459. Facts, Feminism, and Menopause with Dr. Jen Gunter

[music]

Sarah Wendell: Hello and welcome to episode number 459 of Smart Podcast, Trashy Books. I am Sarah Wendell, and with me today is Tara Scott, and we are going to basically exclaim at Dr. Jen Gunter about her newest book, The Menopause Manifesto. We are going to cover what’s in the book, the facts and science about menopause, and the history of how predatory, patriarchal bullcrap has influenced how we think and talk and learn about menopause.

I do want to say that we talk very briefly about weight changes during menopause and how people in medicine treat people based on their weight, which is terrible, so when we start talking about that, if you want to skip ahead, just skip ahead about, mm, two minutes.

I will have information about where you can find Jen Gunter, where you can find a copy of The Menopause Manifesto in the show notes at smartbitchestrashybooks.com/podcast, but I’m, I’m sure you knew that already, right? Of course you did.

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Stay tuned at the end of the episode for news about Dr. Gunter’s new, awesome podcast and, as usual, an absolutely dreadful joke, one that I have told many people this week. Let’s get started with Tara and me and Dr. Jen Gunter about The Menopause Manifesto.

[music]

Sarah: Tara and I are so excited that you’re here. Tara has a very demanding job and told her office, I’m not available; don’t even talk to me while we’re doing this. This is like, this is such a thrill for us, right, Tara?

Tara Scott: Oh yeah. No, abs-, like, you, to me, are like a superhero. I loved seeing you go after Vagisil most recently?

[Laughter]

Tara: I have two daughters, they’re nine and six, and, you know, some of those messages are already hitting my nine-year-old. Which is like, how is that possible when she’s doing school from home and – [laughs] – and yet it’s happening. Like, she’s asking those questions that are very much informed by the patriarchy, and so I love knowing that there’s somebody out there that’s just going, what are you doing? You are predators. So just, also as, as a human and as a mother, thank you so much for everything that you do, because it, it helps me as I’m preparing to hopefully keep some of that fuckery off my kids’ shoulders.

Dr. Jen Gunter: Aw, well, thank you! Yeah, it’s, it’s getting worse. You know, since I wrote The Vagina Bible – like, I wrote it in 2018; it was published in 2019 – I swear it’s become worse.

Sarah: Oh.

Dr. Gunter: You know, with, you know, TikTok and Instagram, the messaging and the companies and the predators who make this stuff – they’re all predators; doesn’t matter if it’s a “natural” product or whatever – they really have, are really leveraging that. It’s frightening, and I think the best way is to, you know, inoculate your kids early to, you know, the, the lies and the messaging and, you know, and, but it’s really sad to see, to hear like a nine-year-old getting that messaging.

Tara: Yeah.

Dr. Gunter: Like, it feels like, you know, we’re like five thousand years ago. Like, how different are we?

Tara: I feel like it perfectly lends to the first question that we had for you!

[Laughter]

Tara: Which is a thing that really struck me almost immediately, is that The Menopause Manifesto really is a manifesto, as much as it is this informative health guide, and patriarchy is, you know, rightly so, the villain. So how would you say, like, in how many ways is patriarchy a villainous presence when it comes to menopause?

Dr. Gunter: You know, yeah. So when I started writing it, I, I was, there’s no way I could write this book without, without showing the patriarchy for the villain it is, because essentially since the beginning of reported time, you know, menopausal women specifically have basically been written out of the picture, you know. Where it’s sort of, we are like the nonexistent – we’re not even worthy of shame, you know? We don’t even get the derision. We’re just like an appendage, a useless appendage. And, you know, this is clearly not supported by evolutionary data and the fact that, you know, we’re probably all here in large part due to grandmothers and this hypothesis that historical women in menopause helped to drive evolution. So this i-, so it’s like the ultimate sort of perversion of the truth, and you know, you run this reproductive gauntlet your whole life. You’re, you’re, you’re at the whims of your ovaries and your bleeding and, and even if you’re someone who has never had a menstrual problem and never had, never had any health issues really, you had perfect pregnancies, you popped your kids out after four-hour labors, you’re just, you had, like, everything perfect, you’re still judged for your biology. You’re still judged for, you’re even judged for if you never use your biology, right? The fact that you have that equipment, you’re judged for it. And I just, I was just done with it! I’m like, I’m just done with the judging, I’m done with the lies, and the best way, I think, for people to see is to show how these lies were crafted, and so that’s why there’s a lot of historical information in the book, and to give you information so you can have the facts to advocate for yourself.

Sarah: You’re right that it’s an act of feminism to know how your body works, but to also have the language to talk about it. And in the history you talk about how the, there was a lot of talk about it, and then it all went away, and now it’s coming back. And I’m curious: has the language around menopause with your patients begun to change at all? Or are you hoping that this book will create that change? Because it, having the ability to actually talk about what is happening and using words that make sense is deeply empowering. Have, have you noticed that language changing at all?

Dr. Gunter: Unfortunately I’ve noticed it changing in bad ways, and it –

Sarah: Bugger.

