The Hotflash inc podcast

60. Gerianne DiPiano: "We've been conditioned to accept hormones from cradle to grave"

January 27, 2023 Ann Marie McQueen
The Hotflash inc podcast
60. Gerianne DiPiano: "We've been conditioned to accept hormones from cradle to grave"
Show Notes Transcript

Gerianne DiPiano is chairman and CEO of FemmePharma, which produces among other things a range of solutions for women going through menopause. That includes personal lubricants and moisturizers, and hot flash and sleep remedies. Geri has had a three-decade career in women's health, working at the top levels of the pharmaceutical industry as well as founding her own companies. She has amazing stories to tell about the business of menopause, about the science behind hormone therapy and various products. We talk about everything from clinical trials to letting your hair go gray. 

Highlights:

• Hormones sure, but women need options for individual symptoms
• The problem with a lot of vaginal moisturizers and hormone therapies
• How we are conditioned to take hormones and what might be the problem with that
• There are risks to hormone therapy – don’t let anyone tell you there’s not
• Why you need to fact check influencers, doctors on social media + your own doctor (PubMed is a great place to start)
• What we’ve finally figured out about women – and how to use that power
• We’ve finally reached a North American menopause revolution – and what needs to follow
• A peek inside her experience as one of the only women inside Big pharma at the C-suite level
• How the traditionally male-dominated Big Pharma continues to impact women’s health care today
• The anecdote you have to hear about the possibility of a testosterone patch from Geri’s former career
• The one big thing pharmaceutical companies need to do in developing products for women safely
• Her peri/menopause experience + philosophy
• Becoming a certified silver sister

Where to find FemmePharma and Mia Vita:

Web: FemmePharma.com
Instagram: @FemmePharma

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you cannot generalize. And I, really have a problem when, when there is an overgeneralization about any of these types of products, you have to look at your individual risk factors. You need to consult with your healthcare practitioner and you need to remember that anytime you put anything in your body, there are consequences. Am so excited today because I had a conversation with Jerry d Piano, who is chairman and c e O of Fem Pharma. That's a trio of companies she'll explain, and one that offers non-hormonal solutions, mostly for vagina things, although they do have a portable B Day, which I think is a great. Idea. I live in the Middle East and I think one of the reasons I can't leave here is that there is a hose by every, toilet called a shutoff, and people take travel shutoffs and people who grow up in this region and travel can't believe that the rest of the world doesn't have them. I really digress. I'm so excited to talk to Jerry because mean, she has a three decade career in women's health. She has been inside. Pharmaceutical companies at high levels and has amazing stories to tell and amazing perspectives, and she's gone through menopause herself and has a really unique perspective on that. She's an entrepreneur, but she's got the sort of inside information scientific know-how to explain to us why it's always good to be skeptical. Why there's nothing that's ever perfectly safe for us, even a glass of milk. And, she's just one of the most refreshing, clear, experienced, trusted voices I've come across. So I hope you enjoy our conversation and I encourage you to listen to all of it because there are so many nuggets in there. Enjoy.

Ann Marie:

Okay. So you're focused on products that deal with vaginal issues. Not exclusively, but mostly to do with the menopause per menopause transition and non-hormonal products.

Geri:

Correct.

Ann Marie:

And how, how did that get, become the focus.

Geri:

Fem Pharma, is a company that I started I've actually, this is the third company.

