Joanna Strober’s Post

Last week I talked about the impact of anti-depressants on weight gain, thanks to a great article by Owen Muir MD DFAACAP, and today he wrote another really good column on the impact of antidepressants on sexual desire. Some women need anti-depressants and they are appropriate. But when women stopped taking hormones in 2001, the percentage of them on anti-depressants skyrocketed and remains high. According to the WSJ, one in 5 women in midlife have taken an SSRI in the last 30 days. So, sexual desire goes down, stress on the marriage goes up, then, more anxiety and depression. Essentially, as the WSJ points out, women are getting prescribed anti-depressant medications when what they really need are hormones... https://lnkd.in/gYrFPGmn

Owen Muir MD DFAACAP wrote a really good post explaining how the use of anti depressants is directly tied to weight gain. Many women are given anti depressant medications to manage depression in perimenopause because psychiatric providers are not trained to differentiate hormone change from other types of depression. Then, the women gain weight, leading to increased depression. It is a vicious cycle we see every day at Midi Health - women on anti depressant medications that are upset about their midlife weight gain. Hormones are absolutely the solution here… estrogen, progesterone and testosterone. Many women will find their anxiety and depression disappear immediately with hormones. With Midi Health over 95% of our patients see their mood improve without therapy or anti depressants! Plus we have found hormones alone can help women lose weight. All of this is interconnected….if you are a woman over 35 and experiencing an onset of anxiety or depression, please consider this could be related to a change in your hormones and get appropriate care.

Moved my son into his nyc apartment over 4th of July. Fun to think about all that’s ahead for him. When I started my first job, I had no idea what would change in the world. I have been an attorney, a venture investor, a book author and an entrepreneur. They were all challenging and the skills I accumulated were useful, although not always apparent. To all of you starting new jobs…enjoy the ride. You never know what’s ahead!

This is so well written -  Healthcare providers often fail to make their female patients aware of medications that could help alleviate perimenopause and menopause symptoms. We are trying to fix this. But the symptoms are serious - starting in perimenopause - declining bone and muscle max, wrinkles, sagging skin, vaginal dryness, sleep disorders, depression, hot flashes. Why are we not educated on this before it starts?

Most of Midi Health's care can be done virtually...and women often prefer to have online visits rather than going to the provider in person. Our visits are also longer than most in-person visits. However, there are lots of times when in-person care is necessary. At Midi, we often refer women to get mammograms, endometrial biopsies, colonoscopies, hysteroscopies, bone infusions and other procedures, and we need to ensure that we send you to get high quality care. We also want to offer continuity of care by integrating with hospital systems so you can have a seamless experience, by sharing healthcare records, coordinating with your other providers and avoiding replicating tests. So I am delighted to announce this partnership with Keck Medicine of USC that will help us ensure high quality menopause and perimenopause care for all women in the Los Angeles area, both in person and online! https://lnkd.in/g9YJ63uF

Not everyone wants to take medications for menopause symptoms. The good news is that there are supplements that can work to alleviate symptoms and Midi Health we have trained all of our providers in which supplements have true evidence behind them. Here, Lauren Streicher MD lays out options that you should consider…especially when hormones are not an option. https://lnkd.in/g4-BeTsM

Bone health is one area that is often massively overlooked by women until it’s too late. At Midi Health we are recommending that women get DXA scans at a younger age if they have risk factors for osteoporosis and then take proactive steps. All of our Midi protocols include medications (hormones help a lot to maintain bone density and there are non hormonal medications to improve bone density), supplements and lifestyle. I have started wearing a weighted vest around the house. Weighted vests in conjunction with weight-bearing exercises help increase your bone strength and density. Added weight increases the strength of your bones because it encourages your osteoblast cells — the cells in your bone marrow — to build new bone. It also makes your bones adapt and grow denser to account for the extra weight. We all want to stay strong as we get older… this is an easy add!

It is MUCH harder to fix a mistake than to make one. Nowhere is this more true than with regard to the Women's Health Initiative. A misinterpretation of the results, combined with sensationalized headlines regarding an elevated risk of breast cancer, led to a significant shift in the perception and utilization of HRT. All research on hormones essentially stopped and women's health suffered. So it is quite frustrating to see this NYT article again misinterpret the results and claim that "Women taking the drug had an increased risk of heart disease, blood clots, strokes and breast cancer". The design of the WHI was flawed. among other things, the majority of the women in the study were over the age of 60, statins were not taken into consideration, and only an oral estrogen was considered. In a subanalysis in the 50-60 year old group who took estrogen alone there was a 23% decrease in breast cancer, a decrease in cardiovascular disease, and a 30% decrease in all cause mortality. Subsequent studies, including SWAN, support that estrogen is beneficial in terms of cardiovascular disease. We are finally making huge strides in educating women that they need not fear hormone therapy and that not only will it improve quality of life, but it will increase length of life. This article shows how hard it is to fix old mistakes...

Best story of the week! I got on a call with a potential local partner. The woman introduced herself and said, I have a funny story to share. She was feeling "off" and experiencing a lot of mood changes. One night her son said, "you know, my friend's mom is starting a company on menopause and hormones, maybe this is a hormonal problem". Fast forward, she is now a Midi Health patient and expressed gratitude that I had taught my son so well...and that he had shared with her son. We need everyone talking about hormones and the impact on our lives - excited that we are starting to normalize it enough that 17 year old boys discuss it in conversations!