Episode 20 - Dr. Amy Day, ND - Taking a holistic look at women's healthcare

Hi everyone, welcome to Menopause Chats. This time we will be talking with Dr. Amy Day, who is a women's health expert. I will let her tell you all the things she's an expert in because it's a lot and it's great. So I'm very excited to have you here, Dr. Dr. Day. Uh tell us a little bit about yourself and then about your your journey as uh as a a woman in a in a body.

That that we are, indeed. Yes. Um yeah, so I I'm a naturopathic doctor and then a menopause society certified practitioner as well, um, and really have specialized in women's health uh all of my career. While I was in school, this was back in like 2000, 2001. Um, my personal journey was that I was diagnosed with stage four endometriosis after an emergency surgery, that I was just in so much pain, and I I had grown a huge endometrioma cyst and had major endo all over the place. So I was toughing it out, um, like many of us can do, and pushing through and like kind of get getting through really, really painful things, and then I then I would be you know relatively okay for a few weeks. So it kind of uh snowballed into a bad situation that landed me in that surgery and that diagnosis. But coming out of that, um, while I was in naturopathic school, I was just in such a good environment to get resources and to learn and to really focus. And I I chose at that time to really focus on women's health as my specialty and just wanted to learn everything that I could about women's bodies and hormones and everything because I really clearly needed to take care of myself. Um, so it was really that parallel journey of like learning and and becoming a doctor at the same time that I was on my personal journey um with uh taking care of myself around the endo.

So probably such a gift to be able to like, oh, I know how to like help myself, but also might be a curse in some ways, right?

It's like, oh, I know I know all these things and yeah, I think it makes me a much better doctor, I feel like. I think that that uh you know just being able to connect and understand how challenging things can be for patients, both in the symptoms that we deal with and in navigating healthcare. Like I really made a strong commitment to providing a very different experience of healthcare than what I was able to access and and receive at the time.

Yeah, so tell me a little bit about how you work with your clients.

Yeah, so we are maybe not clients.

We're both.

Um yeah, we're we're really comprehensive and compassionate. So just that idea of really educating people, helping them understand what their options are, help them understand their bodies and what the signals mean, and you know, putting the put putting the puzzle pieces together and not just like treating one thing or one thing, like really looking at that the whole person. And that's the whole person physi their physiology and their body and their health, but then it's also their life and their you know the things around them and their their beliefs and their preferences and their priorities, and so really working in partnership with patients and giving them a lot of education and a lot of um uh compassionate support on the journey.

And for those that don't know, what's the difference between an N D and an M D?

Yes, so as an ND, a naturopathic doctor, um I'm in the state of California. We are licensed as primary care doctors, and um we do lab tests, we do diagnose, we do treat we treat diseases. Um, so we that's very similar, people are used to, but we take a very comprehensive, holistic approach to things. So again, like looking at being really proactive and looking at being more preventive and looking at how things interconnect and treating the whole person. We're really well trained in natural modalities like herbs and nutrition. Um, it's something that that you know, in conventional medicine, there's kind of this gap from either like do nothing or like just like very basic advice on like we'll lose weight or diet and exercise, or something like kind of that to the on the other end is like more um dramatic interventions and medications, the surgeries, the procedures. There's a time and a place for everything, but to me, there's this huge gap in between that I think naturopathic medicine serves really well. We understand conventional western medicine, and we do a lot of things that are more integrative, holistic, and natural, um, so we can help people walk that that line. Yeah.

And between your training as an ND and also as a menopause, you know, certified menopause provider, which I know you have to go through extra. Like, it's not just like you go, oh cool, I took an online class and like that's it. Um how does that like how does what have you learned through through both of those that are the things that might help people watching or listening the most?

