Episode 18--Billy and Brian Discuss the Emotionally Mature Female Brain with Women's Health Nurse Practitioner Krista Margolis (Part 4 of The Female Brain by Louann Brizendine)

In Part 4 of 4 episodes on The Female Brain by Louann Brizendine, Billy and Brian discuss  the emotionally mature female brain with women's health nurse practitioner Krista Margolis.  Krista walks us through the biological changes of perimenopause and talks about why menopause gets a bad rap (when it should really be the "IDGAF" years of a woman's life!).

Krista Margolis is an advanced practice registered nurse (APRN) and women’s health nurse practitioner.  Krista has also had advanced training in functional medicine. Krista believes in working WITH each woman because a woman knows as much or more about her body than she does, so we work together to create health and balance.  Krista also leads "Menopause Mondays" workshops. 

Like what you heard from Krista?  Contact her at:
Website: www.kristamargolis.com
Instagram: @kbmargolis
Email: krista@kristamargolis.com

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Transcript

(intro)

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Welcome to The Mindful Midlife Crisis, a podcast for people navigating the complexities and possibilities of life's second half. Join your hosts, Billy and Brian, a couple of average dudes who will serve as your armchair life coaches, as we share our life experiences — both the good and the bad — in an effort to help us all better understand how we can enjoy and make the most of the life we have left to live in a more meaningful way. Take a deep breath, embrace the present, and journey with us through The Mindful Midlife Crisis.

(interview)

Billy: Welcome to The Mindful Midlife Crisis. I'm your host, Billy. And as always, I'm joined by my good friend, Brian on the Bass. Brian, how are you doing over there, man?

Brian: I am tremendous. Thank you.

Billy: Oh, you took the day off today. Didn’t you?

Brian: Off of work.

Billy: Yeah.

Brian: Not off of the podcast.

Billy: Right. No, no, never.

Brian: Obviously.

Billy: No, we're always here. We're running like clockwork and taxes over here.

Brian: And a day off for me consists of only like 10 hours of work instead of 15.

Billy: Well, you were working on the bus today. What's new with the bus?

Brian: Yeah, just rebuilt the generator, housing, plugged a few holes, did various nonsense.

Billy: You guys are gearing up for a big summer trip.

Brian: Yellowstone. Yeah, heading out through South Dakota, Yellowstone. We've got three or four nights in Yellowstone. We've got three nights in South Dakota. I think we're going — I don't know where else we're going. My wife just plans, and I drive.

Billy: That's a fair way to do things.

Brian: Yeah, I just say, "Where are we going?" She would just point that way. Okay.

Billy: There you go. Do you think you guys are going to Badlands?

Brian: Probably

Billy: Do you think you’ll stop at Rushmore?

Brian: Maybe. I would think she wants to hit all of them for the kids. So, yeah.

Billy: Got it. Have you ever been to Rushmore and Badlands?

Brian: I have, yeah. My family did that, and Kathlyn's family did that. So, I guess, this would be a tradition now, wouldn't it?

Billy: Yeah, I suppose so. Something that you're passing down. Fantastic. That sounds like fun. If you have room for one more, let me know.

Brian: I figure, I'd better pass something good down. Because as soon as they get the gout, they're going to be fu*king pissed. They're going to be so pissed. I know. I'm pissed about it. So, thanks, dad.

Billy: Oh, bummer. That sounds like a real bummer.

Brian: It's terrible. It's awful.

Billy: Something to look forward, too, kids. I, on the other hand, April and May are my two busiest months of the school year. Because it's the end of the school year, obviously. But then, I also am a coordinator for — it's a freshman transition program. We are currently in the process of interviewing all of our juniors and seniors who are going to work with those freshmen next year.

Today I had the pleasure of conducting 13 half hour long virtual group interviews on Zoom, five to six students per group, which is I think it was a total of 75 kids that I interviewed today. 235 over the course of the last two weeks. So, I'm a little exhausted today. But I'm always energized when you and I get together, and we get to conduct our interviews for the podcast. It's a little different to do.

Brian: It is, yeah. Would you say it's a little more fun than doing the student?

Billy: Yes, it is. It's a little bit more engaging, a little more enlightening, a little more interesting. Albeit, they're great kids. They're wonderful, and they have a lot of great things to say. I'm just happy that they are committed to making the world a better place. But I do look forward to this every Friday.

Today we're actually bringing a close to our four-part series on The Female Brain by Louann Brizendine. Now, notice we only did a three-part series on The Male Brain. The Female Brain, a bit more complex. Brian, do you feel like you understand the complexities of the female brain any better?

Brian: If I was going to give it a percentage, 0 to 100, I'd say about 4.5.

Billy: Well, luckily, we have an expert today in female health and an expert in the female brain. Our guest today is Krista Margolis. Krista is an advanced practice registered nurse and a women's health nurse practitioner. Krista has advanced training in functional medicine. Krista really believes in working with each woman because, ultimately, they know as much as or more about their own bodies than she does. So, they work together to create health and balance. Krista is also a mom of two teenagers and a 12-year-old. She has been happily married for almost 19 years. Welcome Krista Margolis. Thank you for being here today.

Krista: Thank you.

Billy: Yeah, absolutely. So, Krista, to start things off, we always like to ask our guests what 10 roles they play in their life. So, what are the 10 roles that you play in your life?

Krista: My 10 roles are mother, wife, daughter, sister, friend, healthcare provider, runner, nature lover, adventure seeker, and exercise addict. Is that 10?

Billy: Yeah, that's right on the dot. Nice work. We also like to ask our guests then what are the three they're most looking forward to in the second half of their life. What are your three?

Krista: I would have to say — my kids will hear this. I might be in trouble. But probably not mother, because they're going to go. They're going to leave, and I won't be doing as much mothering, right? Probably, the sister, friend, and adventure seeker tied with nature lover. I don't know.

Billy: Okay.

Krista: That sounds fun, right? They go hand in hand.

Billy: Yeah, it's funny that you mentioned that maybe not so much mom, because you're not going to be doing the same nurturing.

Krista: Right.

Billy: That's actually something that we're going to discuss later on in this episode.

Krista: Fantastic.

Billy: So, pay attention to that when we get to that point. Then let's talk about this. Well, what nature do you love? What do you enjoy?

Krista: Well, earlier before this, today, I was mountain biking at Wirth. I like to just be in the woods. Anything water, woods, it just makes me really happy.

Brian: Logging?

Krista: Logging, yes. Actually, I'm a huge fan of stacking wood, and the appearance of it. It's a weird thing. I know.

Billy: Do you cut your own wood?

Krista: Often I do, yeah.

Billy: Nice.

Krista: I mean, I don't go chop the tree down and do the whole thing. But if there's a piece that's too big, I got to take it down to a stackable size.

Billy: You'll get after it. Nice work.

Krista: Right.

Billy: We know each other through a mutual friend. You are going on a little nature trip with some cross-country runners this summer. So, can you talk a little bit about that?

Krista: Yes, our mutual friend is fantastic. We're taking 20-ish high school seniors, maybe some juniors, varsity runners, out to the Black Hills — where it sounds like Brian's also going — and going to spend a week camping, not showering, and running with a bunch of teenagers. It’s going to be awesome.

Billy: Well, that's going to be part for the course for many of them if they’re not showering.

Krista: Right. But it'll be great.

Billy: I imagine there will be some wonderful odors that you will get to—

Krista: Then a 15-passenger van, that's going to be even better. I'm super excited about that.

Brian: Oh, that's going to be a veritable cornucopia of stench. Wow.

Krista: Right.

Billy: Oh, what a beautiful use of both of those words right there.

Brian: Thank you very much. I’m like Sting. I'm gonna break out the Scylla and Charybdis soon, as well.

Billy: That was wonderful. That was wonderful. Are you driving any of the vans?

Krista: Jamie, our mutual friend, is in charge of it. I'm just being told where to go.

Billy: Got you. You're just along for the ride.

Krista: I'm along for the ride. So, we'll see.

Billy: You sound like Brian. You get your—

Krista: Right.

Brian: Exactly. I mean, that's how I live my life. People tell me, "Go over here," I'll go.

Krista: Really, there's another woman that's going to tell me to get in the car and go west. All right. I'll do it. I'll do it.

