldn't anyways because of the caffeine. So I wouldn't even go there.

JP Errico (44:04.237)
Okay.

Navaz Habib (44:06.912)
It sounds like the caffeine may be a contributing factor potentially, right? And so that may play an important role. We also know that the chemical structure of the cacao, kind of the chocolate, mimics dopamine as well. So it's one of the reasons why we're motivated or driven towards chocolate, why it's one of those areas that we're like, we want that and it creates that dopaminergic response or mimics it. So that's an interesting reason for maybe why you're

Andrea Donsky, Menopause Researcher (44:10.265)
Yeah, to be. Yeah.

Andrea Donsky, Menopause Researcher (44:28.037)
So good.

Navaz Habib (44:37.203)
or so many people, not just you, but we do, that we are driven towards this idea of like, we want that chocolate.

JP Errico (44:43.31)
I've personally found that if I eat any kind of chocolate in the morning, I am absolutely craving it all day. If I hold off and don't eat it until the evening, don't eat, obviously don't eat it at all, but if I don't eat it until the evening, I don't crave it, even through the rest of the evening. But if I do it in the morning, it is just impossible for me not to.

Andrea Donsky, Menopause Researcher (44:53.243)
Mmm.

Andrea Donsky, Menopause Researcher (45:04.557)
Interesting.

JP Errico (45:09.07)
I will find myself subconscious unconsciously all of a sudden there's a piece of chocolate that I didn't even remember getting. So it's dangerous.

Andrea Donsky, Menopause Researcher (45:15.963)
I know it's so good.

Andrea Donsky, Menopause Researcher (45:22.327)
It is and it's so yummy and the dark chocolate but and it has does have antioxidants and all these good things. anyways, I'm still I'm still looking for the evidence on that one. But yeah, I do believe that the caffeine can play a major role for it.

JP Errico (45:34.99)
Yeah. And, and those hot flashes and the amount of time, the sleep architecture, that you're, that, that you're losing now as a result of that two to 4 AM window. you know, men, men have the same problem of getting up and going to the bathroom. It's a, it's a, it's a trick of trying to figure out how to get back to sleep at that point, after you've gotten up to go to the bathroom. But what I, you know, what I have found in my life in, in different periods in my life where there was serious stress is going on and.

I would wake up in the middle of the night with that stress. What I found was that vagus nerve stimulation, and I'm putting a plug in for it, but for me personally, during those periods of time, vagus nerve stimulation is able to quiet my mind in a way that really nothing else can. One of the reasons why vagus nerve stimulation is used with therapists, for example, who dealing with people who have been through a trauma is because

Sometimes just reliving the memory is enough to cause an autonomic response. And trying to process through the thoughts is very difficult in the memories if you have an autonomic nervous system response that's driving your physiology. So I found that using vagus nerve stimulation, even if it's at two o 'clock in the morning and I've been up for 15 minutes and I say, I'm not going to get back to sleep here. If I use that within five minutes, I'm back to sleep.

It can be a powerful way to at least quiet a portion of the problem and let your mind drift back into sleep.

Andrea Donsky, Menopause Researcher (47:10.255)
I also say like some of the, our brain is a muscle, right? So for me, I know that now maybe not if you're under acute stress and you've got like major things on your mind, but I trained myself to go back to sleep though. So obviously I take supplements, which I find really helped too. So the melatonin and certain combinations, magnesium, bisglycinate, I find that that can help. But I also find that if I wake up in the middle of the night and my mind starts to go, I learned to stop it before it goes. So I will,

talk to myself, it might not out loud, I'll talk to my head and be like, nope, we're not going there because you know what, right now, if it keeps me up for two hours, not gonna help me. I'm gonna stress about it in the morning anyways. So why don't I just go back to bed, get my good night's sleep and then worry about it in the morning. And it took work, but it does work. I kind of look at it, I put a big X over it, right? I visualize a big X. I'm like, nope, not going there.

