84. Tania Elfersy on the Medicalization of Menopause
Welcome to the radically genuine podcast. I am Dr. Roger McFillin. Sean, there's a Zen Buddhist concept of beginner's mind. And that's where you look at every situation that you are placed in, as if it is the first time you are seeing it. I think as a clinical psychologist, and as a middle aged man, I want to approach today's conversation with a beginner's mind. We are certainly behind the pharma iron. here in the Western world and United States in particular, where we tend to view a lot of normal and expected lifespan shifts through this medical perspective. We certainly live in a society that tends to medicalize normal experiences. And where I need to approach my work in conversations like this, is to think about and see the experience of being a woman from varying perspectives. It's not new to any of our audience that women are more likely to be diagnosed with a psychiatric disorder. And be diagnosed with a psychiatric disorder or look at their experience through a medical lens. So their mood changes, shifts that might happen premenstrual or middle age experiences perimenopause or menopause can certainly be pathologized. And especially in the mental health system, how you communicate your experience matters to how the allopathic medical doctor is going to interpret what you are feeling. So there is a direction on our podcast around women's health that I want us to move forward in by bringing in experts, alternative voices, authors, researchers, to begin to have this conversation. And that takes me to today's guest. I want to introduce a very interesting woman who is taking this subject from an alternative perspective. She's an author, The Wiser Women's Guide to Perimenopause and Menopause, which upon launch became a number one Amazon bestseller in the UK and US. She's also authored an additional book called Purple Leaves, Red Cherries, a book on motherhood that she co-authored with Andrea Katzman. That's won four international book awards. Now the Wiser Women's Guide to Perimenopause and Menopause provides an alternative perspective. from lived experience in how to develop a path towards natural symptom relief and enhanced sense of well-being. She's doing a lot of excellent work, coaching, consultation, education, and she's promoting alternative ideas that are outside the realm of I think what is the typical Western medical approach. I know from a mind body spirit kind of connection, there's a lot that's familiar in her book and in her work. And I do believe that there's a bit of awakening in the Western world to considering globally and generationally cross culturally, how different viewpoints and ways of living can create enhanced sense of well being. as well as alternatively a certain way of thinking about our experience and approaching our life in that way can create many problems. So without further ado, I want to welcome Tanya Elfersy to the Radically Genuine Podcast. Well, I want to just open it up. There's a story to be told as with every guest, because you are a non-medical professional who has taken on the subject of menopause, perimenopause. And I know that there, you know, in doing so, there's going to be some backlash whenever you're outside of the, what is the typical norm and way of viewing things. You're, you're vulnerable, but just tell us your story and how you've gotten to this place in your, in your life.
Tania Elfersy:
Yeah, so I was in my early 40s, juggling motherhood and my little business, and I started experiencing symptoms that I had no clue what they were in terms of putting it in a midlife change framework. But it started off, I started getting sick a lot, I had a lot of migraines, I was feeling really down, mood swings, hair loss, night sweats. And it took me a few years to hear of the term perimenopause, because once upon a time, menopause was viewed as a change that happens over decades. But over the last few decades, medicine has narrowed it down to a point in time one year after your last period. And I, like so many women who enter their 40s, I had no clue. I thought menopause, that's not me. That's like average age 51. And for some reason I thought that would happen really quickly. I don't know why I thought that, but I did. You know, when we become a woman, it doesn't happen quickly. It happens over years. And when we end our reproductive years, it also happens over years. So once I discovered that I was in perimenopause, which can last up to 10 years or more, before that time. point in time of menopause. I started researching and this was about 10 years ago and I, all I heard was, it's your hormones, it's your hormones, your hormones are malfunctioning, you need a hormonal treatment, be it natural or synthetic, but you need a hormonal treatment to overcome this malfunction of your hormones. And that just didn't make sense to me. I was like, well, why would my hormones get it wrong? Why, like, I, you know, was born, became the woman who I was, no one interfered then, everything that I went through in adolescence, becoming a woman, three natural pregnancies, natural births. Like, why would my hormones suddenly, like, get it wrong? Why would my body become stupid? Why would this make any sense? And I had an appreciation. for the female body as a wonder, and I'd seen it, especially in birth and breastfeeding my kids. And so I just rejected this mainstream narrative and set off on a journey to find out what could be causing the symptoms and what could heal them. And I was trying lots of remedies and herbs and acupuncture and... running to different treatments. Because I was feeling very crazy and thinking like, oh, if I could just find that one thing that would make me feel like myself again, then everything will be fine. And so I was just looking outside of me for that one thing. And in 2015, I came across an understanding called the Three Principles of Innate Health, which looks at the interplay of mind, as in universal intelligence, thought. and consciousness and how that creates our human experience. And very quickly, I had an insight into the nature of thought. And the insight was quite simply that if I didn't have unresolved issues, I wouldn't be having PMS. And at the time I was having two weeks of PMS every single month. So that was a joy for everyone around me. And... And I thought, oh, if I didn't have unresolved issues, I wouldn't have PMS, but I'm creating the unresolved issues by taking my thinking seriously. And I saw that taking my thinking seriously was a choice. I didn't have to do that. And I also saw that if I didn't take my thinking seriously, life would be easier. So, sounds simple, sounds way too simple, but in a moment, I knew I wouldn't have my PMS. But within days, I was able to clear up all my physical symptoms, which included the night sweats, the migraines, the, I had really bad eczema and skin outbreaks, and everything else that was going on for me. And just through that shift in consciousness, I was able to clear up all my symptoms. And at the time I was, wow, what's going on? How could that be? I don't really know. And nine months later, I fell back into a sort of stressful situation and my symptoms started coming back. And I thought, oh my goodness, I'm a fake. But then I had another insight and I had an insight, an insight that my default is joy. And I saw in that moment, that no matter what circumstance was going on in my life ever, my default remained joy and... With that, all my symptoms cleared up again. And then I knew, okay, I'm onto something. And I started sharing what I'd seen. I mean, I'd already started sharing it very timidly before because I know how crazy it sounds when the dominant narrative is all about your hormones. But I saw that our mental wellbeing, our understanding of where our innate health lies is really crucial. during the sensitive time of change that happens at midlife, just as it is crucial during pregnancy and postpartum and in the adolescent years. And so this whole idea that it was our hormones that were going crazy was incorrect. And since that time, which was 2015, I've been helping women. come to their own healing of their own symptoms just through shifts in consciousness.