Billy: So, that sounds like an adventure that you're going on, as well, along with the nature. Can you tell us a little bit more about where in nature do you want to seek out and go adventure?

Krista: Oh, that's a great question. I really want to do more, farther away. I haven't been to Australia. That's a big place. Peru. I don't know. All over the place. Everywhere.

Billy: What's the draw to Peru and Australia?

Krista: I think just the different — well, the culture, the photos I've seen, really. That's it.

Billy: You also combined sister-friend into one. So, can you talk about what kind of relationship you have with your sisters? Are you the older sister? Are you the younger sister? Are you the middle sister?

Krista: I have one older sister. She's five years older, but we're a uni-brain. We're very, very similar. People never know which one of us is older. We're super close. She's an adventurer, but I have to sometimes nudge her a little bit. So, that's my next chapter.

Billy: Then you have a younger sister?

Krista: Nope, just the two of us.

Billy: Oh, just the two of you.

Krista: Yeah.

Billy: Got you. Is it no brothers at all?

Krista: No brothers, just females.

Billy: My two sisters are so envious that you don't have a younger brother.

Krista: We always wanted a brother.

Billy: Oh, I'm sure they're willing to hand me off to you at any given time.

Krista: I doubt that. I doubt it

Billy: You may be surprised. And a friend, of course.

Krista: Yeah, because they do all my activities with me. I'm sorry. If my husband's listening, wife is really important. I'm just realizing. Oh, my God. I didn't even think about that one. Is it that one that I just take that one for granted? I don't know.

Billy: No, I think there's probably — we'll talk about it later, too. I think that's something that's just a given.

Krista: Of course, I'm going to be with my husband, right? My friends, I have super fun active friends. They just always say yes. I'm like, "Who wants to do this?" I'll do it. Great. So, we have a lot of fun.

Billy: One thing that I've noticed, Brian, when we talk to guests, and they talk about their 10 roles, almost all of them talk about wanting to travel.

Brian: Yeah, you're right. That's pretty much universal so far.

Billy: Yeah, every one of them was talking about a real need and desire to travel. So, just out of curiosity, have you done a lot of traveling up to this point?

Krista: I would say yes. Nothing super extreme or crazy. But yeah, I've definitely done a fair share.

Brian: Have you ever been to Europe?

Krista: I have been to Europe.

Brian: Oh, nice. What parts? Where?

Krista: Let me think where I've been. Spain, France. That’s kind of it, actually.

Billy: Nice. I guess, where in the US are you thinking about? Where would you like to go to?

Krista: You know, I haven't been to Santa Fe and Taos, New Mexico area. I've driven through it, but I've never spent time there. It's high up for me.

Brian: I've heard that's a sleeper, It's a gorgeous area.

Krista: That’s what I've heard.

Brian: But it's not really well-known that it's super beautiful and expansive and really awesome.

Krista: Yeah, and then the Northeast is another area that I haven't spent a lot of time in.

Brian: Skip it.

Krista: Really?

Brian: Skip it.

Billy: What? Really?

Brian: Dude, I’m just kidding

Billy: I was going to say Zeb is just— Our friend, Zeb—

Brian: That's what I was thinking. Zeb’s up there. Don't go there.

Krista: My son is super interested in Vermont for college. He's a junior. We're going in the fall. I don't know. There's something that I feel like I'm going to love. But we’ll see. I could be wrong.

Brian: Vermont is nice. It is.

Krista: So, don't skip Vermont?

Brian: Don't skip Vermont, no. I was thinking like New York to about Massachusetts, forget it.

Krista: No, we’re going a little further west.

Billy: That's funny. So, we also asked you what some advice that you would give your younger self.

Krista: I think what I wrote down is talk less and listen more. I would stand by that. I'm still not good at it. I'm trying. I'm really trying.

Billy: I think that's good advice. The only problem is, I'm so interesting. I'm usually the most interesting person in the room.

Krista: Oh, for sure.

Brian: Yeah, of course.

Billy: Yeah, so why would I talk less?

Krista: That's a good point.

Billy: I get to listen to other people's boring ass stories the whole time and dumb.

Krista: This is why I'm still working on it at 48 years old.

Billy: I guess, why is that advice that you would give the younger version of yourself?

Krista: I think I've learned through some tough moments of parenting. Just stop trying to fix it. Stop interfering, asking questions. Just listen to what your kid is saying. Then I've learned that, as a health care provider, as a wife, just shut up sometimes. It's hard, though, for me.

Billy: I think you make a good point. Because I know I especially have a tendency to rush to conclusions and make assumptions because I'm waiting for my turn to speak. I'm listening to respond as opposed to listening to understand. That's the feedback that I've been given multiple times, and something that I still work on to this day.

Brian: Wait. What were you saying, Billy? Because I was just waiting to jump in here.

Billy: Precisely. That's actually my MO there. It's something that I would work on, too. So, I can relate. Can we talk a little bit about being a healthcare provider, considering we are in a worldwide pandemic right now? First and foremost, we want to say thank you for being an all-around superhero. Because you are a real life superhero for the work that you have done here during this time, and even before that. So, thank you so much for all that you do. Can you talk about what it's been like at being a healthcare provider the last 18 months?

Krista: Yeah, so it started out — I mean, I really don't see myself as a superhero because I'm not in the hospital. I'm in a clinic. I'm not doing emergency care so I haven't come that close to COVID. I look at the providers that have. I can't imagine. I know what a day feels like. That's so stressful, where you can't stop. You can't even go to the bathroom if you're running behind or whatever. These people are relying on you. They've got their days to get, too. Then you still have to walk in the room with that centered, clear space to listen and to help people. I don't know how these hospital workers and ICU care providers have done it. I'm just like, "Oh, thank you."

Anyways, when we started out, it just hit. My niece was actually at our clinic. She's training to be a PA. She was here doing her women's health rotation with me. She hates women's health. She's like, "Oh, will you get me through this?" I'm like, "You're going to love it." She still doesn't like women's health. But she was here. She's 27 years old.

She had to get two pelvic exams, a breast exam. You see, this thing she had to get done to be checked off. She got them done. We left the clinic on March 12, 13, whatever was a Friday. I got a phone call saying she can't come back, because we need less people around. I was like, "Yep, I understand." She got what she needed.

Then they called back later that week, and they're like, "Actually, you're not going to come back either. You're furloughed for now." I was like, "Oh, okay. All right." So, I was not working for four months maybe, which was interesting, really interesting. We were only seeing pregnant patients. Some of them bleeding, really, very small things.

But when I got back, it's been a normal sense. No dads or partners in the room with pregnant women until now. Wear masks. Everything's covered. It's been fine, though.

Billy: Well, that's good. That's good to hear. I guess, what are some words of wisdom that you have for people as we continue to navigate this? Governor Walz has announced that we might be — I don't know if Governor Walz has. But it sounds like by July 1, we might get rid of the mask mandate. I think in the very near future, things are going to start opening. I know gyms and restaurants are going to start being able to go to capacity, that sort of thing. But we're not there yet. Even when we get there, I imagine we'll need to proceed with some caution. So, I'm just curious, what is some advice as a healthcare provider that you would have for people as we get closer to these things?

Krista: Well, I think I personally — we're not here to talk politics, obviously. But I think the governor has done a great job. He's truly followed science. So, I trust and I see where we're headed. I think it's 60% vaccination rate. If we can just get a little further, I think all that makes sense. We're all really fatigued by this. I feel okay about it. I think what we're going to realize is we're all going to start to have colds and flus and all these things again, that no one has had because we're not masked.

We’re forgetting that super simple thing about anytime you go somewhere, go wash your hands. It's a really, really effective, super easy thing to do. Most people aren't that good at it. You go to the bathroom, you wash your hands. That's probably it. So, I think there are some simple things that will keep us on the right path. But I think we'll be surprised at, "Oh, I got a cold, or this or that." But I think we're ready. I think we're getting close to ready.

Billy: Do you think there's going to be a rebound? Do you think there's going to be a big influx of colds and flu?

Krista: I think in the fall, maybe. Because I think our immune systems will be like, "Wait. Well, what do we do? What happened?"

Billy: That could be. I agree with you.

