Dr. Suzanne Gilberg- Lenz: Menopause, plant medicine, Psychedelic's and Integrative Medicine

Dr. Sameena Rahman [: 00:00:01

Hey, y'all, it's doctor Samina Rahman, Gyno girl. I'm a board certified gynecologist, a clinical assistant professor of Ob GYN at Northwestern Feinberg School of Medicine, and owner of a private practice for almost a decade that specializes in menopause and sexual medicine. I'm a south asian american muslim woman who is here to empower, educate, and help you advocate for health issues that have been stigmatized, shamed, and perhaps even prevented you from living your best life. I'm better than your best girlfriend and more open than most of your doctors. I'm here to educate so you can advocate. Welcome to Gyno girl presents sex, drugs, and hormones.

Dr. Sameena Rahman [: 00:00:47

Let's go. Hey, y'all, it's me, doctor Samin Rahman, Gyno girl. Welcome back to another episode of Gynel Girl presents sex, drugs, and hormones. I am so, so, so excited to have one of my buddies and menopause members here today, and I'm going to introduce her, and we're going to have a great discussion, and you guys are going to enjoy this a lot. Welcome, doctor Suzanne Gilbert. So excited to have you, Suzanne, but let me introduce you. And so, not that and you need an introduction, but just in case. Doctor Gilberg is a board certified Ob GyN who has received her medical degree from the USC School of Medicine in Los Angeles and completed her residency in Ob gyn at UCLA Cedar Sinai Medical center.

Dr. Sameena Rahman [: 00:01:32

She is incredibly involved in women's empowerment and public education. This is her jam. She appears frequently as an expert in women's health and integrative medicine in print, online, and on tv. She's a chief medical correspondent for the Drew Barrymore show, and she's the author of an amazing book, Menopause Boot Camp. Optimize your health, empower yourself, and flourish as you age. So welcome, Suzanne and Doctor Suzanne, how are you?

Dr. Suzanne Gilberg [: 00:02:01

Hello, Doctor Samina. What a pleasure. My ring light. What a pleasure to see you. Because usually we're just like, texting.

Dr. Sameena Rahman [: 00:02:10

I know, and we just had, like, a 30 minutes conversation, but I'm in my closet sitting like I told you, because Lollapalooza is happening in Chicago, and I just didn't want to go to the studio area that I recorded.

Dr. Suzanne Gilberg [: 00:02:21

I don't blame you. It's nice to see you in your closet.

Dr. Sameena Rahman [: 00:02:26

I'll come out of it later. Anyway, let's talk. You know, let's get into it. You do so much amazing work. You're like a medical advisor for so many great companies and have been in practice for such a long time as well in terms of, you know, and really in the forefront when it comes to menopause management and getting the word out. We all know that menopause and our menopause, we talk about it every freaking day. Every ten minutes we get a new test all day.

Dr. Suzanne Gilberg [: 00:02:53

I wake up to 90 text messages.

Dr. Sameena Rahman [: 00:02:56

Exactly. But it's awesome because everyone updates.

Dr. Suzanne Gilberg [: 00:02:59

Do these girls sleep? No, it's amazing. And it's like free continuing medical education.

Dr. Sameena Rahman [: 00:03:04

Right? Cause somebody will say, hey, I found this article. What do you guys think? Or what about this? Why do we do this? Have you thought about this? So it's really nice, but what I want the listeners and viewers. Cause this will probably go on YouTube to know a little bit about you. I like to talk. My tagline is, I'm here to educate so you could advocate for yourself. So I wanna make sure that patients know how to do that with your recommendations. But I always tell, I always have been my guests tell their story first and then, so you can tell us your story about how you came into menopause, how you yourself have maybe experienced perimenopause or menopause and how you navigated it.

Dr. Suzanne Gilberg [: 00:03:42

Wow. I mean, so first of all, it's such a great. I love your tagline. And I now I understand why we resonate with each other. Cause that's exactly what I feel like my mission is. I feel really, really strongly attached to that. And I have my whole career for a variety of reasons. Like, why are we the people we are? I mean, some of it's just the way I was raised.

Dr. Suzanne Gilberg [: 00:04:02

Some of it's accident of birth, you know, all sorts of interesting experiences. Right. You know, I mean, to be truthful, I think I grew up very privileged, but my dad came from a pretty poor background and I did grow up. It was a little bit like how a boomer raises people anyways, which was like yours. You know, how lucky you are, like that kind of thing.

Dr. Sameena Rahman [: 00:04:23

Yeah, yeah, yeah.

Dr. Suzanne Gilberg [: 00:04:24

I definitely got a lot of that. And also we were very, very. We traveled a lot. We traveled a lot, like, all over the world. I was very fortunate. My parents were extremely adventurous travelers, and I saw a lot of different things as a young, like a kid. And, I mean, I'm like poverty, but also like the richness of different cultures. And so I had sort of embedded in me a deep curiosity and respect for other people.

Dr. Suzanne Gilberg [: 00:04:50

I really, that had a huge influence on me as a person, and it definitely had a big influence on me in terms of medicine.

Dr. Sameena Rahman [: 00:04:56

Yeah.

Dr. Suzanne Gilberg [: 00:04:58

You know, I trained at La County Hospital in the early nineties, right?

Dr. Sameena Rahman [: 00:05:04

When I was. General Hospital, yeah.

Dr. Suzanne Gilberg [: 00:05:07

General Hospital, yeah. You know what?

Dr. Sameena Rahman [: 00:05:09

I told you I was there.

Dr. Suzanne Gilberg [: 00:05:10

You know, we were there. You were there after. Right before I got torn away or nothing. It was. Right, so it was the old general hospital. And let me tell you, should be rickety. I mean, it was like you'd go up because this was after the. There was a big earthquake.

Dr. Suzanne Gilberg [: 00:05:28

There were a couple of earthquakes in the nineties here. So it. The. And one of the elevator shafts, I mean, for sure was not a Dakota anymore because it would go like this and you're like, God, this doesn't seem right. So. But whatever. That was just like.

Dr. Sameena Rahman [: 00:05:43

Let me tell you a side story. When I was there, actually, this was in 2005 when I first started working there. And I had done a couple, like, mission trips into Niger. And I came back and, like, I think the lights went off or something during, like right before surgery. Something weird happened, like can related. And I was like, oh, my God, this is just lightning.