All the same name by the way. So the first fem pharma was started about 20 years ago, prescription pharmaceutical company that focused on, some diseases and disorders that disproportionately affect women. Including endometriosis and overactive bladder and, fibrocystic breast condition and a host of other ones. That company, within five years was sold to a public company in an all cash transaction. And I did not have enough. I had spent the first part of my career in the multinational pharmaceutical industry, with some of the big names that you'll know, because. Multi-billion dollar entities that serve up products, for men and women all over the world. But in those years that I spent in large pharma, what was really clear was that women's health was really a second class citizen. And that is really unfortunate because when you look at the. Diseases and disorders that disproportionately affect that affect women, it becomes quite clear that this is a significant opportunity. Nu, I mean, if you're motivated solely by greed and Aric, then you would pursue women's healthcare as your top priority. And if you really care about women, you would pursue that as your top priority. So we always say women are at the top of the pyramid, right? I mean, they really have to be because they control everything they. Spending. They control the spending for their families. They're the largest single demographic. at any age group cohort. So why not? Why not focus on women and why Only focus on what I will call, you know, the obvious reproductive conditions of women. So when I started the first FM pharma, it was after having spent time in the big companies and the multinationals and we, we had the first series of products. When we sold the company, we decided we needed to keep. So we did, so second company was started. That company is still in existence. It is a prescription pharmaceutical company. We were able to carve out most of our intellectual property and our products that were ready to go into phase two and phase three. And so that, that company, still in existence, f Pharma, global Healthcare. But along the way, we realized that women. Should have many options, right? It shouldn't only be about taking a prescription product because perhaps that isn't necessary. So how could we use some of our technology and know-how to design a product that would utilize, some of the key characteristics that helped women with compliance? But didn't put them in the quandary of always having to put a hormone in their bodies. Now, there's nothing wrong with hormones if that's your thing. I believe in options. However, many of us, including me, would prefer to start with something that's more benign, which is, you know, something made without hormones that works, on individual symptom. And that can be true of any condition, not only, for conditions that affect women after the age of 40 during perimenopause or menopause, but certainly it can be for women who are younger and who may be looking for a natural sleep aid or a product that, provides them with stress relief. So any, any number of those. Ways in which we might attack or tackle whatever symptom or whatever issue we may be facing. So we, we are a believer in. Also uti, utilizing more natural, more holistic ways in which to deal with conditions that women may be experiencing. So we started the, the third company separated that completely from the prescription company because two different types of sales techniques, marketing audiences, primarily the consumer audience, women in our case. Although we are very, very committed to the healthcare practitioner because the healthcare practitioner also needs more tools in her toolkit, we happen to focus on gynecologists and the reason we focus on gynecologists because she, and yes they are, it is largely dominated by women, the practice of gynecology. Is faced with limited tools in her toolkit. So we wanna provide her with as much as we possibly can. So we do promote, to the healthcare practitioner, engage very much so with the healthcare practitioner. Also to enable her to have the kind of confidence that she may need, particularly when dealing with some of. Symptoms, which are often not discussed. So you mentioned that we, we do, work with conditions. What I'll refer to is the vaginal symptoms of perimenopause and menopause. And those products use our core technology and some of our competency and our learnings from the prescription companies. So for example, we have products that are very low volume. Less is actually more. You don't need to have three or five grams of material placed in your vagina, If you need a little bit, it will actually work well. We used really great ingredients. Like hyaluronic acid and vitamin E, which we know are superpowers on the skin and especially on mucosal skin. And then we make the product very viscous so it doesn't leak, it's not drippy, it's not messy. Why? But we want you to use it every single day, right? You don't stop using your facial lotion. or use it occasionally, use it every single day because you wanna make sure that your skin is well hydrated and protected. While mucosal skin is no different. So the, the lead to products, which is our personal lubricant and vaginal moisturizer, we're actually. Spun out from our prescription company. They're made without hormones, but the, all the, the other ingredients are the same. And then we're, we've continued to, bring forth products that we believe would be helpful to women to companion with some of those product. in order to address some of the other symptoms of menopause. Again, these are more natural products. These are products that are largely focused on the symptoms that women experience when they are going through the transition.

Ann Marie:

So is this a kind of, you know, everyone thinks about dryness, but I what I hear a lot. and experience myself is like just sort of feeling like you might be on the cusp of an infection or an irritation and you might not have dryness, but you just have a sort of like an irritated feeling.

Do your products sort of focus on that too.

Geri:

So the, what we now refer to as genital urinary symptoms, g s M, it's the new way to refer to what you just described. So urinary frequency. Meaning? Meaning I have to go to the bathroom all the time. And burning. Mm-hmm. right? Mm-hmm.

