Kim Vopni (00:01.673)
Dr. Fiona, lovely, I am really excited to have you on this episode. You are like an OG in the world of podcasts, especially as it pertains to the topic of menopause. And we're gonna jump into a kind of a specific aspect. We'll probably talk about a few things, but a really specific one that both you and I have become really kind of bullish on is MSK, musculoskeletal syndrome of menopause.
Dr. Fiona Lovely (00:30.286)
Yes.
Kim Vopni (00:30.611)
all these all these new syndromes of menopause that keep coming out right but I want you to introduce yourself tell us a little bit about who you are what you're a chiropractor what got you into the world of chiropractic what made you start a menopause podcast before podcasts were cool and before menopause was cool
Dr. Fiona Lovely (00:46.828)
goodness.
Yes, goodness. Okay, thank you for asking. First of all, I had a chiropractor that was influential to me when I was a kid. My mom took us, my brother and I, in to see a chiropractor because her brother had scoliosis really badly. And so it was, I think it was about 10 years old when I saw my first chiropractor and I absolutely loved her. She still practices from what I understand, which is amazing to me. And she was heavily influential for me. And so I entered chiropractic college. was sort of a late,
20s is when I started and pretty much right away by that point in my life I had experienced being gaslit by my gynecologist more than once. Now I we didn't have that term right we weren't using terms like you know are you are you woke are you gaslit all of these things right but I knew enough about my body Kim to know that what she was saying wasn't correct.
And I knew enough to or trusted myself enough to just not believe what she was saying. And sure enough, many years later, we come to find out that the exact thing she was gaslighting me about has now been shown to be true in the research.
When I started Chiropractic College, was very interested, I a keen interest in endocrinology. I really enjoyed the class that we had as part of our curriculum and I started taking additional classes on the weekends and whenever I could get seminars. At the time, it wasn't called functional medicine yet. I took it as restorative endocrinology. Keep in mind, this is 25 years ago. And I never thought I would practice it. I thought it was just going to be one of those things that I was adding to my knowledge library.
Dr. Fiona Lovely (02:34.704)
one of those things that I didn't ever want to be in a position again with my own body where I had a doctor tell me something that was true and I knew it to not be true.
And so I went about getting that information for myself first and foremost. I never in a thousand years thought I would ever be practicing talking about menopause. Like that was not even on the radar. And when I was in my first or second month of practice, like I was brand new. I had a lady in her forties come in. She was somewhere in her 20, sorry, lady in her forties come in to see me. She had a toddler with her and he was sort of clinging to her skirts and
she was coming in for low back pain as I recall and she said she asked me something and of course I had like three patients at the time so maybe I had full of patients I'm exaggerating I had full of patients so I had lots of time and so I just shared with her what I knew about the menopause transition we didn't even call it then we just called it he was either pre menopause or menopause right so she said you know I'm having all these symptoms my doctor says nothing's wrong with me you know what's happening and so I just shared when
I knew and she sat there just flummoxed. She's like, why isn't my doctor telling me this? And of course I'm just baby chiropractor. like, I don't know. I'm the spine doctor, right? But I was eager. lost the time. So I was eager to just share the information I had, cause that's just the person I am. love sharing information. And that was really influential for me because I saw in that moment,
She said to me, she said, can you, can you take care of my friends? I said, well, of course I can. I would love to please, please give me something to do. I've got this big education, give me something to do. And so I did. And that's how I started really what we call now functional medicine. That's how I started being a menopause expert.
Kim Vopni (04:20.647)
Yeah.
Dr. Fiona Lovely (04:35.702)
before I was even close to perimenopause. I was in my early 30s. And did I ever in a million years think that this is where my career would take me? Hell no. And I have loved every minute of it. No regrets. I would do it again in a heartbeat. I'm so grateful I made the choices that I did. And when I was about 10 years into practice, I sort of accidentally hired a podcast coach.
Kim Vopni (05:01.556)
As you do.
Dr. Fiona Lovely (05:02.446)
Again, was one of the as you do it was one of those Jesus take the wheel moments Kim You know the ones are talking about where you're just like, okay somebody else is in charge here like looking back on it now for sure I'm certain someone else was in charge the goddess was speaking through me. That's for sure and I had a friend that had hired a part I didn't even know what a podcast was at the time. I'd been doing lots of lectures in the community That's how I built my practice in my in my city and so lots of people knew me as the hormone Oracle and I was the chiropractor that was talking about menopause and
so people would come and see me for that and for non-menopausal things as well. And I was so busy in my practice, but I loved doing these community lectures. And I thought, well, maybe this podcast thing is like a lecture, but that people can like listen to on their own. I had no idea how it was even dispensed, okay? So I thought it was like, do we send people a file in their email? Like that's literally what I thought it was. So naive. Anyways, so I hired this podcast coach and...
He said, you know, have to come up with three episodes to start. So I did. thought, okay, well, what are the three things that women want to talk about most? And so I just started talking and we launched those three episodes. I was too chicken to do it. He actually pressed the launch button. I thought for sure, maybe my mother would listen. Maybe my patients would listen.
What I did not expect was within a very short amount of time that there were thousands of downloads of my little radio show. And that was 10 years ago. And some some years I've put out an episode every month or every week. And some years I've done nothing. And then COVID hit. And then we started talking about menopause. We really started talking about menopause.
and the retraction of the Women's Health Initiative and all of that just made it a different space. At the same time, I was going through the depths of my own perimenopause, still am. And so the time was just such an important factor here, but again, I'm just so grateful. So that's my story. That's...