Dr. Suzanne Gilberg [: 00:06:01

No, it was. It was. It was like working in a developing nation, it's unfortunately. Which I. But you know what? Listen, I do. I think that. That if you don't develop a tremendous amount of humility about what you're doing, why you're doing it, and also, like, get really resourceful, then I. Then you're never going to.

Dr. Suzanne Gilberg [: 00:06:24

I think, and diligent like you just.

Dr. Sameena Rahman [: 00:06:26

Like, I got to work.

Dr. Suzanne Gilberg [: 00:06:27

I think training in a county hospital.

Dr. Sameena Rahman [: 00:06:29

Wonderful.

Dr. Suzanne Gilberg [: 00:06:30

Really should be de rigueur for everybody. A part of your education should be in a hospital like that. The other thing is that, like, you really learn. You are reminded that you are here to be of service. Like, my patients, our patients, were really without resources and were absolutely the most unbelievably generous, great human beings. I can't tell you how many people said to me they would like, take your hand. Maybe we were speaking the same Spanish, maybe not. Like a lot of them spoke indigenous languages that were Central America or from Mexico, but they didn't speak Spanish, really.

Dr. Suzanne Gilberg [: 00:07:06

And they. They would thank you for, you know, basically they would tell me, like, God was working through me and stuff like that. It was just like. So that stuff really. I'm getting the chills. Like, it really affected me. And I'm going to tell you something really interesting that just happened because, you know, we were just talking before we started. I just came back from South Africa where I had the honor and privilege to teach, but also to travel.

Dr. Suzanne Gilberg [: 00:07:27

And one of my most formative experiences in my medical education Samina was that while I was at county hospital, we had a huge, horrible, horrible crisis in Los Angeles with violence and specifically gang violence. There were, like, huge cartel and gang wars going on during the time. And, you know, there was a big, big, big problem with young men shooting each other. It was really, really bad. And they were overwhelmed with category of trauma called penetrating abdominal wounds. I mean, we're surgeons, so this is something we know, but the lay public wouldn't know. That's really anything that literally penetrates the abdominal cavity. Gunshot wounds, knives.

Dr. Suzanne Gilberg [: 00:08:07

And the prevailing protocol prior to this time was if somebody had a penetrating abdominal wound, everybody had to go to the operating room for exploratory surgery. There was a team from Soweto, South Africa, because during the end of the apartheid era, there was obviously tremendous violence, same kind of problems. They had published on this and found that for similar reasons, they were overwhelmed. They didn't have resources. It turned out only about 30% needed to go to the operating room. So they had developed a triage protocol. They brought this team of trauma surgeons from Soweto to La county while I was there. That is who I studied with.

Dr. Suzanne Gilberg [: 00:08:46

That's who I did my general surgery rotation with. And they were. They changed my life. They changed my life. While I was in South Africa. Two weeks ago, I took a tour of Soweto, and I got to go. I didn't go in, but I got to go to the hospital.

Dr. Sameena Rahman [: 00:08:59

Wow. Full circle.

Dr. Suzanne Gilberg [: 00:09:00

And it was. I cried. I cried because of a million different things. But I could go on and on and make the whole podcast about that. But these are all important things, because these are things that reminded me of why I'm here, what I do. I'm here. Look, I'm curious. I love people's stories.

Dr. Suzanne Gilberg [: 00:09:19

This is why I like ob gynae. I like getting to know people. It turns out I don't love pathology very much. I think people who do ob gyn are a little bit, like, high risk. Like, we like drama. You have to. We have a surgical personality. We like to fix things.

Dr. Suzanne Gilberg [: 00:09:33

But also, like, I don't really want to do the chronic stuff. Although with menopause and sexual med turns out not so much.

Dr. Sameena Rahman [: 00:09:39

It's a transition. I always tell people, don't you miss major?

Dr. Suzanne Gilberg [: 00:09:43

So maybe as we matured, we were able to do it. It's a transition.

Dr. Sameena Rahman [: 00:09:47

It's like we've saved lives. Now we want to improve lives.

Dr. Suzanne Gilberg [: 00:09:50

As I have. As I've matured, I've been more tolerable. I. More tolerable and tolerant. I. Exactly, exactly. And also, like that cortisol stuff on labor and delivery. Ugh.

Dr. Suzanne Gilberg [: 00:10:01

I can't anymore. I'm too old for that. I did it for 22 years, and it was great, but it was like, it was killing me. It was, like, literally bad for me. So how I got into menopause is kind of interesting. I early in my career, one of my mentors, Washington. Okay, well, one of my big mentors was Doctor Beth Carlin, who is a world renowned gynecologic oncologist, ovarian cancer specialist. She had a very close relationship with a breast cancer oncologist on staff named Philomena McAndrew, who's since become quite renowned herself.

Dr. Suzanne Gilberg [: 00:10:31

And when I graduated residency and started my practice, doctor Carlin was very generous, you know, as your mentors will, and she would refer me patients, and I guess she had shared with doctor Philomena McAndrew. Hey, this is a new gynecologist. She's really good. You should send patients to her. And she started sending me her young breast cancer patients, her pre menopausal breast cancer patients, and I was faced with a reality. I didn't know how to deal. I didn't really know very much about menopause. Now, I had a 34 year old with chemo induced menopause, and I just started reading the literature, and I was calling her and being like, I think it's my read is it's okay to give vaginal estrogen.

Dr. Sameena Rahman [: 00:11:10

Yeah.

Dr. Suzanne Gilberg [: 00:11:11

What do you think? She's like, yeah, sounds good. You'll figure. I'm like, I don't know how to deal with this. She's like, she's like, Suzanne, nobody knows how to deal with it. You will figure it out. You're smart. And I was like, okay. So that was my first taste of menopause, to be perfectly honest.

Dr. Suzanne Gilberg [: 00:11:24

Unfortunately for me, fortunately for my patients, I became a premenopausal breast cancer patient myself, and that accelerated even more. And then, I think just aging with my patients. Samina, like, you know, I am very fortunate that I've been in the same community for a long time. I have a very stable population in general, and I have a lot of patients who've been with me their entire lives. And so as all of us aged together, I just saw more and more how little anybody knew. I had been studying. I had been, you know, getting up to speed, but they didn't really understand what was going on with their bodies. And I knew that I could not address their needs educationally in an insurance based encounter.