Dr. Gunter: – it’s really, yeah – and it gets back to the same predatory messaging that goes to the, you know, nine-year-olds. It’s predatory messaging about so-called bioidentical hormones; it’s predatory messaging about so-called plant-based hormones; predatory messaging about you have to have a bowel movement once a day to regulate your estrogen levels. So all these lies about how the body works are, you know, are now, you know, menopause is an untapped financial goldmine, right? So it’s the same, it’s, so these aren’t good conversations. These are companies promoting unnecessary tests; these are naturopaths and functional medicine doctors promoting unnecessary tests and treatments and, you know, lies about compounded hormones and all this kind of stuff, and so the language and the facts people are, are being given are, are often incorrect. You know, so it’s, again, we’re seeing sort of the predators run away with the language.

Sarah: Yep. The minute there’s a, there’s an absence of knowledge, you can either fill it in with, with real knowledge, which is nuanced and not as specific, or you could rush in and make money by scaring the hell out of people, and we all kind of know what’s going to happen.

Dr. Gunter: Yeah, exactly. I mean, this idea that, you know – now, again, if everybody knew about menopause like a gynecologist, then when that messaging came about they’d be like, yeah, sorry, man, that’s a scam, right? We all want a pill to fix everything. I mean, even doctors, right? But, you know, at least if you have, but I have that information to know it’s a scam, I might –

Sarah: Yep.

Dr. Gunter: – I might read the post and go, ooh! And then like, no, no, it’s a scam. Pass.

Sarah: Mm-hmm.

Dr. Gunter: You know. But everybody should have that.

Sarah: One of my favorite parts is the terminology of menopause? ‘Cause everyone has a different term, especially terms in other countries that aren’t so negative, like the Change of Life and Hot Bloom. My personal favorite that I have to share with you is I was standing line with someone at a conference, and she sort of stepped back and started fanning herself. She goes, I’m so sorry; I’m having a Personal Summer right now.

Dr. Gunter: [Laughs] I love that!

Sarah: I love that one! What are some of the favorite terms that you discovered as you did your research? ‘Cause that was one of – I love language; I’m a big word nerd. That was probably one of my favorite parts.

Dr. Gunter: Oh my gosh, I love that: my Personal Summer. I’m going to have to add that to my list. I loved Hot Blooms, because that’s really how it feels. It feels like it’s blooming up outside of your head! And, and I love the term from, you know, the 1700s, the Dodge, so that, you know, women are dodging between periods and dodging between pregnancy, and I’m like, you are always dodging, right. Like, that’s sort of how it feels. And I heard one, someone recently left a message on my Instagram, and her phrase for menopause was Crossing the Crimson Bridge.

Sarah: I love this so much!

Tara: Very good! [Laughs]

Dr. Gunter: Isn’t that the best? So I think we should –

Sarah: I love it!

Dr. Gunter: – Crossing the Crimson Bridge, the Dodge, Hot Blooms, Personal Summer, I love it.

Sarah: Oh, what good language!

Dr. Gunter: [Laughs]

Tara: So good!

Dr. Gunter: You know, and historically, I mean, before, you know, Dr. De Gardanne in the 1800s, I mean, it was just all sort of called, like, the Change, you know, or the climacteric. So, you know, more generic, less pejorative terms.

Sarah: Crone-ification.

Dr. Gunter: Yeah. You know, and some people – oh, someone told me that, you know, they are celebrating it, calling it their Croning.

Sarah: I love that too!

Dr. Gunter: [Laughs]

Tara: Sarah, you’ve got to make some merch!

Sarah: Love this! Oh, there’s a whole merch line here for you, Dr. Gunter; the possibilities are endless.

Dr. Gunter: Welcome to the Croning!

Sarah: Yeah!

Dr. Gunter: [Laughs]

Sarah: Crone Town, population all of us!

Dr. Gunter: Yeah!

Tara: So you talked about Dr. How did you learn about him, and how, how easy is it to kind of dive back that far? And how important is it for us to take into account these various historical contexts as we’re recognizing and addressing menopause? Like, was the research fun, or did you just want to punch a wall all day long?

Dr. Gunter: Well, actually, I found it really interesting, because it was stuff I hadn’t, you know, known. They don’t teach you, you know, what happened in the 1500s so much in medical school, except to tell you maybe, like, who named something. And, you know, I, I’m very influenced by the idea that we’re influenced by things we don’t realize. So, you know, how did the way people thought about menopause in the 1500s impact the way they thought about it in the 1600s and 17- – like, we’re all sort of a product of that, and how much has, you know, how much has stayed the same? How much has changed? And so I was really, also really trying to, as I address also in the book, sort of explain how, like, ancient therapies aren’t necessarily, like, all they’re cracked up to be by, you know, people who promote them on Instagram. And so I really wanted to understand, like, the context: like, what they thought about bodies and how they came up with these treatments. And so, you know, it just took, you know, a lot of research, and fortunately there’s amazing, you know, medical historians and, you know, medical anthropologists, you know, and so that’s where a lot of the information came from. But it’s really interesting, you know, now, because of these efforts to archive everything digitally. You know, that first formal manuscript on menopause from the 1700s, I found it online through Google Books!

