The Hidden Struggles: The Reality of Perimenopause

00:00 Understanding Perimenopause
09:06 The Importance of Education and Support
10:55 Individualized and Inclusive Approaches to Treatment
18:38 Addressing the Stigma and Ageism
25:18 Cultural and Societal Empowerment
28:48 Advocating for Your Health
31:42 Symptoms and Tests for Perimenopause and Menopause
34:18 Finding Knowledgeable Doctors
37:14 The Canadian Medical Situation
39:49 Importance of Baseline Tests
43:18 Support and Community
48:16 You’re Not Alone

• Cultural perceptions of aging can lead to feelings of invisibility.
• Support groups provide a vital space for women to share experiences.
• Women should advocate for their health and educate their doctors.
• Mental health issues can be exacerbated during perimenopause.
• Tracking symptoms can help in discussions with healthcare providers.
• Education about perimenopause is lacking in medical training.
• Women are encouraged to share their stories to foster understanding.
• Community support can significantly impact women’s health journeys.
• Knowledge is power in navigating perimenopause and menopause.

Whitney (00:43)

Hello and welcome to reduce the stigma. Today I’m talking with Jessica Eriendson van Remmen. Jessica has a bachelor of arts, having studied anatomy, physiology, pathologies, psychology with a minor in anthropology. A certified yoga therapist with over 900 hours of yoga trainings, including pre and postnatal women’s health. Jessica has been working in the field of peri and post menopause care since 2019. Her Canadian support group includes over 9 ,000 members and continues to grow at a high rate, which indicates a woefully underserved demographic. Jessica, thank you so much for joining me today.

Jessica Eriendson Van Remmen (01:26)

Well, thank you for having me, Whitney.

Whitney (01:28)

I, you know, you are serving an underserved demographic and I want to dive right into it. Let’s talk about perimenopause. I have to say, as someone in her mid coming on late thirties, I don’t know really anything about it. What exactly is perimenopause?

Jessica Eriendson Van Remmen (01:49)

Right. And you’re not alone in not knowing anything. So don’t feel that you know, you’ve missed the boat. They just leave that part out of our education. You probably got like a really basic anatomy and kind of an idea of what could happen during puberty. And then most of us know menopause when your period stops. But perimenopause is the fluctuation of hormones that can happen for some women as and they’ll say, you know, up to a decade, it depends on the person.

Whitney (02:03)

Mm

Jessica Eriendson Van Remmen (02:17)

And it could involve any number of physical symptoms, but also impacts your emotional life and your, you know, your ability to work sometimes is impacted. Even for myself, I feel like I’ve had a bit of an identity crisis because I’m transitioning from being, you know, a fertile mom, I had two children. And then now I’m becoming, you know, in our culture, Western culture, you become what? Like nothing. Unless you become a grandmother.

Whitney (02:47)

Right. Which, yeah.

Jessica Eriendson Van Remmen (02:47)

You know, that’s a pretty big part of your life if you think lifespan is somewhere around 75. And a lot of us are living into our 80s, especially women. So it’s a long time to be in post menopause. So that’s basically how I think about it. Peri is before. Menopause is the day that you reach that one year where you haven’t had a period. And then post menopause is the rest of your life after that.

Whitney (03:14)

Okay. You’re right, not taught. Even menopause, I have to say, it was almost like the thing, you know? She’s going through the change of life. Right. What is like, why have we approached this natural occurrence in a woman’s life with such almost fear and as if it’s like contagious?

Jessica Eriendson Van Remmen (03:26)

The change. Yeah, and I think a lot of it has to do with our ageism. Like, we are an ageist culture. We like young and beautiful, right? I mean, like, who comes to mind is Britney Spears. Everyone was all about her when she was young and beautiful. And, you know, then she decided that she wasn’t going to play into that, which was a lot of the, you know, what she did with her hair and was rebelling against what she had become. And now she’s moving into more of a mid age range and, you know,

Whitney (03:45)

Okay.

Jessica Eriendson Van Remmen (04:10)

Less visible and where is her career opportunities at this point? And a lot of actresses talk about that too, you know, the pressure to change their appearance and have surgeries and avoid becoming older or avoid becoming seen as older. A lot of women talk about feeling invisible as they age because their opinions are maybe not important, which is very opposite from more Aboriginal cultures where they would honor their elderly people who’ve been through it, you know, like, and it’s very sad in a lot of ways because if we are going to live, let’s just say average menopause would be somewhere around 52. And we’re gonna live say to 82, that’s 30 years of our lives. Does that 30 years then not count for anything? Are we then no longer important in our lives? kind of like your life is over. But that’s a perception and a mindset that individual women now have decided that they’re throwing out. They’re just going to throw that in the garbage. It’s not applicable to them anymore. And I feel like a lot of us, because I’m Generation X, we don’t like authority. We don’t like being told what to do. And we’re going to rebel against it. So we’re yippee yapping online about our period and how it’s changing and what’s going on with our doctor and the husband or the work situation and we want to talk about it. Now, not everybody wants to talk about it because some people really do feel like that’s very private, very personal, and they should be allowed to do that. But I’m not one of those people and that’s partially why I started the group that I started because I wanted to talk about it. And other people that want to talk about it have joined.

Whitney (06:03)

Right, clearly 9 ,000 members.

