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HerMoney Podcast Episode 267: The Menopause Manifesto With Dr. Jen Gunter

Kathryn Tuggle  |  May 26, 2021

Nothing is off the table in this episode: Hot flashes, supplements, hormone replacement therapy, managing our careers, and so much more. 

On this week’s HerMoney podcast, we sit down with Dr. Jen Gunter, an OB/GYN with more than three decades of experience as a vulvar and vaginal diseases expert. She’s routinely referred to as “Twitter’s resident OB/GYN,” she’s author of the international bestseller, “The Vagina Bible,” and her new book, “The Menopause Manifesto” just hit bookstore shelves this month. 

We dive into her new book and have a candid discussion about what it really means to go through menopause — not just to survive it, but to move through it in a better, more empowered way. 

Menopause is something that most women go through between ages 45 and 55, and a woman is considered officially in menopause one full year after her last period. But this time in our lives is so much more complex than that, as Dr. Gunter has described for decades. She summed up many women’s struggle with menopause in a popular article she wrote for Glamour last year, which you can read in its entirety here (and we highly recommend doing so). She writes: 

“What if I told you that something major was going to happen to your body, but instead of accurate information, you’ll receive a barrage of negative messaging and be slapped with depressing stereotypes? That’s menopause for many women.

Menopause is simply puberty in reverse. But while puberty is celebrated, menopause is ignored.

Menopausal women are expected to choose their player—witch, lady detective, snarky matriarch, or woman with an ever increasing number of cats—and cope in silence, as their value to a patriarchal society vanishes along with their estrogen.

Consequently, many women don’t know what to expect when they’re no longer expecting a period, and that lack of information can be frightening and disempowering. It can negatively impact quality of life and even lead to serious health consequences. Take hot flushes, for example. Many women are told by their medical providers that they are something to simply endure or that they aren’t bad enough to need treatment.

When we exclude menopause from our discourse, we say it doesn’t matter. But I’m here to change that. It shouldn’t take an act of feminism to understand what’s happening to your body or to find the therapies that you need to improve your health, longevity, and happiness.” 

Listen in as Jean and Dr. Gunter dive into what it really means to be “Twitter’s resident OB/GYN” and discuss how she got her start, both as a physician and an author. We talk about her first book “The Vagina Bible,” which has been translated into nineteen languages, and her new release, “The Menopause Manifesto.” 

Jean asks Dr. Gunter: “What is it about this period in a woman’s life that calls out for a feminist leader — that calls out for a manifesto? Why do we need a manifesto? The pair break down and dispel some of the worst misconceptions surrounding menopause and women’s health. And while we dive into some of the bigger challenges that women face during this time in their lives — hot flashes, hormonal changes, and more — we also talk about how this phase of our lives can be beautiful and incredibly empowering. We also talk about specific steps (including supplements and hormone replacement therapy) that women can take to manage their transition into menopause. 

“Menopause is a time when you have all this world experience to use, and you shouldn’t be defined by what your ovaries are doing,” Dr. Gunter says. “For me, I started writing for the New York Times after the age of 50. I met the love of my life over the age of 50, and I think it’s really important not to accept those patriarchal views that you’re done, and to think: I have so much more to offer. I now have this collective life experience that has accumulated, and this is ‘Me, 2.0.’” 

In Mailbag, Jean and Kathryn dive into questions around retirement savings benchmarks for a couple who have very different levels of savings, and we hear from a listener who is considering buying a home outside Washington, D.C., but is unsure of whether she should take the plunge in this crazy market. Then, in Thrive, how to get comfortable asking for a raise — and why more women don’t do it.

This podcast is proudly supported by Fidelity Investments. Life is full of big moments—both the planned and the unexpected. Fidelity can help you navigate both with confidence. Learn more at Fidelity.com/HerMoney. Fidelity Brokerage Services LLC Member NYSE, SIPC.

Editor’s note: We maintain a strict editorial policy and a judgment-free zone for our community, and we also strive to remain transparent in everything we do. Posts may contain references and links to products from our partners. Learn more about how we make money.

Transcript

Jen Gunter: (00:01)
Menopause is a time when you have all this world experience to use and, you know, you shouldn’t be defined by what your ovaries are doing. And for me, I started writing for The New York Times after the age of 50. I met the love of my life over the age of 50. And I think that it’s really important not to accept those patriarchal views that you’re done. And to think I have so much more to offer. I now have this collective life experience that has sort of accumulated, and this is like me 2.0.

Jean Chatzky: (00:38)
HerMoney is supported by Fidelity Investments. At Fidelity. We believe planning for retirement can help you feel better about where you stand today and more prepared for tomorrow. Visit Fidelity.com/HerMoney to learn more. Hey everybody, I’m Jean Chatzky. Thank you so much for joining me today on HerMoney. I want to just start by saying that I love all the episodes of our show and all of our guests, but that today’s show is a really special one. It is one that I’m so excited about. I am sitting down with Dr. Jen Gunter, and she is an OB/GYN with more than three decades of experience as Evolver and vaginal diseases expert. She is routinely referred to as Twitter’s resident OB/GYN and author of the international bestseller, “The Vagina Bible”, her new book, “The Menopause Manifesto” just hit bookstore shelves this month. And today we’re going to be diving into that new book, all about menopause and what it means to go through it, not just to survive it, but to go through it in a better, more empowered way.