Krista: Yeah, I think it could be interesting. But we'll see. I mean, maybe not if people keep washing their hands. We'll see.

Billy: I'm curious how that will play out in terms of, "Hey, I have these symptoms. Now, is it cold? Is it flu? Is it COVID." Those sort of things. I can't even imagine what it's like for health care providers and the scientists who are trying to make these decisions at the CDC, and keeping in mind that we're trying to get back to normal. But then, you have people on who are like still boy in the bubble. Then you have people who are they're boys in a bubble, There's like 17 of them, and they're not masked. They're doing shots and body shots and what have you. It's like, oh, goodness gracious. It's so interesting to see the spectrum of where we are with things. So, I'm curious.

Krista: Yeah, I'd be curious about that, too. I think that's the other thing. We have never. Any of us that aren't over 100 years old, we've never lived through a pandemic. All you can do is learn with each day each bit of science. Look at what we know now that we didn't know a year ago. There was no way to know some of this stuff. So, it's a lot of patience, and a lot of grace, and a lot of trust in the things we learn in the science, and shutting your mouth and listening, like I said.

Billy: I think that's a great way to end our first segment here. It's just shutting your mouth and listen. I think when we come back, we will take a listen to what Krista has to say about the emotionally mature female brain. Thank you for listening to the Mindful Midlife Crisis.

(break)

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And now, let's take a minute to be present with our breath. If you're listening somewhere safe and quiet, close your eyes and slowly inhale for 4, 3, 2, 1. Hold for 7, 6, 5, 4, 3, 2, 1. Slowly exhale for 8, 7, 6, 5, 4, 3, 2, 1. Let's do that one more time. Inhale for 4, 3, 2, 1. Hold for 7, 6, 5, 4, 3, 2, 1. Slowly exhale for 8, 7, 6, 5, 4, 3, 2, 1. Go ahead and open your eyes. You feel better? We certainly hope so. And now, back to the show.

(interview)

Billy: Welcome back to The Mindful Midlife Crisis. We are here with our guest, Krista Margolis, who is an advanced practice registered nurse and a woman's health nurse practitioner. We're talking about the emotionally mature female brain.

Now, a few things here. When I read The Female Brain by Louann Brizendine as a follow up to The Male Brain by Louann Brizendine, I will tell you that The Female Brain and The Male Brain book have the same number of pages. The Female Brain book is eight point font and The Male Brain book is a 72 font. So, I found The Female Brain book to be a more interesting read. I especially found it to be a more interesting read, because of what we're going to be talking about today.

Just to start things off here, it says that, a woman's emotional sensitivity is finely tuned. The female brain is an expert at reading faces, interpreting tone of voice, and assessing emotional nuance. Do you find that you've got those skills right there, Krista?

Krista: Definitely.

Billy: Can you talk a little bit about that?

Krista: I think it comes to that word intuition. I think it's not just looking at faces and tone of voice. It's walking into a room. There's an energy. There's a feeling. I can walk in with a patient and immediately be like, "Oh, she doesn't want to be here. She's annoyed that I'm running behind, or she's really happy I'm running behind because she can lie here and chill." I mean, you can just immediately sense, I think.

Brian: I wonder if that has anything to do with women having to, in general, be more aware of their surroundings, or danger, or stuff like that. You know what I mean?

Krista: Yeah, awareness. I think we've also been taught to be more careful.

Brian: Exactly, yeah.

Krista: Be careful what you say, careful how to interpret it. Don't sound like a bitch. Do sound like a — I mean, there's been so many subtle and not so subtle messages given to women, I think, that it's kind of ingrained.

Billy: Do you feel like you can read people's minds? Are you at that level?

Krista: No.

Billy: No?

Krista: No.

Billy: All right. The reason why I asked that is, I'm glad that you're here because I'm not sure if I've been pronouncing this correctly this entire time that we've been talking about it. The ACC, the Anterior Cingulate Cortex.

Krista: That's it. That's how I would read it, yes.

Billy: All right. Fantastic. It says that that's larger in females and is more easily activated to sense negative emotions. So, that's why women can read emotions better because their ACC is larger. We'll talk about this a little bit later. But you have to be in tears, for a man to recognize your emotions. That kind of thing.

Brian: Conversely, though, we can really read tacos very well.

Billy: Well, I mean, but tacos — don't you feel tacos should be a love language? I feel bad that we neglected the importance of a good taco.

Brian: Well, we can dedicate an episode later to the taco.

Billy: We should.

Brian: We really should. It's definitely merited, probably a series.

Billy: We would actually like you to email us or send us a message on Instagram. Our Instagram is @mindful_midlife_crisis or you can email us at mindfulmidlifecrisis@gmail.com. Let us know your favorite tacos, preferably in the Twin Cities, which may sound like an oxymoron. We like to travel, and Brian's got a bus. So, maybe we can do The Great Taco Bus Tour.

Brian: What's your favorite taco right now?

Billy: Oh, boy.

Brian: How about you?

Krista: I was just thinking about that.

Brian: I like our taco. Rusty Taco is badass.

Billy: Yeah, that's a good taco.

Brian: That's a great taco. Because they've got the corn shells, the soft corn shells, which I just — I love the corn. If I have a choice between flour and corn, I'm going corn. 10 times out of 10.

Krista: Same, 100%.

Billy: I was at 612Brew the other day, and they had a food truck there. I really wish I could remember what the food truck was. The corn taco was delicious, and the meat was plentiful. I will find out what was there and get back to everybody, because it was really good. It was a very tasty taco.

Al right. We'll get back to talking about female intuition. It's actually grounded in biology according to the book. It says an estrogen increase means that girls feel gut sensations and physical pain more acutely than boys do. The areas of the brain that track gut feelings are larger and more sensitive in the female brain. So, do you get those gut feelings?

Krista: Yeah, I actually didn't know that, about the estrogen increase and feeling the gut sensations. It makes sense. There's estrogen receptors in our gut. That's really interesting to see that. Yeah, I do. I get gut feelings all the time.

Brian: Wait a minute. Can you explain that to me. There are estrogen receptors in your—

Krista: In our gut and in our brain.

Brian: Is it in just females, or is it males and females?

Krista: Way more in females, way more.

Brian: That's fascinating. I had no idea.

Krista: Yeah, and tons in our brain, too.

Brian: This, Billy, is why you have experts.

Billy: Exactly. Because otherwise it's just two jackasses who were like—

Brian: Never would have known that.

Billy: —sound good to you? Sound good to me. That's about it.

Brian: Yeah, that's probably it. We’re kind of like social media. We just know nothing about it.

Billy: Yeah, we should have our own memes. It says, your emotional congruence is when one person is in tune with the other person's emotions and body language. Women may mirror the reactions they see from their partner in search of the emotion that correlates with how they think their partner is feeling. They'll match breathing and posture to become a human emotion detector.

So, if you ever see, Brian, Kathlyn standing a certain way, it sounds like what she's doing is she's mirroring you. If you're like, "Oh, why is she doing that," maybe that's because you're doing it. Have you ever been in that situation?

Brian: No

Billy: No?

Brian: No. Or you know what? Maybe I've just missed it. That's probably more likely.

Billy: That's probably more likely, too. Because we're going to talk about here, we, as men, just don't read those kinds of things very well. Do you feel like your husband picks up on your emotions?

Krista: Yes and no. When you're with someone that long, you start to. But I'm still sometimes shocked. Again, sorry, Jeff. Sometimes I'm like, "How does he not know that? How do you not get that?" Then I’m reminded because we're two very different brains. We're two very different human structures, just as individuals. But I do think there's such a huge difference. Huge.

Billy: I could tell that when I was reading this book, it's obvious that this book came out first. Because she does make a lot of comparisons between the male and the female brain. And The Male Brain book doesn't make as many comparisons. It's more straightforward. I think maybe that's why I found this one so interesting. Like I said, the complexity of The Female Brain is just far more fascinating than the complexity of The Male Brain. I'm wondering, do you ever have sympathy pains?

