Mary Claire Haver (on menopause)

Mary Claire Haver (The New Menopause, The ‘Pause Life) is a board-certified OBGYN, culinary medicine specialist, and best-selling author. Mary Claire joins the Armchair Expert to discuss how she ended up as one of eight children to restauranteur parents, the reason she became an OBGYN being that delivering babies never gets old, and how she misinterpreted her own menopause as grief amid the death of her brother. Mary Claire and Dax talk about the untenable claims of the study that HRT gives women cancer, her argument that hormone replacement therapy is the longevity drug for women, and a hormonal solution to reverse declining libido as one reaches menopausal age. Mary Claire explains why women can still get pregnant during perimenopause, the woeful lack of information and training received by medical professionals when it comes to women’s health, and the hive of practitioners she helped crowdsource to meet the needs of the menopausal community. Follow Armchair Expert on the Wondery App or wherever you get your podcasts. Watch new content on YouTube or listen to Armchair Expert early and ad-free by joining Wondery+ in the Wondery App, Apple Podcasts, or Spotify. Start your free trial by visiting wondery.com/links/armchair-expert-with-dax-shepard/ http://www.wondery.com/links/armchair-expert-with-dax-shepard/ now. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Dax Shepard?

  Welcome, welcome, welcome to Armchair Expert, Experts on Expert. We are joined today by Dr. Mary Claire Haver.

• 0:07Speaker 01

  Wow.

• 0:08Dax Shepard?

  This is a long time coming.

• 0:10Speaker 01

  Big time.

• 0:11Dax Shepard?

  Armchairs demanded it, and we have produced it. We actually leaned on Armchairs to tell us who their favorite menopause expert was.

• 0:19Speaker 01

  Yes.

• 0:20Dax Shepard?

  And by unanimous, popular.

• 0:23Speaker 01

  Dr. Mary Claire.

• 0:24Dax Shepard?

  She popped up, and she fucking delivered. I love her.

• 0:27Speaker 01

  I thought she was so great. This is so informative and helpful and needed. And I've brought this up, obviously, to a lot of my female friends.

• 0:37Dax Shepard?

  What was the main thing you said? Cause I brought it up to some people, too.

• 0:39Speaker 01

  Oh, I'm, I'm just like, guys, we had a perimenopause, menopause expert on. This is really intense.

• 0:47Dax Shepard?

  It's very positive. It's like the most hopeful.

• 0:49Speaker 01

  It is, it is. I was overwhelmed.

• 0:52Dax Shepard?

  Okay.

• 0:52Speaker 01

  Um, in a good, in a way that I needed to be overwhelmed. We're like, there's a lot.

• 0:56Dax Shepard?

  Hear everything coming your way.

• 0:57Speaker 01

  Exactly. There's a lot coming slash here.

• 1:01Dax Shepard?

  Yeah.

• 1:01Speaker 01

  And, and there are real things to do, and so I gotta do them.

• 1:06Dax Shepard?

  I've been telling people about the topical vaginal rub.

• 1:08Speaker 01

  Sure.

• 1:09Dax Shepard?

  That's what I was most interested in.

• 1:10Speaker 01

  Yeah, we learned a lot. We learned a lot.

• 1:13Dax Shepard?

  Okay, uh, so Dr. Mary is a certified menopause practitioner from the Menopause Society. She is a board certified in obstu- and obst- I said this in the episode.

• 1:24Speaker 01

  It's hard to say.

• 1:25Dax Shepard?

  In obstetrics, obstetrics and gynecology specialists, and a certified culinary medicine specialist, and a bestselling author. Uh, two of her books, The New Menopause, uh, which is hugely successful, and The Gallaston Diet. I urge everyone to follow her on Instagram. She has really, really great videos that will be addressing all these little things that pop up. And also you could go to her website, thepauslife.com, which is a comprehensive approach to menopause education and support. Um, this is awesome. She was rad.

• 1:57Speaker 01

  Yeah.

• 1:58Dax Shepard?

  Yeah. Enjoy. Enjoy. We get support from Quince.

• 2:03Speaker 01

  Okay, can we talk about the fact that the holidays are already here? It's crazy. I feel like I blinked and now we're in gifting season, which I'm not really mad about because I do love giving gifts. And Quince is making it so easy to find something great for everyone on my list, including myself, because let's be honest, self-gifting is a love language.

• 2:22Dax Shepard?

  Quince is seriously the gift that keeps on giving. Their high-quality staples are made with premium materials like 100% Mongolian cashmere, 14-karat gold, and Italian leather. Full-on luxury quality at prices that won't wreck your holiday budget.

• 2:38Speaker 01

  It's the dream. The cashmere sweater is starting at $60. Down jackets, wool outerwear, cashmere accessories. You and everyone on your list are staying cozy and looking incredible all season long.

• 2:49Dax Shepard?

  Well, I'm gonna tell you this, it just got chilly for the first time this year in California, and I'm so excited, and I'm wearing my Quince cashmere right now.

• 2:56Speaker 01

  It's great.

• 2:57Dax Shepard?

  Yeah, and I am going to gift this to some of my friends. I hope they're not listening.

• 3:01Speaker 01

  Quince is also more than clothing. They've got fine jewelry for your significant other, leather bags for your bestie, hotel-quality bedding to set up your guest rooms, chef-grade cookware. That's an amazing thing they offer here, and it's such a good gift because people don't like buying cookware for themselves, but it's very important. And they also have five-star luggage, another good gift that people don't like buying for themselves.

• 3:24Dax Shepard?

  Give the gift of quality this holiday season. Download the Quince app for app-exclusive offers, or go to quince.com. Get free shipping on your order and 365-day returns. Now available in Canada and the UK too. And when Quince asks where you heard about them, let them know it was Armchair Expert. It's the best way to support the show. This episode is brought to you by McDonald's. The Quarter Pounder with Cheese with Medium Fries and a Drink is now $8.

• 3:54Speaker 01

  What?

• 3:55Dax Shepard?

  Okay, I need to talk about something that doesn't get enough respect. The Quarter Pounder with Cheese. This is not a casual burger. This is a crafted burger. We're talking 100% fresh beef cooked right when you order it. No artificial flavors, no fillers, no preservatives, just beef doing what beef is supposed to do. And here's a detail I love. There's a cowbell sound in the kitchen. When somebody orders a Quarter Pounder with Cheese, a cowbell goes off and the grill master throws a fresh patty down. That's like having your own entrance music at McDonald's. I want a cowbell for everything in life. The onions are hand-topped by someone who just knows the right amount. Two slices of cheese laid out in a star pattern, so every single bite gets cheese. And two pickles, side by side, so you're never in a pickle desert.

• 4:40Dax Shepard?

  Every bite is accounted for. Someone engineered this thing with love. I love a Quarter Pounder.

• 4:45Speaker 01

  Me too, that's my order. It's a Quarter Pounder with cheese. I love it. I didn't know they put so much effort that they did a star formation. I should have known because you can taste it when there's effort.

• 4:58Dax Shepard?

  Yeah, the love. Don't tell anyone this, but I'll put two of them back.

• 5:01Speaker 01

  Yeah, I'm not surprised.

• 5:03Dax Shepard?

  The Quarter Pounder with Cheese with Fries and a Drink, now $8 for a limited time only, only at McDonald's. For a limited time only, prices and participation may vary. Prices may be higher in Hawaii, Alaska, and California, and for delivery. Fresh beef not available in Alaska and Hawaii. Offer not valid for delivery.

• 5:38Dax Shepard?

  Langwa Franca, what is it?

• 5:40Speaker 01

  Lingua Franca. So they hosted my book launch, my big New York, one of the deals, and she made this for me.

• 5:49Dax Shepard?

  Will you wait 39 seconds?

• 5:50Speaker 01

  Absolutely.

• 5:51Speaker 02

  This is so nice. I feel left out because I do indeed.

• 5:55Speaker 01

  Hydro magic, I love it.

• 5:57Dax Shepard?

  I'm told it's a wicked reference.

• 5:59Speaker 01

  It is, yeah.

• 6:00Dax Shepard?

  And the colors are wicked.

• 6:03Speaker 02

  I'm going to a Mardi Gras ball that is Wizard of Oz wicked themed.

• 6:08Dax Shepard?

  In New Orleans?

• 6:09Speaker 02

  In Galveston.

• 6:10Dax Shepard?

  I love Galveston.

• 6:11Speaker 02

  You've been there?

• 6:12Dax Shepard?

  I have.

• 6:13Speaker 02

  There's like three people and he's one of them. Yeah.

• 6:15Dax Shepard?

  I used to work for General Motors and we had a car show there and our ride route ended there and we stayed at a very cool hotel. And each room was like kinda unique. You know the one I'm talking about?

• 6:24Speaker 02

  So that's gonna be the Galvez, more than likely.

• 6:26Dax Shepard?

  Okay, very, very nice.

• 6:27Speaker 02

  On the water, old.

• 6:29Dax Shepard?

  Yeah, very old. Felt like vampires would stay there.

• 6:31Speaker 02

  That's it.

• 6:32Dax Shepard?

  And you guys moved there. You're from Louisiana.

• 6:35Speaker 02

  Yeah, I grew up in Louisiana, went to undergrad. I was a raging Cajun, so at what, U S L? I'm dating myself. It's now U L L. They're fancy. And then I did grad school for a little bit, almost went the PhD geology route. Oh. My undergrad's in geology. I went to work for an oil company. Kinda had a change of heart and was like, what else can I do with this science degree? And I was moving towards the PhD and I'm like, if I'm not gonna do this PhD, I need to do something cool and big. Let me just take the MCAT and see what happens. So then LSU format school, which was in Shreveport, North Louisiana. And then I did residency in Galveston and we've stayed in the Houston-Galveston area pretty much since then. Do people tell you you look like Courtney Cox? Yes, yes. Especially back in the day. Yes.

• 7:18Speaker 02

  When she was on Friends, I was a resident and we would have Friends watch parties. And now it's kind of Tina Fey. Anyone with black hair and big glasses is me. Well, both are compliments. Yeah.

• 7:30Dax Shepard?

  And we love them both.

• 7:31Speaker 02

  Yeah, we do.

• 7:31Dax Shepard?

  Huge fan. You're one of eight.

• 7:33Speaker 02

  Yeah.

• 7:34Dax Shepard?

  What did mom and dad do?

• 7:35Speaker 02

  A lot of sex.

• 7:36Dax Shepard?

  Well, clearly, yeah.

• 7:37Speaker 02

  Good for them.

• 7:38Dax Shepard?

  Yeah, yeah.

• 7:39Speaker 02

  They weren't shy about it. I would walk into the parents, make it out in the corner. Really? Stop. So mom and dad were restaurateurs.

• 7:48Dax Shepard?

  Oh, yes. They owned a Cajun restaurant.

• 7:49Speaker 02

  Yeah. We just called it food. You would call it Cajun and it was a little more upscale. It was steaks and seafood. And I grew up in a big restaurant family. My grandparents, my aunts and uncles, most of my siblings.

• 8:00Dax Shepard?

  That's why they couldn't keep their hands off themselves because restaurant people party a lot and they're horny. That's a whole lifestyle.

• 8:06Speaker 02

  Lots of naps, work the lunch shift, come home, nap.

• 8:08Dax Shepard?

  Nap, quotes. How do you choose obst-

• 8:11Speaker 02

  OB GYN?

• 8:12Dax Shepard?

  Yeah, I want to say obstetric.

• 8:14Speaker 02

  It's a hard word.

• 8:15Dax Shepard?

  I can say obstetrician, but-

• 8:16Speaker 02

  Obstetrics.

• 8:17Dax Shepard?

  Obst-

• 8:18Speaker 02

  Obstetrics, that is tricky. Obstetrics and gynecology. So in your third year in most traditional programs, first two years are just in classroom and you get a little taste of different things, but you're mostly just getting the basics down. And your last two years are out in the wards where you're in the hospital rotating and figuring out what you want to do. I remember I thought I wanted to be a pediatrician. I was president of the Peds Interest Group, what they called PIG. And I did Peds first and I realized quickly, I love babies, but I don't love their parents. The whole dynamic, this is not my niche.

• 8:46Dax Shepard?

  Yeah.

• 8:46Speaker 02

  So then you rotate through surgery. I really liked aspects of surgery, but I didn't like surgeons. They were kind of awesome.

• 8:52Dax Shepard?

  Yeah.

• 8:53Speaker 02

  A and T was cool, but super competitive. I had the grades, turns out, but my last block was OB GYN. And that first night, I caught a baby. The block I happened to have first was labor and delivery. Wow. I have some awesome upper level residents who's like, we got this, come on, get in there. And I was like, ugh. And I remember calling my mom, like, I finally figured out what I want to do.

• 9:12Dax Shepard?

  Yeah.

• 9:12Speaker 02

  I want to deliver babies. I didn't want to have anything to do with menopause.

• 9:15Dax Shepard?

  What part do you think was so rewarding?

• 9:18Speaker 02

  I still could cry. It never gets old, being there for a birth.

• 9:22Dax Shepard?

  Well, I wanted to dial in on it because two of my favorite experiences on earth are the second both of my daughters were born, holding them, looking in their face and going, "Welcome to earth." Like, there is something so crazy-

• 9:34Speaker 02

  And I get to see them before you.

• 9:35Dax Shepard?

  Yeah, right, right.

• 9:37Speaker 02

  And I'm just like, how about- You know, it's never gets old. It's a miracle. And I make a big production. We lay the baby on mom's tummy and I let the daddy cut the, I let, you know, he gets to cut the cord and everyone's crying. Through the whole birth labor process, I'm hanging out. Where'd y'all meet? Let's talk. Because you don't get that connection in a 15 minute visit all through the OB stuff. So I'm there for delivery. I'm not just rolling in to catch the baby. I'm there for the whole labor.

• 10:02Dax Shepard?

  You're also getting to be a part of the most intimate thing that a couple will share, or one of them, for us, for sure. Like, oh my God, we made a thing and it's here. As opposed to a meter maid who has to give people bad news all day. This is like-

• 10:15Speaker 02

  The opposite.

• 10:15Dax Shepard?

  Yeah.

• 10:16Speaker 02

  There's occasional bad outcomes and tragedies and I'm trained- For all the crazy stuff that could happen. But most of the time, I just get to be there and it's just such a cool experience. So that's what I fell in love with and I'm like, and I have to do surgery. And I have to do this menopause thing and do gynecology. But it's a necessary evil to do this baby thing.

• 10:32Dax Shepard?

  Yeah, yeah.

• 10:32Speaker 02

  So this menopause thing was a sector of it? Yeah.

• 10:36Dax Shepard?

  But not even, right?

• 10:37Speaker 02

  Not even. Medical school, right? We do four years, two years on the books, two years in the wards. And we had one one hour lecture in that first two years. This is menopause, just a basic overview.

• 10:47Dax Shepard?

  One one hour lecture.

• 10:48Speaker 02

  I'm not shocked. I know almost nothing. That's why I'm here. I got you. Exactly.

• 10:53Dax Shepard?

  And you pointed out, this isn't my realization, but we're going to do one hour to address a third of a woman's life.

• 10:59Speaker 02

  That 100% of women will go through. It's not optional.

• 11:04Dax Shepard?

  And it's not a couple of weeks or a couple of months. It's a third of their life we're gonna just not worry about.

• 11:09Speaker 02

  Yeah, but you know, it wasn't put to me that way. This is just a transition and estrogen declines and off you go. And she might have some hot flashes. We've got medicine for that. Okay. Then in OB GYN residency, which is women's health, probably 55, 60% of what we did was to do with OB. Getting people pregnant, staying pregnant, un-pregnating them. All the trials and tribulations, important stuff. So proud of everything I learned. And then everything else gets shoved in the box of gynecology. And we have reproductive endocrinology, which is basically endocrine stuff that happens, weird chromosomal things, and getting people pregnant for fertility issues. We have pediatric gynecology, how to take care of smaller people with the same organs who have issues and need help. We have general gynecologies, well, woman exams.

• 11:53Speaker 02

  So menopause was part of our REI block, reproductive endocrinology, which we only did second year for six weeks. We had a one hour lecture each week. So I got six hours. So in eight years of medical training and education, I had seven hours of menopause. We had no menopause clinics. And then I was leashed onto the world, go be free and practice. I didn't know anything. Yeah.

• 12:14Dax Shepard?

  Yeah, you've come to regret how many women were basically asking for your help. And in that paradigm, you pretty much were just turning people over to different specialists.

• 12:24Speaker 02

  I didn't know enough at the time to know that. Her palpitations, her frozen shoulders. Her, you know, myriad, oh, girl, wait, we're gonna get that. My mom? Oh, no. Our laundry list of complaints. I'm the well woman examiner and I got 15 minutes to get through this. So I'm like, we're gonna send you to cardiology for your palpitations. We're gonna go to the ortho for your shoulder. So I'm giving her six referrals.

• 12:45Dax Shepard?

  Sleep specialist for your insomnia.

• 12:47Speaker 02

  Yeah, and a nutritionist for your weight gain. And we're good. Your pap is normal. See you next year.

• 12:52Dax Shepard?

  And then you yourself started going through menopause.

• 12:55Speaker 02

  I was, policies, you know, I had an endocrine condition. I didn't ovulate regularly. Why I had fertility treatments for my kids. You had PCOS? PCOS. I had the two pay kids, finally got that done. I don't want to go through another miscarriage. We're done. So I go on birth control pills to manage my condition, which I did great on. That was fine for me. And then I get to about 48 and I'm like, okay, I think we're getting close to where we're gonna be. And I'm totally suppressing my period, so I'm not taking the inactive pills. So I'm totally replace all my hormones and shut it down. I felt better that way than PCOS. I was like, probably time to get off, see where we're at. So I talked to my nurse practitioner who took care of me and was like, I'm gonna get off the pill. We're gonna get some blood work in a month and see where I'm at. She's like, cool. Very same time, my brother dies.

• 13:39Speaker 02

  So I have six brothers from the same parents. My oldest brother died when I was nine from leukemia. So I was a kid when that happened. And then my next brother, Bob, had HIV and hepatitis. The HIV is actually really under control, but it was his liver just tanking, tanking, tanking. So I've stopped the pill, see where Marie Claire's at. And I'm in the OR, the phone's ringing, ringing, ringing. I'm like, get the phone. And they put it to my ear when they're like, Bob's in a coma. You probably should start heading home.

• 14:02Dax Shepard?

  Did you know that was coming?

• 14:03Speaker 02

  Eventually, I'd sat the kids down and said, you know, Uncle Bob's getting sicker, but not like today.

• 14:09Dax Shepard?

  It kinda was abrupt despite knowing it was coming.

• 14:12Speaker 02

  I thought we had a year, two years. Anyway, my partner comes down, we get to a good part in the case, scrubs me out and I go and prepare to go home and figure all this out. So here I am grieving this horrible thing and I am in full on menopause, but I don't know it. I'm gaslighting myself. I'm attributing all the things to grief and certainly grief was a part of it. But after like month six, I realized the grief is lifting. I'm not crying all the time on the way home. I'm like, when was your last period? Shit.

• 14:40Dax Shepard?

  It must be so comforting to hear an OB be out to lunch on their own health.

• 14:44Speaker 02

  Yes. I didn't like menopause. I was like, ew. Right. I was like Samantha on Sex and the City, not the menopause. And so I was like, Dora, I'm gonna come get the blood work now. And so we did everything. And sure enough, I was fully, fully menopausal.

• 14:59Dax Shepard?

  And that's detectable.

• 15:00Speaker 02

  Yeah, check your estrogen, check something called FSH. One's high, one's low. That's it.

• 15:04Dax Shepard?

  So it's all in the blood work?

• 15:05Speaker 02

  Yeah. Perimenopause, no, we don't have. Okay, that's what I was gonna ask, cuz I think I'm in it.

• 15:10Dax Shepard?

  I know, everyone your age does.

• 15:11Speaker 02

  I looked up all the stats for Southeast Asia. Oh, you did? Yes, I did. Thank you. Yeah, so we'll go over that. But I reluctantly go on hormone therapy cuz I'm like, I cannot live like this. I was still in the impression I would get breast cancer and die. It was gonna kill me.

• 15:25Dax Shepard?

  Well, let's address that right now because I happen to know way more about this than I should cuz I love.

• 15:30Speaker 02

  Women.

• 15:31Dax Shepard?

  Well, I do love women. But Dr. Atiyah, I love Peter Atiyah, and he's been such a vocal supporter of this. But so all of this, the hysteria that you probably received was based on the work of two people, virtually.

• 15:44Speaker 02

  So the WHO study was a large, multi-center trial. It was one of the biggest projects the NIH had ever taken on. And for the first time, they were studying women. We were so fucking happy. We knew from anecdotal evidence that women who were on HRT before the WHO.

• 16:00Dax Shepard?

  Hormone replacement therapy.

