Episode 26 - Sharon Lemoine, ARNP-FNP - HRT, Supplements, & Lifestyle - Oh My!

Hi everyone. Welcome to Menopause Chats. I'm your host, Aaron Daruska. Just a reminder that this uh conversation is for informational purposes and is not medical advice. Today we are speaking with Sharon Lemoyne, who's an advanced uh registered nurse practitioner uh with uh Gig Harbor Concierge Med uh Medicine? Medicine in Washington, in Gig Harbor, Washington. So thank you so much for being here today.

Well, thank you for having me. Like I was saying, I love connecting with other like-minded providers.

Yeah. So tell me a little or tell us a little bit about um what you do and and how you help us uh us ladies.

Well, I have been in the medical field for our almost 30 years. I worked at the bedside mostly in uh in the emergency room, and then later got my nurse practitioner degree and was able to work as an independent provider in emergency medicine. And I love that experience. But as my career expanded, I started looking outside of corporate health care. I got into some aesthetics, quickly realized my passion was health and wellness. And so the practice expanded into a full primary care that specialized in weight loss, hormone therapy. We do treat both men and women. Uh, we are now using peptides and really coming from a faith-based functional medicine approach and really looking at mind, body, and spirit. And it's been so rewarding and really learning that we have the capability to advocate for the care our patients deserve. And it's really been embraced. So yeah, happy to be here.

Yeah, it's so interesting to, I don't know, like people there's so many options that people don't realize they have when it comes to their health care. Most of the time, at least I knew this was my it was true for me, thinking of only like, well, I have insurance and I go to a doctor for my insurance and that's it. But not realizing that there are other options out there. Now, not everyone, I also understand not everyone can afford to go to, you know, one, not everyone has insurance, and then not everyone can afford to see a healthcare provider outside of their insurance as well. But um, if people are curious about it's not it's not alternative care, but just an alternative arrangement to corporate medicine, as as you've as you termed it. Uh where should they start?

Yeah, you make some great points. The idea that I have insurance and I can only go see this one particular list of providers. That that is that traditional idea. I think patients and know patients want more. The corporate health care is not able to meet the demand and the needs of what patients want, especially in a world we live right now. There's so much information out there, and navigating that that the patients are coming in, they're well educated, they've done their homework. And in a corporate health setting, it is so rushed and driven by medicine. And people want more holistic approach. They want to look at the causes of what is lying behind their disease or their issues. And so, knowing that these providers are out there coming from a functional-based approach, a root cause, where they're not so quick to write a prescription but actually fix the problem, that's functional medicine in itself. So, for somebody to look for that type of trained provider, and then with the forefront of menopause and really the movement we're seeing now, there are so many providers that have been in a certain specialty or maybe been practicing primary care. They have stepped out of their traditional education and had specific education in the hormone space. That's what the patients really should be looking for, is somebody that's going to validate how they feel, who has had that specialized training in functional medicine hormones, whatever certain care they're looking for. And that will help guide them, find that right match for them.

Yeah, and as it and it's it's hard, right? Because you're there's so much information out there, too. And to to your point, women are more informed than they used to be. And if they're going to their traditional provider, who, as we know, may not have been trained in menopause at all. I mean, that was I've said it before though, it's it's my experience where it's like I went in and it's like, well, I'm not gonna talk to you about that. Well, okay, well, then who's supposed to talk to me about this? Right. And that's I've had enough of these conversations to know that that is a very common experience across the, you know, probably across the world, but definitely, you know, across the country, of people feeling like they're they're not heard, they're dismissed, you know. Lately it's been conversations talking to women who are in the perimenopause years saying, Oh, my doctor's telling me I'm too young.

Yeah.

It's like, okay.