Krista: Yeah, definitely. I think the highest time I can think of feeling sympathy pains is around my kids. I can just tell when something's off with any of them. You go right into, like, "Oh, what is it?" I'm feeling it. I can see it on their face. I've had to learn, though, to let them navigate a lot of their own pains. I can't fix it. But that's taken a lot of years of parenting to figure that out. I would say this. Last year, really, during COVID, you turn on the TV, and you're like, "Oh my God." You feel the human suffering. I feel a lot when you see that.

Billy: Well, it says here that women actually pick up signs of sadness 90% of the time. Men only pick it up 40% of the time. Men usually don't read a woman's emotions until it's too late. So, when they're in tears and then when they're crying, men are like, "Why are you crying? Where's this coming from?" Well, have you been paying attention to the emotions leading up to that, you would have recognized it. It wouldn't be such a surprise.

Krista: Right.

Billy: It says here men also just don't want to take the time to figure out the emotion because it's too much work, which very well can be true. Because when I have students in my office, and they're going through an emotional time, I'm on the phone with the social worker or the counselor, and I'm like, "Can you come in here, please?" It is emotionally taxing when a student is coming in, and having an emotional moment.

I also know that, in my position, I don't have the same training as a social worker or a guidance counselor. We have male social workers, and we have male guidance counselors at my school. I just haven't gone through that training and that schooling to be able to recognize that kind of emotion, and empathize with that emotion the same way that they can. It's not to say that I'm cold-hearted and I'm like toughen up, "Get out of my—" I'm not like that. But it's like, who in here is going to be able to better process this emotion and this experience with this student than I am? I recognize what my strengths and my weaknesses are in the building.

It says here that women are hardwired to handle emotional roller coasters, which can be frustrating when men won't sit with discomfort. I think that's important as we look back on what we discussed with why the middle-aged male suicide rate is so high. It's that, we, as middle-aged men, don't like to sit with discomfort for very long. We want to fix it. If we can't fix it, then we feel frustrated.

It says here that men are more inclined to become distant when they, themselves, are having a difficult emotional time. We've talked about this in the past, too. We talked about, when we had Scott and Lee on, when there is such a lack of mental health resources available, and there's such a stigma around male mental health, that how do you actually navigate those difficult emotions? I'm kind of curious, how do you provide emotional support? Do you refer your patients to other mental health supports?

Krista: This whole section, we're just talking about just my brain just going, "Yes, yes, yes." I think, first of all, the men and women piece, women are used to having — roller coaster is a good word, but it's a cyclical change. Some women have it more than others. But there's a definite —

You guys will talk about it later, I know in the notes, about PMS. I mean, there's a real shift that happens. Men have a tiny, tiny fraction of the degree. I think we just get used to it. We're used to maybe a little more like, "I'm a little bit up here, and I'm a little bit down here." It becomes part of your nature. You’re used to dealing with it and handling it. Like today, I need to listen to myself and just hide under a rock or stay home because I'm just — that's it. You're comfortable being uncomfortable. At least, more so than I think, men are for that reason.

In terms of offering emotional support, yes. I mean, it's a big part of my job. Women aren't afraid to ask for it when they come in. They're in a vulnerable position anyways, sitting there half naked with a paper wrapper on, basically, before an exam. They're vulnerable, and they're very quick to — this is going on and they're in tears. You're immediately helping them through that, in addition to physical complaints or reports.

Yeah, I refer a lot. I refer a lot to therapy. We talk a lot about nature. I mean, nature therapy is a huge thing right now, and always has been. Hopefully, it will always will be. Acupuncture, exercise, diet. There are so many. Relationship, work, so many different ways to support a woman. She's almost always willing to put it out there and talk about it.

Billy: I like that you talked about being comfortable with being uncomfortable. Because it says here that only women report feeling comfortable being close with someone who is sad. I'll be honest. That is awkward to be sitting next to somebody who is sad and trying to comfort them, because I think the male brain is trained to fix the problem.

Krista: Right.

Billy: Emotions are really difficult to fix. It's not like a chair. It's not like a truck. They're really difficult.

Brian: I wouldn't say that. Drugs and alcohol are perfectly good solutions.

Billy: How did those work for you?

Brian: Oh yeah, not so well. Never mind. Just forget I said that. Forget I said that. Keep going.

Billy: I did a bang-up job for you.

Brian: Yeah.

Billy: It says here that if women don't get the emotional response they want, they become persistent until they do, or they'll come to the conclusion they've done something wrong, or that person doesn't love them anymore.

Krista: Yeah, that's extreme, but I think there's a lot of truth to that. I think validation is huge for women, which is why backing up a little bit. I think most women are comfortable sitting with someone who's sad or lonely or crying, because we feel like we can help and do something. It's just listening.

It's just literally like, "Here's my shoulder. It's okay." I'm not going to fix it. I'm not going to fix the problem. But I do agree that I think a lot of men, they want to fix it, which is noble and great. But you can't fix someone's 30-year dilemma or this issue with this family member. You can't fix it. You just have to listen and be okay with sitting there in someone else's sadness. Then you can move on. You don’t have to do it for very long.

Billy: It says here that women have the ability to navigate emotional nuance, just because their amygdala is more easily activated by it. Men's amygdalas, on the other hand, they respond to threat to the relationship or a physical threat.

The other thing, too, and part of that is because men have bigger amygdalas, and women have bigger prefrontal cortex. The prefrontal cortex is what regulates our emotions. That's why we talk a lot about the importance of practicing mindfulness. Because mindfulness actually develops that prefrontal cortex. When we talked to Sarah Rudell Beach, the reality is that a lot of the people that she works with are females. They're in tuned and okay with developing that prefrontal cortex.

I've been to mindfulness retreats, and I'm very often one of the very few dudes that's there. It just seems like that idea of developing — I don't think men really look at it that way, that you're developing your prefrontal cortex. They just look at it like that. It looks like some fluffy shit that I'm not going to do. But really, what it's doing is it's actually enhancing your ability to regulate your emotions that much better. So then, would you say you got a good memory?

Krista: Well, interestingly enough, I would say most of my life, I have, until what we call perimenopause, which I know you guys talk about a little bit. It's kind of shitty right now.

Billy: You're losing memory?

Krista: Yes.

Billy: Okay. But do you still have memory for emotional moments and sentimental things?

Krista: Oh, yeah, past memory is all fine. Even like, "Oh, yeah, you sent me that." It's just, where'd I put something? It's the short-term kind. Long term is fine, yeah. Definitely, I can remember things that made me feel sad from when I was four.

Billy: Oh, wow.

Krista: Yeah, and happy, like big emotions.

Billy: Right. Well, that's interesting. It's funny that you mentioned that. It says here that the female brain has more circuits dedicated to sentimental imagery and memories. On the flip side of that, the female brain has an aversion towards conflict. Because your prefrontal cortex and your ACC is larger than those that are in men, women are able to chew on their anger longer and not be as reactive.

Now, there's a controversial take. Yes, you're able to chew on it longer, but I feel that makes the woman more plodding. When I'm angry, I will immediately react. I feel a woman is like, "Okay. Oh, is that really what you want to take, huh? Okay."

Brian: Why don't you just go to sleep?

Billy: I'll make you some oatmeal in the morning. That's not a cinnamon, not arsenic. I'm curious. That made me chuckle a little bit, that they're able to chew on their anger a little bit longer. Once the woman has processed the anger, her verbal circuits kick into high gear. She can lash out verbally, whereas men will lash out physically.

I think that goes back to what we were talking about when we had Judy on, that women have that verbal processing that's a bit more refined than what men have. Do you see that, too?

Krista: I do. I think what's interesting is aversion toward conflict. I have a lot of friends who will say, "Oh, I just hate conflict. I don't want to do this or that." But I think it's, again, changes — I know we're going to get to a little more this no BS stage that we get to. You've kind of grown into who you are. Maybe if you have kids or you've done it, you're raising them. You move into the stage where you just care less about what other people think.

I think conflict becomes less. Say it. Mean what you say. Be honest. Just don't be harsh and rude. But just the boundary. Say it and mean it. Carry on. I do think, as women get older, the caring so much about the person who they’ve conflict decreases. Not in a mean way. You're like, "Okay. I said it. I was respectful. I was kind. I'm moving on to the next thing."