• 16:02Speaker 02

  Sorry, hormone replacement therapy, 40% of women were utilizing HRT in menopause. So that was kind of the baseline. It was recommended by the American College of Physicians. I mean, it was like, everybody should consider this. We knew that women who chose it had lower heart disease, had lower certain risks. But that's not proof. That's an observational study.

• 16:17Dax Shepard?

  Yeah, correlation.

• 16:18Speaker 02

  If you follow Atiyah, you need a randomized, controlled, blinded, so NIH billion-dollar study. Wow. Let's study women. They got 37,000 women recruited. Half were placebo versus estrogen or estrogen and progesterone if they had a uterus.

• 16:32Dax Shepard?

  Huge issue already right there if you're not combining the two.

• 16:35Speaker 02

  Particular estrogen that they were on was Primorin, which we don't use today very often. And then a very specific progesterone. It wasn't using modern HRT formulations. It was just looking at this one. But at the time, in the 2000s, that was the most common formulation. Nothing weird there. Because they were looking for heart disease as the outcome, is this really protective for heart disease? Or are just wealthier, healthier women on HRT and we're getting an artifact? The average age was 63 in the study. A little late. We know it works for hot flashes. We know it'll take care of menopause symptoms, but does it really help with heart disease? So they wanted to start later because it's expensive to go 20 years. So if we start later, then we'll start seeing the heart attacks in a quicker timeframe. They did have younger, they had some women in their 70s start. They went up to 79. Off they go with the trial.

• 17:20Speaker 02

  The women on estrogen only had a 30% decrease risk of breast cancer. And that was statistically significant. The women on the combo saw a slight increased risk, but it never reached statistical significance.

• 17:33Dax Shepard?

  Really quick, the reason it was kind of irrelevant statistically is that the control group had an abnormally low rate.

• 17:41Speaker 02

  That's it.

• 17:41Dax Shepard?

  Which was not even considered.

• 17:43Speaker 02

  So when you compared the two groups, whoa, this is really causing. It was four guys.

• 17:47Dax Shepard?

  Chlobowski, Aragaski.

• 17:49Speaker 02

  I can't even pronounce their names. And they still stand by, it's crazy.

• 17:53Dax Shepard?

  Just recently, they're back at it.

• 17:55Speaker 02

  There were 17 centers involved in the study. There were multiple PIs, primary investigators. And these two or three guys wrote this paper and said estrogen causes breast cancer, HRT causes breast cancer. And they called everybody in the room and said, take a look at it. You have one hour to make changes. They rejected all the changes and then they went to the breast.

• 18:13Dax Shepard?

  There's no peer review.

• 18:14Speaker 02

  Yeah, no. They just said it and it was like letting a genie out of a bottle. Flawed interpretation and hysteria. There was no viral for internet back then, but it was the number one medical news story of 2002. It was on the cover of every magazine. Nancy Snyderman is on ABC saying, don't give anyone estrogen. I was a chief resident. I remember the day it came out and we were like, what? I was terrified to give people HRT. What I didn't know in the ensuing 20 years, being board certified, getting my recertification every year, reading every article they put in front of me. I was the straight A student. They never walked it back to the OB GYNs. And the guidelines have not been changed in American College of OB GYNs since 2014. And they still say only for severe symptoms, smallest amount for the shortest time.

• 18:59Speaker 02

  Possible. Wow.

• 19:00Dax Shepard?

  And in pre-study, it was at forty percent, what you said.

• 19:03Speaker 02

  And then last year in 2023, we just got this published in the menopause society. It was four percent.

• 19:07Dax Shepard?

  Four percent.

• 19:08Speaker 02

  Wow. Four percent of women who are eligible are receiving FDA approved. Now, there's probably more with compounded. It's hard to track that because they don't report. So maybe seven, but still.

• 19:18Dax Shepard?

  There's a great bit of context around this. So you start having the symptoms, you decide you want to do some investigation in this. In your investigation, you quickly find out if you were to search medical peer reviewed articles and journal entries about pregnancy.

• 19:33Speaker 02

  Almost 1.2 million.

• 19:34Dax Shepard?

  And if you look at menopause at that same period, 94,000 articles were.

• 19:38Speaker 02

  Do you know how much brain power we're talking about? How much NIH funding, how much private funding, how many labs? That's 10 to one, and more women will go through menopause than bear children. Exactly.

• 19:47Dax Shepard?

  And the bearing children process will last them however long you want to say that window is.

• 19:52Speaker 02

  Average of two kids, nine months each.

• 19:54Dax Shepard?

  Thirty years? No. So pretty nuts. And maybe now's a fun time. Because I actually want you to explain menopause, but I think now would be a fun time to just talk about men versus women here.

• 20:05Speaker 02

  Yeah.

• 20:05Dax Shepard?

  Because my father, at the same time that's being published about HRT for women, my dad is being advised to be on testosterone because his level's low and it improves his life. He goes off of antidepressant. It's fine.

• 20:16Speaker 02

  So men have a slow decline from like 18 or 19 down till they die. But for most, it's still detectable. Now, you might function it better at a higher level and no one's going to deny that to you. It would be as if your testicles shriveled up and died at the average age of 51 and your empty ball sack is flapping in the breeze for the next 30 years.

• 20:37Dax Shepard?

  And we're not going to do anything about that.

• 20:38Speaker 02

  Yes, and good luck to you, dude. Yeah, exactly.

• 20:40Dax Shepard?

  We're never horny again.

• 20:41Speaker 02

  Here's a sleeping pill. Here's something to improve your libido, maybe. Here's a palpitation medicine. Here's an antidepressant. Yeah, it's just like get through the rest of your life. They're talking about over-medicalizing menopause, the critics, and I'm like, bitch. Yeah. I'm giving her six drugs or I can wipe the whole thing out with just replacing her estrogen that's gone missing. Yeah.

• 21:01Dax Shepard?

  Right. And it'll actually increase her bone density. It'll actually have real results.

• 21:05Speaker 02

  It is the longevity drug for females. Nothing's going to work. Better than that. Wow.

• 21:10Dax Shepard?

  Yeah, so I mean, there's a lot in there.

• 21:12Speaker 02

  Now, you can raw dog menopause. You know what's making you go on it?

• 21:15Dax Shepard?

  You can't underestimate the layers of sexism that exists within the fact that it would take however many years before we would acknowledge, oh, yeah, women are really suffering from this. And they have a bunch of symptoms from a bunch of different issues arising from this. And better to treat those than to get to the core of what's going on.

• 21:33Speaker 02

  When you look at why menopause hormone therapy was developed, it was to treat a hot flash. And forever, the pathognomonic, the post your child symptom was hot flashes. What we call medicine vasomotor symptoms. What was never taught to me ever, and I learned like three years ago, was we have estrogen receptors in every single organ system in this body. And what I also was taught is in peri-menopause, it's a slow, gentle decline. That's all I learned, one sentence, decline until full menopause, when you lose function. It is a rocking roller coaster. And your worst symptoms tend to be the mental challenges, the brain fog, the cognitive disorders, the frozen shoulder, all of it is peri and late peri and early menopause.

• 22:11Dax Shepard?

  That's when you're accelerating your loss of.

• 22:13Speaker 02

  Bone and muscle.

• 22:14Dax Shepard?

  And the eggs, right?

• 22:15Speaker 02

  We were born with all of our eggs.

• 22:18Dax Shepard?

  A million, though. That was a shocker to me.

• 22:19Speaker 02

  So one to two million at birth?

• 22:21Dax Shepard?

  One to two million eggs.

• 22:22Speaker 02

  But isn't this a weird, it's like that thing where you're born with all your eggs. So really, your grandma's eggs are your eggs? Yes, when your grandmother was pregnant with your mother, the egg that made you was inside of your mother, inside of your grandmother. In some ways, women have always existed. So there's all this knowledge, wisdom and drama.

• 22:41Dax Shepard?

  Also the mitochondrial eve.

• 22:43Speaker 02

  That this imprinting that goes on through a traumatic pregnancy. Okay, a million to two million eggs. One to two million at birth. We lose eggs two ways. One, and from the minute they form, we start losing it through atresia, which is like an aging process. And it's kind of survival of the fittest because not all eggs are good eggs that you want to fertilize. So we want to leave the healthy ones behind to catch the sperm. So atresia is happening, boom, boom, boom, and it accelerates at 35. We see a big drop off. And then just from ovulating, we lose about 10,000 to get one to like pop off. Every ovulation. Every ovulation.

• 23:13Dax Shepard?

  Is that in your menstrual discharge? Where are all those eggs?

• 23:16Speaker 02

  They just kind of dissolve. So when one egg pops out, the. Fallopian tube picks it up and it gets swept like a chimney through the fallopian tube and it's fertilized or not in the fallopian tube and then it goes into the uterine cavity. And sometimes they can pick it up in the men's, you know, when they've done studies, but sometimes it just kind of dissolves. But it's tiny, tiny microscopic. Yeah.

• 23:35Dax Shepard?

  Yeah, but I wrote it down. By the time you're...

• 23:37Speaker 02

  Thirty, you're down to 10%.

• 23:39Dax Shepard?

  Down to 10%.

• 23:40Speaker 02

  So how old are you now? Thirty-seven. Okay, so at forty, most women, and this is different for you and I'm going to explain why. Don't shoot the messenger.

• 23:46Dax Shepard?

  She already knew.

• 23:47Speaker 02

  Most women are down to 3%. This is for people who look like me. This is the average American white girl. Are you Indian or Southeast Asian? Yes. Okay. Average age of menopause is 46.5. For me, it is 51. Okay. So that's average. The window, 41 is still normal for an Indian descent. And then that goes up to 51. You start younger. And then perimenopause back it up seven to 10 years before that. Am I in it? Maybe.

• 24:12Dax Shepard?

  I bet you have a mix of emotions, validation and depression.

• 24:15Speaker 02

  No, I don't want, yeah, this one is not good to be validated. I don't, oh God, okay. Well, how would I know? That's a great question. Certainly if your cycles were starting to become irregular and if you had hot flashes, if you had the kind of cliche symptoms, but those are usually late in the game in perimenopause. I don't have that. The most common symptoms, actually, now that these online telemedicine companies have developed for menopause and they are doing scoring systems on hundreds of thousands of women, because everybody goes to their website, Am I in Menopause? And we have all these quizzes and things you can take. Fatigue, out of the ordinary. Nothing has changed. Your diet hasn't changed. Your stresses haven't changed. New onset mental health changes. We have a 40% increase in depression and anxiety across the menopause transition with no real environmental changes. We have weight gain.

• 24:58Speaker 02

  So it's a steady state weight gain, but what's happening in the background with body composition is we have this acceleration of muscle mass loss and an acceleration of body fat gain, typically in the viscera, so the intra-abdominal fat. So my patients used to come in and grab their tummies in their little paper gowns and be like, what the fuck is this? Mary Claire, I worked in a small town and we all went to church together. What is this? I knew her. I worked out with her. We ran together. I know this woman. I know what she eats. That's when I was like, why are all my friends and now me gaining weight in weird places? Uh huh. None of us have gone off the deep end. We're not secretly eating bonbons at night.

• 25:31Speaker 01

  Yeah.

• 25:32Speaker 02

  And then bone density is another key thing. So we're seeing acceleration of bone loss. And so I'm telling my patients, let's get early bone densities. Let's not wait till 65.

• 25:41Speaker 01

  Yeah.

• 25:41Speaker 02

  Especially if you're programmed to go through younger than what's expected.

• 25:45Speaker 01

  Okay, can you get pregnant?

• 25:47Speaker 02

  You absolutely can get pregnant.

• 25:48Speaker 01

  During perimenopause.

• 25:49Speaker 02

  It's just a little harder because your supply and the quality of the egg goes down, which you knew.

• 25:53Speaker 01

  I did know.

• 25:54Speaker 02

  You know, the older you are.

• 25:54Dax Shepard?

  She's frozen some eggs.

• 25:56Speaker 01

  I have.

• 25:56Dax Shepard?

  Did you all the way up to speed?

• 25:58Speaker 01

  I've done two rounds, but it wasn't great. There's already been some telling, but it is still regular periods. But as you said, maybe that's the later end of it.

• 26:05Speaker 02

  Yeah, towards the end of peri mean you're getting close to exhausting the whole deal.

• 26:09Dax Shepard?

  Combattiveness with coworkers?

• 26:11Speaker 01

  My God, that's, that's specific to who you're working with.

• 26:15Speaker 02

  Brain fog, you know, suddenly you lose your words. We all do it from time to time, but this is consistent. Get in the car and you're like, where am I going? You walk into a room, what was I doing here? You know, everybody does that from time to time.

• 26:26Dax Shepard?

  Okay, we should have done this at the beginning, but now I'm going to make you do it now. Were you unique as an animal?

• 26:31Speaker 02

  There's a pod of certain whales that do it and elephants are very matriarchal. But when you look at like the anthropologists and they're like, why do women go through menopause? So from a survival standpoint, it behooves a woman to not keep being pregnant over and over again. You kind of have your batch of children and then you have better survival rates if you stop. The anthropologists also think that women served as the source of wisdom for the tribe. They were the passers on of knowledge. The dudes tended to die younger because they're getting killed by saber toothed tigers. The grandma stayed back. Now, remember, these people were still very young compared to when we think of a grandmother now. We also die a lot sooner. Things that don't take people out now, like vaccines and childhood diseases. We have a reason why we live longer.

• 27:11Speaker 01

  You're right.

• 27:12Dax Shepard?

  There was a very predictable role for the grandma. She was passing on all this wisdom, helping with children. Now we have all these things. We have childcare and we farm things out to strangers. And this whole role that once served our genetic fitness.

• 27:29Speaker 02

  We've industrialized our way out of it. We've evolved past our genetics.

• 27:34Dax Shepard?

  Yes.

• 27:35Speaker 01

  Wait, so we're saying the reason that human women didn't die. Is because of their

• 27:40Speaker 02

  Well, those who kind of ran the gauntlet of disease and being killed by accidents, if they survive, they seem to take on these very wisdom creating, teaching the next generation. You know, if you look at whales, they're teaching the babies to hunt while the moms are hunting gathering with the dads.

• 27:55Dax Shepard?

  Or grandma elephants, they're very involved.

• 27:57Speaker 02

  They're very involved.

• 27:58Dax Shepard?

  And I guess too, would I be wrong to say this, I'm assuming childbirth gets more dangerous as you're older?

• 28:04Speaker 02

  Yeah, it's harder to do and it's harder to stay healthy doing it. In general, we would lose more women to cardiovascular issues, hypertension, preeclampsia, that kind of stuff. Before modern medicine, we had medications to help manage those conditions, diabetes.

• 28:18Dax Shepard?

  So that's how we got there. We're kind of unique. As you say, there are a couple of other people. But let's talk about what physically happens during menopause. Let's talk about the endocrine system. What is it? What does it do and how does it change?

• 28:31Speaker 02

  So let's talk about what you're going through right now. A healthy woman who has a regular menstrual cycle, nothing is ever steady state. It's an EKG-like ebb and flow of some key hormones. And ovulation starts in the brain, not in the ovary. In order to ovulate, the brain registers that our estrogen level is low. So you have your period, estrogen progesterone drop off. The brain gets that signal, whoa, we're low. The hypothalamus is testing, says, all right, it's time. Sends a signal to the pituitary, next gland underneath. And pituitary is like, all right, boss, I got it. The pituitary then sends LH and FSH. So if you've done any fertility treatments or you know these words or had the shots, you know, I did all that too. So those two hormones go down and bind to the ovaries to stimulate the ovulation.

• 29:14Speaker 02

  Around each egg are a set of cells, follicular and granulosa cells, and then produce our sex hormones. Estrogen in the first half of the cycle, which peaks at ovulation. After ovulation, we see progesterone rise. And that cycle is unbelievable and goes month after month after month in perfection. Unless you're ill or you're pregnant.

• 29:32Dax Shepard?

  Crazy athlete.

• 29:33Speaker 02

  There are things that we can do to mess it up, but for the average woman, the cave woman, this worked very well month after month after month.

• 29:39Dax Shepard?

  And is testosterone going up in preparation?

• 29:42Speaker 02

  That's the one steady state that we have. It might mildly fluctuate, but really testosterone starts high in our twenties and thirties. And then, just like a man.

• 29:51Dax Shepard?

  It seems it would be evolutionarily advantageous if it upped your testosterone when you were fertile.

• 29:56Speaker 02

  When you're ovulating, but we just don't really see that. Female male drives are a little bit different. So then, what happens in perimenopause? In the background, we're losing eggs, losing eggs, losing eggs. We reach a critical egg threshold level, which is different for every human, where the signals coming from the brain no longer work. We become resistant because the quality and the quantity of the cells around the eggs available are declining. So the brain's like, where is my estrogen? The pituitary is like, boss, I sent the signal. He's like, send more. You start pounding the ovary with the gonorrhoea to the pituitary. Pituitary is like, fuck, all right. Shoots out FSH and LH. We see the stimulating hormones start to rise much higher than they ever, ever were in a premenopausal woman.

• 30:38Dax Shepard?

  Just trying to kickstart this system.

• 30:40Speaker 02

  Right, and just take it in the ass. So we see delayed ovulation, so the period starts to become irregular. And then, because you were just pounding that egg, we end up with higher estradiol levels than we ever had before. That's why twins are a little bit more common towards the end of your fertility. Oh, interesting. Yeah, than they were when you were younger because you're getting your self-made fertility drugs, basically. Right, right, right. To push that egg out. And then progesterone never quite gets to where it was before. So it used to look like this gorgeous EKG each month. Now is literally a zone of chaos. Interesting. So you have estrogen doing this. Progesterone's like, I'm trying to keep up. FSH and LH are all over the place. And that's why we don't have a great blood test for perimenopause. I can't do a one-time blood test and say, obviously.

• 31:23Speaker 02

  Now, for post, when you run out of eggs, FSH and LH, the brain is always looking, always pushing, always trying. And now we know, we have FSH receptors in other areas of our body. We think the bone, we know the liver. So sometimes it's not just the loss of estrogen, but it's these high FSH levels that are leading to the cholesterol changes that we see. A new study just, just, just came out two weeks ago that was looking at using a specific cholesterol marker, LDL marker, called super dense LDL as a marker for perimenopause. Like, we don't have a good blood test, but would AMH be helpful? Which is one of the fertility. Things that we check, which is ovarian reserve hormone.

• 32:02Dax Shepard?

  Would you have needed a baseline test prior to any of this?

• 32:04Speaker 02

  Yeah. So that's a great question. People ask me all the time, okay, so if I'm going to replace my hormones in my menopausal journey, would it have been good for me to know in my 30s where they were? I'm like, where in the month would you like me to check? Probably not the high, because that's when we have the breast tenderness. We worry about stimulating the uterine lining too much. Right. So one of the problems with menopause treatment is we've just titrated to get rid of hot flashes. But now we know women absorb very differently and not everyone's therapeutic on our transdermal doses. So in my clinic, we're starting to check three months out. What are her levels? How is she absorbing? We know that women who start HRT in the first 10 years have a 50% per year lower risk of new heart attack, cardiovascular disease, atherosclerosis. It's very protective of the endothelium. What we don't know is what

• 32:48Speaker 02

  were those levels? We just know she was on it or she wasn't. Right. Yeah. So should we be taking estrogen during perimenopause? I think so.

• 32:56Dax Shepard?

  Wow. Yeah, there's quite a big group of data for that.

• 32:59Speaker 02

  We can decrease your risk, but it's just how? Do we suppress and replace, like what's in a birth control pill? Or do we just support? Give you just enough to calm the brain down and make your symptoms better, but allow the process to proceed in the background? Right. There's tons of debate in my world about what's better.

• 33:14Speaker 03

  Stay tuned for more Armchair Expert, if you dare.

• 33:20Dax Shepard?

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• 34:03Dax Shepard?

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• 34:48Dax Shepard?

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• 34:59Speaker 04

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• 35:43Speaker 04

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• 35:55Dax Shepard?

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• 36:05Speaker 01

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• 36:08Dax Shepard?

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• 36:45Speaker 02

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• 36:49Dax Shepard?

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• 36:57Speaker 02

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• 37:06Dax Shepard?

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• 37:36Dax Shepard?

  Okay, so 6,000 women reach menopause every single day in the United States. And there are only 2,300 providers certified in menopause medicine. So, once this occurs to you and you're going through it and you start getting serious about your own reluctance to go through this, which is a great motivator. How do you approach it? What do you start looking at? How do you even begin assembling what becomes the toolkit?

• 37:59Speaker 02

  I wish that I could tell you, you could confidently walk into your OB-GYN, your family medicine, your internal medicine doctor, and have a reasonable, logical conversation about your plan of care in perimenopause and menopause. That is not possible right now. It is not the fault of the individual doctor. They may have been excellent in your birth. In your pregnancy, every aspect, but because of the six hours. So right now, they surveyed residents coming out three years ago. Only 30% felt barely adequately trained to treat menopause. It's awful. So at least they're honest. Call ahead, look on the Menopause Society website, which is menopause.org, and see who has passed the test and is certified there. It's not perfect. There's always people out there who aren't great doctors who took the test, but it's somewhere to start.