Sean:
Okay, this is the radically genuine podcast so I'm not gonna overthink this There's gonna be a lot of people are listening to this and they're going to say Well, you're on this podcast with this quack. Dr. McPhil and are you actually just saying you can change your mindset and Shift consciousness and your body can heal and so I think we have to take this step by step I know exactly what you're talking about because I'm just doing so much reading and personal work in this area and I experience it myself, obviously not through menopause or anything of that nature, but the idea that we can shift consciousness and it alters our entire experience. We know this through holistic health and meditation, and the placebo response, that our beliefs are actually powerful. What's going on in our body is much more complex than what they want to sell to us. So are you saying that we have this innate ability to potentially heal ourselves? And so much of our own sickness can be at least influenced by our consciousness, our mindset, how we think about our lives, our body and stress and all of the, all of the challenges that exist in modern living that can impact how we approach our lives and how we think about our lives, that it has a profound impact on our physical health.
Tania Elfersy:
Yes, 100%. And not only have I seen it, obviously in my own experience, but I see it with women again and again. And it doesn't matter the complexity of their symptoms. They have the ability to heal from within. And left to its own devices. and it's really difficult within the human body to imagine what that would be like, but it's like taking this human free will essence, you know, aside, the body would know how to heal. I don't believe the body acts beyond a divine intelligence in anything that it does, not when we breathe, not when the heart beats, not when the food is digested, but we can in our innocence. create conditions that interfere with the path of nature. And one of the ways that we do it is through a misunderstanding of our innate mental health. Or, you know, to say that another way, through having peculiar relationships without thinking and believing that just because a thought enters our head, then it is true, it needs to be taken seriously, and it defines us. And
Sean:
So we're creators of our own reality.
Tania Elfersy:
we are creators of our own reality. And I would add, we're innocent creators of our own reality because we don't get taught this when we grow up. we get all, oh, analyze, fix, you know, go on a journey, which is, you know, you're gonna sort it out by yourselves. And we don't learn to relax into a divine intelligence within. And the beautiful thing about midlife is that everything that happens, this sensitive time, for women and for men, by the way, I think it happens, it's a pushing to the surface. a need to recognize this divine intelligence, a need to recognize that we're not alone, even though we are the innocent creators of this imbalance on many levels, you know, like huge imbalance, a little imbalance, we're not alone in the healing process. we can just get out the way and let nature do its thing. And nature, in this case, knows exactly how to take us through midlife change. We come in with our little stories about hormones, going crazy, so wild, need to be fixed, the doctor needs to fix me, that we don't see it, but nature knows. And we can just relax into that divine intelligence. And if we're experiencing symptoms, we can heal them.
Sean:
So Tonya, that's not dismissing the fact that there are changes hormonally that occur through menopause, correct?
Tania Elfersy:
there are changes that occur hormonally through menopause. I can't actually, I don't have a lab in my house or access to a lab, so I am going on the fact that people have told me that there are these things called hormones, and I guess when I was pregnant, I did these tests that showed that the hormone levels were a certain level and that was useful. But the idea that we become hormonally deficient and thus malfunction. and thus need replacement hormones is completely made up. And so we have this whole discussion around estrogen, progesterone, and some people now bring in testosterone, and there is this idea that the body gets it wrong and that we need to come in and fix it. Well, I don't know that there's not something else that rises when the hormones go down. Like this whole idea that we go into lack rather than we're moving through a rite of passage. to an elder, what are we gaining as we move through that time? So it suits some financial interest to tell us that we're moving into a deficiency and into a lack. But I don't see it that way at all.
Sean:
That's an interesting perspective. Let me ask some other questions here. So I think what you're saying is you're talking about the natural process that occurs across the lifespan and there's some function and purpose
Tania Elfersy:
Right,
Sean:
to this, maybe biologically, spiritually. What then would be the function of menopause in a lifespan?
Tania Elfersy:
so first of all I'm sure there are some listeners thinking, but women never used to live beyond menopause because I hear that all the time, right? Because we think. of these graphs of average life expectancy through the ages. And you can look back, for example, at a graph of 16th century England to the present day, and you can see, oh, back then, people used to have an average life expectancy of 40. The reason why that was true is because there was really high infant and child mortality. And that was creating the average life expectancy to be so low. But the lifespan, like you said. you know, takes us beyond midlife change. And in hunter gatherer societies, we can see that even where there is high infant and child mortality still, the elders live, you know, beyond the age of 70. So we're talking about this design that's supposed to happen. We are supposed to live beyond menopause. And I often say, well, if you've ever had, you know, small kids and... If you're a mother with small kids and a woman walks into the room who has experienced having small kids and she doesn't have a small kid attached to her, like how amazing is that? And I'm sure that any mother knows that feeling. There is a role for elders to play. And it's not only about, you know, being the wiser elder who has experience with child care that can... help the younger generation, but it is also in that. We have a role to play as elders, and our brains change as we age, because we're supposed to see the bigger picture, and we do see the bigger picture. And we have different roles and experiences that are supposed to happen when we're in our 20s and 30s, and when we move through midlife, which I see as this. push of the body to help us experience something different, to help us change, to help us understand where good health lies so that we can age well and in good health and wellbeing and become elders that share our wisdom with the community. And also as an individual, have a nice joyful long life. And so researchers often have to think, well, would it make any sense though? Why would it make any sense? A woman would be not able to have birth and yet she's still living and surely this is, you know, like, like what's her purpose? And this, this like all flows into the, oh yeah, so that's why our hormones are malfunctioning idea. And so then they looked at whales, orca whales. Also, the females live beyond menopause and they found that orca whale pods that are led. by post-menopausal orca whales do much better than pods that are not led by a post-menopausal orca whale because she is able to bring her wisdom. She isn't distracted by her own offspring and she's able to help find food when food is scarce and deal with conflict resolution. I don't know how they know that in Wales, but that's what they say. And so then they... scientists began to think, well, that's interesting that in Orca Wales, post-menopausal women, post-menopausal Wales do really well, leading the pod. But we don't think about that in the human society, at least in Western human society. In other societies, there's more respect given to elders than we give in our society.