Kim Vopni (07:11.878)
Okay, and do you have the domain for the hormone oracle? Yes!
Dr. Fiona Lovely (07:16.854)
No, should I? Okay, before you launch this show, need to... I had it on my card at one point, on my business card. Yeah, okay, I will.
Kim Vopni (07:25.746)
Yes, get it. Yeah, okay, that was a sidebar. Okay. Okay, so you are still now so like the interesting part to me is before menopause was really being talked about before podcasts were were out there and before you were also going through so this is something that you witnessed in in this one patient, you ended up starting to work with other people and were taking this knowledge that you had had aside from the chiropractic piece and integrating it.
And I just think that's so fascinating. And now you said you're in your own transition. So you are not on the post menopause side as of yet. What has your own menopause transition journey been like?
Dr. Fiona Lovely (08:02.517)
Mm-mm. Mm-mm.
Dr. Fiona Lovely (08:08.834)
Well, looking back now, I can tell you that the signs started at about 37. And here's the fascinating part. I didn't recognize that even though I was the hormone oracle talking about it. that's, yeah, that's another thing to come back to if we want to pick that up. about 37, I started having disrupted sleep and I would wake in the middle of the night and I wouldn't be able to fall back asleep real, real easily. I just learned to open up my iPad and have my book on the
Kim Vopni (08:20.374)
interesting.
Dr. Fiona Lovely (08:38.928)
mode and just read until I felt like I was sleepy again and sometimes that would be 20 minutes and sometimes it would be three hours and so that was the big one and then I remember
experiencing it still to this day that's been the single biggest thing for me is my sleep disruption which is now managed with HRT very well managed with HRT but you know I went to my doctor and asked all the questions I knew I didn't want to take a sleeping pill it was not interested and and I asked for progesterone she said I'll give you a month's worth but you need to go see a gynecologist of course the gynecologist said
You're too young for HRT. Anyways, so we're learning. We're learning, right? We're learning a lot. The doctors were taught in an old system. I remember being about 40 when I experienced the menopausal rage the first time. We need to bottle that stuff, Kim. Holy shit. Honestly, if we could figure out how to package women's rage. man.
Talk about a lightning bolt. So I literally was, I had just gone gluten free at 40 and I was attempting to make gyoza with a gluten free dough. Now, looking back on it now, I go, what the hell were you thinking? Of course that was gonna be a disaster. You need the stretch in order to get the dough pliable enough. I literally was throwing those things around my kitchen. I was so mad.
Kim Vopni (09:49.075)
Yeah.
Dr. Fiona Lovely (10:16.62)
Now, interestingly enough, the only other time I actually experienced rage like that was when I was taking the birth control pill as a young woman, which is one of the reasons that my doctor gaslit me was she said, no, that's not connected to the pill. you know, yeah, like, okay, well, listen, I'm not an angry person. anyways, so if women are experiencing that, I'm here to say to you that absolutely, if you're taking the birth control pill and you're feeling...
Kim Vopni (10:29.65)
Interesting.
Kim Vopni (10:34.898)
Yeah.
Dr. Fiona Lovely (10:43.018)
Emotional in a way that you were not before taking the pill chances are babe. It's the pill. Yeah. Yeah, it's the pill So kim i'm so far down the rabbit hole. I can't even remember what question you asked Okay, yeah yes. Yes my own so the rage which thankfully i've just seen a couple of times But it was enough to be memorable. I'm sure to my husband as well and then after that really
Kim Vopni (10:53.94)
I don't even remember what question I asked either. was your own menopause journey. Yeah.
Dr. Fiona Lovely (11:10.882)
did just fine until about, I don't it about two years ago or so, and I just started to feel flat. I was taking the HRT, I just started to feel flat, and I recognize now that I fell off the estrogen cliff is what happened. And it was precipitated by some...
estrogen detox that I was doing because I was estrogen dominant and for those of you listening the estrogen cliff is where literally you're cruising along at estradiols up nice and high and then all of sudden boom it's just gone and it's gone real fast and let yeah
Kim Vopni (11:45.64)
Just to clarify, sorry to interrupt you, when you say you were on HRT, were you on estrogen or just progesterone? Okay, got it. Okay.
Dr. Fiona Lovely (11:49.837)
No.
No, I'm still not on estrogen just progesterone at that point. Yeah, and to help me sleep which again it has done and my periods were still regular all of that was just sort of taking along and I fell off the cliff and I went flat and I'm a person that gets shit done. I have high drive. I've got lots of ideas in my head. I love engaging with people. I always have and all of a sudden I didn't want any of it. I felt awful. I felt ugly. I felt like I didn't want to talk to people. I didn't even want to leave
my house. I'm like is this depression? Like that's literally what went through my head and in talking to my hormone provider she said oh no you just fell off the estrogen cliff. She said we probably rapid we what had happened was I took dim too much dim for too long but it was only about two weeks.
Kim Vopni (12:40.136)
Really? Wow.
Dr. Fiona Lovely (12:40.648)
Yeah, yeah, so this is the thing I learned, know, all of these things are things I will learn from my own patients as well, but we've got to be really careful how we're giving DIMM in particular. And I was eating the broccoli sprouts as well. I was doing both at the same time and it was, it only took about two weeks and then I was just flat. So I did it too fast and it definitely had consequences. And I, it took a while to come for my system to come back online. I didn't go on estrogen. The test,
showing that I was okay in the estrogen zone but I did start using testosterone cream which really has helped with confidence, moods, sleep, certainly strength too. So that's been my journey really and I don't think if my listeners are listening to your episode they're going to hear that they haven't heard me talk about it quite that that way so thanks for asking.
