Kim (00:01.513)
Good morning, welcome. Thank you so much for joining me, Kristin and Maria. This is the first time I've actually done an episode with two guests at the same time. So this is interesting, but I'm really excited to chat with you. We have been following one another on social media for, seems like a really long time. I love the information that you share. I feel incredibly grateful the fact that you sent your book to me. I know it's not launched yet, but I got to be a pre -reader. I have it here with.
Probably, I don't know, like the majority of the book earmarked, if you can see, like all the pages and all the little notes I've made on the side. It's the book I wish I'd had, you know, 10, 15 years ago. just, it is amazing. So thank you so much for allowing me to read it and ahead of the launch. And I'm excited to be able to recommend it to my community as well. But let's dive in. I would love to learn more about each of you. What led you to
Kristin Johnson (00:33.274)
I love it.
Kim (00:59.475)
be focused in menopause, but then also what brought the two of you together to create wise and well.
Maria Claps (01:04.705)
Okay, it starts with a great personal need usually, and that's no different for each of us. So I'll start. It was about 43 when I noticed that I just didn't feel like myself. And I sought out a doctor in New York City that I thought I did my due diligence and research on. He was holistically minded. He was a medical doctor. And first thing that happened when I walked in, just to let you know how kind of
desperate I was, this was like December 26th. So if you've ever been in Manhattan on December 26th, you cannot have a cab. It's really, really a busy time of year there. And, you know, first thing, again, winter in New York City, I walk into the office and the front desk asks me, do you want a flu shot? And I'm like, this is such and such holistic center. Why are you asking me if I want to?
That was probably the first red flag, but I didn't quite recognize it then I knew something was off. Turns out I got a battery of tests. It was out of pocket. It was quite expensive and I was given hormone replacement therapy. I was 43, not necessarily a bad thing. In fact, in retrospect, looking back, it's so easy to look back at reproductive history.
and see what you wish you would have done at a certain time. I wish I would have started full HRT, I'm gonna say at about 45. And by full, I kinda mean estradiol and progesterone. But so in addition to the HRT, I was given a lot of supplements, a lot. And I was also given clonopin to help me to sleep, which is a benzodiazepine. And I got a little bit hooked on the clonopin for...
I don't know, mean, like on and off for a year, maybe two years, I managed to wean myself off of that successfully. I did not continue with the HRT. I maybe stuck with it for about six months. And then I would say people ask why, I didn't know what I was doing. Why was I using this? Like what was happening in my body? I was given zero guidance as to, you know,
Maria Claps (03:13.511)
Why do this and that? mean, I was told the Kalani Pinay, if you can't sleep, you know, then just pop one of these. okay. Make it a half. Fine. Easy and slowly. Take as little as you can. With the HRT, it was just like, you need this. But I was never really explained the whole kind of transition, perimenopause journey that I was in. And so I stopped and I said, okay, there's got to be a better way. This is complex.
and I know something's changing it. So at that point, I just sought more education, mentorship with physicians, and I just really, I ate this, I drank this, I slept this. This was like an all -consuming passion to learn everything I can. And I haven't really stopped for now over 10 years.
Kristin Johnson (04:00.122)
Yeah, so my timing is almost identical to Maria's, but my journey is completely different. And I think that's why we tend to kind of represent both ends of the book or both ends of the book with a spectrum. I was 43 as well. I was living outside Boston, home of some of the best medicine and big pharma that there is if you have a disease and acute problems. But for someone who was just, I just felt like my world had kind of been shook.
Kim (04:01.851)
My timing is almost identical to Maria's, but my journey is completely different and I think that's why we tend to kind of...
Kim (04:14.897)
as well. was living in Saipan.
big pharma that there is if you have the disease and acute problems. for someone who was just, I just felt like my world had kind of been shocked. didn't know what was going on.
Kristin Johnson (04:27.13)
I didn't know what was going on. My mom had surgical menopause at 32, so I didn't have, I didn't live through her experience as a child and because she had everything removed in my birthing room. So, you know, I don't remember any of that. And then I didn't have any genetic sort of timing, right? To kind of base my experience of timing off of. So for me, it was probably started with a little bit of lack of sleep. But then after that, it was truly...
Kim (04:31.009)
you
Kim (04:40.979)
genetic sort of timing, right, to kind of base my experience and timing off of. So for me, was probably starting with a little bit of lack of sleep, and then after that, it was truly not being able to perform as a human the way I was used to. Like my brain just was not there. My mood, I felt, to shift. It wasn't anxiety or depression or anything like that. was sort of just my outlook on things was really rough.
Kristin Johnson (04:53.556)
not being able to perform as a human the way I was used to. Like my brain just was not there. My mood, I felt, started to shift. It wasn't anxiety or depression or anything like that. It was sort of just my outlook on things. It was really rough. You know, I had been a corporate attorney. I raised three kids while practicing law. I was competing nationally in rowing. I had a lot of type A high achieving things that I was doing and suddenly doing any of them was like white -knuckling it through my day. And I was like, what is wrong with me?
Kim (05:09.639)
I raised three kids while practicing law. I was competing nationally in rowing. I had a lot of type A high achieving things that I was doing and suddenly doing any of them was like white knuckling it through my day. I was like, what is wrong with me? And I assumed that I was sick. And so I went to my doctor and I said, something's wrong. And she said, nothing's
Kristin Johnson (05:22.858)
and I assumed that I was sick. And so I went to my doctor and I said, something's wrong. And she said, nothing's wrong with you. And I said, no, it's gotta be something. Something's off. Like I'm not myself. And I'm like, it Lyme disease asked to be tested for Lyme? I'm like, could I have mold? it, you know, I'm looking through all of these things. And then my last thought was, could it be my hormones? And she's like, no, you're too young. Wouldn't even test my blood levels, wouldn't look at anything.