Sarah: What?!

Dr. Gunter: Yeah! So I –

Tara: Oh, that’s amazing!

Dr. Gunter: – you know – I mean, it’s in Latin, so I had to get it, you know – but then through Google Translate, right, you can, you know, I know some Latin words. You know, you’re able to all of a sudden have this access to these documents! You know, I have Dr. De Gardanne’s original dissertation from 1816; I found it online!

Sarah: Wow, that’s cool.

Tara: That’s the nice part about living in the future.

Dr. Gunter: I wanted to know, like, what this man who named it contributed, and he contributed very little. Like, clearly we should be changing the name. And the idea that, you know, his, his term was really supposed to be, like, it was meant to be the end of mens-, of menses, but the way, the way “-pause” in Greek, which is stop, sounds in English is pause, right? And so now the word’s taken on sort of this meno-pause, as opposed to meno-cease or meno-stop.

Tara: The, the snark is very, very strong – [laughs] –

Sarah: Oh yes.

Tara: – in The Menopause Manifesto, and –

Sarah: Well played.

Tara: – to me, I felt like it was even more so than in The Vagina Bible, and just, was it a conscious choice to be snarkier, or are you just like, is your jar of fucks completely empty at this point?

Dr. Gunter: Yeah. There are no fucks left to give in this household, I think. Yeah, I mean, and it’s so funny, ‘cause I really didn’t set out to write this sort of like manifesto, and I really set to write, ooh, a, you know, Your Girlfriend’s Guide to Menopause! And as I started doing all this historical research, I just realized that book wasn’t possible. That you have to reconcile, you have to reconcile the past, because that’s informing how we’re thinking. And also, that past is being distorted by the people selling natural products. You know, if compounded hormones weren’t forty percent of the market, I wouldn’t, probably, have had to, you know, maybe – and maybe I still would have, but, you know, the fact that a lot of this sort of historical information is being repurposed – I mean, we see purity culture and all of this in, you know, in the natural marketing. You know, they use the same terminology: pure, clean, natural. Like, are you talking about a religion, a religion? Are you talking about, you know, the entry requirements for a new TV show, America’s Next Virgin Bride? Like, you know, and all of that being repurposed for menopause, and so, you know, I felt like I just had to, I had to go for it, and, I mean, that might not speak to everybody, but I think the oppressive weight of the patriarchy on menopause is still so profound, and if people aren’t angry about it, they should be.

Tara: Mm-hmm.

Sarah: It’s also present in the fact that when you look at what is known about menopause, which is despicably little, it’s the erasure and the pushing-aside of an entire segment of population that is still alive!

Dr. Gunter: Yeah.

Sarah: We’re not, we’re, we’re not pause! We’re not dead! There’s just a change!

Dr. Gunter: Right.

Sarah: But we don’t get written about. Meanwhile, you know, men, God forbid they have the slightest problem. It’s all good.

Dr. Gunter: Yeah! I mean, George Clooney is –

Sarah: They get lots of attention.

Dr. Gunter: – George Clooney is the sexiest man, right, or has, was, definitely over fifty. How many women over fifty have been on the cover of People magazine as the sexiest woman alive?

Sarah: I don’t know if you’ve, you’ve got the, the newest Netflix movies, but this weekend we watched a movie that just came out on Netflix called Thunder Force, and it stars Melissa McCarthy and Octavia Spencer as crime-fighting superheroes, and I’m like, hold the phone! Two fifty-year-old women get to be the heroines of a superhero crime-fighting movie? I shouldn’t be –

Dr. Gunter: Right.

Sarah: – so delighted about this, but how many times have I seen Adam Sandler do that same thing?

Dr. Gunter: Right.

Sarah: I’m going to see Adam Sandler in his eighties doing that, right? And it’s going to be –

Dr. Gunter: Right.

Sarah: – completely normal, but I am delighted to see older women who have normal bodies for older women kicking ass –

Dr. Gunter: Right.

Sarah: – and looking really good.

Dr. Gunter: Absolutely! I mean, I think, you know, actually, my favorite movie still is Melissa McCarthy’s Spy, which is –

Sarah: Oh! It’s so good!

Tara: I laughed until I wept.

Sarah: [Laughs]

Dr. Gunter: Oh my God –

Tara: – just the first time I saw it! [Laughs] Like –

Dr. Gunter: I’ve seen that movie probably thirty or forty times, I’m not ashamed to admit. My kids, it’s one of their favorite movies. Every single time, every line in that movie, and to see her just being unabashedly her and kick-ass and all the, the, the women, and it’s just, it’s a perfect movie, and why can’t she be an action star? Everybody can be an action star! It’s fantasy! And, and she’s just, she is amazing: totally believable in the character. I, I’m like, why can’t you make Spy 2? I’m waiting.

[music]

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And now back to our conversation with Dr. Jen Gunter.

