Let's Talk About Menopause

​[00:00:00] Quinn: What if talking about menopause out loud was as normal as talking about sports scores or school pickup? Imagine it on, primetime TV doesn't exist anymore, I don't think. I'm a thousand. Imagine it in movie plots, in your group chat, at the clinic and on the campaign trail because when we name what's happening in our bodies, three things can follow better care, better research and better policy. Normalizing the conversation around something that's gonna happen to half the population isn't oversharing. It's infrastructure. And you guys know how much I love infrastructure of every kind. This is how we're gonna get appointments that move the needle for people. This is how we're gonna get workplace benefits that actually matter and research dollars that finally match the need, especially for those most impacted and least studied. [00:01:00] So what can I do to make menopause a public everyday conversation?

Well, every week, thousands of people ask us the most important question in the world. What can I do? And every week I turn around and ask someone who actually knows what the hell they're talking about that very same question. Someone who's already answered it for themselves, who's working on the front lines of the future, like today's guest.

And again, that could be in global health of which menopause is clearly a big part. Climate change, connected. Artificial intelligence could be. Food and water, probably, medicine for sure. We talk about all that stuff. I find out why they're doing the work they're doing and what we, you and I, can do to support it, to join their work, to fund their work, to find our own way to the front lines of the future of menopause.

I am your host, Quinn Emmett. And my guest today is Jennifer Gerson.

She's a journalist at the 19th, one of my favorite publications, and the author of their new menopause newsletter. Jennifer blends sharp reporting with practical scripts, and memes, how to talk to your [00:02:00] doctor or your partner or your teen or someone in HR, and maybe your elected representatives too, because you know we love that.

So that this thing that's been so intensely private and understudied on purpose becomes public. And so progress compounds. Please stick around. This one can definitely change the conversation in your home and far, far beyond it. As always, for feedback, please hit us up at questions@importantnotimportant.com.

Jennifer, welcome to the show. So excited to have you today.

Jennifer Gerson: Thank you. I'm excited to be here.

Quinn: Absolutely. It is a lovely fall. What is today? Wednesday. We're both sort of in the southeast. Do you consider Virginia the southeast?

Jennifer Gerson: That's a great question. Yeah, I think so. Mason Dixon line, right?

Quinn: Theoretically. On one hand we're trying to move away from the Mason Dixon line thing, just a little [00:03:00] bit. On the other, it's very interesting. We get a lot of Mid-Atlantic, which what does that mean? I don't know. I guess that's what they made up.

Jennifer Gerson: No, Virginia's definitely the south, like Pennsylvania, Mid-Atlantic.

Quinn: Yeah, that's fair. There's definitely parts of Virginia that are for sure still in the south, and then there's parts of this town. It's a little weird. I don't know. It's great, but it could go either way. Anyways I just wanna say because of the topic today to preface, we're talking about menopause today and all the people who have experienced it, will experience it, might not, who can know? Not everyone who does are cis women. We will do our best today. I will do my best. I will mess it up to use the language most specific to the specific topic or study or lack thereof, which is a big part of this.

Obviously, and as longtime listeners know, we're 200 something episodes in. I am not a doctor. I don't even play one on TV. Oh, I did play one on TV once, actually. That's really interesting. Forgot about that. [00:04:00] Nothing here is medical advice. Take your medical questions straight to your trusted clinician.

If in the year of our Lord 2025, you were lucky enough to have one. Am I missing anything there?

Jennifer Gerson: No, I think we're good.

Quinn: Okay. Rock and roll. I usually have this two part question to get us started about why you have to do this work. But I'm actually, my wife is a screenwriter, so I'm always interested in sort of what they call the inciting incident at the beginning, why you have to do this thing, why you're called to do it.

And I remembered from your intro email on this newsletter you mentioned you pitched this in your company Shark Tank. Among your DMs and group chats and stuff. Tell me about when you were like, I gotta pitch the menopause newsletter. Why?

Jennifer Gerson: Well, I have to say, I mean it was definitely a group idea of this menopause newsletter. And second, someone tossed it and I was like, oh my God. Yes. Because it felt like my own life. I'm in my early forties, I have children and I spend time in carpool lines and pickups, drop offs, all that. And where [00:05:00] there are groups of women standing around, there's inevitably some kind of conversation quietly starts percolating in a corner of, are your ears itchy?

You know? And then does the sound of your husband's voice make you want to scream? And was this not always the case? And everyone, it always goes, all roads to, is this the perimenopause symptom? So it was just so prevalent and I think you know, someone actually recently interviewed said, unless you have like a really forthcoming book club. It's not something that's being talked about in like wide open spaces. And so for me, again, like I said this in the first edition, this is for me too. I'm this demo and I hope this can be a place for conversation. That was really kind of the impetus. I was like, my goal with this newsletter is can we bring people in conversation with each other so people don't feel alone in their questions and their symptoms in this season of life?

And can we try to parse out what we know from what is, you know, a lot of internet speculation, which [00:06:00] happens a lot with health topics. And when we were just all talking about, just felt like the more we kind of got into this idea, there's a lot of people this felt into, if you are old enough, you know about half the population's gonna go through this phase of life. So let's figure out how we can talk about this more honestly, more robustly, in an evidence backed way, felt important to do right now.

Quinn: It seems obvious when you put it that way. Right. And I know you know, Dr. Jen Gunter has written, she's like the volume of people who are either just finished with this transition in the phase or in it or coming up to it in some way. It is a lot of people, and like you said, it's insane on its face that we don't talk about it.

Unless, like you said, you have a book club coming up these are the things that make me angry. But all we can do is try to make it better. And so I'm so glad that this exists. Because again, like I kind of mentioned offline, like our parenting podcast, so much of today is just identifying with people who are also going through it.

Right. And that really matters because especially for something like [00:07:00] this, that is both so widely applicable, but also just criminally, and truly like devastatingly understudied in so many different variations. Finding your people is really helpful.

Jennifer Gerson: There's so much noise right now. If you're my age and you're on Instagram, like your algorithm, it's all menopause content. So it's interesting too, 'cause in the midst of that, I'm just trying to find what does the science say?