Kim (05:35.524)
asked me to test it for live and like what I had to
Kristin Johnson (05:47.63)
sent me on my way like I was kind of a deranged crazy lady in her 40s and needed to get my crap together. And that made me mad. And when I'm mad, I'm like, I'm going to figure this out. so I, like Maria, I went back to school and started digging into some things. And then ultimately, I think that we attract the clients that we resemble. And so I'm getting all these women who have different issues, but kind of all the same timing and all just that similar feeling of what happened to me.
Kim (05:49.726)
arranged crazy lady.
Kim (06:01.512)
digging into some things and then ultimately I...
Kim (06:11.593)
different issues but kind all the same timing and all just
Kristin Johnson (06:17.462)
And so that's when I was like, okay, there's something going on here and this is midlife and this was hormones. And I started to seek out some training and functional testing and Maria had sort of this mini course for practitioners on a particular test. And that's how we connected. And then we both figured out like, yeah, she's as mad and passionate as I am. And let's do this together. And it's just been, you know, it's, as you know, it's hard to be a business owner and serve clients at the same time. So.
Kim (06:17.936)
So that's when I was like, okay, there's something going on here.
We started to seek out some training in functional testing and Maria had sort of this mini course.
Kristin Johnson (06:44.396)
energetically being partners, it just made such a good match for us and the women we serve.
Kim (06:49.895)
So cool. you know, hearing your stories is similar to myself and all of a sudden knowing something's changed, but not totally understanding what. at the time I sort of knew about naturopaths. I'd never heard the term functional medicine. I'd never heard the term perimenopause. Went to my medical doctor. I think something's off with my hormones because I had crazy heavy periods and that's all I really knew. And then of course those tests came back as everything's normal.
And same like you, I'm like, that's, I'm not normal. So then you do your own deep dive into research, find out all these things and, and then finally get to the root cause. I had an autoimmune layer in there as well, but, but it's, it's, hear the story all the time, all the time. So now we're in this explosion of now we, now we can't get away from, in a, in a good, but also kind of overwhelming way of menopause. So the world has exploded with conversation around menopause. What
Kristin Johnson (07:31.172)
Yep. Yeah.
Kim (07:45.457)
What do you feel has fueled that? But then I also, as part of that answer, if you could talk about the terminology. As I said, I'd never heard the term perimenopause until well after. So what is perimenopause? What is menopause? What is postmenopause? Or what do we label all of these things that we are experiencing?
Kristin Johnson (08:05.464)
Yeah, I'll let Maria take the terms and then I'll kind of take the theory behind the boom.
Maria Claps (08:10.574)
Yeah. Perimenopause is just the time immediately preceding menopause. And menopause is that one day or we say the 366th day.
where you've gone 12 months without a menstrual cycle. And then the day after that is the you begin your post menopausal phase of life and then peri menopause, you know, it doesn't, it's not particularly time bound, right? It's it could be four years, it could be 10 years, I personally tend to doubt when women are like, it could be 12 years. I think the typical is more like, you know, four to seven years that
there are shifts going on in the body. It's you know, they say it's like it's reverse puberty really.
Kristin Johnson (08:57.498)
Yeah, and it's variable. That's the thing. You know, it's so different. you know, why we're in this boom, I think we have a demographic that's aging into this, like a much larger percentage of the population is sort of aging into this. And it's just going to get worse if you look at kind of population age across the globe. And I credit or blame, I'm not sure which, a little bit of social media, right, that there's kind of now this prolific constant conversation that women are able to have.
Kim (08:59.263)
And it's variable, that's the thing. It's so different.
Maria Claps (09:00.982)
there.
Kim (09:24.38)
that women are already.
Kristin Johnson (09:25.806)
with each other, even if it's virtual and online and whatnot. And then I think we had the advent with the pandemic, for better or for worse, of telemedicine. And suddenly people were able to kind of go outside their typical construct and be like, wait, people are doing this differently and learning and whatnot. And so I think those three things have kind of combined. There's a lot of.
Kim (09:43.813)
and learning and whatnot. And so I think those three things have kind of combined.
Kristin Johnson (09:48.916)
money now behind the movement. There's a supplement for just about every ill of perimenopause if we wanted to dive into that. And again, for better for worse, I think the awareness and the discussion is good. I think the content is noisy, and I think it's confusing for a lot of women. And I think like Maria just said, it's, you know, it's it is like puberty. And maybe I had acne and puberty and Maria didn't. But does that mean she didn't go through puberty? Right. And and
Kim (09:56.051)
Dive
Kim (10:03.935)
think the content is noisy and think it's confusing for lot of women. And I think like Maria just said, it's, you know, it is like puberty and maybe I had acne and puberty and Maria didn't, but does that mean she didn't go through puberty? Right? And this mindset.
Kristin Johnson (10:18.798)
this mindset of like perimenopause is this one thing or it's this bucket of these things. And we're starting to kind of label and pigeonhole women. And that's really unfortunate because Marie and I didn't have hot flashes. So if hot flashes are the like benchmark for perimenopause, I guess we didn't go through it, right? And we know we did. So it's a little frustrating because I think that's where the volume of content out there is kind of distracting women a little bit.
Kim (10:23.699)
of these things and we're starting to kind of label in pigeonhole women and that's really unfortunate because...
Kim (10:33.893)
smart.
Kim (10:37.603)
And we know we did. it's a little frustrating because I think that's where the volume of content out there is kind of distracting women a little bit. It doesn't really matter if you have symptoms or not. And that's not to say it doesn't matter from your lived experience. Obviously, no one wants to be uncomfortable. But in terms of your journey, you're headed to the same place no matter what path you take to get there, right? Everyone's going to have a different road.
Kristin Johnson (10:47.778)
It doesn't really matter if you have symptoms or not. And that's not to say it doesn't matter from your lived experience. Obviously no one wants to be uncomfortable. But in terms of your journey, you're headed to the same place, no matter what path you take to get there, right? Everyone's going to have a different road and stopping the comparisons amongst women, stopping the one doctor's definition or their criteria. That's kind of what we're pushing back against.