Yeah, no, and you make a great point. In traditional medicine, they have not spent a lot of time uh in education on menopause. If you follow some of the big uh speakers in the space right now, OBGYNs, urologists, and they've even said themselves, this was my specialty, and I did not get much, if any, specific training in hormone therapy, in menopause. So it is something that uh we have to make sure we're we seek out that information. I always say, like every single provider out there, I think has the best intentions. We all want to do good by our patients, but we also have to understand that there are limitations and we can't treat everybody. So, for women who are sitting there wanting to be validated, make sure you're going to the person that has been trained in that area. If they don't, take the time. That's okay, that's just not your person. But the bigger picture is a women, we know our bodies. We know when something is wrong. And really not ignoring that voice, validating that and finding a provider that's going to do the same for you.

Yeah, because I think in traditional, you know, we might be traditional medicine, often it's like, oh, well, I'm listening for these certain things. And if they check these boxes, this is what it is. And if it's not, then I don't know, you know, I don't know what it is. Like I remember talking to somebody and now in hindsight, realizing it is like when our um, you know the our skin changes, right? And our skin everywhere changes. And then being like, oh, well, that sounds like you've herpes. It's like, well, no, like, because of course anytime you go in, things don't, things are not presenting themselves when you when you need them to. And they're like, oh no, it's like it sounds like you've herpes. And I was like, I don't, I'm pretty sure I would know at this point if I had it. Right. But because it, you know, what she was hearing sounded like, oh, we have irritation and it hurts, and it's like, oh, it must be these things. And so it's like, fine, I'll go get the blood test for it. Right. But I already know that that's not what it is. Actually, what I ended up doing was texting my husband on the way to the thing, and I was like, listen, if I've hurt means, you got some explaining to do. That's right. Explain what I did. That's right. And so I was like, wait a second. Um, and of course it was nothing, and you know, but that's what she heard. And it was also the last time I went to that provider. Yeah.

You know, yeah, and that's you know, it touches on the fact that you can come in, one patient can say one thing. They could say, hey, I have fatigue, or I have you know, vaginal dryness, or I have all of these things, and one fix doesn't fit every single patient. That's what makes my job very interesting, is I can have women come in with similar symptoms, but it might be coming from a different source. It might be a vitamin deficiency, it might be an underfunctioning thyroid, it might be completely related to her gut health. And then again, it could be hormones. So you have to keep an open mind and not be so recipe driven as a provider and really listen to the patient, because again, we know our bodies, and look at every level. And it it's it may again make it interesting because you never know unless you start looking for the cause. Um, and then when you start looking at treatment options, that's also another piece of it because I can treat women with testosterone, estrogen, progesterone, and every single one of them might have a different response. All good, but they're all gonna come back and say something different. So it is very, very individual. And hopefully your provider is looking at it in that sense.

And so when it comes to like hormone therapy, it's not a one size fits all. There's a ton of different options. How do you kind of how do you look at it when you say you've, you know, like you said, you have three different women and they might have three different needs, three different tolerances, three different interests in doing that, or wanting to do um, you know, non uh, you know, doing something else instead of that, but wanting still to have some symptom relief. How do you how do you approach that? Where do we even start?

Well, the first thing is we have an hour-long appointment. I get to know their history, and then I really get to help them prioritize what are their symptoms right now that is really impacting their lives. So that's our starting point. The second thing is doing a very comprehensive workup. So we can do basic labs as you would get in your typical primary care, and that's okay, but we got to take it another layer. So we're going very deep into some genetic testing and looking at gut health, looking at every hormone different levels, not just an estrogen level, right? We're looking at FSH and we're looking at total testosterone and free testosterone. We're looking at sex hormone binding globulin. There's so many different tests. So we have to do a comprehensive workup. And then my patients usually come back in a couple of weeks when I've got all those results. And we sit down and I can sit, I can lay out exactly what their symptoms are. I can look at their blood test results, and I can give them all the options and I tell them pick a lane. Do you want to be really conservative and want to do take one lane right now and one approach? Let's let's take that head on. Do you want to take on multiple lanes at the same time and be a little more aggressive and start some supplementation, maybe start a weight loss program and add in some hormones by all means. So we have to make it individual, but you got to start with the data. You got to look at the symptoms and find from the patient what is stopping you from living a healthy lifestyle, right? If you are coming in with chronic fatigue and maybe a little bit of weight gain, well, of course you don't feel like getting up in the morning and working out because you can barely get out of bed to just start your day. So we have to look at the reasons for that. I need to give you your energy back. Is it a vitamin D deficiency? Is it testosterone, lacking motivation and mood and the ability to recover from a workout, right? So there's a lot of different layers to this. And we just have to, my question to my patients is how conservative and aggressive do you want to be? Where do you want to start today? I give them all the options, and they usually pretty much know right out the gates where they want to start. And then that just starts the relationship we develop over time. I tell them, look, I'm not gonna fix you in one appointment. We're just going to pick our a goal right now. And as we see how these therapies are working for you, then they come back and we can take away, we can add. And ultimately, it is symptom management. I tell my patients, I want you to feel your best right now so that you can go out living that healthy lifestyle. However, we have to be thinking 20 and 30 years down the road. So all the measures we're doing now certainly have an impact 20 years later. And I like to educate them on that. And again, that motivates them to start the work.