Jessica Eriendson Van Remmen (06:07)

Yeah, with no advertising. don’t go out searching for it. It’s all women coming in and realizing that compared to other groups, because I’m leading it, my personal philosophy is you Whitney, I don’t really know you, we’re just meeting. But I believe that if you want to try a certain thing, say skydiving, I would never skydive. If you want to try it though, I will support you to try it. Because this is your life, it’s not my life, it’s not for me to decide what’s right for you.

Whitney (06:17)

Mm, See you next time.

Jessica Eriendson Van Remmen (06:37)

So when we have people join and they say, think, know, prescriptions, it’s all wrong. It’s like, you’re entitled to that opinion and we’re going to support you in that opinion. I will help you as a yoga therapist to stay off the prescriptions. However, if Judy wants to take all the prescriptions, we’re going to support her to do that too. And because of that, they’re just inviting their friends like, come on, let’s come in, let’s talk about it.

Whitney (06:59)

Yes. There are so many parallels there with mental health and substance use, the stigma surrounding medication in general. And I’m sure, I know me personally, it takes a lot for me to be accepting of a medication, not because I think down on it, but because I want to try and address it in a natural way or in ways through other coping skills and such.

Jessica Eriendson Van Remmen (07:16)

Mm

Whitney (07:27)

And so hearing this approach that really, you know, we’re talking about a natural occurrence in our body’s physiology. What I’m also hearing is a cultural and societal empowerment that you are doing for these women.

Jessica Eriendson Van Remmen (07:44)

Yeah, and definitely there’s a, every so often we get like some backlash. Well, someone will say, you’re really into HRT, hormone replacement therapy. And I’m not, right? Like I take advantage of some prescriptions, but I can’t do like a more traditional, you know, the one that they would, their go -to treatment, I can’t do because I have endometriosis. But that doesn’t mean that it’s not appropriate for someone else. And I think there’s, for me, a lot of it feels like that inclusivity. We’re including everybody, include everybody, right? And then they get to learn and they get to read about it. And then maybe their opinions might change on certain things. You know, I’ve had people come in and be like, I’m not giving up sugar or alcohol or whatever it is. And then after participating in the group for a while, they’ll start to say, you know what, did you actually really feel better? Because I would like to feel better. And then their opinion might change. But you’re not going to. You know, I have a background. This is how I learned to run support groups in Al -Anon, Friends and Family of Alcoholics. And I did that for over a decade and it’s all volunteer led. So I’m offering women recovery in my group. I just don’t talk about recovery because they’re not thinking about it in that term. So it doesn’t really matter, but everybody can take advantage of the fact that I’m going to allow them.

Whitney (08:48)

Mm -hmm. Great.

Jessica Eriendson Van Remmen (09:06)

To be themselves and be wherever they’re at in their journey and take as long as they need to and go whichever path they feel is best for them. And as women, we don’t often get that. Someone’s almost always telling us what to do.

Whitney (09:20)

Right, which comes back to that identity about you’re a child bearer or a child caregiver as the grandparent, which doesn’t match in, I’m sure, Canada, like the US, the numbers of women who are in high successful positions is just continuously increasing. And not that there’s anything wrong with being a stay -at -home mother or full -time caregiver. That’s absolutely just as important and valid. It’s no longer, though, an accepted

Jessica Eriendson Van Remmen (09:45)

Hmm.

Whitney (09:54)

Only path forward.

Jessica Eriendson Van Remmen (09:56)

Exactly, exactly. We don’t, everybody gets to decide and have the dignity, I think that I keep going back to that. Like one time I had recently a woman get really upset with me because she felt that I was being unsupportive of her because she was right about something. Okay. So the truth of the matter is that estrogen does not cause cancer if it’s introduced with progesterone, unless you already have something growing, and then it would feed what’s already growing there.

Whitney (10:25)

Okay.

Jessica Eriendson Van Remmen (10:26)

So that is correct. She was right about that. But my argument to her was, this isn’t an I’m right group. It’s a support group. And this woman was posting a question about HRT and really needed to hear reassurance and have her questions answered in a kind and loving fashion. So educating her on something that she wasn’t prepared to hear and hadn’t asked about is not supportive. It’s not the right group. It’s a support group where everybody gets the opportunity to be right about their own lives. And you know, she didn’t really appreciate that, but I think she’s still in the group. You know, I haven’t checked. She didn’t leave right away. Sometimes they do, right? As soon as you correct them. But it’s a different philosophy. was like, if you want to be in a group that only talks about using HRT and that is the go -to and they do not discuss anything else, join a UK group. The UK groups will talk only about HRT. Yeah.

Whitney (10:57)

Great. UK as in the United Kingdom. Interesting. See, I didn’t know that. there are even differences between countries, it sounds like, as to what is kind of the accepted approach. Is that it?

Jessica Eriendson Van Remmen (11:31)

Mm -hmm or even what’s available or how well educated the doctors are. It kind of goes UK, US, and then Canada. So we’re stuck educating our doctors a little bit more than you would be in the US, but you’re still gonna have to educate your doctor more than the lady who lives in the UK.

Whitney (11:38)

Yeah. Well, that’s interesting. We would have to, as women would have to educate our doctors, the medical professionals who should know these things. Is this not a common component of general practitioner training?

Jessica Eriendson Van Remmen (12:01)

You know, it’s unbelievable. So when I decided I wanted to move from the yoga teacher training directly into yoga therapy, which is treatment of specific issues, right? So I mean, I treat women in perimenopause and menopause with yoga therapy. I was really excited to go because my program was at Mount Royal University. And I had to do pathologies with a textbook that is like the grade one kind of level one, you know, textbook for disease.