Kim Vopni (13:38.453)
Cool. Thanks for sharing. think the thing to recognize is we see menopause portrayed as a list of symptoms and we know the common ones and hot flashes is right up there. Poor sleep, poor mood. Those are, I would say, kind of the top three. But it's very individualized in terms of how it influences each person. And some, there may be some overlap, but it really is, it's not a cookie cutter approach to how we deal with it. It's not a cookie cutter.
Dr. Fiona Lovely (13:39.724)
Yeah.
Kim Vopni (14:08.318)
hormone replacement therapy prescription. It's very individualized. for, I think this is my interpretation, but back from the women's, before the women's health initiative, it was very much a cookie cutter. just was, everybody was on conjugated equine estrogen or Prem Pro, two, if they had a uterus, they needed to have the progestin in there as well. And that was kind of it. And that's what it was. And then now what has changed, obviously we know more from the women's health initiative. We know the,
the inaccurate results that were portrayed, the craziness that ensued for 20 years, the whole generation that missed out on the benefits of hormone therapy. And now we've come to this place where there's bioidentical, which already did exist, but was never really talked about. was like witchcraft for a while, it was woo woo. Now it's becoming accepted by mainstream, but there's also now this highly individualized, nuanced approach, which I'm finding is happening
Dr. Fiona Lovely (14:56.364)
Mm-hmm.
Kim Vopni (15:06.95)
in nutrition, in longevity, in everything is now recognizing that we are all individual, unique people who might be experiencing the same phase of life, but we're all going to have different, different factors that play into what our experiences.
Dr. Fiona Lovely (15:24.096)
Yeah, absolutely. And that's part of what
I makes it difficult for medicine to treat us is because medicine likes protocolized things, right? So, you you've got this diagnosis, this is what we use to treat that. And what works for me, you know, lot of women my age are taking estrogen already. I'm not, okay, I've got lots of fat cells, which means my fat cells make estrogen. That's likely why I don't need it at this point. I don't know, is that a benefit? I'm not sure.
Kim Vopni (15:55.347)
Yeah.
Dr. Fiona Lovely (15:56.352)
But we do know that weight-bearing exercise is good for the bone So that's what I tell my patients who are always like, you know this and that and should I be worried about my body? Yes, you should be but keep in mind Those extra 20 pounds are also as good as your weighted vest. Anyways By the way, I did see your Instagram. It was really good or was it tick-tock about the weighted vest? So we'll talk about that. But yes, probably both so
Kim Vopni (16:07.516)
Hahaha
Kim Vopni (16:18.036)
Probably both. Yeah. Yeah. Okay. So that's a good segue into bone. So you and I both listened to a podcast episode. It was on the Mel Robbins podcast. It was with Dr. Vonda Wright. Dr. Vonda Wright has been taking over the world by storm making bone health sexy again. I'm hoping Dr. Wright if you're listening you did say yes that you would come on my podcast. I hope that you will still come on my podcast to join me because I'm really curious about
Dr. Fiona Lovely (16:28.556)
Yeah. Yes.
Kim Vopni (16:47.09)
The messaging that's out there for in this menopause explosion of the conversation exploding is women need to lift very heavy and we need to do impact exercise. And of course in the world of pelvic health, there are a lot of people who have self-selected themselves out of impact, out of heavy resistance training or maybe have been told, don't do resistance training, don't do impact. And many of those people were also the people in that.
Women's Health Initiative era where hormones are going to kill you, you can't have them. So they were without hormones, dealing with pelvic floor struggles, not doing impact, not doing resistance training. Now they're being told that they're supposed to. I'm trying to bridge the gap there of let's optimize the pelvic floor and let's get you going. I'm coming back to that episode was very, very eye opening. was, it's something that will be shared in the notes. I've shared it in my community as well. I'm witnessing it with my aging.
parents, a lot of people in our age are also witnessing that as well. What got you fired up about that episode? I will share what did for me too, but
Dr. Fiona Lovely (17:54.24)
Yeah, so...
I it was about a year ago, I saw Dr. Wright, who's an orthopedic surgeon, for those listening, her Instagram is excellent, please go follow her. I saw her talk about the MSM, and it was like one of those moments where, just to be dramatic for a second, because I am a Leo, everything sort of falls away and goes dark, and I'm literally left looking at my phone going, holy shit, this explains everything.
So at the time I made a bunch of notes about what she was talking and I started to go into the research of what she was talking. It turns out she was in creating her own paper and Kim if you have not read that paper, it's excellent, it's excellent, excellent.
Kim Vopni (18:38.816)
I've read it. Yeah. And just to clarify, the MSM is the musculoskeletal syndrome of menopause.
Dr. Fiona Lovely (18:46.41)
Yes, yes, yes. So...
And I for one am actually, I'm for, I'm loving the creation of these syndromes because they help compartmentalize so that medicine can treat us, right? It's not for the patient, right, so much, but it also helps us with the understanding, right? And what Dr. Wright's research shows, and of course this was when I was looking at the research, it was before her paper had been released, her and her colleagues.
and I became quite surprised to say the least, that's me being polite, that we first talked about the arthritis of menopause showed up as terminology in the medical literature in 1927, 100 freaking years. So this is, again, this is gonna get fiery, Kim. Okay, good, good.
Kim Vopni (19:43.38)
I'm ready, I'm ready.