And then I say something called ho 'oponopono, and I don't know if you're familiar with it, but it's a Hawaiian healing method. And I read the book years ago, I got it as a gift as a Christmas present years ago. And it's four sentences. It's I love you, I'm sorry, please forgive me, and thank you. And it's these powerful sentences that I would just repeat in my mind over and over again until I fall back asleep. And it works like a charm. stop, so the vagus nerve stimulation is a great one. Stop, you know, stopping your brain.

from doing it, training your mindset, training your mind to not go there and then repeating those mantras I find and taking supplements, I find that that has really worked well. And that's what I believe has really helped my HRV be as high as it is. I truly believe that that's what helps me get that better night's sleep and that recovery from stress because I'm not immune to stress. I look at my aura ring during the day and I'm like, wait.

I didn't even feel stressed. Why is it in the stress part? Like, wait, didn't like it. That stresses me out. I'm like, wait, what are you doing? But my nighttime recovery is like, my gosh, like amazing, amazing.

Navaz Habib (49:04.962)
That's awesome. I want to quickly kind of lean into this because you mentioned something there, the stress is always going to be there. It's not stress that's the driver. It's how you feel about the stress. It's the perception of that stressor. And kudos to you for coming up with and creating this ability to stop that thought process occurring in the middle of the night. It's something that I do very well. My wife has a lot more difficulty with that.

I think it has a lot to do with being able to say, this is not the time for dealing with this challenge, right? This time does not make sense. We need to stop this. We know that we're only going to benefit if we go back to sleep and then we can deal with it on a fresh mind in the morning and doing something along those lines, having some sort of strategy. One of the strategies I like to use personally for that is my four, seven, eight breathing in that.

time as well, right? The longer exhale, the very particular belly breath, being really focused on nasal breathing through the night. That's one of the best ways that I've found to help shift back to parasympathetic and really get myself back to sleep. That's used by a lot of my patients and a lot of great successful stories about that.

JP Errico (50:22.4)
So just quick two things. One is, and these are two separate strategies. One is I learned this watching my son play basketball when he was young. I watched his teammates. They would try to learn something new from the coach and it's so frustrated them that they would actually start to cry. I mean, these are, these are kids who are, you know, sixth, seventh, eighth, eighth grade boys crying because they can't get something done. And the coach said something really wise. He said,

Andrea Donsky, Menopause Researcher (50:43.76)
Mm -mm.

JP Errico (50:52.706)
Guys, it's okay to be frustrated. That's when you learn. And so how that ties back is when you wake up with stress, recognize that when you look back on your life, the times where you did the most growing, the times that when you learned the most, when you gained the most, they were not the easy times. They were the hard times. They were the stressful circumstances. So welcome it.

welcome those stresses because that's an opportunity to grow. So if you change your perspective on it and recognize that stress is not a bad thing, how you deal with it, how you respond to it, and how you cope with it is what's bad if you do it in the wrong way. Or if you allow it, if you don't take the time out to break from it and get your rest, it will be worse. So what you want to do is that's the first thing. The second thing is I have

Andrea Donsky, Menopause Researcher (51:34.309)
how you cope with it.

JP Errico (51:51.17)
know, seeing the brain scans, I've seen the EEG results, I've seen the fMRI work. When you are hyper -focused on something, and it's not a stressful thing, but when you find some problem to think about, okay, and for me, actually, it turns out to be math problems. I actually just like to think about math problems as I go into bed. The rest of your brain, focus and concentration requires that the rest of your brain quiet down and go to sleep effectively.