Yeah, you know, I did get the menopause society certification because I know that that is recognized by a lot of people and it's a resource that a lot of um a lot of us providers can share with people. Like this is how you can find someone who can do that. Yeah, and that's how I found my doctor. Great, yeah. It's a really important um resource like that. Honestly, in my studying for the certification, I learned very little. Um, I not because there isn't much there, it's because I already knew it as a naturopathic doctor. Um, so I which is validating in some ways, or something like that. It's validating, exactly. So there's some things like some of the you know non-hormonal prescription medication things that are newer and that kind of stuff, like being up on those was was helpful, and just knowing what the standard guidelines are is helpful. Um, but as NDs, we always individualize, we always have that patient for you know, patient education and informed decision making and um and partnership. So, and I my path at in naturopathic school and then seeking education afterwards has always been in this realm of women's health and hormones, and and the the new, I'll put in quotes, new understanding of things is really not new. There's nuanced interpretation of the data that came out of the women's health initiative trial back in 2002, but we it that that the information isn't different, it's just getting broadcast more widely now. Yeah, we've known that that detail of like using a natural biodenical progesterone instead of a synthetic progestin. We've known that all along, going not non-oral routes for the estrogen decreases the risk. So more studies have come out to look at more nuanced details and confirm things. Um, but that that misinterpretation that scared everybody about hormone therapy so much did not affect the naturopathic profession as much as it affected the global population.

And I mean, still in some ways is is a when I talk to women that they're like, oh, I can't go on hormones because they're bad for you.

Yeah, yeah. Yeah. I have to remember that because to me, I'm like in this bubble of conversation with people who who are you're like, if you're l watching podcasts or listening to things or reading books, or you're like, if you're looking for it, but if you're if you're not looking into it, this has been the pervasive message for 24 years now, is that hormone therapy is bad or dangerous. And um we really know that that's not the case for most people, but it's yes, that belief is still like and menopause seems to be having a moment in like media and stuff.

Like, what do you what do you think that's attributed to?

Great question. I think there's a few things that are really uh can like all overlapping at the same time. Um, one is the new guidelines. So the menopause society used to be called NAMS or the North American Menopause Society, now they're just called the Menopause Society. It's menopause.org is the website if people aren't familiar with that. Um they put out a new position statement uh in 2022, and that really that that's something that a lot of conventional, you know, OP guys and primary care and everything look to for guidance. So that shifted things a lot. Um, also, very importantly, is social media and access to information and more doctors sharing, speaking out, more you know, podcasts, like all of that. It's really this groundswell, I feel like of energy from women and people who are experiencing perimenopause and menopause who want better answers. Like you don't want to just be told, sorry, you have to tough it out. That's just how it is. Like that's not an acceptable answer. And and we're taking our power and and looking for information and educating ourselves.

Yeah, because certainly my mother didn't have social media to turn to or to post about or to share or to to reach out to other you're only talking to your sort of, if you're talking about it at all, just the people that were close to you.

Right.

And you likely probably weren't talking about it.

Right, more often than not, not even talking about it at all. Yeah, or if you were talking about it, it was hot flashes, and that was kind of the end of the conversation. Um, so now really more people are connecting the dots of understanding all the different kinds of symptoms that can be related to hormone changes. Um, but that doesn't mean that taking hormones is always the answer for things that could have to do with hormone changes. Right, right.

Um, I'll tell you the problem I'm having right now, which is that I have a patch and I go to hot yoga and it comes off. I'm just like, okay, can't you can't make these better? Like to me, like that's an activity, like it shouldn't come off. I get I'm sweating, but like people sweat, you know, it's like, oh, work out, but then if you're on this. Yeah, yeah, yeah, yeah.

You know, I was just at a menopause boot camp, um, continuing education class, and someone posted in the chat something they they put over top, and I'm gonna find that note for you while we're while we're talking.

So I re I reapplied it with a band-aid today.

Yeah, that's kind of the thing. And is your patch a once a week or twice a week? Twice a week. Okay, that's good because trying to make it a whole week with a patch can be really challenging too.

So I'm just like, and like, yeah, one of the days I go is the day I change it, so that's good. So it's always, yeah, but there are other days that I go as well.

Here, here's what the person wrote. They I don't even know what this is, but Tegaderm. Okay, I'm gonna read it. Okay. Tegaderm. All right. Well, good job. I'm glad I mentioned this. While we're at it, just in case this would help anyone else. Another thing with the patch is that some people get like a contact dermatitis, itchy rash kind of thing. And you there's a nasal spray that's used for allergies that's called chromolin sodium, and you can take a it's in common name is nasal chrome. Okay, and you can apply that before you put the patch on, and it reduces like onto the skin irritation onto the skin. Interesting, and then put the patch on. That said, this is all staying really focused on the patch. Yeah, and and one of the things about hormones is that they can be delivered in many, many different ways. So, and and anyone who it you're working with who is a hormone expert really should be able to help you, you know, consider all the different delivery routes and pros and cons and yeah, and that. But those are a couple tips on.