Dr. Fiona Lovely (19:46.51)
100 years now I did my chiropractic training 25 years ago as we talked about Never once in my training as a spinal specialist as a joint health
muscle, tendon, ligament, bone health expert, doctorate level expert, was I ever told about the musculoskeletal syndrome and menopause or even that estradiol has massive effect on these tissues, which we know it does. Estradiol also is a pain modulator.
Why was this is what I deal with in my chiropractic practice every single day is People in pain primarily women in pain women come into my office. They have a great experience. They send their men in You know, they send their sons and their kids and their sisters and their neighbors and aunties and whatever. So essentially I've worked with this syndrome for 20 plus years and It just it wasn't until I saw dr. Wright's post on instagram that I literally
went, holy shit this is it. This changes everything. So in when I go into the research I get pretty fired up about it because it explains much of what I've seen in my clinical practice. It explains why women in their 40s show up in my office with frozen shoulder, plantar fasciitis,
Gluten tendinopathy so for those of you that are listening that's low back pain that shows up with either your sacroiliac joint your physio your chiro's already told you about that your massage therapist told you that's what it's called Or it's pain the glutes. So it's literally a pain in your ass. Okay, it's sore knees Right and what happens to women in our system that go to the doctor and say I've got sore knees This is what the doctors say you need a knee replacement But I'm not gonna put you on the two to three your weight list until you lose 50 pounds Helen
Dr. Fiona Lovely (21:50.164)
the hell are you gonna lose 50 pounds when your knees are in pain when your hips are in pain when you've got heel pain like it just doesn't make sense so again I get really fiery about this because to me it's it's
its answers to questions that we've had clinically and have not had good solutions for. Now when I look at the research I can see multiple examples of women taking estrogen, progesterone, testosterone, DHEA all play a role as well we can talk about those a little bit if you want but I'm talking about estradiol in particular right now which is the strongest form of estrogen.
The women who take estrogen replacement therapy, potentially with the others as well, have less fractures, have better bone density, have less muscle pain and joint pain. They have healthier tendons and ligaments.
and they've got more stem cells in the muscles themselves, which is really, really important because the stem cells are the ones that take care of things. And so we have less osteoarthritis as well. And this is the research I found this morning when I sent you the message, I'm like, blah, we gotta talk about this. How did I not know about this? Women who take hormone replacement therapy have more robust intravertebral discs.
Now as a chiropractor, I'm particularly interested in that because I see a lot of disc injuries and disc related injuries that typically happen in the low back or the neck causing pain that can last years if it's not managed. So the thing about this research body is that it's 30 years deep.
Kim Vopni (23:40.435)
Yeah.
Dr. Fiona Lovely (23:42.126)
I was in school. Why didn't anybody tell me this? Why do we not have continuing education loaded with this stuff? I asked the physios in my office. I said, do you guys know about this? Like, why are we just starting to hear about it, but not from our governing bodies? Right? Once again, women have to self source health and this gets me fired up.
Kim Vopni (24:07.848)
Yeah, yeah. Hallelujah. I yeah, I all of the above is for me as well that it's been and I can appreciate why it's even more so for you having been trained as you say you were a bone spine doctor. Yeah, all of the things and not one thing was communicated and I think also when with what I'm now
Dr. Fiona Lovely (24:21.89)
Yeah, yeah, yes.
Kim Vopni (24:31.186)
learning and following various people specific about bone and it's funny because back in the day when I first became a personal trainer almost 30 years ago, I was teaching everything and one of which was an osteo fit class. This is a Canadian organization now called BoneFit, but I was teaching an osteoporosis basically, a class for people with osteoporosis. And my knowledge at the time was what I had learned in that course and there was no mention of anything to do with hormones in there. It was all movement.
and reduce fracture risk and balance, which is important. I want to say that. But now coming back to here I am now again, almost three years later, being post menopause myself, all the people in my community who are in that phase of life, many of whom have missed out on this information, knowing that our peak bone development is at age 30. So also kind of like, why aren't we teaching? You know, I think school honestly,
Forget history, forget social studies, forget that. It should be science and body. Really, that's what school should be, is to teach us about our bodies and the systems and become experts in our bodies and we can learn history and all the other stuff with YouTube.
Dr. Fiona Lovely (25:37.421)
Mm-hmm.
Dr. Fiona Lovely (25:47.182)
We also need to have accounting, how to balance, checkbook, and investments because that's the other thing. We get so messed up about that, about money stuff, and then we get to, for me, I get to 40, 45, I'm like, oh, retirement? What's that? My dad was an accountant. I should have known better. Anyways, go on. Yes, I totally agree with you. Yep.
Kim Vopni (25:51.048)
Yes. Yes. Yes.
Kim Vopni (25:57.14)
1000%.
Kim Vopni (26:01.332)
What's an R.S.P.? Yeah.
Kim Vopni (26:06.952)
Yes, yes. So peak bone mass at age 30. I feel blessed that I was always in sports. I did from around age 15. I remember going to aerobics classes. However, here's the other part that was also kind of firing me up was at the time and still I would say there was women's gym, pink weights, light weights, aerobics, leg warmers, butt up, you know, the up your butt leotards. I wore them.
Dr. Fiona Lovely (26:28.172)
Ha! Yes.
Dr. Fiona Lovely (26:34.798)
The bump, bump did you really? come on. So good. Bump floss. Yep.
Kim Vopni (26:37.14)
Yes, of course I did. Oh my gosh. Yes, it was like, you know, you had the tights and then you had the one piece bodysuit that went on top and the straight. It was like a was like a thong underwear except over top of the tights and and maybe leg warmers too. Right. But anyway, so aerobics. Sure, you could say there's a little bit of impact in there, but it was very much women do cardio, men lift weights. And I did start lifting a little bit, but it was very high rep, low weight.
