The Lab Work Every Midlife Woman Needs (And the Expensive Tests You Don't) with Dr. Jila Senemar
Show Snapshot:
Managing menopause shouldn't feel like guesswork, yet many women walk into their doctor's office unprepared and walk out confused. Dr. Jila Senemar, founder of Jila MD and menopause specialist, is changing that. After realizing conventional training left her without answers for perimenopausal patients—including herself—she went down the research rabbit hole. What five labs reveal your longevity roadmap? Why are you wasting money on unnecessary "Instagram famous" tests? Which supplements actually move the needle? Learn Dr. Senemar's "ice cream sundae" approach to building optimal health from the foundation up. Ready to be a smarter patient and partner with your doctor more effectively? This one's for you, beauties!
Transcript:
Katie Fogarty [0:03] Welcome to A Certain Age, a show for women who are unafraid to age out loud. I'm your host, Katie Fogarty. I do not need to tell you that managing menopause is not a one-size-fits-all situation. Women have different symptoms and have to handle vastly different stuff, but what we have in common is the need for tools to help us feel our best in perimenopause, menopause, and beyond. We also want clarity. What's the deal with all these different supplements? Why do I keep seeing advertisements for up to 400 different labs and bloodwork popping up in my Instagram? How can I cut through the clutter and zone in on what really works? Today, we are exploring real solutions and real steps that you can take to better partner with your doctors to feel your best. Meet Dr. Jila Senemar, founder of Jila MD, a top voice in menopause care, a board-certified OBGYN, a menopause specialist, a women's health advocate, and podcaster. Dr. Jila reaches thousands of women with her compassionate expertise and is here today to help us crack the code on how menopause and longevity intersect, the role of key lab work, supplements, and lifestyle choices to optimize our health. If you want to be a smarter patient, if you're hoping to team up with your own doctor to come up with an effective menopause care game plan, stick around. This show is most definitely for you. Welcome to A Certain Age, Dr. Jila.
Dr. Jila Senemar [1:38] Thank you for having me, Katie. So exciting to be here today.
Katie Fogarty [1:42] I am really excited about this conversation because we connected in Texas at South by Southwest a little over a year ago. I've been following your work ever since. You share fantastic information. You share it in an engaging way. I know you're going to help us think through how we can be smarter patients, because you've been doing this for 20 years, right? You have vast expertise. But as a starting point, we want patients to be smart so they can walk into a doctor's office and help make that doctor a partner. What is the best way for a patient to show up in your office? Is it having taken notes on their symptoms? Do you want us to be logging what's going on? Should I come prepared with a list of questions and concerns? Help us walk through that doctor's door effectively.
Dr. Jila Senemar [2:31] So I think that's a great starting point, Katie, because most women don't really know what's happening to them. And luckily, with the platforms that we all have and that we're using to the best of our ability in terms of putting the information out there, now I'm seeing more and more women walk in not only with a list of symptoms but actually also a list of questions that they want addressed. So I think we're getting there slowly but surely with all the amazing books that we have out there for midlife women. As I'm sure you know, there's The New Menopause, and now there's a second component to that, The New Perimenopause, that we're eagerly awaiting from Mary Claire Haver, as well as Tamsen Fadal's book and Dr. Jessica Shepherd's book, Generation M. These books have provided the platform for patients to start educating themselves, so when they walk into that office, they will find out what kind of provider they have. Are they going to be working as a team together to improve their health and well-being, or is this not the right place? And therefore, they can kind of cut their losses, move on, and find a provider who's willing to listen to them, understand what's happening, and help them through it correctly and appropriately with the most up-to-date information and research data. So I really want patients to advocate for themselves, and the way to do that is to walk in armed with a list of symptoms. Log your symptoms, what you're experiencing. And it's not just about your periods; it's about your mood, about your sleep, about your appetite, about your overall well-being. Do you feel okay? Do you feel like yourself? Do you think things are kind of shifting and changing? Are you having aches and pains where you didn't have them before? So really walk in with that symptom diary, number one. And number two, have targeted questions, have actionable things that you want answered.