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Jean Chatzky: (01:55)
If you are one of our younger listeners, you may understand menopause’s basics. It’s something that most women go through between ages 45 and 55. Technically speaking, a woman is officially in menopause a year after her last period, but I want to use Dr. Gunters own words to sum up the real struggle with menopause that she has spent years trying to address. This comes from an article that she wrote for Glamour we’ll link to it in the show notes. And she writes, what if I told you that something major was going to happen to your body, but instead of accurate information, you’ll receive a barrage of negative messaging and be slapped with depressing stereotypes. That’s menopause for many women. Menopause is simply puberty in reverse, but while puberty is celebrated, menopause is ignored. Menopausal women are expected to choose their player. Which lady detective, snarky matriarch, or a woman with an ever increasing number of cats, and cope in silence as their value to a patriarchal society vanishes along with their estrogen. Consequently, many women don’t know what to expect when they’re no longer expecting a period. And that lack of information can be frightening and disempowering. When we exclude menopause from our discourse, we say it doesn’t matter. Well, we are not saying that it doesn’t matter anymore. Jen Gunter. Welcome. So happy to have you here.

Jen Gunter: (03:34)
Oh, thank you so much for having me.

Jean Chatzky: (03:36)
So tell us a little bit about you. I’m particularly interested in, and a little perplexed with “Twitter’s Resident OB/GYN.” How does that come about and how does that feel?

Jen Gunter: (03:49)
Well, yeah, somebody named me that in some magazine, like, I guess about eight years ago or so. I mean, I’ve been on Twitter for, oh my gosh. It must be more than 10 years or a long time. So I was there sort of from the beginning, one of the earliest physicians, I think really active on Twitter and I guess I really want people to have information. And I think when you’re a woman, that means that you’re loud and obnoxious, right? Like that’s how you’re perceived. You know, I’m not, I’m going to put up with anything. And so if that makes me seem like a strong or strident personality, I guess that’s just the way it is because I’m me.

Jean Chatzky: (04:29)
You know, I just have to say, I don’t think that loud and strong and obnoxious are the same thing at all. Right. Strong is a good thing. Strong is an important thing. And strong, particularly when we talk about things that people don’t talk about. And I put what we do in talking about money in the same category as what you do in talking about our bodies and menopause, I mean, that’s important, that’s a service and that’s something that we all should celebrate. So I thank you for what you do. Your first book, “The Vagina Bible” was translated. It has been translated into 19 different languages. That’s amazing. And “The Menopause Manifesto” is generating so much buzz. Tell me about these books and why now to take a deeper dive into menopause?

Jen Gunter: (05:20)
Well, “The Vagina Bible” started because I’ve been online for a long time, writing articles for my blog, The New York Times, multiple different outlets and always talking about the vagina and vulva. And I had a day in the office where I had five or six women in a row who had done something because of misinformation about about their bodies. It could have come from the internet or from another doctor. And I just went, how is this possible? How are we in this age of information, and yet people don’t get it. Why isn’t this block from A to B, how come women can’t get that information? And I just realized that women need a textbook. They need something on their shelves that they can pull off because we all access information online, but they need a reliable reference.

Jen Gunter: (06:07)
So that’s how “The Vagina Bible” came about. And then when I was on book tour for “The Vagina Bible”, every stop, there were questions about menopause. I mean, that’s all people wanted to talk about. And when I was doing interviews for it, every reporter who was sort of 42 and up, all they wanted to talk about was menopause. And if I mentioned that I was on estrogen, it was like, oh, oh, how do I talk to you about this. And so I just realized that menopause is as poorly treated as the vagina and vulva, but maybe even worse because at least with the vagina and vulva, there’s conversations. Now, there’s shameful ones and they’re not necessarily beneficial ones, but there’s this acknowledgement that they exist. Right. And with menopause, it’s just silence.

Jean Chatzky: (06:48)
Yeah. And it’s silence that can, boy, really mess us up. I mean, I have my own stories and I’m happy to, to delve into them, but I started menopause in my, or pre-menopause I guess, in my mid to late forties. And for me, it manifested itself in hot flashes so many times during a day. And I dealt with them for a while. I mean, typically 20 a day. And for a while I dealt with them and then I had a couple while I was on stage doing a speaking engagement. And I had a couple when I was on television and I was just dripping. And I knew if I could feel me dripping, then people could see me dripping. And I thought, all right, I got to do something about it, because it’s messing with my work. And people are talking about this book in that it is a feminist handbook, that it is a feminist handbook for women 40 and over, and that you are the feminist leader that women need for this period. I’m latching onto this word “manifesto.” What is it about menopause that calls for a manifesto?

Jen Gunter: (08:03)
Well, I think it’s this historical culture of absolute silence and neglect, right? So a manifesto is a public declaration and I’m here to publicly declare that that’s not okay. And I’m here to publicly declare that life doesn’t end at 50. And that throughout history, women have been incredibly productive and contributed to society and evolution over the age of 50 that, menopause is a planned biological event that helps to perpetuate the species. Like women need to know that women have been in cultured to believe that this is basically a pre death and that, you know, they should just be popping around in their dotage. Right. And yeah, we got to change that script.

Jean Chatzky: (08:48)
So let’s talk about how we break down these myths and how we empower women. Let’s talk about our bodies first and then talk about how it relates to our work lives and the rest of our lives and how we can strategize to deal with all these things. So when menopause happens, I mean, I gave a one sentence explanation at the top, but what’s going on inside us.