and sometimes itching. Mm-hmm. and sometimes pain or all of the above together. So itching, burning, pain, frequency, urging, I gotta go, go, go, go. Those are all part of what we refer to as the genital urinary symptoms of menopause, G S M, the older term. V and vaginal symptoms of menopause, which is the vva and the vagina, but it didn't begin to describe the genital urinary symptoms. So sometimes it's very confusing for women. So they will have itching, they will have burning. and it is dryness. Other times not so much. It could be a U t I and di. Distinguishing between the two is is quite important, right? If you have a U T I, you may have pain upon urination. You may have some foul smelling urine and you may, if you start to experience fever. If you have fever, you believe that you have a rise in temperature, then you probably do have something such as a uti. and obviously if there's heavy discharge from your vagina, then you obviously may have something worse. Again, I'm not a physician, I'm not practicing medicine and I'm not giving medical advice, but I have been doing this for a very long time. So and I've been a drug developer for more than 20 years. So in terms of symptom relief, if you're having burning, if you're having itching, if you're experiencing pain during intercourse or use of the toy or you know, self-pleasure, then we definitely have products that may be able to ameliorate some of that. Those issues. And you can use what one or both of our products that are focused on the vagina and the vva. So Vva is the area outside the vagina. Starting up at the very, top of your, near your clitoris and your, the lips, which are your labia, the madura and the menorah. And so you can apply what we call the Mia Vita Intimate Skin Moisturizer. To those areas. Then if you have vaginal itching, burning pain during intercourse or self-pleasure, you would wanna use the vaginal lubricant and per personal lubricant and vaginal moisturizer, which is also Mia Vita. Personal lubricant, vaginal moisturizer that comes in a pre-filled applicator. Very, very small amount of material contained in that applicator you inserted just like a tampon. So we wanted to make this very easy for women to use and it w has actually been, this applicator has been used in clinical trials that we have run. Mm-hmm. for two, two decades. So it is very safe to use. It is very easy to. There's not a woman that was in any of our studies that had any issues with it. Now, if you have vaginal narrowing, right, because that does happen mm-hmm. in perimenopause and menopause, then you would gently insert that, but it would actually help to keep the vagina. slightly pa patent and open. Some women who have significant narrowing will use something else along with the personal lubricant and moisturizer, and they may use a series of dilators to help with that problem. But our applicator was actually, designed as a kind of a, a two for one benefit. Right, right. You keep the vagina open, but you also get the benefit of what's inside of the applicator, which is the lubricant and the moisturizer to help to hydrate the tissues in the vagina. Right? Yeah. There's,

Ann Marie:

it's a really inappropriate term now.

I found out the hard way on social media, but the sort of use it or lose it when it comes to your vagina is, you know, whatever I need, we need to come up with a new term for that because it's sort of ableist. But, definitely. it's something to pay attention to. It's something for women to really note and file and do something about because it can worsen. Right?

Geri:

So vaginal narrowing can happen for a variety of reasons. And actually you, we're gonna have a, a blog post about, vaginal narrowing. So, stay tuned for our blog post on the use of dilators. And what women will sometimes say is, why is my vagina shutting down?

It's not that your vagina is shutting down. What's happened is there's loss of estrogen. You may begin to experience pain during intercourse or, or masturbation, or. Of sex toys. And so if we have pain, why would you wanna insert anything? So why would you wanna have anything inserted in your vagina, including a tampon that can then worsen over time? Right? So if you don't do something to keep it paint and think about an arteri, right? So if your arteries aren't open, You would do, you would go to cardiologist, obviously an interventionalist and you'd have an angioplasty. Well, we're not talking about doing that with the vagina necessarily, but we still do need to keep it open and hydrated. And if it's, if you keep it open and you keep it hydrated, that will limit or minimize the potential for more of that vaginal, what they call vaginal stenosis, where the vagina can collapse on itself.

Geri:

What about some of the things we hear about sensation muted, sort of pleasure. Those things that can happen.

Can higher lanar acid do anything for that? Or do you need to go the hormonal route, do you think?

Geri:

So if you're talking about libido,

Ann Marie:

not so much libido because that's one thing so that you can address that too. you know, you hear from women that, oh, their orgasms are disappearing, they're not as good as they were.

they have less sensation. Is there any, can your products help that? It's also in this constellation of G S M.

Geri:

Sure. If you are, if you're not properly lubricated. So let's talk about, you know, having an orgasm if you're not properly. Not enough lubrication. You're not gonna have an orgasm. You're gonna be focused on the pain and that's not going, that's not helpful, right?

So you need an appropriate amount of lubrication. So yes, what you want is you wanna be able to use a personal lubricant and moisturizer because it will enhance the comfort in the sensation during inter. What women are often confused about, and this is what I, I dislike about companies that produce lube per se. Mm-hmm. and it's just for the, you know, at the moment, right? So right before intercourse or you know, you stop mid act and you know, you use some lubricant and that may help. And if you are a younger. who is premenopausal in your reproductive age group cohort, maybe in your twenties, thirties. You may use that if you're having a lot of sex, right? Because it will help, no question about it. But if you're a woman who is moving beyond that and you're starting to experience the decline in estrogen and some vaginal dryness, what you ought to be doing is something prophylactic, which is to use your personal lubricant and vaginal moisturizer every. The reason that we understand is from our market research that women will not do that is because personal lubricants and moisturizers are largely so disgusting and gross that they leak out and you're using a pad every day. Ah. To prevent these products from leaking into your lingerie. Well, that doesn't make you feel sexy. I'm sorry, but I don't want anything looking in my underwear. Right. And then add to that, even during the act, even if you're having insertive intercourse, I. and you have semen and you have mucus. You know, mucus coming out and you have this lubricant. My gosh. Yeah,

Ann Marie:

that's a lot in there.