Whitney (12:37)

Yeah.

Jessica Eriendson Van Remmen (12:38)

I thought for sure I was going to learn so much about perimenopause and menopause, right? I mean, like most of the yoga teachers who become yoga therapists are women. No, there was one section in the whole book that said under menstrual issues that women would go through menopause and some might have troubling symptoms such as hot flashes. That’s all it said.

Whitney (12:59)

Wow.

Jessica Eriendson Van Remmen (13:00)

Nothing about perimenopause, nothing about any of the other symptoms that can, and there are a lot that can be associated. It was extremely disappointing. And that just kind of put me in that position where I needed to learn more on my own. And so that’s what I did. Luckily, I know how to do that, and it’s not on Instagram, not that I’m bashing Instagram, just don’t go there to learn about something because…

Whitney (13:07)

Wow.

Jessica Eriendson Van Remmen (13:26)

People can say whatever they want. If you want to find someone to tell you menopause isn’t real, you know, or drug addiction isn’t real, there’s someone on there right now saying that. They’re wrong, but they can say whatever they want. So, you know, I’m talking research like go to the library, start taking out books.

Whitney (13:35)

Absolutely. Sadly. Right. And that highlights what I imagine can be significant differences amongst different socioeconomic statuses. You mentioned the UK and Canada and in the US in that three country comparison. And there’s a really big difference between the US versus the UK and Canada, which is centralized health care. And so there is also like, can you get to a specialist who may have that education?

Jessica Eriendson Van Remmen (13:59)

Yeah.

Whitney (14:15)

But then, if you look at it beyond the healthcare that’s provided or the system, that education. Do you know how to educate yourself? Has that education been provided to you or have you been dependent on maybe a clinic that is just so overwhelmed with patients in dire need that they can’t take the time to educate you? So I imagine there’s probably a big gap in that education and awareness of what the signs are, the symptoms, the potential approaches for treatment, but also coping skills. Can you help us? What are, like, let’s talk about those signs and symptoms. What could be something that a woman experiences?

Jessica Eriendson Van Remmen (14:58)

I’ll talk about myself because that’s, you know, I’m the expert of my own life. So my doctors were women. Like your general practitioner, your family doctor, and then I have a specialist who’s a functional medicine specialist. So she is, she’s going to look under every stone. She’s used to working with people with chronic conditions. I have an inflammatory condition. So I was already seeing her for that. And they were looking for perimenopause. So when I started saying, you know, my periods are getting wonky and I’m feeling more uncomfortable and I’m having more cramps and I’m having some trouble sleeping and I’m feeling more anxiety, they were like, okay, well, let’s start treating you. And so they did with an IUD, but I hated it. So they pulled that out and then they put me on a pill that worked okay, but then I had estrogen dominance. So then I had to switch to another pill. And then I found out I had endometriosis and then they switched me to another pill. And now I’m pretty stable. I’ve been..very stable for the last probably year and a half. did have to have, I did not have to have, but I opted to have endometrial surgery in March, which was a very good idea on my call. It was a good call because it was actually a lot worse than I was thinking or even the surgeon was thinking. She said it was everywhere. So I probably had it my whole life, but it was just asymptomatic. But in perimenopause, I was going estrogen dominant and then estrogen down. And same thing with the progesterone, right? So your hormones are doing these huge fluctuations and not at the right time in your cycle. So your cycle’s all over the place. And I think that’s part of the stigma of perimenopause because we don’t know when our period is coming. We don’t know how bad it might be. We don’t know how long it might last. Sometimes there’s clotting that’s really concerning. Like one time I was at my desk doing homework for one of my psychology classes and I thought, maybe I need to go to the bathroom. You know, it wasn’t a big warning. was just a little, hmm, might be something happening over there. So I went to the bathroom and I passed a clot. And it was like, what the? Did I just have a miscarriage? Like, what is going on here from nothing? And yeah, so, you know, you have that happening. You’re like, what is that? But for me, because I knew that that could be part of perimenopause, I could file that under perimenopause, you know?

Whitney (17:06)

That fear.

Jessica Eriendson Van Remmen (17:17)

And not panic about it. That’s why I think the education is so important. And for us in Canada, what’s happening right now is one of our group members yesterday was just, you know, beyond desperate. Like honestly, she’d been talking about, you know, unaliving herself because she can’t get in to see a specialist. She doesn’t have the money. She’s destitute. And in Canada, there is some welfare kind of like bare minimum income that will keep you, hopefully not homeless and she’s in that kind of situation, man. She can’t afford to go and spend. Some of these doctors are asking for $500 for one session just to do all the intake and all the information. No way she could do that. So because of the group members being like, you can’t be in this situation, babe. Like we’re in Canada, we have free healthcare. You just have to go back like what’s close to you. And the girls talked her through it. I didn’t even get in there because, you know, it was like 53 comments got her to go back to the specialist doctor that she’d seen before at the hospital and just sit her butt down until someone took her seriously and walked out with prescriptions to try. But you think about like, why, why does this woman have to suffer to that point where she’s completely desperate?

Whitney (18:15)

I love that.

Jessica Eriendson Van Remmen (18:38)

Talking to basically a room full of strangers who thank God had all been trained by me to be supportive and kicked out if they weren’t, because unsupportive people get booted right away. She could have ended up with some really terrible advice, right? Or someone just being cruel to her when she was down. And instead, she has an opportunity now to try those prescriptions. And hopefully, a lot of the time, they do make a huge difference. But it’s certainly not an even and fair situation for women in Canada.