Not what does an influencer say, not that's what someone who's selling a supplement, you know, where can I find what's evidence based? And that's what hopefully we're here to do.

Quinn: It's a tall order because it's one thing to be like, well, RFK said blueberries cause testicular cancer. And like we've got information on that because we've studied men's testes and blueberries quite a bit, but looking for the science on menopause is hard 'cause we haven't done so much of it.

But hopefully these conversations spur more of it, or at least people going, what the fuck? Like, why can't I find it? You really started off with we just don't know that much about menopause, which is great. Perfect [00:08:00] introduction. Let's talk about known unknowns, if we could. What specifically do we not know that has the potential or already does harm the most folks today?

Jennifer Gerson: I mean, I think what we don't know is most everything is really the answer, unfortunately. And I feel like a theme that has emerged since we've started this newsletter is that I feel like every week I say, and we actually don't have research on this yet. The last kind of major, huge study on menopause was the Women's Health Initiative study that came out in the early two thousands. It's been about 20 years since there was a large-scale look at menopause research. And what's been cool about doing this project is that I've gotten to talk to some of the researchers who are trying to make up for lost time, like Emily Jacobs, who's at UC Santa Barbara, her lab is the first now that’s mapping the brain from before, during, and after menopause to see what happens to the brain.

Well, no one's ever done that before. There's a lot of questions about what happens to the brain during menopause. There's a lot of [00:09:00] hypotheses. There's a lot of speculation online. No one's ever done it. We'll know once she's, you know, completed that work. There's a lot obviously of conversation right now about hormone therapy.

FDA just removed the black box warning on estrogen which is a really major development that a lot of people have been lobbying for, for a long time. But there's also still a lot of, you know, questions like we know that hormone therapy in different forms can be really great for addressing certain symptoms for certain populations. There's also a lot of claims that it's doing a lot of things that we actually don't have data on yet. Is it protective against heart disease? Is it protective against dementia? Maybe, the research is just not there yet. So I think one thing right now is to just know that for so many things we simply don't have the research. And I think that's really the biggest through line that comes through when we're talking about where we are today in 2025 with menopause care.

Quinn: It feels analogous in some ways trying to state this correctly, it's like when you see a headline that we've got a spoonful of [00:10:00] microplastics in our brains and everybody goes, great. One, what? Two is that affecting me? And three like, what do I do about that? Besides not drinking outta plastic water bottles.

We go like, we don't know. And there's a lot of reasons we don't know, obviously. And some of those are very intentional, obviously. I mean, it was 1993 was the first time it was required to include women in medical trials. I'm very old, but that doesn't feel that long ago.

But my children would say differently. They call it the 19 hundreds, which is a whole different conversation. But you did mention one thing, and this really starts to open up the box because, you know, I've talked to some amazing researchers and people who are supporting research, which is a thousand different jobs and amazing jobs are all very important about the brain and the gut and people who are studying both the brain and the gut, which is like, good luck because I can't imagine something more complicated.

And the underlying theme, which I think is good and how the best science usually happens, which is you [00:11:00] start pulling a string and maybe that string itself is unexpected and you start to realize the sweater is so much bigger and more complicated than you can possibly imagine. Right. And you mentioned cardiovascular disease, which our friends at the great shop called Our World In Data, and they always make a really good point, and I think they just republished it recently about these are the things that kill us and these are the things that we talk about the most. And then there's the whole different segment about what gets funding much less preventative funding or educational and cardiovascular disease is obviously in the west, like an enormous chunk of that.

What do we understand and I guess obviously still not understand about the link between cardiovascular disease and menopause. And I know there have been some data on how it affects at least black women even more adversely. Could you talk about that a little bit? Again, I'm just trying to paint a picture for folks as much we can.

Jennifer Gerson: Yeah. I mean, this is something else where there's like a lot of question marks. We know that there is more cardiovascular disease [00:12:00] with anyone as people of all genders age, right? Comes with age.

What gets interesting when we are talking about the menopause relationship is it does seem that there is, you know, there's obviously more cardiovascular disease in women post menopause.

Now, this could be because again, aging bodies. But like you said, there's this interesting kind of phenomenon that's happening with black women. And again, this is something where researchers are trying to get some answers. Cardiovascular disease disproportionately impacts black women, older black women.

And these women also experience cardiovascular disease a lot younger than other populations too, these are all true things. For a recent edition of the newsletter, we actually spoke with a really fantastic researcher at Emory University’s Rollins School of Health today, Tene Lewis, who is doing some really interesting research right now where she's really trying to unpack what are maybe some of the societal factors that are impacting why we're seeing these kind of rates of cardiovascular disease in black women. She's looking specifically at women under 60 who've had cardiovascular events and for [00:13:00] this kind of line of research she's in right now, which is fascinating to me. It's really looking at what she's calling cost of caring stressors. And something she's kind of identified already is that for women and especially black women who are experiencing heart disease, it seems that it is care for others, it's not even worry about yourself, stress about yourself, but stress of caring for children, caring for parents, caring about your community. She mentioned caring about democracy, you know, what is going on in the world and this care for other people. Her hypothesis and early research seems to be pointing to it is impacting cardiovascular outcomes and these are disproportionately impacting black women. So again, a lot of research still to be done, but we know who is being disproportionately impacted.

And I think it's really interesting that we are seeing people like Dr. Lewis who are pursuing this kind of research. Just start to say, okay, well what is biological, chemical and what kind of things are more societal, systemic, and have to do with things like [00:14:00] institutionalized racism, the way that we move through the world, the way that caring for other people is impacting us. Things like that.

Quinn: It's such important work and, you know, again, not a scientist, not a doctor, but someone who really tries to help tie all these pieces together for folks, which is a lot of the times the flow chart ends with its racism in this country because that's how this whole little experiment started and where we continue, you know, I've always had an idea for sort of two columns. One is more fun, one is not, one is scientific research comes out and you just caveat it all as like in mice because that's where most of it is. And the other is it always ends with like social determinants of health and socioeconomics.

Like you can talk about blueberries or whatever you want all day, but what about if the only food you can afford is much less as accessible is from CVS and Dollar Store and 7/11 and clean air, clean water, all the way down the line, right? Before we even get to how, menopause may or may not affect you specifically.