Geri:

we're talking about like four or five mls of material.

Ann Marie:

That's a lot of material. It's a lot of material. Yeah.

Geri:

One little cavity. So you know it's bound to get on your bedsheets and it's bound to get up on your clothing. So it's not, it's unpleasant. Yeah. And that's a, that is gonna kill the moment, right? Right. So what we want is something that is elegant, discreet, easy to use, and if you use it every day, by the time you get ready for that moment, it should make your experience much more pleasurable.

Ann Marie:

Do you hear some of these things from the vaginal hormones? Do you hear that? It's like, I've never experienced it and I need to talk to more women about it, what it's actually like. But is, is that a problem with the, the vaginal estrogen and, and testosterone that people use or? No.

Geri:

So I really, you know, when, when I have, when I worked in prescription pharma and I did work with, a large, manufacturer of, one of the leading products, that was hormonally based, we would hear that.

It didn't always work right away, right? So it takes a while for the hormones to kick in. That's number one. Number two, if it is inserted in the vagina, again, because of the volume, you will. Some of that discharge, right? Which is not highly desirable, but for some women it works. And if it works for you, then I'm all about options. So I personally, so you know, I am, bent, menopausal, and I personally do not use hormones, had, have never used hormone replacement therapy. And, um, don't feel comfortable for a variety of reasons. I, I do not have any risk factors. If you're a woman who has any risk factors that are identifiable, whether that's cardiovascular or whether that is a cancer risk, then obviously you wanna consult with your healthcare practitioner to make sure that, hormonally based products are safe for you. And all products are, that are hormonally. we'll get some, there will be some systemic absorption. What does that mean? That means it will transport from your vagina into your circulation. Into what we call your systemic circulation. So you are getting some levels of drug. They may be low, but they are not non-existent. So when someone says, if you place the, the hormone in your vagina, it's not traveling into. Systemic circulation. That's not true. We know because we've run all those studies, right. With the fem pharma and prior to that, when I was in the big pharma companies that made those products,

Ann Marie:

that brings me to you are in this cool intersection cuz you've got this company and you worked in pharma and so I wanted to talk to you a little bit about the messaging because even that message, I hear that all the time.

It's perfectly safe. It doesn't go systemically, but you know, I know that's not true and doctors have told me that's not true yet. People are saying it, it's almost. there's an irritation with any questions you might have about anything to do with hormones. I just got right before I got on the phone with you, the phone, I got a press release from the North American Menopause Society saying, menopause hormone therapy is the best way to deal with hot flashes and night. it remains the best way. There's two doctors quoted in it, a past president and a doctor, and it's fine, but there's a tone of irritation, like women are still asking 20 years after the women's health initiative study that you know, created all these problems. Women are still asking if it's safe and it's like, Yeah. We are asking, and, and you've worked in pharma and you are, you are not comfortable with it. You wanna give women options yet we are getting messaging from all over saying this is safe. Why? Do you still have questions? You should be taking it. like years and years and years and years. You should be taking it to prevent things. You should be taking it to prevent cardiovascular disease, dementia, osteoporosis, varying degrees of research. I'm just interested in your take cuz you worked in it, you've gone through menopause, you have this company, the messaging, the messaging that were deficient that we need. to get through this transition. Sorry, I went on for so long. I am not against hormone therapy, but I am wondering how to relay this to people, how this works. And I think you can help me

Geri:

So I, we've been conditioned to accept hormones from cradle to grave. Let, let's talk about that for a moment. So, if you're a young woman, And you have irregular periods, you're often, it's often recommended that you use birth control, right, to regulate your periods if you have mild endometriosis.