Katie Fogarty [4:45] Yeah, it's so important to come in fully armed. And I also want to put another resource into the hands of listeners. I sit on the board of the education and advocacy nonprofit Let's Talk Menopause. They have a symptoms checklist on their website. So Dr. Jila just mentioned several great books that I hope listeners will avail themselves of—read, really get smarter. But there's also a very simple one-stop-shop checklist of common symptoms on LetsTalkMenopause.org. You can print that out, you can tick off the ones that you have, and perhaps take that into your doctor's office with you, because if you're like me, one of my symptoms is brain fog, and sometimes I walk into the doctor's office and I'm like, "I can't even remember half the things I wanted to talk about when I got here."
Dr. Jila Senemar [5:32] Absolutely. That happens every single day.
Katie Fogarty [5:36] Take a notepad and write stuff down so you remember what to ask and you remember the answers you're given. Because I follow you on social media, and I love that you share so much actionable content on it, I noticed a recent post that you did about five labs that you like to run on your own patients to get a baseline assessment for women in peri and menopause. And I would love it if you could walk us through what those labs are. And I want to maybe, once you share what they are, ask: is this something that every patient should be getting, or is it only certain patients?
Dr. Jila Senemar [6:07] I kind of break them down into different categories. We have the basics—the metabolic, cardiovascular health things that we look at. Those labs are one component. Then your hormones. Obviously, that's all we talk about: hormone, hormone, hormone. And then there are nutritional things, right? What supplements do I really need, and what do I not need? And what really matters? And what can I get away with not having checked at every single visit? And are all labs going to get covered by insurance? Because that's another big thing. We can do all the labs we want, but there are some that the insurance companies aren't going to cover. So it has to be done in a way where it makes sense, there's something you can do about the results, and it is reasonable financially for the patients. There are all these new companies popping up with bloodwork that's being done, and there's Function Health, which for $400 will do all of your labs. But the fact of the matter is, what are you going to do with that? You need to be able to interpret it and act upon those numbers. There's a DUTCH test that we hear about all the time, and it's really above and beyond what we need on a regular basis. For most midlife women, they don't need a DUTCH test to tell them what we can really find on serum lab levels that we do routinely.
So in terms of the basics, right, your metabolic, your cardiovascular, I'm looking for a hemoglobin A1C or a fasting insulin level. Those two things will tell me about insulin resistance, chance of developing diabetes in the future. Those are things that we do routinely, and it gives you a lot of data without being overdone or being too expensive of a test. Your lipid panel, for sure, right? We've been doing those forever. But again, in addition to the lipid panel, there are certain biomarkers you can add to that, like an Apo B or a lipoprotein(a). These are markers that will tell us if you have the chance of developing heart disease in the future. Do you have plaque formation happening already? And we can address heart disease sooner rather than later. Because as we know, midlife women—our biggest risk of mortality is heart disease. When we get into menopause and that estrogen level declines, it's really affecting our heart and our bones. So we really want to hone in on those markers.
Another one: inflammation. We're looking for inflammatory markers, so your high-sensitivity C-reactive protein that we check will tell us, is there any kind of cardiovascular inflammation going on, and if so, how do we address it? So these are some basics in that realm that I tend to check. And then the hormone panel, right? That's the one everyone wants to hear about. You really just need to look at your follicle-stimulating hormone, your FSH level, which, as we know, really is significant in terms of menopause. That's really where you're going to see the biggest change, where it's going to be elevated. Otherwise, if you look at that in perimenopause, and in that stage, it may not fluctuate, or you may not catch it where it's elevated. And so does it mean anything? Does it mean the patient isn't going through those hormonal shifts? Absolutely not. It's just a marker to look at, and we can actually later use it to see if our treatment is effective and if the levels are where they need to be and in the right therapeutic window. So we have these markers.
