It’s Not Too Late to Transform Your Health! How to Improve Your Bone Strength, Supercharge Your Brain & Increase Longevity

Age Backwards! Dr. Vonda Wright Reveals the SHOCKING Truths About Your Health, Longevity, Hormones & Bone Loss Is everything you thought you knew about aging completely wrong? In this eye-opening episode of Mayim Bialik's Breakdown, Dr. Vonda Wright (double-board certified orthopedic surgeon, internationally recognized authority on human performance, and author of UNBREAKABLE: A Woman’s Guide to Aging with Power) exposes the hidden truths about your body, your hormones, your health, and your future. Discover how your musculoskeletal system is secretly tied to your mood, hormones, and even your purpose in life, and why osteoporosis symptoms infuriate Dr. Wright (and what you NEED to know before it’s too late!). Dr. Vonda Wright also breaks down: - The jaw-dropping statistic that 80% of women experience incontinence, and how to prevent it - Why the majority of Alzheimer’s patients are female, and what you can do NOW to lower your risk - Biggest MYTHS people believe about aging debunked! - How your diet and exercise actually change your genetic code - Why visualizing your ideal aging process can literally improve your future - Incontinence 101: Who it affects, what causes it, and how to retrain your body - Why women’s health is decades behind, and how this delay is costing lives - The 3 keys to resilience: Control, Challenge & Commitment, and how they make aging easier - What’s behind the alarming rise in suicide among female doctors and male orthopedic surgeons - How athletic activities improve mental health - Easy, realistic steps to boost fitness (no gym required!) - The shocking differences in how men and women age - Why you don’t have to choose hormone therapy, but why you MUST educate yourself - In your 30s or 40s? Over 50? Here’s exactly what to do NOW to protect your future health - How our culture’s obsession with thinness is killing women - How much calcium and protein you REALLY need for optimal bone health - Best ways to build bone density - Silent dangers of prioritizing weight loss over muscle strength - What REALLY causes osteoporosis (it’s not just a women’s disease!) - Shocking links between alcohol and hidden health risks - How the medicalization of midlife health changes is hurting women - Why menopause is behind a rising number of midlife divorces - How improving mobility can reverse chronic disease - How bone health predicts overall health - Surprising links between Alzheimer’s & osteoporosis - Dr. Wright’s top creatine supplement recommendation - Why cardio is more important than you think PLUS... Mayim teaches us the correct way to do Kegel exercises! This episode is a blueprint for powerful aging. Whether you’re 25 or 65, you NEED to hear what Dr. Wright has to say. Hit play, take notes, and take control of your future! Dr. Vonda Wright’s latest book, UNBREAKABLE: A Woman's Guide to Aging with Power: https://www.penguinrandomhouse.com/books/777365/unbreakable-by-vonda-wright-md/ Go to Superpower.com https://superpower.com/ to learn more and lock in the special $199 price while it lasts. Live up to your 100-Year potential. #superpowerpod Follow us on Substack for Exclusive Bonus Content: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://bialikbreakdown.substack.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠BialikBreakdown.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ https://www.bialikbreakdown.com/ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube.com/mayimbialik⁠⁠ https://www.youtube.com/mayimbialik%E2%81%A0 Learn more about your ad choices. Visit megaphone.fm/adchoices https://megaphone.fm/adchoices 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.

• 0:00Speaker 00

  The myth is, there's nothing you can do to age better. The reality is, 70% of your health and aging is due to the lifestyle choices you make every day. Everything we do, from the thoughts we have, to the broccoli we do or don't eat, to the walking around we do or don't, changes the very expression of our genetic code.

• 0:21Mayim Bialik?

  Dr. Vonda Wright, she's a double board certified orthopedic surgeon, and a recognized authority on human performance, longevity, and in particular, women's health.

• 0:32Speaker 00

  My entire life's work has been focused on changing the way we age in this country. Growing old is not for sissies, people. Women are living half of their lives past their fertility period. Medicine doesn't know what to do with us. More than 40 to 50% of all women will have osteoporosis. The minute you fall to the floor and break your femur, you have a 30% chance of dying, and a 50% chance of never returning to the home you left. There are actually 33 chronic diseases lumped together into a nomenclature called Sedentary Death Syndrome. Without healthy bones, you lose the efficacy of all that metabolic function.

• 1:15Speaker 00

  That is going to have effect on the physical brain. I decided that it was time to tell women not only what was happening to them, but what to do next. We can still change our biology. Our brain is not static. Your body is an adaptability and homeostasis machine. It is ready. There is never an age or skill level when a simple investment in your daily mobility will not transform you. You are worth the daily investment.

• 1:44Jonathan Cohen?

  What are the top ways to care for your bones?

• 1:53Mayim Bialik?

  Hi, I'm IMB Alex.

• 1:54Jonathan Cohen?

  And I'm Jonathan Cohen.

• 1:55Mayim Bialik?

  And welcome to our Breakdown. Today, we're going to be talking about some information about your body that you may have never thought about before. And we're going to be talking about an aspect of the functioning of your musculoskeletal system and how it interacts with your hormones, your mood, and your purpose in life. There are some statistics that we are going to talk about in this episode that I have never heard before and that literally have the potential to change how you live, how long you live, and how flexible you are with the changes that inevitably we will all experience

• 2:40Mayim Bialik?

  as we age.

• 2:41Jonathan Cohen?

  This might be one of the most important conversations to shape your future, keep you out of the hospital, help you stay healthy. It can impact your parents, it could impact the people you love around you. This conversation has information in it about the health of your body and the fact that it has been designed to be healthy, to be resilient, to be strong in a way that you may never have considered before.

• 3:12Mayim Bialik?

  It is never too early and it is never too late to incorporate the information that we're going to talk about today with Dr. Vonda Wright. She's a double board certified orthopedic surgeon and a recognized authority on human performance, longevity, and in particular, women's health. We're going to be talking about her book, Unbreakable: A Woman's Guide to Aging with Power. Pretty much everything that we've been told about aging, it's not inevitable. Everything that you have heard about, "Don't get old, getting old is for the birds, do anything you can to not have to have X, Y, or Z happen," there is an answer to it. And guess what? It starts today, it starts right now.