That's why people find when they concentrate, like I like to write also. I mean, if I'm writing, I could sit down and start writing and get into a flow state, a zone and write for five or six hours. And I'm not tired. I'm not thirsty. I'm not conscious of anything else other than what I'm doing. And then when I finish, I'm exhausted. I'm tired. So what I'm saying is if you find something that's non -stressful, that's enjoyable to think about.

that you can really capture your attention and concentration and think about it as you're going to sleep, as you're trying to go back to sleep, you may find it much easier to do so because the rest of your brain will go to sleep very quickly. It's trained to do that. And then you just have to shut off that one part that you're thinking about and it's easy to do that. So just a little trick that works for me and maybe for others.

Andrea Donsky, Menopause Researcher (53:14.329)
I like that.

Navaz Habib (53:14.338)
That's awesome. I want to be conscious of the time. So I want to hear a little bit about these doctor visits, surveys and to understand what people were going to the doctor for and what were some of the more common outcomes from those visits.

Andrea Donsky, Menopause Researcher (53:28.549)
So we talked about it earlier that it's important that, and I think JP might've been you who mentioned it, is that we have these symptoms, but we don't necessarily connect them to perimenopause and menopause. And then our healthcare providers don't really necessarily, I think it was when you were saying your dad was an OB -GYN. And here's the thing. So I really wanted to understand when we're going to our healthcare providers, first of all, how many of us are going to seek doctors?

are going to our doctors. And we now know that women in menopause look to their doctor for help, more so than women in peri. They'll still go to their doctor, but they're more looking online and speaking to friends for solutions, which is very interesting according to our signs and symptoms survey. But I wanted to spin off another survey and be like, okay, so let's understand these doctor visits better. So we know that 88 % of the women who responded to our doctors visit survey, this was 1 ,189 responses. And by the way, we got this, within two months we had like over

the 1 ,189 responses and we had over 600 comments from women when we said, there anything else you want to share with us? Like it was the most engaged survey that we have had to date. So it's something that obviously women are very passionate about. So we know that 88 % of the women who filled out this survey talked to their doctor or healthcare provider about their symptoms. But when we asked them if they got, you know, how many times they went to their doctor to get answers, only 25 % of the women said they saw their doctor once.

Only 25, before the healthcare provider or doctor made the connection between how they were feeling, they shared their symptoms, and it being connected to perimenopause and menopause, only a quarter. We know that 40 % saw their doctors between two and three times, 18 % between four and five times, and 17 .5 % more than five times. And the comments are heartbreaking. If you actually read the comments,

from the women who've left it like, saw my doctor 10 plus times over the last two years. Nobody's giving me, my doctor is gaslighting me. My doctor's telling, dismissing me. My doctor's telling me to lose weight. It is heart wrenching when you see these comments. So for me, it was really important that we get this information because this was also published in the journal Menopause in September.

Andrea Donsky, Menopause Researcher (55:44.027)
For me, if we are going to change the way doctors and healthcare providers look at women over the age of 35 when they come into their office and instead of saying, well, it's part of aging and deal with it and okay, well, you this is gonna happen or, you know, if they're complaining about libido, like go do something else to turn on your husband or like crazy comments that women are getting from their healthcare providers, that to me, that is probably one of the most satisfying things that we can do to make a difference in these women's lives. So we know that

when it came to what doctors are recommending solutions, we know that doctors are recommending antidepressants, hormones, and supplements. I thought that was really interesting that supplements even made the top three. So I think that is amazing that doctors and healthcare providers are becoming more attuned to providing supplements as a form of their healthcare. So I love that. And then when we asked the women who went to their doctor and healthcare providers, who brought up or if the topic

of perimenopause or menopause was brought up as a possible reason for how they were feeling. 35 % said they brought it up to their doctor and their doctor was receptive, but 40 % said their doctors were dismissive. They brought it up, but their doctors were dismissive. 15 % said the topic was never brought up at all. 15 % and about 10 % or 9 .8 % said that their doctor brought it up to them.

So under 10 % of the women of the 1189 responses we received, under 10 % of the women said their doctors brought it up to them. I mean, that's mind boggling if you think about it.