And then again, I love my thyroid panel. I do a full thyroid panel on everybody because thyroid disorder—there are really three big things you want to look at in the perimenopausal woman. It's thyroid dysfunction, iron deficiency, as well as perimenopause. Those three things have a lot of overlapping symptoms, and you don't want to just tell everybody they're in perimenopause. You want to make sure you're ruling out other things happening too, because let's say they're iron deficient—you can implement iron therapy and their symptoms can improve, and hormonally they're still okay. So there's a nuance to all of this, and that's why it really behooves us as healthcare providers to really look at the individual as a whole, not just as their gynecologist or as somebody taking care of the reproductive organs. No, we're looking at the whole overall woman because all of these things kind of tie into one another. So you need to do that iron panel, do a full thyroid panel, and their hormone levels. And basically, those are the big ones I like to do.
And then I do throw in a couple of vitamin levels. So like the vitamin D level, it's very important because we're looking at it in terms of your immune system and also for your bone health. And these are all parts of what we look at to make sure we're optimizing our patients, not just for today, but for living a long but healthy and well-balanced life going forward.
Katie Fogarty [11:36] And I know you do not have a crystal ball and you have no way of knowing if the average woman's healthcare provider is doing these tests for her. I mean, is this sort of the standard of care when a woman comes in for an annual that she could be expected to be given all of these different panels, or is it something that is like a case-by-case?
Dr. Jila Senemar [11:55] I would say it's more of a case-by-case situation right now, because even us as gynecologists, I've been doing labs for over—I don't know how many years, 20-plus years—but I've even kind of specialized my panel more and more over the years, and I've added more of these biomarkers to the panel. I want to say over the past three, four years, as I've become more well-versed in this realm of treating the whole patient and not just compartmentalized care.
Katie Fogarty [12:27] Okay, so all the more reason to find yourself a healthcare provider who gets it. So the DUTCH panel, you mentioned that this is a panel that people talk about. It's very buzzy. I'm going to be honest, I haven't heard of it. What is it? And why do you feel that people are hoping to get it? What's the buzz about it? And why is it not necessary for everybody?
Dr. Jila Senemar [12:50] So here's the thing. You know, there's conventional medicine, which is what I am, right? Or I say I used to be conventional. I'm more of a cross now. I practice more of a cross between conventional medicine and lifestyle functional medicine, because conventionally, I was trained as an OBGYN to kind of do the obstetric, reproduction, childbearing side of things. But I've learned, as we all know, it's more than that. There's a lot more to us women after childbearing and reproductive age. What happens to us after that point is I need to be more of a healthcare provider that is generalized. I become their primary care provider, and I become their hormone specialist, and I become a mental health therapist, basically all in one.
So in functional medicine, the opposite of conventional medicine, they're looking at root cause analysis, basically, and they go to the root of issues and treat it accordingly, as such, in that way. In that manner of thinking, there are other tests, and the DUTCH test is one of the tests that they use as part of their management of their patients. The problem with it is it's very costly, and not everybody has access to it. And so the functional medicine providers use it in order to see what the breakdown is in terms of hormones. They don't just look at estradiol. They look at the precursors, they look at other components, and then they supplement accordingly, then hoping that the body will take over and convert those precursors into the active forms. Versus conventional medicine, we say, "Listen, you're deficient in estradiol. We're just going to replace you with estradiol." So that's, I think, a little bit of a difference.
One of the smallest, you know—I'm sure if you speak to a functional medicine doctor, they're going to have more to say about this. But from our perspective, that's where the DUTCH test comes into play. And to be honest with you, at the end of the day, it's not really going to change the patient's overall treatment plan that I'm going to provide for them. So in my mind, I know what's missing. I know what's going on. Let's just get to the bottom of it, and let's treat you with what's deficient. That way you start feeling better sooner and faster.