Billy: As you bring that up, for me, it connects to this next point where it talks about anxiety is four times more common in women. It didn't specify at what age. I know when we talked a couple of weeks ago, that rates of depression are twice as high in women as they are in men. That especially starts around at the age of 15, which just so happens to be when girls start to menstruate as well.

So, we talked a little bit about the role that menstruation has on a woman's emotional stability. I'm curious, with the women that you work with, do you see or do you hear more women in their 20s and 30s, maybe their early 40s talk about anxiety? And you hear less of that in late 40s, 50s, 60s?

Krista: I would say, for sure, a lot of teens, early 20s, more now than I've ever seen. We've also had a really weird year. But yes, interestingly enough, I think women in their later 20s, 30s, when they're having babies, aren't talking about as much. Because guess what? They're totally focused on somebody and something else.

Now, postpartum mood disorders are a separate issue and are very huge. But that aside, women aren't coming in and talking about it. They can barely get on their clothes and get out the door for their yearly exam. I mean, they're doing so many other things. But definitely in the 40s and 50s, I would say, truly — if, say, I see 14 patients in a day, I bet 9 of them score high on the anxiety scale.

Billy: Wow.

Krista: Medium to high. It's not often that someone's like, "I'm all good in my mental health." Because we give a screening for every patient. They're not all off the charts, but it's significant. Then women that come in in they're later 50s, 60s, 70s, oh my god, they don't have an ounce of anxiety, whatever.

Billy: When they score high on that, do you ask them what's causing this?

Krista: Yeah.

Billy: Is there a standard response, or is it all over the board?

Krista: It's all over the board. It's relationships, it's the work. In the last year, there have been a lot of reasons for people to score high. I think it's been a record year. At the end of day, we're all like, whoa, big day. Our job is to make sure they're safe, that they're not suicidal, or going to cause harm, that they're getting the help they need. It takes a lot of women, a lot of encouragement, to seek help for themselves in that regard.

Billy: So, you talked about 9 out of 14 would score medium to high on an anxiety spectrum. We mentioned this just a little bit ago, where women are twice as likely to suffer from depression, especially during their reproductive years. It says here that scientists believe this is due to a surge in progesterone and estrogen during puberty.

Krista: I think this is when it starts, the cycle. Serotonin is our happy brain chemical. It's what we want. Estrogen has a huge impact on — it's a neurotransmitter. Estrogen not only helps stimulate that neurotransmitter, but it increases its effectiveness. As a woman who goes through a perimenopause, where the estrogen starts to drop, the receptors in the brain are like, "Wait. I'm missing something.

A lot of women starting around 40 go in and get put on antidepressant. That's not wrong. But it's more likely, or quite possibly her just lowering estrogen that's causing it. She's not depressed, per se. It's working on the hormone balance. It has a huge impact.

Brian: It manifests in the same way, but the cause is not either.

Krista: Right. Again, antidepressants are not wrong. It's not the wrong choice. But a lot of women are left going, "Oh, now I'm in that category." I'm like, "No, you're just aging appropriately. It's really what's happening."

Billy: The book talks a lot about hormone therapy. There's actually a small chapter that's dedicated, at the end, to hormone therapy. We'll talk a little bit about that in the next segment, as well. I have a couple questions for you when we get to that.

So, we talked about this in the first episode of the female brain. It says here, the serotonin transporter gene — that you just mentioned, serotonin is what generates happiness, right? That may also have an impact on a woman's depression. So, if they're missing that gene, because it's a hereditary gene, sometimes that doesn't get passed down from generation to generation. We talked about how trauma is actually a hereditary gene that's passed down. I'm curious, do you see that? How do you see that? What does that look like?

Krista: Yeah, I do. When they come in for the visit, I'm doing — it's not a therapy session. It ends up being that a lot. But sometimes, if we can get to that, what's causing it, it's a lot of, "Well, this happened when I was younger, and this and this." They're sitting there going, "I've never talked about this. It's probably time." Or grief, unresolved grief, loss — a lot of those things show up when women are starting to have symptoms of anxiety or depression, or realizing all this has been living there, or it was just passed down to me, like you said. This happened. I think we're hearing a lot more about that with race, this lived experience. There's still a lot to learn about it, and a lot of work to be done around that for sure.

Billy: It's interesting that you bring that up. Brian, and I talked to our friend Mina. She talked about how, just now at age 36, 37, 38, she was finally unpacking all this emotional trauma from her life. She had talked about their family actually has a name for it. I can’t remember what she said. The Johnson gene or something like that. They're just like the Johnson sadness gene or something along those lines, that it's been passed down. That's just how they've operated under that mindset for a while.

She had to unpack that and process, "Hey, this is what you've experienced in your life." Let's come to grips with that in a healthy way, so that we can move on and make healthy decisions around our relationships, in our communication.

Krista: Yeah, I think talking about it is important. I think we get in these patterns with family stuff, too. The great grandparents did this way, so the grandparents and then the parents. I feel like our generation is kind of like, yeah, but that makes no sense. Why don't we talk about it, resolve that, and break that pattern, do things differently with our own family?

Billy: I do see more and more people supporting, talking about their mental health. So, it's important that we continue to talk about our own mental health, especially if we are struggling, or especially if we have family members who are struggling, to encourage them to continue to talk.

It says here that, as we age, women are more inclined to express their emotions. But for men, this can be a whole new world. Because men, actually, as they age, they build more oxytocin and they lose testosterone. There’s this switch. All of a sudden, they become more emotional, and that's really challenging. That's really strange for them. It may become difficult for them to come to grips with that.

I think that goes back to what we were talking about before. I just wonder. Is that a cause for such an alarming suicide rate in middle-aged men, that this shift in hormones is actually what's causing them to have these emotional responses that they probably have tucked away for such a long time?

Krista: Well, yeah. I've always truly felt bad for guys. Because I think it's sad that the expectation or the groundwork that is laid for you from being little boys on is that whole, "Don't cry about it," the whole being tough, that macho. I have such a strong opinion against that. I think you do you. If you've been shoving stuff down or just not talking about something, you get to that age, and then you feel like, "Well, I don't know where to go with this." It's suffocating and overwhelming if you don't have an outlet for it.

Who can do that? Who can carry on like that? So, I don't know the facts behind it. My guess is, it would lead to, for sure, some of those horrible outcomes. Again, it's not fun to live in discomfort. But we're humans, and we all have to at some point.

Billy: Yeah, that's a big reason why we wanted to start this podcast. It's because we wanted to give people an opportunity to hear from a couple of guys who have gone through these shifts and have struggled with a variety of things, and maybe that opens up the dialogue. We've heard from people who listen, and they're like, "Hey, thanks for putting that out there. We really appreciate it, because it means a lot to know that we're not the only one out there who think and feel this way."

Krista: Absolutely.

Billy: So, we're going to take a break. When we come back, we're going to continue talking about the emotionally mature female brain. We're going to dive into those menopause years. Thank you for listening to The Mindful Midlife Crisis.

(break)

Thanks for listening to The Mindful Midlife Crisis. We will do our best to put out new content every Wednesday to help get you over the midweek hump. If you'd like to contact us, or if you have suggestions about what you'd like us to discuss, feel free to email us at mindfulmidlifecrisis@gmail.com or follow us on Instagram @mindful_midlife_crisis. Check out the show notes for links to the articles and resources we referenced throughout the show. Oh, and don't forget to show yourself some love every now and then, too. And now, back to the show.

(interview)

Billy: Welcome back to The Mindful Midlife Crisis. We are here with Krista Margolis, who is an advanced practice registered nurse and a women's health nurse practitioner. Krista, I was so excited to start talking to you that I forgot to ask you, well, what does an advanced practice registered nurse and a woman's health nurse practitioner actually do? So, can you talk about that really quickly?

Krista: Yeah, I work in a clinic, a private clinic. I will see women, really — probably the youngest patient I've seen is 14 up till 80. I'm mainly doing wellness exams, yearly physical exams, birth control consults, STD testing, a lot of perimenopause and menopause consults, breast health. We do a lot of mental health, but that's not — because a lot of women has one visit a year kind of thing. So, we end up doing that. But that is not my — I definitely move people on to that. I will start people on antidepressants, anti-anxiety meds. As long as that takes care of it, and they're getting therapy, I'm okay. But if they need more, it definitely needs the bigger guns.