Jen Gunter: (09:17)
So, leading up to menopause in what we call the menopause transition and what many women may refer to as pre-menopause, you’re getting erratic ovulation and you’re getting basically hormonal chaos. So actually in that time, your hormones can sometimes be higher than they normally would. And so that’s why many women have some of their worst symptoms during the menopause transition because your hormones are just basically all over the place. You can have irregular bleeding, you can have hot flushes, you can have mood swings, you can have depression, you can have sleep disturbances. You can have a lot of things going on. Menopause itself means that you’re a year from your last period. And at that point there’s just no more eggs capable of ovulation. So now there’s no more hormonal production going on. And during this sort of phase of transition, some people are very bothered by symptoms. Other people aren’t at all. For some people menopause starts a cascade of events that increases their risk of other medical conditions. And some people don’t develop those medical conditions and, you know, people need to have the information so they can manage bothersome symptoms because medicine’s about quality of life too. I think we forget that, especially with women so they can be prepared for preventing and treating any of the medical conditions that could arise because of menopause, because information is power.

Jean Chatzky: (10:38)
Well, I want to make sure to come back to those medical conditions because, as of yesterday, I’m experiencing one of those. And so not that this show is all about me, but I do think that I’m a very good test case for our audience. So I want to come back to that. But so all of this stuff is happening in our bodies, right over what can take 10 years, which I remember when, when my doctor told me that perimenopause or pre-menopause could last 10 years, I was like, what the hell? Like, puberty is not 10 years. This should not last 10 years. But we’ve got to deal with that. But these 10 years coincide with what are often our most productive, highest earning years. Right. So how does that all come together and how does society deal with that?

Jen Gunter: (11:30)
Well, I think society doesn’t deal with that. That’s the big problem, right? Everything in a business room is designed around a man in a suit, right? Nothing is designed with the need of someone in menopause at all. And if you think about, if you’re working in office building, you have no control over the temperature in the room, you can’t open a window, maybe they give you a space heater in case your office is cold in the winter, but they certainly don’t give you a portable air conditioner, for the times it’s hot. So I think like many things that marginalized women, this is just something that can marginalize women more. I mean, if you’re having 20 hot flashes a day, like you said, and you’ve got a big presentation coming up, you gotta be in front of the board. It just adds more stress. Right? Many women are also during their forties and early fifties, if you’ve also had children, your kids might be in middle school or high school, which, you know, it’s stressful. So you always have that going on as well. So it’s a time that is just kind of one more thing on your plate

Jean Chatzky: (12:30)
At the top of the show, you talked about how after women go through menopause, at least in the past society expected: well, that’s it, you’re just done, right? You’re past your due day, your “sell by” day, you’ve expired, you’re off the shelf. However you want to put it. Has that changed?

Jen Gunter: (12:49)
I think yes and no. I mean, I think here’s a great example. So yesterday, a new trailer for “Fast and Furious 9” was released. I’ve never actually seen any of those movies, but Helen Mirren is in it. And she plays an action hero and she’s got the guns blazing. She is epitome of cool. And yet there were all these negative comments on Twitter about “look how old she is, how can she do that?” I’m like, it’s an action movie. Not one of the stars can do those things. You know that, right? Like Vin Diesel can’t jump between buildings. He’s on a wire. So, you know, so why can we extend fantasy to men and young women, but we can’t extend it to a woman who is post-menopausal. And so I think that’s just like a great example. And so I will go to that movie or see that movie because I might not be ready for movie theaters, simply because I want to put my money where franchises businesses are showing that women can do anything at any age.

Jean Chatzky: (13:50)
I’m totally with you on that. I was on the Kelly and Ryan show yesterday. And John Corbett was on talking about “Rebel” the new show that he stars in with Katie Segal. And it’s based on the life of Erin Brockovich, but the current life of Erin Brockovich, who is still a bad-ass in her sixties, doing this work and taking down corporations. And I thought, “yes, I am in for that show.” And I hope that it doesn’t get this sort of negative reaction that you were talking about online. Because I think until we start to see this kind of modeling, you know, on social media and in real media all the time, things are not going to change.

Jen Gunter: (14:30)
Yeah, I absolutely agree with you. You know, the script until now has excluded women basically over the age of 40. I mean, girlfriends in Hollywood are 20, 30 years younger. You don’t see movies centered around women over the age of 50, unless they’re generally sort of like, “Ooh, look at how sad their life is,” or, “look at the trauma they’re going through.” So I think that we need to have that kind of representation because it matters when you see yourself in movies, when you see yourself on TV, you think, “yeah, I can do that too.”

Jean Chatzky: (15:06)
Yeah. A hundred percent. I want to get into some tactical steps that we can take to manage our bodies, but also manage our lives through this process of menopause and leading up to it. But before we do that, let me remind everyone that HerMoney is proudly sponsored by Fidelity Investments. Whether you are just starting to save for retirement, inching closer to it, or you’re already enjoying your post-career years, Fidelity can help guide you every step of the way. And when life throws you changes, just like we’re talking about today, Fidelity is there to help you keep your financial plans in check. So you will feel better today and more prepared for tomorrow and you can visit Fidelity.com/HerMoney to learn more. I’m talking with Dr. Jen Gunter, author of the new book, “The Menopause Manifesto”. Okay. Jen, let’s talk about managing this transition. You see it coming. You said women 42 and up are starting to talk to you about it. When you go around and you give speeches, we want to prepare for it so that we can handle it in the best possible way. So how do we prep? And then how do we take ourselves through?

Jen Gunter: (16:21)
So, yeah, I mean, even younger women are asking. So, I tell people to think a bit about puberty. That wasn’t exactly the most enjoyable time for a lot of people.

Jean Chatzky: (16:33)
Yes. You could not pay me to go back there.