Katie Fogarty [15:15] Okay, so it sounds like there's just a lot of different tests that you're running through a conventional practice. We want to make sure that our listeners are familiar with them, so that they understand what their own doctors are doing or may not be doing, and they could ask, "Why this? Why not that?" Is there a place beyond any of the books that we've talked about where you could recommend a listener could go do a deeper dive, if they just wanted to get a sense of the type of panels that they want to be familiar with so they can ask their doctor and have an intelligent conversation at their annual?
Dr. Jila Senemar [15:51] So actually, I'm developing my website. It's up and going, but I'm adding all these resources on there where patients can just refer to it, print it out, and take it to their provider and say, "Are you checking all of this stuff?" So basically, I'm putting my whole lab panel online so women can print it and take it to their provider and have them run it for them.
Katie Fogarty [16:14] Well, phenomenal. And so when it's up on your website, you're going to let me know, and I will blast it out on social.
Dr. Jila Senemar [16:21] Absolutely.
Katie Fogarty [16:22] Dr. Jila, we're heading into a quick break, but when I come back, I want to ask you about some of these third-party testers that you referenced that have been popping up on social that are getting women excited about doing different types of panels and bloodwork. We'll be back in just a minute. Dr. Jila, we're back from the break. We went into it—you gave us a very comprehensive look at the panels that you like to use in your own practice, some other panels that are used by functional medicine practitioners. I hang out on social media. I know you hang out on social media. I'm getting pushed a lot of third-party ads from companies offering these very full panels of bloodwork. You can literally get hundreds of labs. I have read articles about how patients are using ChatGPT to analyze their blood labs. From where I stand, this seems like too much of a good thing, or maybe even too much of a bad thing. People can make their own decisions, but it seems like if you're getting this bloodwork and having all this volume of information, the average patient doesn't know what to do with it. What is your stance on this? And do you see any value in doing some of these assessments?
Dr. Jila Senemar [17:31] And that's such a great question, because actually, I have patients who do that. They go to these third-party testing sites and get all their labs drawn, and they then put it into ChatGPT, and then they bring it to me. And I appreciate the fact that they're taking ownership of their health and that they're invested in it, and that they are curious and want to do the best for themselves. But what I think the downside to all of it is sometimes too much knowledge is not a good thing either, because then you're nitpicking at little things that really, in the grand scheme of things, aren't going to change anything drastically. So do you need to be on 100 different supplements in order to do all of this? And my answer to them is no.
And the way I explain it to my patients is, imagine an ice cream sundae. Your base is the ice cream, right? That ice cream, in our mind, in my mind, is the pillars of health. It's your exercise regimen, and it's your fitness regimen and your nutrition component. Those need to be in tip-top shape, meaning you're eating clean, you're getting all your protein, you're eating vegetables, you're getting everything in without diet restriction, right? And your exercise regimen includes cardio, it includes weight training, it includes all the things we talk about. So that is the base of everything that we do. Now add on top of that your fruit. Let's say you're still working with an ice cream sundae. So we have the ice cream. The next thing is the fruit that goes on there, the banana. What is that? Those are supplements that you may be lacking based on what your diet is. So let's put in some supplements—again, a few handfuls that we can discuss later. Then comes, on top of that, the whipped cream. The whipped cream I refer to as your hormone optimization. You're in perimenopause, menopause. You need some hormone supplementation. Let's put in the hormones. Then on top of that, the cherry on top of everything is peptides and things like that. So I have patients who come in with these labs and they're like, "I want to do peptides." Well, my answer to them is, "Well, the base of everything isn't addressed yet. So we need to fix all of that in order for the cherry on top to make sense, to be part of the equation."
So you can't really outrun or out-supplement a bad diet or bad exercise regimen by just taking supplements and taking different new, trendy peptides to feel better. It all works from inside out. So I tell them, "We can talk about it. I will guide you through all of it, but we need to get the basics in place first."