That's really exciting. It is [00:15:00] one thing to highlight that work, and we wrestle with the same thing, especially being what I am, a white cis guy. Like how do you report on those racial disparities without erasing structural causes, how do you center those and then go, and also here are the other things?

Jennifer Gerson: You know, I think it's just important to, first of all always name these things and then also name what we know and we don't know. Like we know that black women experience typically symptoms of perimenopause and menopause for longer than women of other demographics. Now I can tell you that that is true, that data seems to point towards that.

I can also tell you we don't know why, and I think it's really important to say what we know and what we don't know, and I think that helps lay that foundation of saying, we know that there are disparities and we're not saying it's definitely this. It's definitely that, and pointing out in research where that exists, that kind of severance between here is the fact versus has anyone identified what is a social component?

What is socioeconomics, what is biological, [00:16:00] and saying when research hasn't accounted for those things. I think naming those things is really important and important for getting people to kind of engage with some of these factors and dynamics that contribute to health outcomes, which is certainly something we're seeing with menopause right now.

Quinn: Right. And again, we will talk about it very generally here. At least I will 'cause I'm a moron. But we know that stress is awful, right? Especially how much it can be carried again, far less for someone like me who, my health is okay and my kids are okay and their school is, all these different things.

How detrimental it can be, day-to-day stress. And we know that that can affect cardiovascular stuff. And we know, about, for instance how stressful care can be for someone living with Alzheimer's, right. Or dementia of some sort. Like how much that can take out on them. So it wouldn’t surprise me, right? At the same time it's yes, keep pulling the string. 'cause we need to know those things. But just like structural racism, like this shouldn't surprise anyone if that's at least a foundational piece of that.

We have a real [00:17:00] problem with masculinity in this country right now. Young white men especially are not hanging out with people. The chauvinism at best is out of control. And there is really a gulf between how they might in the future care about someone much less a partner or a daughter or an elder or a mother, whatever it might be, because of this massive tide of information and misinformation and disinformation coming their way.

I say that, because as it happens often and will happen to me, you might have the double rollercoaster of a teen going through their first periods and someone else in the house who is in perimenopause or menopause or after whatever it might be.

On the list of like things we're struggling with, with young men. I'm trying to like, oh, we also need to prepare them to be able to care for those people in some way. I know you talked about your work with Lisa Damour, I believe it [00:18:00] is, about how to both care for those people, but also not group them together because that's really important. It's two really, really, really different experiences, obviously. How do we approach this?

Jennifer Gerson: Again, this is certainly my household too. I have a fifth grader and I'm in my early forties, so I know that dynamic. But I really loved getting to speak with Lisa Damour, whose work I love. And, you know, if you loved Inside Out 2, as much as my family did, you probably also love Lisa Damour who consulted on that. And I was so excited to speak with her and I was really excited that what she told me was not what I was expecting going in. That these things are so different that what is the kind of project of puberty and the project of perimenopause and menopause biologically are such different things, and that it's important to, first of all, take a step back as the adult, as the parent and recognize those differences. And that when children are going through puberty, everything is changing. I mean, they come out of this process, over this two, three year period. Their bodies look so different. How the world looks at them looks so different and [00:19:00] that, you know, just to be really cautious to not always ascribe to hormones how they are feeling, how they're acting. It's more that their brains are developing now. Hormones are a reason for that brain development. But I love, she mentioned, you know, if you measure saliva levels and to track hormone levels based on kind of emotionality, there is not a correlation. It's not oh, you're acting so hormonal, you know, to your teenage daughter is not actually a thing, but the brain is changing. I loved, she called it this total renovation project.

Quinn: I loved that. It's so I was like, that's the one.

Jennifer Gerson: I have used it many times since she has said that. And you know, I love, she said too, that it's helpful to explain that to our kids, you know, to let them know, Hey, you may feel like you don't know what's going on. You may feel out of control. You may not know how to process the world around you. That's not bad. There's not something wrong with you. This is your brain changing. And that as adults we have the ability to sit back and have that conversation with our children. And I think that is actually really empowering to hear. And that, you know, again, menopause is [00:20:00] different.

That is hormones, it is changing in hormone levels. And like we've talked about, a lot of this has to do with things we're still waiting on the science on. We know that there's this drop of estrogen, progesterone, testosterone, all of our hormones, and we're still kind of waiting for a lot of answers on what this is doing, especially to our brains.

But things are changing. There's a lot of physical symptoms, there are some emotional symptoms. And you know what? She really stresses that anything you're experiencing, if you're in a bad mood, if you're angry, if you're tired, treat those things as symptoms. You know, it's okay to say something heals off.

I should go address what that is. Because when you can take control of your own wellbeing, when you can care for yourself, whether that's addressing things that are changing with your health or just again, this kind of idea of self-care. Are you taking care of who you are as a fully formed adult human being? That these things are all important for our ability to parent and that our best thing to be as parents, I loved, she said this so many times when we spoke, is to be so boring. Our children think we are the most boring people in the world and that it is okay to be, you [00:21:00] know, sure. We should all have open and honest dialogues about our bodies, our, this, you know, can I have a 10-year-old daughter. We certainly have talked about periods and what happens and all of that, but it doesn't have to be about us. Our children should think we are so just immaculately boring, that they can grow and live their lives and are not interested in what is happening to us. And there's something really empowering about this because I think this season of life, as women especially, you know, there's a lot of things we are thinking about, about entering this next phase of life.

I think there's a lot of feelings that come with it. For a lot of people, this idea that, you know, for so long, I think we talked about fertility as this, I don't know, marker of something that really means something. It means something to women's identity and that changing, but it felt, for me at least, there was a lot of strength in saying, I can take myself out of the equation.

I'm also a parent. My job is to really be here for my kids and they don't need to engage with any of this. And I think that is actually something really special about this time of life too, that we [00:22:00] hopefully have lived long enough that we can have the experience to say, I have the ability to take care of myself and it's not about me.

Quinn: Thank you for that. It's so eloquent and thoughtful and I understand a lot of folks don't have the space to be able to take that step back in some way. Or again, the support system, wherever it might come from, whether it's structural or personal or whatever it might be. But at the same time, like you are going through something really fundamental that can affect your daily ability to not just care for someone else, but care for yourself.