• 3:55Mayim Bialik?

  It's such a pleasure to welcome Dr. Vonda Wright to the Breakdown to help us understand all of this and so much more.

• 4:03Speaker 03

  Break it down.

• 4:05Speaker 00

  Oh, it's my pleasure to see you.

• 4:07Mayim Bialik?

  One of the ways that we'd love to start this conversation with you is to sort of give you the floor to kind of set the stage here, like, set the table for what people can hope to get out of hearing you talk about what it means to be unbreakable.

• 4:25Speaker 00

  I wrote Unbreakable because my entire life's work has been focused on changing the way we age in this country, because I have never believed that aging goes from an inevitable decline, from youthful vitality to frailty, and that there was nothing that we could do about it. I've never believed that. Maybe it's because my now 86-year-old dad has been running on the roads of Kansas since I was a child, and I would see these really old runners, like 60-year-old Millie Hartung, who, in the 70s, when I was a child, that's really old to be out on the road, right? That's really old to still be alive in the 70s.

• 5:08Speaker 00

  Right, actually, true, true that. But maybe I had that in my brain. Maybe it's because I started doing research on what are considered senior masters athletes, which the NIH defines masters or older athletes as 40. I hate to tell them not so old. But so I started studying these remarkable people who were aging in a way that was different from the population, because if you believe population studies, meaning, let's take the health ABC, you take a group of 70-year-olds, you watch what happens over time, you are

• 5:51Speaker 00

  led to believe that aging is this inevitable decline. But when you take the variable of sedentary living out and investing every day in your mobility, like we did when we studied masters age athletes, we found very different things, knowing that there are things we can do to be healthy, vital, active, joyful. So I wrote Unbreakable. Because of this background, I also wrote Unbreakable, named it Unbreakable with a nod to the fact that I'm an orthopedic sports surgeon and fixing people is what I do. But I also wrote it because in the last five years, there has been an explosion and dozens

• 6:32Speaker 00

  of great books about what the heck is going on in midlife with women, this menopause thing, the peri-menopause, which is what everybody's talking about now. But I decided that it was time to tell women not only what was happening to them, but what to do next. Because here's the reality, as a practicing orthopedic surgeon, I still have to take call, even at my advanced age, I still have to take call. And what I see on call is the future of women, unless we step in front of this, which is frailty. And I'm going to give you a picture, and I told this story at the FDA recently as we were trying to talk about hormones with that group of people.

• 7:15Speaker 00

  But when I get called to the ER and I met with a woman who has fallen and broken her hip, she is in excruciating pain from osteoporotic fracture that frankly, we probably could have prevented had we gotten in front of it when she was 30 and 40, right? So there she is in excruciating pain, often not to be indelicate, but she is often incontinent because 80% of all women are and never talk about it. And we can prevent that too with vaginal estrogen, never talk about it. It's a thing women don't talk about. So she's laying there in pain, incontinent.

• 7:59Speaker 00

  Number three, to take her to the operating room, I have to get the hospitalist to clear her heart. But she has often so much microvascular heart disease that we have to delay surgery just so we can optimize her heart. And finally, whether she is, her brain is reacting to the stress of the moment, or she is one of the 70% of all people with Alzheimer's who are female, she is confused. And so there she lays, usually with her daughter, her daughter, usually it's a daughter at the bedside.

• 8:39Speaker 00

  And you know what, in a moment of clarity, she says to me, she, this has happened more than once. She says, you know what, doc, I was not always like this. Don't ever get old. Don't get, I've heard that so many times. Don't get old, doc. And so I'm like, I have got to step in front of this myth. I have got to equip women while they still have time to get stronger and build an unbreakable future and just help them know what to do because this book is about a physical prescription for exercise and all the things, but it's science and it is mindset. I

• 9:20Speaker 00

  need to pivot the mindset that we are inevitably going to come frail. That's what this is about.

• 9:27Mayim Bialik?

  I just peed myself. No, I'm just kidding.

• 9:31Speaker 00

  I'm gonna get you some vaginal estrogen, darling. We're gonna do that.

• 9:36Jonathan Cohen?

  We have to unpack the two statistics that you shared, but let's first talk about the biggest myths that people have about getting older. Like, I always thought you get to a certain age and you hear everyone say, oh, that's just, it just happens now. Everything just hurts. Talk to us about what people truly don't understand and how their mindset is sending them down the wrong path.

• 10:05Speaker 00

  So, both men and women, it is the natural history of the human race to age and exhibit what have been described as the hallmarks of aging. First, there were six, now there were 12 or 13. Normal cellular metabolism changes with time. We accumulate within our cells a lot of damage, which does age us. The remarkable thing is that, and the myth is,

• 10:38Speaker 00

  That you're genetically predetermined to age, there's nothing you, which we are, but there's nothing you can do to age better. The hallmarks of aging are going to happen and just buckle up, it's happening. The reality is, the epigenetic changes that happen with aging, meaning the way we express the genes we've inherited, is due to our lifestyle. And the percentage of lifestyle influence has changed over the years that I've been in this area, from about 70% of your health and aging is due to the lifestyle choices you make every day. The other day, I heard another longevity person say up to 90%. And frankly, I believe that.

• 11:23Speaker 00

  I think everything we do, from the thoughts we have, to the broccoli we do or don't eat, to the, to the walking around we do or don't, changes the very expression of our genetic code. So, the first myth is that there's nothing you can do about it. Well, that's two myths in one, right? Two myths in one is, it's an inevitable decline. But the second myth is the mental myth, there's nothing you can do about it. Because if you sit here and tell your brain, you know, it's like, it's like when you're upset and your therapist says, you know, we can do self-talk, we can, we can change our behavior by what we tell our brain.