• 38:43Speaker 02

  We crowdsourced with my followers. I've got thousands of testimonials and we organize them by country, city, and state to help people, they don't pay me, just to go find a provider who might be able to help you. And right now, it's pretty slick. There's some great telemedicine companies that have been developed, mostly female founded, who saw a gap in care and they saw a need and they developed these telemedicine companies. I have women calling me from New York, LA, London, the most well-connected you would think, who have the same basic questions and the same worries and the same fears and cannot find help as the woman sitting on the couch in Iowa. Yeah.

• 39:18Dax Shepard?

  Okay, so as you start focusing on it and kind of pledging to get competent in it and start treating women, are you yourself even shocked with the amount of symptoms? Because I wrote down symptoms and it's about the longest list of symptoms I've ever written.

• 39:33Speaker 02

  I was shocked and most of that was driven by questions I got on social. As my little social media platform was exploding, when 10,000 women ask you about frozen shoulder or palpitations or vertigo, you're like, they can't all be lying. Then I'm digging and I'm like, somebody who did the study, there's clear data here. So I go online and I make a little video talking about the correlation between menopause and vertigo, menopause and frozen shoulder, menopause and palpitations, and the world goes crazy. Wow. I get 10,000 comments, why didn't my doctor know? Again, we're doing a terrible job of teaching, but I was literally learning alongside my followers.

• 40:06Dax Shepard?

  Right.

• 40:07Speaker 02

  As I learned, I'd make a video and teach. And that's what inspired me to write the book. And they're like, please write a book. I don't want to chase you all over social media, it's too complicated. Just put it all in one place. Frozen shoulder, that is scaring me. My mom had it, my grandmother had it.

• 40:20Dax Shepard?

  One of my mother-in-laws has been dealing with it for the last six months.

• 40:23Speaker 02

  So this is a great story and I hope I get the lore right, but the story goes. The first study on frozen shoulder in menopause, I know it came out of Duke University, I read the paper. And it was the head of OB-GYN and the head of orthopedics who both happened to be women. And it was something like they were sitting in the doctor's lounge or in the cafeteria and just shooting the breeze over, can you believe all these women with frozen shoulders? You think there's a correlation? I don't know. Let's look into it. They started pulling charts and they were like, fuck me. Look at this. Women who are on HRT have a lower incidence of frozen shoulder and they do better. They're getting it, but they're getting it less than women who aren't and they're having a better course. So they go to get it published. They go to orthopedic journals first. Nobody would touch it. Nope, this can't be right. Nope, this is an artifact. Nope, nope, nope, nope. So one of the menopause journals published it.

• 41:08Speaker 02

  And so then I have a friend, Vonda Wright, she's an orthopedic surgeon, she does a ton of teaching and she wrote the paper on the musculoskeletal syndrome of menopause.

• 41:17Dax Shepard?

  How's that all work?

• 41:18Speaker 02

  Estrogen receptors and probably progesterone here as well are all over the musculoskeletal system. We know bones, we got bones down. We've known about osteoporosis since I was a resident. I know that one really well. But what wasn't understood was tendons, muscles, and the connections between bones and muscles and how that all works together. And frozen shoulder is adhesive capsulitis. There's a capsule around the ball joint in the shoulder that gets absolutely adheased and frozen and it's an inflammatory condition. You can't put your arm behind, like go to take a picture. Yeah. And it's very, very painful. You need early intervention, you need physical therapy, there's needling, they have to break it up. And that we can delay the onset and the duration and probably prevent several cases for women on HRT.

• 42:01Speaker 02

  Because estrogen is protective, so it's an anti-inflammatory. But my mom, I've never heard her once say she had that because of menopause. Well, no, most women don't know. Most orthopedic surgeons don't know. We're working to change that. That paper was written a year and a half ago. Oh, wow.

• 42:15Dax Shepard?

  Okay, so ringing in the ears?

• 42:17Speaker 02

  Yeah. Tinnitus, tendinitis, I still don't know how to say it correctly.

• 42:20Dax Shepard?

  Yeah. I had it for a minute and I didn't know what to tell people.

• 42:23Speaker 02

  I've had it once and man.

• 42:24Dax Shepard?

  People kill themselves from it.

• 42:26Speaker 02

  Maddening.

• 42:27Dax Shepard?

  Yeah.

• 42:28Speaker 02

  So again, this is an estrogen receptor problem. The vertigo is that the crystals break off quicker is basically osteoporosis in the ear.

• 42:34Dax Shepard?

  Oh, wow.

• 42:35Speaker 02

  And the crystals break off and then float around and then you're dizzy, but the tendinitis, the inflammation around the nerve and around some of the auricular bones that they feel like is leading to it and that all these studies say age-matched women, pre-menopausal women definitely have it less than post and women on HRT are less likely to get it.

• 42:50Dax Shepard?

  Yeah, wow.

• 42:51Speaker 02

  What are some other?

• 42:52Dax Shepard?

  Dry skin.

• 42:53Speaker 02

  Yeah, in the skin and tegumentary skin and the hair follicles.

• 42:57Dax Shepard?

  I like tegumentary. I've never heard that word. That's nice.

• 42:59Speaker 02

  All the follicles and oil and sweat glands. It's a whole system.

• 43:02Dax Shepard?

  Largest organ in the body.

• 43:03Speaker 02

  It is. Most absorbent. So we lose 30% of our collagen. You don't have to tell a woman that. She knows. In the first five years of menopause, we can attenuate that with topical or systemic hormone therapy. Topical works better, actually, which is why I'm on my vanity cream. Is it a retinol? No, it's estrogen for the face. Wow. So it's compounded. Some people take the vaginal product and will mix it in their moisturizer and put some on their face. But you should talk to a doctor before you do. You shouldn't do that on your own.

• 43:31Dax Shepard?

  Don't do any compounding at home.

• 43:32Speaker 02

  So, yeah. Mix it up. A little mortar and pestle. You lose oil production in the skin. You lose thinness and the transepidermal water loss is much greater. So you're just losing all of your barrier, your protection. So the skin is less healthy.

• 43:47Dax Shepard?

  Dry mouth? That's the same?

• 43:48Speaker 02

  Dry mouth, same thing. So mucus production, the salivary glands dry up. We have tremendous dry mouth and dry eyes, dry mouth. That's the same.

• 43:57Dax Shepard?

  Guys, I don't want menopause. This is fucking miserable. Body odor. What's creating body odor?

• 44:02Speaker 02

  Early in menopause, as the estrogen levels decline, something that's made in the liver called steroid hormone binding globulin, SHBG, which binds our sex hormones and carries them around the blood and renders them inactive until they let loose and then they bind to go do things. When we lose the binding hormone, the activity of our androgens increases, even though your total testosterone may not be different, but the free is higher.

• 44:25Dax Shepard?

  So when I first got a panel for testosterone, my overall numbers were like, fine, not alarming. My free was super low.

• 44:33Speaker 02

  Your SHBG was high.

• 44:35Dax Shepard?

  Yeah, I had the binding globulin.

• 44:36Speaker 02

  So you had some, but they were bound and you couldn't use it. It's a balance because you can eat certain things, take certain things, certain supplements to increase, decrease. But then sometimes you're robbing Peter to pay Paul. And so in women, when the activity of their androgens increases, we see male pattern baldness. They start getting chin hair and their odor changes. They smell like onions and it's a really kind of weird. Yeah, I hear the onion thing a lot. This is so awful. I am living my best life. You just stick with me. Okay, so I like to hear that because my mom actually said the same thing. I don't think she did any hormone therapy, but I was like, when did you hit menopause? She said 50 and I was like, oh, man, well, I'm nervous. I'm in perimenopause after I read this book. And she was like, well, I like it.

• 45:20Dax Shepard?

  I smell like onions.

• 45:21Speaker 02

  Yeah.

• 45:22Dax Shepard?

  My mouth is dry and I'm happy as a clam.

• 45:24Speaker 02

  I don't want to scare people. Yeah, so many women just go blindly into the night and they have no idea. And so one of my critics have said, you're just fear mongering. You want to scare people, whatever. I'm like, no, I want to educate. So you're not blindsided. Imagine the cortisol levels that will come down where they're like, oh, This is what's going on. This might be my menopause. Fine, whatever. Okay, we got this. I'm not going crazy. Especially the cognitive changes in the mental health. The divorce rates, the suicide rates are all right in there at this age.

• 45:51Dax Shepard?

  They kind of peak there?

• 45:52Speaker 02

  Peak suicide rates are 45 to 55 in women.

• 45:56Dax Shepard?

  Wow, and that should be the kind of transition in life where you're like, oh, I made it.

• 46:00Speaker 02

  Exactly. I'm made it. I'm gonna lean into work. We're gonna go off in the sunset here. No. Wow.

• 46:05Dax Shepard?

  That's heartbreaking.

• 46:06Speaker 02

  And is that hormonal too? The neurotransmitters in the brain are heavily influenced by estrogen progesterone levels. And the brain doesn't like the chaos. So the real mental health that we see, the big, big problems are in peri. Post, things tend to calm down, both cognitively and mental health. You still may need your, sorry, you know, whatever, but we see this wild uptick in peri.

• 46:29Dax Shepard?

  So decrease sex drive. I think this is also something that people have just taken for granted.

• 46:35Speaker 02

  I learned this much about sex drive.

• 46:38Dax Shepard?

  She's holding up a zero for the listener.

• 46:39Speaker 02

  Holding up a zero, sorry. I get my little diploma and I graduate and I'm at the top of my class. I win lots of awards and off we go. I'm gonna go be the best OB GYN. So the pregnant people come and then these other people come. I'm like, ew. So like as you're walking out from the well woman exam, I'm like, okay, we'll see you next year. She's like, can I ask you one more thing? Sure. I have low libido. I don't want to have sex. It's really affecting my marriage. And I was just like deer in the headlights. You're like, I don't know.

• 47:04Dax Shepard?

  So you're old. That's probably what you're thinking like.

• 47:06Speaker 02

  Oh, please. So I go out in the hallway and I find my boss, who's our mentors when we first get out, keep us out of trouble in those first couple of years. I'm like, hey, so Ms. Smith, you know, everything's fine. She's healthy, but you know, there's sex. I can't even say it, you know, I'm deep south and taboo. He's like, oh, tell her to have some wine. She just needs to relax. And it'll be fine. Just pat on the knee, but she's gonna be okay.

• 47:29Dax Shepard?

  Tell her to anesthetize herself so she can get through it.

• 47:31Speaker 02

  Exactly. Women just go through this at this age. So many people were complaining over and over again. I started looking for resources and I read Venus and Mars in the bedroom. Like that was my bible. That was the only thing I knew how to do. No one taught me. I was going back in my textbooks. Nothing was talking about sexual desire, drive. I didn't even know all the causes of female sexual dysfunction. It was never a lecture. No one ever talked about it. Here I am, the expert going, "I'll be right back. Let me see what I can find." So I ended up making little handouts for my patients on what I could dig up on desire and herbs. And I didn't know about, well, they came out later, but Addy and Vilese and testosterone and all these things that might be helpful to a woman and counseling and therapy and looking for orgasmic disorders and arousal disorders and pain disorders and pelvic floor dysfunction.

• 48:16Dax Shepard?

  It's common for sex to get more painful, right?

• 48:18Speaker 02

  When we go through the menopause transition, 100% of us are gonna lose the protective effect of estrogen in the vagina, the vulva, the bladder, that whole what we now call the genital urinary system, pubic bone all the way back and up to the bladder. We lose elasticity. We lose the ability to produce mucus. So if you biopsy to pre and post-menopausal vagina, pre-menopausal, it's this thick, velvety, full of mucus glands, very resilient. It'll take a beating and be fine. Baby comes through there. It's traumatic, but they'll make it. And then post-menopausal looks like a desert. You went from this gorgeous, thick, multi-layered tissue to six cells laying on top of each other with no mucus, no nothing, like a desert. All we have to do for those women is give them back estrogen in the vagina and all that tissue will grow back, even at 70.

• 49:02Speaker 02

  You can absolutely prevent and reverse this condition. So I recommend lubricants for all of my patients on every sexual encounter. Just get used to it. Do it proactively. Normalize this.

• 49:14Dax Shepard?

  Yes.

• 49:15Speaker 02

  And then I'm advising not to wait until you start having symptoms to use vaginal estrogen. It's very safe. It's like skincare. Doesn't absorb much. There's very much risk-free. If you have active breast cancer, you can still use it. It will save your life. I mean, it prevents UTIs. The best treatment for recurrent UTIs for a menopausal person is vaginal estrogen, not recurrent antibiotics.

• 49:36Dax Shepard?

  And it's just topical.

• 49:37Speaker 02

  Yeah, they have creams, gels, they have a suppository, they have a ring. There's multiple ways, but generic and cheap, the cream works for most people.

• 49:45Dax Shepard?

  Yeah.

• 49:45Speaker 02

  Wow.

• 49:46Dax Shepard?

  Where's testosterone in the drive part?

• 49:48Speaker 02

  So, we look at female sexual function, we have five buckets where she may not be happy. First of all, it has to bother her. Some women are like, I don't care, and I'm never gonna care, and I'm like, okay. Then you're good. Other women are like, I used to have it, I miss it.

• 50:01Dax Shepard?

  Yeah.

• 50:02Speaker 02

  So you have to make sure she's not having pain, there's a pain disorder. She's not having a relationship disorder because no amount of testosterone is gonna fix a bad relationship. Can she have an orgasm, or is the plumbing still working if she puts her mind to it?

• 50:14Dax Shepard?

  Does that drop off?

• 50:15Speaker 02

  You see arousal disorders, it's more of a blood flow issue. I kind of had that. I was having delayed orgasm, like, hello, everything's working, I'm ready. I was like, okay, fine, I need vaginal estrogen now. And it took about eight years in menopause because I was on systemic, but I wasn't quite getting enough, and everything's fixed. Libido, which is desire, in medical we say hypoactive sexual desire disorder, HSDD. That is a mood. It's totally in the brain. Everything's working down here, but it's the thought of it. And most women will come to say, once we get going, I'm fine. So if a female has an arousal disorder, vaginal Viagra might work for her.

• 50:48Dax Shepard?

  What does that do?

• 50:49Speaker 02

  Increases blood flow, basal dilator, specifically to the corpus spongiosum. So that's the squishy part that gets erect. We have exactly the same tissue in the clitoris.

• 50:58Dax Shepard?

  Well, your clitoris becomes my penis.

• 51:00Speaker 02

  Same anatomy, except ours looks like Gumby, and yours is like a little rocket. So we've ruled out all the things, and she's like, I love him, I'm not going anywhere, I miss it, please help me. So we have two classes of meds that we talk about. One is testosterone. It works great for these women. If it doesn't help her in three months, that's not the answer.

• 51:19Dax Shepard?

  And the options for testosterone are?

• 51:21Speaker 02

  So, we don't have FDA-approved option for women, so we're either having someone cook it up in a lab, and a compounded cream generally.

• 51:28Dax Shepard?

  Right there, red flag, ridiculous, right?

• 51:30Speaker 02

  Ridiculous, we have studies that prove the safety and efficacy and all the things. And she's so much happier. There is anecdotal evidence that also her stamina is better, her mood is better.

• 51:40Dax Shepard?

  Muscle mass goes up.

• 51:41Speaker 02

  Muscle mass, osteoporosis. So all that works together. So I don't want to say it's a chandelier. So I have low muscle mass genetically, and I'm doing the things, eating the protein, working out. It's a full-time job, wearing my weighted vest, and I was like, what if I tried some testosterone off-label for myself? Did not have a libido issue, and no one was complaining. And then start some testosterone.

• 52:03Speaker 02

  And I see an uptick in the area. Uh huh. A little more interested. He's not cuter. He's not pissing me off less.

• 52:09Dax Shepard?

  He's very less cute.

• 52:10Speaker 02

  He's not my poor husband. But I'm just like, okay. A little more often, or maybe I'm even initiating, which that not happened in a long time. And we've just reached a different level now. And I think I would miss it if it was gone. Of course. So I'm like telling my patients this. Certainly if you're distressed, let's go for it. But here's my experience. So that's a topical. You don't want to do oral. There's no form available in the US that will not affect the liver. There's one they use in Australia, Unductinowit, but it's not available here. So you're going to look at a non-oral option. So some people are doing some compounded injectables. What we're doing in our clinic is either T-STEM gel or AndroGel. So we're doing the FDA-approved gels for men. We're just using them off-label for women. Interesting.

• 52:51Dax Shepard?

  You can also get a capsule.

• 52:52Speaker 02

  So there's Trokis that dissolve that are submucosal. So you put them under your tongue.

• 52:57Dax Shepard?

  Oh, you mean the pellets. The pellet.

• 52:59Speaker 02

  Pellets are commercially available. They're not FDA-approved. There's a problem with pellets that we see kind of in the ethical realm. Two problems with pellets. If you go to a doctor and they are trying to talk you into pellets and they won't discuss any other form of hormone therapy, that is an ethical red flag. They're financially benefiting from the sale of the pellets.

• 53:17Dax Shepard?

  Got you.

• 53:18Speaker 02

  And I just think you can do better because pellets are very hard to manage. You have this rapid rise. And I've seen females with testosterone levels in the 400 and 500s, and I am not kidding. They'd never made a female-level pellet. They just give females the low level and say, you're running 200, you're fine. You're not going to die.

• 53:33Dax Shepard?

  They don't slowly dissolve at a predictable rate.

• 53:35Speaker 02

  They're supposed to. I've never seen a decay curve, have you? They don't publish them. They're not FDA-approved, so they don't have the same regulation. So I'm like, listen, we don't need to be doing this. Yeah. And I can take it away tomorrow. If you have a pellet, you are stuck until it's gone.

• 53:47Dax Shepard?

  Three months generally or?

• 53:48Speaker 02

  Generally. I think we can do better for our patients. I don't need to make money putting pellets in people. It's a cash cow for a lot of practices. And I'm just really hesitant. If your doctor is really railroading you, if they say, I only do pellets, I would probably bounce. Interesting. Okay.

• 54:02Dax Shepard?

  Good tip. Okay. So back to, so we can do an injectable.

• 54:06Speaker 02

  Injectable. You can do a cream. You just rub it, pick an area.

• 54:09Dax Shepard?

  You'll get really hairy wherever you rub it, but that's fine.

• 54:11Speaker 02

  You could. So I'll tell patients. To put it here.

• 54:13Dax Shepard?

  Oh, I was amazing. Is that real?

• 54:14Speaker 02

  There's no hair follicles here. I was studied on the shoulders. Okay. We want to monitor them to see how they're absorbing, make sure we're not going over, checking their free and total testosterone levels and just seeing how they're doing.

• 54:26Dax Shepard?

  I'll say I started on a cream. The only thing I didn't love about the cream is you have this dispensary for it.

• 54:31Speaker 02

  Click, clicky?

• 54:33Dax Shepard?

  The amount that comes out per click per day did not seem very consistent to me. It seemed a little all over the map. I much prefer just an injection. You know exactly what you're getting.

• 54:41Speaker 02

  Another option to think about would be to do the T-stem gel or the andro gel. It's in a pump. So a full pump is 20 grams. For women, we need five to 10 grams. So that's like a half pump or a pea sized amount. I tell my patients to put it on their inner arm where there's no hair follicles so they can see the pea. And then you just rub it in.

• 54:57Dax Shepard?

  Do a little rub.

• 54:58Speaker 02

  Wow. Okay. So you're doing testosterone on your arm, estrogen on your vulva. What else? I think I replaced my hormones like five ways, you know? Yeah. For estrogen, there's oral and non-oral. And in non-oral, patches are what we usually prescribe in my clinic.

• 55:14Dax Shepard?

  On your Instagram, you're a fan of those, right?

• 55:16Speaker 02

  They're very inexpensive. We have multiple strains. So I have a lot of options for patients. But sometimes people have a reaction to the adhesive, tape allergies. So we have gels and creams. It's just the expense goes up. The vaginal ring is great because you get two for one. You get systemic and vaginal. But they're like 200, 300 bucks. They last for three months. It's nice. You just throw it up there and forget about it.

• 55:35Dax Shepard?

  Toss it in.

• 55:36Speaker 02

  Yeah, I get scared of them. Yeah, it's not for everyone. Even like the Diva Cup. It's not for me having something.

• 55:41Dax Shepard?

  You don't want something in there?

• 55:42Speaker 02

  Yeah, I don't.

• 55:42Dax Shepard?

  You have an outsized fear of toxic shock syndrome.