Yeah, well, thanks. I'm glad I mentioned that. It was literally top of mind because it happened today.

Yeah, yeah, yeah. Well, well, good, good.

These are real, these are real conversations. That's why I always say it's like real conversations with real women. This is it.

So your Tekaderm, it's a transparent, sterile, waterproof dressing made by Brian that can protect wounds and tattoos while they're not.

Yeah, I was gonna say it's probably I was thinking, but I didn't know the name of like I have tattoos, so I was like, oh, it's probably the same clear, you know, barrier that they put on a on a tattoo.

Yeah, exactly.

So one of the things I know you're involved with, and it's pretty exciting for someone who spends their day working in human resources, is uh California has some legislation called AB 1940, menopause workplace protections, and you got to speak in Sacramento, and so I'd love to hear about your experience and also like what you're hearing about workplace protections.

Yeah, that's great. I love that you're in HR and that you care about this. That's really good. We need more of you. Um, so yeah, it was it was it was an honor and a privilege. I'm so glad I was able to make it to Sacramento that day. Um, to provide I provided a two two-minute oral testimony in support of the bill. Um, and it it's um about adding perimenopause and menopause and related conditions to the the list of the sex-specific workplace protections, which currently for women, we have pregnancy and breastfeeding, and the the need for accommodations in the workplace around those conditions or times of life, um, and and adding perimenopause and menopause to that list, so that women who need to dress in layers or have a cooler room or have accommodations or be allowed to have notes when they're presenting or things like that, um, or come in late, you know, different hours sometimes, those kind of things, um, that there's reasonable accommodations that can really make a difference in women being able to still provide the value that they're very much capable of providing. And this is not to say, like, oh, when women are in menopause, they're like they're they're difficult or they can't, you know, be valuable or that kind of thing. Like, we have so much experience and wisdom and and connections and talent and things to share. Um, but it might be that a little accommodating for a period of time makes it so that a woman can actually stay, um, stay in her job if that's something she wants to do. So sometimes as women are are leaving the workplace, and that's really, you know, and some so as a health provider, sometimes I'm like, good, that's gonna be um better for you. But for for employers, I think they're really losing on the the talent and um experience that these women can can continue to perform.

Yeah, or treating it as a performance issue when an accommodation might help the performance because sometimes maybe the woman doesn't even know that it's related to something else. It's just like, oh yeah, I'm dropping the ball on things because I'm forgetting stuff, right? Totally. The brain, brain fog and and not as efficient as I used to be, or whatever it is, or to you know, the the simple things of like heat, you know, feeling hot, or fe you know, it's funny, I was meeting up with family last weekend and I met one of my cousins. We both run cold. And so we were like, Oh, getting a hot flash is like a delight, you know. It's like a finally warm. Yeah. I said I was at a hockey game, and it's like this is great. Like, I don't need my jacket.

For those three to five minutes, anyway.

So I was like, I was like, don't let this run cold. So we're like, oh, you know, like this is nice. Um, but yeah, like it's it and I think there's some education that needs to be done too for employers because even managers don't know, HR professionals don't know, um, to ask the questions or to think like, oh, could there be some underlying issue that's causing this person's performance, particularly if someone was a good performer up until this point and all of a sudden something's changed. Um I was talking to someone today who's like, yes, there's pregnancy protections, but not everyone has kids. Not everyone gets pregnant. But if you live long enough, you will go through this experience.

Everyone with ovaries is gonna go through it. Yeah.

And you know, which also leads me to like interesting thoughts around like transgender and like, you know, and I know there's not a lot of research there either, you know, because there's not even that much research on the women's like, and then you you know, look at um, you know, people who've transitioned but still have ovaries, and so it's like well you're still gonna, you know, go through that too.

So yeah, yeah, and workplace protections there are few and far between. Yeah. So yeah, so I'm but the education and having the conversations and having it be less taboo and more of an okay thing to talk about, and having resources available, I think, is a common, you know, answer through HR of like, let's provide some education, let's provide some access to care, um, that kind of thing. So bringing speakers and actually just I'm honored. I was just got an email yesterday from a workplace that I uh gave a presentation to last year, and they were like, the feedback was so positive, everybody wants you back again this year, let's figure out a topic. Um, so yeah, bringing bringing in education and giving giving resources to your employees.

