Manopause: Let’s Have the Conversation (EP 136)

[0:22] Hello, friends. Uncle Marv here again with another episode of my Unhealthy Podcast, where we talk about health, wellness.

[0:32] We talk about a lot of stuff, but we talk about really all the things that affect how we live, feel, and how we age. And today we're going to be talking about... I don't know, let the music go on and on. I like it, though. Uh, today we're going to be talking about something a lot of men experience, but don't necessarily talk about. It was, uh, one of my most popular episodes a couple of years ago with another guest. But, um, obviously when we hit our forties and fifties and suddenly start feeling tired, uh, not sleeping as well, waistline's getting a little bigger, um, It's very interesting that motivation isn't what it used to be. And maybe the sex drive has changed. And so the question is, are we just getting older? Is it stress or is it something else going on? Well, my guest today is going to help us explain that. Dr. Ann Monis is joining me. She was actually a guest on one of my other podcasts. And we got to talking about her coming on here to chat about this. So here she is. Dr. Ann, thank you for joining the show. Thanks for having me again. This is an exciting topic.

[1:48] Exciting because you get to set us straight, isn't it? A little bit, a little bit. You know, it's such a hot topic and I think it's important to have the facts. You know, it's not just words. So I'm really excited to talk about it. Well, we will get into facts versus myth a little bit later. So let me explain to the audience. You are a clinical and forensic psychologist. You're an entrepreneur, healthcare executive. Your work has focused on human behavior, mental health, aging, all that stuff. Is there anything that I left out there? No, you're doing great. I'm just going to take you with me everywhere and you'll intro. So previously we talked on the show. we really just got an introduction to your company there, Transformative Health Services. THS.health is the website that we'll put in the link. You're actually running multiple businesses there. So any others we want to plug before we get started? So, yeah. So I have Transformative Healthcare Solutions, and we provide behavioral and psychiatric intervention all over the state of Florida.

[2:59] And I have a business I started with a co-founder about three years ago called Medical Anti-Aging. And there we deal a lot with hormones, peptides, weight loss, and aesthetics. So something I've had a front row seat to for a few years, and I'm excited about the business and about talking, getting to talk about it. All right. Anti-aging. That's one of those things that is being pushed on the television, right? Right now, all the commercials, all the drugs, all the shots and pills.

[3:31] Yeah, but wait, there's more. Yeah, no, it is. It is that. And I think there's a big distinction from supplements, if you will, to medical interventions to that end. So something we can talk about as well. All right. Well, before we get started, let me ask a question. Since you deal with both mental health stuff, physical health and stuff, is there a relationship between someone's mental health and their physical well-being? Of course. Absolutely. They're directly correlated. And I have a book coming out that's talking all about that. Yes. And you're going to be an author, too. I'm trying. I'm really trying. I'm an author, but I'm trying.

[4:11] All right. Um, so let's, let's kind of use that and springboard onto the main reason we're here. Uh, when we talked, I had mentioned about, uh, some health episodes I had on menopause and then we did some shows on, you know, explaining menopause to men. Uh, and then you just used the word manopause.

[4:34] So, to help me understand what that word actually means. It's just a trendy word for something we've known for a long time in the medical world, andropause. And so, the real, the correct term is andropause. It is similar to menopause, which is a word far more frequently used. And then, menopause was something that just kind of was created. It's trendy. It's fun. It's a joke. But it does represent something very real, and that is something called andropause. So we could start there. Okay. Well, as I understand andropause, it's basically the gradual loss of testosterone, in actually both men and women. Yes. So men over 35 begin a very slow but decline in their testosterone. It's natural. That doesn't mean it happens to every single male that that would mean that there's no bell curve and nobody was on the off side of it. But for the majority, after 35, we see just a slight decline. And then over time, it kind of just does this.

[5:42] It's not anything you're doing wrong. It's not anything that's happening that is an exception. In some cases, we don't see it quite as drastically. And in other cases, we see it more severely. But either way, after a certain age, that's kind of what starts to happen. Okay, so nothing that we're doing wrong, although we're kind of told that if we eat better and sleep better, that will help. Is that really true? Yeah, that is true. Because while we're sleeping and while our brains are resting, we're producing hormones and neurotransmitters that our body needs while it's awake. Okay. Now, for let's just say men and women, I mean, women, it's probably a lot more noticeable when they're going through menopause and those stages. And I've come to learn that you really don't have an end to menopause like we used to think that perimenopause and there can be things that just restart the clock, I guess to say. But in men, we don't really know these things. We're just being told on the TV, hey, when you start losing your sex drive, take this pill.