And, I feel like, you know, there's a great climate scientist, Dr. Katherine Hayhoe, and she always says, the most important thing you can do about climate change is talk about it. Which even I struggle to do sometimes. Like it's a warm, very warm mid-November day and everyone goes, it's a nice day.

And I'm like, don't fucking say it. Don't ruin it for 'em, don't tell 'em why it's warm. But on the other hand, I really should, you know, and I feel like the more we talk about it, again, you don't want to, when you're child of [00:23:00] whatever gender and flavor is going through some version of puberty, which happens to everybody in 70 different stages and 70 different ways and 70 different orders, you don't have to go like, and I'm also going through this, but at the same time you do have to care for yourself.

And that can be really hard. As my wife was telling me, it was very different to be pregnant without a toddler in the house than it was to be pregnant with a toddler in the house. And how do you manage both of those? 'cause we already ask so much from women in this country.

Jennifer Gerson: You know, it's interesting 'cause I actually just kind of am coming off of a week of interviewing a lot of readers about their experiences of thinking about their own fertility as they enter this stage of life that's marked by the absence of fertility. So it's kind of really top of mind as people have kind of reckoned with their thoughts about what it means to kind of get through that phase of life for some people too, the work of being a parent is hard. Right. And I actually loved when Lisa Damour mentioned that too. She said, if anyone tells you that this is not stressful, they are gaslighting you. And I think it's important to say that. And I think that's actually, there's a really poignant parallel between that and [00:24:00] menopause honestly too.

And it's something that Tene Lewis, who I just mentioned to Emory brought up too, she was like, you know, she said when she was early in her career as a researcher, she had so many people say, well, why would you wanna spend your time researching something that just happens? Well, this just happens to people. So like why would you wanna put your focus on that? And she was like, well, yeah, it happens to half the people in the world.

Quinn: Half the people in the world.

Jennifer Gerson: Right. So parenting is stressful. Having your body change is stressful. And I think again, having this moment of saying this is real, is really powerful and I think what I'm trying to hopefully do in this newsletter is call out how much we don't know how hard it is. Parenting while you're going through perimenopause is hard. The fact that we have so little research on, you know, various things pertaining to menopause and health outcomes, that is hard, right? Let's just say all these things out loud and I think that is such a crucial step forward for facilitating some honest conversation and hopefully, you know, some change. I feel like something that comes [00:25:00] up so often when I speak with researchers is, you can write your congressman, you could say, I would like to see more dollars go towards research on X.

And I think you know, that's like an interesting and important part of this too. If you are feeling something, I think you do have the ability to say, and it may look different for different people, but what would I like to do about it? And come at these difficult moments with kind of some sense of agency too.

Quinn: One of the things that, understandably, my kids struggle with the most and I've coached a lot of kids and things like that. And so I see it all the time, which is the honing the capability to hold more than one thing as being true at a time. I still struggle with that.

Jennifer Gerson: Oh man, I say that to my children constantly. Two things can be true at once. Yes.

Quinn: A hundred percent. I was telling my daughter last night, my wife's been gone for two weeks. She was clearly struggling with this, like really missing her and excitement that she's coming home tomorrow. It was really interesting. And that changes over time. If they remember how long she's been gone, this or this and this.

I [00:26:00] said both of those things, they're totally true and probably six other things that aren't getting as much space as that. And it's so true for everything, how you handle losing at a sport, but being proud of your performance, all these things. Right? It is such a lesson. and I feel like parenting is all those things, obviously.

Right? And then at the end you might be like, oh, and also I have a relationship to manage, yeah, best wishes, good luck. But it is really important, like you're saying, and again, I know we keep coming back to the point, but I want people, if anyone takes away from this and from your amazing newsletter the same message, which like, it is okay to say, I'm going through this.

Everyone goes through this differently. We need to talk about it more publicly. We also kind of don't know what we're talking about. Much less like what can be done about it for any one of us.

But the more we say that out loud, we do normalize it. Right. On a personal level and for our village, if we're lucky enough to have one in our and our society. Right. And that's what I think is so great about the newsletter. Let's talk about some specific stuff. Okay. Because like you said, Instagram, holy shit, everybody's experience is different, but at the same time, all of the things, [00:27:00] how do you help readers interpret, something like hormone therapy, right?

Which kind of took off and everybody hears about now. Obviously you're not giving medical advice, but how do you help them interpret how they interpret things and how they talk to their clinicians if they're lucky enough to have one about something like that?

Jennifer Gerson: Well, yes, we'll always tell people, and we say this a lot in the newsletter, talk to your provider because healthcare is so not one size fits all. And this is especially a space where that is true. You know, you just said everyone's going through this differently. I just spoke with a reader earlier this week who was talking about how her experience with menopause is so different from so many of her friends because she became a parent through adoption versus through pregnancy. And so her body is different in going through different things, even hormonally. No two people are the same.

So just because something is good for this person online or your friend, it may not be the right thing for your body. So the first thing is to find a really qualified provider and someone who can listen to you, [00:28:00] I think, first of all, and hear what you are saying, and then help you navigate these things. The Menopause Society is a fantastic resource. They're the accrediting body for healthcare providers who are seeking specialization in midlife women's health and menopause care. They have a whole directory on their website. You can look up providers, you can see where you are, see where you can find someone.

And I think that's a fantastic first step because finding a good doctor who can listen to you and really listen is really key for all of this, you know, with hormone therapy too. And I've written about the black box warning and the kind of discussion that's happened through this administration about removing the black box.

And then we just saw the announcement two weeks ago. You know, the trick is always gonna come back to talk to your provider. Not all things are the same. There's been a lot of momentum for a very long time, for, you know, for 20 years since the black box first put on about topical vaginal estrogen. I think most providers agree that that is something that is safe for most people.

That would be used for, it can be very good for helping women address things like [00:29:00] urinary tract infections, any kind of pain or itching they might be feeling. There's a kind of a range of things, but again, your provider can help you. Things like systemic hormone therapy, that's pills, patches, sprays. There's, you know, different other forms or ways that estrogen can be administered systemically, but those are typically done to address vasomotor symptoms or what most people would call hot flashes and night sweats.