Jen Gunter: (16:36)
Like, you’re growing, your bones hurt, your clothes don’t fit, maybe you have acne. My hair went curly during puberty. So I always remind people, you’ve already been through one hormonal phase that you survived and you thrive through. So just kind of keep that in mind and that the best way to cope the groundwork is to be informed. Because many times when I explain what’s happening to someone, they’re like, “Oh, well, I don’t think I really want treatment. I was just like really scared,” Or, “I thought maybe I needed treatment.” And so information can help reassure people that what’s going on is yes, perhaps uncomfortable, but also normal, right? Because fear can amplify symptoms, stress being dismissed. And so information is the place to start because then any decision that you make about therapies or interventions are also coming from a place of evidence, right? You want to do things that are going to help you. I see so many women who have wasted so much money on useless product after useless product and these things are expensive. That’s how they make people think that they’re useful. Right? So you’re talking about buying three or four $90 supplements a month, that adds up. So I think just having the right information is really the key to get started.

Jean Chatzky: (17:55)
I definitely went down the supplement rabbit hole before I came into the world of hormone replacement therapy. So let’s talk specifically, I mean, do any of these supplements work? Are any of them worth spending money on?

Jen Gunter: (18:12)
So for hot flushes, I wouldn’t bother. There’s a couple that have some low quality evidence Relizen, which is a bee pollen, and S-equol, which is a phytoestrogen. But the evidence is very low quality. So if somebody wants to try those things, okay, I mean, it’s your body and it’s your choice. But if you know that there’s low quality evidence that might change what you decide, as opposed to, you know, not having any information about it. And also cognitive behavioral therapy can be very effective. So for people who want to go a non-medication route and there are people who definitely that’s what they want, you know, there is a great non-medication option, you know? So those are the things.

Jean Chatzky: (18:52)
What do you do with CBT in menopause.

Jen Gunter: (18:55)
Yeah. So CBT is really fascinating. It’s rewiring your brain. So every experience that you have, everything is a pathway in your brain. It’s chemical signaling, right? The way I explain it is your brain is kind of lazy. It likes the pathway that’s working. And so that when that pathway is used more and more, those neurotransmitters, that support that pathway increase. The connections that support that pathway increase. And so here that pathway is hot flashes, right? So that area of the brain strengthens and what it does, it steals from the areas of the brain that might counteract that. Because there’s only so many products in your brain, it’s like shifting Lego blocks. If you want to think about it from an analogy standpoint and cognitive behavioral therapy strengthens the other pathway, the pathway that sort of downplays that, and it’s very effective. It’s also effective for insomnia. It’s incredible how many things cognitive behavioral therapy is effective for. And I always find it amazing that, you know, all the people who sell these useless supplements and there are so many, they’re always talking about “natural,” but it’s not natural to get anything in a pill. Those things are made in a lab like everything else, isn’t it much more natural to use the power of your brain.

Jean Chatzky: (20:09)
Yeah. One hundred percent. So that was never suggested to me as an option when I was going through it, but hormone replacement therapy was, and I remember sitting down with my doctor who has actually been on the show and saying like, I just can’t, I can’t, I can’t do this anymore. If I start to drip, one more time in a public setting, I’m just going to die. And she was on the estrogen patch herself. So what I’m on, I’m on a patch called the Minnieville patch or the, the small estrogen patch. And I’d been on it for about five years. And every three months I take progesterone to sort of clean out the pipes for two weeks. And, it’s been working great. I mean, my hot flashes disappeared pretty much over night, but I went through BRCA testing before I started taking it to make sure that I didn’t have any genes that would get in the way and where this might cause future problems that I didn’t want to deal with. I’m happy with this solution. But I know that a lot of people are worried about the various forms of hormone replacement therapy. Where do you stand on this?

Jen Gunter: (21:22)
Yeah, so menopausal hormone therapy is one of those things that’s either demonized or, you know, held out as the greatest thing since sliced bread. And I tell everybody it’s an intervention and interventions have benefits for lots of people. And, and sometimes they have downsides. And in general, the bulk of the evidence shows that for the right patient, it can be very helpful. Not everybody likes how they feel on hormones and not everybody wants to take hormones. So menopausal hormone therapy is estrogen. And if you have a uterus taking some form of progesterone or a progestin, which is a progesterone like substance to protect your uterus from cancer, and it can treat hot flushes. It can help if the hot flashes are affecting sleep, it can treat mild depression associated with early menopause and it can prevent osteoporosis. So those are the things that we know it can do, and those are some of the reasons to start it.

Jen Gunter: (22:14)
And the risk of breast cancer is actually exceedingly low, especially in the first four years. And especially if you’re on the hormone progesterone, it’s very, very low. So I tell people that with transdermal estrogen using it as a patch, which is also not associated with blood clots, the oral form is that you have an incredibly low risk therapy and that may very well help you get through that hormonal chaos. Once you can hit about year four or five? The risk of breast cancer starts to increase a little bit. And it’s anywhere between, you know, six to eight per 10,000. And for some people that sounds like a high number. And for some people that sounds like a really low number and we all appreciate, we all look at risk differently. And so you have to think of what the hormones are doing for you.

Jen Gunter: (22:57)
If they’re dramatically improving your quality of life, then that very low risk of breast cancer is probably worth it for you. There are many other medications that have similar or high risks. I mean, Viagra can cause blindness, right? So, you never hear about this three out of a hundred thousand men taking Viagra will get blindness. And why do you need like erectile dysfunction that doesn’t interrupt your day, like hot flushes do, but you don’t hear about that. You don’t hear about men being warned off Viagra. So, I think it’s important to, you know, that a lot of these conversations about menopause or anything to do with a woman’s body always come back to sort of purity culture and this sort of like ideal that we’re expected to conform to. So, I will say that genetic testing isn’t indicated for starting menopausal hormone therapy. So just so people know that, you know, if somebody has a family history of breast cancer, not personal history, then that may be very different, but for the general population it’s not needed.