Kim (11:05.983)
stopping the comparisons amongst women, stopping the one doctor's definition or their criteria. That's kind of what we're pushing back against. Because even with the book, we're trying to say, look, it is global. There's so many, and it's physiologically global, right? There's so many things. Your only sign might just be dry eyes, right? So it's something that the discussion's good.
Kristin Johnson (11:15.192)
because even with the book, we're trying to say like, look, it is global. There's so many, and physiologically global, right? There's so many things. Your only sign might just be dry eyes, right? So it's something that the discussion's good, but the content's noisy, and we're kind of out there to change that.
Kim (11:33.363)
Yeah. Yeah, I agree. and as I, you know, my experience similar, I think it was, I can't remember which one of you said your mother was in surgical. that you Kristen? I think, same with my mom. And so in talking to her now, she had a similar experience to myself with really heavy bleeds and, and, know, flooding and all the things that I was experiencing. However, as when she was experiencing it, she kept it very well hidden, wasn't talking about it. didn't, I had no idea until now.
Kristin Johnson (11:42.787)
Yeah.
Kim (12:03.143)
And she ended up having a hysterectomy for this heavy bleeding. And now, of course, with the knowledge that I have now, I think, like all the things that she could have done differently. And she was also in the, the boomer category that was started on HRT. And then all of a sudden it was taken away or it was strongly recommended you stop and it's dangerous. And, Dr. Kelly Casper son has a quote that said, no, a podcast episode that said boomers should be pissed.
which I really liked that title. And I think my mom was sort of like on it and then off it and really unsure. anyway, so now we're in this time now where there's this shift trying to bring the light of what was wrong about that, big women's health initiative study. There was a statistic you said by 2030, more than 1 .2 billion women worldwide will be considered post -menopausal. That's a huge amount. And then you have a whole list
of, I'm not gonna read them all, but the very first one, when we think about, most people, when they think about hormone therapy, or when they think about menopause, they think about hormone therapy, and then they think of cancer. And the first, in this section that you've written here, by age 65, 75 % of women have high blood pressure, surpass men in the incidence of stroke and aneurysms, and equal men in incidence of heart attack. And that is the bigger killer than cancer, yet no one's talking about that, and no one has that fear.
So what are the, there's this health shift that happens with menopause. What is, what's happening and what are all, we don't have to list all of them, but what are the main things that we need to be concerned about?
Maria Claps (13:39.093)
Well, it is primarily the loss of estrogen and its receptors on the target tissues. Because if there is a receptor for estrogen on a target tissue and there's pretty much a receptor on almost every target tissue and even cell in the body, that loses function without estrogen. And the estrogen that a lot of people say, well, you're supposed to, this is natural.
You make some from the adrenal glands, you sometimes the holistic crowd or the even the functional crowd. Well, you don't need it because, know, you just got to take care of those adrenals. There's so many arguments for that. But the one thing I want to stick on is that that's mostly Estrone and we have three estrogens and estradiol is the most important one. It is the one that has that balanced effect on the receptor. just goes into the receptor. again, we lose
the hormone and we lose the receptors. And then that's a problem.
Kim (14:41.512)
Can I ask a quick clarification on it? Because I have that actually earmarked in the page with a question written. Do we lose the receptors or do the receptors stop working or is it a combination of both?
Maria Claps (14:54.013)
We think they what we've kind of learned from mentors is that they flatten, they just kind of lose receptivity. So I don't know that I would say we don't actually lose the receptors. did just say that but what I meant was we lose their functionality. But when they're not being supplied with the hormone, it's like they kind of just drop or they flat, they become ineffective.
unable to receive a signal. Yeah.
Kristin Johnson (15:24.996)
I think though there is the reality that we're living in a modern world and so we're still being subjected to certain insults. Chemically, we have issues with our digestion, which means poor nutrient absorption. And we do know that receptor function can be impaired even in the presence of hormones simply because we're lacking certain minerals such as zinc or we've had some endocrine disruptors that have kind of gone and altered the receptors capability and stuff. I think, you
Maria's spot on in terms of our physiology and what's happening with the receptors as we lose our hormones, but women have to remember that's a textbook, right? Like we're a living human being with all these experiences. And so we've kind of got this double whammy that's happening as you the receptors ability to function has been impaired by our daily living, right? Because of the things that we're exposed to. And then they're also losing their stimulation from the hormones. And so those two things combine and you know, the
receptor capabilities just gone down.
Kim (16:26.259)
Yeah. I think of sort of the main topics that come up from a health perspective are heart, brain, bones, and then there's the disease of the cancer. So when we think of, well, yes, of course. Thank you. Thank you. Yes. Yes. Yes. Totally true.
Kristin Johnson (16:38.156)
We say bladder too. Don't forget bladder because a lot of women, yeah. I mean, you of all people come, no. Yeah.
Kim (16:48.223)
So let's start with the heart and that one thing is so the 75 % of women over age 65. We've talked about the loss of the function of those receptors as well as the loss of the estrogen. So what is it specific to the heart? Why are we it because of that? Yeah.
Kristin Johnson (17:06.03)
What impact? Yeah, I mean, we have, so we have endothelium, that's the lining of the pipe, so to speak, of our vascular tissues. That is lined with estrogen receptors and it's heavily dependent upon estrogen signaling it in order to continue the tissue to be healthy. You we know that plaque deposition is essentially an immune process based on an inflammation trigger. Loss of estrogen causes inflammation. We start to lose the health of those tissues.
We also start to lose the flexibility of the vascular tissue. So this is where it becomes more rigid and now women have increasing blood pressure. We also start to have a lack of signaling as to how to handle these plaques essentially that may be circulating and things just start depositing in the coronary artery. So we have this multiple things that are happening with it and it's.