Sean:
Yeah, this is interesting because there's an entire field of evolutionary biology who actually would speak to this that the shifts that occur biologically have some evolutionary adaptation up protective factor. So let's just take men, for example. So as men get older, testosterone begins to decrease. But what you might be saying is there might be some innate intelligence behind that regarding maturity and growth and the impact biologically on how we experience the world. So when you're when you're younger and you're going through these transformations through adolescence, for males, higher testosterone feeds aggression, and muscle strength and procreation and drive which might be very necessary at a certain time in development from an evolutionary perspective. But then as you, as you age, there's a greater perspective and wisdom that the elders can bring to an entire community. And that includes a shift biologically, as well as a shift in perspective and thinking. And I think what you're speaking to is this much more complex than biological reductionism. Meaning there's a shift in a hormone, there's an imbalance, there's something wrong with you, it needs to be fixed. And if you fix it, you can feel better, be healthier and live better.
Tania Elfersy:
Yeah, yeah. I mean, it's pretty hilarious when you look at it. When you take a step back and you think, oh, the body does this naturally. Women is naturally designed to go through menopause and live decades later. And yet we think that we know what her body needs, not only to overcome symptoms, but also there's this narrative of preventing disease. Like we, little we, we know better than what the human body has worked out over. tens of thousands of millions of years, I don't know. But you know, we come in from the 20th century and we think, oh, it's the hormones. Oh, because we can see that there's a drop in certain hormones, oh, that can't be right. She must need those hormones. Why, why do I need those hormones? Why do I not need actually this sensitive time, which is pushing me through this rite of passage, it's pushing me to change. and to become an elder. And without this sensitive time, I could just go on in a high-stress life for some women, you know, eating crap, not exercising, like doing all these things, and there would be nothing that came along to tell me, oh, if you don't like stop working out how health is created, think you're gonna have trouble down the line. and you're not going to be able to serve yourself and the community. So it seems like there's this system, you know, that is designed to have us wake up at midlife so that we know where health lies. So we can serve the community. So we can be useful for ourselves and fathers.
Sean:
Tanya,
Tania Elfersy:
It's,
Sean:
I'm really
Tania Elfersy:
yeah.
Sean:
interested in you as a person. Before you entered this stage of your life and you went on your own personal journey in terms of looking at nutritional supplements and trying to alleviate the symptoms and that whole process, before you came to this position of almost acceptance and mindset. Prior to that, were you the type of person that approached life in that way? Or is this something that you discovered and then adopted fully?
Tania Elfersy:
I grew up in a household that was more about natural approaches to health than running to the doctor for medication. So that was in my favor. But what happened was I came when I was in my early 40s and trying to get my little business going. I had really strong ideas about myself. that I was the kind of person who set goals and achieved them. And I had, I had lived in different parts of the world and done all kinds of exciting things. And it did seem that way that, you know, I could create a story that I was that kind of person. And I remember doing this exercise once for sort of online business course where you get to ask your friends, well, how would they define you? And my friends defined me like that too. Well, you're passionate and you set goals and you achieve them. And so this was really part of my identity that I held on to very tightly. And I thought that was true. That was me. And so when I came to midlife and my little business wasn't going as I had defined that it should go, that felt like... my identity was falling apart. That felt like I was falling apart. And that was new. And that was sort of a new struggle that I was experiencing. Because before then, I guess, things, you know, I just had a lighthearted nature about me. But coming into midlife, I kept hearing this thought of I'm not enough. And I believed it. Because... when I heard it, it made me feel bad, right? Because I believed it. And so then you're on this circle of, well, I'm not enough. And then I'm like, well, surely I am enough. Well, surely there's things I need to do to realize I am enough. So maybe, you know, gratitude journal, or maybe meditate. And then I would, you know, fail at doing that. And then I'm not enough again, but surely I'm enough. And so there was just these thoughts storms that were just growing and growing. And actually it was just my body, you know, sending me symptoms to wake me up to the idea that I didn't have to take any of those thoughts seriously. But I, like at first, I didn't realize that. but it's, you know, an intelligence that's within the body. So I guess I had an awareness and appreciation of the body and a misunderstanding of innate mental wellbeing, because I hadn't really
Sean:
Yeah,
Tania Elfersy:
experienced
Sean:
I think.
Tania Elfersy:
something like that before.
Sean:
Yeah, I'm trying to put myself into the position of a woman who's in her mid life right now, talking to her friends about entering this stage and they're probably collaborating about ideas or what they may be reading or something that might be working for them. And it's almost like you had to go through this period of discovery before you came to what works for you and has worked for others. Is there a message that you can provide to those women that are listening right now that might be reading blogs or talking to an acupuncturist or an OBGYN about how to be proactive and alleviate symptoms.