• 12:07Speaker 00

  The physical brain is one thing, but, but the, the emotional mental brain can be influenced. It will believe what you tell it. And if you tell it that the best of your life is when you were 20, I always look over my left shoulder, "Oh my God, 26 was so amazing." Well, 26 was frankly, easy. I mean, in terms of getting around, I mean, I wouldn't want to be 26 again. I had two decades of education still to go. I am not going back there, but, but we think that, and if we think that that was the best, well then what's the point of the future? But if we pivot to know that we can still change our biology, we can still learn, our

• 12:50Speaker 00

  brain is not static, the best can be ahead, and thank God, we learn from the wisdom of our age, and our confidence comes from the memory of our success, or even our failures and how we got out of that. That's why I believe that it's the mindset is the second myth. Cause we can pivot and to an unbreakable future.

• 13:16Mayim Bialik?

  My and the Alex Breakdown is supported by Quince. You know, those pieces in your closet that you reach for over and over again? That sweater that somehow works with everything? The jeans you know will always fit just right? The bag you carry everywhere? Those are the pieces that earn a permanent place in your wardrobe. And that's what Quince does so well. Quince makes elevated everyday essentials using premium materials like Mongolian cashmere, organic cotton, premium stretch denim. The designs are timeless, thoughtfully crafted and made to be worn again and again. And as the weather gets colder, Quince has everything you need to round out your wardrobe. From warm, responsibly sourced down jackets and cozy cashmere scarves and gloves to beautiful 14 karat gold jewelry that adds the perfect finishing touch. I'm personally obsessed with Quince's 100% European linen wide leg pants.

• 14:00Mayim Bialik?

  I can wear them year round because I live in Southern California. They feel like PJs, but it looks like I put a ton of effort in. Whether I'm dressing for casual workdays, lazy weekends, or vacation vibes. I'm also obsessed with their sheets, so soft. Everything at Quince is priced 50 to 80% less than similar brands. They work with ethical factories and cut out the middle people. So you pay for quality, not brand markup. And it's not just apparel. Quince brings that same approach to everything they make. From hotel quality bedding to kitchen essentials and thoughtfully designed furniture. Find the fall pieces you'll reach for most at Quince. 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 my and the Alex Breakdown.

• 14:44Mayim Bialik?

  It's the best way to support our show. One of the things that you suggest quite early in the book, kind of caught me off guard. You want me to create a vision for my unbreakable future. And when I heard about you, when I learned about you, I was like, I'm going to learn what exercises to do and I'm going to learn what I should have done that I didn't do in my 30s. And I was very pleased how early in the conversation about how to be unbreakable, you start talking about this vision. And you know, one of the- Things that Jonathan and I love to do here is find the intersection of kind of science and spirituality. We find the places where science is supporting things that mystics and healers and you know,

• 15:28Mayim Bialik?

  people have said for thousands of years. So this is one of those where I was like, she's basically telling me I need to positively manifest, except you're doing this from a clinical and scientifically backed perspective. Talk a little bit about what it means to craft a vision and why that's the starting place for being unbreakable.

• 15:51Speaker 00

  You know, simply put, and too simply put, you can't know where you're going unless

• 15:59Speaker 00

  you visualize it. I mean, otherwise you're just wandering around in the dark. So how do we create a vision? Because when I put together another book I wrote, which was a strategic plan for health, the first step is create a vision before the second step was is action. So that's the way I framed this book. But how do you create a vision? Well, you can make up whatever you want to make up. I could say to you, oh, my God, I love singing in the shower. I'd like to be Pat Benatar. I mean, that is not it, right? You have to start with what you value, especially when it comes to doing hard things. Sometimes exercising is hard. It takes more than me just telling you,

• 16:42Speaker 00

  right? It's hard. We're Min Max people. We're going to do the minimum for the maximum. What are your values? What do you want? And what's important to you now? What do you want in the future? So here's how it plays out with me. I just like to give my examples. I think just helps people say, what is she actually talking about? I value, in a little sassy way, being able to do what I want to do, when I want to do it. When I'm a really old lady, if I want to ask for help, I'm going to ask for help. If I want to be at the front of line, then I am going to ask for a wheelchair so that my wheelchair gets to the front of the line. But I

• 17:24Speaker 00

  don't want to have to ask for help. I don't want to be dependent and lose my agency.

• 17:37Speaker 00

  You know, I didn't work this hard in life to lose the agency I have earned, right? So for me, that value, among others, drives my action. So if I value independence, then a vision for my future is being independent until the day I die, after ninety-seven years old, because I want to live until I'm at least ninety-seven. And what are the lifestyle things I have to do? And mindset things to get there.

• 18:11Jonathan Cohen?

  Well, we know that the vision, one, helps us navigate, but two, can also help us then take action towards that in a way that we might not have, whereby our brain actually goes and seeks out the activity. It feels more natural. Instead of forcing myself to go on that walk, I may just naturally feel more energized and inspired to do that. So it is amazing, we see more and more that medical doctors are explaining how mindset can be incorporated and is actually not just part of well-being, but actually core and integral to getting where you want to go, getting those health objectives and goals met.

• 18:50Speaker 00

  I agree with that so much because, interestingly, unless you're motivated by your why, it just becomes another checklist. And, and once it gets hard, people jump off the checklist train at a rate of more than fifty percent. So it can't just be another program.

• 19:13Jonathan Cohen?

  You mentioned two statistics that we had not expected. One of them was eighty percent of women at some point are incontinent and don't talk about it.

• 19:22Mayim Bialik?

  Yeah, I need you to talk to me about incontinence. Because it's a big word. And I think what most people picture is like, I just walk around and urine comes out. But, which is one definition of incontinence. That's one. Um, but I want, I want you to get more specific because I especially love to talk about the things that we don't talk about. And many women who have had children that have passed through the vagina will experience like the coughing, sneezing, like I will never go on a trampoline again and I used to enjoy it. It's not happening. Are we, is that also under this umbrella of incontinence?

• 20:04Mayim Bialik?