• 55:44Speaker 02

  I wouldn't say outsized. I have a real fear of it. Yeah, as you should. Yeah, scary as hell. It's scary and you die. And then there's local estrogen options for the face and/or the vagina. And then your progesterone. So progesterone is typically given in the menopause. We're giving oral micronized progesterone. It's the safest.

• 56:02Dax Shepard?

  I believe I understand a lot about testosterone and estrogen and estradiol. But I don't know that I know a ton about progesterone. What is it doing?

• 56:09Speaker 02

  So progesterone is mandatory if you have a uterus, if you're doing estrogen, because the inside lining of the uterus, the endometrium where the blood would be made each month, is sensitive to estrogen. If we let estrogen play in there unopposed with progesterone, you'll develop. Hyperplasia and potentially malignancy.

• 56:24Dax Shepard?

  This is where some of those studies were misleading because

• 56:27Speaker 02

  That was in the early, early days of hormone therapy and the like get your wife back sexy movement with estrogen. They were doing just estrogen and women were getting into metrial cancer. So we learned that lesson. You give her a progestogen, you will negate that. So if she has a uterus without the Marina IUD, which has progesterone in it, you must give progesterone to not potentially give her cancer. Turns out progesterone is amazing for sleep. It upregulates GABA in the brain and it is our sleep, sleep hormone. So when patients are coming in an early perimenopause, still having regular cycles, but they can't sleep. They're waking up at two or three in the morning. Progesterone might be your new best friend. It's fine to start with progesterone without estrogen. We do that in a lot of cases.

• 57:09Speaker 01

  I have so many things to take.

• 57:10Speaker 02

  No, I do. I do. I need you. Anxiety thoughts. It's great for that 2:00 AM wake up. I'll just take an extra one if I still have that.

• 57:17Speaker 01

  I mainly have a hard time just falling asleep.

• 57:19Speaker 02

  I mean, it's worth a trial. It's not going to hurt you. It's a natural hormone.

• 57:23Speaker 01

  And none of this is a problem with getting pregnant.

• 57:26Speaker 02

  If you're in perimenopause, your chances of getting pregnant are lower.

• 57:30Speaker 01

  Yeah.

• 57:30Speaker 02

  But if you are trying to spontaneously get pregnant, you have to make sure you're giving low enough doses where you're not going to inhibit a standard ovulation. And menopause hormone therapy really was not high enough to suppress ovulation. So the biggest difference between birth control pills and menopause hormone therapy, you think about why they were created. Birth control was formed for contraception. We need a high enough dose to shut the signal down from the hypothalamus to tell the hypothalamus, we're cool. We got enough estrogen, no signals, no signals, no ovulation. Menopause hormone therapy was developed to simply stop a hot flash. You don't need nearly as much. Got it.

• 58:03Dax Shepard?

  So it's lower.

• 58:04Speaker 02

  Formulation, though, is different because of big pharma. Formulation is tends to be ethanol estradiol, which is cheap and easy to make, and it's 100 times as potent as estradiol. And that's why you have those little tiny birth control pills. Whereas estradiol in its natural form, which is body identical, it's much less potent than its cousin ethanol estradiol. But it's got a great safety profile and you don't need much to stop the hot flash. Now, how much do we need to prevent cardiovascular disease? You don't need much to help your bones. They did study those numbers. We're all kind of debating if we're going to check levels, what's therapeutic?

• 58:36Dax Shepard?

  Okay, wow. Okay, so we really covered HRT, hormone replacement therapy. I'm so glad you're an advocate for it. I think it's insane that women have been just left out of this. What I have experienced being on hormone therapy, which has made me want to work again, made me want to do my hobbies again.

• 58:52Speaker 02

  Right.

• 58:53Dax Shepard?

  Made me mentally, and then my fitness, everything.

• 58:56Speaker 02

  All the things.

• 58:56Dax Shepard?

  I remember Kristin going like, this is bullshit. I'm like, you're right, it is. This is insane.

• 59:02Speaker 02

  How many doctors did you go to?

• 59:03Dax Shepard?

  Oh, one. I mean, they're dying. I have to police them.

• 59:07Speaker 02

  A woman on average has to go to six to eight doctors before her menopause is diagnosed. This is how bad the problem is.

• 59:13Dax Shepard?

  Well, I'll be clear. The general practitioners tend to still be pretty adverse across the board in my experience. But we have hormone clinics on every 10 feet for men. Most of them don't see women. So all one needs to do is go there. You actually need to police them, I think, is my tip.

• 59:30Speaker 02

  Yeah, and that's kind of the pellet. It's the bio T really, that got into, whoa, let's put these in women and see what happens, you know?

• 59:36Dax Shepard?

  Yeah, and you don't need to be at 1100.

• 59:39Speaker 02

  Yeah, I know. I mean, these women are coming in, they're like, I don't know why my hair is falling out of my beard, and I check her level and it's 450. I'm like, hmm, I might have a clue.

• 59:46Dax Shepard?

  Because women, what, naturally in their 30s would hover around what?

• 59:49Speaker 02

  So around 40 to 70-ish.

• 59:51Dax Shepard?

  Yeah, so that's a good 8x.

• 59:52Speaker 02

  So, you know, most of them come in in menopause, 12, 15, 20, 25. Let's get you up. So I'm trying to titrate my patients 60 to 70. Let's overshoot just a little bit and see if this is going to help with your libido. But there are two FDA-approved medications for libido that are not testosterone. One is Vilese, and it is an injection you give yourself 45 minutes before. And it causes a massive dump of melanocortin that then stimulates dopamine. And when our dopamine levels are higher, it makes us want to do things.

• 1:00:21Dax Shepard?

  Yeah.

• 1:00:22Speaker 02

  So unfortunately, most of my patients don't choose that. Because they're like, there's a praying mantis on the other end of this waiting, the 45 minutes going, is it working?

• 1:00:31Dax Shepard?

  Well, additionally, it's almost the wrong medicine for the arousal type that women are. Which is like, that's great for a man, because a man's sitting around thinking about wanting to fuck in an hour, and he's like, oh. Do this, or the woman needs to be brought into arousal.

• 1:00:46Speaker 02

  Romantic.

• 1:00:47Dax Shepard?

  Yeah, so it's almost like a counterintuitive solution.

• 1:00:49Speaker 02

  For the women who like it and can unlock that part of their brain, it's great. Is it a base dopamine? Like, don't give it to an addict. I've not seen those studies. I've not had a patient yet who was like, yes, please. Addy is another. So Addy was studied in mood and they saw an uptick.

• 1:01:07Dax Shepard?

  Tell us how Addy works, because they're a sponsor.

• 1:01:09Speaker 02

  Addy works, same thing. It's gonna increase your dopamine levels and it's something you take every day. It was studied in mood. It works by increasing happy sexual encounters a couple of more times a month or however they measure it. So the detractors of Addy are like, well, that's not enough. And the women are okay with it.

• 1:01:25Dax Shepard?

  Right, right, right.

• 1:01:26Speaker 02

  If you were having none or one, go into four.

• 1:01:28Dax Shepard?

  That's enormous.

• 1:01:29Speaker 02

  Great. I'm like, let the patients decide. Most of my patients choose testosterone purely because of cost and potentially the other benefits for bone and muscle. Even though we don't have great studies yet, but the anecdotal data is looking very positive in that area.

• 1:01:42Dax Shepard?

  Right, so if you just kind of reverse engineer, as I understand, or if you believe Atiya, and I do, the best way to combat osteoporosis.

• 1:01:49Speaker 02

  Is to not get osteoporosis. Well, yeah, that'd be great.

• 1:01:52Dax Shepard?

  Is to not get it. But your bones respond immediately to muscle and strain. So if you can work out heavy, you're putting a lot of strain on your bones and they will react. They will make themselves stronger. And for you to do a lot of strenuous and high intensity heavy lifting, you're gonna benefit from testosterone with your muscles. They're all related.

• 1:02:16Speaker 02

  The musculoskeletal unit works together. It's not like it works in isolation. So testosterone will help a little bit. We looked at, one of the things from WHI, when the Women's and Health Initiative, is they followed these women forever. And they followed them into nursing homes and they looked at protein intake and frailty scores. And the women who ate the most protein, like 1.6 grams for every kilogram of lean body mass, had much lower frailty scores. I'm drilling down. We're gonna prevent your osteoporosis. We're gonna consider hormone therapy and estrogen. We know will prevent 50% of fractures.

• 1:02:44Dax Shepard?

  Yeah.

• 1:02:44Speaker 02

  So she's on HRT. We're gonna work out heavy, we're gonna lift heavy, and we're gonna eat the protein. We're gonna give some creatine on board. So all of that works synergistically. I call it my nursing home prevention program because once I put out the fire for menopause and she's functional and she's your mom and me. Now we're like, I don't want to be my mom. My mother is in a nursing home with Alzheimer's and a broken hip. She just got out of rehab. She's not doing well. Right. It's gonna take a long time.

• 1:03:06Dax Shepard?

  And all of these four horsemen are metabolic disorders.

• 1:03:10Speaker 02

  Alzheimer's is not the natural course of aging brain. There's 14 risk factors. So of course, the easy stuff. Don't smoke. Eat a balanced diet. Stay away from processed foods. Don't get diabetes. Don't get insulin resistance. All of that. But then it's social connection. Keep your brain moving, thinking, working. Do the puzzles. When my dad died, mama had lost Bob in 2015, one of my brothers. My second birth of esophageal cancer. The third one, they lost the one when he was 18, when I was nine. She'd lost two kids and a husband in five years. And she was like, I'm out. She locked herself in the house and started drinking. Yeah. Which I can't blame her. What I've seen it do to her, the relationships with her kids and this long, protracted course she's gonna have until she goes. And all the talking of the children on how to manage and who's doing what.

• 1:03:55Speaker 02

  I don't want that. Exactly. You know, I want to die like my dad. He was great until like the last month and then he kind of slowed down. And then we all gathered around and we sang songs and told stories and we're there and sang to him and he slipped into a coma and then it was over. Yeah, that sounds great. That's not what happens to women. We have this nursing home. She's frail and she breaks and yeah. Yeah.

• 1:04:16Dax Shepard?

  Boy, that's so true for my grandparents. The men just collapsed.

• 1:04:21Speaker 02

  Yeah.

• 1:04:22Dax Shepard?

  And the women just struggled for five years.

• 1:04:24Speaker 02

  Struggled for five to 10 years.

• 1:04:26Dax Shepard?

  More miserable.

• 1:04:27Speaker 02

  My patients are not interested in option B. Yeah.

• 1:04:30Dax Shepard?

  Okay, so we have diet and I'm glad you're flagging protein.

• 1:04:33Speaker 02

  Top nutrition tips for aging and longevity for women in menopause. Is she limiting added sugars? So the whole keto movement, sugars got demonized. But it turns out that sugars added to stuff are much worse than found naturally in fruits and vegetables because the sugar in a fruit is wrapped in a fruit which has fiber and vitamins and minerals. And this is a doctor who sells supplements. But I think everyone should be able to get everything they need from food. That just doesn't happen. That would be amazing if it happened.

• 1:04:58Dax Shepard?

  That's ideal.

• 1:04:59Speaker 02

  So I'm here to help you fill in the gaps where you need it. Fiber, vitamin. D. Eighty percent of my patients are deficient in vitamin D. We're checking everyone's levels. We're telling them to supplement. I'm giving prescription doses if they're super low. We're trying to give them loading doses. Magnesium is really great for a lot of patients. I've been taking magnesium. I have a specific collagen product that was studied in menopausal osteoporosis that seems to have some benefit. So we're talking about that. For movement, most of my patients are walking, minimum. You have to meet her where she is. If she's sedentary, just walking thirty minutes a day will decrease her risk of diabetes by fifty percent.

• 1:05:30Dax Shepard?

  Yeah.

• 1:05:30Speaker 02

  That's it. If she's walking, let's put on a weighted vest. If she's doing that, let's get in the gym. You have to meet them where they are. All the fitfluencers, they're lifting and all that. I'm like, that scares the shit out of most women.

• 1:05:40Dax Shepard?

  Yeah, it seems insurmountable.

• 1:05:42Speaker 02

  So we're easing them into it. I love to run these challenges for my followers. We'll get a hundred thousand people who are lifting weights for the first time and I'll have a fitness person in there. I didn't know either. I was injuring myself.

• 1:05:52Dax Shepard?

  Of all theologies, you can do chemios.

• 1:05:53Speaker 02

  Chiropratology is not on my list. So I will hire someone to come in and show my followers how to do a squat. You say, you don't have to do a lot of different exercises. Just the really basic push, pull.

• 1:06:04Dax Shepard?

  There's some real key ones that are super beneficial, particularly for osteoporosis.

• 1:06:09Speaker 02

  Squats, lunges. For osteoporosis, good studies with walking with a weighted vest, doing yoga with a weighted vest, balance training with a weighted vest is super helpful. Fibre tory plates, again, you're stimulating that musculoskeletal unit. I tell patients to brush their teeth on one foot because you're working on balance, to always be decreasing your risk of fall with balance training. And then lifting, they were putting eighty year old ladies in the gym from nursing homes and they were seeing all these gains.

• 1:06:32Dax Shepard?

  And grip strength, a big indicator.

• 1:06:34Speaker 02

  Grip strength is a proxy for the rest of your body.

• 1:06:37Dax Shepard?

  Right. If you do deadlifts, you will inadvertently get.

• 1:06:40Speaker 02

  Yeah. So it's not the grip strength. It's, that's an easy thing to measure. I got it. That's an indicator.

• 1:06:46Dax Shepard?

  Stay tuned for more Armchair Expert, if you dare. We are supported by Walden University.

• 1:06:56Dax Shepard?

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• 1:07:41Dax Shepard?

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• 1:07:59Dax Shepard?

  So that's exercise diet. Now, where do GLP-1s fit into this?

• 1:08:03Speaker 02

  We do use them in our clinic, and probably 20% of our patients end up on them. When they come to us, it's usually, "Hi, I'm in menopause. Help me, I'm dying." Probably 50% to 60% of them now have a weight problem. They have either always had it, or they have new weight gain. So the first thing we do is break down where their fat is, if they have it. Because some patients come in, they're just muscular, and they've been told they're obese their whole life, and they're crying their eyes out because, "Oh, my God, I'm healthy." What? If they have a visceral fat problem, I really don't care about subcutaneous fat. It's not metabolically that active. It's just storage. It's the intra-abdominal fat that'll kill you. And so, we are working on that number. And what do we know works for that? Starvation, but that's not why they're there. High-fiber diets, low added sugar, diets rich in probiotics, or a probiotic supplement, zone 2 training, all of that works.

• 1:08:47Speaker 02

  So we're focusing on that, and we get her start in HRT. Across the menopause transition, a woman will go from 8% of her total body fat being visceral to 23 on average, just from becoming menopausal. No changes in diet and exercise. I have the unusual circumstance of most of these people follow me, have read the book. It's an investment to come and see me because I'm outside of The insurance model.

• 1:09:07Dax Shepard?

  Yeah.

• 1:09:07Speaker 02

  So they've done their homework.

• 1:09:08Dax Shepard?

  They're dedicated.

• 1:09:09Speaker 02

  Yeah. So they're like, okay, let's do this. We start HRT. We bring them back in three months. If her cardiometabolic risk factors are still there, and she's like, I want to give it a try. I'm like, let's go for it. A GLP-1 needs a lot of counseling to be done well.

• 1:09:24Dax Shepard?

  Yeah, because you're taking on a lot of risk of muscle mass loss, which is so important for your

• 1:09:27Speaker 02

  And they know that.

• 1:09:28Dax Shepard?

  Although there's supposed to be a new one coming out.

• 1:09:29Speaker 02

  Yeah, that's three. So there's simaglutide, which had just the GLP-1, and then terzepatide, which is what we usually start with now, which has the GLP-1 and the glucagon agonist. And then this new one has, I forget what the third ingredient is, but I'm excited to see when it comes out.

• 1:09:44Dax Shepard?

  Yeah, it's supposed to reduce the loss of muscle mass.

• 1:09:46Speaker 02

  In our clinic, if the patients eat the protein and do the resistance training, we are seeing some muscle loss expected, but not this massive loss. And they are able to maintain. And then it's like that first three months, if they lose 20 pounds, maybe five is muscle, maybe 20%, but then that just levels out and it's all fat loss after that. It is absolutely the coolest thing to watch because we bring them back every six weeks to check their muscle mass. We stay on top of it. We're checking in with them. They're doing this not to look great in a bikini. I mean, maybe that'll happen and that'll be great, but they're doing this to decrease their risk of all these diseases they don't want to die from.

• 1:10:22Dax Shepard?

  Yeah.

• 1:10:22Speaker 02

  Or plague their children with.

• 1:10:23Dax Shepard?

  Protect the last 15 years of their life or 10 years of their life.

• 1:10:25Speaker 02

  And be happy during those. They're so motivated to avoid the diseases that plague their elders.

• 1:10:30Dax Shepard?

  As you might expect, my wife, knowing that I was interviewing you, had some specific questions. Are there any ways to predict when onset will be? Kristin Heard, your mother's sister can be a guide.

• 1:10:42Speaker 02

  There is a genetic component. So there's an ethnic genetic component. So I was telling Monica, for me, it's 51 is average. For her, it's 46.7. African Americans is about 18 months behind Caucasian. Asians get a little bit longer. Interesting. Does sexual activity impact that? Trauma does. So we know lots of things that speed it up. You were born with X amount of eggs and they're gonna go before you die. If you live a normal lifespan. But what do we know speeds up the process of egg loss? Yeah. Smoking, chemotherapy, radiation, abdominal surgery. You have a hysterectomy, leave the ovaries behind, but we've cut a significant blood supply to the ovary. We're gonna lose average of four years off the life of the ovary. A lot of women undergoing necessary hysterectomy, aren't getting that counseling. There's nothing they can do about it, but wouldn't that be nice to know?

• 1:11:26Speaker 02

  Yeah, I have a friend's friend who had to have a hysterectomy. She's like, I'm about to be in menopause.

• 1:11:31Dax Shepard?

  My mom had one when she was 30.

• 1:11:33Speaker 02

  My mom had one after baby number eight. They were like, this is your Catholic birth control. Time for that uterus to come out. So does it instigate menopause? It cuts the blood flow. So you lose the shelf life of the ovary, where you may have gone through a 51, now you back that up four years on average. Okay, but it's not like you have the hysterectomy and then... No, unless they remove the ovary, right? Exactly. So that's surgical menopause. And we have premature menopause and early menopause. So those are a little bit different animals. Premature ovarian insufficiency is usually with an autoimmune condition. So it has its own set of risks. And then surgical menopause, you don't get a trial period. It's like boom. So whenever I had to take out ovaries for medical reasons, I was putting a patch on them in the OR. Yeah, that makes sense.

• 1:12:16Dax Shepard?

  Okay, so ethnic is a predictor.

• 1:12:18Speaker 02

  Ethnicity and then family history. You look at the women in your family, when did they go through it?

• 1:12:22Dax Shepard?

  But on your mom's side, is she right about that?

• 1:12:24Speaker 02

  Mom's side and sometimes dad's side. I mean, you're half genetically...

• 1:12:27Dax Shepard?

  She compared it to male Potter and Baldness, which we know comes from your mom. But I was saying, well, that's because it's on the 45th chromosome and you can only get an X from mom.

• 1:12:35Speaker 02

  So this isn't a chromosome only thing. It's more of a general health and kind of how things are gonna go. Certain tribes in Africa have a lot of twins or certain cultures are more prone to twins. That's more of a general than a chromosome thing.

• 1:12:47Dax Shepard?

  There's a couple of things happening. A, it was completely understudied, as you pointed out. It's beginning to get studied, but also we're seeing an art. What do you think about the impact of all fours?

• 1:12:57Speaker 02

  I'm literally on 79% of the chapter. First of all, I hate the protagonist.

• 1:13:03Dax Shepard?

  Okay.

• 1:13:03Speaker 02

  Yeah, so she's not my girl.

• 1:13:05Dax Shepard?

  Yeah.

• 1:13:06Speaker 02

  But I'm researching and writing the new peri-menopause. It's not coming out till 2026. I'm in the middle of it. And so Gretchen, who's my co-writer, I write like an asshole. I am so clinical. My collaborator will take my disgusting prose and spin it into something that sounds

• 1:13:20Dax Shepard?

  digestible.

• 1:13:21Speaker 02

  Like a human, not a normal person could read, not geek. And Gretchen's like, read it from the perspective, this is resonating. And that just flipped the switch for me. I read for entertainment. I read about fairies and dragons and lots of sex. And my daughter reads all the dystopian novels, so I read to read with her and talk about stuff. And then I read medical journal articles. So to pick up a book that is outside of my usual and not have a 15-year-old little girl who turns into a princess with magical powers was like hard.

• 1:13:44Dax Shepard?

  Yeah.