And it can be very effective for that. But again, this is not for, depending on your own health history, your own risk profile, your provider can really work with you. The black box has been removed. There's now that strongest FDA warning is off all of these products, but you should no matter what. And this is something that Monica Christmas, who's a wonderful clinician, she's the Associate Medical Director of the Menopause Society, but she and I have talked about before.

Talk to your doctor. They can tell you what you need to know and they can help you make the best decision for you and your body and your own health history. And that's hopefully what a good healthcare provider is there for. And [00:30:00] that's where you should be going with your questions, because again, online, there's a lot of people in this space and their experience might be really different than yours, so don't assume that it's all a one-to-one.

Don't assume that just because someone is saying they had X, Y, Z experience, that it's automatically gonna apply to you. Talk to your doctor, they're gonna help you decipher your own medical history and help figure out what's best for you.

Quinn: I love that. Thank you for your eloquence on that. I feel like I have a few different threads to follow, and one is, again, so many things can be true. With a very broad stroke, we can say half the population is gonna encounter this in some way at some point. That's wild. And it's gonna be critically different for so many of them.

Jennifer Gerson: Yeah.

Quinn: Right. And how that breaks down is a never ending river, right? And series of tributaries, I had a woman on a few years ago who started a company called Adyn, A-D-Y-N to help folks try to find the right birth control for themselves because if you have encountered it in any way [00:31:00] either adjacently or yourself, you know, that it can send you for quite the journey that search. She is very honest and sharing that she tried to take her own life because it made her so depressive. And she was like, why is this the way it is for not just for me?

This is crazy. Again, like with a broad stroke, so many people use or should or could use these things, we have to at least make this better. So I love that path. It's someone pulling at something that's very personal, but at the same time extremely impactful. I do wanna talk about, you know, like when we get the shit from Instagram when people then take, maybe that's some of their only knowledge because either they've been going through their periods for however long, or they stopped for some period of time 'cause of pregnancy or the pill, whatever, all these different versions. And now they might be getting to their forties or their fifties, whatever it might be. Talking about normalizing the way we've talked about menopause, which is an interesting word into itself, right?

The history of that, it has been just predictably, but also so detrimental that we have such a hole to [00:32:00] dig out of. I mean, I think Jen Gunter used the words like in the past, it has been referred to as like the women's winter and things like that where you just go, oh fuck, okay. Like, how, how do we start over? Like it, because again, it didn't start from nothing. It started from, again, predictably a hole. And that is not ancient history for any part of women's health, which like you said, has always been tied to fertility, of course. Which we failed to engage any further past that we didn't talk about pleasure or any of this different stuff.

I had Rachel E. Gross on the show a couple years ago to talk about her book Vagina Obscura and the rest of her work, which is amazing. And she's very upfront. I think it was like the first chapter where she said, she got treated with rat poison.

Jennifer Gerson: Oh God. Okay.

Quinn: Right? And she was like, this is a thing that we still do, for a UTI, of course, for a UTI, which everybody blows off. And you're like, yeah, that's not a hundred years ago, much less 200 years ago. So how would you, as someone, let's say you're, you're not [00:33:00] writing a newsletter about this, you don't work at the 19th, how would you start a conversation with a clinician to start to unpack like from what we do know, which issues might apply to me, and what should I expect, basically?

Jennifer Gerson: Well, I think that's what's, you know, really interesting about perimenopause and menopause too. There are so many symptoms potentially, and this is, you know, part of that double-edged sword of what's happening online right now too, is I think there's so much conversation of everything being a menopause symptom.

So again, it's just about being really explicit. I think it's okay to say to your provider I feel like I'm angrier than I used to be. Could this be related to perimenopause? Hear all the time from, again in my own, you know, friend group, right? If your skin is drier, that could potentially be, there's so many different things. So I think part of it is just having, feeling comfortable talking about your own body, which I think is also something a lot of people deal with. There's that stigma still. I think for people who have been socialized as women, I think we still can carry this discomfort [00:34:00] with, first of all, discussing when something doesn't feel right or doesn't feel good and then just talking about our own bodies.

Next week's edition is actually gonna be on dermatology and some of the issues with vulva health that can come up, but I think people just don't feel comfortable talking to their doctors and it's okay to know that, especially if you're going to anyone who is a especially menopause specialist, they are comfortable with you talking about this.

Quinn: That's what they're there for, right?

Jennifer Gerson: You shouldn't feel uncomfortable. And it is okay to say, could it be X, Y, Z? And then you have a sounding board of people to say, oh yeah, this could be related to hormonal changes. Or, no, that's probably not at all related to anything hormonal, but maybe you should go see a podiatrist about that,or whatever it is, you know?

I think that, feel comfortable using your healthcare providers as a sounding board, as a first line of defense over doctor internet. Definitely. And, you know, go to people with this kind of expertise who can really help you navigate some of these issues. And again, obviously another issue is healthcare access. And not everyone is gonna be able to access a doctor in general, depending on where you live, but certainly be able to [00:35:00] access a menopause specialist. But I think trying to seek out these people, and again, the Menopause Society is such a fantastic resource for this. Finding someone who is invested in midlife women's health and wants to be a partner in navigating those things and helping you understand X from Y and what you are feeling is gonna be just such a critical step and doing that and just not having that fear of asking and not feeling, you are not an imposition for wanting to advocate for yourself and your health.

Quinn: What I love about the newsletter and clearly your perspective that you carry throughout, not just there, is this ability to weave this very personal with this broader part of again, even if the mission is just to normalize talking about it more among your friend group about the symptoms, like asking questions, are we related?

Who could it be? And then again, like having a private and professional sounding board. Someone who, if they're, I imagine if they're part of the menopause society in any way, then they're someone who's opted in. It's probably not one of the guy doctors who’s gonna [00:36:00] blow you off at most, which does happen all the time, of course. But I would think if they self-selected themselves into that, they would not. But the way we talk about it, and I know I keep coming back to this, but this is important and I work on a lot with climate too. So I work a lot with a group called Good Energy, run by this wonderful woman, Anna Jane Joyner.