Jean Chatzky: (23:53)
And I should be very clear that there is so much breast cancer in my family. That that’s why my doctor sent me right through, and other forms of cancer too, that I’ve had genetic testing for. So I’ve been, I have very test happy doctors and I really love them. All right. Let’s talk about what happens after you go through menopause. I mean, you mentioned that there are medical conditions that can crop up. I went for, again, I’m going to, I’m like, this is just all about me. This show. I went for my physical last week, my cholesterol is up and my doctor said, ah, menopause. I was like, what? Like, I’ve never heard that before.

Jen Gunter: (24:32)
Cholesterol, you know, that’s a combination of aging and multiple factors. Certainly increasing cholesterol can be associated sort of more with weight gain with menopause. You know, if you’re putting more weight around the middle, which is what happens, right? So, as we age, we lose muscle mass. Estrogen can actually slow that down a little bit, but the biggest is exercise. And when we lose muscle mass that affects our metabolism. And when that affects our metabolism, there’s sort of a complicated series of changes that leads to, if you’re putting on fat, you put it in around your belly, not anywhere else. And that kind of fat is inflammatory and that can certainly indirectly affect like lipids and cholesterol and things like that. But aging also affects it as well. So, and that’s the thing with menopause is that it’s happening at the same time that you’re aging. And if you start your menopause transition at 45 and you ended at 53, you know, you’ve also aged eight years during that time, which is a significant amount of time. So probably a combination of factors, but you know, there’s great therapies for high cholesterol and things to do. So I’m sure that you’re getting great care for that.

Jean Chatzky: (25:39)
What other things happen as we go through?

Jen Gunter: (25:42)
So there is an increased risk of type 2 diabetes. I think that’s a really important thing to know, increased risk of cardiac disease. There is an increased significantly increased risk of osteoporosis. And I think that’s a really important one. And then vaginal dryness pain was sex, urinary tract infections. So a variety of things, some of these can certainly be abated with therapy, you know, osteoporosis exercise bearing, weight bearing exercises, estrogen. There are also other medications that can be helpful. I would think of hot flushes both as a medical condition, but as a symptom and a medical condition, I mean, that’s complex changes that are causing it. And I think when we sort of just call hot flashes as symptom, as opposed to a medical condition, it sort of downgrades it a little bit. So there’s that as well. And I always like to point out there are also, you know, non hormonal prescription therapies for that too, for people, for whom hormones aren’t an option, or they just don’t want them.

Jean Chatzky: (26:37)
As you mentioned earlier, there’s a cost to all of this. I mean, when we start talking about osteoporosis, we start talking about bone density scans. We start talking about, you know, testing along the way, all of these therapies, how do you weigh the cost versus the outcome? How do you know when you’re being given the right advice or when you’re just being sold something?

Jen Gunter: (27:01)
Well, I always tell people to get back to professional guidelines, medical professional societies don’t have any investment to tell you when, you know, for example, OB/GYNs don’t make any money from bone mineral density testing. That’s not their department. They don’t make money from that. So you’re going to get an unbiased opinion from them about when that’s indicated. So if you look at medical professional societies and many of them have the same recommendations, then that tells you that evidence has been pretty well vetted. There’s also the us preventative task forces that also looks at guidelines and they’re also very unbiased. Sometimes they’re a little conservative, but they’re very unbiased. And so I always tell people to kind of start there. And if the thing that’s been recommended for you is supported by The North American Menopause Society, The American College of OB/GYN, then you’re probably getting good advice because they really vet that. So the biggest tip I have is if you’re trying to find information about what you’ve been told is to go to The north American Menopause Society website or The American College of OB/GYN and search internally. So then you don’t get contaminated with ads on Google and other things and search internally on that website. And if the information is not there, then you might be getting told something that has been completely unstudied. And if the information is there, you’ll then know what the experts have to say.

Jean Chatzky: (28:24)
I think that’s fabulous advice about any medical problem, because if you’ve ever gone down the Google rabbit hole, when you’ve had some symptom, you know, it’s just a recipe for one sleepless night after another, and one worry after another, it just, it can drive you crazy.

Jen Gunter: (28:42)
It’s just not possible to navigate a Google search about health, even when you’re a physician, right? Because a lot of these sites that come up first are so crafty with their URLs and how they look, and they can look like a medical professional society, or they might be a doctor and they’re quoting what we call junk journals. So it’s so hard and to tell the ads at the top, from the actual sites, and then it’s based on popularity, right? I mean, that’s how celery juice got to be like such a big thing is it’s all driven by page clicks. So it’s very hard when I’m looking something up, I start my search in PubMed, which is a site where all the medical journals are indexed and then medical professional organizations. And I go and see what their consensus statements are. And then I work from there.

Jean Chatzky: (29:31)
You’ve got a bunch of people now with their mouths open or like celery juice doesn’t work.

Jen Gunter: (29:37)
I mean, if you like it, great, it’s not going to hurt you, but it’s not going to cure anything. And the guy, who’s the one who started this LA juice trend is the medical medium, and he gets his health advice from talking with a ghost.

Jean Chatzky: (29:48)
Excellent. All right. On that subject, what are the biggest clickbait headlines falsehoods about women’s health, including menopause, but not just limited to it? I mean, what are the ones that make you the maddest?