Dr. Suzanne Gilberg [: 00:12:06

And I started to. I was frustrated. The other thing that happened was sort of in the post women's health initiative vacuum here in southern California. You can imagine we're very progressive, but sometimes it's a little wacky. There was a big, you know, what came in to fill that vacuum was, yeah, a lot of compounding pharmacies, a lot of, like, bio identical, blah, blah. And I started availing myself of that. I started going to their conferences to learn and sort of pick apart well, what makes sense to me, what doesn't. And I learned a lot, to be perfectly honest.

Dr. Suzanne Gilberg [: 00:12:37

They were ahead of the curve in some ways. Some of it was obviously not very evidence based.

Dr. Sameena Rahman [: 00:12:41

I mean, totally understand why. I mean, we totally understand why they exist. Just like I understand why the compounding of semiglutide exists. It's not accessible to some people that need it.

Dr. Suzanne Gilberg [: 00:12:51

It wasn't accessible. And also, the conventional medical community had shut itself down and just basically refused. And women were like, this isn't, this isn't enough. I feel bad.

Dr. Sameena Rahman [: 00:13:04

How can I live like this?

Dr. Suzanne Gilberg [: 00:13:05

I don't, like, right? Like, forget, like, the long term health issues. Like, they just felt they were nonfunctional. So all of these things kind of came together. And, you know, when I would go give a talk about what? Anything, all the hands would shoot up at the end asking about that. And I thought, okay, I got to do something about it. The final kind of event that pushed me in that direction was that I was interviewed publicly. Bye. A dear friend of mine and colleague, who's 20 years my junior, in a public, at the time, the wing at a women's workspace on menopause, they wanted to bring me in to have a public conversation with her about menopause, which I thought was really interesting and really smart.

Dr. Suzanne Gilberg [: 00:13:44

And midway through, I realized, oh, my God, this intergenerational conversation has been lost. It all kind of came to bear. I was driving down. I couldn't stop thinking about it for days. And I literally have told the story so many times. I was driving. I can tell you exactly where I was. I was at Fairfax and Santa Monica Boulevard.

Dr. Suzanne Gilberg [: 00:14:04

And, I mean, a download in my brain. Menopause boot camp, you just had that word. I went home and I said, I have to do this. I don't know what this is. I have to do it. And I did. I made it up. I called my friend who at a yoga studio, I said, I want to do this.

Dr. Suzanne Gilberg [: 00:14:17

She said, do it. And I started beta testing it. I started creating. I created a four hour program of education so that people could advocate for themselves. This is not how to treat menopause. It was how to be a human being and get through menopause and thrive and understand why it's important not to just white knuckle it, how to approach your practitioner, how to change your mindset. What are some practices? Because what we haven't talked about is that I'm board certified in integrative medicine as well. So I had a long history of plant based medicine, growing my own medicines, yoga, meditation, in addition to being in a conventional setting.

Dr. Suzanne Gilberg [: 00:14:53

And it was very popular. And then the book came from there, and I created a certification course to allow more advocacy for grassroots efforts, for laypeople, professionals, whoever, to bring menopause boot camp into their own community, to educate in order to create community, a social network, decrease isolation, increase advocacy. And it's really beyond my wildest dreams what has happened in the last four years. I mean, all of us in this menopause group, the women who have rose up and said, we deserve better, we deserve everything. And actually, the policy change that we're starting to see happen.

Dr. Sameena Rahman [: 00:15:37

Wonderful. I know. It's amazing, actually.

Dr. Suzanne Gilberg [: 00:15:39

We are making a difference. You are making a difference.

Dr. Sameena Rahman [: 00:15:41

Absolutely.

Dr. Suzanne Gilberg [: 00:15:43

I never in a million years would have thought.

Dr. Sameena Rahman [: 00:15:45

And I think that's what keeps driving us. Right? Like, we all have this inner something that's saying, keep going, keep going, keep going. Even, like, I remember just a couple weeks ago, I spoke to a friend of mine who I hadn't spoken to in a long time, and she was like, I've been listening to your podcast. I was like, really? She's like, yeah. And I was like, oh, because I love it. I love everything you're doing. I'm telling my friends about it. And I was like, oh, wow, thanks.

Dr. Sameena Rahman [: 00:16:05

Every time I think about, like, shutting it down, she's like, no, sometimes we.

Dr. Suzanne Gilberg [: 00:16:08

Don'T realize what we're doing, so it's like we don't know who we're touching.

Dr. Sameena Rahman [: 00:16:11

Yeah, because you don't know if it's what. Exactly. And that's wonderful.

Dr. Suzanne Gilberg [: 00:16:15

Tell us.

Dr. Sameena Rahman [: 00:16:15

Tell the listeners, for the very few that probably haven't, you know, tapped into the menopause boot camp, you know what it is. What are some of the essentials that you talk about in your book and some of the integrative stuff that you mentioned? Because I want to continue to talk to you about this and then talk about the other stuff. Psychedelics.

Dr. Suzanne Gilberg [: 00:16:33

Well, it's interesting. Some of it was driven by. Okay, so really the basics, because what I found is that people didn't even understand language. And by the way, sometimes in our little echo chamber, I'm like, okay, do people know that? No, they don't. No, they don't. People don't even know the definitions. So, literally, the first part is just talking about the demographics, who it's happening to, where it's happening, when it's happening, why it's happening, the basics. Okay.

Dr. Suzanne Gilberg [: 00:16:58

Definitions of the terminology. Understanding. One of the reasons I've enjoyed this career where I love speaking to my colleagues, but I really do enjoy speaking to my. Not colleagues. And I think I tell people all the time, I'm bilingual, I speak medicine, and I speak normal person. I also do it in the medical community because from the beginning, as I mentioned, I have this background in integrative medicine. So I've done a lot of teaching in the integrative medicine community and in the conventional communities and speaking that language. So that was a big motivation for me to bring those.

Dr. Suzanne Gilberg [: 00:17:39

Bring those to bear. Right. Like, I feel really strongly, like I.