Yeah, and it's and it's hard, I get too like, you know, women don't want to draw attention to the fact that they're aging, right? So it's like there's this all this stuff that makes it harder. So having those protections in place might help someone actually feel comfortable to have the conversation because they know then they can't be retaliated against for having the conversation. The way I always approach HR in general is like, oh, let's, you know, even if it's not protected, let's talk about it. And is there something simple that can be done? You know, and they're very much there, you know, very likely could be, you know, most, particularly post-pandemic, a lot of jobs can be done remotely or have more flexibility than they used to. Even the jobs of that I, you know, I support around, you know, scientists who need to be in a lab still have flexibility in when they can come in. So um, without it being like, oh no, you need to be here at your desk at nine o'clock.

And you know, yeah, yeah, that's that's really good. And I think having the conversations with everyone, so it doesn't have to be like you have to, you know, isolate yourself out saying that you need this conversation. Everyone at the workplace has an educational conversation, even the men, like everybody needs to know it. The higher ups, the the the lower downs. Like everybody needs to know and have and have women in their lives, and again, if the women and they're working with people, and then for them to know for their own, you know, other people in their lives too, absolutely. So that way someone who feels like it could negatively reflect on them personally can still get the information and know their resources are available without having to you know make make a big difference.

Yeah, I did a presentation and like a webinar on menopause in the workplace and accommodations and how you can help and support. And my host was a male and he had the best questions, you know. So, because he's like, My wife's going through this, he's like, I have these questions, which never really led to me like uh I think men couples aren't necessarily talking about it, you know, themselves. And so it's like I was that safe space where he he's like, I can ask the questions I kind of want to ask my wife, but I can't, but I might get my head shirt off if I ask it the wrong way. Tell me about this, right?

Yes, have you seen the M Factor II movie?

I have, you know, it's on my DBR. I have not watched it yet. I know you had hosted, right?

A uh I hosted a screening here in Berkeley, and I'm actually one of the experts in the film. So I I was interviewed for the movie. It's called the M Factor II before the pause. Yeah. And um, it's available on PBS for another couple weeks or so. That's it's a time-limited thing on PBS. From our screening in Berkeley, we actually also video recorded our panel, and we had a fabulous panel. So if anybody's watching and is interested, if you if you don't mind another link in the show notes, um, our event page, it has the link to the PBS if you're catching this. I think it's May 19th that that it's gonna be uh available through PBS um uh for free. Other otherwise, I I don't know what the future is for the availability of the film itself. We're probably gonna host another um screening. Um, I don't have specific plans on that yet.

But yeah, and I think it's only is it only an hour? Is that right? It's only an hour, yeah.

It's just under an hour. So yeah, and it's I just thought of it right then because there's a couple of scenes that are really applicable. One is a couple, there's a husband and wife having a conversation, and it's just really touching and really meaningful. And he's like, I don't if you want me close, if you want me far, like I can't always tell, you just have to let me know. Um, and sweet. And there's also some scenes of a men's group talking about menopause and perimenopause and how it is with them and their wives and that kind of stuff.

I'm uh I'm actually in a couple weeks speaking with some a friend of mine, male friend of mine, um, we were talking about this thing. He's like, Have you ever had a man on this? I was like, I have not. And he's like, I was like, 'cause do you want to do you want to be on his wife's a doctor? Like also, you know, we're all around the same age, and so um, it'll be interesting to hear, you know, his perspective. And you know, but it's like, yeah, there's this this these conversations need to happen, and you know, there needs to be maybe a safe space where like a guy can be like, I have a question, but I don't want to like ask my wife, like yeah, yeah, that's really interesting.

It's making me think a little bit about maybe we could host some kind of a thing that was like, you know, if your partners have questions or just men. So yeah, interesting. Yeah. I think that the actually was talking to someone who does menopause education and coaching and stuff, and she was planning on starting like an offering for men and for partners. Yeah. Um, because that's it's yeah, it's as as hard as we know that it that it is for ourselves personally, like it's it's kind of rough on the people around us too, or it can be. Um, but the more support we have, the more communication, the more we can like bring. break the taboos and just be like, hey, this is what's going on. Like, let's talk about it and and understand how we can help. And now that we kind of now that the kind of the box is open in terms of the safety of hormone therapy, like we have that available as a tool. And there's so many other things that you can do to help through this transition as well. And your food really matters, your exercise really matters, you know, we're finding out what's going on with your thyroid and your blood sugar and your adrenals, the stress response, your nervous system is a huge part of the the mix of what's going on as you move through the transition.