Billy: So, you talked about menopause here. That's where we're going to start in this segment. It says, the average age of menopause is around 51 and a half years old or 12 months after a woman has stopped ovulating. So, am I right on par there?

Krista: Right on par. Stop ovulating. Also, stop having your periods. So, 12 consecutive months of no period, then you get the label. You're in menopause.

Billy: Oh, interesting. So, I always feel like menopause gets a bad rep. I'm curious, what are your thoughts on that? What do you hear from the women you see about going into menopause?

Krista: Yeah, when I read that, when I was looking at your notes, it was — yes, absolutely. Young girls have a horrible outlook or thought about getting their period. Puberty is just this awful, horrible thing. It's the same thing with menopause.

I think it's, again, the society we live in. We don't value women after a certain point. Or, at least, traditionally, we have it. Women think I'm useless. You know what, what's going to happen? If you look back, I don't remember the exact dates. But late 1800s — I think you maybe have that in your notes — women only lived to 49, 50. So, postmenopause wasn't a thing. You went through menopause, and you were dead. That was what happened.

We know. I'm 48. Once this happens, I hopefully have 30, 40 more years. I mean, this is just a fraction of my life. There's a big chunk of my life that I'm not going to have my period. So, I'm trying really hard to change, to shift that paradigm and make it be, it's not scary. It just is. I'd rather live without menopause till I’m 90 than barely get through menopause and be dead at 49, if I have the choice.

Billy: It says here that a woman's menstrual cycle plays less of a role on their emotions as they age due to plunges and testosterone, estrogen, progesterone. As a result, their amygdala and prefrontal cortex are fully functional and consistent at that time. So, you just have to wait until menopause in order to be a rational woman, I guess.

Krista: Right. Exactly.

Brian: Wow.

Billy: It says here that women are less concerned about emotional nuances and keeping the peace once they hit menopause. She doesn't get the same rush of dopamine as she once did when socializing with friends. She's less inclined to attend to other's needs. I feel like menopause should just be dubbed the ‘I don't give a fuck years.’

Krista: Absolutely. I might write a book and label it that.

Billy: We'll take 30%.

Krista: Perfect.

Billy: It says here that the hormonal changes in the brain during the beginning stages of menopause may make a woman act erratic, like she's going through puberty all over again. Now this is where we talked about perimenopause. That's defined here as the two to nine years before menopause. Can you talk a little bit about perimenopause?

Krista: Absolutely. I think it's something you just said a little bit ago, when you said women are less concerned about emotional nuances and keeping the peace. We've touched on that a couple times. It's very true. It's like, I can't care anymore about this sensitive thing over here, and this person that thinks I don't do this well enough. Whatever. You just care less.

Women are so — the focus is so outward in those childbearing years. We're trying to work and volunteer at the school, and raise kids, and be a good wife, and be a good friend, and adopt all these things. Not all that isn't as important, because it is. But the shift does change. They've done it. There's been a lot of research on this. You become more inward at a certain point. There's not exactly a magic age.

But it's generally in this timeframe, which is leading up to menopause where you're more about, "What do I want? Am I doing the job I want? Am I happy with myself? Am I productive?" You care. There's a lot of job changes, a lot of divorce. Empty nest becomes a real thing. So, it's a huge time of shift — the perimenopause years.

This is what I try to tell people. Again, like you said, menopause gets a bad rep. Perimenopause should maybe get a bad rep. Because it's, again, we talked about these cycles. Now the cycles are like, up, up, up, up, down, down, up, down, up, down, up, down. I mean, there's no pattern anymore. It's very chaotic. When you think about what the hormones are doing, they're not playing this nice game of tag anymore. They're just like, "I'm doing what I want." Once that stabilizes, once you reach that menopause point, everything is calmer seas. I see it. I see it all the time. It makes sense with what's going on. But the process, the transition to menopause can be really challenging for a lot of women. Not for everyone, but for a lot of women.

Billy: It says here that right around 80% of women will go through perimenopause. Some of the signs of perimenopause are hot flashes, energy bursts and drops, cravings for sweets and carbs, and a shortened menstrual cycle. Anything else to add to that?

Krista: Oh my god. Everybody's system is affected. Thinning hair, thinning nails, achier joints, more broken bones because you've got less synovial fluid because of lack of estrogen, brain fog — that's what I hear almost all the time. "I can't remember stuff. I’m foggy" — sleep gets out of whack for a lot of women, weight gain particularly around the middle, acne. I mean, it's all sorts of fun things

Billy: That's so interesting that you said that. You really do revert back to puberty all over again.

Krista: Yeah, it's like you're going in reverse. You're winding down versus starting up, but it's the same fluctuations that are happening.

Billy: Ladies, I'm so sorry that you have to go through this. It's such a hormonal roller coaster your whole life.

Krista: Many of us are sorry to you, gentlemen, that we also go through this emotional—

Billy: Yeah, that's what this book made me realize. It's just like, wow. There's a lot going on in a woman's bodily system and then her brain. That's why I found it to be such a fascinating read more so than The Male Brain. So, this is where she talks a little bit about therapy or hormonal therapy.

It says here estrogen therapy may increase those levels of oxytocin that decreased during menopause. It may help women feel more nurturing. It may also help with these drastic shifts in brain and body regulation. Do you recommend hormonal therapy, estrogen therapy?

Krista: Yeah, in 2002, there was this huge study called the Women's Health Initiative. That got shut down. Because women were taking combined hormones — estrogen and progesterone. You have to take them together to protect your uterus, if you have a uterus. Hormones got a bad rep. Everyone was like "Cold turkey, off your hormones." Oh my god, within six months, everyone was sitting in the office sweating and crying and going, "I love my hormones back."

What we learned was really good. Because we learned that they're safe if your history allows, such as your family history, your health history. We learned it's the smallest amount for the shortest amount of time possible. But only if you need them for quality of life. Some women kind of breathe through it. They're like, "Nah, nothing." Other women are like, "Give them to me now, or everyone around me is going to be dead."

Yes, I prescribe estrogen all the time. Is it just a cookie cutter approach? Like you're in menopause, here's hormones? Absolutely not. But they can be very helpful.

Billy: Estrogen plays another important role because it increases the blood flow to the brain, which is why women experience fewer strokes than men. Now, women also have testosterone. They just don't have — they're not flooded with it like men. Because men have, I think it's like 25 times the amount of testosterone. That's why we're such horndogs.

Brian: Interesting.

Billy: Yeah, as testosterone levels fall in women, their libido falls. So, they may suggest testosterone supplements in order to boost your woman's libido. Because women lose 60% of the testosterone that they had in their 20s by the time menopause rolls around.

Brian: Have you ever had testosterone boosting supplements or anything? Have you ever tried them?

Billy: I haven't. Have you?

Brian: Yeah, they're awful.

Billy: Oh, tell me more.

Brian: Well, it's the classic, you want to fight and f*ck. That's it. You're either having sex, or you're f*cking pissed. Well, I guess, that depends on your natural testosterone level. I have a fairly high testosterone level, so supplements were not a good idea for me. Because it just got out of control. I found myself like Pete Berven bore the brunt of it once out of it. For no reason at all, I just completely berated him. I was like, "Oh my god. What am I doing? I got to stop taking this thing."

Billy: Did you try to f*ck him after that?

Brian: No.

Billy: Okay. I just wondered. Well, just out of curiosity, why were you taking them?

Brian: I was doing it for workout supplements. Because I was trying to build muscle at that time, so I'm thinking, okay, I'll do a little more testosterone. It'll help with the muscle building, that sort of stuff. It was totally not worth it. It was an awful experiment for me.

Billy: Not joking here. How is taking testosterone different from HGH or an actual steroid?

Brian: I don't know.

Billy: Did you breakout in acne at all?

Brian: No, I didn't.

Billy: Interesting

Brian: It really just affected my mood, but it did enhance the workouts, obviously. It gives you a little more — I don't know if it's drive or ability to work out a little harder. If you want to, you can go harder. You can lift more. But the emotional trade off was not good for me.

Billy: Do you have an answer for that? How related is testosterone to HGH or steroids?