Kim (17:51.868)
and things just start depositing.
Kim (17:57.171)
things that are happening with it. And it's not just the presence of estrogen, but we know...
Kristin Johnson (17:59.574)
not just the presence of estrogen, but we know that the peaks of estrogen and the rhythm of it, and then hand off to the peaks of progesterone and its rhythm, are what's controlling those things. so again, it will eventually, that kind of foreshadows getting the discussion on HRT is that it's not just the presence of hormones, right? But it's having proper levels and proper presentation of those hormones that, you know,
Kim (18:06.655)
to the peaks of progesterone and its rhythm.
So again, eventually that kind of foreshadows getting the discussion on HRT is that it's not just the presence of hormones, right? But it's having...
education.
Kristin Johnson (18:26.08)
stimulate, fluctuate and control those actions within our cardiovascular system.
Kim (18:26.398)
stimulate flex weight.
Kim (18:31.679)
Part of the conversation around hormone therapy, so I want to talk a little bit about the acronyms, MHTB, you know, all of that. But the point I want to make here too is along with this receptor. So the first 10 years or as close to the start of your menopause is considered the best time to start the hormone therapy. So is it before? Yeah.
Maria Claps (18:56.385)
Before, actually.
Kim (18:59.647)
As you were saying, wishing you had started around age 45, and I would say I've wished the same thing. When we think of the receptors and losing their functionality, is it part of it, like if we start too late, some of those receptors are maybe just out of service and they're not going to come back to life, so to speak. Is that part of the reason why we want to start or why is that so important to start as before or as close to your menopause?
Kristin Johnson (18:59.854)
But I think you think conventional says. Yeah.
Maria Claps (19:22.561)
No, I think that it would be disingenuous for us to say that we really know exactly what the concentration of those receptors are, but can we lose function? So we don't know. Well, Kristin and I think that with the right amount and rhythms of hormones, you can build bone. But again, for your average woman that, say, starts, we'll say 10 or 15 years after menopause, how much
is she going to really regain in terms of her bone? Right? So.
Kristin Johnson (19:54.03)
Right. It's like Maria said, the earlier the better. And the reason is not because of the symptoms of perimenopause, but because of the changes, the underlying global changes. So we know that as we're losing that beautiful rhythm, anyone can go on Google and look at a chart, because I think most women don't know, right? They just think...
Kim (19:55.806)
like Maria said, the earlier the better. And the reason is not because of the simple.
Kim (20:05.598)
I learned more about my menstrual cycle going through perimenopause and menopause than I had before.
Kristin Johnson (20:15.194)
Yeah, exactly. And I'll just say one thing because it occurred to me when you were talking earlier about the cycle. We need to recognize there are plenty of women who have IUDs, ablations, and hysterectomies, but with ovaries that don't have cycle changes to signal to them that something's happening. And I just say that because you had bad cycles, I had an IUD. I had no cycle to really tell me what was going on. And so those women are even sometimes in a worse situation, one, because we're probably flattening the receptors with something like an IUD.
But two, because we don't have that like, hey, something's going on, pay attention signal. And that what's happening is when you look at that rhythm, things like tell protein deposition and clearance in the brain are dependent upon those signals. So as we're losing those signals, that means we're starting to accumulate these problems, right? We're accumulating more rigid vascular tissues, we're accumulating more plaque deposition, we're accumulating
Kim (20:51.166)
signal.
Kim (21:01.897)
So as we're losing those signals that means...
Kim (21:07.774)
accumulating more rigid vascular tissues. We're accumulating more plaque deposition. We're accumulating...
Kristin Johnson (21:12.794)
bone mineral density declines, et cetera, before we even hit menopause. And that's the thing Marie and I want to hit home for people because it's not like menopause is some magic finish and start line, right? It's menopause is like, okay, you know, we've been asleep at the wheel a little bit. Now, you know, it's really important to pay attention. But why this 10 year window exists is because a lot of those women have seen, or I shouldn't say they haven't seen it, but they've experienced damage.
Kim (21:19.262)
to hit home because it's not like menopause is some magic finishing start line, right? It's menopause is like, okay, you know, we're going to sleep with the wheel a little bit.
Kristin Johnson (21:40.282)
to these global organ systems and they don't know it. And so once you start HRT to think that it's going to restore things or preserve them is a little bit naive because we've already lost some of them. Does that make sense? I'm
Kim (21:40.85)
these global organ systems and they don't.
think that it's going to restore things.
Kim (21:54.301)
Yeah, yeah, absolutely. So the terminology with hormone therapy, a comment that you had written in the book was, hadn't thought of it this way, but so there's HRT, hormone replacement therapy. There's BHRT, bioidentical hormone replacement therapy. And then there's MHT, menopause hormone therapy. And the point you're making, which is what you're establishing now is the terminology, menopause hormone therapy is giving us the thought is planting the seed that
You only start it if you've reached your menopause, which is, again, now we're wanting to start this much earlier.
Maria Claps (22:31.763)
or if you're symptomatic. You get it if you have symptoms. We'll give you a little sprinkle.
Kim (22:39.304)
Do you, so Maria, you went on it, you didn't know why you were on it, you went off of it. And I'm going to assume you went back on at some point after you had, yeah, yeah, yeah. Okay.
Maria Claps (22:44.683)
Right.
Maria Claps (22:49.665)
I did, yeah. I was about 47, 48 when I went back on, yeah.
Kim (22:54.545)
Okay, okay. So, so if you can just clarify those terms, what they mean and, and what should we, I guess, be looking at? And I guess also the clarification of bioidentical is also a word that for so long was just called the marketing term. And now, now it seems to be more accepted even in the medical community, but there's still confusion there. So if you can, can highlight some of the terminology we might need to know about hormone therapy.
Maria Claps (23:21.867)
Give them hell, Kristen.