Right. And it's so hard sometimes to like we were at least my experience has been with people saying, we want a quick fix.

Yeah.

And it's like, but not thinking like, oh, in 20 years, like, oh, I'm lifting these weights because in 20 years it's gonna help my bones. Right. Or oh, I'm uh eating healthy because in 20 years I won't have a heart attack.

So And we do need to be thinking about that, but ultimately all of those things, if you do those things now, you're gonna feel it now, right? Some women come in and they're like, actually, I feel pretty good. I heard I was supposed to get my hormones checked, but I feel good. I feel fine. I'm like, okay, that that's fair. But then when they come back and I've optimized their thyroid and their hormones and their vitamin deficiencies, they typically will say, Wow, I forgot what I was supposed to feel like because I definitely feel better now.

Right.

So I feel good, but now I feel better. Yep. We as women, you know, we put our heads down, we work, we take care of families, we have careers, and we just kind of put our health and our symptoms on the back burner. And when I get you feeling your optimum, it can be a big eye-opener. And then it gives you that much more motivation to continue taking care of yourself. Absolutely.

I know uh there's so much information out there right now. And so much probably misinformation, confusion. Like I like for me, it's like I see all the stuff because it's just in my algorithm, right? So I'm always seeing the things like you should take creatine, you should take this, you should take that. And I'm like, I don't know if I need any of it, you know, some of it, none of it, I don't know. Um, so how do people kind of figure out what what's what's real, what's not real, what what would help, what wouldn't help. And I'm probably also I'm assuming different for every person. But yeah, but where where do we start with the information that we're gonna do?

It's hard. Yeah, it's hard to navigate as a medical provider. It's hard sometimes because I there's so much noise on social media on so many different platforms. For me, I have found those few mentors, those few well credible, respected uh professionals in this space that I know that are they're looking at the research, they are rational how to device like what is correct, what is not correct. So for me personally, I would love to sit and have the time to go through all the research. And I don't, I'm I'm running a practice, but I still need to get up-to-date information. So I do a little bit of research on my own, but I do find those few people that I know are credible, that they are able to not have biases and look at the information in front of us. Uh, one particular uh blessing that I've had in my education is that because we do hormone therapy, we do pellets, I use BioT, which is a company that's been around for a very long time with pellet therapy, and they have moved well into the industry of health and wellness. And so their level of education, their providers, their educators are just top-notch. I know without a doubt, I can trust the information I'm getting and bring it into my practice. And I've seen it firsthand with my patients and how much better they're getting. So, in that sense, it's worked out well for the patient to navigate. Again, I would I would really take the time to do backgrounds on people that are speaking out. Uh, I could list five to 10 right now that I see often on YouTube, Instagram, all the socials that have established well backgrounds. They're very credible. Um, and they're pretty much all saying the same thing because they are using the same research and the same rationale in the information. So you'll find there is a trend in a certain group of people that you see in the limelight that are sharing the same information. And it is accurate, correct information because they're doing the work behind it. So it can be tough, it can be very tough. Uh, but always look at the source, you know, if you're looking at research, where's that research coming from? Was it a multimillion dollar study backed by, you know, with biases to prove something that they wanted to push out? And um or is it just a double, you know, blinded uh type of study that's gonna get us more accurate? Yeah, yeah, yeah. Um I'm I love observational studies, and I think a lot of us, uh like myself with small practices, we're doing observational studies every day in our office. You know, if we all took our information, exactly what we see and the outcomes in our patients, that's an incredible amount of research we're doing. So um it it can be tough. It can it can really be hard to navigate. So just look at the source and who is telling you what.