And it's a nonprofit whose entire job is to get more climate characters, stories, jokes into TV and film. And as I mentioned, my wife is a screenwriter, so I hear about this all the time. She wrote the two Wicked movies. I'm very proud of her. She co-wrote those. So it's been a crazy week for us, but people asking them about, well, did you explicitly write about fascism in this line from the witch?

And it's like, no, that's been there for 25 years. And it is also in the Wizard of Oz. The point is, that can be such a tool if used well and incorrectly and enough to normalize it in whatever, living rooms, whatever it might be. Families. What would you want to see from whatever we call TV now, streaming, movies, about midlife [00:37:00] bodies and sex and menopause?

Jennifer Gerson: Oh gosh, that's a great question. Especially because readers of the newsletter don't know. I feel like I talk about TV a lot and music a lot.

Quinn: But this is so important, and again, I didn't wanna pivot it but it is such a vehicle if we use it right.

Jennifer Gerson: I think again, it would be great to see just this, honestly, this frankness, I think of people having this moment that I feel like I've heard so much of, especially since beginning this project, of this newsletter, of talking to people who are saying, am I crazy or is this really happening to my body? I think there's so many people having that conversation very quietly, and I think just having that on a more public stage is just so important. And I think, again, just normalizing that there is not a one size fits all experience. So I think the more diversity of experiences we see is gonna be so important. I feel like that's probably true with all things in media. If we can get more different kinds of stories out there, that's always gonna be important. But I just love, and I think we're having a moment, honestly right now, a little bit where we can say that, [00:38:00] you know, people older than 40 exist, people older than 35 exist.

Seeing them on screen is fantastic. And I feel like I've mentioned this, you know, a few times in the newsletter. We're gonna be in the golden era, like right Nicole Kidman starring in streaming shows. I mean, here's this woman who's, you know, well into her fifties and I love, put her in a wig and have her with a secret. It is my favorite show.

And I'm so glad that we are in an era where women are not being ruled out for parts because of their age. I think we're seeing more and more of this. I think there's, you know, if you're roughly in my age demographic, I always kinda joke like we're this, like Lilith Fair generation. We grew up with, I think, really incredible women artists who were dominating pop culture in so many ways. And I think it shifted what our expectations are. I think we are a little louder and we are not afraid to ask for what we want. We saw that modeled I think during a really fundamental time when we were developing.

And I think we want to continue to see people who look like us. And I think that [00:39:00] is always fun and exciting. And I mean, like my husband would joke, anytime someone is like on anything and they're like, older than 40, I'm like, I love them. Don't they look great? So I always am there for that.

Quinn: Good for you. Yeah, a hundred percent.

Jennifer Gerson: Bring me everybody, like an all 40 plus show of anything. I'm there. Let me see those women being complicated and messy and weird and all the other things that women are allowed to be.

Quinn: Have you seen, it ended now and oh, it was so good. Did you see Sex Education that was on Netflix?

Jennifer Gerson: Oh gosh, no. But I've heard it's incredible. I know people, many people have told me I have to watch it.

Quinn: It's so wonderful on so many levels. Not perfect, but funny and as raw and as honest and as inclusive as it can be and weird 'cause it's about clearly like a high school type that doesn't exist in the world. It's like somewhere between an American fraternity, but it's beautiful and it's about sex and puberty and all the existential things. And I know you said you got a [00:40:00] 10-year-old and my 13-year-old every day feels like life or death. Right? Every moment in the hallway of everything. I remember it. It's visceral.

Your body's changing, your brain. You have no idea what's going on, but you think you know it all. And then you're like, but what if I don't know everything? And that's one moment. And then there's sex, and like it's everything. And I'm like, where is like the Golden Girls meets Sex Education show, right? Where that is like as honest as possible. And it's mental health and all the health and all that. And like you said, it's just people and you're just like, I get it. I get it. Like I feel you. Right.

Jennifer Gerson: Yes. Not that, at all, but I kept saying I loved you know, Parker Posey's character on this past season of White Lotus.

Quinn: Oh my God. I mean, first of all, talk about people we grew up with, like Parker Posey.

Jennifer Gerson: The best, right? If you know Parker Posey from Party Girl, like you can sit with me. Right. And she was so flawed and it was so fantastic to see and you can be more AARP members being a mess is always what I'm there [00:41:00] for. You can be a mess.

Quinn: I thought you'd appreciate last year, for the first Wicked movie my wife and the co-writer, Winnie Holtzman the one award they did win was from the AARP and they call it the Movies for Grownups Award. But my 12-year-old kept telling people my wife won a movie for adult movies.

And she was like, no, no, no, nope. It's called, it's called Movies for Adults. It's a very important difference. But it was great, you know, I really appreciated it. So this brings me back to your newsletter though. Like you've said, you really want it to be a conversation.

You really want it to be two way, and I feel like you're already doing that. What are we, like only three or four in, I love it, but also like with the Parker Posey and the White Lotus memes and this and this. Like, what have you learned so far? And like, how are you approaching, how you balance that out, right, these personal stories versus the research stuff with this oh, Parker Posey, White Lotus meme.

Jennifer Gerson: You know, hopefully every issue has a little bit of all of these things and I hope that people feel like they know me and I love that the people who are reading it [00:42:00] who have known me in real life before this, I keep saying it, it sounds like me. And I really think that’s how I talk, I think that's the trick.

I think it's, again, trying to get at how holistic this experience, we can hold so many truths, like you said, at the same time. Let's talk about science. Let's see where the research is. Let's get into the numbers. Let's talk to an amazing researcher and scientist. Let's also talk about how I love the new Nico Case album.

Let's talk about my pitch for an old people Love is Blind. I think like we can do all these things and I think we can talk about how diverse this experience can be of aging and aging in a body and what this can mean and look like. And I think that brings people into conversation. I think it's how we all live our lives, right?

Like we don't all just only read, you know, a one New York Times, we’re reading, you know, all kinds of chat on the side too, so let's do all those things. And I think it doesn't mean that we're worse for it. We're just complicated. Interesting people who also sit in carpool lines and have to shuttle around kids. So let's talk about all those things all at once.

Quinn: I love that. And to be clear, I didn't know you [00:43:00] before, but I do feel like I know you and I do feel like that comes through in a really wonderful way. And you're right, like we are all very complicated. So our only other full-time person is our production director, Willow Beck. Hello Willow.