Tania Elfersy:
Number one, your body is brilliant. So how does that change things? Right? No doctor. It's interesting because when I first started off in this work, I was terrified that people said, but you're not a medical health, you're not a doctor, you're not a medical health, medical professional, et cetera. And now I realize that I can say the things that I say because I'm not trained. You know, I don't have to tear down all these ideas of you need someone else to fix you in order to feel good. Our bodies are brilliant and there is no one who lives beyond divine intelligence. Like it runs in every single body. So if we can play with that idea, even if it seems like a woo woo concept or something to begin with, how does that change? what we're experiencing at midlife. How does that, you know, if the body is brilliant, and if we realize we are designed to live beyond midlife change, then what do these symptoms mean? And as I like to ask my clients, well, what does your body want you to know? And there will be women that go, well, I don't know. Can't you tell me what my body wants me to know? I mean, I'm not hearing anything here. What does my body want me to know? And I'm like, okay. Normally something pops up, but we often don't wanna hear it. And if we can just play with that and just wonder around that, I wonder what my body wants me to know. If I accept that my body's intelligent, I wonder what my body wants me to know. And there's normally an answer right there. And the great news is, it's so much simpler than we think. Because if we get caught up in this story of, oh yeah, you need to go to that doctor and she does compounded hormones, and then you need to pay that much money, and then you need this and you need that, and you need to take it this time of the month or that time of the month, and then you need to add the progesterone. It's really complicated, and it plays into this idea of the body doesn't know, which is historically what, you know, medicine has thought of women's bodies. But what if the body does know? What if the body's brilliant? What's our role then?
Sean:
Well, this is a revolutionary concept in today's Western society, because we are taught to view our emotions, our physical sensations, our experience as symptoms of illness or disease. And who is there to fix our symptoms of disease? Who's going to restore our disease-based self back to health? Well, it's the doctors, which is a medicine or a drug. It's not really medicinal. It is a drug. So this is revolutionary because you would be shifting your idea, your mindset, that what you're experiencing is actually transformative. So last couple of days, I've been getting in here quite early, feel like a little bit overworked. I haven't exercised since Tuesday. We had a lot of rain here in Pennsylvania over the past four or five days. We're gonna have actually beautiful sunny day, but I feel it in my body. Like I feel a little bit lethargic. I... My mood is down a little bit. And so now we're, we're faced with an opportunity. How do we view it? How do we think about that experience? Is it my body sending me a message? Now I know I need to be out in the sun today. I know after this podcast, I got to go get a workout in and I have to take a look at what I am eating, but in the Western allopathic medical world, they're going to view that as something is wrong with you and that is profound because It drives an entire industry. My question is this, I'm fascinated because I actually want to play both sides of this around hormone replacement therapy. Because the research I did in response for this podcast was also to look at the other side and the medical viewpoint of how to treat hairy menopause and menopause. But what do you know about the history of viewing menopause from a perspective of a hormone deficiency? What do we know about these outcomes physically, the dangers potentially of hormone replacement therapy because this is getting to be something that is standard care in the United States medical system at least to now view this from a perspective as a hormone deficiency.
Tania Elfersy:
Yeah, so it all started in the sort of almost 100 years ago when they were able to isolate hormones. And the FDA first approved estrogen therapy for use for menopause symptoms in 1942. But it really took off in the 1960s when there was a book published called Feminine Forever. I happened to have a copy here. It's such an incredible read. It was by this gynecologist from New York who had a certain bedside manner about him. He used to call menopause of women castrates and living decay. And he promised women that they could use a wonder drug called estrogen therapy, and they could cure around 30 symptoms that they may be experiencing in menopause. And... that it would prevent cancer, heart disease and strokes. So all benefits, no risks mentioned, no large randomized control trials, of course. And it was pushed out and marketed. and women just lapped it up because who wouldn't, right? Who wouldn't want all these amazing benefits and it will be your health, you know, solved for you for the rest of your life. And it took 10 years. In 1975, there was research published in the New England Journal of Medicine that showed that there was an increased risk of endometrial cancer, which is a cancer of the lining of the uterus. And... Medicine's response wasn't, oh, maybe it's not a good idea to play with women's hormones, even though there'd been people right from the beginning, and you can see an editorial written in 1939, JAMA, talking about estrogen therapy, a warning. But medicine's response to this rise in cancer... wasn't maybe we shouldn't play with hormones. It was, oh, women's bodies just don't know even more. They don't know how to deal with this excess estrogen that we're giving them. So we just need to add progesterone and that will protect the uterus. So let's do that instead. No large randomized control trials. Women were given this new combined hormone therapy. And it was only in the 1990s and then the Women's Health Initiative, which was halted early in 2002, that these large trials like should, you know, should have been done from the beginning were actually carried out. And they realised that it increased breast cancer, strokes, all kinds of other problems, heart disease. And the industry went into shock and came back. again by saying, oh no, it was misinterpreted. And it was because older women, women who were 10 years beyond menopause were included in the Women's Health Initiative and this other study. And so if we just give it to women for under 10 years, then we should be okay. Now, risks are certainly increased, seven plus years, 10 plus years, et cetera, but they carried on telling women that, you could take hormone therapy for symptom relief and it would reduce the risk of heart disease and reduce the risk of cancers. And I can show you, you know, doctors going on stage in 2015, 2016 and sharing these messages with women. And so again, the message is your body is malfunctioning. You need medicine to come in and save you. And this will protect you as you go on. Something happened in 2017 where an 18 year clinical trial was published in JAMA. And it showed that there was actually no difference between women who were given hormone therapy for an average of like six, six, seven years to women who received a placebo in terms of all-cause mortality. And this shook the menopause world. And suddenly the North American Menopause Society, which before then had included disease prevention as an advantage of HRT, they had to change their policy document and they took out all the disease prevention ideas that had been made up and they reduced the use of hormone therapy to hot sweats and night flashes, vaginal dryness and urinary problems and prevention of osteoporosis and bone fracture. Those three categories of symptoms. to talk about bone fractures and osteoporosis. You read the headlines still until today, and the menopause societies and doctors will say, HRT prevents bone fracture and osteoporosis. And many women, they'll look at their mothers and they'll say, oh, I don't want that, so maybe I need HRT. It changes bone density only for the amount of time that you take HRT. Women generally take HRT for less than seven years these days. As soon as you stop taking HRT, your bone