Katie Fogarty [20:30] I love this metaphor so much, and I'm going to remember it forever, because nobody wants to be handed an ice cream sundae that's just a bowl of maraschino cherries, right? And so we want to build our sundae correctly, and you had me at ice cream. And I think one of the reasons why women are doing these sorts of tasks and really trying to take control of their healthcare—I think it's twofold, right? We've gotten the message culturally on social media and all these wonderful books and voices that are spotlighting that women have been underserved in terms of menopause care, right? Women suffer from a range of challenges. I've talked about it on the show a lot: low libido, joint pain, hair loss, painful sex. But people have also gotten the message that menopause is linked to longevity. You know, better bone health, better cardiac health. I know you're going to be in New York City this fall at a healthcare conference that is focused on longevity. What topic are you speaking on? What are you bringing to the conversation at that event?
Dr. Jila Senemar [21:31] This is a first-of-its-kind type of event. Actually, it's a friend of mine who is in the longevity space and has been there for quite a while, and she brought together women who are in the longevity space, and we're all discussing different aspects. So I'm going to be there on a panel discussing the sexual health aspect in terms of longevity care. So I'm quite excited about this, because you have a room full of experts. We have Dr. Vonda Wright, who's going to be talking about longevity as it relates to bone health. And then you have Dr. Amy Killen, who's going to be talking about it in terms of all the peptides and all the other things, along with Dr. Elizabeth Boham. These are top-notch experts in their fields. And basically, we're going to teach women how to build that sundae from scratch all the way up, but from a longevity standpoint, so it's going to be really quite an experience that day.
Katie Fogarty [22:29] Yeah, phenomenal. I had the pleasure of having Dr. Wright on the show. She's been on four times, actually, and she came on recently to talk about her book Unbreakable, which became an instant New York Times bestseller, and that book belongs on every woman's bookshelf when they want to think about building for the future, aging powerfully, and remaining unbreakable as they age. So when you talk to your own patients, Dr. Jila, when they sort of walk through your door, what are messages that you're trying to have them focus on?
Dr. Jila Senemar [22:59] So my roadmap that I set out for them is I go over that nutrition component with them, and I really have them dial it in. I work with a nutritionist, and we go down—I have them write everything down, and then we sit down and we change it or tweak it or add things to their food regimen. And then the next part I work on with them is their exercise regimen. I work with an exercise therapist here who is well-versed in midlife women, so she knows how to bring in that weight-bearing if they've never done that before, or if they have, she knows how to improve and add to their weight regimen of what they're lifting. And that way they remain strong. They have their muscle mass.
So I make sure we optimize their body composition. We do body composition testing when they first get here and throughout the year, as they're with me, every three to six months, we reevaluate to make sure that they're gaining the muscle that they should be gaining, and that way protecting their bones and them going forward. So I really dial in with the younger patients on those two fronts. And then, like I said, then we go and we add in certain supplements that they would need, which, again, like I said, I do not believe you should have 100 different supplements. I think there are some core ones that everybody should have. And then if I see they're deficient based on their bloodwork, then I would replace those accordingly. But my goal is to give them this well-being lifestyle, you know, roadmap, that way they don't struggle and suffer unnecessarily.
Katie Fogarty [24:42] We're going to get to the supplements that you recommend in just a minute. But before we move on, I want to ask you about the body composition testing that you do in your office, because I think there are a couple of different ways you can do it. You know, there's the DEXA scan, that's one of them. There's sort of, I think, water tanks are another. Do you use multiple testing options? Is there one that you prefer?
Dr. Jila Senemar [25:04] So I do both. So I do like to have a baseline bone density on my patients, because even some of the younger patients may already have underlying osteopenia that we're not aware of. And like Dr. Vonda said before, if you really wait till age 65 to check a bone density on a woman, most likely you've missed the boat. By that point, they probably have osteopenia, if not osteoporosis. So I get a baseline DEXA on everybody, especially in late 30s, early 40s. That's part of my testing that I do. And then in the office, I do have an InBody scan where they stand on that, and it will give me complete composition from head to toe.