[music]

Tara: You mentioned the grandmother hypothesis, and that’s also a very strong feature in The Menopause Manifesto. So what can we all do collectively to try to encourage this different understanding of menopausal women?

Dr. Gunter: So I think it needs to be taught in curriculums in schools. I think if you learn about puberty, you should learn about the reverse of puberty. I think if everybody from age, you know, whatever, nine, ten, eleven, twelve, when sort of human biology is taught, they should learn that! They should learn that menopause isn’t a sign of weakness, that it, that it’s not ovarian failure. It’s a planned ending, just like pregnancy ends at a point, just like childhood ends at a point. You know, we wouldn’t ever say that, that someone is diseased ‘cause they’re no longer a child and they’ve gone through puberty, right, so why do we use that same language? Because, you know, the patriarchal prize of a reproductive-age woman, right? Like, that’s, that’s the, what it boils down to. So I think if everybody learned that, oh hey, look, you know, menopause has played an important role in evolution. You know, maybe if everybody knew that from the beginning, they’d be more inoculated against the misinformation and the disinformation.

Tara: I was actually angry when I read about it in your book, only because I had never heard it before. Like, there was so much of, of your book that infuriated me because I felt like, why wasn’t I told this before? I mentioned that I’m French-Canadian. Do you know how many aunts I have? I don’t; there’s too many.

[Laughter]

Tara: I have a mother; my grandmothers both lived until I was at least in my teens; like, and yet I was still, there was so much that I had just never heard, and so I’ve started being that annoying person saying to, like, a friend who’s in their thirties, by the way!

Dr. Gunter: [Laughs]

Tara: Just so you know!

Dr. Gunter: Yeah, it’s super important, right, and of course it makes so much sense! It makes so much sense that, you know, you know, so for, you know, for people who are listening who, you might not have read the book yet, the hypothesis, which has a lot of good supporting evidence, is that the ability to live beyond your ovarian function meant that you were a helpful contributor to your family, and so obviously the very first few people that were, that lived a few years beyond their, their ovaries stopping functioning helped their family have more children, and then those genetics started to perpetuate, and so on and so on, and so you can only care, help your, your own children care for their children if you’re done. So, so we need this slowing down, because, you know, you can’t just stop having kids at fifty-two, because then you can’t actually be that helpful, but if fertility winds down in the early forties, then by the time, you know, your children are having children, your kids are, your youngest kid’s eight, nine, ten years old and can forage for themselves, so now you can help the next generation.

Sarah: I look how motherhood and the, the, sort of the deification of being a mother, a mother, there’s no discussion of what happens when your kids are all grown up. Like, you just disappear from the collective narrative. And it’s astonishing to think that –

Dr. Gunter: No, I absolutely agree. I mean, I think it’s been, you know, there’s been sort of a patriarchal mindfuck from the beginning. Like this idea that, you know, motherhood is, is basically, as you said, a deification, that, you know, that there’s something holy or special, and how much of that comes from, you know, I don’t know, like, you know, Mother Mary and, you know, Christianity, and how much, you know, how much of that is intertwined with it? You know, this forcing people into narrow scripts of motherhood, we would never have evolved if everybody filled a narrow script, right?

Sarah: Right.

Dr. Gunter: Because we needed people to push bounds and seek new things and try different things, right?

Sarah: Yeah.

Dr. Gunter: So if motherhood had meant to be this sort of narrow, heteronormative, stay-at-home, domes-, you know, diminutive, dismissive type of, you know, life that faded away, if every single mother had been like that, no mother would have like, oh, let’s try eating this plant, or, let’s try this different way of raising children, or, let’s try – like, like, human creativity requires that we don’t all conform, right?

Sarah: Yeah, absolutely. Now, you also wrote that by the time a woman enters her menopausal transition, she has absorbed a lifetime of toxic messages about her size and shape! Yes, can confirm. Too fat, too thin, too big, too small, too much, too little, and sometimes – this is my, one of my favorite lines – the essence of being a woman is to be in a constant state of apologizing for your body. You’re very careful in this book about how you discuss weight loss and the way you’ve even approached your own dieting for thirty-plus years as you wrote it. Was that really difficult to, to share, and why do you think it’s important for us to talk about this collectively?

Dr. Gunter: Well, I think that there’s so many awful narratives about weight –

Sarah: God, yes. Oh yeah.

Dr. Gunter: – and there is so much fatphobia in medicine, and so many people have come to doctors and been dismissed and said, oh, if you just lose weight, right, and there’s a lot of awful backstory to that. But at the same time, weight can also have health implications. Many things can have health implications; you don’t want to focus just on that. But I wanted that information to be available for people who were in a mind space that they could take it in, but I also basically wanted to put a, you know, a trigger warning up about it, and saying, you know, if this segment isn’t for you, please skip over it. You know –

Sarah: I really appreciated that.