JP Errico (57:20.078)
This reminds me 100 % of the research that we did about 10 years ago over in the UK. We looked to find people who had severe headache conditions and wanted to understand their total experience better. And what we found was that patients who were headache sufferers, especially severe headache sufferers, oftentimes experienced a set of other symptoms.

Navaz Habib (57:20.513)
It really is.

JP Errico (57:49.282)
that are considered separate medical conditions or medical diseases, things like asthma and allergies, things like sleep disorders, depression and anxiety, gastric motility problems, and widespread pain problems. And what we found was that the overlap of those symptoms was so tremendous that it...

I know it actually mirrors the numbers that you're sharing as well, that about 12 to 15 % of the population is suffering with three or more of those symptoms that I just talked about and had been diagnosed with them. So not just experiencing them, but been diagnosed with them. And they were going to the doctor so frequently with no benefit, getting nothing from the doctors. The doctors actually referred to them as the heart sync patients because when they saw them in their waiting room,

their heart sunk. They didn't want to see them. And I thought to myself, that's, it's, yeah, it's just so dismissive of these patients. So I'm a hundred percent on board with, with your data and, and, and what it's showing. And this is why I said at the beginning, it's a women's health issue. A lot of the things that we're focused on with vagus nerve stimulation is a women's health issue because women are suffering with these conditions and for decades, they're experiencing these problems.

Andrea Donsky, Menopause Researcher (58:47.547)
So.

Andrea Donsky, Menopause Researcher (59:07.129)
Absolutely.

JP Errico (59:13.176)
So I would love to see whether or not women who are migraineurs or women who are suffering with fibromyalgia symptoms in their 20s, even in their teens and 20s and 30s, whether or not they are more or less likely to experience severe menopause symptoms. what, and it would just be an interesting parallel to see, I think we've tied the autonomic nervous system pretty well.

Andrea Donsky, Menopause Researcher (59:13.53)
Yeah.

JP Errico (59:42.594)
to those conditions in their teens, 20s and 30s that I was mentioning. And we know that the autonomic nervous system is involved with menopause and the symptoms of menopause. How does that link together? What's that trajectory and how can we help these people, not just in their 20s and 30s and not just in their 40s and 50s and 60s, but all the way through life.

Andrea Donsky, Menopause Researcher (01:00:07.323)
So I hear from women, so headaches and migraines, 43 .2 % of women experience it. It's the number 20 most common symptom of perimenopause and menopause on our list out of the 100 plus, 103 plus. So, and I also know from friends who have always been migraine sufferers who have it worse now, who it's more often, it's triggered more often, it's exacerbated. So that would be very interesting research.

to actually look at because I would, if I had to guess, I would say it probably is, whether it's related to other symptoms, I don't know, but I know that it probably gets worse or changes as they go into this phase of life.

JP Errico (01:00:48.898)
Yeah, I think you're right. I think that's my intuition as well. I'm coming at it from the other end of the spectrum, from the teens, 20s and 30s, but I think what we're talking about is apples to apples. I mean, it is absolutely a trajectory that we can intervene early and we're not just masking the symptoms. That's the problem. A lot of the medications that are handed out, if you're lucky enough to get medications handed out and not just be dismissed outright.

But they're just masking the symptoms. They're not getting to the root cause of the problem. And if we get to the root cause of the problem, I think we can have a profoundly positive effect on women's health all the way through.

Andrea Donsky, Menopause Researcher (01:01:32.889)
Absolutely. Absolutely. And let's talk about like the healthcare costs and let's talk about the health anxiety. Let's talk about the divorce rate that goes up. Let's talk about the department, like on and on trickling down into so many different things. If we actually, once we are able to educate healthcare providers and doctors about this phase of life, once medical schools are teaching it more, once we're learning, once also the women, once we understand it better, forget, know, sure, our doctors and our healthcare providers play an important role, but

We need to understand what's happening to our body because a lot of us, about 20%, according to our research, have no idea what stage they're even in. Like I was one of that 20%. I didn't know. So once we all have better education and knowledge, then we can all do something about it. But first we have to know what it is to be able to do something about it, right? It's kind of like, how do we get there?