density returns to what it was before. So if a woman takes HRT at midlife, it's not going to have a knock-on effect two decades down the line to protect her bones. And apart from that... Bone density doesn't equal bone health. You increase bone density and you keep on increasing bone density, you're gonna have bones like glass. You actually want bones that behave like wood. Wood is less dense than glass. So, you know, this whole idea that's still promoted, that HRT helps prevent osteoporosis and bone density, you read the small print and it's in there, it's in their documents, but you just have to move beyond their headlines and you'll see that it's made up. It's very specific and it was done, the trials originally, this idea came about because they did trials on women who had hysterectomies and yeah, if you have a hysterectomy and you have your ovaries removed, there is a rapid drop in estrogen and that can affect bone density. So perhaps in those cases, there is a reason to adjust the hormones. But for women going through natural menopause, it's shocking how that message is still pushed out. But something very interesting happened in 2017 And that was that there was a split between the North American Menopause Society and the rest of the world that endorsed this new policy statement on HRT and the British Menopause Society. And I didn't realize it at the time I was following at the time, but the British Menopause Society sort of supported the statement, but didn't endorse their new policy document. And what we see today in the UK and Ireland is a return to the messages that were sent out in the 1960s on hormone replacement therapy. And now in the UK, women are being bullied and under this massive psychological experiment to change their behavior and to believe that they need HRT if they're gonna stay healthy. So it's pushed out again and again and again by menopause influencers personalities and famous doctors that if you don't take HRT, you're going to, first of all, you're going to have so many symptoms, but also you're more likely to get dementia and Alzheimer's and commit suicide and experience heart disease, et cetera, et cetera. And it's all made up. And they'll quote, what's become really popular now on social media is they'll quote like tiny irrelevant studies, irrelevant, maybe not for academia, you know, because it's used as a baseline that maybe you could do further research, whatever, but relevant in terms of the general public and how they should not change their behavior. And they quote these studies and say that they are facts. So for example, on dementia and Alzheimer's, which was a really big thing in the UK last year, it was based on a study that was carried on, carried out for about five years, right? You're talking about hormone therapy given to women at midlife. and you're checking for dementia and you carry out the study over five years, like why does that make any sense? But you have to go in and actually read the study to see that this conclusion, that HLT can prevent dementia and Alzheimer's is false. And it's based on these made up studies that are not done scientifically or to a scientific gold standard and are pushed out as truth. And it's like even just... even like the last few days, there's been a famous menopause doctor in the UK who is publishing her own research on testosterone, which is the latest fad now to sweep the UK island and coming to the rest of the world soon, that women need testosterone. And so she does like some study among her clients without a control. without long-term follow-up, just three to six months follow-up, and she claims that testosterone can help women with all these problems. I'm not even going to mention what they are, because it's so irrelevant, it's so unscientific, but the headline is out there, and women believe it. And so now women in the UK really think that they need testosterone to feel better and prevent future disease.
Sean:
This is such a familiar narrative because this is what exists in the mental health field. There's a machine behind this and the machine is, you know, driven by the pharmaceutical company who pays for major medical organizations, hires academics, they ghost write papers and they have this marketing machine behind them. Often the conclusions to their studies didn't even actually fit the science that was generated, but they count on doctors. and the public to just read the conclusions or just read the headlines. And it's this biological reductionist model as if they've been able to identify some aspect of the human body, usually something small. Maybe it's a hormone, maybe it's a neurochemical. And if they can just manipulate that, then that is the path towards health. And then behind it obviously is a drug that was created and now it's a, it's a billion dollar marketing machine. that has so much power and influence that actually being critical of this exact science or this idea now puts you so far outside the mainstream that you are considered the extremist. And often people just like Tanya or myself just went into this research, read these studies and started to look at exactly how the study was created, or what some of the data suggests, or the limitations of the study. And you come to the conclusion, there's no way they can make this assertion. How would they know this? And there's just a there's a money marketing machine that is behind it.
Tania Elfersy:
Yeah, it's incredible. And I have seen the shift in the UK and I'm worried that it's spreading to the rest of the world. And so the UK is the experiment, but it has changed women's behavior in the UK. It's changed the way they think of their bodies. It's changed the way they think of menopause. And it is nonstop and relentless. And you see it throughout the mainstream media. You see it on social media. Journalists who would once write like balanced articles about menopause, and maybe they would suggest hormone therapy. And I'm not saying never ever use hormone therapy. Like I'm not a doctor. If someone wants to, you know, to try that path, they can try it. By the way, it's a really complicated drug to take. Most women do not get it right the first time. They have to go back to their doctor three or four times until they find a combination that's actually giving them relief and not increasing their symptoms instead of decreasing their symptoms. And that's one of the reasons that doctors are really wary of prescribing these drugs. But. Anyway, if a woman thinks like she cannot survive and you know, she's got to, you know, the end point and she says, I just need something and you look at it as a first aid measure. Okay. First aid measure, but when it becomes a lifestyle and you're not told the risks of long-term use and you're not, and you're not, you know, doing the regular checks that you need to do, then it's just dangerous. But what they, what they've done is it seems that there's like HRT editors in the newspapers in the UK. And you have to sort of like, it seems like they have to get HRT into the most ridiculous stories just because they're under some kind of agreement. You know, I don't know this, but it seems like this must be the case. Otherwise, why would journalists who used to write about things in more balanced way, why would they suddenly not write about it in a balanced way? Why would they only say that HRT is the only solution when, you know, a few years ago, that wouldn't be what they were writing. So who is telling them what to write? And why is this campaign going on to change women's behavior? Well, you've seen it in your industry. Like this just the way these big interests work. And this farmer sales of HRT have gone through the roof in the UK. There are now like all these women are now caught up in these unreliable supply chains. And so they're not getting the HRT on time. And then they're experiencing withdrawal symptoms. And then they believe even more that they need the HRT because their hormones are now going all over the place. And so how amazing is that for the business model that all these women now think they need even more and they're telling their friends who are then running to get it even more. And I hear from women again and again, I feel so alone because I feel like all my friends have now just bought into this narrative. It's a complete psychological operation.