They often recommend that you use birth control to deal with that. If you want to prevent pregnancy, it's hormonal birth control. And again, I'm not against hormonal birth control by any stretch of the imagination, but imagine this, let's say you're 16 years old and you start on hormonal birth control and you continue on hormonal birth control until you are ready to have a family. Or maybe you don't wanna have a. how long do you stay on hormonal birth control or do you use some other means to control your reproductive rights? That I can get into that in a, in a long conversation you start to enter, so we move in from our teens to our twenties, to our thirties, and now perhaps you've decided that you wanted to conceive, but you're having difficulty consider. Now there are more hormones for you and then you've completed your family and you have to decide, do you want to go back on hormonal birth control? Do you want to use something else That's, you know, puts woman in a, a woman, a woman in a quandary, and then comes the next transition, which. Perimenopause. So your estrogen levels are declining, and you're trying to find ways in which to deal with some of the individual symptoms. And here we go again. Here we go again, more hormones. So when, when I, when I speak of hormones from cradle to grave, there comes a point in time where the exposure to these hormones will have consequences. They just will. If you are relatively healthy with no risk factors, and by the way, I'm not sure that we know that we have a risk factor until it's been identified as a problem. As in you walk into the ER and you had a blood clot in your leg. Or you, perhaps you have a first degree relative, a mother. A sister who had cancer or had cardiovascular disease. So if you know that you have a family history, maybe it becomes more obvious, but maybe it doesn't. In my family, there were no risk factors. Do I know that I'm fully risking? I assume I'm fully risk free, but I don't know for sure until I end up in an er. So when we think about hormones, there are ways in which to address individual symptoms of menopause that don't necessarily require us to use hormones. If you want to use hormones, I believe that the, the studies that that were done by the W H I. restricted the number of years during which hormone replacement therapy was recommended, and then they revisited that more recently. and so they've expanded the number of years for which hormonally based products to deal with menopausal symptoms could be relatively safe. I always use that word to speak about safety. There is nothing. Is 100% safe, nothing. Mm. Even drinking that glass of milk. It's not 100% safe. Giff, just gif peanut butter just did a recall Right. Because of salmonella contamination. Oh, right. So, so it's relatively safe based upon you as an individual woman, your particular habits. If you are a woman who smokes, you have higher risk factors. If you are a woman who is using other types of me. You may have comorbidities. So you cannot generalize. And I, really have a problem when, when there is an overgeneralization about any of these types of products, you have to look at your individual risk factors. You need to consult with your healthcare practitioner and you need to remember that anytime you put anything in your body, there are consequences. By the way, there were a number of studies that were done in big pharma many years ago looking at hormone replacement therapy, assessing cardiovascular risk, cancer risk, risk of demen, reduction in, in terms of, dementia and other types of cognitive issues. And quite frankly, they were not compelling in some cases. it made one take a step back and scratch one's head to say, wait a minute, we are not going to reverse all of the effects of aging with hormone replacement therapy.

Ann Marie:

Yeah. I mean, I've interviewed on the first season of the podcast, I think I asked almost every doctor I had on, if I'm managing my symptoms, should I go on hormone therapy?

And then no one said yes. But I'm seeing big doctors with million plus followings on social media saying, yes, you should definitely go on it. And it just seems strange to go on something that you don't need to go on to prevent something when there's so many other factors that contribute to cardiovascular disease and dementia and even osteoporosis. I haven't seen the studies and maybe I'm missing them, that say, um, yes, hormone therapy will reduce your, your, your risk this much. and compare that to lifestyle interventions. Like I don't think those studies exist. Right. But the messaging, this messaging, you know about this, this like talking points that come, this is this stuff that we're getting through, it's coming from, it's coming from the pharmaceutical companies. Is it not? Is it, is it not coming from them indirectly.

Geri:

So we always look, when we look at studies, when I look at clinical studies that have been performed, whether they're the, published, studies that are performed, randomized clinical studies, any of the publications they will site, they will cite, whether there are any conflicts.

Yeah. And wanna see who's sponsoring those studies. Mm-hmm. right? Mm-hmm. Mm-hmm. because investigators that are, you know, on the. of receiving some form of compensation from the pharmaceutical companies it's not to say that they're going to compromise their integrity, but if it is a sponsored study by a pharmaceutical company, one has to take that into consideration when one looks at the data. And that's very important. Same deal with influencers that are, you know, large influencers with, you know, very prominent names, whether they. Practitioners of medicine or whether they are. Those that come out of Hollywood and, you know, pontificate about their beautiful skin, their beautiful hair, their nails, the fact that, you know, they, revitalize their entire vagina. With vaginal laser rejuvenation procedures, one has to look beyond the surface to see who is sponsoring those individuals influencers, especially the ones that have very large audiences. are compensated very well.

Ann Marie:

They can be doctors too, right? They can be doctors. Yes. Absolutely. And you might not, you might not know.

Yes. You might not know that they're being paid because I've seen some doctors lately, that have seemed to have changed their tune a little bit, and I, I, I will never say anyone's name. I, I don't even wanna say it, but, I feel like something's changed here. Yeah. I feel like something has changed. I feel like some money has started to flow. That happens, right? That happens.