Dr. Fiona Lovely (26:44.364)
Yeah.
Dr. Fiona Lovely (26:51.746)
So good.
Kim Vopni (27:06.292)
I wouldn't consider myself doing resistance training really to any major degree. Even after I became a personal trainer, I was lifting weights, but I would still say I was in the women do it this way category and not heavy lifting. You know what I mean? So just kind of like if we were given this information ahead of time earlier in our life to plant the seed, we have to do a really a lot of work.
by the age 30. And it doesn't mean that you can stop at age 30 because you've reached your peak bone mass. what we're learning about it when we are now 20, 30, 40 years later, plus many of whom have lost out on that estrogen piece. Plus, we've been in that cardio era where we spend an hour or two hours a day on an elliptical machine to, you know, to reduce impact on our knees. Yet the impact is what is really ultimately going to be helping us. Right? Yeah. So
Dr. Fiona Lovely (28:01.452)
Yeah, yes, yes.
Kim Vopni (28:04.828)
Anyway, that was kind of what I would my big takeaway from there. And also another takeaway was her recommendation of what heavy lifting is. So four sets of four to six repetitions where that last, you know, one to two reps is you're not a complete failure, but it's very difficult. And again, I just think of all the people in my world who have been told don't lift anything over 10 pounds or
Dr. Fiona Lovely (28:12.694)
Yes. Yes, that was so good.
Kim Vopni (28:34.568)
Don't jump, don't run, don't do all of these things who are now struggling with osteoporosis and now they're even more afraid to move. Yeah, yeah, it's.
Dr. Fiona Lovely (28:44.684)
Yes, yeah and they're still being told that they can't have estrogen which is a whole other problem.
You know, it's an interesting thing. A couple of things I want to pick up on. The lift heavy movement. Fantastic. And I like that Dr. Wright took the time to explain what that is. As a chiropractor, I'm the one people call when they screw this one up and hurt themselves. Right? So whenever I hear an influencer say lift heavy, I'm like, hold on a second. Can we talk about technique? Please. Like, let's get the technique right. Exactly. Exactly. And
Kim Vopni (29:08.094)
Yeah.
Kim Vopni (29:16.762)
progressive overload. You don't just... yeah.
Dr. Fiona Lovely (29:21.182)
I always say, because for me, when I first heard resistance training lift heavy, I thought, my God, I have no idea how to do that. And my God.
No, right like just no like I can't thought I can't even imagine going into my gym back then and Lifting weights with the blokes like the the sweaty blokes that throw the the big heavy weights on the ground I'm like, I don't want any part of that. But at the same time I don't really want any part of the whole pink weights thing either which you know is fine We're figuring the way through Kim and I think that's what's important but what I want to say here is that if you hear us talk about
Resistance or heavy lifting, please go to resistance first Pick up a resistance band You can get them for next to now you buy them at the dollar store and a yoga mat and get yourself a free app on your phone and literally just Use your body weight use the resistance bands. It's going to give you confidence
It's gonna make you feel like hey, you know what I can probably do this rather than all of the the uphill stuff This was true for me too of getting to the place where I could go with the sweaty blokes who are the most supportive people ever by the way So I just would like to say that too, but do it do that do it with the right technique. It's really really important For sure. Yeah Yeah
Kim Vopni (30:42.644)
Yeah, yeah, 1000%. So the hormone piece I want to cover on here as well. So I know you just did a post and an episode strictly on progesterone. That's something that you are taking right now. That is something that I like when you when you hear of the benefits of estrogen, bone health is it's the number one prevention for prevention of osteoporosis with is with estrogen. However, there's nothing
Dr. Fiona Lovely (30:54.476)
Yes, ma'am.
Kim Vopni (31:09.628)
really communicated about how beneficial progesterone is for our bones. Okay, go!
Dr. Fiona Lovely (31:14.112)
Let me get started. All right, okay, so first of all, you have to recognize that the bias in the missing information is that the medical research has been progesterone is associated with pregnancy and reproduction period. Okay, and that women have been left out of the research and the conversation about
longevity etc because of the unstable or the unstable nature of our monthly cycle. Okay so there just is a huge gap in research number one so we just don't have as much information available on progesterone that we do and what we do have is primarily based on the synthetic progestin which has a number of problems with it and yes that is the progesterone in air quotes that is in your birth control pill that was
in your PremPro and in a number of other things. And that's actually the number one question I get asked on the podcast or on my TikTok channel is, do I need progesterone still if I have an IUD?
So these are not the same things. I just wanna say that. The synthetic progesterone that's in the IOD and the birth control pill, et cetera, is not the same thing as natural progesterone. And we're learning a lot about progesterone. It is sedating. Now that worked like really well for me because my primary issue was sleeping through the night. And so we've got it to the point now, my prescriber and I, that I've just take a dose. Although I'm looking now at, did you see our friend Zora's episode?
with Felice Gersh, did you the most recent one? So now I'm looking at doing more of a cyclic...
Kim Vopni (33:01.756)
And Karen too, Karen Martell also just did one about cycling as well.
Dr. Fiona Lovely (33:05.518)
Okay, fantastic. haven't she I think she might have shared that I have to listen to that Thank you for the reminder. So I know Karen loves to talk about the cycling for the progesterone. So Last night as I was getting dispensing out my pills. I was like, uh-huh. Is this the night? gonna go I was like no, no, I gotta be sharp for Kim. No, I can't this is not the night to not sleep
Kim Vopni (33:26.813)
haha
Dr. Fiona Lovely (33:30.806)
So, but I'm paying attention to the research as it's coming out. So let's just say that. What's really interesting when I was doing this research after seeing Dr. Wright's post last year.