Krista: I don't know, actually. Because I never prescribe them. Women's testosterone has waned a little bit. But for a while, it was all women taking — oh my god, I'm blanking on the little blue pill.

Billy: Viagra?

Krista: Yeah, like the Viagra in women. People tried it. I will be honest. I have not ever had a woman take it and say that it helped. That's maybe just the patients I've seen, but it's never been a big success story.

Billy: It's interesting here. Had you been taking estrogen supplements, you might have remembered the name of Viagra.

Krista: Exactly.

Billy: Because it says here that women who use estrogen supplements were found to have better memories than older women not using estrogen supplements.

Krista: All true.

Billy: They also saw less shrinkage of the brain areas that regulate decision making, judgment, verbal processing, concentration, and listening in women who took estrogen supplements. I feel like I should take estrogen supplements.

Krista: Right. It's too bad there are potential risks with it, because it is kind of magic.

Billy: Isn't soy milk rumored to be high in estrogen?

Krista: It's like a plant-based estrogen. It's what soy is. If you look at an estrogen receptor, the receptor, if estrogen goes in, it fits it perfectly. Soy fits the receptor. It helps fulfill some of that. That's controversial. Some people say stay away from it. Some people say take it.

Brian: Why is estrogen bad? What are the risks associated with taking estrogen?

Krista: Our native estrogen, during all these years, is so good and so important — over 400 functions in our body, and a lot of important ones. I mean, libido is huge. That's when we were talking about all the different things that can happen, hot flashes, blah, blah, blah. Decreased libido is up there with weight gain and sleep. That I hear the most — decreased libido.

Increased risk of potentially breast cancer. The studies go like this. If you've got a little cancer maybe sitting there, and it's an estrogen receptor positive, any exogenous estrogen we're giving you is going to go feed that possibly.

Brian: Wow. Interesting.

Krista: But they're not all estrogen positive. Then it's helpful for the brain. It also has an increased risk of blood clots and stroke.

Billy: Wow. Interesting

Krista: That’s true for a birth control pill with estrogen in it also. But as we get older, we're a little higher risk for that anyways.

Billy: I've heard that too much soy milk will give you man boobs because of the estrogen. Can you verify, debunk that?

Krista: I can't say that's totally true. I can't say it's totally not true. It makes sense. But you'd have to, I think, be drinking a shit ton of soy milk for that to have that kind of effect.

Billy: Silk soy chocolate milk is very tasty.

Krista: I agree. Like tofu. My son's a vegetarian. He eats blocks of tofu all the time. I'm always like, "You don't have boobs yet?" He's so far okay.

Billy: Brian, the scientist nerd in you is loving this conversation.

Brian: It's interesting. It’s fascinating to me. Absolutely. Yeah.

Billy: It says here that if a woman goes five to six years postmenopause without estrogen supplements, she'll lose out on the benefits of these supplements if she starts taking them. So, there's a window in which you can take them.

Krista: Well, kind of a window. Because then, what happens is those receptors are, like I said, it's the perimenopause, this up and down. You kind of imagine how a water, perfect water scheme morning, how the water is just glass. It gets like that. Taking the estrogen is going to — there aren't any ripples to fix anymore. So, taking it doesn't do a whole lot. If you're taking it while you're needing it, it has a different effect.

Billy: So, we alluded to this when we were talking about how you're starting to unplug from the mommy brain, right? That's what happens. As women get older, they just become less nurturing. Because you've taken care of your kids. They're old enough to take care of themselves. You just don't have the need for that, but you also have that hormonal shift. So, it's not as imperative. It’s not such a drive.

It says, as kids get older and are less inclined to hug their moms, moms begin to lose that maternal nurturing spirit. Because the same amount of dopamine and oxytocin just isn't released as often. This can be both liberating but difficult at the same time. Are you going through this?

Krista: I didn't know that till I read that. I was like, yeah, I guess that makes sense. They just don't need you as much. I would say, when you first realize that, it feels like someone has taken a really sharp tool and jammed it. Now I'm okay. I'm getting used to it.

Billy: Is your 12-year-old still?

Krista: Yes, but she's a third kid, and she follows her older siblings. So, she's like, "I got this mom." She's hands down the most independent person in our whole house.

Billy: Oh, wow. That's actually very interesting coming from a third child, the baby boy. Because I'm not.

Krista: My husband's a third child, and I wouldn't say he is either.

Billy: Yeah.

Krista: She just does her thing.

Billy: Interesting. Usually, that's a firstborn trait. It says here, just having the child around the house, even adult children, can continue to activate oxytocin and dopamine levels for moms. But once the children leave, those levels begin to decrease.

I'd be curious to talk to empty nesters about whether or not they feel that. Once their children are out, I wonder— Both of my sisters are going to be empty nesters here very soon. My middle sister, both of her kids are out the house. They're in college. My niece graduated this year. Then my older sister who lives in Washington, my youngest niece is graduating high school and is going to the University of Kansas. I should ask them.

How are you feeling about being empty nesters? I think my middle sister is just fine. But I know that she misses having the kids around. She's very much like an intense mom. She loves having the kids around, as much as possible. It says, having a close connection with a grandchild may actually improve that child's prospects for survival. I thought that was interesting.

Krista: Yeah.

Billy: Studies show that women who are unhappy in their marriages report more illness and negative moods during their menopausal years. Do you hear a lot of that in your office?

Krista: Yeah, I see this a lot. It reminds me of a patient I saw yesterday. That's her primary reason for being so unhappy and scoring so high on that. It's something we talk about every year. Finally, COVID has forced her. She's like, "I'm done. I can't do it anymore." I was like, okay. All right. So, I'll be curious to see if she's not married next year.

Billy: Wow. That's a nice segue here because it says, 65% of divorces by people over the age of 50 are initiated by women. So, it's rarely the case that a man is running away with a younger woman, that old trope right there. It's actually the women who are just like, "I'm done."

Krista: Yeah, that statistic doesn't surprise me.

Billy: No, me either. Yeah, I could see that.

Krista: Yeah.

Billy: Brian, make sure you're nice to Kathlyn.

Krista: I'm always nice to Kathlyn.

Billy: You are. You treat her well. She treats you well. Like I said, you guys are relationship goals.

Brian: It's true.

Billy: It says here that the book suggests that the lack of reproductive hormones may be why women view their husbands as being the cause of their misery. I just like the way that they put that.

Krista: I do, too.

Billy: I like to call this the Eat, Pray, Love segment right here. It says, Margaret Mead counters all of this by coining the phrase postmenopausal zest, which a woman can feel due to feeling freed from menstrual cycles and all that comes with it. So, I'm just going to get rid of all my personal attachments and go to Rome for a year, and then go to India for a year, and go to — where does she go to — Indonesia after that. India, Indonesia, and Italy is where she goes, the three I's. You see, because I think it's like a chakra thing.

Krista: Okay.

Billy: Have you guys — no one's ever read Eat, Pray, Love. Just me?

Krista: Can I be honest?

Billy: Yeah, go ahead.

Krista: I remember having discussions about this in yoga classes when it was popular. I couldn't finish it. She made me crazy.

Billy: Oh, she's the most entitled and over privileged woman of all time, and doesn't recognize her privilege and her entitlement. It drove me nuts.

Krista: I was like, I just can't. No.

Billy: I mean, good for you to be able to travel like that. But never in my life have I read through a book that described more first-world problems in my entire life.

Krista: Right. What seemed to be, people were talking about how where she was. I don't hear any self-awareness. We go through hard times. I respect that. But she was just kind of like — I don't know. It didn't do it for me.

Billy: I'm working. I'm going to work on the male version of that book. It's going to be better.

Krista: Okay

Billy: It's actually going to be called The Mindful Midlife Crisis.

Krista: Perfect.

Billy: Trademark, copyright. Boom.

Brian: I don't even recall that being popular. This is how, in the pop culture, I am. I know the words Eat, Pray, Love. But together, they don't have any significance for me outside of those words. I don’t even know what the thing was.

Billy: There was a movie with Julia Roberts in it.

Brian: Oh yeah.

Billy: And I believe it was — I don't think it got very good. I don't think it received very popular reviews. I think you can skip it.

Krista: Right.