Dr. Sameena Rahman [: 00:17:42

You're gonna be, like a bridge between us. Yeah.

Dr. Suzanne Gilberg [: 00:17:45

I really. As you know, I'm. I really have a problem with the either or ing. The gatekeeping and the finger wagging. That is not anything you will ever seeing me do. I am. And I'm. And, yes.

Dr. Suzanne Gilberg [: 00:18:00

And that is my thing, so I like to see the evidence.

Dr. Sameena Rahman [: 00:18:04

Yes.

Dr. Suzanne Gilberg [: 00:18:04

But I'm also very open to the wisdom of the ages, and I find it amusing sometimes. Well, actually, it's not. So. You know, sometimes it's amusing. But to be perfectly honest, there's a lot of white supremacy and colonial white colonialism baked into medicine that we don't appreciate. And I'll tell you where I see it the most, is this name calling around indigenous medicine. Because anytime somebody says snake oil, the hairs on the back of my neck go up. I'm like, you're.

Dr. Suzanne Gilberg [: 00:18:36

You don't even hear how racist you are because you're talking about indigenous medicine and poo pooing it. Not doing more than poo pooing it. You're dismissing it, and you're gaslighting people, denigrating it.

Dr. Sameena Rahman [: 00:18:50

Denigrating it? Yeah.

Dr. Suzanne Gilberg [: 00:18:51

30% of pharmaceuticals come from the plant world. Where do you think you learned how to do medicine? The people who lived on the planet 10,000 years ago were doing this. Like, you think that it just started in 19 with the Flexner report? I mean, please stop it. No, but people do, and we have colleagues. We know who they are who do that. And it's really rude. It's just rude. It's racist.

Dr. Sameena Rahman [: 00:19:12

I agree with you.

Dr. Suzanne Gilberg [: 00:19:13

And I not going to be part of it. So I came into this with a lot of that. And as a breast cancer survivor, people at that point knew that I was a breast cancer survivor, and I used a lot of non pharmaceutical things. Now, what's interesting is, in the time since the book came out, I've started hormone therapy myself because I read, I challenged myself. I primarily read Avrim blooming and Carol Tavris's book. And I changed my mind and I was like, you know what? This is safe. I'm a ten. I'm eleven years in October, and I'm more concerned about the impact on my brain and my bones and my heart.

Dr. Suzanne Gilberg [: 00:19:49

So I'm kind of going far afield. But the bootcamp itself is basic definitions, basic understanding, leveling the playing field, making sure that we're speaking the same language, and then going through the biggest complaints that people present with now, early on, it was the basic stuff, hot flashes. Now, you know, everybody knows about hot flashes. We're talking more about musculoskeletal health. So I go through and I use my deeper, wider toolkit to discuss lifestyle, pharmaceuticals, and plant based options. Okay. And when I say lifestyle, I mean everything. I have something called the successes of self care.

Dr. Suzanne Gilberg [: 00:20:23

So sex, sleep, stress, social connection, sustenance, senses we can go through it at another time. That's a whole other talk, but. And the science of it, and then practical things you can do. So I wanted people to leave with practical tools that they could use when they left. And then finally, my partner, my longtime partner at the time, we're no longer together. He is a 35 year fitness pro. And so he developed, he'd been working with older women for a very long part of his career, and he would do a fitness routine with us that was based in that, like, how do we preserve musculoskeletal health, flexibility, prevent the fall. Right.

Dr. Suzanne Gilberg [: 00:21:07

So, so really? And then, you know, going into the toolkit of herbs and things like that. So, yeah. And then, and then finally, also really looking at understanding what is hormone therapy, what is bio identical, what is available, what is safe, what can we use? It's a lot. It's a lot to unpack. And the book is basically based on the bootcamp itself, but woven with more of my personal stories in there, too. So here we are today.

Dr. Sameena Rahman [: 00:21:36

That's awesome.

Dr. Suzanne Gilberg [: 00:21:37

Yes.

Dr. Sameena Rahman [: 00:21:37

I love it. I love it. So it started out just as these meetings and boot camps, and then you evolved it into it. That's amazing. When you say integrative medicine. Do you mind defining that for some of the listeners? Because some people get confused with that.

Dr. Suzanne Gilberg [: 00:21:51

Well, I mean, it's literally integrating the best of western conventional medicine. And either. I mean, I think 20 years ago, people were calling it eastern medicine, whatever that means, and the best of more natural, plant based, lifestyle prevention medicine with some. With. There are evidence where you can find it. So, for me, my personal brand is I'm very interested specifically in lifestyle things. So fitness, yoga, meditation, spirituality, with a person who's open to hearing it that way. Cause, I mean, there is a lot of science to suggest that it is very important to our physical and mental well being and then bringing in the plants.

Dr. Suzanne Gilberg [: 00:22:39

I'm a big. I love plants so much. I love everything about plants. I love things that grow. And my ayurveda, so, specifically, I'm trained in ayurveda, the ancient medical system of India, and a big part of indigenous medicines in general are reestablishing a connection with nature because we are part of nature. Humans are just another component of the natural world. And so the integration, on a spiritual level, kind of the integration, literally, of plants into your person is a practice. It's a practice of joining with the rest of the natural world.

Dr. Suzanne Gilberg [: 00:23:18

And there's something very healing about that that's wonderful. But plants themselves have all these.

Dr. Sameena Rahman [: 00:23:23

I feel like I'm getting healed just listening to you.

Dr. Suzanne Gilberg [: 00:23:25

But it's really important because it reminds you that, you know, it takes you out of yourself a little bit.

Dr. Sameena Rahman [: 00:23:30

Yeah.

Dr. Suzanne Gilberg [: 00:23:31

It gives you a bigger perspective, literally grounding. And there's scientific evidence that putting your feet on the ground, you're having contact with electromagnetic fields. This is not. Whoo. This is science. Yeah.

Dr. Sameena Rahman [: 00:23:45

It's really cool.

Dr. Suzanne Gilberg [: 00:23:46

And it has an impact on your vagal system. Right. So calming. But then the plants themselves have these really powerful chemical components in them that are healing. I mean, anything from. Look, aspirin comes from Willow bark. Okay. To a lot of the herbs that we cook with have a lot of antibacterial, you know, rosemary, basil, oregano have antibacterial activity that is, we know is a thing.