Dr. Gunter: You know, I think that you want to try to make it welcoming; you want to try to give people the information. We haven’t learnt the ways to talk to people appropriately about their health, and that’s because we’ve made it all about body size and shape, and, and so I hoped that, you know, giving some of the, the medical information about, you know, why, why things like where we put our fat matters, you know, and I thought a lot about that because it’s so upsetting to me that we focus on the size and shape of a woman, but actually the fat that is the most destructive is the fat that we can’t see! We’re not even giving them, people the right health messages. It’s just – and not that health messages should ever be tied to anything negative – but it’s just this sort of total absence of discussion about the thing that could actually be useful to somebody. And so, you know, I, I just, I wanted people to have the information. Many people notice that their body changes in menopause, and I think people want to know why that happens, and so why can’t we just talk about it that way? You know, that, you know, this is why you should know about it, and –

Sarah: Yeah.

Dr. Gunter: – you know, next!

Sarah: Speaking of things that were learned in this book, I had no idea that there was a positive outcome for mesh in cases of bladder problems with menopause and age? I had absorbed the messaging that mesh is terrible and bad and is, it’s going to come and get me. It’s going to come in the house and drink all my beer, and it’s going to take my health away, and it’s just very dangerous; don’t go near the mesh! And you’re like, actually, no. Also the thing about not having to pee after you have sex; that blew my mind too. I did not know that that was –

Tara: Yes, that one!

Sarah: Yeah? I thought the post –

Tara: Yeah!

Sarah: I call it the PCU! The post-coital urination! I thought it was a necessary thing, and you’re like, nah, it’s fine. You’re all right.

Tara: Yeah, I was –

Dr. Gunter: Yeah.

Tara: – that was one of the ones where I had this, like, little pop of anger ‘cause I was like, why are family doctors still saying that all the time?

Sarah: What can women do to better advocate for their bladders? [Laughs] Let’s be real!

Dr. Gunter: You know, that’s, it’s interesting. So the, you know, not peeing after sex has been taken out of all the guidelines now. You know, it’s kind of like one of those old, you know, it’s one of those things that, that people said in the ‘50s and ‘60s before they understood the biology, right. Like, we didn’t have the microbiological ability to, to know a lot of what we know now. So, you know, now we know it’s far more complex than just flushing bacteria out of your bladder, right? So, like, for example, there’s lots of people who have bacteria in their bladder and never get infections! You know, it’s, you know, so, for example, if you just did a random urine culture and you have no symptoms and you’re full of bacteria, we wouldn’t treat it! It’s not causing a problem! So it’s not, you know, so there’s a lot more to it than just having bacteria. And I talk about this a bit in The Vagina Bible: there’s sort of this ongoing burden of all these useless things we tell people to do, right?

[Laughter]

Sarah: Yes!

Tara: Yep.

Dr. Gunter: And so, and so it feels like you’re in a game of Twister with your body, right? You’ve, you’ve put your right arm on the yellow circle and your left arm on the green – but oh, wait, but now you have to put your right foot on the blue circle, and you’re twisted up doing all these things that can’t really help you. So then when someone comes along and gives you advice that could help, you’re like, oh, fuck it, I can’t do it; I’m doing too much. And so my personal theory is all these sort of useless things can sometimes actually be a barrier to, to actually getting the right therapy, because, you know, if five doctors have told you something didn’t work, why would you believe the sixth one?

Tara: I also find, especially with vaginal concerns or urinary pain or anything like that, if you, even if you’re talking to friends, they all want a solution for you, but it’s all the same solutions that you’ve heard before! And I, like, wanted to punch one of my friends because I was like, if you talk to me about cotton underwear one more time I’m going to lose my mind!

Dr. Gunter: Right. And think about how many of these things we tell people to do overlap with purity culture. So white cotton underwear –

Tara: Yeah.

Dr. Gunter: – purity culture. Peeing after sex! Ooh, getting that dirty semen out of you. Right? So, you know, so all of these things that we, sort of these hoops all feel like purity hoops to me as well. And once you see it, you can’t unsee it. You’re like, oh, purity culture –

Sarah: Oh yeah.

Dr. Gunter: – purity culture, purity culture. Yep.

Tara: The thing that’s interesting for me with that is, like, hearing you talk about purity culture is making me connect other things, because I actually grew up in an evangelical church during the height of like in the ‘90s, where you’re writing your, you have your promise rings and you’re writing that little, I promise to God I’m – whatever it was, the True Love Waits things, and so seeing, like, ‘cause I’ve left the church, and as much as I think, you know, these things are behind me, it’s like, no, no, it’s, it’s still, it still keeps going with you, because it’s a part of the whole system of patriarchy and white supremacy. Like, it’s all –

Dr. Gunter: Right.

Tara: – just the same thing. [Laughs]

Dr. Gunter: Absolutely. Yeah, they’re really, the two systems support each other. I would say that.

Tara: Yep.

Dr. Gunter: Yeah. But, but back to mesh, yeah, so not all mesh is bad. You know, just like not all cars are bad. There are some cars that are definitely dangerous and should never be on the road, and there’s some cars that if they’re driven by the wrong person could be dangerous, but if they’re driven by an expert wouldn’t be, right? And then there’s some cars –

Sarah: Yep.