Geri:

Yeah. Absolutely.

So one needs to err on the side of caution. It's not every one of these companies, oh, we stays on the right side of the US Food and Drug Administration. So there are, there are lots of times when, you know, folks stray into that gray area. And that's not good. Customer needs to be where

Ann Marie:

the customer needs to be. Where there's a lot of blind trust in doctors. I find on social media it seems like, oh, I found a doctor, I'm gonna follow them. And often if I ask questions, people will say, oh, do you follow this doctor? Do you follow that doctor?

Like that doctor is gonna answer all my questions. And I. Following a range of people. And then sort of, I mean, if social media is where you're gonna get some of your information, which is the way it is these days, following like an array of people and then sort of pulling from them, but always thinking who might be getting paid?

Geri:

You're a journalist, so you fact check everything. Right? And that's, that's really important. So we, we like to fact. And, and you should, as a consumer, you should fact check. I fact check. You know, I pulled up like the other day, my HCP recommended some, natural products for me to try, and I went to PubMed.

and I searched Aerody articles about this particular natural ingredient to see if there was anything in the literature. Now, if perhaps it, there were no randomized clinical trials that were done on this, for the most part, there aren't. Right? Right. But, but there may be some studies and some really great information that you can find. If you look at these publications and you check to see, well, what's been. Which populations? Is it a younger population? Is it someone in my age group, cohort? What's been studied in women? Has there been anything that's been studied in women? Mm-hmm. So we, we need to be our own advocates. And your hcp, your particular HCP knows you best. Mm-hmm. doctors that are, you know, on social media that are influencers should probably always say that, use the caveat that this advice does not replace the advice of your healthcare practitioner. He or Sheen does not know what's going on with your medication. With your body type, with your lifestyle requirements. So you should always consult with a healthcare practitioner, your healthcare practitioner.

Ann Marie:

You've been in this a long time. What do you think of the current, like, you know, I know in the UK it's really far ahead with awareness and all that. In the US it seems like I'm seeing a lot more movement since I started this officially two plus years ago.

What do you think of the, where do you, what do you think of where it's. And, and where it's going in terms of products and companies and, awareness and celebrities and all of it.

Geri:

Yeah. So in terms of menopause per se, I bel I believe we have both observed a similar phenomenon. We have finally figured out.

That we rule that women of, of a certain age rule. So we reach that point in our lives where we are, we're sophisticated, we are well educated, we are in control. We need options. And we are tired of the same singular option that existed in the past. Right? So we're looking for different ways to. What's happening to our bodies, and yes, we're all looking for that fountain of youth. We're looking for ways to preserve our health and wellness. Looking at, you know, whether it is for vaginal and vulva symptoms of menopause or mood or cognition or energy or weight and, and metabolic issues. We're all looking for ways in which to combat the effects of the natural. of our bodies changing. And no secret. there is a gigantic movement underway. I call it the menopause revolution. That menopause revolution is here. We are living the, in the midst of it. And I speak to a number of other entrepreneurs, women who have started these companies like I have, who are offering different resources. I'm really excited about it. Finally, finally, we still have a long way to go though. We do have a long way. But finally we've reached that, we've reached that point. We're talking about menopause, not as a disease, but it's just a natural transition in life. Yeah. We don't become shriveled and ugly and crazy and we haven't lost our minds. We are still very vi We're vibrant. We've just reached that next phase of life.

Ann Marie:

Well, I think once you start talking about it, you know, I. it was gonna be, I don't know what I thought when I started talking about it and I was a little bit e and you know, now I'll talk about it to anyone and it doesn't matter.

People are interested and it doesn't matter if people are old or young. I, I really see a difference. I see a complete difference. I wanted to go back to the, when you talked about pharmaceutical companies and not coming up with solutions for, people our age, women our age, when. Greed wise, it would work and, and for other reasons it would work. Do you think it's just patriarchal? Sort of, you know, we see the same thing in film, right? Like women flock to films that are about them. Women our age go, but they always told us, oh, like people won't go see films about women your age. But then they totally do in their box office successes, not always right. But, I wonder what you think the reason is. Is there one reason?

Geri:

Well, there are many, there are many reasons. Yeah. But let's start with paternal benevolence, which has always been a part and parcel of these companies. So when I, when I joined the industry many, many years ago and worked for these multinational companies, There were no women in the C level suite there.