Dr. Suzanne Gilberg [: 00:24:16

So turmeric.

Dr. Sameena Rahman [: 00:24:17

We know turmeric has its anti inflammatory properties 100%.

Dr. Suzanne Gilberg [: 00:24:21

Right. Of course, like curcumin, you know, pain, anti inflammation. We go on and on and on. So I think there's, like, so many levels at which it makes sense, and it just, to me, is fascinating.

Dr. Sameena Rahman [: 00:24:34

I love it. Yeah, that's so. So I love when you're, like, you're talking about all that and just your connection with everything around you. Because I think, you know, one thing I remember when I lived in Los Angeles is that, like, you know, I came from, I grew up in North Carolina. I moved from North Carolina to the New England area. Then I moved to laden. And I remember, like, you know, you can get really, like when you're in these big cities and we can get very self centered, right? You can be very centered around yourself and what's going on instead of centering yourself to everyone else kind of thing. You know what I'm saying? Like, and I find that what you're saying so compelling is that you're, you know, really just on a primal level, just connecting with the ground, the plants, everything that can really, that very much have a calming effect on your whole nervous system.

Dr. Suzanne Gilberg [: 00:25:22

I mean, even just talking about it, I feel calmer. And I think for people, no, because for people like us who are constantly, you know, we were talking about this, we're very empathic. We are blessed to be healers and to be doctors and to be surgeons and to have all these opportunities to work with people, meet people, hear their stories, help them, it's super gratifying, but it's, you know, it's exhausting, a lot of emotional energy. And, you know, don't forget all during this whole period of time, like, I was pregnant, my, when talking about this, I was pregnant my whole residency. I had two kids. I came into practice. I was like a young mom trying to make it work, starting my career. And I really, honestly, I came to integrative medicine for my own personal healing because I was just, like, exhausted.

Dr. Suzanne Gilberg [: 00:26:06

And I actually was always curious about indigenous medicine. I think because of my early experiences traveling, to be honest, and then working at county and, like, meeting all these people and, like, I remember learning, like, how to address, you know, the color of the medication that may have an impact on the patient and be, understand that, like, red may mean something to them or pink or blue. And just having that respect, I mean, that was, that was part of our medical education, which I think was really important. So all these things kind of came together. Cultural humility, you need to know, like, you need to meet your patients where they're, where they are if you're going to have an impact. But I was going to be burnt out, like, within a minute of starting practice. And I started meditating and I had done yoga on and off, and I really did it to save myself. And then I just found so much more in it.

Dr. Suzanne Gilberg [: 00:26:52

Initially I did it for myself and then I realized, like, oh, no, no, this is for my patients, too. So anything that you do for yourself is something that your patients are going to benefit from.

Dr. Sameena Rahman [: 00:27:02

Yes, I agree with you.

Dr. Suzanne Gilberg [: 00:27:03

Yeah.

Dr. Sameena Rahman [: 00:27:04

I think we're the type that will always experiment with this stuff first.

Dr. Suzanne Gilberg [: 00:27:06

Totally. Oh, my God.

Dr. Sameena Rahman [: 00:27:08

Well, let me just try it. Okay. And then you could tell the patient, like, okay, yeah, well, but it's also.

Dr. Suzanne Gilberg [: 00:27:13

Samina, you know, it's really interesting because I think, especially in our field, a lot of what we deal with is, like, developmental, normal physiologic stuff maybe gone awry. So, like, it's. And we're privileged because we are women in this field. And, you know, and my patients do ask me, I'm sure they ask you to. Have you ever tried that? Do you do that? What would you do? Sometimes I'm like, this isn't about me. A lot of times I say that, but I'm honest, like, you know, yeah, me too. I'm using, you know, I use vaginal estrogen. I was using it before.

Dr. Suzanne Gilberg [: 00:27:46

I mean, I, like, I know that what it feels like to use a vagifam, to use interrosa, to use the cream. Like, I get it. This one maybe you like. You know, and our friend and colleague Corinne men is the one who really encouraged me to be out in public about using hormone replacement therapy as a breast cancer survivor, because don't think people didn't ask me. They did.

Dr. Sameena Rahman [: 00:28:09

Right, right. No, of course. And it's always a question, like, well, would you do this for yourself, or would you put yourself. And I tell them something. If I were in your position, and sometimes I, like, I am in your position, but this is how I would approach it, you know, like, and that's just for me. And obviously, we can make a joint decision, but this is how I look at it. This is the evidence. This is what I would do.

Dr. Sameena Rahman [: 00:28:29

This is what I would do for my mom's, you know, like that kind of thing. And I think they. That's powerful.

Dr. Suzanne Gilberg [: 00:28:34

It is. It is. I don't think it's required, but I think it is an added layer of, you know, rapport that we can establish with people and authenticity. Yeah, yeah.

Dr. Sameena Rahman [: 00:28:48

What? So, like, if you have a patient who maybe is on the fence of, you know, hormones, maybe wants to try some more than natural stuff or some of their symptoms, whether or not it's like, the vasomotor stuff or muscle stuff or, like, anxiety, like, what kind of stuff do you tell them to integrate into their life? Or maybe they're like, I want to try all this before I try them.

Dr. Suzanne Gilberg [: 00:29:10

Well, I mean, in terms of. In terms of herbs, I do that a lot. I do that a lot, by the way. And I think because of my reputation, people know that I do this. And I do see often that patients will come in and they're not quite ready to use hormones, or they think that they never wanna use hormones. And I always tell people, like, look, as long as you're making a decision based on education and not fear or like, the absence of information, we're not.

Dr. Sameena Rahman [: 00:29:35

Like hormone pushers in the menopause. We just want education.

Dr. Suzanne Gilberg [: 00:29:39

You get to choose whatever you wanna do. But I do have a lot of people who start. No, well, even though we get accused of that, but that's not accurate.

Dr. Sameena Rahman [: 00:29:47

Yeah, we get accused of it all. Yeah. You guys are just a bunch of hormone pushers. No, we're not.