Katie Fogarty [25:47] It sounds like you have patients that are highly motivated. They're educated. They're coming in armed with information and questions, ready to get in front of things. For listeners—and no one needs to raise their hand, you're listening in the privacy of your own home—but if someone's thinking, "Oh my gosh, I didn't think about any of this stuff at 35. I feel behind. I'm not sure if I'm doing the right things." Is there an action step that you think people don't pay enough attention to? You know, if you could wave your magic wand, what is every woman doing? Period. End of story.
Dr. Jila Senemar [26:27] They should all be lifting weights. They should be in a gym under supervised programming and doing weightlifting in their 30s, if not, or whenever they can get to it. Because we were trained, we were taught cardio, cardio, cardio. I'm of that age. I know what was going on back then, and I was fortunate enough that I happened to fall into the realm of CrossFit when it first came out. So unbeknownst to me, I was doing the right stuff, but not really. I was doing it for other reasons, because it was the new fad. So I was doing CrossFit and building muscle back in my 30s and early 40s. But a lot of younger women really are afraid of lifting that weight, thinking just by lifting weights, they're going to look like a bodybuilder, which is completely the opposite of what's happening. We need you to just lift weights to build muscle. Not everybody's going to look like a bodybuilder. That's a different mindset, that's a different modality, and a different training regimen. So really that needs to be worked into their fitness regimen.
And fitness is not because you have to do it. It's something that should be a part of your lifestyle going forward. It's just like you get up and you brush your teeth. Your exercise regimen should be the same. It should be enjoyable. You should enjoy it, and you learn from yourself, and you push your own limits, and it's really satisfying when there are things that you can do that you never really thought you could do. Doing one pull-up where you never thought you could do that is very self-motivating.
Katie Fogarty [28:12] Absolutely. We need to spread the word to the younger women in our lives, including our daughters, our nieces, you know, our colleagues at work. And I've had the pleasure of interviewing the fitness pro, Holly Rilinger, on the show, and she is shredded because she has a phenomenal muscular figure that she's worked hard for. And she has basically said on this show, "If you don't want to look like a bodybuilder, don't worry. It's really, really hard." You know, it's very hard. You could spend—you need to be a pro to get those kinds of, you know, shredded and ripped abs. So I think that it's something that we all need to—there's been a steady drumbeat around this. Lifting is important, and it doesn't need to be gigantic iron. You could start off with bodyweight, smaller weights, and then work your way up to some of the bigger stuff. So thank you for pulling out your prescription pad and writing that on it for us. It's such a great reminder. Dr. Jila, I want to switch gears. You recently wrote an article for Mind Body Green on supplements. You've mentioned supplements in our conversation, saying that there are some that you turn to for patients, that no one needs 100 bottles on their kitchen counter or their medicine cabinet, but there are some that you consider to be effective. I will link out to that Mind Body Green article in the show notes, but I would love it right now if you could give us a rundown on some of the supplements that you think are effective and what they offer.
Dr. Jila Senemar [29:38] The biggest one, I think, for me is the vitamin D3 and the K2 combo. This is great for bone health, which we know, immune system mediation, good for your heart, and we know K2 also helps with calcium use by the bones. So you want to make sure you're getting your vitamin D-K2. And what I actually have on the list is there's another component to it, which is the omega-3 fatty acids, which we need. We know it's good for lowering inflammation, supporting your brain health, heart health, and other longevity pathways. So Mary Claire has an amazing supplement that includes all three of those things together. So it's a vitamin D3-K2-omega compounded together that she sells on her website, The Pause Life. So I refer all my patients there, because I also know women don't want to be taking 50 pills a day. So if I can minimize that to a few key products, it makes their life easier, and compliance goes through the roof. So the vitamin D3-K2-omega, that combination is my first one. I'm a big believer in magnesium. I love magnesium glycinate. It's helpful for sleep at night, especially in a lot of my perimenopausal women who aren't sleeping through the night. They have a nice cocktail between their progesterone as well as the magnesium glycinate. It helps them fall asleep and stay asleep all night, and it calms the nervous system the same way progesterone does.