  Are there other things? I mean, everything kind of gets less strong. Is it literally like the sphincter that's holding the urine in my body is weakening? How can I fix this? Sorry, asking for 80% of the people I know.

• 20:21Speaker 00

  Asking for a friend, for 80% of our friends. Do you want a visual aid? Do you want to see this?

• 20:28Jonathan Cohen?

  Do we ever?

• 20:29Mayim Bialik?

  Sorry, do I want to see the sphincter?

• 20:31Speaker 00

  No. Yeah, hold on. You think I'm kidding?

• 20:34Mayim Bialik?

  She's taking her pants down, people.

• 20:37Speaker 00

  No.

• 20:38Mayim Bialik?

  Oh, dear.

• 20:39Speaker 00

  Oh, I don't know you guys that well. I feel like I may by the end of this conversation. But, I mean, I am a bone doctor and this is a pelvis, right?

• 20:47Mayim Bialik?

  Yes, that's where the baby goes through.

• 20:49Speaker 00

  This is where, right, so this is where your guts are. This is where the baby comes out. But this whole empty space that you see my eyes in now?

• 20:59Mayim Bialik?

  Yeah, yes.

• 21:02Speaker 00

  That is your pelvic floor. And that is made out of what? Skeletal muscle. It's the same type of muscle as your biceps. So if we're lose, if you can stretch out your muscles in your biceps or your hamstrings, it stands to reason you can stretch out your pelvic floor muscles when a baby sits here and a head comes through there, right? Number one. Number two, if we lose about 8% of our lean muscle mass a decade, you're going to lose that in your pelvic floor. So imagine this sheet of pelvic floor muscle going from, from

• 21:47Speaker 00

  strong to saggy. And the bladder sits right on top of that. So the bladder is kind of hanging down. So there are lots of reasons for incontinence in women. One is our pelvic floor gets weak. Our pelvic floor gets stretched out. It's less to do about the sphincter. It can be, but less to do about the sphincter. But you will see in CrossFit, if you ever watched the CrossFit Games, these are air quote, the strongest, the fittest people in the world. And women who have had babies in CrossFit who have not retrained their pelvic floor, they'll box jump and be peeing all over the box jump. It's a thing. So it's not just mere mortal women like me.

• 22:32Speaker 00

  It's fittest people in the world who haven't been taught to retrain their pelvic floor because here's the good news, my friend. You, you can retrain it. The other critical thing, and then I'm going to shut up and let you talk.

• 22:45Mayim Bialik?

  I'm busy doing kegels over here. I can't think about anything else.

• 22:48Jonathan Cohen?

  I started doing them too. I don't even.

• 22:50Mayim Bialik?

  We're both doing kegels.

• 22:51Speaker 00

  Are you doing kegels, Jonathan?

• 22:52Mayim Bialik?

  Both of us.

• 22:53Speaker 00

  Right now?

• 22:53Jonathan Cohen?

  Both of us started independently of one another.

• 22:56Speaker 00

  That is so funny. Every woman needs vaginal estrogen, which helps maintain. And some of the men. But are you kegels? Let's talk about that.

• 23:05Mayim Bialik?

  Oh, I want to talk about it. My midwife says I'm doing great.

• 23:09Speaker 00

  Oh, good. Because kegels, lots of women just squeeze together.

• 23:14Mayim Bialik?

  No.

• 23:15Speaker 00

  And you, and you go into tetany? No, it's a.

• 23:19Mayim Bialik?

  That's right. Elevator.

• 23:20Speaker 00

  It's a showing up. It's an elevation.

• 23:21Mayim Bialik?

  The elevator going up and down.

• 23:24Speaker 00

  You're so right. You're so right.

• 23:26Mayim Bialik?

  Why would God make my body this way? Shouldn't I just die after giving birth? Rather than experience the indignity of needing to retrain every part of my body because I decided to make a baby. I know a lot about animals and in some groups of animals, you crank out a baby and then the other ladies take care of that baby. So you can just recuperate and then you get pregnant again. And those other women don't have babies. They just help with your baby. Because like not everyone's pelvic floor needs to sag.

• 24:11Jonathan Cohen?

  This has just gone a little metaphysical.

• 24:13Mayim Bialik?

  Well, but, but, but I have to tell you that it's kind of like, what is this human design? Because we evolved for hundreds of thousands of years, right? To get to this conversation. It's very hard for me to believe that we're the first generation that's like, oh, by the way, you don't have to constantly pee yourself. Is it because we're living that much longer? Is it because our mothers and grandmothers, it was just like, sucks to be a woman. You're just gonna have everything go to hell and everyone's gonna just think you're a when you just need some hormones.

• 24:50Speaker 00

  There is so much to unpack here. I don't even know where to start. There's so much to unpack.

• 24:56Jonathan Cohen?

  That's our podcast. So much to unpack. We don't know where to start. Welcome.

• 25:00Speaker 00

  Well, I am so glad to be here with you. Why do women live longer? If, okay, we can talk about why people live longer, vaccines, trauma, whatever. But why wouldn't you just die after you have a child like a praying mantis or something? I don't know.

• 25:17Mayim Bialik?

  Or rather, why do I have to live like this?

• 25:20Speaker 00

  You don't. That's why we're here. You asked the metaphysical question, why would God keep us around? Well, obviously, we're important. Obviously, we are holding this whole frigging world together. We are the 51%. We are not the minority. We're led to believe the minority, we're the minority. But the way we age, my friend, is actually statistically the norm. 51% the norm. The 49%, which is the way medicine has focused on the way they age, is not the norm. If we look at where the, right? And I love men, please, Jonathan, I-

• 26:00Jonathan Cohen?

  This is a conversation for both, both groups.