Whitney (19:12)

And you said the words for someone to take her seriously. And that’s what, when you were talking about the support group, I imagined too many other people and they just missed it, right? you’re just, you know, whatever, know, complaining or, or, you know, I can’t help but think about the fact that there’s so much judgment about a woman’s

Jessica Eriendson Van Remmen (19:24)

Mm -hmm.

Whitney (19:38)

Behavior and activity actions during menopause, you know, they’re crazy, they’re hormonal, that who like who wants to acknowledge that and say, hi, I’m going through menopause or to push for people to recognize it because then you can’t just be dismissed or you’re exaggerating because your hormones are all over the place and to have to fight to be taken seriously that that’s just unacceptable.

Jessica Eriendson Van Remmen (20:02)

It’s not right. It’s not right. And this woman I know I’ve been back and forth with her quite a lot because she has needed quite a lot of support. And she really is in that situation where they have diagnosed her with anxiety. She does have an anxiety disorder. She has gone through the hoops of trying different treatments for the anxiety prescription treatments and had reactions to the medications for that. It’s not an option for her because she’s sick from medication. Do you know what I mean? But there’s a tendency to be like, here’s the umbrella of an anxiety disorder. Here’s the woman underneath that umbrella. And then the doctor’s just going, well, she’s non -compliant. was refusing to treat the anxiety. Therefore, my job is done. I offered her this. And she even though she would say, you know, I did try that one. And I had a bad reaction to it. And this is in the same family of drugs. So please don’t give that to me. It’s going to make me sick.

Jessica Eriendson Van Remmen (21:01)

And you know, whether that’s true or not, you really need to give the medications a try. I encourage everyone. But if you also have a belief that that’s going to make you sick, right? Should she have to take that stuff if she doesn’t want to take it? No, she shouldn’t. Especially when they know that that weird anxiety symptom responds really well to HRT.

Whitney (21:23)

And just because someone may say that medication does not work for me and I’m not going to take it because I’ve had an adverse reaction to a similar medication, that does not mean non -compliant. Are you kidding? No.

Jessica Eriendson Van Remmen (21:36)

Yeah, yeah, it’s not. Yeah, it is very patriarchal. It’s very condescending. And I kind of look at like, like you said, fight, right? So you think about a fighter. Think about Rocky. Remember the movie Rocky? Okay, so imagine him, but he’s strung out and no one’s been helping him and he hasn’t eaten properly in six weeks. And then you put him in the ring and see what happens. How well is that person able to fight?

Whitney (21:49)

Yeah.

Jessica Eriendson Van Remmen (22:04)

So this woman with her anxiety being so high, she’s having trouble sleeping, she’s having trouble eating, she’s having digestive issues. She’s been in the emergency room at least six times in the last year and sent home with the all clear as in you’re not dying. Why didn’t they just help her in the first place? Like that’s a huge drain on her and the system because she’s going back to get tested again and again and again. And you know, we’ll see how her story unfolds, but I mean, it’s not a magic pill, right? We can’t say a hundred percent it’s gonna work for everything, for everybody, cause it doesn’t. But I hear again and again that that is the tipping point for people.

Whitney (22:43)

What is the tipping point exactly?

Jessica Eriendson Van Remmen (22:45)

Actually getting to try some hormone replacement therapy. They just want to try it.

Whitney (22:48)

Okay. Okay, great. And so in that example, you’re talking a lot about the anxiety the person was experiencing. That’s a little bit of an overlap with mental health. I’m curious if there is more correlation between anxiety, depression, and what a woman experiences during peri and menopause, post -menopause.

Jessica Eriendson Van Remmen (23:15)

Absolutely. it’s one of these, like, I think what happened with my mom and her generation, when they had their perimenopausal or menopausal anxiety spike and mood disorders, they got diagnosed as having a nervous breakdown and sent to the hospital to special care for, you know, a few weeks or a few months, and then probably put on to some kind of anti -anxiety, anti -psychotic medication and sent back home and maybe even had a hysterectomy to treat the bleeding if they were having those kind clot passing stories for themselves. But the whole thing of menopause was never part of that discussion. It was just kind of taken away. Mommy had a nervous breakdown, she needs a little break in the hospital and then she comes back home and everybody’s okay and we just don’t ever talk about it again. And I know several of my friends who had mothers go through that kind of thing and doing the math, it’s like,

Whitney (24:07)

Great.

Jessica Eriendson Van Remmen (24:13)

wait a second, she would have been somewhere in her late 40s, early 50s. I wonder if it was actually menopause related, but there was no, maybe it’s like, what is the cookie for the medical establishment to actually identify exactly what’s going on? Maybe there really isn’t one. And perhaps, I mean, when I talk to women sometimes like, well, my doctor never said perimenopause. So I started wondering why. Why? Because they slapped an IUD in you, which we know is treatment for perimenopause, abnormal bleeding. I know that. So they treated you for perimenopause, but they didn’t say perimenopause. Why wouldn’t they say it? And I think it’s because they don’t want to upset anybody. So if they don’t say anything about it, you don’t have to…

Whitney (24:59)

Yeah, I’m just imagining that and there’s that stigma again, even like I don’t want to see this because she’s gonna think I’m calling her old or you know, she you know, wow.