Kristin Johnson (23:22.778)
Yeah, so MHT is your red flag. MHT is your signal that the provider to whom you're speaking is interested in suppressing your symptoms, i .e. shutting you up, ladies, let's be honest, and not really concerned about longevity, either because they don't understand, they don't know, they don't care, they just haven't accepted that these hormones are disease protection molecules in the body. And so they're going to give you low dose.
They're usually only going to offer it to you if you fit within a certain criteria of symptoms Primarily it's hot flashes and established bone loss Like crazy town, right? Why are we gonna wait till she's lost her bones? But whatever and then you're only gonna be kept on it until your symptoms are controlled Well, the logic in that is also problematic, right? Because if we recognize that she needs the hormones because of the bone loss
Kim (24:03.89)
Yeah.
Kristin Johnson (24:18.924)
And then what, we wait till she gets a stable dexa scan, we remove the hormones and we think it's gonna stay stable again. Like that's just, there's so much ridiculousness in there. So MHT is primarily promoted by the major medical societies covering menopause in the various countries. So Canada has its own, in the United States it's North American Menopause Society, the UK has one. They focus on MHT. That is their thing. Shut women up, give them a little bit and then they'll get through it.
HRT, you know, is, we just use it simultaneously with BHRT to be perfectly honest, but within the medical community, there is a slight distinction. HRT could be birth control pills. It could be, you know, restoring hormones for anyone who's lost them prematurely, such as my son had a growth hormone defect for a while. So technically he was on hormone replacement therapy, the transgender movement. You know, we could look at those things as all being inclusive, but with respect to menopause.
Kim (24:49.642)
you know
Kim (24:58.275)
H .R .T. be birth control pills, could be restoring hormones for anyone who's lost them prematurely.
Kim (25:09.599)
He was
Kristin Johnson (25:17.326)
What we're really talking about is replacing hormones that have been lost or on the decline. BHRT, adding that B, is making the distinction that some physicians see the birth control pill as HRT. And because that is a synthetic molecule, we're not even going to give it the title of a hormone. It's just a synthetic drug. It's an endocrine disruptor, and it causes all sorts of problems in our endocrine feedback loop. This is why some providers will say, I'm only for BHRT. And that's a good sign.
Kim (25:19.646)
policing.
Kim (25:27.313)
See the birth
Kim (25:36.19)
endocrine disruptor.
Kim (25:41.202)
Some providers will say, I'm only for HRT.
Kristin Johnson (25:44.964)
That's not to say that those who use HRT are also using synthetic. Some people just drop the B because they can't even imagine anyone's not using bioidentical, to be perfectly frank. So bioidentical, it has been disparaged as a marketing term. It's a load of crap. Anyone saying that is lying to you and being disingenuous. What the reference is is to the molecular structure of the molecule being delivered. And we now can mimic.
Kim (25:45.982)
say that those who use HRT are also using synthetic. Some people just drop the pinky because they can't even imagine it.
Kim (25:58.354)
barrage.
saying that is lying to you and being disingenuous. What the reference is is to the molecular
Kristin Johnson (26:12.506)
the exact molecular structure of 17 beta estradiol that we as women produce in our ovaries, that can be synthesized in a lab. So there are people who'll be like, it's still synthetic. You're correct. It's synthesized in a lab. didn't extract it from Kim and give it to Kristin, right? So sure, it's synthetic from that standpoint, but on a molecular level, it matches what we made. And that's the most important thing because we go back to those receptors. They only recognize
Kim (26:19.112)
synthesized in a lab.
Kim (26:23.679)
We didn't extract it from Kim and give it to her.
Kristin Johnson (26:39.96)
you know, a certain signal, it's sort of like, I don't know, expecting a mobile cell phone to receive a walkie talkie signal. There might be some static, I don't know, but they're not going to communicate that well. Or I think some people we talk, Maria, about, you know, it's like when you speak to Siri, and then she talks back to you, it gets a little jumbled. That's kind of what can happen with the non -molecular identical chemicals to the receptor. So the signals get crossed. And this is a bad thing because in particular,
Kim (26:40.127)
you know
a mobile cell phone to receive a walkie
Kim (26:55.944)
She talks back.
Maria Claps (26:57.963)
you
Kristin Johnson (27:09.838)
the progestins, this is a synthetic form of progesterone. Any doctor who doesn't know the difference scares the heck out of me to be perfectly honest. But progestins, when they signal in the breast tissue at the receptor, they actually alter the receptor, both the estrogen receptor and the progesterone receptor, they alter it. And what happens is we develop folded proteins, these result in DNA damage, and this is what starts the breast cancer process. So in some instances, not all, but that can start it.
Kim (27:35.524)
in some instances, not all of that can start. So those sorts of things is why those two are.
Kristin Johnson (27:38.56)
Those sorts of things is why those terms are really relevant, right? It's telling you what is the objective and the goal of your provider and what are they giving you? How healthy is what they're offering you for your body? And so that's why we try and raise that distinction in that chapter is just to say, one, it's a tell, and two, use these terms to navigate your way into the healthiest and best HRT.
Kim (27:43.23)
What is the objective of
Kim (27:54.525)
So that's why we try and raise that distinction in that chapter is just to say, one, it's a tell, and two, use these terms to navigate your way into the healthiest and best HR team. Yeah, and it's challenging because a lot of people are being directed to these organizations for guidance, and now we have this other layer of confusion. the world's trying to explore this conversation, yet there's now, of course, as anything with social media, we get
There's always different opinions and different information shared. for them, for, guess, for many people, it is at least prompting some research, some people to do their own research to figure things out. But there are other people who are led by one voice and it depends on who they land on, if that's the right voice or not, I guess.
Kristin Johnson (28:38.606)
Yeah, I mean, I think they overestimate what a medical society is, right? It's really just a gatekeeper of talking points and direction for physicians. The physicians look to it, they take what it says. I think women assume that if we hear something like North American Menopause Society, they're on our side, they're concerned about our long -term health, they're doing all the research. Newsflash, they're not. In fact, they have been the ones, and just sadly said this on a
Kim (29:03.293)
Yeah.