There were very few women at senior executive levels at vi, the vice president levels. That, and that has changed over the years. But again, remembering the. Sort of the demographic within the organization. So you did not see the same proportion of women as you did men in these entities. So the decisions were largely being made by a number of, men sitting around a conference table in a women's research institute. In a big pharmaceutical company. Mm-hmm. with one or two, or if you were lucky, three women sitting at that same table. So 12 men and three women, and they're make and they're making decisions about what should come next. Now have there been some strides? Sure. There are products that are available for osteoporosis, obviously. Hormone replacement therapy. There are products that have now come to market for libido. But again, let's look at how long it has taken these newer products to reach the market. So number one, you had paternal benevolence wanna protect our women, the little women. So if you are a woman of reproductive age, everyone's concerned about, well, what will that, how will that impact her child bearing? Okay, well maybe she's not interested in having children. That's an option. That is an option. And if she is, what will happen to her? Right? What will happen to her, you know, potential offspring. The second issue is, well, when she gets old and, and shriveled. And we would have men sitting around the conference table, and I'm not joking, they would chuckle and laugh about dry vaginas. Now that is so disrespectful, right? That is so disrespectful. There was a senior executive of a very large multinational pharma company that I worked for who wanted to, work on a testosterone patch, and he said, can you develop a testosterone patch that can cover my wife's entire body? Right. I have a lot of funny, I have a lot of funny anecdotes about this, but they're really not funny. Right. They're really, they're very disrespectful. Yeah. to women. Yeah. They're demeaning. Yeah. And they, it is inappropriate. So a lot of that went on in the past. Yeah. I haven't been in big pharma in many, many years and I believe that is changing. And there are companies that now have women who have moved into the sea level suite. Yeah. And if they are working on products, what they ought to be working on is how the sex-based differences should. Their product development, and that is where we are falling short in general. So putting menopause aside for one moment, whenever a product is developed, if the condition disproportionately affects women, we should be looking at different dosages, different dosage forms, and the ways in which those drugs are metabolized differently. in women versus men. Mm-hmm. And if we're not doing that, then we are short-changing women and women's health. Okay. So if there's a pharmaceutical company that's listening to this podcast, you best be thinking about how to use sex-based differences in your drug development efforts, whether it's for a sleep aid or something for Alzheimer's or something for major depressive disorder, which by the way, these are all conditions that disproportionately affect women. Mm-hmm. they do. Mm. I threw Alzheimer's in there because women are outliving men. So you're gonna have a larger number of women experiencing cognitive, these cognitive issues, right? Yeah. Yeah. We ought to be thinking about all those. And in menopause, same deal. We ought to be thinking about what we put in women's bodies. As their hormone levels start to change, including antidepressants, if you're delivering an antidepressant to a woman, you ought to be thinking about the dose and dosage regimen. Mm-hmm. for that woman. Mm-hmm. And whether it works better in her than it might work in the guide. And it doesn't, no one thinks about that, that's barely addressed anywhere. It's it's shock. it's not, it's not addressed as adequately as it needs to. There was a point in time where in studies, they weren't populating the studies, um, that, um, were consistent with the demographic of the population. So the, um, at least in the United States, the Office of Women's Health at the, um, F D A began looking retrospectively at those studies okay. And making the appropriate recomme. For how to populate studies. So they reflected the population of individuals who experienced that type of condition. Yeah. And that's the right way to be thinking about this.

Ann Marie:

Okay. So, um, I wanna know, just switching gears, I would like to know your personal philosophy about the menopause transition. What, what has it been like for you? Do you think There's a physical. And are there other components for you? Emotional, spiritual, philosophical, like what, what's your take on that part of it?

Geri:

So I, I've view menopause, you know, it's just a part of life. You know, it's, you know, when I was 14 I got my period and, you know, I was like, okay, I'm just, I'm gonna figure this out and, you know, just move on. Next phase, do I wanna be a. took me a long time to become a mom. I was blessed with a daughter, who's really awesome.

Okay. But, you know, I had I, and then it was, okay, well I'm past my childbearing, so what else is gonna happen? When I, when I started experiencing my menopausal symptoms, like a lot of women, I wasn't quite sure what was going on with my body and here I was working in women's health.

Ann Marie:

So Interesting. Oh, wow.