Dr. Gunter: – that everybody can drive. And so there is, you know, something called a, you know, a suburethral sling that is a mesh for incontinence. That’s one of the most studied procedures, probably, in gynecology, and it’s very effective. And so, you know, this is what happens when journalists write about it and they either have an agenda, you know, because also a lot of things have been harmful for women’s bodies, right, like the Dalkon Shield and, you know, thalidomide, and so we have this history of understudied things, but I think in that zeal, some of the good procedures got swept up with the bad, and so I just wanted people to be open to that, that if their, you know, their doctor recommend, you know, if they have bad stress urinary incontinence and all these other things aren’t working, there is a mesh procedure that’s very well studied and, you know, very safe.

Tara: What’s your TL;DR on The Menopause Manifesto? Like, if, if we were to read it and only take away one thing, if everything else were to fall out of our brain, what’s the one thing you would want to stay there?

Sarah: Other than simmering rage?

Dr. Gunter: [Laughter]

Sarah: Got plenty of that.

Tara: That’s just a, that’s just a baseline, right?

Sarah: Yeah, it’s just –

Tara: Isn’t that just where we all live?

Sarah: Yeah!

[Laughter]

Dr. Gunter: Yeah. Oh, take one thing away. Well, I do think that, you know, the, the strength of the grandmother hypothesis, I think that is that, you know, you were not meant to die at forty-nine. We evolved to live for, you know, twenty or thirty years beyond our ovarian function, and that makes us unique – pardon me – that makes us unique. It’s us and killer whales, toothed whales, which I think is really cool.

I think my number two takeaway, if I’m allowed to have a second one, is –

Sarah: Yeah, absolutely! As many as you want!

Dr. Gunter: – is – [laughs] – is there’s a lot of predators in this space, and –

Sarah: Yeah.

Dr. Gunter: – there’s a lot of people selling you potentially harmful therapies, unstudied therapies, therapies I would never use on myself and, you know, don’t you want to, you know, use something that a, that, you know, a gynecologist who’s an expert in the area would only consider to be safe enough for her. People selling you products have an agenda, you know, and it’s really sad: we see so much misinformation in, you know, in the, in the menopausal hormone therapy realm. You know, the compounded therapies, as I mentioned earlier; the, you know, the lies about things being plant-based.

I guess that would be my other takeaway: all hormones are made in a lab the same way, so if anyone’s telling you they have special plant-based hormones, they’re lying to you.

Sarah: I think my biggest takeaways were never get your healthcare advice from Facebook and Instagram? Those are not –

Dr. Gunter: [Laughs]

Sarah: Those are not places to get your health advice? But also the unfortunate truth, much like politics and government, is that there is no one short, definitive answer. Everything is nuanced and complicated, so if you’re talking to an actual doctor, you’re going to hear things like, well, these studies have shown this, and this is an option, but there is also this, and you have a lot of factors to make a decision, whereas, you know, Instagram and Facebook, with this tiny little space, the answer is This. Well, it’s really nice –

Dr. Gunter: Yeah.

Sarah: – to believe the answer is This, but that’s not actually the answer; things are more complicated and nuanced than that!

Dr. Gunter: You know, we all like heuristics, right? We all, I think this is –

Sarah: Yeah!

Dr. Gunter: – evolutionary thing, like –

Sarah: Yup.

Dr. Gunter: – is the drinking water over there safe or not? You know, is the tiger in that jungle going to kill me or not? Like –

Sarah: Yeah!

Dr. Gunter: – I think that, you know, this appeals to us on sort of a visceral level that we can’t really quite explain, and there’s probably, I’m sure some brain scientist could explain it, but, but it, it appeals to all of us. And I think that that doesn’t work in medicine. And so certainly where I can be absolute I try to be, but that’s why, again, I get back to this idea, if everybody had more information about how it all works, then they would see the charlatans for what they were; they would be able to make decisions that, you know, they’d block those people and hopefully not be exposed to them and, and sort of spread the, spread the manifesto.

Sarah: I want to ask you about curly hair, and this is a menopause story.

Dr. Gunter: [Laughs]

Sarah: Okay, so as you can see, I got –

Dr. Gunter: Yes, I love it! I –

Sarah: – I got curls going on here, right. I usually have short hair, and I didn’t get my hair cut for a year ‘cause Quarantimes, and when I was getting my hair cut at one point I had one curl back in the back of my neck, and my hair stylist said, well, you know, maybe you’re going through the Change of Life and your hair is getting curly! And side note: I told a neighbor that story and she went – [gasps] – did you smack for saying that to you? And I was like, why would I smack my hairdresser for thinking I’m going through menopause? This is not a cause for violence! But apparently in that person’s world –

Dr. Gunter: Right.

Sarah: – it is a cause for smacking my hairdresser, which I did not do. I think the Change of Life is changing my hair. This has never happened before in my entire life, and I am learning to take care of curly hair. It is its own hobby.

Dr. Gunter: It is.