Katie Fogarty [31:18] Is there a particular brand, or does it not matter?
Dr. Jila Senemar [31:22] Honestly, it doesn't matter. But you want to make sure it's the magnesium glycinate component, because there are six, seven different types of magnesiums out there. The one I refer my patients to buy is from Whole Foods. It's their Whole 365 brand. They have a magnesium glycinate supplement. Perfect. And then L-theanine, right? We talk about this. It's for brain fog, the mental fatigue that we all have in midlife, and it helps boost that clarity, and it doesn't give you any kind of rush or crash coming off of it. So that one, I refer patients to pick up, and they use that as well. And it's found on Amazon.
Katie Fogarty [32:05] All right. I love it. We love an easy button.
Dr. Jila Senemar [32:09] I'm all about making things easy for patients. That way they stick to their regimen. And the last one is creatine, which, you know, has been getting a lot of buzz, but it used to be just for muscle and muscle maintenance and getting shredded at the gym. And now we know there are cognitive benefits to taking creatine, so it's good for brain as well as muscle metabolism and bone support. And that one I get from Mind Body Green, actually.
Dr. Jila Senemar [32:42] Okay, great. A little powder that I put in my water every day. I drink it without even realizing it. Tastes great.
Katie Fogarty [32:47] And do any of these supplements have any contraindications for anyone who might be listening?
Dr. Jila Senemar [32:53] No, and they're fine with all of the hormone therapies that we administer as well.
Katie Fogarty [32:58] Okay, terrific. All right. Well, thank you so much for that rundown. So I want to switch gears for a minute. So you, as we've been discussing, have had a long medical career. You run your own office, you have speaking engagements that bring you across the country. I know that you launched a Women's Health Conference, which you do in Florida. You have a podcast. We love podcasters. Welcome to the podcasting pond. What made you decide to take on this new kind of creative outreach in midlife and at this stage of your medical career?
Dr. Jila Senemar[33:31] I was at a crossroads, to be honest, and it was kind of—my kids are all grown. They're all in college. I have young adult children, and I saw a disconnect. I saw missing pieces of healthcare for my patients, and I didn't like not having answers for them. I've always had answers. I've always been able to take care of anything and everything in terms of gynecologic care, surgeries, complex obstetric problems. And I got to this point where they kept asking questions, and they were in perimenopause, and we didn't have solutions for them. This is about four or five years ago when all of this kind of started, pre-pandemic. And it wasn't until it started affecting me personally that I was like, "Something's missing. What am I missing here? Why don't I have answers?" Until I went down the rabbit hole at 2, 3 a.m. like all of our patients say, and I realized that we weren't taught this. I remember exactly where I was when the WHI came out, and what we were taught, which was not to give anything. Hormones are bad and just move on, and women will get better. That was the extent of my training. So I realized it's a missing piece. I'm not being a good provider if I cannot have solutions for my patients and for myself. So I went down that rabbit hole, found the Menopause Society, and as they say, the rest is history, because once you start that, you realize all the missing pieces, all the things that need to be done. I joined the Society for Women's Health and Sexual Wellness. I joined ISSWSH. I joined The Menopause Society—everything, because I realized this isn't just me. This is everyone talking. Yet I looked around my community and nobody was talking about it. Nobody was doing anything about it. And that's where my second passion, I guess, was ignited, was to educate my community and my peers and say, "Listen, guys, we're missing this. We need to all get better at this." And because women are going to be needing us going forward, we cannot just dismiss them left and right. It's not right. It's not good for them. And so that's where all of this came from.