Sean:
Tanya, you brought up lifestyle and I'd like to use this as a transition to talk about other cultures. My mother-in-law is Taiwanese. After the birth of our child, my wife observed that traditional practice of the sitting moon or the sitting month, which is that period of postpartum care intended to kind of restore balance. I'm curious about how different cultures view and approach the transition to menopause.
Tania Elfersy:
Yeah, surprise, surprise, where there is a respect for elders, where menopause isn't viewed as a pathology, women experience fewer symptoms and easier transition periods. And the famous example that's quoted often is in Japan, the equivalent word for menopause in Japanese is konenki, which means a sort of transition period of energy and renewal, just exactly how we think of menopause in the West, right? And it's viewed as a time of change between the ages of 40 and 60. It's not even connected so much all the time to the end of the menstrual cycle, but it's just connected to this idea of a different energy coming through. women in Japan have far fewer symptoms. So there will be some who say oh that's because they eat tofu but it's not only in Japan it happens in Pakistan, in Mexico, you know in all different countries where women have different experiences and of course if you're going to come into menopause like is happening in the West where you fear it, you fear aging, you have got no idea of it being a rite of passage. that you need to lean into and relax into, but rather you're fearing the symptoms, you're reading what's out there in the media, you think it's gonna cause disease. Well, you're coming in with a stressed mind, just into that time, and of course you're gonna have a worse experience. And then, yeah, it is a sensitive time. So if your life is out of balance, as it is often in the West, because we're trying to, you know. Well, do the best we can with thinking that we have, but you know, create, we create these lives that are not in balance. And then the body starts talking to us and we're, you know, flawed because we just think, Oh my God, my body's gone crazy. It's my hormones. I need to fixing, et cetera, et cetera. And we're on this cycle and yeah. So
Sean:
so
Tania Elfersy:
yes,
Sean:
happy you
Tania Elfersy:
I
Sean:
shared
Tania Elfersy:
think.
Sean:
those. I'm so happy
Tania Elfersy:
Go
Sean:
you
Tania Elfersy:
on.
Sean:
shared those examples because it had me thinking about the limitations of the English language. And I'm aware that I think it might be Italian. There's like 13 words for love. And you shared the example of how the Japanese language approaches. And even on today's conversation, we were using the words of symptoms and symptoms leads to diagnosis, diagnosis, lead learned kind of goes to treatment. So. Do we need a new word for this? Do we need to stop saying symptoms? Is there something that you use to help that mindset change?
Tania Elfersy:
Yeah, I do call the messages from the body and I even call them gifts. And it drives women crazy sometimes. And I understand that because I've been there in that sense of I'm falling apart. I just want the thing to fix me. Right. But they really are blessings, gifts, messages, and the body cannot work in any other way if it wants to communicate with us, but through sending feelings or symptoms. And if we just had an understanding and appreciation for the way the body works, we would have a different relationship with what we're experiencing. And that, not only would that create a different experience of what we're experiencing, but it would lessen these messages from the body, because the body would be able to work with us in cooperation to bring us back into ever is for us to come back into balance. We misinterpret the symptoms as malfunction. It's not. It's intelligence.
Sean:
I love it. Yeah, brilliant. All right, I'm gonna play the other side. So I did some research here in preparation, and was listening to a famous medical professional who is a big believer in the hormone deficiency model. And she said something I thought was kind of reasonable. She said that we should be able to provide people with a range of alternatives. And not everybody views the lifespan as a quantity of years. So let's say that hormone replacement therapy does increase all cause mortality or the risk of disease further down the line. But if you engaged on hormone replacement therapy, it would improve your quality of life during some key years. Let's say 45 through 60 increased energy, vitality and mood. Is that a reasonable medical kind of response to this period of time in your mind? And what are the risks of that?
Tania Elfersy:
Because I believe the body is talking to us through what we call symptoms, it's been my experience that if we numb those symptoms, if we try to desensitize ourself during this sensitive period, the body is going to find a different way to speak to us. And it seems to be true for all discomfort. that becomes disease. It starts off gently. If we don't do the work, it's not even work, but you know that's the term that we use, create awareness about what's going on, the body's going to find a different way to talk to us and it might get stronger. And I speak to lots of women who come off HRT after they've finished their seven years and the symptoms just come right back. because the body was tricked in those years of you know it was going towards a sensitive time and then given hormones oh no it's not the sensitive time but then the body's like oh we're back in the sensitive time again i'm going to use this time to communicate with you boom all the symptoms come back and they often come back worse So we're just like, women get to this conclusion that they weren't told by their doctors to start with, that if you take these hormones at midlife and then you're gonna have to stop them because of the increased risk of prolonged use, you're still gonna have to deal with what you didn't wanna deal with then. So yeah, that could be a choice. Some women could say, you know, right now I need to squash my symptoms. The truth is, like I said, Lots of women take HLT and don't have a reduction of symptoms. So they're still going to have to work out what their body's trying to say to them. And why wouldn't we want to work that out? And why wouldn't we want to understand where our innate health lies so that we can live happier, healthier lives moving forward?