• 1:13:45Speaker 02

  I'm trying to identify this, and she says, stop trying to identify. Read it and figure out why the hell the world is resonating. And then I'm like, oh. So then the doctor in me is like, she's having palpitations. That's a panic attack. That's menopause. That's menopause. That's menopause. Now, have an affair and redo this room in this weird hotel. That's a whole nother thing, but I'm getting it now. It is so hard resonating. Movie rights are done. Oh, yeah. All my friends write it. Did you love it? I loved it.

• 1:14:10Dax Shepard?

  I haven't read it. I've been told what it's about from Monica, who loved it. To me, it's like, I was prescribed a role I don't want, or I want to test, or I want to shake up, or I want to break because I just prescribed it and now I want to decide.

• 1:14:23Speaker 02

  I don't want to do it anymore.

• 1:14:24Dax Shepard?

  That's so perfectly parallel to, hey, guess what? I don't want to live a third of my life in discomfort.

• 1:14:28Speaker 02

  That. So what I'm finding, and I think why the divorce rate's so high, is that women, and myself included, and thank God, my relationship is better than it's ever been, and we're working together. We have a small business through the supplement company, and he's now running it. I've never liked him more. But yeah, she's getting to choose the last third of her life, and so did I. I chose differently than her, and that's okay, but women are circling the wagons around themselves. Menopause is fucking them so hard. They are giving themselves permission to put themselves First.

• 1:14:57Speaker 01

  Yes.

• 1:14:57Dax Shepard?

  To me, it's I've had enough on all the levels.

• 1:15:00Speaker 02

  And now it's a survival thing. If I don't do this, for me, my journey was quit a job that didn't serve me, stop serving a system that was broken, absolutely get the hell out of Dodge, figure out what the fuck I wanted to do with my life, put my own oxygen mask on first.

• 1:15:14Speaker 01

  It's time for you.

• 1:15:15Speaker 02

  And I really didn't give a shit if the kids or my husband cared, but I had to do this. Thank God it all worked out and look where I am now.

• 1:15:21Speaker 01

  But that's what it is. It's I'm making choices for the first time that are for me that aren't just handed societally to you. But what's scary about that book is now is the time I get to make the choices and my body is disintegrating. That's the part that I think everyone was like, oh my God, we have to wait till then and it's coinciding with that. What do we do?

• 1:15:42Dax Shepard?

  How do we prevent ourselves from getting to the too late?

• 1:15:45Speaker 01

  Exactly.

• 1:15:46Speaker 02

  Too late to celebrate. Well, educate yourself as soon as possible.

• 1:15:49Speaker 01

  Yeah.

• 1:15:50Speaker 02

  That's part of my mission is just vomiting all over social media.

• 1:15:53Dax Shepard?

  I think a lot of people think of HRT as being what you do after you have all the symptoms.

• 1:15:57Speaker 02

  Right.

• 1:15:57Dax Shepard?

  That's the next wave, I think, is preventative.

• 1:16:00Speaker 02

  Where some of the hardcore, old school menopause people are like, don't say prevent, they come after me every time I talk. Look, FDA approved for the prevention of osteoporosis and that is enough for me. But let me tell you, the US preventative services tax force needs to get their shit together because you have a window of opportunity for cardiovascular disease prevention and the data coming out clearly for mental health. We can prevent the suicides, the job loss, the brain fog, unless you're on the dementia spectrum with early and judicious hormone therapy, not allowing your body to withdraw and go through that chaos.

• 1:16:34Dax Shepard?

  Why wait till you have all the symptoms?

• 1:16:35Speaker 02

  Why wait till your vagina is broken?

• 1:16:37Dax Shepard?

  But there's no other condition that we don't think early detection and treatment is beneficial.

• 1:16:42Speaker 02

  It's never been thought of like that. It's wait till you're miserable.

• 1:16:46Speaker 01

  Yeah.

• 1:16:46Speaker 02

  And then it was severe symptoms only. A doctor's going to tell me if my symptoms are severe enough.

• 1:16:51Speaker 01

  What does that even mean?

• 1:16:52Speaker 02

  What does that even mean?

• 1:16:53Dax Shepard?

  And why? It's like some old vestigial Protestant suffering something.

• 1:16:58Speaker 02

  Look, women have been taught to minimalize. Did you read the WW story?

• 1:17:02Dax Shepard?

  Oh, yeah. Whiny women.

• 1:17:03Speaker 02

  The whiny woman. This is just what women go through. They tend to whine a lot.

• 1:17:06Dax Shepard?

  Early in her residency, they'd come to her and say, we got a WW in room 305.

• 1:17:11Speaker 02

  The woman with a laundry list of complaints, very vague, weight gain, brain fog, low libido. And they're like, check her thyroid, get these tests, make sure you're not missing anything, but you're not going to be able to help her.

• 1:17:22Dax Shepard?

  It's just a whiny woman.

• 1:17:23Speaker 01

  Just one of those whiny women.

• 1:17:25Speaker 02

  I've talked to other doctors across the country and in California, they called it whiny guineas.

• 1:17:29Dax Shepard?

  Oh, nice.

• 1:17:30Speaker 02

  And on the east coast, around New York, it was TBD, total body delore. And in Miami, it was Madame Dolores.

• 1:17:36Speaker 01

  Oh, my God.

• 1:17:37Dax Shepard?

  What is that?

• 1:17:38Speaker 02

  Pain.

• 1:17:39Dax Shepard?

  Oh, okay.

• 1:17:39Speaker 02

  Like, she's got a lot of pain. Women who come in and complain a lot, kind of vague, libido, go have some wine, you'll be okay.

• 1:17:44Speaker 01

  Yeah.

• 1:17:45Dax Shepard?

  Yeah, yeah, yeah. Oh, my God.

• 1:17:48Speaker 01

  This is wild.

• 1:17:49Speaker 02

  I don't want to scare people, but when it's a no.

• 1:17:52Speaker 01

  We don't know anything.

• 1:17:54Speaker 02

  And your doctor, not their fault, may not know anything.

• 1:17:58Speaker 01

  None of us know, even the smart people who are educated. I do these girls dinners and we just had one recently and we were talking about something random. We were like, why don't we know the answers to any of these questions that keep popping up about our own bodies?

• 1:18:11Speaker 02

  Yeah, because it was never studied. Women in medicine have been treated as small men, so excluded from studies till 94 because of thalidomide and what happened. If there's a chance in hell she might be pregnant, we need to exclude her. And, oh, we probably shouldn't study them anyway because hormones are hard.

• 1:18:25Speaker 01

  Yeah.

• 1:18:26Speaker 02

  They didn't even study female rats in the law.

• 1:18:29Dax Shepard?

  Oh, really?

• 1:18:30Speaker 02

  Because they have estrogen.

• 1:18:31Dax Shepard?

  They too.

• 1:18:32Speaker 02

  So they too will fuck up your study.

• 1:18:34Speaker 01

  It'll be confusing.

• 1:18:35Speaker 02

  The cardiovascular data is awful for women. You go into the ER with a heart attack, if you're a woman, you have a 50% higher chance of dying than if you're a man. Because we have atypical chest pain. So men have the classic clutching their chest, going up their neck, sliding down their arm. You're an actor and they're like, pretend you're having a heart attack. I know exactly what you're going to do. A woman has fatigue, abdominal pain, it's very vague. Because men have the LED, the widow maker, the very large vessels that immediately come out of the aorta to dive into the heart muscle, to feed that heart, that's where the plaques happen. Women, it's way down below that. It's the diffuse microvascular disease.

• 1:19:12Dax Shepard?

  You're always shoving it down.

• 1:19:15Speaker 02

  Oh, another way to speed up your menopause is trauma. So there was a study that looked at women who were sexually abused, who then had kids who went on to be sexually abused. And they went through menopause nine years sooner.

• 1:19:26Speaker 01

  Wow.

• 1:19:27Dax Shepard?

  My mom must have hit menopause at like 35 because she had a hysterectomy. She got the trauma, then the kids with trauma.

• 1:19:33Speaker 01

  Her libido's okay.

• 1:19:35Dax Shepard?

  That somehow is, well, I think it's trauma related, but yeah.

• 1:19:39Speaker 01

  That's true. There's a million factors.

• 1:19:40Dax Shepard?

  Your book's a bestseller, The New Menopause. You have the Mary Claire Wellness Clinic.

• 1:19:46Speaker 02

  It's my little baby clinic in Galveston.

• 1:19:48Dax Shepard?

  You have many millions of followers that are interested in this subject.

• 1:19:52Speaker 01

  You were the person people wanted to come on the most.

• 1:19:54Dax Shepard?

  Yeah, we turned it over to Americans. So who's your favorite menopause expert? And you were voted on. You were elected.

• 1:19:59Speaker 01

  And we were like, who do you want to come on Experts? And your name came up over and over and over and over.

• 1:20:03Speaker 02

  That's, you know, it's a different audience, but is it? It's all women.

• 1:20:06Dax Shepard?

  I don't know. Yeah, we have a lot of, a lot of women.

• 1:20:08Speaker 01

  Just people need to know. People don't know anything.

• 1:20:11Speaker 02

  Well, I appreciate being on here. And actually, my kids now think I'm cool.

• 1:20:14Dax Shepard?

  Oh, wonderful. Two daughters?

• 1:20:16Speaker 02

  Two daughters, 21 and 24.

• 1:20:18Dax Shepard?

  Okay, cool.

• 1:20:19Speaker 01

  Are they on? Oh, that's a question. How early can someone get on these things?

• 1:20:25Speaker 02

  Well, it's a little early for them. So Catherine's in med school. She's tough, man. She has guaranteed me she's not doing OB-GYN. But talk about having someone hold a mirror up to you and keep you in line and double check your facts behind your back.

• 1:20:37Speaker 01

  Yeah.

• 1:20:38Speaker 02

  So I'm like spitting out studies and she is literally looking at it to make sure I am toeing the line. She's talked about it. She's a little freaked out and wants to freeze her eggs now for the highest quality.

• 1:20:48Dax Shepard?

  I think that's the move.

• 1:20:49Speaker 02

  So I did a talk. I was at Reese's event, Hello Sunshine. I was the MC for the first time. That was fun, of a panel. And one of the panelists started this, where you go and you donate your eggs, but you get to keep some.

• 1:21:00Dax Shepard?

  Oh.

• 1:21:00Speaker 02

  So it's a way for the younger women with these juicy gorgeous eggs to afford.

• 1:21:05Dax Shepard?

  Oh, it gets paid for by the donor.

• 1:21:07Speaker 02

  She gets to keep a few for herself.

• 1:21:09Dax Shepard?

  Oh, I like it. A little for you, a little for me.

• 1:21:12Speaker 02

  I'm a terrible host because I forgot the name of the company, but you know.

• 1:21:15Speaker 01

  We'll find it in the fact check.

• 1:21:16Speaker 02

  So cool. And so I went home and told Catherine about it because she's starting to think about that kind of stuff.

• 1:21:21Dax Shepard?

  Yeah.

• 1:21:22Speaker 01

  I love that.

• 1:21:22Dax Shepard?

  I'll be whispering that to my. My girls.

• 1:21:25Speaker 01

  Oh, yeah.

• 1:21:25Dax Shepard?

  Then the time clock.

• 1:21:26Speaker 01

  I have a friend in Telluride who gifted his daughter with egg retrieval. Yes. Again, I didn't even know about this. I didn't even know about egg freezing, really. Like, you kind of hear about it. And then my best friend works at Netflix. They pay for that. And so she was like, oh, I'm getting this done. That's a covered benefit. That's amazing. It's amazing.

• 1:21:45Dax Shepard?

  I mean, it's smart for them, too.

• 1:21:46Speaker 01

  Yeah, it is.

• 1:21:47Dax Shepard?

  They have someone in the prime of their career who doesn't want to necessarily take the time at that moment.

• 1:21:51Speaker 01

  It's so smart. But I was like, why are you doing that? She was like, well, they're paying for it and you might as well. And I was like, interesting. So then that's when I started thinking about it. But my age person did not think about it at all. Did you just do it? I did it at thirty five. Okay. And then thirty six.

• 1:22:08Dax Shepard?

  It's ubiquitous and common knowledge to go like, at thirty five, you're officially in a geriatric.

• 1:22:13Speaker 01

  They act like you fall off a cliff and all that, but it is a steady state. But I did better the second time, weirdly. Amazing. But I wish I had known so much earlier and just done it and felt insurance. My twenty one year old is not on the radar. She's just trying not to be pregnant and is living her best life.

• 1:22:29Dax Shepard?

  I know, you're trying not to get pregnant. It's kind of intuitive.

• 1:22:32Speaker 01

  That girl gets to college. My oldest is by the book, straight A's, pre-med. I'm like, go to the party, have fun, come on. I'm like, so worried about her social life. My second one has rolled with twenty kids her whole life, you know? She gets there, within October, she's like, I'm out of money. Like, she went with her summer money and her graduation money. I'm like, what? I check her account. I'm like, bars, beers, clothes. That's about right. Fast food. I go, you have a meal ticket? She goes, I don't like it. So I'm like, you're out of money. You still have an allowance. I'm not gonna let you starve. But she went and got a job and now she's a nanny. Oh, that's great. The funniest stories ever. It's her taking care of other people's kids. That is so. These Baton Rouge moms, you know? That will definitely not get her to freeze her eggs nannying. I will say that. She's not at all worried. Yeah. To any young people, I'd just really encourage it.

• 1:23:17Dax Shepard?

  I think a lot of people get a ton on your book. It's wonderful, the new menopause book. And please follow you. What's your handle on Instagram?

• 1:23:25Speaker 01

  Dr. Mary Claire. D R M A R Y C L A I R E.

• 1:23:28Dax Shepard?

  You're very cute in your videos. I watched a hundred of them today and they're so cute.

• 1:23:32Speaker 01

  Most no makeup.

• 1:23:33Dax Shepard?

  She's in her.

• 1:23:34Speaker 02

  brought glam with me and I'm like, no one's gonna recognize me. Who's this girl?

• 1:23:39Speaker 01

  Oh my god, that's so great. And you're doing all these fun things. You mentioned Reese. I know you're doing something tomorrow that's very cool. Love it.

• 1:23:45Dax Shepard?

  We're grateful for you.

• 1:23:46Speaker 01

  Thank you.

• 1:23:47Dax Shepard?

  The women I know are so grateful for you.

• 1:23:49Speaker 01

  Big time.

• 1:23:50Dax Shepard?

  Yeah, so everybody, read the book, follow you on Instagram. This was awesome.

• 1:23:54Speaker 01

  Thank you. Thank you so much.

• 1:23:58Speaker 06

  Stay tuned for the fact check. It's where the party's at.

• 1:24:06Speaker 01

  Hi.

• 1:24:06Dax Shepard?

  Hello.

• 1:24:07Speaker 01

  Cute jacket.

• 1:24:09Dax Shepard?

  Well, thank you. Instagram impulse buy.

• 1:24:11Speaker 01

  Really?

• 1:24:12Dax Shepard?

  Got one in this color and one in blue.

• 1:24:14Speaker 01

  From where?

• 1:24:16Dax Shepard?

  Marine layer.

• 1:24:18Speaker 01

  We like Marine layer.

• 1:24:18Dax Shepard?

  Right?

• 1:24:19Speaker 01

  Yeah.

• 1:24:20Dax Shepard?

  That's a place.

• 1:24:21Speaker 01

  Mm hmm.

• 1:24:21Dax Shepard?

  That's a thing.

• 1:24:22Speaker 01

  We are sweatshirts were from Marine layer for a little while.

• 1:24:25Dax Shepard?

  Yeah, I like this quilted thing.

• 1:24:26Speaker 01

  Yeah, quilted is nice.

• 1:24:28Dax Shepard?

  That's what we call. Well, what one's quilted for comfort? The toilet tissue.

• 1:24:34Speaker 01

  Oh, uh.

• 1:24:36Dax Shepard?

  Charmin?

• 1:24:36Speaker 01

  Charmin.

• 1:24:38Dax Shepard?

  The quilted quicker. Well, that's a paper towel, right?

• 1:24:41Speaker 01

  Yeah, that's a paper towel.

• 1:24:42Dax Shepard?

  The quicker picker. This is Mandela effect. We've created.

• 1:24:46Speaker 01

  Wow.

• 1:24:46Dax Shepard?

  People are like, do you think there's a product called Charmin's quilted quicker picker upper?

• 1:24:52Speaker 01

  People would say yes, definitely.

• 1:24:54Dax Shepard?

  Yeah.

• 1:24:55Speaker 01

  Cause it's Bounty.

• 1:24:56Dax Shepard?

  Bounty, the quicker picker upper.

• 1:24:58Speaker 01

  But Bounty doesn't have the same alliteration as Charmin and quicker.

• 1:25:03Dax Shepard?

  Charmin quicker picker upper. How's your morning?

• 1:25:06Speaker 01

  My morning is, was good. Um, every two weeks I get a flower delivery on Friday.

• 1:25:14Dax Shepard?

  Oh.

• 1:25:14Speaker 01

  From Flamingo Estate.

• 1:25:16Dax Shepard?

  Uh, okay.

• 1:25:17Speaker 01

  And it's really exciting.

• 1:25:19Dax Shepard?

  It is. You've signed up for a bi-weekly annual Sitch?

• 1:25:23Speaker 01

  Yeah.

• 1:25:24Dax Shepard?

  Do they spice it up? Is it a different bouquet every time?

• 1:25:27Speaker 01

  Yes, so you don't know what you're gonna get.

• 1:25:29Dax Shepard?

  So you have anticipation, what will it look like?

• 1:25:31Speaker 01

  Yes. And it's always from a cool, like, farm.

• 1:25:36Dax Shepard?

  They find a guy who just has one flower bed in his backyard.

• 1:25:39Speaker 01

  Very limited a dish.

• 1:25:41Dax Shepard?

  Yeah, extra, extra small micro business.

• 1:25:44Speaker 01

  Today it was ranunculas. And they're orange.

• 1:25:47Dax Shepard?

  That's the name of something.

• 1:25:48Speaker 01

  Flower.

• 1:25:49Dax Shepard?

  Ranunculus?

• 1:25:50Speaker 01

  Mm-hmm. And they're orange and they're so pretty. I did lose a little track of time because I was cutting the ends and I was, you know, cleaning up the stems.

• 1:26:00Dax Shepard?

  Yeah.

• 1:26:01Speaker 01

  And, uh...

• 1:26:03Dax Shepard?

  He's straight. We just learned a fascinating fact from somebody. It's a, a rule in sketch comedy.

• 1:26:10Speaker 01

  Uh-huh.

• 1:26:11Dax Shepard?

  It's not our rule.

• 1:26:12Speaker 01

  Yeah.

• 1:26:13Dax Shepard?

  But it's if, if a man comes in to pick a woman up on a date in a sketch.

• 1:26:17Speaker 01

  Yes.

• 1:26:17Dax Shepard?

  Have her, have him bring chocolates, not flowers. So if you bring flowers, the audience starts getting very distracted.

• 1:26:24Speaker 01

  Well, they gotta put them in a vase.

• 1:26:25Dax Shepard?

  Oh, my God. She's gotta get those in a vase, gotta give them in water, and you can't even pay attention.

• 1:26:28Speaker 01

  I know. It's so smart. These delivery services.

• 1:26:32Dax Shepard?

  Yeah.

• 1:26:33Speaker 01

  They can really brighten your day. I would recommend that for a gift.

• 1:26:38Dax Shepard?

  Yeah, that sounds like a good gift.

• 1:26:39Speaker 01

  Yeah.

• 1:26:40Dax Shepard?

  Yeah.

• 1:26:41Speaker 01

  Unfortunately, I did try to gift this exact thing today.

• 1:26:45Dax Shepard?

  Oh, just today?

• 1:26:46Speaker 01

  Today's Callie's birthday.

• 1:26:48Dax Shepard?

  Oh, happy birthday, Callie.

• 1:26:49Speaker 01

  Happy birthday, Callie. And I was gonna get her this weekly bloom bundle.

• 1:26:54Dax Shepard?

  Right. The gift that keeps on giving.

• 1:26:57Speaker 01

  Yeah, but, um, it's sold out.

• 1:26:58Dax Shepard?

  Oh, right. Alright.

• 1:27:00Speaker 01

  So I can't.

• 1:27:01Dax Shepard?

  That's the problem when you go with these micro growers that only have one flower bed in their backyard.

• 1:27:05Speaker 01

  Yeah, they run out.

• 1:27:06Dax Shepard?

  Yeah. It's a really great idea, but then in practice.

• 1:27:09Speaker 01

  It's part of the fun. It's part of the limited edition element.

• 1:27:12Dax Shepard?

  Okay, so I don't wanna say this, and I just really can't control myself to not say it.

• 1:27:18Speaker 01

  Okay.

• 1:27:19Dax Shepard?