[6:55] Right. So they give you something to help maybe with the sexual performance, but I'm not sure that the conversation is being had about why it's happening in the first place.

[7:05] And I do think that social media and access to so much information has changed that significantly. In other words, we're so much more educated than we were even 10 years ago, 30 years ago. And these are topics that are now circulating. We're able to research them, ask, chat, Google it, do all of these things. And so there's a lot more information available. Still, though, I'll talk to people all the time, clients that come in and they'll say, oh, no, it's OK. I'm supposed to feel this way. And I'm like, well, Who told you were supposed to feel this way? Men and women, right? Oh, I'm going through the change. It's fine. Why is that okay? Why shouldn't we help ourselves feel better when we are inevitably going through those changes?

[7:51] Okay, but let's talk about what those changes are, because even you said there's no real bell curve. So each person is different. Yeah, and it's very, and it's individual journey. Some people will experience one thing; some will experience another. But the general symptomology, the bubble of symptomology is going to be very similar to what you said, maybe just a couple more things. So fat storage in the abdomen, less sleep. In men, more pronounced depression. Their mood actually is directly correlated to the amount of testosterone that they have, which in the mental health world is significant because that's something we like to ask first. We don't want to put you in an antidepressant if you just need a little bit of testosterone. There's no reason to do that. So things like that.

[8:38] A couple of other things that could happen is you say, I'm going to the gym. I'm eating well. My muscles aren't growing and I'm still storing fat. Well, that's a byproduct of a hormonal imbalance. So we want to be very aware of something like that. In women, we tend to hear less about testosterone in women. You hear more of estrogen, progesterone, estradiol, and all those things. But interestingly, one of the main feel-better treatments for women going through perimenopause or menopause is actually female testosterone. And the reason is brain fog.

[9:14] We tend to have word-finding difficulties and brain fog when we go through these hormonal fluctuations. Men do too, but they'll also report more of a depressive, like a low-grade depressive symptom. Okay, I'm not quite sure I understand. So, because here's why I was thinking in my head, we have so much thrown at us right now. We're so busy. A lot of these things happen, but not always because of hormones. So how do we know if, you know, if we're going through a foggy, sloggy day, I mean, is it only a matter if we've got to go get tested to figure that out? Actually, I don't believe that. I believe that the clinical interview is the most important thing that we have with a client. And I'll explain that. Sometimes you'll come in and your blood panel looks average, and you'll still say to me, I don't feel well. And just to be clear, I'm not the medical provider. I'm not that person. I'm able to combine all of these worlds into one and put together something that makes sense. But if somebody comes in and says, I don t feel well, I'm feeling these things. And it is incumbent upon us to figure out why.

[10:26] Conversely, you could say, I'm feeling great. And we see something in your blood work. We're not going to send you home and say, well, since you're feeling great, we'll just ignore these elevated red blood cells. That's fine. You feel good, so we're just going to run with it. So we really do need to ask you how you're feeling and then compare that to what we're seeing in the data and the science. The way to differentiate to more strategically answer you is if it's happening more days than not, if there is no real reason or precipitating event or a trigger, for example, if you've had a bad day at work, you know why you're not feeling great. If you've had an argument with your spouse or insert problem here, but if there's otherwise nothing significant to report and you find yourself feeling, say, sluggish or with low mood, on an ongoing basis, more gays than not, then certainly there's something to talk about.

[11:18] Okay. But there has to be a reason for it. I'm speaking more from the man perspective because we're going to be the ones that are not wanting to go talk to somebody about it.

[11:31] We might just think like, oh, okay, I'm feeling a little sluggish. I've just got to slow down. Let me not hit the gym as hard, that sort of thing. are there, I guess, quote unquote warning signs that a man can say, okay, what I'm doing isn't working. Let me go get something figured out. Yes. So a couple of things on that note. We don't always have to talk. In other words, sometimes you come in, you tell us five things for your symptoms, and then every six months we just check in and you go on your merry way. It doesn't have to be an ongoing session where we're hanging out for an hour. It is literally seven to eight minutes of your time. We check the blood work. You say, hey, these are the symptoms I'm feeling. You get your medication and you're out the door.

[12:18] The other thing is that in doing that, you're also preserving so many other, systemic issues that could be coming up. Low testosterone in males is directly correlated to early Alzheimer's, your memory, in women as well, just a little bit later. So things that we want to be aware of and things that we want to address before they happen. So we don't need to take that much of your time, but there is help and there is something to be done.

[12:50] All right. So we're learning that testosterone is a real thing because I'll be honest, i don't know when did we start seeing those commercials 10 15 years ago i thought i thought it was a made-up thing I m like okay they're just they're just doing that stuff so uh.