Sean:
This same doctor who said something very reasonable, followed it up a little bit later with something I thought was completely unreasonable. And so then I lost all trust in the credibility of that doctor. Here was the statement. This particular doctor was talking about suicide and depression in middle-aged women, menopause aged women. And she thought that they were suicidal and severely depressed due to a hormone deficiency. Why did she believe that was the case? It's because she said they were already under psychiatric care and on psychiatric drugs for their depression. And that was absolutely insanity to me because these drugs that are provided for depression or suicidality significantly increased the likelihood of a suicide event. They increased suicidality. I don't think they're beneficial and I think they're harmful. So you would. mood, lobility and difficulties in managing mood. And that not being the solution to what they're actually experiencing was viewed from the medical professional as, well, they're already treated, so it's not psychiatric. It must be hormonal. And that line of thinking is what I find to be dangerous because it's very simplistic. And it goes back to that, the fallacy, the... post hoc ergo proctor hoc fallacy. After this, therefore, because of this, and scientifically trained physicians fall into that fallacy all the time. They have all these anecdotal reports that they gave a medical intervention. The person reports some form of improvement, they attribute it just to the medical intervention. But I think what this conversation does bring us back to is the power of beliefs. So if you do believe you are sick, if you believe you are ill, you're disordered, you're diseased, you are broken, then that limits and restricts your options. That your option then is to be fixed by the doctor. And if you believe that you were, at least temporarily, at least for a discrete period of time, you might feel like you are better. And that's why long-term studies are so important because you can get out. of this initial placebo response period where there's patient-doctor interaction and you have a strong belief that the drug works or the medical intervention works. And so it's not coincidence that these studies are very short-term because there is going to be a strong placebo response that exists in these trials and that gives them the opportunity to do some statistical gymnastics and other things to create a... a difference between a group so they can publish it and then come to the conclusion that their drug intervention is safe and effective, although there's nothing about that trial that study would state that to be true.
Tania Elfersy:
Yeah, yeah. I mean, it's such a dangerous approach for so many different reasons, but one of them is, well, there are lots of women who can't take hormone therapy. And so what this doctor is telling them is that, oh yeah, you are likely to be suicidal because you can't take hormone therapy. Like, that's just one of the dangers. It's like the most incredible approach to health. but it actually just all falls into the same playbook as we saw in the 1960s. It's just a copy and paste with a sort of updated version. So this doctor that you're talking about, she doesn't call women castrated or living decay, but she does tell them that they've got a hormone deficiency and she'll say disease. And... She wants women to think that they're diseased and she wants them to come running to her and pay a lot of money to be fixed because they're broken. Well, you know, I'm coming and saying, you've actually got everything you need inside you already to feel better. Why wouldn't we try that?
Sean:
there would be more of a feminist movement behind these ideas. The belief that women are liberated by the new drug that exists, whether maybe it's a birth control pill or it's hormone replacement therapy, when you look what's kind of behind it all, it's to say that being a woman in itself is a disease. There's a malfunction in the concept of femininity and the natural cycle that exists through experiencing your your menses and then the transition from life into menopause. And I don't think we philosophically even get into that enough to say, you know, what are we doing to young women with synthetic hormones? And then what are we doing to women as they transition and transform into a new stage in life? And so From a philosophical perspective, I have a hard time seeing how that has improved the well-being of a woman across the lifespan because we see that there's higher rates of depression. Women dominate the use of antidepressants and other psychiatric drugs, which right there gives us pretty strong idea that women are going into the medical settings saying, I am not doing well. We view our existence. I'm not enough. I'm not good enough. And I don't feel well. Please help me fix me. I'm broken.
Tania Elfersy:
Yeah, and it starts right at adolescence when girls are told it's your hormones. Right, so if we understood the menstrual cycle, again, as brilliant, a brilliant part of our design, this sensitivity that many women experience in the days before their period could be viewed completely differently. It's a time to slow down, to tune into what's going on. And if you're having a bad time in those days, it's a reflection of something else that's going on through the month. But girls are taught, no, it's your hormones. And so girls are being put on the pill in their teenage years. And I'm reading more and more stories of girls that are being put on the pill. And then all of a sudden they're in early menopause or they have masses of depression and suicidal. It's just like... unbelievable and you trace it back and you look oh but at 14 she was put on the pill and we completely you know we can grow up as women we can grow up our whole lives blaming our hormones so of course when we come into midlife and there's this by the way we can blame our hormones, you know, postpartum as well. It's like, oh, the hormones, it's got nothing to do with how the way society isn't set up to support women in early motherhood. No, it's just the hormones. And then we come into midlife and we don't look at this crazy way that we live our lives, how out of balance we can be. But we brought this story from our teenage years and we're saying, oh, it must be our hormones. Like it's incredible. And going back to the idea of, you know, what would the feminist perspective could be in the UK. They've totally switched it and they've said you to be a feminist You need to have the access the free access to all these hormonal drugs And it's an outrage that we don't and thus we want more women to be tied into these big pharma Supply chains and they think that that's feminist and they've literally called it a menopause revolution To get more women tied into the pharma supply chain and they're calling it a feminist You know a feminist goal and it's just mind-blowing like when you take a step back and you're like, how is this an expression of feminism? How is viewing the female body as deficient, viewing the right path through midlife change being one of relying on pharmaceutical supply chain, like how is that feminism? It's beyond me.