Jen Gunter: (30:04)
Well, I think there’s a couple, it’s certainly a couple. So anything about special vaginal cleansing because first of all, those sites are preying on purity culture and know generations and centuries and eons of fear about having a prepped vagina for a patriarchal society. And also those sites often confuse the term vagina and vulva. If you don’t know the difference, you shouldn’t be making a product for either, but you know, any attempt at vaginal cleaning is harmful any attempt and the vulva doesn’t need special care just to cleansers fine, a gentle facial cleanser. And every single day, someone tags me in some new vulva cleanser product, which is advertised as a vaginal cleanser. And so many celebrities are in on this. I want to say, you know what, don’t you celebrities have enough money from your movies that you have to like prey on patriarchal fears to sell your garbage. So I think that bothers me the most because it’s getting worse. It’s not better. And I think it’s because it’s so easy to sell these products on Instagram. And so I think that that’s what’s going on.

Jean Chatzky: (31:06)
Well, we’re going to do our best to shut that down here today. I think we have gotten a little heavy in this conversation and I do want to point out that there are some benefits here to menopause. There’s some silver linings. What do you see as the good part of this transition in terms of our lives, our careers, our health?

Jen Gunter: (31:29)
Well, I think it’s amazing that I don’t have to have a period anymore. I have to say it’s really, you know, it’s really nice. When I used to travel in the, before time, not to have to worry about packing pads and tampons. So I think that’s a huge plus. I think that for many women, the cyclic hormone changes every month can affect them in many ways. And having that non cyclic just nice and smooth can be great for a lot of people. I think that what happens is a lot of people think that sort of the chaos during the menopause transition, the time, that can be really hard is something that’s going to continue forever. And it doesn’t. So, you know, just like you, might’ve felt really bad during puberty for a bunch of reasons, but that didn’t continue through your whole adult years.

Jen Gunter: (32:12)
It’s kind of the same thing. So yeah, and I think that menopause is a time when you have all this world experience to use and you shouldn’t be defined by what your ovaries are doing. And I mean, for me, I started writing for The New York Times after the age of 50, I met the love of my life over the age of 50. And I think that it’s really important not to accept those patriarchal views that you’re done. And to think I have so much more to offer. I now have this collective life experience that has sort of accumulated, and this is like me 2.0

Jean Chatzky: (32:52)
Yeah. I felt over the age of 50, so much more free to say whatever I wanted to say whenever I wanted to say it.

Jen Gunter: (33:01)
Yeah, I’m doing my best to get the term menopause changed, because I don’t really like it. But I think that it’s great for us to invest in euphemisms that we like about it. I heard one the other day that I just loved “crossing the Crimson bridge.”

Jean Chatzky: (33:21)
That is a good one. Maybe that’s the next book title. As we wrap up here, where can we find out more about you and more about “The Menopause Manifesto”?

Jen Gunter: (33:25)
Sure. So you can find “The Menopause Manifesto”, wherever books are sold, your independent bookstores, Amazon, Barnes and Noble. You can find out more information about me and where I’ll be speaking. Cause I’ve got a cool speaking tour coming up, virtual, so anybody can attend on drjengunter.com. And I also have a newsletter called the agenda, which I cover all things sort of reproductive health related that you can find on Substack.

Jean Chatzky: (33:51)
Awesome. Thank you so much for spending this time with us. I appreciate it!

Jen Gunter: (33:53)
Thank you so much for having me!

Jean Chatzky: (33:56)
And we’ll be right back with Kathryn and your mail bag. And HerMoney’s Kathryn Tuggle has joined me for our mailbag. Hey Kathryn!

Kathryn Tuggle: (34:12)
Hey Jean, how are you today?

Jean Chatzky: (34:15)
I’m good today! I’m good. I enjoyed that conversation with Jen and she just made me smile when she was talking about not going down the internet, Google rabbit hole of diagnoses. When I was pregnant, my ex-husband actually took away the “What to Expect When You’re Expecting” book, because I was getting all the symptoms, like, as soon as I read about them, every time I would like read about some new disease, I would decide that I had it. And then I would panic and think that, oh my gosh, how am I ever going to finish this pregnancy? And so it’s not just Google that does it. And not just the internet that does it. Books can do it too.

Kathryn Tuggle: (34:57)
Yeah. We are so much the same person in that regard. I saw this meme the other day that I thought it was the funniest thing ever. It was like me: I have a headache. Web MD: And it will be your last.

Jean Chatzky: (35:16)
Exactly, exactly. I’m so susceptible and I don’t usually think I’m susceptible to that stuff, but yeah. And the “What to Eat When You’re Expecting” book, that was even worse because it had me eating so many calories a day in order to get all the nutrients that they said were important. That I was just sick for a couple of weeks until I figured out, oh, I can’t up my calorie count that much.

Kathryn Tuggle: (35:41)
Yeah. It really is such a rabbit hole. I mean, they call it the web for a reason.

Jean Chatzky: (35:46)
Yes. Good point. They absolutely do. And I liked menopause as a manifesto. I like it as a feminist conversation. I felt like there was a lot of power in her words.

Kathryn Tuggle: (36:00)
It’s so true. I think also just that idea of reclaiming this as, not a time in your life to be dreaded or avoided, but as a time in your life, that can be empowering in its own way.

Jean Chatzky: (36:14)
Yeah. I know we got a little dark there for a second and I don’t want people to feel like that. I mean, if you happen to get hot flashes, there are treatments to deal with them. If you happen to feel depressed when you’re going through menopause, there are treatments to deal with it. I mean, I think the big takeaway is talk to your doctor, not just talk to your girlfriends and your partner and the other important people in your life, but really talk to your doctors about solutions. And if you find yourself with a doctor who is not willing to provide you with the sort of solutions that you think makes sense for you, then find yourself another doctor.