Dr. Suzanne Gilberg [: 00:29:52

It's not. It's so true. No, it's like, the hormones are amazing, but, like, you don't have to use them. Like, you just need to know what you're doing and why you're doing it. So I have a lot of patients who choose to use herbs first. So I would say, you know, it's interesting, I was trained. Part of. Part of ayurveda is actually using what's locally available, and it's seasonal.

Dr. Suzanne Gilberg [: 00:30:11

Like, there's a lot of ties to nature built into the. To the paradigm itself that's pretty common in a lot of indigenous medicines. So I was taught about the kind of classic ayurvedic herbs like shatavari and ashwagandha. And now everybody's in Shilajit. I mean, using this stuff, by the way, in an allopathic way, it's not ayurveda, but okay, that's a conversation for another time. But we were taught to use western local herbs in an ayurvedic way, so, which I really like. So I love Vitex or chaseberry. I love it a lot.

Dr. Suzanne Gilberg [: 00:30:45

For perimenopausal stuff, especially mood. And like, PM's getting really ramped up. Mood getting really ramped up. Cycle kind of management. It's not going to fix your, you know, it's not going to fix everything, and it's not going to change when you have menopause. But it does have a pretty significant impact. And there's evidence to support this. Let me just say, when we talk about evidence in plant medicine, it's nothing like pharma, but we're honest about that.

Dr. Suzanne Gilberg [: 00:31:11

Right? That's part of being. Having integrity. So, Chase, barrier Vitex I love a lot black cohosh, which I just. Black cohosh has been really maligned for some reports on liver toxicity, but those are case reports, the standard that's not necessarily related to pharmacokinetics. And I just want to point out that, like, you know, I don't know what the numbers are at some. At one point, I did. But the number of cases of liver damage from acetaminophen, which you can buy without a prescription, far exceeds the five case reports in the literature on black cohosh. But it does point to the fact that just randomly treating yourself with stuff you got on Amazon is not a good idea.

Dr. Suzanne Gilberg [: 00:31:53

This stuff is medicine. So I'm always very careful about sourcing, making sure I have specific brands that I know how they are sourcing, because I think a lot of times this is contaminant. So black cohosh, I love siberian rhubarb has been. It actually acts like a serum, like a selective estrogen receptor modulator. Very, very interesting. Actually. Terrific for hot flashes. I mean, pycnogenol, I wish had better data.

Dr. Suzanne Gilberg [: 00:32:17

It's. It's what's called an adaptogen. So it's probably having some kind of immune system impact. It has been shown to be beneficial for hot flashes for some people, but I don't think the data is as strong. So, I mean, those are just some that are coming to mind. I mean, obviously, all the isoflavones, the phytoestrogens, in other words, these are estrogen like compounds that come from the plant world. Soy, red clover. The truth is, I don't think the data is that fantastic.

Dr. Suzanne Gilberg [: 00:32:40

I think the data is better than these other herbs. So those are just like a small.

Dr. Sameena Rahman [: 00:32:44

And I think the sourcing is very important, like you said.

Dr. Suzanne Gilberg [: 00:32:47

Very. And I work with specific companies that I know. I know how they do what they do. I know where they're getting their stuff. I prefer to work with companies that actually conduct research that are trying to advance knowledge. They're not just trying to sell something, you know? So I. And you do the best you can, and you're honest about it, but those are. Those are some that I really, really like for perimenopause and menopause.

Dr. Suzanne Gilberg [: 00:33:12

Maca is kind of interesting, but I don't think Maca has the best data. I wish somebody looked at it more. I feel like it was really popular for a minute, for sexual health.

Dr. Sameena Rahman [: 00:33:20

Yeah, it was.

Dr. Suzanne Gilberg [: 00:33:21

But I don't think the data is great, you know?

Dr. Sameena Rahman [: 00:33:23

Yeah, I don't think so.

Dr. Suzanne Gilberg [: 00:33:24

Yeah.

Dr. Sameena Rahman [: 00:33:24

Yeah. All right. Cool. So that's, you know, some things that you can look at. And again, I have stuff in the.

Dr. Suzanne Gilberg [: 00:33:30

Book, too, although, I mean, I've updated. I do. There's like a whole table in the book and there's like, dosage recommendations and, like, where appropriate, like brand recommendations and, you know, I references in my book as to where I pull this data from. So. Yeah, perfect.

Dr. Sameena Rahman [: 00:33:46

Well, put in the show notes so they can know where to get your book to and some other links for that. So that's awesome. All right. And I want to talk to you also about this new phrase around psychedelics. I don't know that you're kind of. I mean, it's kind of like blends in with what we're talking about.

Dr. Suzanne Gilberg [: 00:33:59

Everything old is new again. Yeah, 1973.

Dr. Sameena Rahman [: 00:34:03

But, you know, you hear about psychedelics.

Dr. Suzanne Gilberg [: 00:34:05

And you're like, oh, but different. But different. But different. People were doing, like, dropping out, right. They were like trying to. Although, you know what? But if you look at people, like Ron Dawson stuff, I mean, it was about enlightenment.

Dr. Sameena Rahman [: 00:34:16

But, like, you hear about psychedelics, people think about tripping out and, like, mushrooms and all the things. I know that in, you know, my husband's interventional pain sports medicine, but he also, like, you know, works with some of these because he's PM and R, but he works with some of these anesthesiologists that are doing, like, Iv ketamine and all these things, which is, you know, in that category of drugs that we think are rewiring your brain to some capacity for these patients who are either depressed or, you know, PTSD, that kind of stuff. So, you know, it's all kind of like, you know, these things are coming up, and I do find I'm seeing more on social media and other places and even looking at what are. What's happening with the psychedelics. So tell me what. What you're, like, interest is and where you're seeing some of the psychedelics being used in menopause.

Dr. Suzanne Gilberg [: 00:35:00

Well, I mean, I think. I think it grows out of all the things that we just were talking about. I mean, I think now that, like, we've set that up, I don't think anybody would be surprised that I'm interested in psychedelics, because I am. Because for a number of reasons, like personal growth, it's everything. It's like a marriage of all of it. It's like science.

Dr. Sameena Rahman [: 00:35:17

Yeah. The brain is so. It's just an amazing organ.