Sean:
I'd go even further. I think it's, you know, one big purposeful condition scam to believe that women's lives are better if they can be in the workforce longer and contribute to society through career over other things. And the use of a birth control can then prevent you from having children and somehow liberates you to have more sex or unprotected sex. And somehow that leads to a higher quality of life. Show me where that has, you know, any standing as we see more women are miserable and their lives are nothing what they imagined it to be. It's an emptiness. Listen, if you want to work more and not have family and then the birth control pill can be able to provide you that path, I think more power to you to have that freedom. But you have to break through the messaging first. Working more, being outside of the home, and it goes far less now than it ever has economically. And the idea that you can just have more sexual partners and have more freedom around sex. I don't believe that that has demonstrated from a mental health perspective, a higher quality of life. I don't see people happier living that life. So I don't understand how that is liberation.
Tania Elfersy:
Yeah, and. A good point about menopause is that wisdom does come through. And so I speak to a lot of women who realize that they're not on the path for them come midlife. And they realize that that high powered job that's sucking all the energy out of them and is not their passion perhaps isn't the answer for them. And so they do make shifts. And we often misinterpret that sort of uncomfortable feeling that we have with the lives that we've innocently created as the midlife crisis, totally made up. But it's like, we are getting these messages. And so if we misinterpret them, then there can be this explosion. But if we tune in and realize the intelligence that's coming forth at this time, then we can. say oh you know what I think I'm gonna get my life back in balance I don't think I'm gonna be working that 12-hour job anymore I think I'm going to be spending a bit more time doing things that I love. And I see it time and time again, that women are moving into these like new positions or they're freeing up time for themselves and they're creating the life that actually creates health. And that's the intelligence bubbling to the surface. And, and we didn't, perhaps we don't need to do that when we're in our twenties and thirties, but come out forties and our fifties, the body's saying, If you think like that's serving you, because I'm here to tell you that it's not. And so I'm not saying, oh, that means all women come 50, you know, you need to leave your big high powered job. You know, if that's your passion and you think that you can do that while your life is in balance, that's fine. But like I said, so many women have this awakening at midlife about what they truly want to be doing. And that is healthy for them. And we see that in the work of Dan, what's his name? The Blue Zones, the guy who investigated the Blue Zones. And if we look at the health, you know, the points that he discovered are crucial to good health as we age, like that sense of purpose, passion, relaxing time, community, like that's lacking in so many of our lives in the West. But women see that when they come to midlife and then they get pushed making changes that best serve them.
Sean:
One final question before we end today. Roger, unless you have any additional questions. I do, so we'll make it two final questions. You go first. Okay. And then I'll go last. I just wanna know if you meditate and how much that might have been a contributor to kind of maybe detaching from the narrative of the mind.
Tania Elfersy:
I do not. Sometimes I do guided meditations, but I do not need a meditative practice because I have, I believe, an understanding of the way the mind works. So this enables me to quite quickly have a different experience of any circumstance that I face. So for example, I will say, and I mentioned this in the book, the last three years have been literally the most challenging for a number of reasons. And I'm totally fine. And the reason why I'm totally fine is not because I've had to meditate and find all kinds of practices to do, but because I have an understanding of. the way thought works, the way I can have different relationships with the thoughts that come through my mind, and the way that I can, without effort, but just through shifts in consciousness, have a different experience of anything that's happening. And it's, you know, it started off with creating this healing, this spontaneous healing of my symptoms. But this understanding continues to nourish my life and allow me to spend more time in joy and less in stress. And so that's, you know, that's good for me.
Sean:
So we have two guys here having this conversation. What are some ways for men to identify and support their partners during this period?
Tania Elfersy:
question. It's all in the loving feeling. That's always the answer. And if men don't buy into this narrative of the malfunctioning woman and stay in the loving feeling, that will help her stay in the loving feeling for herself, for her body, for your lives together. And It is a sensitive time. So a recognition of that is really important. But if you've experienced a woman in pregnancy and giving birth and postpartum, it's very similar to that. Or if you have teenage kids at home. It's a sensitive time. So we need to hold space for that and realize that... there'll be times when even today, I'm still in that sensitive zone. So I even said there'll be times when I'm like, okay, I'm going to bed, it's seven o'clock, because I have to, because I'm very tuned in with what's going on in my body. So... you know, if a man is watching his partner do that, it's a bit like, what are you doing? Right, but we give that allowance for pregnant women, postpartum women, or even teenagers to, you know, sleep in hours that we wouldn't normally expect people to sleep. So the woman needs time and space because it is a sensitive time. It's not a time of malfunction. but it's a time of learning and it's a rite of passage. And it could be challenging, but the reason why it's challenging is because we come out a different person than when we went in. And I think that men go through a similar journey and they have to because men also have roles as elders to play. And the roles that men play in their 20s and 30s is not what is needed for a 50, 60 something male. And... we can have an appreciation of that, of our bodies, of the intelligence that runs through it, and have a better time of these sensitive times of change.
Sean:
Brilliantly stated, fascinating discussion. Tanya, how can people find you?
Tania Elfersy:
Yes, the easiest thing is thewiserwoman.com, that's my website, thewiserwoman.com. I'm also on Facebook, on Twitter, and my book, The Wiser Woman's Guide to Paraminopause and Menopause. A short, hopefully inspirational read, inspiring read.
Sean:
And I also saw you have an online course, which I think is excellent. So
Tania Elfersy:
Yes, I do.
Sean:
how long is the online course?
Tania Elfersy:
Yes, it's a three week online course and it can completely transform a woman's experience of midlife change. You can read the testimonials and I also offer one-on-one coaching as well. The beautiful thing about what I'm sharing is that it's not complicated. and every woman has exactly what she needs to get through this time. And so my role is really just to shine light. You know, that's all I'm doing. But she is the healer. And my, you know, business name, the wise woman, that's not me, right? But the wise woman is within me and within every woman, just as there's a wiser man within every man. And that's the unwavering divine intelligence there but we have just forgotten to listen to it.
Sean:
check out her book, The Wiser Women's Guide to Perimenopause and Menopause. Tanya Elfersy. Thank you for a radically genuine conversation.
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