Jessica Eriendson Van Remmen (25:10)

Yeah, especially if she maybe wants to have another baby, right? Because when you say perimenopause, what you’re saying is like…

Whitney (25:13)

Mmm. The end of that, yes.

Jessica Eriendson Van Remmen (25:18)

You know, your time is coming up. So if you’re going to do it, like.

Whitney (25:23)

Which is a disservice if you are aware that that could be happening for the woman to not inform her. What if she does want to have additional children? Or honestly, why shouldn’t we know what’s going on with our body? It can be very stressful whenever your body is acting in certain ways and you don’t understand why. So let’s not just say, here’s an IUD.

Jessica Eriendson Van Remmen (25:32)

Exactly. Mm -hmm. Exactly.

Whitney (25:49)

Please explain to me why an IUD is valid for this and what’s going on, what can I expect, what else do I need to know?

Jessica Eriendson Van Remmen (25:58)

Yeah, what exactly are we treating here with this IUD, right? Like, let’s be really clear about it. I think that a lot of it is just our culture has a tendency to just leave things out that are uncomfortable, perhaps. We just don’t even talk about it. We leave it out. The example I gave recently was when I was in high school, one of my girlfriends called me over because she had the biology book out and it was female anatomy. And she said, where’s the clitoris? And I was like, well,

Whitney (26:02)

Yeah.

Jessica Eriendson Van Remmen (26:25)

They left it out. It wasn’t there. And I was like, holy shit. What? I was like, it’s right there. It should be right there. It looks like this here. Probably a little triangle right about there. That’s like, how did they do that? Like how on what a huge disservice for everybody to just leave that information out. But, you know, maybe it’s, yeah, it’s just.

Whitney (26:26)

They left it out. Draw it on.

Jessica Eriendson Van Remmen (26:51)

Ignorance and an old -fashioned idea that women don’t need to know what’s going on. They just need to be obedient and compliant. And it’s not going to fly with this Generation X. We’re all like, nope, I want to know. I want to know what it looks like.

Whitney (27:03)

Great. Yeah, and how to do something. I think there’s also that part, right? So this is with your generation and those coming behind you, it’s I’m not just going to sit and let something happen to me.

Jessica Eriendson Van Remmen (27:12)

Hmm. Yeah, exactly. And why would you, right? Like the one that really gets, you know, makes my blood boil is the uterine biopsy. So there’s two cancers that women often get that the Western medicine is terrible at diagnosing and treating. That’s ovarian cancer because the ovaries are inside internal and they’re not easily accessible like the cervix you can get to quite easily and they can just do that little exam when you do your yearly checkup. It’s not a big deal. But the ovaries they can kind of look at with ultrasound, but they can’t really tell what it is. It looks like it’s probably this kind of assist or it looks like it’s probably that kind of assist. But until they pull it out and actually take it apart, they don’t know what it is. And the other one is uterine cancer. So I had this abnormal bleeding like I was saying, and I finally got to a gynecologist and I had to drive. Talk about privilege, right? I had to have a car so that I could drive to Canmore to see the gynecologist because everybody in Calgary was too busy to take anybody. And my referral got lost twice. So now we’re talking over a year before I get in when my family doctor is saying you need to see a gynecologist over a year. So I drive all the way out there and a lovely, lovely woman, Chelsea Topping, she’s the best. And she said to me, well, every woman who’s had abnormal bleeding should be offered a uterine biopsy.

Whitney (28:29)

Wow.

Jessica Eriendson Van Remmen (28:47)

And, you know, we’ve just met, so maybe let’s not do that today. Like, we’ll do that on our next appointment, you know? Think about it. I think that you should, because this one is a really easy one to treat if we know you have it. But we don’t know you have it unless you do a uterine biopsy. And then, you know, so I thought about it I was like, you know what, she’s right and she’s an expert and I should just do it, right? I’m chicken about getting medical testing, but we’ll go do that. So I did it the next time.

Jessica Eriendson Van Remmen (29:17)

And I, my mind like, my goodness, it sounds terrible. But it was really like a Pabst mirror, except for just going scrape, scrape. went zoop, zoop, and that’s it. Really not a big deal. And then I said to her afterwards, I was like, so is there some reason why that can be part of my checkup that I did with my doctor? Because we did the Pabst mirror and it didn’t seem like it’s more involved. And she said, it’s not more involved. It’s just not.

Whitney (29:27)

Alright. Right.

Jessica Eriendson Van Remmen (29:45)

part of the training that we give general practitioners. And then I’m thinking about it afterwards going, so we’re just going to let a bunch of women die.

Whitney (29:54)

Why isn’t it a part of the training?

Jessica Eriendson Van Remmen (29:57)

Why isn’t it a part of their training? She said it’s not hard. It’s no harder than a Pab smear. You just need to know how to do it. But the training takes, you know, like 20 minutes to, and the right tools, right? You have to have the right tools on hand. But how many women, like I didn’t have anything in my uterus of concern, but if I had, now it’s a year and a half later by the time I get the uterine biopsy. What are my chances that it’s grown into something that’s now difficult to treat? You know, like three months is not long enough for it to grow significantly usually, but a year and half sure is.

Whitney (30:33)

Absolutely. And thank goodness that you were someone who continued to advocate and push and say, no, I’m going to get this. I’m going to look at this. I’m going to get this appointment. because so many people would give up. Understandably.