JP Errico (01:02:22.892)
Yeah, we've got this amazing instrument, this amazing machine, it's the most complicated system in the universe, and there's no instruction manual. And we have to figure out, and to the extent that we can help open up what we do know of this instruction manual and share it with people, they're gonna be able to make that machine work better for themselves.

Andrea Donsky, Menopause Researcher (01:02:32.47)
We need that manual.

Andrea Donsky, Menopause Researcher (01:02:44.836)
I agree.

Navaz Habib (01:02:45.74)
I think there should actually be two instruction manuals because, and this was a really interesting opportunity that I had. was able to listen to Dr. Stacey Sims who presented at the IFM conference earlier this year. And she explained this whole concept of a lot of the research that's been done that we're basing a lot of what we do on is based on male changes and men being.

Andrea Donsky, Menopause Researcher (01:03:08.495)
then. Yeah.

Navaz Habib (01:03:12.066)
the researchers, men being the subjects and men being the outcome product. And that information then being applied to females and females then suffering and not having the answers come through that they're really looking for and not having real solutions presented to them. She had a really great TEDx talk called Women Are Not Small Men. And I think we need two very different, very specific instruction manuals to understand that women's health is very useful.

It's very different from what we've seen in the research for so many years. one massive instruction manual with two very, very large different chapters because women's health is something that is clearly incredibly overlooked. And the fact that doctors are having that moment where they don't want to see these patients mostly out of guilt of not knowing what to do, not being able to provide a solution. Like I'm a healthcare practitioner.

JP Errico (01:03:57.944)
different things.

Navaz Habib (01:04:10.38)
I've had those moments where a patient comes in and their back pain is so severe that I literally can do almost nothing to help them or one of those types of situations. I never wanted to experience that and that moment was always really challenging for me. So for healthcare practitioners, let's do some research on our own. Let's do some really intense work to try to figure out what are some of the better solutions that we can provide? Who are some of the specialists or experts that we can look towards? Andrea, this...

this amount of work that you've done. These surveys are so powerful in helping to create this new opportunity to look into this area, to understand that if you're having that sleep disturbance between two and four a that's very clearly a sign of perimenopause occurring. And it can be starting at 36 or 37, like it did in your case, right? It can be something that can be supported with the right supplements, with the right tools, the lifestyle.

strategies that we can provide early on. And what we're seeing more and more is symptom severity seems to be pretty similar throughout, right? If they're having headaches early, and the severity increases or the frequency can increase down the road. The fact that we have this hot flashes leading into heart disease, or we have these particular symptoms that are experienced during the perimenopausal time that are

showing that there's correlation to challenges that occur more significantly postmenopausally. I'd love to hear if there's any research that you've come across that showed any challenges or any conditions that were experienced prior to perimenopause, things like PCOS, endometriosis, any of these types of conditions, did they correlate or was there any alignment to?

severity of perimenopausal or menopausal symptoms.

Andrea Donsky, Menopause Researcher (01:06:06.405)
So I don't have my own research on it yet from our citizens research, but I have my N of one. So again, we always go back to the N of one. I had PCOS for, ever since I can remember since my teens and it definitely plays a role. Now, again, we know there's certain things that obviously the preexisting conditions that play a role in certain things, but for example, PCOS and insulin resistance. So we know that there's a huge correlation. Now, when I had PCOS when I was in my teens,