Kristin Johnson (29:08.003)
famous menopause doctors post the other day is, know, the NAMS is the one that's been screwing women all these years. Like if the boomers want to be really pissed at somebody, go after NAMS. They are the problem. So that piece of it, you know, now they're kind of repackaging themselves as being your best girlfriend and they're going to have your back and they're going to be there for you. Beware, buyer beware, because there's a huge pharmaceutical capture that is involved with these medical societies.
NAMM's one of their top funders is Pfizer. And this has nothing to do with the conspiracies of the last few years in our lives, but it truly shows that profit drives narratives. And unfortunately, the narrative that they're giving isn't directed towards your best interests, it's directed towards the best interests of their constituents.
Kim (29:39.08)
years in our lives.
it drives narrative.
isn't directed towards your best.
Kim (29:52.764)
Yeah, yeah. Something else that is a buzzword and especially the longevity space and the biohacker space is mitochondrial function. And that's a topic that you both cover in the book as well. So can you, what is mitochondria? Most of us remember it from biology class, but if you can, what are the mitochondria in our bodies and what shifts, again, with this menopausal transition and how can hormones?
therapy, BHRT, HRT, whatever we want to call it, how can that help?
Maria Claps (30:25.791)
Yeah, in simplest of terms, they're just a part of our cells that kind of they give us energy, really. They do lot of functions in the body. The problem is mitochondria need estrogen to function well. And so when, again, when we don't have that estrogen, that estradiol in particular, we're just losing them, really.
Kristin Johnson (30:49.486)
Yeah. And we have superoxide dismutase, SOD. It's an enzyme that's highly dependent on, or the mitochondria are highly dependent on it for their ATP generation and good function. That is also driven. The supply of that is driven by estrogen. So they kind of have this multiple dependence on estradiol in the body. And as we lose it, that powerhouse of the cell starts to not be as so powerful. And, you know, this is where
kind of we develop aging to be perfectly frank. And Marie and I get frustrated because I think so many women want to say, well, this is just part of aging. And we're like, but is it, I mean, is it estrogen loss is driving aging or aging driving estrogen loss, which is it? And does it really matter at the end of the day, if we can supply the needed ingredients for this energy chain, why are we not doing that? And we can see that even like in MRI studies, women lose their hippocampal volume of their brain as they lose estrogen.
Kim (31:20.984)
I think so many women want to say, well, this is just kind of aging. like, but is it, I mean, is it estrogen loss is driving aging or driving estrogen loss, which is it?
Kristin Johnson (31:46.276)
That's horrifying to me. I'm comfortable with cancer for a variety of reasons because of my own personal situation. I feel confident about my own ability to control my heart disease. I do not understand fully the brain and I'm gonna do my best, keep my sugar low and all those good things so that I don't develop the type three diabetes and Alzheimer's.
But let's face it, we lose cognition and that is scary to me. That to me is the number one thing that I don't wanna lose as I age. And so if providing my brain estrogen can preserve that function, I'm all in. Yeah.
Kim (32:22.643)
Yeah. When it comes to using hormone therapy, we've talked about bioidentical. The questions that also come up are what time of day should I take it? Should I cycle? for a while it was just you take it every day and then there was a conversation around, we should be cycling as we were when we were in our fertile years. What's your stance on how we like, is there a better time of day? I also had somebody who
She takes one pump of estrogen, herestadial in the morning and one prometrium in the morning and then one of each again in the evening. So is there benefit to doing that versus before you go to bed at night? it, I guess if you can elaborate on time, just how to take it, what to take.
Maria Claps (33:12.48)
Transdermal creams because of the pharmacokinetics do need to be applied twice a day. So for all the women that are putting on their gel or their cream once a day, they're getting half the benefit because after 12 hours it's gone. I feel bad for that woman taking progesterone in the morning. Yeah, yeah, yeah. And then...
Kim (33:30.791)
Well, that's, yeah, the sleepiness or sort of, yeah.
Kristin Johnson (33:34.02)
Sedative, yeah.
Maria Claps (33:37.301)
You know, estrogen as a hormone estradiol, I need to keep correcting myself. That's really the correct term. It's estradiol. It's a daily thing. It's not every other day. I mean, there might be some very, very, very rare cases where a doctor might be kind of slowly on ramping a woman into like a full dose. But really, for the vast majority of women, it's every single day. It's your healthy body never has a day off of estrogen.
That is not, let's say it again, estradiol. That is not the case for progesterone. So if we want to mimic nature, we make a huge case for that in the book. You might have remembered that chapter where we talk about replicating what we had happening in the body when we were at our peak, our peak fertility, our peak health. Well, let's call it 20s and 30s. We only made progesterone half of the month.
That is because again, as Kristin said earlier in the show, is that we have very unique rhythms of estradiol, of progesterone, and there are physiologic processes in the body that are dependent upon, again, not just the presence of hormones, anyone can just do hormones, but it's the amounts, it's the rhythms.
Kristin Johnson (35:00.882)
I think each hormone, again, I think it's more common in Canada for women to see transdermal, which is great. Transdermal is incredibly safe. And I say that not to say that hormones aren't safe, but we know that when we swallow our hormones, particularly swallow our estrogen, we end up increasing clotting factors, inflammation, things like that.
Kim (35:01.222)
And I think each hormone, again, within, I think it's
Kim (35:09.021)
And I say that not to say that hormones aren't safe, but we know that...
Kim (35:16.945)
end up increasing.
Kristin Johnson (35:20.468)
Swallowing estrogen is not the greatest case. Unfortunately, in the US and the UK, there's still plenty of women getting it. The vast majority of women we talk to in Canada, they are getting transdermal, which is wonderful because even women with clotting disorders, factor V Leiden, they can use transdermal estrogen perfectly fine. It does not increase their baseline risk from their genetic condition. So that being said, there's so many different ways to give or get hormones.