Katie Fogarty [35:54] You know, the conversation on menopause—and perimenopause now—has really cracked open in recent years. I launched this podcast five years ago. People were barely talking about menopause then. I had no familiarity with it as a patient until I went through it. And I really feel like the conversation, the landscape, has shifted. We have talked about some of the resources that are out there that women are availing themselves of: Dr. Sharon Malone's Grown Woman Talk, Dr. Jessica Shepherd's Generation M, Tamsen Fadal's How to Menopause, Mary Claire Haver who's coming out with her second book, Vonda with Unbreakable. I mean, there are easy-to-read books and tools that people can have in their hands. One of the challenges is finding a doctor like you who's taken the time to get up on the latest science, to kind of retool her toolkit in order to become a menopause-trained specialist. It's still tricky for women to connect with a provider. So when you look at the landscape, the conversation has shifted, there are more resources—that's an improvement, so we can feel optimistic. But what do you think still needs to continue to happen?
Dr. Jila Senemar [37:05] I think providers need to continue to be educated because I still see a lack of it here in my own community in Miami. And I think a lot of them just think they're at the end of their career, so they don't really want to spend the time, or they don't know where to start. And so I think we need, as healthcare providers on all fronts—so not just obstetrician-gynecologists, but it's a primary care situation as well, ER, you know—all those doctors need to be aware of these symptoms. Because a lot of women end up in the emergency room with palpitations. If a 42-year-old goes to the ER for palpitations, and you know, if you're not paying attention, they'll do a full cardiac workup on her and send her on her way. But nobody really realizes, "Hey, maybe she is going through perimenopause and it's her hormones, and maybe she should follow up with her gynecologist." So I think we need to educate the providers, and not just one field, but all fields need to be up to date and on board with this. And I'm hoping that that's what's happening because I know The Society meeting this year sold out in a matter of days. So I'm hoping that these are other healthcare providers who are willing to learn and are going to the meeting in Orlando to update themselves.
Katie Fogarty [38:26] Yep, the providers need to shift and be part of the solution, like she just pointed out. And the patient needs to be smarter and better. And that's what I said at the top of the show. That's why you're here. You're here to help us walk through our own doctor's doors, better communicate what's going on with our needs, make us a little bit smarter about what the options are out there. When I interviewed Dr. Sharon Malone, whose book, again, was an instant New York Times bestseller, Grown Woman Talk, she said on that podcast that the patient is really their own primary care doctor. They work with doctors who are part of their support team, right? You guys are like, it's like a baseball team, but we are the pitchers, we're the general managers. We need to know what everyone's doing and how they can help, and we need to bring our own A-game to our own healthcare. So I so appreciate you joining me today to help us become better patients, because that way we can get the healthcare that we deserve. Dr. Jila, before I say goodbye, though, how can our listeners find you? How can they learn about all the places that you're going to be speaking across the country, and where can they keep up with you, all your work, and all your resources?
Dr. Jila Senemar [39:38] So the best place to find me is on social media, on my Instagram, which is my name, Dr. Jila Senemar. All of my upcoming speaking engagements are there as well. There's a link to the website. That way, a lot of the resources will be linked there as well, so they can follow along there and also on my podcast, where I discuss all different topics that I see on a weekly basis in my practice. I kind of break it down for patients on the podcast, which is Her Time, Her Health with Dr. Jila on Apple and Spotify.
Katie Fogarty [40:09] Thank you so much for joining me today.
Dr. Jila Senemar [40:13] Thank you for having me.
Katie Fogarty [40:15] This wraps A Certain Age, a show for women who are aging without apology. Thanks for hanging around with me and Dr. Jila today. I hope you feel smarter, seen, more supported. I know I've got some ideas that I'm going to take to my own doctor by my next appointment. I know how important it is for us to be smart patients. We need to partner with our doctors. We need to educate ourselves about the options and resources that are out there to help us feel our absolute best. Thanks for sticking around to the end of the show. If you learned something, I would love to hear what it was in an Apple Podcasts or Spotify review. Reviews help other women, other patients, find the show. Special thanks to Michael Mancini, who composed and produced our theme music. See you next time, and until then, age boldly, beauties.