• 26:03Speaker 00

  That is. But I always give that little caveat, because now I start going down the road of what's up with medicine and why aren't the 50%, 51% annoyed? So number one, we're needed. Number two-

• 26:17Speaker 00

  Why do we just tolerate this? Well, you know what? Something about what you said, I think, is completely true. Meaning, women are taught that suffering is normal. And in fact, in the 1900s, women going through menopause, who are going through all these changes, were called hysterical and put in asylums. Right? And so I think there's this long cultural history of, you know, periods hurt, women suffer. Childbirth hurts, women suffer. Menopause hurts, women suffer. It's just what women do. And in fact, in fact, I just got out of clinic today. I'm in my orthopedic office. Every day, there's never been a clinic

• 27:00Speaker 00

  when most of the women who come to see me say something similar to this. They say, um, I think I'm falling apart. I think I'm also going crazy because my doctors tell me there's nothing wrong. But I didn't want to come today. And then they pause and they're like, because I have a very high pain tolerance. As if at this point, they're going to get a badge. The pain tolerance. I have a very high pain tolerance, but I just couldn't take it anymore. And I want to know why we wait so long. It must be, because I've given this some thought, because we just think that that's what's expected of us.

• 27:42Speaker 00

  And so we don't seek care for our incontinence, by and large, because we're, we just suffer as a, as a group, a people group. We just suffer. It's what we do.

• 27:54Jonathan Cohen?

  Can I offer a counterpoint, though? I think as much as it may be, they think that it's expected, they also go to get help and are told that there's nothing that can help them.

• 28:05Speaker 00

  Yes. Gaslighting. Well, and you know what? I'm a doctor and I'm not trying to badmouth doctors. I think a lot of what's going on in women's health right now is because the very word women's health. For a very long time, just meant childbirth. And the reality is, at this point, women are living half of their lives past their fertility period. And medicine doesn't know what to do with us. Because not until 1993 were women required to be in medical studies. 1993, I mean, that's like yesterday in my world.

• 28:40Mayim Bialik?

  And also, part of it is the complexity of the female hormonal system, which we now know starts changing often in the very early 30s, right? Meaning, in terms of, it's not just that the patriarchal system of, you know, medicine hates women, it's that there are other factors when you're examining a woman's health that need to be taken into account and given their own attention, which is often harder to regulate when women are on hormonal birth control, or have been given hormonal birth control, or have a variety of other problems that are very, very hard to account for because there's not been enough attention given to women's health.

• 29:18Speaker 00

  That's what it is. Because I was about to respond to that complexity of women's hormones, which was the excuse. Why aren't women included in studies? Oh, women are so complex. To which I was about to respond, well, listen, I watched the movie, I know you can calculate your way to the moon. I mean, math, I mean, we've got some smart people on this planet who could have figured it out. But what you were really saying is, we don't know because there has been this excuse. And we will get there, right? When strong women like you and I and podcasts like this allow me to rant on and on about the fact that, you know, what we can do better and should do better and will do better, we'll get there.

• 30:00Speaker 00

  And I always say this, and it's, and it's not meant to be dramatic, but I will not lie to my daughters. My parents told me I could be anything I wanted to be, and I believed them, and so I sought the highest education I could possibly get from people, you know, who grew up on a farm, my parents. I will not lie to my daughters who grew up with me telling them they can be anything you want. Oh yeah, but you're gonna suffer, you're gonna be incontinent, and there's gonna be no research for you.

• 30:28Mayim Bialik?

  Well, it's, I mean, an interesting side point, you know, as the mother of two sons, I won't lie to my sons about what the female experience is like, which is incredibly complicated. You know, I chose to give birth with my second at home. I believe in natural birth. I'm a lactation counselor. So my children also know that the, the complexity of the human experience is one that is critical for all of our existence, right? So all of these things impact both men and women. These are critically important things. And I think also, when we think about what we tell our children, what do we tell them about what aging looks like, right? You know, my, my vision has definitely taken a turn.

• 31:12Mayim Bialik?

  My hearing has taken a turn. And it's become a little bit of like a joke in the house, right? Like, she's yelling, but also can't hear us. Like, what's going on? And so also, to be able to understand what the difference is between gracefully accepting certain things about our bodies while also building resilience. One of my favorite things in the book was this list. And the list came out of a variety of research about what qualities, people who are hardy or resilient, what qualities they have. And this was the research of a Barton and Stein, I believe.

• 31:50Speaker 00

  Yeah, the hardiness research.

• 31:52Mayim Bialik?

  Yeah, can you talk about, because sometimes I feel really weak. Sometimes I feel really fragile. I feel like, you know, anything small can lead to a big emotional reaction. Or if you have an autoimmune condition, anything can disrupt it and cause a flare up, or why am I having this weakness? What is it about trying to build resilience? Can we offer people, even in their twenties, even in their thirties, what is it to be a hardy person?

• 32:19Speaker 00

  I love that you flipped to that because I first became interested in a deeper dive into resilience, which is a pretty catch word right now.

• 32:30Speaker 00

  During COVID, when I had a bit of time and I realized that

• 32:36Speaker 00

  female doctors and male orthopedic surgeons kill themselves at a higher rate than any other population, doctors certainly, but higher than the general population. I said, what is it? Can you say that, wait, can you say that again? Yeah, the, the suicide rate amongst female doctors is the highest in medicine and male orthopedic surgeons due to the stress, the burnout, and it's much higher than the general population. So I'm like, what the what? We have got to get it. And because it was stimulated by a male colleague of mine stopped living in a very violent way at his own hands. And I think, I have got to figure out what's going on because, you know, we're

• 33:16Speaker 00

  supposed to be the orthopedic surgeons. So I started reading and I came across the work of, of these two

• 33:26Speaker 00

  scientists. Here's who they studied. That's why this is really fascinating. They studied Vietnam prisoners of war. Why did some survive and some didn't? They studied current Army Rangers and that class of soldier, the really doing the really hardest things. And then they studied people with congenital problems that made their life really, really hard and yet they were thriving. They're like, what is going on with these three groups of people? And so out of the hardiness umbrella, I mean, of the, out of the resilience umbrella, they start, they define hardiness. Now to separate it from another concept in resilience called grit, which Patty Duckworth has spoken about from Penn.