  Ah, cuz I gotta get out of the habit of addressing commenters.

• 1:27:24Speaker 01

  Yeah, I would prefer not because I, that's why I don't look at them.

• 1:27:28Dax Shepard?

  Yeah, yeah. But I just wanna make this simple point because, um,

• 1:27:34Dax Shepard?

  people, you know, they'll, Jonathan Haidt will be on. So people will be like, you know, he's so anti-technology and he doesn't know and it brought people together, blah, blah. Great, great, great, great. Um, but I was just thinking, you know, what I like about our show is we have Reid Hoffman on. He's a techno-optimist.

• 1:27:52Speaker 01

  Yeah.

• 1:27:52Dax Shepard?

  You get to hear the full sales pitch for why technology's great. And then we have Jonathan Hyde on and you get to hear the full sales pitch on why it's bad.

• 1:28:02Speaker 01

  Mm-hmm.

• 1:28:03Dax Shepard?

  And instead of being like angry at these guests who have a different point of view, I would really wish people would be grateful that they got to hear the counterpoint to what they believe. I mean, that's, that's what I so enjoy about the show.

• 1:28:16Speaker 01

  Yeah.

• 1:28:17Dax Shepard?

  And guess what? I don't know which one I think.

• 1:28:19Speaker 01

  Yeah.

• 1:28:20Dax Shepard?

  It's like I half believe what Reed's saying and I half believe what Jonathan's saying. I don't agree with Jonathan.

• 1:28:25Speaker 01

  Yeah.

• 1:28:26Dax Shepard?

  But I'm so grateful to hear a very smart person.

• 1:28:30Speaker 01

  We gotta hear.

• 1:28:31Dax Shepard?

  Tell me the opposite point of view that I have. And I just wish people could click into like, yeah, that's a gift to hear someone with a different point of view tell you what the opposite side thinks. It's not shut that person down and get them out of here and I don't like what they're saying.

• 1:28:45Speaker 01

  Yeah, I agree.

• 1:28:46Dax Shepard?

  Now, if we only had one sides of all these debates, I think that would be a pretty reasonable criticism.

• 1:28:51Speaker 01

  Yep, I agree.

• 1:28:53Dax Shepard?

  Yeah. That was burning a hole in my... Go ahead.

• 1:28:59Speaker 01

  You know what I'm gonna say?

• 1:29:00Dax Shepard?

  Yeah, I wanna hear it.

• 1:29:01Speaker 01

  It might sound disrespectful to the audience, what I'm about to say.

• 1:29:05Dax Shepard?

  Yeah.

• 1:29:06Speaker 01

  And I don't mean that. I love our audience so much. I love the Arm Cherries. I'm so grateful that people listen to us, but I don't care.

• 1:29:18Dax Shepard?

  Right, that's healthy.

• 1:29:20Speaker 01

  If they don't like an episode, I also personally, I don't believe it. I don't believe that what you're reading is indicative of what people think. And that, it bums me out that you get, you get like.

• 1:29:36Dax Shepard?

  Yeah.

• 1:29:37Speaker 01

  Ensnared.

• 1:29:38Dax Shepard?

  Well, some woman told me, I need to apologize for saying young men are disenfranchised. And I said, apologize to who? Like, who am I apologizing to?

• 1:29:47Speaker 01

  I know, but this is the... Like...

• 1:29:51Dax Shepard?

  I know, I know, it's really tricky. Now, I'd say the good news is like, I'm not gonna change at all what I'm doing.

• 1:30:00Speaker 01

  Yeah.

• 1:30:00Dax Shepard?

  So it's not like I'm subject to altering how I'm going to invite Jonathan on and invite Reid Hoffman on. This is gonna have no impact on how I do the show.

• 1:30:11Dax Shepard?

  I think I have a, I do have maybe an arrogant, delusional belief I could explain the value of hearing this and people might lock into it and go like, oh, you know what? You know, I'm gonna stop blasting everyone I disagree with. It's okay to disagree with people. You don't have to hate them.

• 1:30:28Speaker 01

  Yeah.

• 1:30:29Dax Shepard?

  Jonathan's a great guy. I totally disagree with a lot of what he's saying, you know?

• 1:30:32Speaker 01

  But...

• 1:30:33Dax Shepard?

  So I have this stupid belief I can encourage people to embrace this. And that's, that's my own delusion.

• 1:30:43Speaker 01

  It is, it's a delusion, but you're only seeing like one piece of the whole puzzle.

• 1:30:48Dax Shepard?

  You're so right.

• 1:30:49Speaker 01

  You don't know who you're even talking to.

• 1:30:52Dax Shepard?

  No, you're absolutely right. And I do think about that. So like naturally, you're in a nice debate about men and women.

• 1:30:57Speaker 01

  Obviously.

• 1:30:58Dax Shepard?

  Yeah, yeah, it was very polarizing. I expected that, and that's totally fine.

• 1:31:01Speaker 01

  Yeah.

• 1:31:01Dax Shepard?

  And I get it. I get it from both. I totally understand from both sides.

• 1:31:07Dax Shepard?

  But yeah, it's like 50 people.

• 1:31:13Dax Shepard?

  You know, on either side, out of, out of millions of people.

• 1:31:16Speaker 01

  It could literally be one person. This is what I'm saying.

• 1:31:19Dax Shepard?

  Oh, that's got 30.

• 1:31:20Speaker 01

  Yes, this is my point. Like, to get wrapped up in it, your strongest trigger is getting taken advantage of. But when you react like this.

• 1:31:30Dax Shepard?

  Yeah.

• 1:31:31Speaker 01

  I think you've been taken advantage of.

• 1:31:34Dax Shepard?

  Cause I got wound up about it?

• 1:31:36Speaker 01

  And you don't even know.

• 1:31:38Dax Shepard?

  But, but what's, what's perfect about it is...

• 1:31:43Dax Shepard?

  It is a facet of this thing I obsess about without the comments.

• 1:31:48Speaker 01

  Yeah.

• 1:31:49Dax Shepard?

  Right? So I, your big concern is women's reproductive rights, which is, makes total sense.

• 1:31:55Speaker 01

  It's a concern, yeah.

• 1:31:56Dax Shepard?

  Yeah, but it's like a very paramount concern, and rightly so.

• 1:31:58Speaker 01

  Yeah.

• 1:31:59Dax Shepard?

  And you'll think about that a lot, you know?

• 1:32:01Speaker 01

  If it feels threatened. I don't think about it on a regular basis. But if it's, if it's threatened, yes, of course.

• 1:32:07Dax Shepard?

  And I'm regularly so scared about the inability for people to listen to one another.

• 1:32:14Speaker 01

  Yeah.

• 1:32:15Dax Shepard?

  I'd like, think about it too much. Uh, and it really frustrates me and it scares me. I'm scared of the future where there's two camps on the planet and they don't talk to each other.

• 1:32:27Speaker 01

  Can, can we deep dive?

• 1:32:29Dax Shepard?

  Yeah.

• 1:32:30Speaker 01

  Why is that so scary to you? Like, of course it sounds, it sounds, it's bad, right? Like, I think it's bad too. I'm like, this is a huge problem. But it does, I don't have this reaction that you have, and, and I wonder, I mean, obviously, we know that if anything's like causing that much of a reaction, it's something else. It's something about us, or our past, or our, like, the fear is about us.

• 1:32:55Dax Shepard?

  Yeah, I guess probably dysfunction. I grew up in dysfunction. I grew up in two parents that hated each other till they got divorced, like dysfunction.

• 1:33:03Speaker 01

  Yeah.

• 1:33:03Dax Shepard?

  Um, not rising to one's best self to navigate these things. We have gotten embarrassingly dysfunctional.

• 1:33:12Speaker 01

  Yeah.

• 1:33:13Dax Shepard?

  And I see the total root of the dysfunction is us against them.

• 1:33:17Speaker 01

  Yeah.

• 1:33:18Dax Shepard?

  And, and I see that as such a toxic quality. And I have children that are entering a world and I care about the world for them. So, yeah, it really bothers me really deeply. Cause my childhood was plagued by dysfunction and two people not communicating, and it's winner takes all. And I hate that situation.

• 1:33:39Speaker 01

  Yeah.

• 1:33:40Dax Shepard?

  I don't, it wasn't compromise. It wasn't working together to, it was, you know, as I always say, the paradigm everyone needs to wrap their head around is, we're married. The left and the right are married. We all live in the same country. And so we have a Gottman approach through this marriage, or we have a fucking, um, what's the famous War of the Roses version of this marriage? And I lived through the War of the Roses versions of the marriages. And so for me, I didn't want that in my life when I grew up. And then when I feel ensconced in a whole society that's way. And then I put out a show and I see people saying, you know, heights of conservative, whatever. Like they've just written him off. I think I've said this before, but it's like one time we went out to, and this is a ding ding ding.

• 1:34:25Dax Shepard?

  It came up on an episode yesterday we recorded, but Ted Olson, you know, this, um, he was the most successful Supreme Court. He argued in front of the Supreme Court more times and more successfully than anyone else. And he, very confusingly, from my perspective, both won Citizens United, which is a very right cause, giving businesses personhood. But he also defeated DOMA. And he believed in both of those deeply. We had a dinner with him and there was three of us liberals and then him. And we started kind of hitting them, him with all of our points of view. And I, I said, hold on a second.

• 1:35:07Dax Shepard?

  We have an opportunity to be with one of the smartest people in the world who has a different point, point of view from us.

• 1:35:13Speaker 01

  Yeah.

• 1:35:13Dax Shepard?

  What an opportunity to hear the best version of this point of view that I disagree with.

• 1:35:17Speaker 01

  If you want to look at it in a way that's selfish, it's good to hear the other person's point of view so that you know how to combat it.

• 1:35:26Dax Shepard?

  Well, you'll find if you combat it, some of their pushback will make some of your points fall flat.

• 1:35:32Speaker 01

  Mm hmm.

• 1:35:33Dax Shepard?

  And those are points you need to rethink.

• 1:35:35Speaker 01

  Yeah.

• 1:35:35Dax Shepard?

  Or jettison or figure out another way. But it's as much as you can learn from them, you also learn the weaknesses of your own point of view.

• 1:35:43Speaker 01

  Yeah.

• 1:35:43Dax Shepard?

  Which I like. I'm arguing with people all the time and I get to one and, and I'm like, mm. That's not a good point. I gotta get rid of that and that can't really be a part of my.

• 1:35:52Speaker 01

  I also think you are in a program that requires self-reflection, growth, checking yourself. And so I do think you're extra.

• 1:36:08Dax Shepard?

  I'm extra.

• 1:36:09Speaker 01

  Hurt. No, no, no, no. It, it bothers you more when you see people who aren't doing that or don't care to do it.

• 1:36:16Dax Shepard?

  Yeah.

• 1:36:16Speaker 01

  But there's just a lot of people who don't and. I I guess I respect that that bothers you. To me, I think if that bothered me, I would die. Like, that'd be too much. Like, I can't take on that people don't want to change. That's not my job to make people want to change. And, you know, like, I can only do me.

• 1:36:41Dax Shepard?

  I just wish everyone thought I have, I'm holding all my beliefs in my hand right now. And they're certainly not the best version of my beliefs. They're gonna evolve. Hopefully, that's what they're supposed to do.

• 1:36:54Speaker 01

  Yes.

• 1:36:54Dax Shepard?

  So you don't have the complete finished version of your beliefs and your points of view in your hand.

• 1:37:01Speaker 01

  People really have a huge problem with wishy-washiness.

• 1:37:07Dax Shepard?

  Right.

• 1:37:07Speaker 01

  I've heard that a lot, like.

• 1:37:09Dax Shepard?

  Flip-flopping.

• 1:37:10Speaker 01

  Flip-flopping and a lot about politi- they say that a lot about politicians. That, oh, they said this and now they're saying this.

• 1:37:17Dax Shepard?

  Yeah, if you catch them having changed their opinion.

• 1:37:19Speaker 01

  Right. I find that so strange.

• 1:37:22Dax Shepard?

  Yeah, it's really disappointing.

• 1:37:23Speaker 01

  Why can't, they should be changing their opinion. It's so weird to me. I, it's so much worse to me that they would have said something so long ago, felt stuck in saying that, and now they just have to believe that forever. That's a big problem. But both sides hate that.

• 1:37:42Dax Shepard?

  Yes.

• 1:37:43Speaker 01

  Which I, I really do not understand.

• 1:37:47Dax Shepard?

  Yeah, yeah, yeah.

• 1:37:48Speaker 01

  It feels very backwards, but, but again, like, I can't get that riled up about other people feeling that way, because I can't change them.

• 1:37:57Dax Shepard?

  But I think you're right. I think, I think this whole thing feels like dysfunctional family to me.

• 1:38:01Speaker 01

  Yeah.

• 1:38:02Dax Shepard?

  And I hate it.

• 1:38:03Speaker 01

  Yeah.

• 1:38:04Dax Shepard?

  And I want everyone to be a bigger version of themselves, myself included.

• 1:38:08Speaker 01

  Yeah.

• 1:38:09Dax Shepard?

  And it's disheartening to live in a dysfunctional family, which is this country.

• 1:38:13Speaker 01

  Yeah, yeah, yeah, yeah. Do you think that it's because when your dysfunctional family ended in, I mean, it ended in pain for you specifically and pain for your mom and pain.

• 1:38:25Dax Shepard?

  All involved.

• 1:38:27Speaker 01

  Pain for all involved.

• 1:38:28Dax Shepard?

  The stepdads were miserable afterwards, their children were miserable.

• 1:38:32Speaker 01

  Because I think ever, not everyone, I'm sure, I'm sure some people are spared this, but there's a fair amount of dysfunction that happens in a lot of families. And I, I think I also grew up with

• 1:38:44Dax Shepard?

  Some dysfunction.

• 1:38:45Speaker 01

  Dysfunction amongst the adults. But they didn't split up over it. Obviously, for me, having grown up and seeing things I didn't like, I think, well, I can't do that. Like, for my life, that I don't want to replicate that. But I also am kind of like, eh, like, it's sort of worked out and it's kind of fine. And I don't, I don't know.

• 1:39:09Dax Shepard?

  If I were you, I might want to challenge me by saying, maybe everyone's happy with this. Which is also possible, you know? Maybe right now, the right's super pumped and they're pigs and shit. And the left is vindicated and validated and feeling even more self-righteous. Maybe, maybe everyone's getting exactly what they want out of this. And so that's an interesting thing for me to consider. Like, you're trying to fix something that people will like. As much as

• 1:39:37Speaker 01

  That's true.

• 1:39:38Dax Shepard?

  They might not want to say they like this, maybe they do.

• 1:39:42Speaker 01

  Yeah.

• 1:39:43Dax Shepard?

  Maybe the person that's like, Jonathan Haidt's a monster, felt awesome.

• 1:39:47Speaker 01

  Yeah.

• 1:39:47Dax Shepard?

  And told nine of their friends they did that, and they love it.

• 1:39:51Speaker 01

  Yeah.

• 1:39:52Dax Shepard?

  It, it's hard for me to

• 1:39:53Speaker 01

  I also think people, I mean, again, the generous offering is that they want their opinion

• 1:40:00Dax Shepard?

  To be heard.

• 1:40:01Speaker 01

  Heard and seen.

• 1:40:02Dax Shepard?

  Yeah.

• 1:40:03Speaker 01

  And they want to feel, people just want to feel like a person

• 1:40:06Dax Shepard?

  Yeah.

• 1:40:06Speaker 01

  Who's, who's, who exists. I mean, we all just want proof that we exist.

• 1:40:10Dax Shepard?

  Yeah, yeah, yeah.

• 1:40:11Speaker 01

  And that is a version of it.

• 1:40:13Dax Shepard?

  I will watch them exist and validate them without that approach. They don't need that approach.

• 1:40:20Speaker 01

  Yeah.

• 1:40:21Dax Shepard?

  You know? But I know, I sound like, and, and that's why I said I didn't want to say anything. I, if I were not, it's really just, hey, shut the fuck up about the counters. Just stop reading. I fully get that criticism, and it's, it's true. It is true. But yes, it is this, it is a perfect little encapsulation of this other thing I spend too much time obsessing about. And if I were really working my AA program, I would just accept this.

• 1:40:49Speaker 01

  Yeah.

• 1:40:51Dax Shepard?

  I would accept.

• 1:40:54Dax Shepard?

  But that's how it is.

• 1:40:55Speaker 01

  There's nothing you can do.

• 1:40:56Dax Shepard?

  And if someone's attracted to my approach, that'll be appealing to them.

• 1:41:00Speaker 01

  Exactly.

• 1:41:01Dax Shepard?

  More so than me saying someone should have this approach.

• 1:41:05Speaker 01

  Yes, I agree.

• 1:41:06Dax Shepard?

  And I should just have faith in that.

• 1:41:07Speaker 01

  Yeah.

• 1:41:10Dax Shepard?

  Yeah.

• 1:41:10Speaker 01

  Well, it's funny that you brought up hating because on my ride here, I was listening to a podcast and they were talking about Meghan Markle. And they were, they weren't saying that they hated her, but they were saying like, there is this like vitriol around her. And there is, and it was,

• 1:41:29Dax Shepard?

  Oh, yeah.

• 1:41:29Speaker 01

  It was interesting because it did make me think.

• 1:41:33Dax Shepard?

  People really dined out.

• 1:41:35Speaker 01

  They like.

• 1:41:36Dax Shepard?

  On her show.

• 1:41:37Speaker 01

  Oh, yeah. But people like really hate strangers. Like it, to me, that is so interesting. And then I was thinking, I was like, who do I hate?

• 1:41:53Dax Shepard?

  Well, I think we're hardwired to do it right. We're hardwired to extremely punish someone who has values and morals outside of our in-group.

• 1:42:02Speaker 01

  Mm hmm.

• 1:42:03Dax Shepard?

  And make a, make a emblem of them, right? So I do think when someone represents some, you know.

• 1:42:11Speaker 01

  Yeah.

• 1:42:11Dax Shepard?

  I don't even know how they articulate why they hate her, but.

• 1:42:14Speaker 01

  Yeah.

• 1:42:14Dax Shepard?

  She's interesting, though. I have a story about this, but I, I want you to expound more.

• 1:42:19Speaker 01

  No, I was just gonna ask if you hated anyone.

• 1:42:21Dax Shepard?

  When they first, when, when you were gonna ask if I hate her?

• 1:42:24Speaker 01

  Hated anyone.

• 1:42:25Dax Shepard?

  Oh.

• 1:42:25Speaker 01

  Cause I was like, I don't, when I really think about it, I, I mean, I don't hate any strangers and even people in my life who I like, who, who I, I do have like friction or cause stress.

• 1:42:37Dax Shepard?

  Yeah.

• 1:42:38Speaker 01

  I don't hate them. I don't think I hate anyone, actually.

• 1:42:42Dax Shepard?

  I hate a couple people in public. I hate Tucker Carlson.

• 1:42:48Speaker 01

  Right.

• 1:42:49Dax Shepard?

  I just think he's a smug bully. I don't even really give a fuck about his politics.

• 1:42:54Speaker 01

  Right.

• 1:42:54Dax Shepard?

  Is this a smug bulliness about it?

• 1:42:56Speaker 01

  Yeah.

• 1:42:57Dax Shepard?

  Is there anyone else?

• 1:43:00Dax Shepard?

  Like, I'm trying to imagine, and if you're saying you hate them, you have to take it to the, like, literally, you hate them to the degree if you saw them in person, you'd go, you're a fucking asshole.

• 1:43:08Speaker 01

  Yeah, yeah.

• 1:43:09Dax Shepard?

  And so I think the only person I, I can think of him, that if I met him in real life, I'd go, you're a fucking piece of shit.

• 1:43:15Speaker 01

  Right.

• 1:43:15Dax Shepard?

  Would be him.

• 1:43:17Speaker 01

  Yeah, I feel like, I remember one time, years and years and years ago, probably when I was babysitting, and we were playing games and stuff, to Tan, um, I think, I said something like, ugh, I hate this. And you said, you say, you say hate a lot.

• 1:43:33Dax Shepard?

  Uh huh, we've talked about this before.

• 1:43:35Speaker 01

  Well, it's been a minute, probably. I was, was saying it just ra, as a random word, really.

• 1:43:41Dax Shepard?

  As an adjective.

• 1:43:42Speaker 01

  Yeah, it didn't, it didn't carry the weight that it was carrying for you, but then I was like, yeah, that is a big word to be sort of throwing around. And I think I don't really say it as much.

• 1:43:54Dax Shepard?

  No, not at all.

• 1:43:55Speaker 01

  Yeah.

• 1:43:55Dax Shepard?

  Yeah, I think I used to say it too. I think that's one of the aspects of my

• 1:44:01Dax Shepard?

  point of view shifting of moving to California that I liked a lot.

• 1:44:04Speaker 01

  Yeah.