Kim (35:22.759)
Unfortunately, in the US and the UK, there's still plenty of women getting it. vast majority of women we talk to in Canada, are getting transdermal.
like clotting disorders factor by life, they can use transdermal estrogen perfectly fine. does not increase their baseline risk.
That being said, there's so many different ways to give or get hormones. So progesterone is typically oral or cream. Estrogen can be pellets, patches, creams, pills, injections, you name it. Testosterone tends to be cream for the safest dose for women.
Kristin Johnson (35:47.898)
Progesterone is typically oral or cream. Estrogen can be pellets, patches, creams, pills, injections, you name it. Testosterone tends to be cream for the safest dose for women. But we are seeing more more telemedicine platforms handing out testosterone injections, which is concerning, because that's a male dose in a male presentation. But so that's the thing is women need to understand that whatever your HRT is,
Kim (36:06.318)
testosterone injection.
male presentation. So that's the thing is women need to understand that whatever your HRT is has its own distinct, as Maria said, pharmacokinetics and therefore its own distinct needs.
Kristin Johnson (36:17.402)
has its own distinct, as Maria said, pharmacokinetics and therefore its own distinct needs in terms of dosing and timing and things like that. without a doubt, however you're taking your estrogen, it should be every day. And Maria and I see crazy HRT plans from these doctors that are like, take it Monday through Friday and don't take it Saturday and Sunday. And we're like, what? And their rationale, it's flawed, but their rationale is, well, it gives your receptors a break.
Kim (36:28.648)
every day, remaking crazy HRT plans.
Kim (36:36.403)
Don't take it sad.
Kristin Johnson (36:45.676)
Our receptors didn't need a break when we were pre -menopausal. They saw these hormones all the time. And then standard of care, ironically, actually is to cycle progesterone. This is a fact that many large platform doctors will absolutely claim is untrue, is untrue. We've got the receipts. We can show it. It's there for all of them. But a woman with a uterus who cycles her progesterone is going to have a bleed because after that progesterone stops, the uterine lining sheds and...
That is a no -go for many physicians. They don't want to deal with you ladies. They don't want to manage a period. They don't want to spend more than 17 minutes with you, essentially. So that is why there's been all this pushback. And they'll say, well, you you're menopausal. You don't need the progesterone to be the same as it was in your premenstrual cycles. And we're like, but, you know, there is research showing, in fact, not rat research, which is another favorite. They'll say, you only see it in rat and mice studies.
Kim (37:21.629)
know, spend more.
Kim (37:37.285)
you
Kim (37:40.702)
right the whole
Kristin Johnson (37:43.31)
Okay, that's not entirely true. There's a phenomenal study out of Denmark that shows that the cardiovascular disease risk was highest in the women who were taking continuous progesterone. So we wanted to kind of bring out those points because I think we can all accept the body's really smart. It does the things it does for a reason. And so it does the things it does during our premenstrual cycle, which is an on -off of progesterone and an all the time of estrogen for a reason.
Kim (38:02.963)
does the things it does during our pre -monstrual cycle, which is an on
Kristin Johnson (38:10.872)
And that reason isn't fertility and menstruation. It's not. It's about that catalyst for all those physical processes in the body dependent upon them. So if we're going to give a woman HRT, why would we give it in a way that's not going to achieve the same catalyst responses? Right? And that's, you know, something and it's perfect. Marie and I totally get it. She had horrible periods in terms of pain. I had horrible periods in terms of heaviness. Neither one of us wanted to bring back those periods.
Kim (38:23.018)
in a way that's not going to achieve the same catalyst responses, right? And that's, you know, something. it's perfect with Moran. I totally get it. She had horrible...
for me here is
Kristin Johnson (38:39.598)
But that's not what you bring back with HRT. It's a very light, managed, no PMS, scheduled bleed, three days long, not a big deal. And we've lived it, so we can attest to that. And if it's not, then it's a sign for your provider to change your dosing and to mix things up. So we sit back and say, look, it's every woman's choice. We get it. Some women are like, no way, I am never bleeding again. That's fine. Just know what you're choosing. What you're choosing might not be,
Kim (38:57.195)
sit back and say, it's every woman's choice. We get it.
Kim (39:04.638)
That's
What you're choosing might not be protection against heart disease. It might not be protection for your bones because bones in particular have an on -off switch too.
Kristin Johnson (39:08.942)
protection against heart disease. It might not be protection for your bones because bones in particular have an on -off switch too, right? They're constantly remodeling. Fun fact, that's triggered by the estrogen and progesterone fluctuation. choose your period or choose a walker. Like that, at the end of the day, without being too harsh, and I know that was a little harsh, that is the choice that women are making. And we're just saying, just know what you're choosing. Don't do what you do because your doctor told you to. Do what you do because it matches your goals and your needs. And then
know, figure out who can kind of partner with you on that.
Kim (39:42.302)
Yeah. So estrogen twice a day, every day, and progesterone at night. then would it be 14 days or how often would somebody be taking their progesterone?
Maria Claps (39:54.497)
14 days, usually.
Kristin Johnson (39:56.27)
Yeah, and estrogen, that's if it's transdermal,
Kim (39:59.646)
Correct. Yes. Yeah. Yeah. And so is it to be expected then that there would be this small bleed for the rest of this person's life or would that eventually prop like could that eventually shut down either or not supposed to? Cool.
Maria Claps (40:13.505)
not supposed to.
Kristin Johnson (40:17.242)
And Maria, how old are some of our clients who are cycling? Yeah. Yeah. And we know a doctor who's got her 90 some year old mother still cycling. Yeah. And I read, talked about this yesterday. It'll sound a little weird to say this, but there's something sort of youthful feeling. And I know that's right. Yeah. Yeah.