Sarah: It’s, it is its own – it’s like having a toddler that grows on my head. How are your curls doing, ‘cause I follow you on Instagram and I know that you are on your own curly hair journey?

Dr. Gunter: [Laughs]

Sarah: Does menopause make your hair curly? Is my hairdresser onto something here? I mean, I know there’s no yes/no answer, we just covered that, but.

Dr. Gunter: I’ve never heard that. Now, it, I also don’t know if there’s any data on it, so hor-, you know –

Sarah: Fair enough.

Dr. Gunter: – so can hormones influence hair follicles? I mean, it wouldn’t surprise me! Some people talk about their hair changing around puberty, you know, so, so is it –

Sarah: Chemotherapy has changed people’s hair too.

Dr. Gunter: Oh, absolutely, yeah.

Sarah: Yeah.

Dr. Gunter: Oh, I have a friend who finished, you know, chemo about a year ago for breast cancer, and her, she had pin-straight hair, like pin-straight, and oh my God, her curls! And she’s just like –

Sarah: [Laughs]

Dr. Gunter: – you know, there’s, she’s got some videos on Instagram just pulling the curls out, and it’s just like, I, like I’m, like, I mean, it would be sort of as if I grew up, if all of a sudden something gave me pin-straight hair I’d be like, this isn’t me! What are you even – [laughs] –

Sarah: So how are your curls doing?

Dr. Gunter: So – well, my curls are doing okay.

Sarah: Gorgeous.

Dr. Gunter: They’ve just recently been bleached, so they’re a little sad. But, so I had a little extra gray put in my hair. You know, so that’s – [laughs] – as opposed to people hiding it, I decided I was going to lean into the gray.

Sarah: It looks fabulous!

Dr. Gunter: Thank you! But, yeah, my curls are doing good. It’s, that was my quarantine project. I tried to grow sourdough starter and I killed it. I’m very bad with any plants. Any –

Sarah: But you’re, but you’re a gynecologist! Shouldn’t you and yeast be, like, good buds? Like –

Dr. Gunter: See, I try to kill the yeast I look after.

Sarah: Oh, that – well, there you go. [Laughs]

Dr. Gunter: So I’m a yeast killer! That’s me, Yeast Killer!

Tara: Better to kill your sourdough starter than your hair.

Dr. Gunter: Right! [Laughs]

Sarah: Yeah! For sure!

Dr. Gunter: So anyway, so yes, so I killed the sourdough starter, ‘cause apparently I’m just, like, dripping in azoles. It’s just, like, emanating from me, the, you know, the therapy we use for yeast, so it’s not a yeast-friendly home. So, but my partner, he’s an amazing, so he makes amazing sourdough, so he took over the sourdough starter; he’s good with that.

And so I decided to embark on a curl journey and to try to, you know, get my curls in better shape, ‘cause, you know, I had time to let things air dry. [Laughs]

Sarah: Oh, don’t we, though? We’ve got lots of time; we’re not leaving the house.

Dr. Gunter: Exactly.

Sarah: Now, you also mention – it’s a key question! – you also mention in The Menopause Manifesto that you had tried out the Lunya PJs. I own their travel kit, which is wonderful, ‘cause the pockets hold so much, but I’ve never –

Dr. Gunter: Oh!

Sarah: – tried the PJs. Which ones did you get, and do you still like them?

Dr. Gunter: I got the silk short comb-, so it’s like a little short, like tap shorts and a, a sleeveless tank, and it’s got a big vent in the back?

Sarah: Yep!

Dr. Gunter: And I actually really like them! I mean, I was not swayed by their science, and I wish companies like that wouldn’t, you know, like, oh, our technology’s this and this. I’m like, you know, whatever. But it’s great.

Sarah: Calm down. It’s fabric.

Dr. Gunter: Exactly. But if something feels cool on your skin, you know, feeling cool can help people having hot flashes. I mean, obviously, if you feel cool you’re less likely to be hot. [Laughs] And the back vent, and so, yeah, I really like them! They wash fine; I mean, I don’t care for them in any special way. They go in the wash with – if, basically, something requires special washing, it’s dead to me.

Sarah: Mm-mm, no. No, my, my –

Dr. Gunter: So –

Sarah: – my religion is, through God, all things are washable.

Dr. Gunter: Yes! Oh my God, and it’s a, and then there’s a corollary that if it’s not dishwasher-safe it’s dead to me.

Sarah: Oh, forget it, mm-mm! No!

Dr. Gunter: Yeah.

Sarah: The dishwasher’s the hero of my house in the Quarantimes.

Dr. Gunter: I love my dishwasher. I have a personal relationship with my dishwasher.

Sarah: Oh. Mine is a hero. It, it, it holds my household together.

Dr. Gunter: I once sang to my dishwasher. [Sings] Did you ever know that you’re my hero?

[Laughter]

Tara: Oh –

Sarah: I’m going to do that, and my teens are going to be like, Mom? Mom, are you okay?