Yeah. Um, and then so you mentioned pellets. So there's pellets, there's gels, there's pills, there's probably other things on escape sprays. How do people know what uh creams, I think, as well? Like, how do people know a ring? I'm like, how do people know what's what's right for them?

Well, I mean, the good thing is you have a lot of options, right? You've got a whole menu. Yeah, and you know, there I I'm a big pellet fan. I've had huge success personally with my patients, but it's not for everybody. And it if I've got somebody coming in very concerned, very conservative, uh, really wanting just to dip their toe in the pond and maybe a pellet's not the best thing. Let's start you on maybe a patch or a cream, and let's slowly get those levels to where we want them. Um the the great thing is that there are good options. There's a few out there that are questionable, anything through the GI tract, the way that you digest, the way you break medications down through metabolizing through your liver, you the absorption can vary, and those responses aren't ideal. So that's why we go to topical injections, pellets. We're bypassing the GI tract. Um, so so there's many, many options. They're all valid. Uh there are it's you just have to figure out what's going to be right for you. Lifestyle people that love pellets, they don't have to think about it for three or four months. My men, you know how men love to go to the doctors, God bless them. So they love pellets because they don't have to come in all the time. They can see me every three or four times a year, and they're often running. And um, to them, they've dodged a bullet having to go to the doctor's office, but they feel better. Uh so yeah, there's lots of options. You just have to have a provider that will offer you every option and figure out what's going to be the best fit for you.

Right. Um, I appreciate that. It's yeah, it's it is hard. And I mean, I've I've been on patch. Well, and I think we talked about this earlier of like I have uh when I first found out I was postmenopausal, thinking I was perimenopausal, uh, because I haven't I have a marina IUD, so I haven't had a period, so I didn't know when my last period ended. And, you know, so I was like mine was expiring because they last for eight years for for pregnancy, uh, for birth control. And I was like, you know, I'm just gonna, I'm just gonna come off of it. This was it. I'm gonna go on an oral progesterone. And I just didn't like how I felt on it personally. And so I was like, you know what? I think I might just get another morena because I already know what my how my body reacts to that. Um, and so that's what I ended up doing instead. But I was glad because we experimented, we tried it, and we're like, well, you know, like this is my body, I just don't like how I feel on it. And for me, this is what I want to do. I know how my body tolerates the marina. So here we are. Um, I did forget how painful insertion is. Um, but you know, the I I am finding out uh a little after my my session is that they will. So this is for anyone listening. If if you have a provider, see if they'll do it under local anesthesia because they can now. That was not offered to me the last time, um, but it was uh, and of course it wasn't technically offered to me this time. It was like, hey, by the way, we could have done this. And I was like, all right, well, that would have been nice for the person who scheduled my appointment to tell me, uh, because I definitely would have taken them up on that. But um, it's bearable. I asked a friend who I know has had children and has also had a marina. So I was like, how does this compare? Because I haven't had kids. And she said, Oh, it's like contractions. And I said, Okay. And I said, good to know. I was like, uh not had that life experience. Yeah. Um, but I was like, I'm really curious now. Um, so again, there's other options. It's like, yes, you can go on your marina for now. Now I'm only good for five years for that. Um, so this may be my last one, but I won't know until five years from now. But it is nice to see that there's different options out there for you know for people. Absolutely. Um, if you uh I guess the thing that you see the most from people coming in, like, what do you think is the biggest misconception people have about the menopause experience?