Jessica Eriendson Van Remmen (30:46)

Yeah. Well, my functional medicine doctor is a little bit scary. She’s like, she said to me, no, Jessica, you have to go. You have to go. want you to, you’re going to drive to Canmore. She didn’t give me an option. She was like, you’re going to go and see this gynecologist and you’re going to get your uterine biopsy. We want to know for sure. We want to know a hundred percent what’s going on with you because I think you have endometriosis and we want to know for sure. And she was right.

Whitney (31:01)

Well, that’s great. Wow. So, okay, we’re here, we’re learning a little bit more. If there’s this, you know, irregular bleeding that’s going on, that’s the type of test to request or ask if it would be appropriate. What are some other things that someone who maybe is early into perimenopause or menopause, what are some things that should be like on their mental checklist of remembering, keeping in mind, maybe educating themself on?

Jessica Eriendson Van Remmen (31:18)

Mm -hmm. Well, I mean, there’s a lot of symptoms that can be related to perimenopause and we shouldn’t assume that they are, right? We do want to go to see the doctor, but it’s a really good idea in general if you can just make a list of your symptoms, like, you know, I’m having more anxiety or like I started having rage. I’m usually like, you know, calm, loving. I write silly little songs and, you know, like I like to paint.

Whitney (32:10)

Yeah, very calm, chill, yeah.

Jessica Eriendson Van Remmen (32:11)

I’m a pacifist. Yeah, but I would be like, and I just put my shoes on and go for a walk. And it was my husband that called it rage walks because it’s just, you pump your arms and you’re just mumbling to yourself. Or sometimes I’d call a friend who would just let me talk and then come home feeling so much better. But that was not normal for me. That was an indicator of high estrogen. That’s estrogen dominance.

Jessica Eriendson Van Remmen (32:37)

So keeping track of those things and mentioning those things to your doctor, like anything that’s out of character for you, anything that comes up that’s new that really wouldn’t be an issue. like I had chronic UTIs all of the sudden. hadn’t probably had one in 20 years and then all of a sudden I had like three in a row. And I went to my family doctor and she was like, we’re gonna send you to the urologist if you get another one. And I was like, I know what that means. They’re gonna look inside the bladder, very unpleasant. I don’t wanna do that. So I went back to the functional medicine doctor and I said, you know, I’m getting these UTIs and she was like, you need a little bit of estrogen in the vagina. That’s all. So we’ll give you a little estrogen cream and you know, you can take a supplement if you want that really good with the D -Manos and Crownberry, which would probably help keep everything nice and clear. And a hundred percent she was right, but I was not having vaginal dryness. Do you know what I mean? Like I wasn’t aware that I was having any less natural lubrication that would

Whitney (33:26)

Mm

Jessica Eriendson Van Remmen (33:32)

Make it a nice funky environment for some greeblies to get up there. But I wasn’t like, I’m uncomfortable. I’m just like, shoot, I have another bladder infection. What’s going on? So anything like that, anything that comes up like I’ve never had headaches before and I suddenly am having like aura migraines. Yeah. any like suddenly my breasts are really, really hard or extra lumpy or.

Whitney (33:39)

Right, anything different.

Jessica Eriendson Van Remmen (33:58)

tender, these are signs of estrogen dominance as well, right? So the doctor, may not hesitate to say you may not have a good doctor, because it’s really not about good doctoring. Yeah, you know, they would have to have educated themselves in the area of perian postmenopausal care.

Whitney (34:09)

A knowledgeable doctor. 

Jessica Eriendson Van Remmen (34:18)

So that doesn’t mean they’re a bad doctor, right? The family doctors are trying to take care of everybody and they’re dealing with cancer patients and they’re dealing with people that are going blind and all kinds of very serious issues. But, you know, sometimes I always tell the girls in the group, you know, you just keep going back. You just keep going back and you keep talking about your symptoms and you write it down or I have a chart. I have a comprehensive symptoms list. Fill out your chart, you bring it in because if you’re, say for example, the not sleeping well, you say to the doctor three or four times you’ve come in, you say I’m not sleeping well. And they go, that’s kind of common for people in their mid -age, we’re not too worried about it. And then they look at your chart, but it says I am always having trouble sleeping. And then beside it in the note section, it says I haven’t slept through the night in 10 days. Now the doctor looks at it and goes, that could be any number of things. And she drove herself here and she’s taking care of three kids or, you know, grandpa or trying to work full time or all of those things. We’re in, we’re in, we’re setting ourselves up for a health crisis.

Whitney (35:12)

Yes. Absolutely. I’m curious, and I don’t know if you even know this, there’s evidence out there that girls are hitting puberty younger. Are we seeing women hitting perimenopause and menopause at a younger age or any change in the moment of the lifespan that this is occurring?

Jessica Eriendson Van Remmen (35:39)

Mm -hmm. Well, we don’t really know because my mom, you know, by the time she wanted to talk about it, I was a new mom myself. So, you know, I politely listened to her, which means I really didn’t understand anything she was saying, except for that she needed a hysterectomy. But exactly why she needed it, I don’t really know. So we don’t really have that.

Whitney (35:59)

Mm, It’s not relevant to me right now, I’m okay.

Jessica Eriendson Van Remmen (36:16)

Tracking, right? We don’t have 100 years of evidence of average woman’s progression. That being said, you’re kind of living under a rock if you haven’t noticed that things are changing in the hormone world around us with people having hormone disruptions and fertility issues are definitely a problem, can definitely in what I’ve seen in my practice with clients that they do seem to have more trouble in perimenopause if they’ve had trouble with fertility.