• 34:11Speaker 00

  Grit being that I'm going to keep going and going and going and going, right? The hardiness concept adds a rationality to it. I'm going to keep going and going, but I'm going to use rationale and mental state. So they have identified in these three populations some common characteristics, including a spiritual, a spiritual belief, support from people, but

• 34:37Speaker 00

  of the 10 things that I talk about most often is that even the prisoners of war in the horrible conditions, sometimes in cages. Had a physical exercise practice because from that, like maybe they were doing pushups in the mud, even that gave them physical resilience, but you know what it did? It gave them mental agency. I am in the worst place in my life, but I still have the agency to do something with my body, right? And so as a hardiness principle, people who are most hardy have a physical practice in addition to the mental practice.

• 35:19Speaker 00

  And so I always, I teasingly like, why this is important and unbreakable as a concept is growing old is not for sissies, people. It sometimes can be really disorienting and hard, but if you apply the principles of hardiness, which are the three Cs of control, challenge, and commitment, when you come upon a decision to be made, do you exercise your agency, take control, even if it's just in the next step, or you just sit in a lump because you don't feel like you have control? In terms of commitment, it's are you really willing to see this through or the first roadblock you have, are you just giving it up?

• 36:04Mayim Bialik?

  This is so interesting and it's so important coming from you because many people, and many women in particular, aren't taught to value or understand exercise the way men are told to value it. And part of it is cultural, some of it may be some physiological differences, but you know, it's among female athletes that you see women who are like, wow, they're so amazing. But so many women, we act like that's a different class of woman, right? And we're actually all the same kind of woman. We all have that potential. We all have that capacity. And I think about the women of my mother's generation. My mother was born during World War II.

• 36:45Mayim Bialik?

  This was not a value that was placed for women to be athletically agile, to be coordinated. You really were told, look pretty.

• 36:56Mayim Bialik?

  Get a man, build a house, have kids, right? And that's your job. And it's kind of like we now have this generation of women where, I mean, I think football, soccer, did this for so many women. That could be me. I could be an athlete like that. But can you talk a little bit about what it is to have a physical practice? Right? Even if it looks like lifting weights that are small. You can use cans, literally cans of beans can be your weights. What is it to do that for your body? And I learned about this when I was preparing to give birth without drugs. Because they say to you, you're about to do something that is an athletically challenging activity.

• 37:41Mayim Bialik?

  You're going to give birth, right? And so we were sort of trained, you're in training to like, what does that mean? What does it feel like to push through something that feels like I can't? And say I can, right? Can you talk about what, what is this that we're crafting? As athletes or as an athletic activity? That is impacting our mental state in a way that can transform our health?

• 38:06Speaker 00

  I love this conversation because part of it, you would think is, I'm just gonna, whatever it is, I'm gonna go for a walk seven days in a row and create a streak, which proves to me that I'm worth it. I've done, I've committed to myself for seven days. So there's that kind of thing. There is the kind of recognition when I sprint on a treadmill and I'm going so fast, air quote fast, it's not really fast, but for me it's fast. And I get off and I'm like, oh, I am such a badass and it empowers me. But it's not just attitudinal. Here's the cool thing. When you contract your skeletal muscle, biceps, quad, whatever,

• 38:47Speaker 00

  it causes the transcription of a protein called galanin that goes to the brain and crosses the blood brain barrier and causes the synthesis of new neurons. And it works on, listen, I'm not a brain scientist, but I believe I'm saying it correctly, the nucleus cearulus, which is one of the resilience centers in the brain. So it's not just you giving yourself a pep talk with some sweat. It is a chemical reaction of your body via the muscle.

• 39:22Speaker 00

  Going to the brain and building resilience, but it's not just the muscle. When you pound your bone, like I'm trying to make bones sexy in this world again because bones are master communicators and critical. When you pound your bone and you cause it to secrete the hormone osteocalcin, osteocalcin also goes to the brain and causes the production of brain-derived neurotrophic factor. Voila, more brain cells, right? So it is this physical interaction of what we think is working out actually builds a better

• 40:01Speaker 00

  brain. And see, we're all connected. We're so not separate. We think this royal orb in the big, in the top of our head is so separate, actually talks to us all the time.

• 40:13Jonathan Cohen?

  You touched on people who push through obstacle to get that benefit, have even more benefit. A lot of people will be like, I can't do anything because it hurts too much, or I can't do a push up.

• 40:27Jonathan Cohen?

  Can you talk about the simple ways that people can start leading up to that? It could be a wall push up. It could be like someone could say, I can't jump and, and you know, put pressure on my bone. And then therefore they do nothing and that sedentary cycle continues. Talk about how people can feel those obstacles, but can take incremental steps.

• 40:48Speaker 00

  So when you use the word can't, I can't, let's just take jump. I can't jump. If you put a period after that, okay, what, end of conversation, I can't jump. However, if you say, I can't jump, or use the however, I can't jump, but what I can do is a heel tap where I sit on a chair, and I've taught people to do this on the internet. Sit on a chair and tap your heel as hard as possible into the ground. That doesn't require any balance. You can do that, right? Or if you say, somebody says, um, what else do they say?

• 41:32Speaker 00

  I can't push up. Boy, that was a scandal on the internet when I said, women need to do 11 pushups. It's not a judgment about whether or not you can do it. You mean in one sitting, like one? Preferably sequentially, not over 11 days. Not over like 40 years. Okay, got it. But you know what? Good for you. In 40 years, you'll accomplish that. That's up. So you know, when I said that, 93% of the women are like, I don't know if I can, but I'm gonna try. If you continue the conversation with but, or however, you continue the opportunity, you just don't shut yourself down.

• 42:13Speaker 00

  I can't sprint for 30 seconds like Vonda tells me to, but I can walk for 10 minutes and tomorrow maybe 12. So you just have to keep the door of opportunity open because I frankly don't care where you start. I care that you start and invest in yourself every day.

• 42:34Mayim Bialik?

  What's going on with women and Alzheimer's and what can we do to prevent it?

• 42:40Speaker 00

  Yeah, 70% of all people with Alzheimer's are female, which is a frightening statistic.