So yeah, and I think you know particularly and this is I think where him and I got on the conversation is like when you have any sort of sexual dysfunction related to that, then there's a whole psychological aspect and then you know and it impacts both partners. And so it's like but then you don't talk about it. And so it just gets to this this point where people um again to your sort of this taboo, you know, again depending on how you were raised depending on sort of your culture it's like oh I don't want to bring this up so I'm just not going to talk about it. And and who knows like I mean I know there's a lot of divorces in this age range too.

So it's like there's all these things and like just come in get and maybe that comes down to partially communication like I don't know how to you know communicate this right yeah so one of the panelists we had at our M Factor screening is a sex and intimacy expert and her her she's fabulous. Everybody was just like wow she was amazing so Susan Bratton is her name and um she's a really great educator and just really awesome so that our our recorded panel on our event page is is worth a watch. Yeah great um is there anything else that you um would love to share today um I just lingering on this thing that the like the men come into the conversation around sex I just I just have to say that that's great that they're coming into the conversation but I really hope that the conversation goes beyond that and that it's not just like I want my wife like fixed so that I can have sex with her. Like this is this is like acknowledging like wow this person that I love is going through a lot right now and what are all the different ways that that's impacting her and all the different ways that that impacting us and what's what's happening in the bigger picture of all of that. So I just the the even even in the film the men's group thing like a lot of it has to do with sex. And it's like let's let's look at at us as as whole people. So just just had to just had to finish my thought on that topic. Yeah anything else yeah I I I think I've kind of already said I I feel like there is a big pendulum swing happening right now in regards to hormone therapy where we went from fear where everybody has been under this black cloud of the research trial that got really misinterpreted and overblown in the media but now that fear has swung to this FOMO. I feel we're kind of going from fear to FOMO where it's like everybody should take hormones and we're like why aren't you taking hormones and and hormones are a great tool but they're not the only thing and there are other options and there are some people that hormones are not great for um but man but navigating through hormone changes and you know doing things to help support your brain and your bones and your heart health like heart disease is the number one killer of women we need to be paying attention to our cardio and metabolic health in all the different ways. So that's just kind of a little plug that I want to say is the holistic care really matters.

Yeah absolutely and yeah and it's not at all one size fits all approach either. Like so if you're talking to a friend and they're like I take this and this is the dosage it doesn't mean that's right for you. It doesn't even mean if that modality's right for you right exactly yeah yeah but it does start the conversation and then someone hopefully can find a provider such as you and then get you know more informed care versus being brushed off because that's also people's experience.

Yeah yeah either so many people are either being brushed off told they're too young or that it's not their hormones there's nothing you can do or they're dangerous you can't do it so you don't do anything or they're going to like an online platform and answering a couple questions and getting hormones sent to them which is great for access but it's what about all the other aspects of person's health so and if somebody wanted to work with you how do they do that? So we are uh supporting patients throughout all of California so we are virtual practice this background was my physical office but we we closed that down in the pandemic and so we're fully virtual working with patients throughout California. I have a team of naturopathic doctors and a health coach so that that bringing in that coaching side to help with the implementing implementing of your plan and what you're doing and the things you're working on plus the mindset work of it of like prioritizing ourselves and how do you have that conversation and how do you you know love and work with the body that you're in now and and move forward from here and um so she's really great too. But anyway our website is women's vitalitycenter.com and people can learn more there. We have a free online workshop called navigating perimenopause is H R T right for me which is a really great starting place and can help you learn more about our holistic approach and we have a vital perimenopause protocol that you'll learn there and a self-evaluation of where you're at and that's a great starting place.

So great thank you so much it was a joy to have you here so uh thank you Dr. Day please if anybody's interested um look in the show notes uh you'll see links there uh and if you'd like to be a guest I have a link there as well so you can feel free to reach out but otherwise I just say thank you for uh watching and uh listening and we'll see you next time.