Whitney (36:19)

Yeah. Interesting. Okay.

Jessica Eriendson Van Remmen (36:46)

Yeah. So I mean, it’s probably somewhat related to that. It really could be a lot of the environmental factors, right? Like the estrogen mimicking type things inside the plastics that are in the oceans, all the birth control pills that we’ve been taking that have been, you know, peed down into the ocean and we’re drinking that up and all of those things. We’re not really sure. But I think it’s a..I would really like to see more of the women in university learning about this so that they can kind of be aware that this could potentially happen as early as mid 30s so that they’re looking for it. So that if they start to have more anxiety instead of going, I’m just nuts, they’re asking that question. Maybe there is something going on. Maybe it’s worth looking into. if you have the money,

Whitney (37:19)

Yeah. Right.

Jessica Eriendson Van Remmen (37:39)

maybe you do go to see a naturopath. They’re a little bit better usually at testing, although one of the ladies I was talking to recently said one of her naturopaths, she tried three before she got one that was bang on for her, but she called her the fairy doctor because she tried to prescribe her cream and she called it like magic fairy dust. This is an educated woman in her 50s, right? Like she wants to take a thing that’s actually like explain to her what it is. Don’t call it magic fairy dust.

Whitney (38:06)

Right. Right.

Jessica Eriendson Van Remmen (38:08)

Nothing against that particular naturopath. Maybe it was wonderful. And the people that need her help are going to find her and get her help. And they will understand her language and it will make perfect sense. But we do need to make sure that the care we’re getting is appropriate for our circumstance and that it isn’t a one -size -fits -all kind of thing. Right now in Canada, there’s a little bit of a trend I’m seeing in my group of people doing the online prescriptions for HRT.

Whitney (38:36)

Okay.

Jessica Eriendson Van Remmen (38:37)

And it’s not bad or wrong, of course, you know, like I wouldn’t be a supportive person if I was going to give them a hard time about doing what they need to do. But if you’re starting on estrogen and you haven’t had a mammogram and you haven’t had a uterine biopsy and you’ve been bleeding abnormally, you see where I’m going with this? Now we’ve added hormones in potentially, you know, not that it is a problem because it might not be a problem.

Whitney (38:56)

Yeah.

Jessica Eriendson Van Remmen (39:05)

it might be fine. But for the person that does have a lump, because you know, the reason we’re doing mammograms is because we can’t always feel them ourselves. Yeah, so that’s the only thing about it. So whenever I do have people saying, you can do the online thing, I will say, go back to your doctor and tell them that you’re going to do that. And make sure that all your tests are up to date.

Whitney (39:14)

Exactly, Yeah, do right, right. Make sure that, you know, if you don’t have the training, the education to understand the different potential contraindications and things like that, just have the conversation. Just be safe. Take care of all of those potential issues or, you know, warnings and then make it that educated decision.

Jessica Eriendson Van Remmen (39:49)

What do they call that? Do diligence, Do your due diligence. Because if you come back later and you say, shoot, I did it online and now I have a breast lump, but I haven’t had a mammogram ever. You know, like whose responsibility is that then? Is it the prescribing agency online?

Whitney (39:51)

Yeah, yes and just if I’m understanding correctly, to clarify for those listening who may not have followed, having those tests done first gives a baseline. Should something come up, then you can compare it so that if there is a lump, you’re able to say that it wasn’t there before. So it’s just about being.

Jessica Eriendson Van Remmen (40:19)

Mm -hmm. Exactly. Exactly.

Whitney (40:30)

I completely understand that and it makes sense. I wish we did a lot more baseline testing just so that we know when something is different. But that can also be, you know, a great like keeping track, like you said, your chart, being able to say, no, starting in September, I was experiencing this every single night. Data helps.

Jessica Eriendson Van Remmen (40:35)

Yeah. Mm -hmm. Yeah, and it makes the doctors take it much more seriously, especially if you can bring in something that, like my chart, is a combination of several different sources that I’ve found. And I even have another section so that, you know, like I think a left elf breast tenderness. So you can add that one if that is an issue for you. And then of course, there’s another document that I will share quite readily called the Pocket Guide to Menopause. And it’s written by the Menopause Foundation of Canada. So it’s written by doctors, for doctors to explain the history of hormone replacement therapy and then gets into the specifics, even product names and dosage, like what to start them at. Yeah. So an ignorant doctor can have that handed to them by their patient and they can wipe their butts with it if they want. But if she comes back again in three months and brings them that again, eventually they will look at it and go, wait a second, wait a second, this is medical language. Who wrote this? Doctors wrote this.

Whitney (41:30)

Wow, yeah. Ooh, okay. There’s an MD behind their name? Yeah, well, you know, it’s, I feel like I could just keep going on. I’ve certainly learned a lot. I want to though, make sure that we touch on your group is thriving because there aren’t many spaces for women or women are not feeling supported, heard, what have you. Can you give us some tips?

Jessica Eriendson Van Remmen (41:55)

Yeah.

Whitney (42:15)

We all know a woman. How do we support women in this experience of life?