She is in Canada on Vancouver Island. Good for her. And all she really wants, so we really talked a lot in the last year about meeting more people where they are, you know, not just like giving 'em their vegetables all the time. 'cause we don't even want that. So that's why we have the parenting show and we're talking about food and all this different stuff, right.

Because like you said, we're not all just reading the A one, I don't wanna read it most of the time I want the trash. For me it's like sci-fi dragons or reading what my kids read. But because that's where we are, that's like a safe place now. And like you said, like an old people Love is Blind. All she wants is for us to someday have a reality show podcast or something that somehow ties into like, what can we do for the world.

Jennifer Gerson: You can bring me back for that one. As an avid reality TV consumer. I feel like this is really my thing.

Quinn: She'll be so excited. She couldn't be more ready to fully cut me outta the process. The problem is I fall [00:44:00] asleep at everything, so the closest I get is either Top Chef, which even that can be like a little stressful for me, but really like Great British Baking Show, which is basically my Prozac at night.

Jennifer Gerson: I love the baking show. Just finished watching the new season. I was behind everyone and I finally caught up.

Quinn: These days, and again, it's pretty privileged, but to find the things that enable you to turn it off a little bit. And I will stream any episode of any season in that show that is really just like my emergency button, basically.

Jennifer Gerson: Oh, absolutely. And it's so kind and I am so happy to see people being nice to each other.

Quinn: It’s so kind and everyone's great, and then once in a while they help each other and you're like, we would not do that here. To be very clear.

Jennifer Gerson: My husband always jokes, he says, I watch every show and say I love friendship, which is so true. And I love, again, Love is Blind, I like to see how all the men always become friends with each other.

And same thing with the Baking Show. My favorite part of the Baking Show is the last episode when you get the montage at the end about how they're all visiting each other after. I love that part.

Quinn: Yeah. To these, you know, the you know, typical 70-year-old [00:45:00] grandma who made it farther than they thought and like the 21-year-old, like young Indian gay guy who made it are like vacationing together and every one of those I'm always like, I just wanna be part of that group.

Jennifer Gerson: I spent the whole season just trying to get to that montage at the end where I feel so affirmed by all the friendships.

Quinn: That's it. That's it. I love it. There's this legendary producer, this is such a sidetrack, sorry. Her name is Lindsay Duran, and she gives this incredible talk. I'll send you the link to it about why relationships are the most important part of movies. Not like the plot thing that happens at the end.

And she always, she uses Dirty Dancing and all these amazing examples to talk about that, which is we're just trying to get to the relationship part. Like, I care about who won, obviously. Like if you put salt instead of sugar in like you're a moron, how have you not learned that by now?

You know, et cetera, et cetera. but it is, those, it's those pieces that go along the way and to bring it all back. I feel like that's what you're doing with your newsletter is creating this two way sort of community for a just enormous amount of people that just wanna be heard, even if they're [00:46:00] not to the advice stage yet.

But let's talk for a moment about that. We've talked a little bit about the individual side, I guess. 'cause we usually come from like, how do you use your voice? We call it be heard. If you wanna volunteer, if you wanna get educated, if you want to contribute in some way. Right. We know Planned Parenthood doesn't make amazing work. And they're threatened in a lot of ways. Teen Vogue was doing amazing work, is what it is. The 19th is doing credible work.

I will say you should support the 19th. I have supported the 19th since day one. What you all do is fantastic, even before this. What are some other examples of maybe things that are working well in, let's say, the corporate environment that people could find and maybe bring to their own workplace?

Jennifer Gerson: Well, I mean, it's something that's really interesting that I think happening right now is we're seeing so much momentum in state legislatures on bills related to menopause. And kind of one of the major trends of these bills is for protection for workplace accommodations. And this can be sometimes as [00:47:00] simple as like asking for can I have a fan at work? If you have hot flashes, a fan might help. So that's a super interesting trend. And the other kind of big state legislature thing kind of happening is there's a lot of bills, Illinois has one right now, there's a number of states, about making sure that menopause training is part of medical training in those states and making sure that doctors receive training, you know, supplementary education in midlife care.

And again, there are kind of these various like buckets of menopause bills we see moving right now, but there's a number of them and it's, you know, now well over, I think a third of states have something like this moving right now.

Quinn: I love all of that. We're trying to do a lot of work at the state level and the local level too, because for a lot of reasons, one well, I think it's obvious but those are very helpful. It's where you're really gonna see and touch and feel and experience frankly, the most progress, the quickest.

Okay. On the policy side, you've talked a little bit about some research that's happening that you're excited about. What are some versions of that that you feel like people should be paying attention to?

Jennifer Gerson: Rhode Island, you know, is a great example. They were kind of the first in the nation to do this of passing kind of a big sweeping menopause bill. Again, we're seeing kind of three main buckets of where bills are going. Like I said, these workplace accommodations, it's training and education for healthcare providers, and then also kind of insurance coverage for care related to these things are the biggest buckets.

And they all look a little different in different states. We're seeing different people kind of put different puzzle piece combinations together of these facets, but I think again, what's really interesting to me about this too is how diverse the states are, where we're seeing momentum on these things.

This is happening in blue states and red states and [00:50:00] purple states and I think it really shows how really apolitical this issue is I think, again, this is such a large segment of the population who is not interested in being quiet anymore and is okay to say, yes, I am this age, entering this phase of my life.

What do I need? I think people are like, yes, I want the ability to age well, to live well, to borrow this phrase from Dr. Lewis who I talked about earlier, you know, we're talking not just about lifespan, but healthspan now. And I think [00:51:00] people are really attuned to that, and I think that's why we're seeing this happening. Just really across the political spectrum right now too.

Quinn: When we're fighting for fundamentals, either again or for the first time, things like this, it does hopefully become apolitical, right? To say kids should eat, you know, we should have policies on menopause. Like you said, you should be able to get a fan at work. You know, we can start with that. Hopefully we can start with that, your newsletter, which again, is this wonderful evolving journey. This is an action step hopefully you can really be specific about. If you wanna become sort of the automatic open for anyone who is interested, for whatever reason on menopause, what do you want readers to send to you the most? Questions myths, myth busters, right? All of it. Memes?