• 1:44:05Dax Shepard?

  I think when I was in Michigan, I had a very long list of enemies, you know, people we hated.

• 1:44:10Speaker 01

  Right.

• 1:44:10Dax Shepard?

  Lot of, lot of people we were against.

• 1:44:13Speaker 01

  Interesting. Uh, wait, back to the question.

• 1:44:15Dax Shepard?

  Okay, back to Meghan Markle.

• 1:44:16Speaker 01

  Yeah.

• 1:44:17Dax Shepard?

  So, I saw, I didn't even see it, but I saw some of the Oprah thing. Their very first interview, right? And a friend of mine from England,

• 1:44:30Dax Shepard?

  like, let it rip on her, like, can you fucking believe this, blah, blah, blah, like, just outrage, right? And so, and this friend, I really respect.

• 1:44:39Speaker 01

  Mm-hmm.

• 1:44:39Dax Shepard?

  Their intelligence, their empathy, the whole thing. This, this person's a very admirable person.

• 1:44:46Speaker 01

  Yes, I agree.

• 1:44:47Dax Shepard?

  And so I had to really force myself to imagine, well, how could he have this strong of a reaction?

• 1:44:55Speaker 01

  Yeah.

• 1:44:56Dax Shepard?

  And the scenario I painted in my head was, and I think I've already told you this.

• 1:45:00Speaker 01

  Yeah.

• 1:45:01Dax Shepard?

  When Obama was in office, a Russian kid go, comes to the DC, falls in love with Malia, takes her to Moscow, he and her go on their biggest television show, and shit all over Obama, and accuse him of being racist, and just trash the country under the guise of this Ameri, or this Russian dude, and I was like, Yeah, I would fucking hate that guy. I would absolutely hate him. And there's a layer of patriotism that has to be acknowledged.

• 1:45:35Speaker 01

  Yeah.

• 1:45:36Dax Shepard?

  That we all carry. And if I do think of that scenario, I just know I would hate the Russian guy who took Malia to Russia for the rest of her life and they go on TV all the time and shit on America. I would hate that guy. I don't understand the Americans who hate her so much, but.

• 1:45:50Speaker 01

  Right.

• 1:45:50Dax Shepard?

  I do understand the British backlash. They took the prize son. They all liked him more than the other one.

• 1:45:58Speaker 01

  Right. But he taking is so like, like he didn't have a mind of his own.

• 1:46:06Dax Shepard?

  Oh, I know.

• 1:46:06Speaker 01

  I mean, that's so.

• 1:46:07Dax Shepard?

  But then I'd be saying Malia doesn't have a mind of her own. But if Malia left with this Russian dude.

• 1:46:12Speaker 01

  Made the choice.

• 1:46:13Dax Shepard?

  Never to return.

• 1:46:13Speaker 01

  I mean, yeah.

• 1:46:15Dax Shepard?

  And then went on Russian television and shit on America.

• 1:46:17Speaker 01

  But I mean.

• 1:46:18Dax Shepard?

  I'd hate the whole scenario.

• 1:46:19Speaker 01

  I guess, I don't know. I don't know that I would. I think I would be like, yikes. She like.

• 1:46:25Dax Shepard?

  No, but him, you gotta evaluate him. You gotta evaluate the dude.

• 1:46:28Speaker 01

  That's the part I actually can't relate to. Like for me, Harry made a choice about his life and his family.

• 1:46:38Dax Shepard?

  Yeah.

• 1:46:38Speaker 01

  And I don't see it as this woman like took him away. I.

• 1:46:43Dax Shepard?

  A siren who called him to the rocks of America.

• 1:46:46Speaker 01

  Exactly. I see it as, as a man who made a choice based on a lot of things, including the death of his mother.

• 1:46:54Dax Shepard?

  Yeah.

• 1:46:54Speaker 01

  And so I don't have a problem with him being like, there's a lot of fucked up shit over there and I had to leave it.

• 1:47:02Dax Shepard?

  But I think we have, we have clarity on that one because we don't have the in-group patriotic bias.

• 1:47:10Speaker 01

  True. But I think if Malia left and married this Russian person.

• 1:47:17Dax Shepard?

  Yeah.

• 1:47:17Speaker 01

  And then they went on Russian TV and they were talking about it and she was saying like, look. The White House was horrible and the media in America was horrible. And this is what they did and this is what happened.

• 1:47:32Dax Shepard?

  But really quick, if that, so I'm not talking, I'm not talking about Harry and Meghan.

• 1:47:39Speaker 01

  Right.

• 1:47:39Dax Shepard?

  I'm talking about this theoretical Malia and this guy.

• 1:47:43Speaker 01

  Yeah, I know. Yeah, yeah.

• 1:47:44Dax Shepard?

  I would go, oh, you hate the media? You're on the biggest fucking show in Russia. You can't hate the media and then willingly participate in their biggest media outlet.

• 1:47:55Speaker 01

  Well, they hate the media.

• 1:47:57Dax Shepard?

  You're such a fucking hypocrite.

• 1:47:57Speaker 01

  Well, no.

• 1:47:58Dax Shepard?

  That's what I would say to this imaginary people who's on the biggest media outlet in Russia complaining about media attention.

• 1:48:06Speaker 01

  But I'm saying they speak specifically about British media.

• 1:48:10Dax Shepard?

  Tabloids.

• 1:48:11Speaker 01

  Yes, and we have had enough people on who have corroborated that the British.

• 1:48:16Dax Shepard?

  I want to be clear. I understand why. I am not, none of this opinion is about those two.

• 1:48:21Speaker 01

  No, I know, I know.

• 1:48:22Dax Shepard?

  But I do have strong knee jerks about this theoretical defecting of Malia to Russia. And being on TV complaining about being on TV.

• 1:48:31Speaker 01

  I guess I don't. I just don't. Like, I think if they were, if they were like, because we have to make it equal. I don't, because I don't, I mean, look, we have obviously media issues, but it's not the same.

• 1:48:44Dax Shepard?

  Well, let's just say it's, the scenario I painted is actually less impactful than the one that really happened. Because Malia was never going to inherit the presidency.

• 1:48:54Speaker 01

  Yeah.

• 1:48:55Dax Shepard?

  Harry could inherit the kingship.

• 1:48:57Speaker 01

  No.

• 1:48:58Dax Shepard?

  Yeah, his brother would have to die.

• 1:48:59Speaker 01

  No, then it goes to the son, William's son. Harry can't be the king.

• 1:49:04Dax Shepard?

  Okay, but the son dies. He could be the king.

• 1:49:07Speaker 01

  Okay, it's a, it's.

• 1:49:08Dax Shepard?

  There's a long list?

• 1:49:09Speaker 01

  Yeah.

• 1:49:10Dax Shepard?

  Okay. Would they give the kingship to a seven-year-old? I don't think.

• 1:49:14Speaker 01

  Yeah, like Joffrey.

• 1:49:15Dax Shepard?

  I'll do a little digging on this.

• 1:49:16Speaker 01

  Joffrey.

• 1:49:18Dax Shepard?

  There's no inheritance in the presidency, so the scenario I'm painting is even less impactful.

• 1:49:22Speaker 01

  I agree. I mean, that's why we don't, it's like hard to make this equivalency, but, but also like, why should he possibly stay in this thing that he sees as fucked up?

• 1:49:36Dax Shepard?

  Oh, yeah, yeah.

• 1:49:36Speaker 01

  Like, I, I, I don't know. I just commend.

• 1:49:40Dax Shepard?

  But an outsider came in and then the beloved person left.

• 1:49:46Dax Shepard?

  And that's easy correlation to get upset about.

• 1:49:50Speaker 01

  I mean, look, I, I.

• 1:49:51Dax Shepard?

  Like, maybe Harry would have defected on his own without a wife that was American. That's possible.

• 1:49:58Speaker 01

  Yeah.

• 1:49:59Dax Shepard?

  But we don't really know, because it didn't happen that way.

• 1:50:02Speaker 01

  But we also, we also, you know, more than anyone, that like, if someone, if you're in love with someone and people around you are not treating that person well.

• 1:50:16Dax Shepard?

  Yeah, you gotta protect them.

• 1:50:17Speaker 01

  You're gonna protect them and you're gonna say, ultimately say, fuck this. Like, this is a problem. We're gonna go now.

• 1:50:24Dax Shepard?

  Yes, but, um, yeah, so I already agree. I understand why he left and I would have left.

• 1:50:29Speaker 01

  Yeah.

• 1:50:31Dax Shepard?

  A thousand percent.

• 1:50:32Speaker 01

  You're just saying you understand why people don't like it.

• 1:50:34Dax Shepard?

  I totally understand why people don't like her that are English.

• 1:50:37Speaker 01

  Right.

• 1:50:38Dax Shepard?

  I don't, it's not hard for me to understand.

• 1:50:39Speaker 01

  It's not hard for me to understand. I do wish they would take a second look at it. Like, it doesn't affect them. It really doesn't.

• 1:50:46Dax Shepard?

  Well, they lost their cutest royal family member.

• 1:50:48Speaker 01

  Get over it. Like, I mean.

• 1:50:51Dax Shepard?

  And I, I hate royalty.

• 1:50:53Speaker 01

  Yeah.

• 1:50:54Dax Shepard?

  But I understand something you value getting, quote, taken from you. Oh, no, you say taken. I understand losing something you value. So it's like, they do value that. I, I, I can't understand it.

• 1:51:08Speaker 01

  No, sure.

• 1:51:08Dax Shepard?

  The notion of like.

• 1:51:09Speaker 01

  I actually can understand that weirdly.

• 1:51:12Dax Shepard?

  Right, you like royalty.

• 1:51:13Speaker 01

  I can buy into the royal family and thinking that's cool and that's a part of your history. I'm like, I, I do get that. Even that, like, I, even feeling that way, I don't think I would feel personally injured by one of them going to live their life. I think differently. I think people don't like her because they think she's fake. People think she's fake. People think, um, she's mean, but she pretends to be nice. Like, there's a lot of, and then with the new show, they're like, what is this? She's just moving pretzels from one bag to another bag. This is stupid.

• 1:51:53Dax Shepard?

  I don't know that reference, but I'm laughing right now because the description was really funny. I just, Meghan Markle, I didn't see that, so I'm not laughing at.

• 1:51:59Speaker 01

  I, you know what? I'm not laughing either, because it's clear that.

• 1:52:07Speaker 01

  She does like it. She, it's not, I don't think it's fake. It may seem ridiculous to someone who's like, living a life, going to work and having to come home and then turning that on.

• 1:52:22Dax Shepard?

  Paycheck to paycheck.

• 1:52:23Speaker 01

  Exactly. Turning it on and seeing that her day is spent moving pretzels from one bag into another bag.

• 1:52:30Dax Shepard?

  Well, now I really want to watch this episode.

• 1:52:32Speaker 01

  She, it's like, that's a very, uh,

• 1:52:35Dax Shepard?

  Simple.

• 1:52:37Speaker 01

  Simple explanation. She's having a guest over and she's gonna put together this like cute little tray by the bed for the guest. That has like flowers and stuff. And then she like buys these pretzels, I think with peanut butter. They look delicious.

• 1:52:52Dax Shepard?

  Okay.

• 1:52:52Speaker 01

  And she put them in another, she took them out of the bag. She put them in another cute little bag and put like,

• 1:52:58Dax Shepard?

  So you've watched it.

• 1:52:59Speaker 01

  Yeah, oh yeah.

• 1:53:00Dax Shepard?

  Yeah, yeah.

• 1:53:00Speaker 01

  Yeah. And put them like, you know, wrote, peanut butter pretzels and like tied it up, made it cute.

• 1:53:07Dax Shepard?

  Cute, yeah.

• 1:53:07Speaker 01

  She made it cute.

• 1:53:08Dax Shepard?

  Yeah.

• 1:53:08Speaker 01

  And I think that does bring her joy.

• 1:53:13Dax Shepard?

  Yeah, sure.

• 1:53:14Speaker 01

  I don't think that's a lie.

• 1:53:16Dax Shepard?

  Right.

• 1:53:16Speaker 01

  And, and so it's kind of what we talked about before with the, with the, you know, podcasts, the like men's podcasts and stuff.

• 1:53:24Dax Shepard?

  Yeah.

• 1:53:24Speaker 01

  If you don't like it, just don't watch it.

• 1:53:27Dax Shepard?

  Yeah.

• 1:53:27Speaker 01

  If you think this is sort of offensive because your life, it's not reflective of your life.

• 1:53:34Speaker 03

  Stay tuned for more Armchair Expert, if you dare.

• 1:53:47Dax Shepard?

  I bet the core thing that people are triggered by is like, why does this woman get a show about the things she likes?

• 1:53:57Speaker 01

  Yes.

• 1:53:58Dax Shepard?

  Why don't I have, like, why would, I actually build birdhouses.

• 1:54:02Speaker 01

  Right, right, right, right.

• 1:54:03Dax Shepard?

  I actually do X, Y, or Z.

• 1:54:05Speaker 01

  Yeah.

• 1:54:06Dax Shepard?

  And I do think it's easy to think in some abstract way, she got something that you deserved more.

• 1:54:13Speaker 01

  Right.

• 1:54:13Dax Shepard?

  As if her thing took from you.

• 1:54:17Speaker 01

  Yeah.

• 1:54:18Dax Shepard?

  And that in general, people who don't deserve things are taking opportunities.

• 1:54:22Speaker 01

  Yeah.

• 1:54:23Dax Shepard?

  That should go to deserving people.

• 1:54:25Speaker 01

  Right.

• 1:54:27Speaker 01

  Yeah.

• 1:54:27Dax Shepard?

  Can I quickly get into some very large moral imperative stuff?

• 1:54:32Speaker 01

  Well, yes, because who deserves anything? Like, we, do we inherit, I mean, we deserve like dignity?

• 1:54:41Dax Shepard?

  Uh huh.

• 1:54:42Speaker 01

  But to me, other than that, we as people don't like come out deserving of

• 1:54:51Speaker 01

  money, or I don't know, it's a weird thing.

• 1:54:54Dax Shepard?

  I'm yes and no.

• 1:54:56Speaker 01

  Yeah.

• 1:54:57Dax Shepard?

  I'm yes and no. There's like a nihilist version of me that I can tap into pretty easily, which is like, who's kidding who? We're all staying busy on this circular globe until we die.

• 1:55:07Speaker 01

  Yeah.

• 1:55:08Dax Shepard?

  There's no God, there's no one is evaluating what should and shouldn't and better and worse. Like, we're just all distracting ourselves in the most entertaining fashion we can manage until we're dead.

• 1:55:18Speaker 01

  Yeah.

• 1:55:19Dax Shepard?

  So there's that version. It's like, yeah, what are you talking about? You don't deserve, you deserve for 300,000 years, you deserve to come out without clothes on and be ill-equipped for this world. In the best-case scenario, you ate and had a kid. So the notion that you, at some point, a TV show was a human right.

• 1:55:39Speaker 01

  Yeah, exactly.

• 1:55:40Dax Shepard?

  Or a cellphone's a human right, or I hate to say it, that healthcare is a human right. These are all really, really incredible, modern privileges.

• 1:55:48Speaker 01

  Yeah, they're advanced privileges, yes.

• 1:55:50Dax Shepard?

  Okay. And now also on the other side, yes, Brene Brown deserves a podcast more than a lot of people because she has spent a good chunk of her life acquiring knowledge that is useful to other people.

• 1:56:07Speaker 01

  Yeah.

• 1:56:07Dax Shepard?

  And yes, she does. I would, I would have to be lying to say that the guy in front of 7-Eleven, who's repeating the same sentence over and over again, is, should have the same level of success on a podcast that Brene Brown has. I can acknowledge, some people do deserve the success more than others because they've put more effort into it and they have more dedication and they have more skill. Jordan deserves his six titles

• 1:56:35Speaker 01

  Yeah.

• 1:56:36Dax Shepard?

  more than a lot of the players.

• 1:56:40Dax Shepard?

  It's not like everyone who entered the NBA deserves six titles.

• 1:56:43Speaker 01

  I just mean, we don't all deserve to be a basketball. That, I mean, like, that's the whole, my whole point. We don't come out deserving everything. We have different skills and, and privileges and things that allow us to like, live the life we're gonna live. But I don't know that we deserve. Like, I don't know that, I don't know that Brene, I mean, of course, I love her, so I, I think she deserves.

• 1:57:09Dax Shepard?

  Yeah, we're biased.

• 1:57:09Speaker 01

  Yeah. But the 7-Eleven guy, if, if.

• 1:57:14Dax Shepard?

  If his one sentence repeated over and over again.

• 1:57:17Speaker 01

  If his one sentence repeated over and over and over again has a massive impact on people.

• 1:57:22Dax Shepard?

  Yeah.

• 1:57:22Speaker 01

  And it changes their life and it like makes them think about the world differently. He deserves it!

• 1:57:28Dax Shepard?

  Absolutely. But what I think is even more interesting is, so I feel that way about that topic. But what I can admit and acknowledge is, there's another scenario you could paint that is the same principle at hand.

• 1:57:41Speaker 01

  Mm-hmm.

• 1:57:42Dax Shepard?

  And I'll go the other way.

• 1:57:44Speaker 01

  Yeah.

• 1:57:44Dax Shepard?

  I think that's what's much more fascinating and more fun to pay attention to is this illusion that I have a consistent policy.

• 1:57:51Speaker 01

  Yeah, exactly.

• 1:57:52Dax Shepard?

  And I don't.

• 1:57:53Speaker 01

  Yeah, none of us do.

• 1:57:54Dax Shepard?

  And what really happens is I look at the person and generally I like them or I don't like them on some weird gut level. And I'm generally accepting of the things that people do that I like and I'm critical of the things from people I don't like.

• 1:58:07Speaker 01

  Yes.

• 1:58:07Dax Shepard?

  And I frame it under this well-thought-out logic I have.

• 1:58:11Speaker 01

  Yeah.

• 1:58:12Dax Shepard?

  And it's just so inconsistent that I have to acknowledge.

• 1:58:15Speaker 01

  Yeah.

• 1:58:15Dax Shepard?

  There's a lot of going on.

• 1:58:17Speaker 01

  I do think so much of dislike, though, is jealousy.

• 1:58:21Dax Shepard?

  Oh, yeah.

• 1:58:21Speaker 01

  In general, and for all of us. If we dislike a lot, not always. Of course, there's like people who do horrible shit to other people.

• 1:58:30Dax Shepard?

  Yeah.

• 1:58:30Speaker 01

  You're gonna dislike that, but like. When, when you're just like irked by someone who you don't know.

• 1:58:37Dax Shepard?

  Yeah.

• 1:58:39Speaker 01

  It's probably because there's something that you're triggered that you wish you had, or, I mean, again, this, this thing she's presenting is, is perfection, right? Like she has, she's able to make her own honey. She has this bee farm.

• 1:58:53Dax Shepard?

  She has her own bees?

• 1:58:53Speaker 01

  Yeah, she has her own bees and she makes her own honey and then she makes these like.

• 1:58:57Dax Shepard?

  Have I told you bees have rebounded?

• 1:58:59Speaker 01

  Really?

• 1:58:59Dax Shepard?

  Yeah.

• 1:59:00Speaker 01

  Really?

• 1:59:01Dax Shepard?

  It's like great news. Remember that panic we were on? They've totally rebounded.

• 1:59:03Speaker 01

  Cause of her.

• 1:59:05Dax Shepard?

  Perhaps.

• 1:59:06Speaker 01

  Oh my god.

• 1:59:07Dax Shepard?

  So we all owe her a debt of credit.

• 1:59:08Speaker 01

  Wow. That's, that is good news.

• 1:59:10Dax Shepard?

  Yeah.

• 1:59:11Speaker 01

  Um, but like she makes her own like raspberry preserves and like, cause she has a raspberry bush. And so people are like, I want a raspberry bush and I want.

• 1:59:21Dax Shepard?

  I want to spend my day doing this nice fun stuff.

• 1:59:23Speaker 01

  Exactly.

• 1:59:23Dax Shepard?

  Well, there's probably that. And then there's also Martha Stewart.

• 1:59:27Speaker 01

  Yeah.

• 1:59:28Dax Shepard?

  There's Martha Stewart who has spent her entire life really becoming a master at all these things.

• 1:59:33Speaker 01

  Yep.

• 1:59:34Dax Shepard?

  And then she has a show and by God, it's very, very helpful and useful to people because she's a master.

• 1:59:39Speaker 01

  Yes.

• 1:59:39Dax Shepard?

  And so if you're comparing these two people and they both have a similar sized show, I can understand people being a little frustrated.

• 1:59:46Speaker 01

  Right.

• 1:59:47Dax Shepard?

  It would appear that one person really is now benefiting from their dedication and love for their whole life.

• 1:59:54Speaker 01

  Yeah.

• 1:59:55Dax Shepard?