Kathryn Tuggle: (36:55)
Absolutely. I have thyroid issues and I probably went to 10 endocrinologist before I found somebody that I liked and I just, wasn’t going to settle. And it’s the same thing with any doctor with any financial professional. We talk about that all the time with financial planners, these people are providing you a service and you need to get what you pay for and you need to feel good when you walk out the door.

Jean Chatzky: (37:17)
Yeah. You’re a hundred percent right on that. And I have to stop saying a hundred percent. It’s like my new catchphrase. It’s ever since it showed up as an emoji. I just can’t stop thinking of that little red 100 and I’ve got to get it out of my vocabulary. So I’m putting it on you to help me with that.

Kathryn Tuggle: (37:35)
Okay. Well, we can try and move away from “a hundred percent” and “absolutely” which we also love.

Jean Chatzky: (37:40)
Okay. We will do our best to do both of those things. Let’s answer some questions.

Kathryn Tuggle: (37:44)
Yes. Our first note comes to us from Catherine. She writes “Hi Jean and Kathryn, I have a question about retirement savings and benchmarks for when a couple is not close in age. I’m 49 years old, and my husband is 56. We own a small business together and make around a hundred thousand dollars. I earn $30,000. He earns $70,000. I had a big headstart on saving before we met eight years ago. So I have significantly more in savings than he does. Our investments include: simple IRAs that we max out every year, $27,000 for myself and $49,000 for my husband. I have $256,000 saved in a traditional IRA, $83,000 in a Roth IRA, which I max out every year, and $27,000 divided between two annuities. My husband has $44,000 in a Roth IRA, which he maxes out each year, and $8,000 in a traditional IRA. We are both invested 80% in total stock market index funds and 20% in total bond market index funds.

Kathryn Tuggle: (38:46)
Our emergency fund is currently at $62,000. And we are able to add to that every month. Our goal is to have double that by the time we retire to use it as a cushion if the market fluctuates. We set that goal after your episode with Suze Orman at the beginning of the pandemic. We each have life insurance that will cover the other spouse until they hit full retirement age. We owe $180,000 on our mortgage and have about $400,000 in equity. We refinanced to a new 30 year mortgage last year with a lower interest rate, 3.25%, and are making additional payments of a thousand dollars a month, which puts us on target to have our home paid off by the time my husband is 66 and a half. Our thought was that we have an extra thousand dollars a month to invest. And if we stay in our home for retirement, it will be paid off.

Kathryn Tuggle: (39:34)
If we decide to sell and downsize, we figured it would be a good investment since we live in the Seattle area and home prices are skyrocketing. We’ve also been looking into long-term care insurance for my husband this year. Our questions: Is the extra thousand dollars a month toward the mortgage a good idea, or is there some other place we should be investing? The only other option I’m aware of is a taxable savings account. Do we include our home equity when factoring our investments in risk tolerance? How do we figure the benchmarks when we’re not going to retire at the same time, and the first person retiring has less money saved? Thank you so much for all your wonderful advice.”

Jean Chatzky: (40:12)
Thanks so much for writing Catherine. First of all, let me just say, I think you guys are doing incredibly well, but I think that YOU are doing incredibly well. And that’s an emphasis on incredibly. I mean, in terms of your benchmarks. And when we talk about the benchmarks, we talk about getting to a point where you’ve got 10 times your earnings put away for retirement. By the time you retire, you’re basically there. My question is really less around earning and more around spending, and how much of that hundred thousand that you earn together, you are going to want to replicate. So in order to answer your questions about the benchmarks and the age difference, I think that’s the information that you need to dig into a little bit more closely and understanding a little bit about how these benchmarks were formed and what they aim to do should be able to help you.

Jean Chatzky: (41:18)
So let me just answer your first two questions before I get to that third part. The extra thousand toward the mortgage with a goal of paying it off before retirement. If you’ve listened to me for a while, you know that I’m a fan. You know I love the idea of having a paid off place to live. By the time you hit retirement, your goal is to have it paid off. By that time, your husband is 66 and a half. You haven’t said exactly when you’ll stop working, but it seems like that’s going to get you there. And so even though the mortgage rate is low, since you have exhausted your other tax advantaged options, I am a big fan of that. Including your home equity when factoring your investments and risk tolerance… No, because you need a place to live. So keep that in a separate pile.

Jean Chatzky: (42:14)
Now, those benchmarks, when I talk about the benchmarks that Fidelity developed, the ones that say you should have one times your income put away for retirement by age 30, three times by age 40, six times by age 50, eight times by age 60, and 10 times by the time you retire the math behind those says that money for people who earn between $50,000 and $300,000 a year, and you and your husband are in that category combined, should be enough to replace 45% of your preretirement income in retirement. And when combined with social security should be enough to live on. And the reason that they don’t aim to get you to a hundred percent of your preretirement income is that the one thing you don’t have to replace is your saving rate, and you are saving a considerable amount of money. So when you look at this puzzle and I do think it would be a good idea for the two of you to sit down with a financial advisor and to chart out the growth in both of your portfolios factoring in, when you’re going to take social security and how much money that will provide the real question here is what do you need in order to live on, and how much of that will be covered by your current investments as well as by the annuity and the other things that you have in your portfolios.