[13:08] When did we start actually understanding that that was a real thing low testosterone or low t, I think we started knowing that a long time ago. I think Arnold Schwarzenegger, I mean, definitely. Science has always been there. It's just a question of whether we believe that you should do something about it and whether we believed it was harmful to do something about it. In other words, did the benefit outweigh the cost in many ways? And I think that we've come full circle in being able to treat and.

[13:42] Have the confidence that we're helping not hurting the system, okay having said that though is are the commercials I m seeing on tv are they actually treatment or are they just a trend because marketing a lot of times, what I ve seen is that there might be a tiny bit of truth but it's not really doing anything so where are we with that okay so let's look at it from a something that would correlate well, okay? If you had diabetes and needed treatment, it would be very simple. You would go get your insulin. If you had a broken arm, it would be obvious on an x-ray and you would fix your arm. This is very similar to that, although not be it as drastic. And so it's like a low-grade problem that kind of just persists and throws you off indefinitely. And the problem just kind of grows, but really mildly over time. And because it's mild, you're like, oh, it's a little worse. It's a little worse. It's a little worse. But if I sat you down, I don't know, at 55 and said, Marv, how does this compare to 25? The feeling may not even be close enough for us as we get older because we can't remember exactly, but we're pretty sure it's not the same or not even halfway there.

[15:08] The football games you probably played at that the energy you had the lifting in the gym you know partying not having a hangover remember that so all of these things um, it is not a treatment that you do and you stop and it's fixed it is something that is going to be permanent and so it's a big decision and then the other thing i get a lot is well if i start this what's next now I m dependent. And so it has a negative connotation. TRT has a negative connotation. Am I going to be dependent on this now? Is it something I have to do forever? How is this going to work for me in the long term?

[15:43] Well, how does that work? Because the way I understand it is you're going to get a shot every so often for the rest of your life if you're doing a TRT treatment. And it's true. Okay. It is true. And I tell this to anyone who's interested, and again, I'm not the provider in the clinic, but when they consult, when they talk to me, you say, what do you think, Dr. Ann? And I say, well, you can either keep living like this or you could take one shot a week of a tiny needle in your shoulder and you can feel better. There are also other ways to do it. There's creams. There's all kinds of stuff available. But, yes, as we age, the testosterone is not going up for anybody. The older you get, it's not your body is like, oh, good, I'm pushing 60. Let me make more. No, everything is going down. Everything, all of it. We make, okay, we make more tartar. We have more gingivitis. But everything else in the way of neurotransmitters, they're going down. Wait a minute. We make more tartar and gingivitis? Oh, my God, yes. Because of the TRT? No, no. As we age, we make less saliva, thus creating more. Oh, okay. Yeah, okay. But in general, as it pertains to your neurotransmitters, your hormones, and so forth, we make less than we should as we age. Okay.

[16:59] Is there not a natural way to boost Testosterone or does it have to be a treatment? Yes, and yes. Yes, there are many natural ways to sustain, improve, make sure that it doesn't drop so significantly. So you hear this all the time. I'm a broken record. Diet and exercise, in men specifically, leg workouts really do boost your testosterone. They'll help with cognitive function. Sleep problem is it's a double-edged sword we tell you that we need you to get good sleep but with low testosterone it's really hard to sleep in women that's represented as progesterone so then we tell you to sleep you're like you're not you don't understand I m trying uh and so it doesn't work so there are things you can do none of them are going to bring you back to your baseline function or shall we say, previous function quite the way you remember it and the way you felt, I m sorry i just had a weird little thought when you said that as you remembered i just kept thinking uh things in the rearview mirror may appear larger than they are, you see amen amen i remember being the best time ever I m like man i don't think i think at the time i didn't think it was that much fun now i know i had a great job yeah.

[18:14] So how differently should men and women look at TRT? I don't know that it's that different. You know, with women.

[18:26] There's a marker that happens for us when we stop menstruating, when things change, when our cycle comes more delayed. It's almost like our body gives us a memo, a notice. With men, it's just a bit more subtle. So you don't get the memo like we do. So it's a little bit more difficult for you to decide when that point might be. We know it's happening for sure because we get a little alert and we're like, oh, look, I'm here. So I don't know that it's different in how it feels, though. I don't think it is. I think that you suffer on both ends. Men will experience side effects and symptoms that create friction. And same for women. The fluctuations will create friction. So really, at the end of the day, we're both experiencing natural fluctuations in our hormonal makeup, and then we need to deal with it.

[19:21] Gotcha. All right. Are there any myths out there that we need to just stop listening to? I mean, I get all kinds of stuff. I'll get, oh, I'm not trying to do steroids or, you know, I don't want to do to damage myself or, you know, I'm not trying to get just really fit. I'm not doing this for muscles. I don't want acne on my back. My hair will fall out. All kinds of stuff.