Dr. Gunter: But yeah, so the curl journey, yeah, I’m all about just using the right products, trying to let it set, realizing that there’s about as much pseudoscience probably in hair care as there is in, in medicine. And it’s really interesting; so, you know, you see all these influencers with their spectacular curls. Like, you’re just like – [gasps] – like they’re so luscious and moist, like you want to reach out and touch them. You know, I follow a couple of curly hair professional, like, hair stylists. This one was like, I know you all see all those influencers, and you just keep buying all those products, but you just really need to get down to basics, and I thought – [gasps] – you sound just like me!

Sarah: [Laughs]

Dr. Gunter: You sound like Dr. Jen! And so that really spoke to me. So she’s like, you’ve just got to focus on your technique; stop with all the products, the crazy products. What you have is probably fine. And I was like, ooh!

Sarah: Ooh!

Dr. Gunter: So yeah, so I’m focusing on my technique.

Sarah: Oh! Well, I mean, it’s, it’s similar to what has happened with, with, with menopause, you know, collective knowledge: so much about caring for curly hair has come from marginalized women who have been shut out of all of the, you know, the, the hair care industry –

Dr. Gunter: Mm-hmm.

Sarah: – and the hair care professional accreditation. All of the care for natural hair comes from marginalized women, and now of course it’s being co-opted and profitized – is that a word? It is now – by, by people who are like, oh, curly hair! I can make money here because there’s a lack of knowledge in this area.

Dr. Gunter: Right.

Sarah: So it’s, it’s –

Dr. Gunter: Yeah.

Sarah: – it just repeats itself, right? Like, we’re just stuck in an international mimeograph machine.

Dr. Gunter: Yeah. Themes, you know, I think that that’s why you’ve got to learn history or – you know, such a cliché – you’re destined to repeat it, but I think it’s true.

Sarah: How funny that it’s a field that speaks to you. Like, let’s just simplify, and here, here’s all of this pseudo-knowledge. Here’s what’s actually happening. Yep.

Tara: Do you have any book recommendations that you would want to share with listeners?

Dr. Gunter: You know, I haven’t done a lot of reading in the last year – [laughs] – ‘cause I’ve been writing. But I, just a few months ago I finally read The Untamed Midwife by, by Meg Elison, and it is amazing. I can’t wait to get the other two books in the series. It’s about a dystopian future, which, you know, reading it during the time of lockdown, a dystopian future triggered by, you know, a viral infection. [Laughs] But oh my God, her writing is just amazing, and it was just, I felt like I was right there the whole time. It just was really amazing. Sorry, it’s The Book of the Unnamed Midwife; sorry.

Sarah: The Book of the Unnamed Midwife.

Dr. Gunter: Yeah, The Book of the Unnamed Midwife; I was, I had the name wrong.

Sarah: Thank you so much for your time and for pivoting and doing a quick interview about menstrual symptoms and the COVID vaccine, and thank you for your book and all of the ass-kicking you do on the internet. It is, it is exhausting to, to be a target like the way that, the way that you are, and I don’t take that lightly to –

Dr. Gunter: Mm.

Sarah: – to not only fight, but also take on all the people who are upset by what you do and are, are deploying really disgustingly gross humiliation tactics about it. That’s, that’s hard work, so thank you for doing that.

Dr. Gunter: Oh, thanks. Yeah, I just, you know, I just want everybody to have accurate information about their bodies, and that shouldn’t really require an act of feminism, but apparently it does.

[music]

Sarah: And that brings us to the end of this week’s episode. Thank you to Kensington for sending copies of this book to both Tara in Canada and myself. This book was life-changing, and if you or someone you know has been dealing with a lot of misinformation or just struggling with menopause, this book is available right now, and I have links to where you can find a copy, including at your library, in the show notes.

You should definitely follow Dr. Jen Gunter, either on Twitter @DrJenGunter or Instagram @DrJenGunter. Her website is – you’ll never guess – drjengunter.com. But more than anything, I want to recommend her new podcast. She has a new podcast through TED called Body Stuff. The first episode is all about the myth that you need to drink eight glasses of water a day. You do not need to drink eight glasses of water a day, and Body Stuff episode one will tell you why. It is all about kidneys, and I learned so much. It is terrific, so look for it wherever you get your fine, fine science podcasts.

I am curious, though: what are your favorite terms for menopause, and what myths have you learned? You can email me and tell me at [email protected], and you know I love hearing from you. I really, really do.

As usual, I end every episode with an absolutely dreadful joke, and this week is no different. Why would I do that to you? Not a chance! Are you ready? I love this joke.

Why was there music coming from the printer?

Why was there music coming from the printer?

The paper was jamming.

[Jams, laughs] Paper was jamming! [Laughs more] I hope you like that one as much as I did! I’m still tickled, and I’ve probably told it six times, maybe? Maybe seven at this point. Probably more than that. The paper was jamming.

On behalf of everyone here, we wish you the very best of reading. Have a wonderful weekend. We will see you back here next week.

Smart Podcast, Trashy Books is part of the Frolic Podcast Network. You can find more outstanding podcasts to subscribe to at frolic.media/podcasts.

[jamming music]