Jean Chatzky: (43:52)
A sit down with an advisor should get you there. And if you haven’t done it, moving at this point toward retirement in a decade or so, makes this a really good time. The last thing that I’d say, and you didn’t ask the question, but I’m going to answer it anyway, is I think you should be looking at long-term care for you as well as for your husband and 50ish is about the age at which we start to look at it. So you could shop for both of you at the same time. And thanks so much for writing!

Kathryn Tuggle: (44:27)
Thank you, Jean. That’s a complicated question, really. Because she is doing well, but there’s a lot of different directions she could go in right now.

Jean Chatzky: (44:36)
Absolutely. And I also wonder whether there’s value in this business, right? When she stops working in the business, they’re in this business together, she said. And together, they bring in a hundred thousand dollars, but when he steps back, will any of that income flow to her? And is the business something that they could sell and then add that money to their portfolio. So, although she gave me a ton of information, it’s not as much as she would get from a sit down with a financial advisor. And if you don’t have one, please use our wealth ramp questionnaire that you’ll find at the top of the page at hermoney.com to find one that’ll work for you.

Kathryn Tuggle: (45:18)
Absolutely. Thanks Jean. Our next question comes to us from an anonymous listener. She writes “Hi Jean. I live right outside DC in the Virginia suburbs and the real estate market is booming. In most neighborhoods, property values are up almost 10% from a year ago. It’s definitely a seller’s market right now. People are waving the bank appraisals and offering sometimes a hundred thousand dollars above asking price. That said I would like to buy my first home. However, I’m wondering if I should wait until the market settles down. My agent has said that property values will continue to rise. I’m torn. Do I get in the market now? Or should I wait? I’m single, almost 40 and have a steady income. I’m maxing out my 401k and have no debt. On a side note, how do you feel about house hacking, where someone takes on a larger mortgage, and then gets a roommate to help pay? It feels risky to me. Thank you, thank you, thank you for all your help.

Jean Chatzky: (46:14)
Well, thank you, thank you, thank you for writing and introducing me to the new term of house hacking. I’ll get to that in a moment. I would not say that you should buy a house if you were looking to flip it in this market.But, it actually sounds like you are looking to be somewhere for a while. So as long as you believe that you’re going to be there for at least five years and maybe longer, I would say, go ahead and look for a house. It can take awhile, particularly in a hot market like this, and the fact that you are not under pressure. The fact that you don’t absolutely have to buy within the next couple of months is an opportunity for you to just keep your emotions in check, to really watch yourself before you get into perspective bidding wars, to keep in mind what you believe these properties are worth.

Jean Chatzky: (47:14)
Of course your agent has said that property values are going to continue to rise. Your agent sells real estate! Your agent has a horse in this race. So look, and if you find something that you think is right for you, then make what you think is a reasonable offer while trying not to get out ahead of your skis. As far as house hacking, taking on a larger mortgage and then getting a roommate to help pay, yeah, it feels risky to me. Particularly from a personality standpoint. What if you decided you don’t like this roommate? What if you decide you don’t want to live with a roommate at all? Maybe if this is the way that you’re thinking about going, you should look into a duplex where you could live in half, but you could rent out half. And that way you’d have an income producing property inside of your own property. And you’d sort of get the best of both worlds. Just my thought.

Kathryn Tuggle: (48:11)
Thank you, Jean, for your great advice. And if anyone’s looking to you ask us a question, please do it at mailbag@hermoney.com

Jean Chatzky: (48:19)
And in today’s Thrive, how to get comfortable asking for a raise and why more women don’t do it. At HerMoney we talk about the gender gap often. The fact that women are paid less than men for doing the same job, 82 cents on the dollar to be exact. That’s an enormous and oppressing problem. And we know that one of the key things that women can do in order to increase their pay is to ask for a raise. And yet, according to a recent study conducted by Laurel Road, just 54% of women, we’re talking about college educated adults, say they’ll ask for a raise this year, compared to 75% of men. And so as we move further into 2021, what can we do to get these numbers up? First, let’s look at the reasons why we don’t ask for raises more often. In many cases, we’re not aware it’s an option.

Jean Chatzky: (49:16)
Women tend to assume that what’s being offered to them is fair. So even when we know we can negotiate, we don’t actually do it in practice. And while we’re talking about practice, we cannot say enough good things about role-playing ask a friend, a partner, someone you trust to stand in for the role of your supervisor and practice asking for what you want. This way, you will better be able to anticipate what might be said or asked during the conversation. And you’ll feel more prepared when time for the real negotiation rolls around. And to get more comfortable and confident going into these conversations. Do your research, find out what people in roles and industries similar to yours are being paid and what your going rate truly is. Connect with others in your company and advocate for pay transparency whenever possible. Finally, before you go into any negotiation, be really clear on what you want.

Jean Chatzky: (50:19)
Are you after a simple increase in salary, would you be just as happy with a smaller salary bump, but a bigger increase PTO, a flexible schedule or a more impressive title? Get clear on your asks before you walk into that negotiation. If you have never negotiated or asked for a raise, we get it. It can be daunting, but if there has ever been a year when women needed to speak up and ask to be paid, what they feel they’re worth, this is it. Thank you so much for joining me today on HerMoney. Thanks to Dr. Jen Gunter for sharing her manifesto with us and giving us the tools, the confidence, the information we need to step into menopause from an empowered place. I can’t wait to get a copy of this book. If you like, what you hear, please subscribe to our show at Apple Podcasts, leave us a review, because we love hearing what you think. We’d like to thank our sponsor Fidelity. We record this podcast out of CDM Sound Studios. Our music is provided by Video Helper and our show comes to you through Megaphone. Thank you so much for joining us and we’ll talk soon.


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