Okay. What is going on with this? So, you know, this whole dysfunctional uterine bleeding thing, excessive bleeding, then disappearing for a couple weeks, then a couple months, it's like, okay, well I'm not having, I'm not having any more of that period stuff. That's, that's kind of cool. I'm excited about that. And then it showed up again. It's like, okay, well I guess. In perimenopause. Good news was I never really had much of a hot flash. But I did have, some of the other anxiety, heart palpitations, which are kind of the uncommon. Mm-hmm. signs, right? Mm-hmm. So women will have more anxiety. They may have some heart palpitations, dizziness, surprise, surprise, right? Mm-hmm. So hormone fluctuations will sometimes impact. That, and those were not obvious symptoms to me, but I just plowed through. I I just plowed through and. Because I haven't used hormone replacement therapy, I decided that I would try different kinds of options, more natural options. By the way, I do use ARM Mia Vita products.

Ann Marie:

Okay, cool.

Geri:

And they do, they do help. Okay. They do help in my particular, circumstance. And I, I believe that had, I started using them earlier in my perimenopause. it would have been a more natural way to, to do this every single day. So I really didn't start in perimenopause using some of those types of products.

I really use, used them very occasionally and didn't use ones that I re, that I liked, cuz ours wasn't developed at that point. Okay. But as, as we have developed this product, once it was f d a cleared, I started using it. Okay. And it has made, it has made a difference. We have some other women that are in the company that are in the same age group cohort. They have also used the products. So it's not that we don't use our own products because we do. Okay. And then my, my personal philosophy on menopause, there's kind of, it's kind of liberating. I find it liberating, because I don't have to worry about childbearing. I'm past that point in my life. Don't have to worry about my period. I wear white. Today though, I'm wearing all black, but I wear white a lot. Nice. Yeah. And so there is, there is something really, fun and liberating about it. And yes, my hair is gray and I don't worry about it. In terms of thinning, although I know women do worry about it because I do be complex vitamins. Mm-hmm. which really helps. Okay. And, methyl folate really helps. So there are a number of ways in which to address the individual symptoms. And by the way, I moisturize my skin all the time. It's amazing. Your skin is great. I moisturize my skin all the time. Yeah, excessively. I, I'm also, um, I'm Italian and I have, I always had a Mediterranean diet, so I, I eat a lot of fish. I use olive oil. Okay. So I do a lot of vegetables. So I, I try to think about more natural ways to address, any of the symptoms that I have. And I remember sort of the lessons of my mother and grandmother. don't bake your skin in the sun. Yeah. And you're a silver sister now. And that's cool too. I mean, in three

Ann Marie:

years now, it's cool to have gray hair. Yes. That's crazy. That's an amazing, amazing development. You know, I was just on a trip and one of the ladies. Had let her hair go gray, as many women did during, COVID. And it just looked so good.

It just looked so cool. And she said, oh, do you think I was thinking of dying it again? And I was like, don't, this is a whole movement. This is a really cool thing.

Geri:

Well, you have to own it. I think that's the, you know, that's my feeling. You have to own it. Um, these, I, I earned every one of these gray hairs and, and my wrinkles and my crepey skin and whatever else is going on.

And as my, my daughter joked with me, a couple weeks ago when we were. Looking at bathing suits for her. She said, mom, you are gonna rock your bikini. And I was like, eh, I will. And she said, mom, you know, you need to embrace whatever it is. I mean, you are your age and who cares. And I thought about it and I was like, you know what, she's right. Like, I don't care. I really, I don't, you know, I'm happy with who I am right now. That's awesome.

Ann Marie:

Listen, thank you so much for speaking to me about this and I think you're sitting at such a cool juncture and I know we're gonna talk again, but I really appreciate it. My pleasure. Thank you so much for joining me. If you like this conversation, I hope you'll check out some of my other interviews on the Hot Flashing Podcast, subscribe, give a rating, maybe a review, and come back for more next week. Hot Flash Inc. Was created and is hosted by Annemarie McQueen, produced and edited by Sonya Mac. The information contained in this podcast is intended for informational purposes only, and is not intended for the purpose of diagnosing, treating, curing, or preventing any disease. Before using any products referenced on the podcast, consult with your healthcare provider, read all labels, and he all directions and cautions that accompany the products. Information received through the podcast should not be used in place of a consultation or advice. Care provider. If you suspect you have a medical problem, ie. Menopause or anything else or any healthcare questions, please promptly see your healthcare provider. This podcast, including Annemarie McQueen and any producers or editors disclaim any responsibility from any possible adverse effects from the use of any information. Contains herein opinions of guests on this podcast. Are their own, and the podcast does not endorse or accept responsibility for statements made by guests. This podcast does not make any representations or warranties about a guest's qualifications or credibility. This podcast may contain paid endorsements and advertisements for products or services. Individuals on this podcast may have direct or indirect financial interest in products or services. Referred to here in this podcast is owned by Hot Flash, Inc. Media.