And I know it was last year because I looked it up in the last few days in preparation for this and it was March of 24 was when she put it out and she first started talking about this as the syndrome of menopause musculoskeletal syndrome or menopause. Anyway, so I was looking at the progesterone specific research and where it plays a role and it's more from what we've got in the research body nervous system related.
Now this is really, really, really important when we are talking about musculoskeletal system because the brain commands the musculoskeletal system. It does that through the spinal cord, the nerves that come off the spinal cord called the peripheral nervous system and out to all of the tissues to signal us signal, first of all, balance and movement coordination. But also we have these antagonistic pairs of muscles in our bodies. And so if the nervous system is
signaling those muscles correctly this is another element of the MSM that Dr. Wright hasn't talked about in her research but again she's an orthopedic surgeon so she's gonna focus on the joint related stuff right so I can bring this element in as a brain expert which is I guess the thing we didn't talk about at the beginning of the episode but that's fine
Kim Vopni (34:57.789)
yeah, there's that too.
Dr. Fiona Lovely (34:58.484)
Yes, right. That's my post-doctorate fellowship training is in functional neurology. And so essentially I fix broken brains in my office. So if we're not talking about hormones, we're talking about brains in my office.
And right now you're going, you've got chiropractic patients too? Yeah, maybe I need to slow down a little bit, Kim, right? Like, Jesus. Although the chiropractic patients love it, because they just can come in and ask me any question and I've got generally an answer for them. So when we're talking about the nervous system, progesterone can be made by all of the glial cells, which are the primary support cells. They make up vastly the majority of the bulk of the nervous system, whether it's the peripheral nerves or it's the central nervous system, brain and spinal cord.
And so all the glial cells in the whole entire body can make progesterone. Wow. What does that even mean? Okay, so again, we don't have the research. So I'm only extrapolating what I can figure out of what I know from having my expertise here, but we know progesterone offers neuroprotection. We know that. That's one of the things that is being looked at in terms of preventing Alzheimer's and dementia.
and is progesterone a factor? Not progestin. We're really clear that that is not helpful. Okay, but progesterone itself, natural, bioidentical if you will. I don't know why that became a dirty word. That's exactly what it is. It's bioidentical. Compounded progesterone or not. We can get it on prescription here in North America. It's called Prometrium. So it's neuroprotective. It is also neuroprotective of motor function.
and that is the movement coordination, balance, et cetera. And so when we're talking about frailty, that was probably my favorite part of that episode was Dr. Wright, which I could not put down, by the way. It was so, so good. I was, as soon as I heard it, I got to send it to you guys, because I was like, guys, you got to listen to this, this is crazy good. Dr. Wright has also just been on the diary of a CEO with Steven Bartlett. I haven't heard that one yet, have you? Yeah, okay.
Kim Vopni (37:03.228)
No, I haven't. I've heard the little clips of it, but I haven't watched the whole thing.
Dr. Fiona Lovely (37:06.304)
Yep, so that'll be a good episode for sure as well. She talked about frailty and this is how she talks about it. As an orthopedic surgeon, she's called to the hospital to round on a patient who is typically a woman in her 60s, 70s, 80s, who has broken a hip and she's being called in as the surgeon to take care of the broken hip. And she finds a woman who is incontinent and confused.
So she's got the dementia piece happening, she's got the incontinence piece happening, and she's got the osteoporosis slash hip fracture, which she may or may not have even known about, right?
Kim Vopni (37:46.317)
And the other the other compelling piece of that story to interrupt you was also that she said her as a surgeon that that person has to be in a certain level of health cardiovascularly in order for them to even perform the surgery and now again, they've been without hormone they if she had been struggling, we don't know beforehand with pelvic dysfunction, she may have opted out or been told not to do certain things. So her overall the
Dr. Fiona Lovely (37:49.26)
Yes, please.
Kim Vopni (38:13.224)
The additional health risk factors are now also going to be elevated to a state where she may not even be able to undergo that surgery. That was the other piece was like for her as a physician, how heartbreaking it is to see that woman there in that state, but then to not necessarily immediately be able to help her.
Dr. Fiona Lovely (38:25.208)
Yes.
Dr. Fiona Lovely (38:30.124)
Yes, and of course we know estradiol in particular is cardio protective as well. there's just, the way she just is able to explain it and sort of set the table and say, is what we're dealing with, let's fix it. Again, that gets me pretty fired up. That's like rocket fuel to a person like me. But anyways, so we want the balance and movement coordination piece of it. So this is where progesterone comes in, is that we know it's neuroprotective. Now here's something interesting that,
Kim Vopni (38:34.526)
Yeah, yeah.
Dr. Fiona Lovely (39:00.208)
really been thinking about clinically because here in Alberta we are the highest incidence of MS, multiple sclerosis of anywhere on the planet. Yes, southern Alberta.
Kim Vopni (39:10.066)
Really?
Dr. Fiona Lovely (39:13.474)
they figure it has to do with the pesticides of the farming around us. Okay, so now you and I aren't surprised by that because we've seen this stuff enough that we know there's, of course there's gonna be consequences. But progesterone is remyelinating.
MS is a demyelination disease. I know exactly that makes me the I this is when I get the righteous anger comes up. Where the fuck has this information been? I literally could cry when I think about all the patients I've had with MS who have been told that they just need to prepare their affairs to live a life where their mobility isn't very good.