• 42:46Speaker 00

  Part of it has to do, I believe, has to do, although I know correlation is not causation yet. The work of Lisa Moscone, she showed that the entire female brain is covered. Covered like sprinkles on a cupcake, dense covering with estrogen receptors. Number one. Number two, the wa- the work of Robbie Brenton, another brilliant brain scientist, showed that without estrogen, a woman's brain goes into a starvation mode. Knowing those things happen. Knowing that at age 40,

• 43:28Speaker 00

  we have less than 1% of our eggs left and we will have a cataclysmic decline in our hormo, our estrogen produced by our ovaries until the point on that arbitrary day of menopause, we're not making any more from our ovaries. That is going to have effect on the physical brain. So we don't have causation yet that loss of estrogen causes the 70% of people with Alzheimer's to be women. But we can't ignore the association between loss of estrogen and oh my God, what is happening to these brains. Because men don't experience it like that. And what's the same, men do not have a cataclysmic decline.

• 44:11Speaker 00

  They have a slow, steady decline in their hormones. Right? So it's one of the reasons, brain health, microvascular disease of the heart. I'm a bone doctor. You're going to lose 20% of your bone density during perimenopause due to the loss of estrogen. It's these total body health issues that make me so like this, yelling at you and passionate about women need to get in front of what they believe about hormones. You don't have to decide to replace your hormones, but you must make a decision based on facts, not fear. You are not allowed in my house to just be fearful without investigating the facts.

• 44:56Speaker 00

  Because we know that instead of waiting until you're a really old lady and showing up in my emergency room with a fracture, I probably could have helped you prevent that if we had started when you were 30.

• 45:10Mayim Bialik?

  If someone were to come to you in their 30s and say, I don't want my life to look like fill in the blank when I'm 70. I don't want to be weak. I don't want to have osteoporosis. I don't want to be at risk of fracturing a hip. I don't want to be miserable. I don't want to feel hysterical. I don't want doctors to tell me, we don't know what's wrong with you. What are the things in your 30s and 40s that you should already be implementing so that that's not the future story that you tell?

• 45:39Speaker 00

  Number one, there is never an age or skill level when it's too late. So if you're like 30 and like, shit, I've never done any of this, doesn't matter, doesn't matter. Your body is an adaptability and homeostasis machine. It is ready. Right? So I love that you're asking this. And if we take, let's just take the life cycle of bone. We could talk about any tissue, but if you were 30.

• 46:04Speaker 00

  Here's what I would be telling you. And the fact of the matter is, many young women are showing up in my clinic with this exact question. Like, what can I do? Especially millennials, the early millennials, 41, 43. What can I do? Tell me now. Okay. So, we know that if we talk about bone as a structure, as an example, we reach peak bone density between puberty and about 25, right? Right. As we come into our estrogen through our adolescence, we start accumulating bone density and tensile strength in bone.

• 46:44Speaker 00

  And it peaks out when we're 30. Now, it doesn't mean you can't build it, but we want to start at the highest level. I have lots of 30-year-olds who come to me because I test everybody's bones who have not built peak bone density. So, for the kids in the room, that could be due to we don't eat enough because women still believe the lie that you have to be this big and can't eat. Lie, you gotta eat people. Number two, maybe it's because we've never bashed our bones. Maybe we just didn't get outside and run around and jump. Bones require impact to build. It's the biochemical way, and I can explain that if you want.

• 47:26Speaker 00

  Or, number three, what if we were amongst the female athletes who grew up in the last 54 years of Title IX? And we're just burning 10,000 calories a day, believing the myth we have to be this small, and eating gummy worms to recover after a hard practice, which, by the way, happens because I'm a sports doc and I've been on the field with many. Those are all reasons you might not build better bone because, in the last example with athletes, if you're not having your periods, you're not building bone. And that was me. I was a dancer growing up, and I wouldn't have a period for six or nine months. And I'm like, yes, only to know that that meant I didn't have enough hormones to do all the things I was supposed to do.

• 48:10Speaker 00

  So, we get to 30 with or without enough bone.

• 48:15Speaker 00

  And at thirty, we cruise along, but what if we decide to have children? Most women don't know that it takes about five hundred milligrams of calcium a day to build a baby. And if we're not eating enough, our body's going to prioritize the baby we're growing, and it's going to take it from our bones. Now, that's called the osteoporosis of pregnancy, and our bodies, because they're miracles, are meant, are, know that this is happening, and we will rebuild that bone, but only if you eat. It's like taking a shower. You don't have time to take a shower with the new baby. Do you have time to eat? Only if you eat, or what if you're breastfeeding?

• 48:55Speaker 00

  Now, I'm a huge fan of breastfeeding. I breastfed my last child for a year, and I would have done it till she was four, unless she was done with me, like she is so done with this. But it is not that I am against breastfeeding, what I'm about to say. Again, it takes about five hundred milligrams of calcium to make milk every day. If you're not latching on and drinking your water and eating some calcium-rich food, you may not have enough calcium without leaching your bones. So then we go through the motherhood period, and then low and behold, you go into perimenopause. When you start losing your estrogen precipitously,

• 49:37Speaker 00

  normal bone loss for men and women is about one percent a year. Once you lose your estrogen, it triples, and that's how, in a very short amount of time, you lose twenty percent of your bone density. So if you did not build bone as a youth, if you did not replenish your bone as a mother or a breastfeeding person, and then you go into perimenopause, you're kind of behind the eight ball. And that's why more than forty to fifty percent of all women will have osteoporosis. And if you have osteoporosis, one in two women will fall and break a bone. And if that's your femur, if that's your hip bone,

• 50:21Speaker 00

  the minute, can you hear that? The minute you fall to the floor and break your femur, you have a thirty percent chance of dying and a fifty percent chance of never returning to the home you left. So if I can tell a 30-year-old, "Oh, my God, oh, my God, oh, my God, let's test your bones. Let's see what the quality is, what the density is." If I can say, "Let's eat enough protein, calcium-rich foods. Let's bash your bones by jumping around a little bit. Let's impact them. Let's eat enough protein. Bones are 50% protein." If we can build muscle mass so that the muscles themselves pull on the bone in a synergic way,

• 51:05Speaker 00

  studies have shown that we can build bone density and maintain bone density over time. This is only one example.