Dr. Suzanne Gilberg [: 00:35:21

Really interesting science. Brain science, neuroscience and plants. So, I mean, technically, it's really. Yes, yes. So I seem to. I'm the most interested in mushrooms, which are technically not a plant. They're a fungus, but whatever, they're in the plant world, right? There's a lot of. And you nailed it.

Dr. Suzanne Gilberg [: 00:35:40

Like, there's a lot of really compelling data in the worlds of addiction, trauma, and mood disorder. And these are good studies. And I mean, psychedelics as a category is broad, right? But things like MDMA, ketamine, and the psilocybin mushrooms, and there's others, I'm sure I'm leaving something out, but a DMT, which scares me a little bit. But anyways, it just seems like a little too intense for me. But there's some really interesting data on that. And I actually. I think that a lot of these areas come to bear in women's health and areas that we just don't understand yet. Right.

Dr. Suzanne Gilberg [: 00:36:19

So chronic pelvic pain, endometriosis, all the perimenopausal stuff, especially mood stuff, trauma and addiction, which we know if you have a history of mood disorder, trauma, or addiction, you're going to have. You're at risk for a big flare or an episode or a shift around perimenopause. And I think you and I know intuitively, because we treat these women, the instability of that particular time of life is very likely to create an opportunity for these problems to resurface. I mean, we see it, and there's data on it, so we know that anxiety and depression increase around this time, but if you have a prior history, you're at even more risk. So it's very, very important. I think the data on neuroplasticity and inflammation is specifically very interesting to me. And there is some interesting data on this with psilocybin in terms of, again, creating new brain connections and increasing neuronal activity, which can. Which you can see might lead to possibilities clinically in these areas.

Dr. Suzanne Gilberg [: 00:37:28

Of course, we don't have much data in that area, and a lot of the older data really was done in men, of course. But there's a lot of activity and interest in this. I was at a conference in Toronto in. At the end of May, June, and, you know, in Canada, they are a little further ahead in some ways than we are. I mean, they have the same kind of legal strictures, but they seem to have more openness about it. So that was a really interesting opportunity to meet others in the field who are doing this work. And I'm working with a company here in the United States called interstate, which actually is doing whole mushroom psilocybin research. So they're not just pulling the psilocybin, which is the active ingredient, the active psychedelic ingredient, out of the mushroom.

Dr. Suzanne Gilberg [: 00:38:15

They're looking at the entire mushroom, which I think is important. So something your listeners may not know about is something called the entourage effect. We know that when we're looking at any plant material, it's not, you know, in conventional medicine, we like to take the one molecule out, amplify it, and understand how it works, and then you turn that into the pharmaceutical, which is why pharmaceuticals are so powerful, because they're taking just the one ingredient. But the thing is that the plant world created this with other components together for a reason. Sometimes we understand. Sometimes we don't understand. I think in the mushroom, that's very, very important. So the company I'm working with is looking at whole mushroom psilocybin research.

Dr. Suzanne Gilberg [: 00:38:57

Now, it is a DEA. It is illegal. You cannot possess it in this country. There are two academic labs in the United States, Ohio State University, Mississippi, where you can get a DEA clearance to study this. So we have a lab at Ohio State University, and they are conducting research right now on just even. What are the components? How does it work? It's so fascinating. Initially, when they came to me, they were looking at mood, basically trauma and mood, and they made a pivot. The CEO, it's a female founded company, Ashley Walsh, really, honestly came to me and was like, I'm perimenopausal.

Dr. Suzanne Gilberg [: 00:39:33

I'm having these issues. Wonderful. And to make a long story short, they made a pivot and decided to look more at women's health issues. So it's very exciting to me what's happening on the down low, Samina, is that. I mean, look, I'm in LA. Everybody and their aunt is microdosing. 30 million documented psychedelic users in the United States. 30 million.

Dr. Suzanne Gilberg [: 00:39:57

I'm sure it's underreported. How many of those are women? We don't really have data on this, but I think we're seeing a resurgence in it because. Because of the mood issues, because of the hormonal instability creating the problems that people have, because we don't have enough people getting support, education, and help, because we know the numbers on how many people are even using hormone therapy, and it's like under 10% probably in the US.

Dr. Sameena Rahman [: 00:40:24

Right?

Dr. Suzanne Gilberg [: 00:40:25

So people, again, are taking care of themselves.

Dr. Sameena Rahman [: 00:40:29

Yeah, I think there was, like a observational study or something. I mean, this is what cannabis and how it got legalized and how, like something like 40% of perimenopausal women were turning to cannabis to help them sleep or to like, you know, reduce their anxiety.

Dr. Suzanne Gilberg [: 00:40:43

And I'm not mad at it. I just think it'd be nice to have more data. I think it's fascinating. Yep. Sleep, sexual disorders, mood. Because, because these are black boxes, because people are not having these problems addressed. And I think instead of us, like, clutching our pearls and be like, they're going to weed because they're not getting help, like, oh, that's interesting. What is cannabis doing for them? Which I think Lauren did.

Dr. Suzanne Gilberg [: 00:41:07

Lauren Stryker did an interesting sort of just like a report on, like, how many people are using it. We were at that issuance. She reported on that. And I think that that's really interesting data. But how can we employ this to our benefit? Because people are turning to it, not just because they're like, oh, desperate. And it's bad. Drugs are bad. I.

Dr. Suzanne Gilberg [: 00:41:26

These are plants that have medical opportunities. Why don't we look at mining those opportunities, leveraging those opportunities. I mean, that's the way I look at it.

Dr. Sameena Rahman [: 00:41:36

Yeah, no, sometimes, because I ask every one of my patients, because we're in Chicago, we can't, you know, it's legal, whatever, you know, you do you use cannabis at all? And like, you know, some of them are like, ah, you know, totally clutching their. And then others are like, yeah, actually, I've tried a couple times, but blah, blah, blah. You know, the gummies or whatever. Yeah, I've tried gummies.

Dr. Suzanne Gilberg [: 00:41:54

Like, I've used it. I, look, I'm in California. It's legal. I've used all of the different forms for all of the different things. Right. Because I think it's really interesting for sexual health. I think it's very interesting for sexual health, both topically. Look, we know that cannabinoids have anti inflammatory properties and help deal with pain.