Maria Claps (40:20.225)
70s.
Kim (40:21.693)
Wow.
Kim (40:26.578)
Wow.
Maria Claps (40:35.403)
Some women feel that way. Yeah, they do. We've heard it.
Kim (40:40.114)
That's really cool. Okay. Testosterone. You've brought that up. This is also another, excuse me, hotly debated topic. And one side is, you know, there's no research on women yet. we, we, that's our most abundant hormone in our fertile years. So what, where do you stand on testosterone replacement for women?
Maria Claps (41:03.083)
testosterone is the most abundant hormone. That's true. It's also a misleading trope. And that is because while it might be volume -wise the most abundant, it is not the most pertinent hormone for women. That is estradiol.
Kristin Johnson (41:22.456)
And where does estradiol come from? Right? It's partly comes from testosterone. We have this sort of chain of, you know, creation of our hormones. So at any given time, is it there, but is it always serving as testosterone? Right? It's not always biologically active as testosterone.
Maria Claps (41:25.803)
from our.
Maria Claps (41:40.945)
And a lot of women will say, you know, if I take testosterone, then I'm going to be able to make any estrolyl that I need. And that is good. That's in theory. We don't see that on blood tests. We just don't see that. And I just don't think women, you know, that we can rely on that. So.
Kristin Johnson (42:01.614)
Yeah, and I think if women understood that if you just took testosterone, there are going to be other changes down the line. And sadly, many of those are not reversible without incredible intervention. So you're going to have clitoral megaliths, or you're going to have a growth of a clitoris that may start to resemble a small penis. I think the number one thing Marie and I see is the voice box changes, and that just scares us. I mean, it's...
Kim (42:15.496)
believe.
Kim (42:24.599)
I mean, it's, yeah, hair loss is definitely in hair growth, right? We have a woman who grew a beard. mean, this is...
Kristin Johnson (42:26.274)
Yeah, hair loss definitely and hair growth, right? We have a woman who grew a beard. I mean, this is horrifying. That stuff can be reversed if you stop the testosterone, but the voice box changes can't. And that's really, really sad because it's a slow change. Most women don't see it, recognize it, hear it until someone's like, whoa, your voice is really low. And then it's like, the cat's out of the bag. There's no going back to your feminine voice.
Kim (42:37.32)
changes.
Kim (42:43.329)
recognize and hear it.
Maria Claps (42:52.545)
Yeah, and that's from large amounts and that is unfortunately really, really, really common. I mean, we've seen women with free testosterone, like 30, 50 and free that high. I'm saying the total, we've seen total gosh, hundreds and hundreds. know, that's just, that is not, we talk a lot about keeping in line with what is natural for the body and we call it physiologic and healthy.
Kristin Johnson (43:05.722)
400 or free. Yeah, yeah, yeah, free.
Maria Claps (43:22.507)
That is not physiologic. Now, that's like, that's a man's levels.
Kristin Johnson (43:28.004)
Yeah, yeah.
Kim (43:28.316)
Yeah. So, so a place for it potentially very small in a cream, not for everybody.
Kristin Johnson (43:34.202)
Yeah, there's a physician who's written a book on it who feels that the research is pretty clear that it's really only about 25 % of women actually need it. That's not to say only 25 % will benefit from it, right? There are definitely women who will see benefit, let's say in muscular retention or muscle gains, even at the lower levels. It's a modest assistance, right? It's not going to suddenly beef you up and have you looking all butchie.
libido is usually the number one thing, libido and energy that most women are sort of seeking from their testosterone. And as Maria just said, that's going to require supra physiologic levels in order to achieve gains in energy and sex drive. And that often doesn't last. that's something that a lot of, cause then they go more and more and more, and it becomes this sort of drug. And Maria and I can tell you the number one driver of libido of the hormones.
libido is so multifactorial, right? And so many women are like, I'm on this testosterone, it's not doing anything. And we're like, it's because it wasn't your problem. But estrogen, estradiol is the number one driver. And you can ask our husbands, like on our highest estrogen dose stays there, happy men. And there's a reason for that, you know? And so we just try and tell women like, be patient. If you're looking for a quick, red, easy button, sure.
testosterone might be it, but know what you're gonna get with that and know that it's probably not a long -term kind of solution for you.
Kim (45:05.118)
Okay, you said something there I want to just clarify before we start to wrap up on your highest dose days. you're also cycling the amount of estrogen. instead of, I'm just throwing a number, but instead of two pumps, one in the morning, one in the evening, it might be two pumps on a specific day, like two pumps in the morning, two pumps in the evening. So you're cycling how much of your estrogen as well.
Kristin Johnson (45:25.87)
Yeah, would say your, it's cycling would be on off. So we cycle progesterone and, or we can do it continuously. Most women are doing what's called static estrogen. So that same amount every day, or you can do rhythmic. So we do follow a rhythmic presentation of our estrogen in order to stimulate that peak and then have a lovely tape.
Kim (45:31.155)
Yes.
Kim (45:47.166)
Cool, interesting. All right, well, there is like, I could talk to you all day and we could go through your entire book. As I said, I've got about like the majority of your book earmarked and flagged and little notes written down. It's a tremendous book. When is it coming out? Where can people learn more about you, follow you, work with you?
Maria Claps (46:05.939)
It's coming out September 10th in the US and probably Canada as well. 10th, September 12th, it's supposed to come out in the UK then. And then they can follow us on Instagram, wiseandwell, and they can look at our website. Also wiseandwell .me.
Kim (46:25.404)
And name of the book is The Great Menopause Myth. Thank you for writing the book. Thank you for your work and for joining me today and sharing your wisdom. I can't wait for this to be my top recommendation for people to be reading earlier in life, not waiting until, yeah, yeah, exactly. Thank you so much.
Maria Claps (46:38.977)
Thank you. Yes. Thank you.
Kim (46:47.057)
Alright.