Well, one thing you mentioned was post menopause, and something one of uh the providers I follow in the education space in menopause and Name is Sharon Malone, and she had mentioned that really struck me is that is it post-menopause or are you in it? Because if you think about, we define menopause as 12 months consecutively with no menstrual cycle, complete ovarian depletion. You're not making estrogen anymore. Well, if you think about it, you're spending the last third of your life in it. So we don't go through it. We are in it and we are estrogen deprived for the last third of our life. So I thought that was kind of an interesting take on that. So when uh misconceptions, when I talk to patients in the office, they're like I went through it, I'm like, well, actually, if we don't give you estrogen, you're gonna be stuck in a very low estrogen level and have all the health, the health issues that can follow. And that is a huge misconception. People don't realize the risks of not replacing hormones. And that's where the conversation has changed. What is the risk of doing hormone therapy? Well, what is the risk of not doing it? If you look at statistics, I love the little one-liner statistics I can pass on to my patients. One in three women after menopause will have a cardiovascular event. One in three. Now we're all concerned about breast cancer, and the average is one in eight women will get some form of breast cancer. That's a low number. But if we're looking at cardiovascular risk, then one in three, well, that's where I'm gonna really pay attention to. Same thing with dementia. We can reduce dementia risks by 50% by maintaining an estrogen level at a therapeutic level. So there's a lot of education. Again, yes, I want my patients to feel really good right now, and we're gonna do that for you 100%. But it's the long-term prevention that I really am trying to embrace and empower the patients to know they can't control it. Don't sit there and say, well, there's a genetic disposition for dementia, and I'm gonna get dementia. Actually, you um actually can do a lot to prevent that. And that's where people don't realize is that they have so much control. There was a study done, and I really have to find the exact study so I can quote it a little bit better, but to the sense that if you work out your quads and your glutes, you are reducing dementia by 40%. And I thought, well, that's kind of interesting, but it makes sense. Blood flow, we need blood flowing through the entire body, big muscle groups.

Yeah, but how sedentary are most people?

Yes, these days they have to move to live. Yeah. So uh I enjoy learning more and more statistics like that that I can share with my patients. And when they walk out, they really have a better understanding of oh, this wasn't just about hot flashes. This is this is long term, and uh, I think they really appreciate that.

Yeah, time for me to do some squats. Yeah, that's it. That's it.

We have two squats, one of those all the things.

Um, anything else that we haven't touched on that you were like, oh, I want to make sure that your listeners hear this.

You know, doing more and more speaking events and podcasts, I I enjoy connecting with everyone to, we all have the same goal, and we really want to educate and advocate for our patients. You know, one big message that my audience has been really receptive to is we can sit here all day and say, you know, you're supposed to eat right and take your supplements and work out and don't stress and get the cortisol levels down. But the question is, what is motivating us? And for me, in my practice, we've really had a chance to sit down and look as uh our faith as a motivator, you know, God's given us this gift and we need to steward our bodies. And that seems to really rewrite that sense of motivation. You know, yes, we want to look cute in our skinny jeans, but really honoring a gift uh that may be imperfect, but there's a reason for that. And I've really, really enjoyed being able to dive into that side of things and motivate from very different aspects.

And so, Sharon, if people were interested in learning more about you, how do they find you?

Well, I have my YouTube channel now, Hormones Health and Faith. I'm on Instagram, Instagram at the ConcierNP. And then, of course, we are here in Gig Harbor, Washington, just about 45 minutes outside of Seattle, and that's where our practice is. And lots of good things coming, lots of big changes, and we are growing quickly. So very excited to share that with the community.

Great. Well, thank you so much for being here. I really appreciate it. Thank you so much. And thank you for uh joining us listening today. And I'd be honored if you subscribe or share menopause chats with others. Uh, if you're interested in being a guest, feel free to reach out to me. Uh, otherwise, until next time.