Billy: It wasn't for me. Actually, if you want the male version of Eat, Pray, Love, I strongly encourage you to check out Leave Only Footprints: My Acadia-to-Zion Journey Through Every National Park. It's by Conor Knighton. It's really fascinating. As a nature lover, I think you would love it as well. Have you read it already?

Krista: No, I haven't.

Billy: Yeah, it's a fun read. It's a humorous read. It's a self-discovery read, as well. I liked it. He did a very nice job with it. He actually just interviewed Rick Steves. Do you know who Rick Steves?

Krista: No.

Billy: Rick Steves does all these great trips and videos on these places all over Europe. He is a Europe travel guide guru. If you're ever planning a trip to any place in Europe, I strongly encourage you just to YouTube, Rick Steves and whatever the name of the country or the city that you're traveling to. You will find all these amazing, just like hidden gems.

When we went to Milan, there's a place there called monument cemetery. It's free. It's these amazing headstones and mausoleums that these Italian families have. They're all beautiful works of art that are 6, 10, 12 feet tall. There are families that have taken up a whole plot. They're just these amazing, beautiful works of art. You can walk through this place for free. Had I not watched that Rick Steves' episode on Milan, I would have never known about it. It was really cool. I wouldn't have known about Lake Como either, which is just a train ride north of Milan. So, there you go, adventure seeker. Check into it.

Krista: It reminded me the other places I've been to in Europe, too, that I forgot. I'm like, all right. That's in Europe.

Billy: So, you talked about how women, their lifespans were only 49 years in the late 1800s and the early 1900s. At the time of publication of this book, 2006, 45 million women were between the ages of 40 and 60, which means more women of that age are in the workplace. Some are just venturing out into the workforce after raising children, which I think is very interesting. They spent that time raising their children. Now here they are, 45, 50 years old, and they're going into the workplace for the first time. Do you see a lot of that? Do you have a lot of those conversations?

Krista: Definitely, yeah. I'm jumping ahead. Four to five women over 50 say having a job, in which to help others, is important to them. I think having a job to go to is super helpful for women in my stage and age group. Because it's purpose. It's something beyond the purpose that maybe you've been doing. I've been lucky to be in a career that I could do both. I've been able to work part time, and I was home for a couple years. I go back to work, work full-time. I think it's really important.

I do see a ton of women who are like, "Oh, okay. My youngest is in fourth grade. I'm going to go back to work. But I'm not going to do what I went to college for, what I know. I'm going to totally change and do something different."

Brian: I think being that, this is the way it is. We should just put all women over 50 to work, so we could finally have some time to ourselves.

Billy: About time.

Brian: Right.

Billy: Brian, that's such great plan.

Brian: Yes, I know. Thank you. I solve problems. That's what I do.

Billy: Just out of curiosity, because we've talked about this before. So, Kathlyn is a stay-at-home mom.

Brian: Yeah.

Billy: Does she talk about this yearning desire to go to work?

Brian: No.

Billy: Because she does photography on the side.

Brian: She wants to do something. But we're not sure what yet after the kids are out of the house. We're talking about that now. "Maybe I'll get some part time. She doesn't really have to, but she wants to do stuff. She's the type of person that is intensely social. So, she needs that interaction more than anything else.

Krista: Yeah.

Billy: It's interesting that you bring that up. Because a work and a sense of accomplishment can be vital to a woman during this time. Women with high career momentum at this stage viewed their work as more central to their identities than women just maintaining the status quo and working towards retirement. So, just elevating their work status and having a high career momentum equals higher self-confidence, independence, psychological health, and effective functioning into their 50s and 60s.

So, it really is important that women seek out opportunities in order to elevate their career. But then, at the same time, it goes to the sexism that we see in workplaces where I can't imagine how frustrating that must be for women who are on this trajectory. Then they hit this stone wall because the old boys club won't let them in the office door.

Krista: Well, I think we talked about it earlier. I know, myself included, a lot of moms I know, patients I've seen, we wanted to be home with our kids. They're definitely some of our friends who were like, "Hell no, I will pay a nanny a bajillion dollars so I can go to work." Again, I firmly believe there's never a right or a wrong. It's what you're able to do. Not everyone can stay home. There's so much that goes into it.

But I was lucky enough. It was the hardest few years of my life being home. Again, like I said, I'm lucky to have a job that was a little bit in the door, out the door. This clinic has always supported me. But I think just having something, again, with a purpose. When you're raising your kids, that's arguably the most important thing ever. But then, if you're like, "Okay, I'm ready for a little something more," volunteer, finding a job or a hobby even, something that is fueling you, I guess, in a certain way.

I think a lot of women, the high career momentum, I do see that at women at this stage. But I also see that I'm good with the part time or the being at home, and then doing just something else over here that's fulfilling. I guess, it doesn't replace raising kids. But it's the next thing. I don't know if that makes sense.

Billy: That's interesting that you bring that up. Because like we've talked about, as women age, it sounds like you really are there to assert yourself. Because you've been the caretakers for so long. Now, it's your time. Your time is here.

I'm curious, as someone who has been married for nearly 19 years, is your husband more emotionally available? Is he more affectionate? Because that's something that we talked about when we're talking about the male brain, where the oxytocin levels rise, and that they become more emotional. So, I'm curious if he has been as you guys get older?

Krista: Yeah, I think so. I'm married to a guy whose pretty — for a man, I think, pretty sensitive. He's always been available like that. But I think we both learned how to hear and read the other person. I don't know if it's his hormonal levels or if it's just a lot of practice, and a lot of me bitching out for 19 years. Maybe a combination.

Brian: Like you said, it just takes us a long time to get a thing. We're not as complicated. We're just, hey, we're a little thick.

Krista: Right.

Billy: Do you find yourself, now as you approach 50, that you're trying to assert your own independence and doing things, finding more pleasure hobbies?

Krista: Yeah, I do, actually. I think there's less guilt around it. I think the word guilt comes in to a lot of people's narratives — women, I feel like more so. For years, I was like, "I shouldn't go mountain biking, because this kid might need this, or I might need to do this, or whatever it was." I would talk myself out of stuff. I think a lot of women do miss these years of doing a lot of things we love. I did a lot less, just outdoorsy things. It was just, "Well, it's easier with the kids to do this."

I don't know when it changed. But now I don't even think about that. I'm at that point, I make dinner many nights. But certain nights, I'm like, "Figure it out. I'm doing this." My kids have to be old enough. They can't be two when they're like, "See, I'm going to do this." So, yeah, I do think that that has happened for me.

Brian: Do they really have to be of age though? I mean, that'd be entertaining just watching a three-year-old just throwing some pasta and head out the door, right?

Krista: I mean, they'd be highly independent. We joked that my 12-year-old is independent because we —People were like, "You ignored her for a long time." I'm like, "This is true." This is true, and she figured it out.

Billy: Can you talk a little bit about what your motivation is to go on this trip with this high school group of runners? Is that coming from a place like you want to give back to community? Is one of your kids involved in this group? I'm curious why you're volunteering for that.

Krista: Yeah, great question. It's all of those things. I'm a little almost embarrassed to say how excited I actually am for it. It doesn't sound dreadful to me, which is maybe weird. Yeah, my son is on the team. He's been one of the driving forces behind this. He's heard about this trip that it had happened for years. Then some of the coaching switched, and they just haven't done it. He's going to be a senior next year. So, he's like, "I want this to happen. I want to do it."

So, that would be the number one reason. Number two reason is, I think these kids are awesome. They really are a great group of kids. They all are pretty familiar with the outdoors. I love that environment. So, I think it sounds really great. The person organizing it, talk about organized and efficient, she's just got it down.

Billy: You give a lot of yourself as a nurse. Again, you've downplayed it. But we view you as a superhero. We want to thank you for giving yourself to these students and taking them on this trip, and being part of that. We want to thank you for giving us the time to talk about the emotionally mature female brain. It was a really enlightening conversation. We really enjoyed having you here. I think having you break down the science behind it all, really added to our understanding of the emotionally female brain. So, thank you so much for joining us today.

Krista: Yeah, thanks for having me. It was great.

Billy: So, for Krista, for Brian, this is Billy. Thank you for listening to The Mindful Midlife Crisis. May you feel happy, healthy, and loved. Take care friends.