Jennifer Gerson: Please know, if you're writing in, I read all of them. I love hearing what people have to say. I mean, I feel like we get a lot of questions about people really just wanting some kind of fundamental [00:52:00] health information, because it feels like that information is so inaccessible.

So if you have questions and you're like, Hey, I'm trying to find out about X, you know, this week's edition was on sexual health. And it largely, 'cause we had gotten a lot of emails on that. People were saying, Hey, I'm looking for some answers on these kinds of things. And we really tried to address that.

I would love for people to tell me just how they, you know, to kind of get at the kind of cultural experience too. We've touched on how they grew up hearing about this.

Quinn: If at all.

Jennifer Gerson: How did you think about aging and gender and bodies? I would love to hear all those things. And this stuff, I think about at three in the morning when I'm up. So if you also think about this at three in the morning, you can email me at three in the morning and I can read it then. So that would be great.

Quinn: I love that. I hope it's an overwhelming amount. Truly. If you can make some people feel heard, it'll be a lot more than what’s currently there. It's wonderful. Before I let you go, one question I ask everybody, well, actually it's two questions now. I'm very excited. The [00:53:00] first one is, what's a book you'd recommend? And to be clear, it does not have to be about menopause. We have done coloring books, the Constitution, anything, whatever's like floating your boat.

Jennifer Gerson: Okay. Okay. I have to think really hard about this. Okay. This is not gonna be related to menopause at all, but I've been reading nonstop with my 4-year-old. The latest if you are a parent and you love the Crayons series, the Day the Crayons Quit, the Day the Crayons Came Home, there's a new one and it's the Day the Crayons Made Friends.

And it is so funny and I have been laughing out loud. And like, my 4-year-old just wants to read it nonstop and we finished reading it and then we start all over again. And it just is so joyful. And again, just absolutely funny. And I love books that as a parent you can really share your sense of humor with your child. And I feel like this really taps into that. And super clever. And I have read it like a thousand times in the past week and I'm not bored of it yet, so I have to give a shout out to the Crayons. Yeah,

Quinn: I couldn't love reading with my kids better. You know, one [00:54:00] example, obviously it's super popular, which is great, is like the Dragons Love Tacos series. And I feel like on like the 18th or 19th read is at least where I started to be like, alright, how do I really perform this in a way that is most fun for them?

Where you're just like, this cannot be good. You know? I don't know who would, where you start filling, I mean it's, they're the best. Like why wouldn't you just read those books?

Jennifer Gerson: Oh my gosh. Absolutely. And that is a lot of my life. Yeah. Love those books too. Spicy Jalapeno Puffers gets you every time.

Quinn: And last one, I can't believe I haven't been asking this for a hundred years. What's a playlist you can't get enough of these days that, again, maybe use it while you're working or to turn off or again, with your children, who can know?

Jennifer Gerson: Okay. I'm gonna answer this. I'm gonna give more than one answer to this. 'Cause we listen to, I have been listening to the new Snocaps album, like nonstop as the, you know, Waxahatchee and Alison Crutchfield project. I love it. It just, if you are an early Waxahatchee fan, this just scratches that itch so intensely. I love it. Love it. Some MJ Lenderman, like [00:55:00] incredible, everything I want in an album. And then my kids are just absolutely obsessed with the Zombies franchise on Disney. And so I can probably do Zombies one through four, every song top to bottom on all four albums by heart. And that's probably the most played thing in my house right now. But there's a lot of Descendants mixed in with that.

Quinn: That universe is quite large. We listened to, was it, what's her name? Freya Skye this morning. We did a lot of Freya Skye this morning. There are Malachi Barton posters in my home.

Jennifer Gerson: I feel like these are my personal friends.

Quinn: Yeah, yeah, yeah, exactly.

Jennifer Gerson: My daughter, like, I had to band like yesterday, she was like, can we listen to Freya Skye again? I was like, I just can't do this one more time. Let's just put on something else. But I can tell you too, I'm not even just saying this, I know it's about to be all Wicked all the time because my kids absolutely love Wicked and we saw the first movie like 12,000 times and they are waiting with bated breath for number two. So I [00:56:00] have a feeling that's gonna be the next thing that we are listening to nonstop.

Quinn: Well, it's wonderful. It's a little more emotional than the first one.

Jennifer Gerson: I cried so much in the first one that my daughter like did not speak to me for an hour. 'cause she was like, it was so intense sitting next to you solving during that one. And she has no idea what she's in for.

Quinn: Oh, yeah. If you know what's coming, then yeah. Be prepared.

Jennifer Gerson: And she's not ready to see the way I'm gonna process that.

Quinn: I haven't processed, I've seen it like six times. You’re gonna have to put on some Freya Skye after just to cleanse.

Jennifer Gerson: Trying to make amends, honestly. Yes.

Quinn: At one point my daughter was like, you know, we're into deep cuts at this point of her making her lunch this morning. And she's like, this was her first song. She wrote it, she did it when she was 13. And I was like, what?

Jennifer Gerson: She's like 15 right now. I think she just turned 16. It's crazy. Good for Freya Skye.

Quinn: Good for her. I think it's great. I think it's all great. It's great. I just feel like I'm a thousand, you know, I could be their grandfather, so that's great. This has been so lovely. Thank you so much. Again, I [00:57:00] know I cold called you, you sent out the announcement, whatever it was a couple months ago. I'm gonna write this newsletter. I was like, we gotta do this. So thank you for saying yes. It's very kind of you.

The more we talk about it, right, and everybody, not just folks who are personally and intimately invested in it. That's it. Anything else you wanna share before we get to it?

Jennifer Gerson: Oh my gosh. I don't know. Write me, I wanna hear from you.

Quinn: Hundred percent. Where are they writing you?

Jennifer Gerson: You are writing me, I think community at 19th news dot org and it all will get to me and I wanna hear your thoughts on being a person in a body getting older. Tell me.

Quinn: It is fun. I saw a thing the other day that said that good news, all injuries after 40 are permanent. And I was like, yeah, it feels about right.

Jennifer Gerson: Sounds right. Sounds right.