every peri-menopausal person needs to read this book

Outliving Your Ovaries: An Endocrinologist Weighs the Risks and Rewards of Treating Menopause with Hormone Therapy by Dr. Marina Johnson

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 Bonafide Health LLC recently released their second annual survey on menopause (see the link in “references” below). While its not peer reviewed, the survey is a window into the current knowledge gaps with respect to perimenopause and menopause.  71% of the 2,000 surveyed didn’t know how to manage symptoms and 64% didn’t know when to speak to a healthcare provider. Did you know that perimenopause, on average, can start at age 35 and last until around age 55-60?  And yet why doesn’t our current (American) healthcare system prioritize it?  A third of a woman’s life is lived in this biological space!  As advocates for our own healthcare and wellbeing, we need to know what real science says about perimenopause and menopause. This isn’t easy to tease out, though. Typically, the academic rule of thumb is to peruse research that is contemporary by a five year span of time. The primary exceptions are if there just are no recent solid studies or if a body of research is historical to the topic at hand.  For me, Dr. Johnson’s book, published in 2010, falls into this category. Why?

 For one, most family physicians and Ob-Gyns are generalists and trained for a broad range of female medical challenges. Ob-Gyns are primarily surgeons. Both are important for us to have on our “healthcare team”.  In fact, we need lots of team members!  However, it’s the internal medicine docs and endocrinologists who most often have the edge on hormones and associated chronic medical problems. They’re kind of like the “systems analysts” for the body. No one physician can know it all and it seems imperative having these individuals on our side as we approach the so called “wisdom years” (as some refer to the perimenopause and menopause years).

 Further, Dr. Johnson’s work outside of writing this book sets the stage for an immense amount of credibility. For me, someone’s life work and not just where they went to medical school, for example, speaks volumes. There is nothing more annoying than the charismatic celebrity MD who constantly reminds the public that they’re an Ivy League trained physician.  I personally don’t care about how many followers you have on social media or where you went to medical school if your current work isn’t based on current rigorous scientific research combined with true clinical practice (versus seeing a few “token” patients between book deals). Dr. Marina Johnson is the real deal as far as I can tell from not just studying this book but from poking around our medical library. She is both a pharmacist and MD as well as the director of Endocrinology and Preventive Medicine in Dallas, Texas. Academically she hails from USC and UCLA. She’s been in clinical practice for over 36 years and, back prior to the publishing date, had already seen over 100,000 patients. And that was around 2010.  She also researched over 450 peer reviewed medical journals in combination with her clinical experience prior to authoring this book. It’s no wonder that my own Gyn recommended Outliving Your Ovaries. It’s clear that Dr. Johnson offers the best of traditional and natural medicine combined.

 As someone who was blindsided by surgical menopause following a necessary gynecological surgery (this can happen to any woman at any age), one of my biggest take aways was Dr. Johnson’s deep dive into the 2002 Women’s Health Initiative (WHI) which is commonly referenced in the literature with respect to menopause. The study concluded that a combo of progestin and estrogen (Pempro) led to more health risks than benefits. What was eye opening for me was Dr. Johnson’s dissection of the study and the point that the adverse effects which emerged in the WHI should really be attributed only to the regimens and formulations in the study.  The reader is cautioned to not assume a blanket statement that all hormone therapy is “bad”. She thoroughly addresses common concerns about increased breast cancer risk and points out that what we neglect to acknowledge is that cardiovascular disease kills more women annually that any type of cancer, diabetes, or accidents combined. I was also interested to learn that when it comes to breast cancer that statins also pose a risk, which is something that had never been in my awareness. 

 There is so much more to this book and, in my mind, it’s a must read that should not be forgotten in the current perimenopause and menopause conversation. We all need to be accountable for our own health and well-being in conjunction with our selected healthcare providers. This book is a foundational tool in our proverbial tool boxes. 

references

Bonafide Health LLC. (2022). The State of Menopause: Our Second Annual Survey. https://hellobonafide.com/pages/state-of-menopause-2022

Johnson, M. (2010) Outliving your ovaries: An endocrinologist weighs the risks and rewards of treating menopause with hormone replacement therapy. Eyesong Publishing. ISBN 978-0-983-02150-6