We didn't know this information, when I couldn't get pregnant and I went to my doctor and she put me on metformin or wanted to put me on metformin, I ended up doing a natural version of it, a supplement that worked. But they know that there is a connection between iron fertility or insulin or blood glucose or dysregulation and fertility. So now that we know that, so women who have PCOS, can we do or intervene in a certain way that will help it because we're more

prone to insulin resistance as we go into this phase of life, glucose dysregulation, all of that. It only gets worse. So I do believe a lot of what I experienced had to do with the fact that I'm PCOS, right? And when I'm writing my book now, I'm digging more into the research around it. And my book's not about PCOS, it's about menopause and other things, but a little chapter of like, okay, a little blurb about it. Like, how does it affect us as we go into this phase of life? Or women who have fibromyalgia or whatever it is. So many of the symptoms overlap.

with perimenopause and menopause. And that's why it's also very hard for a lot of healthcare practitioners to be like, okay, is it this or is it that? And the women ask me all the time, they have this, is it related? They have that, is it related? And everything does overlap. So it becomes a little bit of a, you have to kind of like be a detective and try to figure it out. But I do believe there is that connection of how can we help women knowing if they come into this phase of life with certain preexisting conditions,

Can we do something more to help them? Right? So if I knew that blood dysregulation, blood glucose dysregulation was a major issue for me, blood sugar dysregulation, then I would have been much more on top of that, but I didn't really know. Right? And now I'm saying, my gosh, I'm seeing it. I wore a CGM for about a year for my research. And I'm like, whoa, like we need to really talk about this more because there is that massive connection. So.

Andrea Donsky, Menopause Researcher (01:08:26.361)
Yeah, so great question. Not my own research, but a lot of my N of one and then speaking to women and hearing their stories.

JP Errico (01:08:26.935)
for

JP Errico (01:08:32.628)
It goes along with the idea of there's a whole host of, whether it be autonomic nervous system or immune dysregulation or metabolic dysregulation that leads to symptoms that that's where the root causes. I I always talk about the fact that there's four pillars of health. There's your immune system, your homeostasis with nutrient sensing internally, et cetera. There's your metabolism and then there's your autonomic nervous system.

The autonomic nervous system is the hack that controls all of those other things. And if you let, you regulate that and that's all about stress management and becoming more resilient and exercise and diet, et cetera, you can help yourself immensely with respect to these symptoms that you didn't even realize were connected, but they are. so yeah.

Andrea Donsky, Menopause Researcher (01:09:23.673)
including weight gain, by the way, which is a massive, massive symptom of perimenopause and menopause.

JP Errico (01:09:29.326)
And I know all these symptoms are extremely serious and they do affect people's quality of life. But when we think about things like cancer, later in life, mean, yes, it's true that the rate of getting or the incidence of cancer accelerates as you get older, but it also accelerates with BMI. I don't think most people realize that if your BMI is over 30,

you have like a 40 % higher chance of getting kidney cancer. You have a twice as much a chance of getting lung cancer. You have a much higher chance of getting colon cancer. Basically, every cancer goes up by anywhere from 10 to as much as 40 % for every five BMI units that you go up. So...

It's that's your metabolism. That's your innate inflammation levels. All that goes up. So we have to be very cautious about our weight and controlling ourselves and getting our BMIs back down into that 20 to 25 range. It really is very important.

Andrea Donsky, Menopause Researcher (01:10:41.851)
So here's the thing that's interesting about BMI. know there was a lot of, you know, a lot of experts now who are saying that BMI isn't a great measurement because it doesn't take muscle mass. And again, this is so not my lane, but just from things I'm reading that it doesn't take muscle mass into consideration. But here's the thing for women in perimenopause and menopause, and I have a whole chapter on this in my book. There are over 16 reasons as to why we gain weight in this phase of life. Our autonomic nervous system is one of them. Like inflammation is another one. Insulin, like there are so many different reasons.

Absolutely, JP, we need to take control of our health. that's where the, always say that's where it's, you know, do the best you can do with your nutrition, do the best you can do with your lifestyle, your exercise, your movement, whatever you can do, your supplements, do what you can do that you can control. Because there's a lot that's not in our control as we go into peri and menopause. So unfortunately, so, but yes, absolutely making, doing what we can to help take off that weight is really important.