Kim Vopni (39:36.148)
Wow.
Dr. Fiona Lovely (40:00.428)
to not be given options except these, you know, high flying biologics. Sometimes they're affordable, sometimes they're not. Sometimes the government will kick in and cover it. Sometimes they won't. You know, like, where is this information to really be helpful? Pardon my French. I should have asked if I'm allowed to swear.
Kim Vopni (40:19.348)
Yeah, yeah. You can drop it, drop any of it. Be you, it's all good, yep.
Dr. Fiona Lovely (40:25.934)
Yeah, okay, well, and this is what I say quite often, is that if you are working in women's health right now and you're not saying fuck on the regular basis, you're not paying attention. Tell me I'm wrong, Kim!
Kim Vopni (40:41.588)
I will not tell you you're wrong. I'm with you, babe. I'm with you.
Dr. Fiona Lovely (40:46.99)
Anyways, so progesterone that was a really long way of saying progesterone is Remyelinating for anyone listening to this Take this to your doctor and see what isn't it worth a shot? Right, isn't it worth trying?
Kim Vopni (40:48.422)
Yes. Wow!
Kim Vopni (40:55.187)
Wow.
Kim Vopni (41:06.11)
So here's something else that also now is getting, that I get fired up about with what you've just said there, is in perimenopause, for other, there's other times of life, but very commonly in perimenopause, women bleed very heavily. One of the main reasons for hysterectomy is heavy bleeding.
They are never offered progesterone, which could often resolve that heavy bleeding. And then on the post hysterectomy side, if they are lucky enough to find somebody who would support them with HRT, they are told you don't need progesterone because you don't have a uterus. So the other thing is that progesterone is only thought of from an HRT perspective as to protect the lining of the uterus. We only need progesterone for that.
Dr. Fiona Lovely (41:34.926)
Serenity now?
Dr. Fiona Lovely (41:56.866)
Can we stop valuing women by their uterus and their ability to reproduce? For God's sakes, can we stop that now? I'm done. Like I'm done with that. That's crap. I see that coming. I just answered a question this morning on my TikTok page where someone had said,
Kim Vopni (42:02.088)
Yeah. Yeah.
Dr. Fiona Lovely (42:14.912)
that she had a hysterectomy in her 30s because of these symptoms. But when she went to her doctor to ask for help with the menopause symptoms, which of course would be caused by the surgically induced hysterectomy in her 30s, her doctor said she's too young for them. I was like, what?
Kim Vopni (42:37.044)
It's bonkers. It's bonkers. Yeah. So all the people who've been, who've had their uterus taken out at whatever age for whatever reason. Yep. And now they are told they don't need progesterone. So they are offered estrogen, which, okay, there's some role of estrogen and at least they have something. But I just think that just because your uterus doesn't necessarily, you don't have a uterus that would need protection there, it doesn't mean the whole rest of your body would not benefit from progesterone.
Dr. Fiona Lovely (42:38.188)
Does it even make sense? No, it does not make sense.
Dr. Fiona Lovely (42:45.6)
as if they were disposable.
Dr. Fiona Lovely (43:06.252)
That's right, absolutely. And we're learning more and more about the importance of progesterone for cognitive health as well.
Kim Vopni (43:13.268)
Yeah, yeah. So progesterone is the first hormone to start its decline as we are in the approach to our menopause. At what point, from your perspective, I know you don't, I shouldn't assume this, you don't prescribe hormones. No. So at what point would you recommend somebody working with a practitioner, a hormone practitioner?
Dr. Fiona Lovely (43:19.971)
Yep.
Dr. Fiona Lovely (43:30.849)
No, no, no.
Kim Vopni (43:39.785)
to potentially address. I always look at it as like, can we get ahead of the game? Can we step in early and intervene? Can we prevent the shit storm of perimenopause or reduce the craziness by intervening earlier rather than waiting until we have something to overcome? Yeah.
Dr. Fiona Lovely (43:48.686)
Yes. Yes.
Dr. Fiona Lovely (43:58.622)
Absolutely. And I think this was actually this last podcast episode that you're referring to, which is episode 161, if I remember correctly. That was literally what I wanted to address was why aren't we doing preventative thinking around menopause? And know, medicine isn't really set up to do prevention of disease. Medicine is set up and they're the ones that have the prescribing on this, right? Now in BC, naturopaths can do it.
in Alberta they cannot. So it literally is nurse practitioners, think physicians assistants, although there's very few of them, and medical doctors are the ones who can prescribe. So why aren't we looking at this earlier? So this was the episode I recorded, because my thought was, why aren't we just offering women at the age of 40 progesterone for support?
We already have it on board. You know, this is the thing I come up against sometimes is is is women like well don't want to take HRT because It's just a lot I'm like babe, how many years did you take the pill? Did you think that once? HRT is a fraction of the hormones that are in the birth control pill So you need to think about where you picked up that crummy thinking because it actually doesn't even apply right and I think Kelly Casper son talks about this too. says well, why are we why are we vilifying these?
hormones when women have had these hormones in our bodies our whole lives, especially testosterone. We're talking about her. So, you know, sometimes you don't even realize that you have disordered thinking about something until someone sort of reveals it to you, right? I'm the same way. I had to have those thinking too, not necessarily about HRT, but, other things. But I think, I think offering women support for perimenopause
Kim Vopni (45:27.144)
Yeah. Yeah.