[19:49] Are any of those true? I've never heard of them. Anything done in excess and quadrupling the dose of, including your antibiotics and insulin or your allergy medications, are going to cause side effects that are unwanted and you don't like. Yes, if you abuse your hormone regimen, that is definitely going to happen. At a prescribed dose that is conservative and safe, Those things are not meant to happen. If you're talking to me about, I don't know, 40 years ago when winds trawler or testosterone was used in order to get really bulky and build beautiful muscles. Well, sure, of course, lots of things happen. Your liver was also a problem. Why stop at the hair and acne? What about your organs? There's that and human growth and all that fun stuff. In a medically supervised format and a conservative one, those side effects are really not meant to happen. Hmm. Very interesting. I'm just stuck on acne on the back.

[20:52] It's a real thing, though. It is a real conversation, you know, and it happens. If you use an oil-based product and you inject a lot of it, things start to happen.

[21:04] Interesting. Now, how much of this helped you with the idea of starting the anti-aging part of your business? So interestingly enough, what I was very interested in was hormones and peptides. And then GLP ones kind of just happened while they were already happening.

[21:30] I think that about eight years ago, ballpark, I started to understand what was happening with family and friends. And being in an athletic environment, always a competitive dancer and liking the gym and all those fun things. I was a gymnast. I'm very in tune. And so when something is even slightly off, I'm one of those people that says something is wrong. I can't quite figure it out. So I got very interested and wanted to learn more. And the more I talked to men and women about this, I realized that there's something to be said for that tune-up. And oftentimes I'll speak to people and they'll say, I don't understand, I'm trying and doing everything. I say, okay, well then it's not what you're doing, it's not your lifestyle or habits, we need to look at something else. And we'll find it, it's right there, it's glaring. And none of this is related to like midlife crisis or anything like that or social, you mentioned social media and all of that, influence on us that a lot of this stuff isn't just that wasn't it the chicken or the egg.

[22:43] Maybe. So like, okay, so let's think about it for a second. So let's just say that in midlife-Ish, we know that there's a decline in hormones, okay? And we also know that we start behaving a little bit strangely and make some less than ideal decisions, okay? Could they not, could two things not be true at the same time? Could they not be correlated? Well, that I believe, yes. So maybe in an effort to rescue what we realize is a decline, we act a little bit impulsively, hence called the midlife crisis. Or we can reverse that. We're trying to have a good time because we feel like time's getting away. And in our midlife crisis, we're also experiencing a decline. Or maybe some people never experience either one or two or both at the same time.

[23:33] But I do think that ultimately that ends up being correlated in most not all cases because I've definitely had clients that came in for one thing or another and we looked at their blood work and, testosterone wasn't a thing you know it happens all the time it happens but in the middle of that bell curve you have your outliers but that center is going to be, more likely a decline in our hormonal makeup which is normal and expected and okay and that's Something we can do something about. All right. So it's normal. We just need to learn to work with it in a balanced and proper way and not necessarily listen to the TV commerce. Yeah. I mean, we're aging. It's okay to age. You just want to do it gracefully and gently and maybe not feel awful. Just feel, you know, okay.

[24:25] Okay. All right. Is there anything about menopause that you think people need to hear about that I didn't come up with an interesting way to ask you in a question form?

[24:38] I mean, the only thing I would say is if, you know, the symptoms, they can vary. And I think it is important to talk about those. You don't have to have them all at the same time. It doesn't have to be glaring. It could just be not like it used to, or maybe a couple of things feel off. It's worth just checking and looking into. It won't hurt to do that. And you can make an informed decision after. But it's always good to know. All right. Very nice. Dr. Ann Monice, transformative health solutions and anti-aging and soon-to-be author. So any idea when your book's coming out? They're telling me by December. Yeah? Mm-hmm.

[25:20] So is it like finished and just going through all the final stages? Yes. Nice. All right. We'll have to be back in touch when that book comes out. You know it. I'll be bothering you. All right. Well, folks, that is going to do it for this show. I want to thank Dr. Ann Monis and helping us understand menopause and menopause in a much better way. And if you have any interest in looking her up, all of her information will be in the show notes. Of course, reach out and ask any questions that you want. So one thing I guess we should say is don't dismiss symptoms. Don't think it just happens just because you're in that age. Talk to somebody, figure it out. But don't assume testosterone is the answer either. Not always. Yeah. All right. That's going to do it, folks. Thank you very much for tuning in. We'll see you again soon. And until next time, live healthy and be happy. Thank you.