• 51:13Mayim Bialik?

  I mean, if I could title this episode, it would be that the obsession with thinness is actually killing women in ways that we never understood. The fear of being too bulky, the fear of building too much muscle, the fear of being tomboyish, right? All of those things are actually not enabling us to build the bone that we need, to build the bone density that we need, and over time, it's going to decrease our ability to stand up in our own skeleton and protect ourselves from the world around us.

• 51:55Speaker 00

  It's all mental. It's fear, isn't it?

• 51:57Mayim Bialik?

  So much of our culture, right? "I'd rather be thin than like, you know, I'd rather be thin." And I, you know, I've been working out with a trainer and like, that's one of the fears that I said is like, when I started lifting weights in college, no girls were in the weights room because nobody wanted to get bulky. No one wanted to get big muscles. And I will say, clothing is not made for women with muscles. It's not. Fashion is not made for that. And we've decided that we all need to look like models. When I was a kid, there were models who were like another species of female. And it was like, oh, they walk, they wear lingerie, like, I'm not expected to look like that.

• 52:38Mayim Bialik?

  But whatever's happened, you know, from the time that I was 15 to the time that I'm 49. Young girls now think I'm supposed to look like I'm on that catwalk, right? And that contribu-- like, this is such an elaborate problem.

• 52:54Jonathan Cohen?

  I do think that there's hope to be had in that there's more celebration of muscles, of physical activity, of physical endurance. And it's spreading, I think, more than when I grew up, which had less of that. And that female athletes especially are being seen as role models and people to look up to.

• 53:15Mayim Bialik?

  Well, and that their bodies are admirable, their bodies are strong, right? That they-- they're experiencing something as an athlete that's different.

• 53:23Jonathan Cohen?

  If people don't know what osteoporosis is, give us the quick explanation.

• 53:29Speaker 00

  Osteoporosis is translated literally from Latin as holy bones. Holy bones, you get holes in your bones. And here's why. Bone is a dynamic, constantly remodeling organ, such that you don't get one set and then you have it for your whole life. Every 10 years, you have rebuilt your whole skeleton. And the way that happens is largely due to two cells. And I always use my hands because I'm a visual person. So there's one cell called the osteoclast with a C. It's like a Pac-Man. It's creating an acidic environment, which causes the minerals to be removed from the bone. Your body takes those minerals and uses them because bones are a storehouse, right?

• 54:13Speaker 00

  Osteoclasts are kind of wild children. They're doing their thing. They have to be controlled. One of the things that controls them is estrogen, right? So osteoclasts are doing this. Osteoblasts are building the bone back. So osteoclasts create a hole and osteoblast fills it back because you can't leave a hole in the bone. Well, without the influence of estrogen, the normal balance becomes unbalanced. And we-- We dissolve more bone than we build. And so we lose our density, we lose our, uh, our tensile strength of the bone. Over time. So that's what osteoporosis means. And because it's so dependent on estrogen.

• 54:59Speaker 00

  That's why without estrogen, the holiness of the bone triples in a very short amount of time. And it makes it brittle. Yeah, it makes it more, less likely to be able to withstand impact, honestly.

• 55:15Jonathan Cohen?

  And do men also experience osteoporosis?

• 55:18Speaker 00

  Yes, I love that. So men also experience it. I wrote a paper really early in my career. That, that summarized two million men in the United States have osteoporosis. You only think it about as a woman's problem. In men, uh, it comes in two waves. In the 50s for men who have metabolic problems. And then in the, in the late 70s, 80s, the statistics for men are dire also 30% die in the first year, 50% will never go home. So it does happen in men, but not in one in two men. Like it does in women. It's like one in four or five men. But so it's, it's a much bigger problem for women than men.

• 56:01Jonathan Cohen?

  And what's causing it in men?

• 56:03Speaker 00

  Well, you lose, you lose bone density 1% a year. So between, between 30 and 80, you've lost 50% of your bone density at a normal steady decline. And then, you know, simple falls from a standing position can cause it. And the honest truth is men experience the reality of fracturing the same as women. I, I had an executive man who was, you know.

• 56:28Speaker 00

  He was one of those executive guys ran the world. And to be reduced to laying in bed in a blue gown because of a fracture. I mean, he had the same sentiments. Don't get old. I mean.

• 56:43Speaker 00

  Well, don't get old without being prepared to be healthy, vital, active, joyful is what Unbreakable is about.

• 56:49Jonathan Cohen?

  I've heard that too much coffee can impact bone density. Is there any truth to that?

• 56:55Speaker 00

  Listen, maybe the acidity of coffee, but there are a lot of other things we need to be worried about, like smoking, which is poison to bone, or vaping, poison to bone, or steroids because you have some kind of immune disease or asthma, not great for bones. So there's a lot of big things to worry about besides your cup of coffee in the morning.

• 57:23Mayim Bialik?

  We're going to hit pause here on our conversation with Dr. Wright. There is so much more that we want to get to. Part two of our conversation with Dr. Wright will include early warning signs of osteoporosis.

• 57:37Jonathan Cohen?

  Something that affects more than 25%, one quarter of Americans.

• 57:41Mayim Bialik?

  We're going to talk about the dangers of alcohol, the increases to a variety of things like Alzheimer's, and how changing your relationship with your bones, with bone density, can actually impact the likelihood of being diagnosed with so many other health detriments.

• 58:01Jonathan Cohen?

  We're also going to talk about the role of creatine, very specific cardio activity that you can do to help yourself, and some of the biggest red flags to look out for and get checked out immediately.

• 58:15Mayim Bialik?

  We can't wait for you to hear part two of our conversation with Dr. Wright. So from our breakdown to the one we hope you never have, we'll see you next time.