Dr. Fiona Lovely (45:53.566)
before the symptoms become problematic. Because what usually shows up in that era of perimenopause? It's typically sleep changes and mood changes. In fact, a woman is more likely to be misdiagnosed chronic fatigue and fibromyalgia in her late 30s than at any other time in her life. Guess what? That's medicine misunderstanding perimenopause.
So if we can support the system, by the way, looking back now at 37, 38, I had frozen shoulder. Okay, so here we are. It took me almost 10 years for that pain to go away. I saw every, I have access to the best practitioners. Cairo.
Physio, massage therapy, craniosacral therapy, acupuncture, you name it. I had tried it and it really wasn't until I started progesterone. Now I didn't see those two because it was such a long period of time I didn't recognize it. But looking back on it now, that was a big part of it. I've also had plantar fasciitis but I worked in a practice that had hardwood floors. I didn't make that decision on hardwood floors but I'm no longer in that practice but for the people that are standing on...
Kim Vopni (47:04.337)
Yeah
Dr. Fiona Lovely (47:08.418)
it all day long it probably have some cushioning would be good. I figured that's what it was but maybe not. Maybe not, right? So what if we could start to recognize what the patterns of perimenopause are and support women earlier? And that's ultimately what I talked about this episode and and I do believe that's that's a good place to start. And I know you and I and and Karen Martel and and Zora Benamou and the others are talking about
how do we dose progesterone differently? And we're learning. As the science evolves, we will change how we take it as well too. But for now, I mean, back then, even just one tiny little hundred milligram capsule of progesterone made a world of difference to my sleep and therefore my mood and the quality of my life and my work. Easy to do. It's easy to do.
Kim Vopni (48:00.137)
Yeah. Dr. Doug Lucas, who was recently on the show, was talking about he's, he's also, trained in, in hormone therapy and he does typically the physiologic dosing. the cyclic dosing and he, have not read this research myself as of yet. So I, I'm just going on what he had communicated that the, it's this small amount of evidence that exists.
about bone health in particular was favored cyclic as opposed to static dosing. Yeah, so I myself am a static dose person. I have not done enough and I'm still actually in the middle of the episode with Karen, but I'm still doing my own research on the cyclic versus static. And I also feel good on the static and I don't want
Dr. Fiona Lovely (48:36.299)
Interesting.
Dr. Fiona Lovely (48:58.957)
Exactly!
Kim Vopni (48:59.63)
period again, right? So then you're kind of like, but yeah, but anyway, it's it's an interesting it's an interesting time to be like all the like Dr. Felizcar shoes who is also going to be coming on the show. She I just I laugh because you could just basically say hello, please introduce yourself and she will run the entire show like the knowledge that woman has in her brain is just I could listen to her all day.
long. So I'm really excited about that. But anyway, so point being Dr. Lucas right now has seen some research and evidence about cyclic being favorable for bone. And we have to kind of factor in all of the things. And does that mean that static is not favorable or detrimental to bone? There's nothing to show that. But anyway, up for debate still to be determined.
Dr. Fiona Lovely (49:50.328)
Did he say whether or not he's seen the research on, does progesterone affect osteoclasts, osteoblasts? What are we talking about? Did he talk about that?
Kim Vopni (49:58.843)
it. Yes, I'd have to go back and listen. It was the it was specifically the progesterone and higher levels of estrogen. And I believe it was the prevention of the osteoblast, I think.
Dr. Fiona Lovely (50:05.506)
Yes.
Yep.
Dr. Fiona Lovely (50:15.252)
Yes, okay. Isn't that so interesting? Okay. That's a thank you for giving me an excuse to go back into the research to find another thing to be righteously angry about.
Kim Vopni (50:17.864)
I'd have to go back and listen, don't quote me on that part, but.
Kim Vopni (50:26.152)
Another rabbit hole. We could do this all day, really. Yeah. Yeah. Okay. Well, we're way over time and you have shared so much information. could kind of like for least Gersh, I could sit here and chat with you all day. I so appreciate your brain. I appreciate your laugh. Probably more so than your brain. Yes. Thank you for everything that you do for for women and for women's health and what you have
Dr. Fiona Lovely (50:32.288)
I know, it's fun!
Dr. Fiona Lovely (50:48.206)
Thank you. Thank you.
Kim Vopni (50:56.104)
You started doing it way before other people were doing it. Like I said before, it was cool. Where can people find you and learn more? Where can they listen to your podcast?
Dr. Fiona Lovely (51:04.757)
Okay, awesome, thank you. So thank you for saying that. It's quite accidental, but I appreciate that people are recognizing it now.
Kim Vopni (51:10.836)
however we get to it.
Dr. Fiona Lovely (51:13.066)
Exactly, exactly. My website is drlovely.com, sort of all roads lead back to the website. You can find me on TikTok and Instagram at Dr. Fiona Lovely. And the web, sort of the podcast is called Not Your Mother's Menopause. And it's my great pleasure to interview beautiful experts from around the world. Kim, you're coming on the show next month, I think, is when you're on the show. So we'll be talking about pelvic floor health with you. I don't know, is that what you want to talk about?
Kim Vopni (51:36.35)
Mm-hmm.
Kim Vopni (51:43.22)
probably yeah, cause that's yeah. Yeah.
Dr. Fiona Lovely (51:43.873)
Sure. Okay, yeah. It could be whatever. We'll just turn on. I don't buy that for a second. So thank you again. I really appreciate being here today with you.
Kim Vopni (51:48.724)
I don't know anything else.
Kim Vopni (51:54.931)
You
Kim Vopni (51:59.103)
You're amazing. Thank you.