And that's why when women are like, I'm past it, I don't have to worry anymore. No, no, no, we have to make sure you're getting enough protein. We need a lot of protein in this phase of life because we're losing muscle mass so rapidly. We also know that we need to eat a lot of vegetables, low glycemic fruit, complex carbs if you can tolerate them and probably more in moderation, legumes, good quality fat, right?

JP Errico (01:11:57.144)
more fat gets get that doesn't mean that carbohydrates make you fat fat doesn't make you fat that is critically important you will die if you eat fats you could you could live you

Andrea Donsky, Menopause Researcher (01:12:06.256)
Yes, our brain is fat. We need fat. Don't be afraid of fat, right? And I'm going to add one more piece to the fat is good quality fat because we don't want trans fats. We don't want seed oils. We don't want like canola soy. Like that's not, we want olive oil. We want coconut oil and moderation and we want avocado oil. Like, again, palm oil is more neutral, but like again, from sustainably, obviously.

JP Errico (01:12:15.607)
Yeah.

JP Errico (01:12:21.782)
All right.

Andrea Donsky, Menopause Researcher (01:12:30.543)
sustainable countries, but you know, these are the fats that we want and not be afraid of it and everything in moderation to look, I can't do keto. I can't do crazy high fat, especially like my body just doesn't like it. So for me, like everything in that moderation and do what works for you because we're also unique and different. So what works for me may not work for you and vice versa. Right. So listening to your body. But yes, absolutely control what you can control.

Be mindful of what you're putting in your body and then what you can control, try to get information from other places, see what you can do. Maybe there's like some hacks that you could, you you can implement into your life.

JP Errico (01:13:06.976)
Let food be your first medicine. Yep, for sure.

Andrea Donsky, Menopause Researcher (01:13:08.824)
Always. Foundation of everything.

Navaz Habib (01:13:12.502)
Absolutely. I think there's a lot of info in here. We've had a really great opportunity to connect and to share and learn from each other. This was really a wonderful conversation. Andrea, where can people find out more about you, your research and Morphis and all of the work that you're doing?

Andrea Donsky, Menopause Researcher (01:13:31.419)
Yeah, thank you for asking. So I would love you to, if you listen to today's podcast and you want to help us with our research, if you go to my website, which is wearmorphous .com, so W -E -A -R -E, and it's morphous, -O -R -P -H -U -S .com. So think of like metamorphosis, so morph us as a community. We made up the word. So it's wearmorphous .com. And at the top, you'll see it says research, and we have 10 surveys there right now.

So you could go there. We have also an assortment of supplements that you could choose all that are vetted by me and my partner, Randy. And then we also, I live on TikTok at Andrea Donsky on TikTok, but we're on Instagram at we are Morphous. We're pretty much everywhere at we are Morphous, but my personal favorite is on TikTok. So at Andrea Donsky.

Navaz Habib (01:14:17.102)
I love it. This has been really, really powerful, really important information. And I think what we're going to do is we're going to spark some real thought for people to understand that we don't have all the answers yet. We clearly don't have all of the required tools to make us function so much better, but this is going to initiate a lot more thought. This is going to initiate researchers to understand better. It's going to initiate physicians.

to think about this option or these challenges as being reasons for why their patients are experiencing these very common symptoms. And the fact that there's 103 different symptoms plus that people are experiencing, we need to be more conscious of this as diagnosticians. So thank you for doing the work that you're doing. Thank you for sharing this wonderful information with us.

For anybody who's still here listening, thank you for getting to this point in the podcast and please share this info with one person that you think could really benefit from hearing this information. If you just share with one person, this will blow up and we'll be able to share really important, powerful tools with a lot of people. So thank you so much for listening and we wish you all upgraded health.

JP Errico (01:15:35.544)
Thank you.