Dr. Suzanne Gilberg [: 00:42:15

So if you are having genitourinary syndrome, menopause, or any other pain disorder, it does make sense that it might work. But there's also something for a lot of people, it activates arousal. So I don't know that we understand these, how this works, but I think we should.

Dr. Sameena Rahman [: 00:42:32

Yeah, absolutely, absolutely, totally agree with you. It's so fascinating. And I think, you know, so many, so much of it, again, goes back to the lack of education and distribution of these, you know, more FDA cleared, studied hormones. And again, we're not saying everyone should jump on hormones, but we should know that, you know, there's good data for it and that, you know, the majority of people, it's safe for, and you want to try to find someone that will listen to you before I end this, because I know we both have 02:00 meetings that. What do you give? One piece of advice. I always ask my guests, like, you know, because the whole educate to advocate thing, right? Like, how would you tell a patient to try to get someone to listen to them about their menopausal concerns or pain concerns, whatever, when, you know, they might be getting gaslit or other things. Like what kind of, what kind of things do you tell them to tell a patient? Because, you know, we've all been in a scenario where maybe, you know, we've been in practices that are super busy and, you know, we didn't give someone, you know, I think we can all think in our heads, like, to the times where we didn't give someone the attention they needed.

Dr. Suzanne Gilberg [: 00:43:36

Right.

Dr. Sameena Rahman [: 00:43:36

For some of us, it makes us stay up at night.

Dr. Suzanne Gilberg [: 00:43:39

Right, right. Or. Yeah, okay. That's such a good question. So first of all, I have a couple of pages in my book for people to fill out directly and bring, and I'm going to tell you something. I have had patients bring those pages into me, which I'm like, oh, okay. I guess that worked. Which I loved.

Dr. Suzanne Gilberg [: 00:44:02

I like loved. And I was a little bit, like, taken aback, but I was like, oh, yeah, wow.

Dr. Sameena Rahman [: 00:44:06

Right?

Dr. Suzanne Gilberg [: 00:44:06

So they're in the book. But here's what I would say to you. First of all, think about what your needs and your goals are in advance. Don't come in. And then like, listen, I would tell every doctor, but gynecologist specifically, you know, you got your hand on the door, you're saying your goodbyes, and now the real question comes out. Or the vaginal culture that you just took the speculum out, like what? That happens all the time. So, you know, I understand it's triggering and your brain can shut down. So make sure you've thought about what your needs are, what your goals are to in advance.

Dr. Suzanne Gilberg [: 00:44:38

Number one. Number two, make sure that your doctor is going to have the time to do all this, because if you come in for your annual visit and she takes insurance, she does not have 35 minutes to go over all of your issues with you.

Dr. Sameena Rahman [: 00:44:52

And that's a preventative exam. It's not to not talk about a problem. You can't. Under the insurance based model, you can't.

Dr. Suzanne Gilberg [: 00:44:59

Right? Like, you guys, you guys have to be in reality, like, your doctors are by and large, don't have the time and overwhelmed. So make it. Make her your friend, make her your partner in health and call and say, look, these are the things. Does doctor so and so are these things that she can go over with me? Can I make an appointment for a consult? Does she do telehealth? Whatever? Maybe make a separate appointment or talk about it at the annual and say, I have some issues. How is what's the best way to reach you? So talk with her. She's your partner. Now. If under those basic circumstances this person is dismissive, rude, or, and can't admit that they don't know how to handle it, then you may need to move on.

Dr. Suzanne Gilberg [: 00:45:39

And I understand that that's not so easy because not everybody has access. I think with the rise of telehealth, there are opportunities for us to reach to people who really do care about this and devote their time.

Dr. Sameena Rahman [: 00:45:50

I think it's a great bridge. You know, the telehealth community. Yeah.

Dr. Suzanne Gilberg [: 00:45:54

Yes. But coming in guns blazing and like, TikTok told you that we're here to gaslight you, you guys, like, nobody's gonna respond well to that. Like, I'm not saying that doesn't happen to you. It does happen to you. It's happened to me as a patient, as a physician who's a patient. I have had it happen so many times. But you want to engage this person as your partner and, you know, you get more flies with honey than vinegar. So just, that's some basic stuff.

Dr. Suzanne Gilberg [: 00:46:22

Some basic stuff.

Dr. Sameena Rahman [: 00:46:23

And I always say, like, and this is a generalization, but if you're going in for like a period talk or sex talk or menopause, whatever, and the waiting room is full of pregnant women and at that, you know, unless there's one specific person that is really designated in that practice for this, then, you know, usually you might have to find another practice.

Dr. Suzanne Gilberg [: 00:46:43

Yeah. And, you know, you can go. I mean, I think we've talked about this endlessly. You can go on, you know, international societies, Society for the Study of Women's sexual health practitioner locator. You can go on the menopause society, practitioner locator. This does not necessarily mean this person is going to be a good fit for you, but at least they are a member of the society, so they have a level of interest and that's a good place to start. Or I think the telehealth, because the telehealth library screen these practitioners for you and they're already into it, you know?

Dr. Sameena Rahman [: 00:47:12

Absolutely.

Dr. Suzanne Gilberg [: 00:47:13

Yeah.

Dr. Sameena Rahman [: 00:47:13

Well, thank you so much, Doctor Suzanne Gilbert. It was so awesome having you. I have to have you back because we have so much more to talk about.

Dr. Suzanne Gilberg [: 00:47:20

I know. I loved being with you. I love your podcast. I love what you're doing in the world.

Dr. Sameena Rahman [: 00:47:25

You too.

Dr. Suzanne Gilberg [: 00:47:26

Thank you. Thank you for having me.

Dr. Sameena Rahman [: 00:47:27

Thank you so much and thanks for joining in. Guys. This is Doctor Samirman. Gynell Girl presents sex, drugs and hormones. Remember, I'm here to educate so you can advocate for yourself. Please like my channel and write a review and all the good stuff that you're supposed to do to, you know, help me continue along in life. But we'll see you back next week for another great episode. Thank you so much much.

Dr. Sameena Rahman [: 00:47:47

If you have a second, please subscribe to this podcast.

Dr. Sameena Rahman [: 00:47:49

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Dr. Sameena Rahman [: 00:48:01

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Dr. Sameena Rahman [: 00:48:03

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