  To something. That's a good story.

• 1:59:57Speaker 01

  Yeah, yeah, yeah, yeah, yeah.

• 1:59:59Dax Shepard?

  Versus like, and I could do this. I'm not a good woodworker. But I bet your ass I could sell a show to Netflix tomorrow about me with a wood shop, building things.

• 2:00:07Speaker 01

  Yeah.

• 2:00:08Dax Shepard?

  And if I was a master woodworker, I'd be like, this is bullshit. Why is, and that would be fair. And also, if I want to do a show about woodworking and I think it's fun and people are interested in it, why, why can't I do that?

• 2:00:20Speaker 01

  Exactly.

• 2:00:21Dax Shepard?

  So I think all these things are true. So Kristen came home to me.

• 2:00:25Speaker 01

  Mm hmm.

• 2:00:25Dax Shepard?

  And she said, oh my God, I got like five texts from people. Like I could, they were salivating to share this news about Meghan Markle's show. And she started calling people out, like.

• 2:00:38Speaker 01

  Yeah.

• 2:00:39Dax Shepard?

  It seemed a little too excited about what you determined was a failed attempt by somebody. That's like a, if you're taking a lot of joy out of a failed attempt on somebody. Is that who you want to be?

• 2:00:52Speaker 01

  Yeah.

• 2:00:53Dax Shepard?

  Bigger question.

• 2:00:54Speaker 01

  Exactly.

• 2:00:55Dax Shepard?

  And I also think it's worth delineating because I'm critical, as you know. I'm, I'm trying to shut the fuck up about it, but I am critical of people that are allowing someone to make them miserable. As I've said, right?

• 2:01:06Speaker 01

  Circles back to what I said earlier.

• 2:01:08Dax Shepard?

  Sixteen to now, if you've been miserable for nine years or, or an hour of your day is spent in anger. I just think that's a rough use of your life. Now, if you're seeing the thing, the Meghan thing, and you're excited and you share it with your friends and you all gossip and you all have a good time doing that at dinner. I guess I'm not critical of that in a weird way. I feel bad for the subject of ridicule, but I also can just, again, in a utilitarian way go look at, oh, these five people had a really fun dinner for two hours gossiping, which is a, which is an adaptation of social primates. Like, we're wired to do it.

• 2:01:46Speaker 01

  Yeah.

• 2:01:47Dax Shepard?

  I guess I also can go, yeah, okay, you guys had fun shitting on somebody. Everyone felt better for some reason about themselves.

• 2:01:54Speaker 01

  I mean, that's the part.

• 2:01:55Dax Shepard?

  That's a bummer.

• 2:01:56Speaker 01

  Yeah.

• 2:01:56Dax Shepard?

  But if, if the end result was you all did that versus you all got together and you like, this motherfucker and I can't believe this. Yes, outrage and, and feeling defeated and overwhelmed and all that. I weirdly have a distinction between those two things.

• 2:02:11Speaker 01

  One's harmless and the other one is causing harm, personal harm to them, the people who are doing it. And I mean, I do think it's, it's a privilege to be Kristen or be me. And I'm like watching this, you know, I'm just watching the show and I'm like, oh yeah, like.

• 2:02:28Dax Shepard?

  I want that bag.

• 2:02:30Speaker 01

  Yeah, I'm like, oh my God, like I should order some of those tomatoes and make that.

• 2:02:36Dax Shepard?

  Cause you're not frustrated with the outcome of your life.

• 2:02:38Speaker 01

  Exactly. I am not like, well, why does she get to have that?

• 2:02:42Dax Shepard?

  You have plenty.

• 2:02:43Speaker 01

  I have plenty.

• 2:02:44Dax Shepard?

  That's right. That's right.

• 2:02:46Speaker 01

  I have more than I should have.

• 2:02:47Dax Shepard?

  That's right. And, and, and I do too. And I'm not as bothered by a lot of things that people are bothered by, and I know it's a privilege. What is so tempting to tell, try to tell people is it is a product of your own. You think this person's objectively one thing.

• 2:03:04Speaker 01

  Yeah.

• 2:03:05Dax Shepard?

  And it's helpful to understand, no, if my cup was full, actually, and shockingly, I wouldn't feel the same way.

• 2:03:12Speaker 01

  I know.

• 2:03:13Dax Shepard?

  And you kind of want people to know that. Cause I think it is helpful for development, which is like,

• 2:03:20Dax Shepard?

  my opinions of things are dramatically impacted by how I feel about my own self and my own.

• 2:03:27Speaker 01

  Yes.

• 2:03:27Dax Shepard?

  Outcome.

• 2:03:28Speaker 01

  Yeah.

• 2:03:28Dax Shepard?

  And I would probably be best served trying to love this version of myself.

• 2:03:35Speaker 01

  Hmm.

• 2:03:36Dax Shepard?

  Hmm. Enough that I don't feel anger when other people.

• 2:03:42Speaker 01

  Are doing well. Real quick facts, this is for Mary Claire Haver. Great episode.

• 2:03:48Dax Shepard?

  Solid.

• 2:03:48Speaker 01

  My assumption is it's.

• 2:03:50Dax Shepard?

  Get that topical vaginal cream, everybody. Go out right now and just start smearing it all over.

• 2:03:56Speaker 01

  She already, she posted about it.

• 2:03:57Dax Shepard?

  She did.

• 2:03:58Speaker 01

  Uh huh.

• 2:03:59Dax Shepard?

  Oh.

• 2:03:59Speaker 01

  It was really sweet and cute, cause it was out early.

• 2:04:04Speaker 01

  And she said it was really, she had a good time with us.

• 2:04:06Dax Shepard?

  Can I Easter egg that? I got the text of my life last night that I shared with you guys.

• 2:04:12Speaker 01

  Yeah. We can't say anything else.

• 2:04:15Dax Shepard?

  I urge people to hang on to the show a little longer. I know a lot of people are thinking about quitting, but just, just hang out for a couple more months. Wow, wow, wow. Wow.

• 2:04:23Speaker 01

  I'm gonna have to get a facial.

• 2:04:24Dax Shepard?

  Hard as a rock. I'm gonna have to jerk off before the interview so I can last during the interview.

• 2:04:29Speaker 01

  Same.

• 2:04:30Dax Shepard?

  Yeah.

• 2:04:32Speaker 01

  I'm gonna have to wear really strong pants, not ones that can explode.

• 2:04:36Dax Shepard?

  You're gonna have to be in fucking steel trousers.

• 2:04:39Speaker 01

  Woo.

• 2:04:40Dax Shepard?

  Might want to go short skirt. I say you go all the way.

• 2:04:44Dax Shepard?

  If ever there was a time to take the biggest shot of your life.

• 2:04:47Speaker 01

  This is.

• 2:04:47Dax Shepard?

  You might want to go skirt.

• 2:04:50Speaker 01

  Bra top.

• 2:04:51Dax Shepard?

  Braless, see-through top.

• 2:04:55Speaker 01

  I do have a new top that is pretty see-through.

• 2:04:59Dax Shepard?

  Oh my God. If you, if you did, and this person's a fashion icon, so they would just be like, oh yeah, fashion.

• 2:05:07Speaker 01

  Oh my, I could maybe get away with it.

• 2:05:09Dax Shepard?

  I think you should go.

• 2:05:10Speaker 01

  You'd have to blur it, Rob.

• 2:05:12Dax Shepard?

  Oh, they could.

• 2:05:14Speaker 01

  Yeah, that could be done. On YouTube.

• 2:05:15Dax Shepard?

  Yeah, no problem.

• 2:05:16Speaker 01

  But for, for.

• 2:05:17Dax Shepard?

  For him.

• 2:05:18Speaker 01

  For him.

• 2:05:19Dax Shepard?

  Or for her.

• 2:05:19Speaker 01

  For her.

• 2:05:20Dax Shepard?

  Whoever our guest is.

• 2:05:23Dax Shepard?

  Wow, I can't wait for that. That's a, that's an even more fun element to think about is coming.

• 2:05:28Speaker 01

  How I'm gonna show up?

• 2:05:29Dax Shepard?

  Yes, yes, and how aggressive you'll be. And I just want you to know that I am encouraging you to go up above and beyond

• 2:05:36Speaker 01

  Okay.

• 2:05:37Dax Shepard?

  the realm of what you think is tasteful.

• 2:05:41Dax Shepard?

  And you'll be sitting directly across from this person?

• 2:05:44Speaker 01

  Yeah, but you know, my instinct is to just like play it so cool.

• 2:05:47Dax Shepard?

  No, go for it.

• 2:05:48Speaker 01

  I know, I don't know though. I think this person, I think this person might be more intrigued by someone playing it so cool.

• 2:05:58Dax Shepard?

  I don't think so. Let me just, let me give you some inside baseball on guys.

• 2:06:04Speaker 01

  Yeah.

• 2:06:05Dax Shepard?

  There is no guy who's gonna see a rockin' bot on display and think, mm, not for me. I mean, there'll be no straight guy.

• 2:06:16Speaker 01

  Right.

• 2:06:16Dax Shepard?

  Who thinks that.

• 2:06:17Speaker 01

  Yeah, Jess is, he's starting to turn. The more he hangs out with me.

• 2:06:21Dax Shepard?

  Oh, my God. So you guys might end up.

• 2:06:23Speaker 01

  Might end up together, after all.

• 2:06:26Dax Shepard?

  What a great time. And then you guys bring back money and Jess love boys, but it's like money and Jess are married.

• 2:06:32Speaker 01

  Oh. That would be more, that'd be boring.

• 2:06:37Dax Shepard?

  Well, no, you'd be fighting. All this fun you're having would quickly turn to fighting. So that could be entertaining.

• 2:06:44Speaker 01

  Oh, man. Anyway, okay. Well, that's TBD for people.

• 2:06:48Dax Shepard?

  Yeah, that's exciting.

• 2:06:49Speaker 01

  Okay, some facts. Okay, Rob, can you help me? What did you type in to get the names of those guys who did the W I H. study?

• 2:07:02Speaker 07

  I looked at Dax's notes for the episode.

• 2:07:04Speaker 01

  Oh.

• 2:07:05Speaker 07

  And saw what he wrote down.

• 2:07:07Speaker 01

  That is, I, for the life, I was trying so many ways of typing this into Google and I can't.

• 2:07:15Dax Shepard?

  It won't.

• 2:07:15Speaker 01

  It's, that's not coming up for me.

• 2:07:17Speaker 07

  Yeah. Um, give me the spell.

• 2:07:20Dax Shepard?

  Slabowski.

• 2:07:21Speaker 07

  Yeah, let me find it again.

• 2:07:23Dax Shepard?

  Slabowski and Trabowski.

• 2:07:25Speaker 07

  C H L E B O W S K I.

• 2:07:29Dax Shepard?

  Chlobowski.

• 2:07:32Dax Shepard?

  And A R A G A S K I.

• 2:07:37Speaker 01

  Okay, so these are for the Women's Health Initiative. This is who you say was a part of the study. And this is who.

• 2:07:44Dax Shepard?

  I could be conflating. I just want to be clear. The stuff I was saying that both Atiya and Lane Norton are all over.

• 2:07:55Speaker 01

  Yeah.

• 2:07:55Dax Shepard?

  Is Chlobowski and Eras.

• 2:07:57Speaker 01

  Okay.

• 2:07:58Dax Shepard?

  They're the ones that keep doubling down on this bad data.

• 2:08:00Speaker 01

  Okay, so maybe they've doubled down. But they, I don't think are part of the original study.

• 2:08:06Dax Shepard?

  Okay.

• 2:08:07Speaker 01

  Dr. Bernadine Healy. This is in 91. She was the female director of the NIH. And she announced her plan for the Women's Health Initiative. There was a ton of people involved in this. Um, and it was a 15 year study. I mean, and it was wrong.

• 2:08:24Dax Shepard?

  Yeah. Not right.

• 2:08:26Speaker 01

  It was not right.

• 2:08:27Dax Shepard?

  It led to a mass panic.

• 2:08:29Speaker 01

  Okay, now, peak suicide rates for women. Uh, female suicide is concentrated in the 35 to 64 year age group. That's 64.8%.

• 2:08:41Dax Shepard?

  I don't know why that's so weird for me. I mean.

• 2:08:43Speaker 01

  I get it. I get why it's weird. I wouldn't have expected that.

• 2:08:46Dax Shepard?

  Obviously, we were just given the explanation, which is menopause. But it is, yeah, it's just not the time. You're, you think that's the time of your life. You start fully accepting who you are and what reality is and start transitioning. Yeah.

• 2:09:01Speaker 01

  But so's hormones. Brain changes. Scary.

• 2:09:06Speaker 01

  Um, but good to know. Like, if you're starting to feel.

• 2:09:10Dax Shepard?

  Yeah, that know you're in, when you're in the danger zone.

• 2:09:12Speaker 01

  Yeah, exactly.

• 2:09:14Dax Shepard?

  Higher to the danger zone.

• 2:09:18Speaker 01

  Okay, now, male pattern baldness.

• 2:09:21Dax Shepard?

  M P B. I say one thing?

• 2:09:23Speaker 01

  Yep.

• 2:09:25Dax Shepard?

  I was eating at a restaurant this morning.

• 2:09:26Speaker 01

  Uh huh.

• 2:09:27Dax Shepard?

  With Nate.

• 2:09:28Speaker 01

  Uh huh.

• 2:09:28Dax Shepard?

  He left, I paid. Woman came over to the counter, parts of my table. And she said, I just wanna thank you for the Blaze episode.

• 2:09:39Speaker 01

  Oh.

• 2:09:40Dax Shepard?

  I have BPD.

• 2:09:41Speaker 01

  Oh my gosh.

• 2:09:42Dax Shepard?

  And I think that episode probably saved me like two years of my trajectory to dealing with this.

• 2:09:51Speaker 01

  Great. So she realized she had it because of it?

• 2:09:54Dax Shepard?

  No, I think she already knew, but she, hearing from him, something he did, you know, she's like, it just kinda like, fast forward her two years in the process.

• 2:10:02Speaker 01

  Amazing.

• 2:10:03Dax Shepard?

  And it was very good for me to meet her. Because I think a lot of times you're like, ma, BPD, they fuck up the person's life who loves them. And you villainize them. And it was very helpful to look at this young woman who's so grateful for help.

• 2:10:21Speaker 01

  Yeah.

• 2:10:22Dax Shepard?

  For this thing she doesn't want. Yeah, I was very happy to.

• 2:10:25Speaker 01

  That's lovely.

• 2:10:26Dax Shepard?

  Yes.

• 2:10:27Speaker 01

  Yeah, I like that.

• 2:10:28Dax Shepard?

  So fucking good luck, BPD survivors.

• 2:10:31Speaker 01

  Yeah.

• 2:10:32Dax Shepard?

  Yeah.

• 2:10:33Speaker 01

  Wow, it's the first time you've ever said survivors.

• 2:10:37Speaker 01

  You don't say survivors.

• 2:10:38Dax Shepard?

  I don't like that term.

• 2:10:39Speaker 01

  I know.

• 2:10:39Dax Shepard?

  Yeah.

• 2:10:44Speaker 01

  This is like the most PC you've ever been.

• 2:10:47Dax Shepard?

  Yes, yes, yes, yes. Yes, yes, yes.

• 2:10:49Speaker 01

  Okay.

• 2:10:50Dax Shepard?

  Okay.

• 2:10:50Speaker 01

  Male pattern baldness doesn't exclusively come from the mother's side. It can be influenced by genes from both parents. The AR gene is located on the X chromosome, which men inherit from their mothers. However, other genes and environmental factors also play a role. If your mother's father has male pattern baldness, you're more likely to have it too. If your father is bald, you're twice as likely to have it.

• 2:11:14Speaker 01

  Hormonal fluctuations, fluctuations, nutritional habits, stress level, and lifestyle choices can impact the onset and progression of baldness. Yeah, genetic factors from both parents significantly influence the likelihood.

• 2:11:25Dax Shepard?

  I'm fighting for my life.

• 2:11:27Speaker 01

  You're doing fine.

• 2:11:28Dax Shepard?

  I think I'm, I'm doing fine in the battle, but I'm fighting, I'm fighting with all I got.

• 2:11:31Speaker 01

  I see, I see.

• 2:11:32Dax Shepard?

  It's morning and night, that fucking topical that I hate. Hate how it makes my hair feel.

• 2:11:37Speaker 01

  Yeah.

• 2:11:38Dax Shepard?

  I gotta hold my head back so it drips, but it's, I, it's, it's embarrassing to see me at night in the mirror dealing with, trying to keep my hair.

• 2:11:45Speaker 01

  Do you wanna do that thing that Ike did?

• 2:11:48Dax Shepard?

  What did he do?

• 2:11:48Speaker 01

  The PRP?

• 2:11:49Dax Shepard?

  Oh.

• 2:11:51Speaker 01

  Okay.

• 2:11:52Dax Shepard?

  Yeah. What I really want, more than anything, is for them to figure out how to clone hair. And I want to go in and get my hair cloned and have massive surgery. And get the thickest lion mane head of hair and have long braided hair.

• 2:12:09Speaker 01

  Oh, my god.

• 2:12:10Dax Shepard?

  Like a Viking.

• 2:12:11Speaker 01

  Oh.

• 2:12:11Dax Shepard?

  And maybe I'll be in my Viking outfit for our guest and you'll be in your outfit. And we'll let the chips fall where they may.

• 2:12:21Speaker 01

  We'll both be.

• 2:12:22Dax Shepard?

  Maybe I'll be wearing a kilt.

• 2:12:23Speaker 01

  We'll both be topless.

• 2:12:24Dax Shepard?

  I'll be in a kilt, crossing and uncrossing my legs repeatedly.

• 2:12:28Speaker 01

  Okay.

• 2:12:29Dax Shepard?

  Yes.

• 2:12:29Speaker 01

  Oh, we're gonna be competing.

• 2:12:31Dax Shepard?

  Oh, this is great. It is. So, uh, nineteen seventy.

• 2:12:39Dax Shepard?

  We're doing the Riverdance. I know, this poor guest.

• 2:12:42Speaker 01

  Oh, my god. Um, okay. And then, oh, real quick. So she, she said that, um, there are, there are places that you can donate your eggs for free and keep some.

• 2:12:57Dax Shepard?

  Yeah.

• 2:12:57Speaker 01

  Like, so that's cool. And there's one place called Co-Fertility that does this. I don't know if this is the one she was talking about. I can't endorse this. I don't know much about it, but it is one of the places.

• 2:13:07Dax Shepard?

  It is something that came up in a Google search.

• 2:13:09Speaker 01

  Yes, if you'd like to look into it, that's a place. Um, all right, that's it for Mary Claire. Thank god she came in. That, she really rattled me.

• 2:13:19Dax Shepard?

  I'm gonna use another word I don't like.

• 2:13:22Speaker 01

  Say it.

• 2:13:22Dax Shepard?

  I'm on a roll. She's a rock star.

• 2:13:25Speaker 01

  You don't like that?

• 2:13:26Dax Shepard?

  No.

• 2:13:26Speaker 01

  I feel like you say it.

• 2:13:27Dax Shepard?

  Ah, no.

• 2:13:28Speaker 01

  Oh.

• 2:13:28Dax Shepard?

  Yeah, sorry. This is, the list is long. It's hard to keep track of all the things. Atelier, artisanal, rock star.

• 2:13:35Speaker 01

  Atelier, um, this past weekend.

• 2:13:38Dax Shepard?

  I hate the word cuck.

• 2:13:39Speaker 01

  Oh.

• 2:13:40Dax Shepard?

  It's a thing that, like, aggro dudes use to try to emasculate other men. They call them a cuck.

• 2:13:46Speaker 01

  Cuckold?

• 2:13:47Dax Shepard?

  Yeah.

• 2:13:48Speaker 01

  Oh, weird.

• 2:13:49Dax Shepard?

  Yeah.

• 2:13:49Speaker 01

  Last weekend, I was, um, doing a long walk. I walked on Sunset. I was doing this whole thing. And I, um, passed a new coffee shop and I went in and I tried it and I texted Rob and I asked if he had tried it yet. And then he went the next day and he reminded me there was a merch there that said atelier on it.

• 2:14:14Speaker 01

  Did you buy it?

• 2:14:15Speaker 07

  No, I almost did.

• 2:14:17Speaker 01

  Yeah.

• 2:14:17Speaker 07

  To put in, to put in here.

• 2:14:19Speaker 01

  Yeah, I know. I considered it too.

• 2:14:21Dax Shepard?

  Should we have a t-shirt that says Armchair Atelier?

• 2:14:24Speaker 01

  I've been saying that.

• 2:14:25Dax Shepard?

  Yeah, just, I was just repeating what you said. Just doubling down on what a great idea that you had.

• 2:14:30Speaker 01

  I've been saying that. Okay.

• 2:14:34Dax Shepard?

  All right, love you.