Jessica Eriendson Van Remmen (42:24)

Well, I think it just depends on the person like being open to talking about it, like talking about your own experience. Like now that we’ve had this podcast, it might start a conversation with your aunt or your cousin that you wouldn’t have had because you hadn’t had the podcast, right? And you might just say, you know, it’s kind of like, they call that being an ally, right? Like you’re a trans ally. I’m not…I’m not trans, but I have several friends for whatever reason. didn’t exactly go advertising, but here they are. And I’m an ally because I firmly believe that whatever they need to do, they need to do. And I do not know what they need to do because I’m not them. My job is to support them in whatever it is. And when you approach a woman and talk to them in that same level of dignity and respect, of sharing your story a little bit, you know, like…What’s going on for you? I’m wondering about myself here because I’m getting a little bit closer to 40 and I have noticed that, you know, maybe there are some changes that are happening because the metabolism slows down and you can start there. And then, you know, depending on the woman, she might be really open to talking about it. I’ve been really surprised and thrilled with the amount of women who as soon as they kind of get that permissive indication that you’re cool with talking about it, that they want to talk about it because it can be so, I mean, the one that I hear more than anything else is I felt like I was going crazy. I kept going back to the doctor and they kept saying, you’re fine, because they were looking for markers of disease and they didn’t find anything. But I know I’m not fine. You know, I’m itchy and I’m sad and I’m rage walking and I’m, you know, I yelled at the kids and I never do that. And I can’t drive anymore. That happens a lot where they get sudden driving anxiety. Who am I, right? I’m this weird.

Whitney (44:17)

Can feel like you’re losing all control of yourself, I’m sure.

Jessica Eriendson Van Remmen (44:21)

Exactly. And then you try to explain it to your husband who has absolutely no idea. And then so what I say to women about that is look up andropause. Get them to look up andropause. That’s the male equivalent. Andro -A -N -D -R -O -Pause. It’s the male equivalent of menopause. They do go through hormonal changes, but because they didn’t have these big fluctuations in the first place, theirs aren’t as extreme. But when they start looking into it,

Whitney (44:25)

No idea. Can you spell that for us?

Jessica Eriendson Van Remmen (44:49)

They’ll hear about menopause

Whitney (44:50)

I can’t learn about one without the other. Well, that’s good. Sometimes you need that kind of backdoor way into getting somebody to think about a topic. And for those men who are listening, good job listening. And now you’re more educated to go and support the women in your life. You know, what’s up? You heard it from Jessica.

Jessica Eriendson Van Remmen (44:59)

Yeah. Good job listening. Yeah. And you know what we need you to do? More stuff. Yeah. When I first got into it with my husband, I was like, dude, would you like to come into my group and do a talk for the dudes so that the women could show them like here’s a man, you know, coming from the man standpoint?

Whitney (45:26)

Yeah! It’s fabulous.

Jessica Eriendson Van Remmen (45:32)

But he was like, no, I’m not going to do that. And I said, why not? And he was like, none of them would appreciate what I had to say. And I was like, well, what do they mean? How do you know that? And he said, because I’m going to tell them what you’re doing isn’t cutting it. You have to up your game. Your star player needs more help. And I was like, well, I guess maybe they don’t want to hear that from you because it’s pretty cut and dry. And he said, you know, I had to get honest with myself and be like, I was pretty lazy about it. I let you do all the cooking. let you do all the cleaning. I let you do all the childcare. I mean, that’s an exaggeration, but you know what I mean. It was largely my responsibility. And now he knows, you know, if little joke, it’s five o ‘clock and he’s in the kitchen looking in the fridge and trying to see if there’s something started and if there isn’t, he’s like afraid to ask because he knows that’s, you know, he knows now what that means. It’s not a good day for Jessica. So he’s either buying dinner or making dinner.

Whitney (46:22)

Yeah. Yeah, absolutely. I mean, regardless of the couple’s orientation, we can all do a little bit more for the people in our lives, right? And we can ask people to do more for us.

Jessica Eriendson Van Remmen (46:28)

Yeah and that’s hard for women too, because I mean, we have gotten very used to being very resilient and really taking care of a lot of responsibilities. They talk about the mental load of the woman in the household because she’s carrying the soccer practice and the problem at school and everything that has to happen for everybody to get to work tomorrow. And Buddy just went out and played golf, know, like he’s not thinking about anybody because he doesn’t have to. And then it’s not a criticism of males. It’s actually something they’re looking into with the biological brain and how we’re functioning and what we’re trained to do. But it is humbling for that woman to have to say, you know what? It’s 4 30 and I’m done. Like I can’t do anything anymore. I have to sit here and just be sad because my stomach hurts. And I’ve been bleeding for 10 days and have the husband be like, where’s it’s Tuesday. We usually have tacos and like, well make it yourself. How do you make tacos? Like.

Whitney (47:17)

Yeah. Yeah.

Jessica Eriendson Van Remmen (47:39)

Jeez. I’m going to my room. Everybody can starve. It’s cereal night, kids. Yay. It’s cereal night. But yeah, I try and tell them like, give yourself that slack, right? If you need to go to your room and everybody’s having cereal, they’ll they’ll they’ll live. They’ll survive. It’s not fatal.

Whitney (47:52)

Yes. Right, absolutely, absolutely. Well, as we wrap up here, my question for you is if people walk away from our discussion today and they can only take one thing with them, what would you like it to be?

Jessica Eriendson Van Remmen (48:15)

Really, it’s that you’re not alone. You are not alone. Even if there’s no women around you that want to talk about it or that have that experience or know how to talk about it. I’m estimating right now there’s 1 .6 million women in Canada who are probably in perimenopause. So there’s someone there that does know what you’re talking about. And if you look around, you’ll find them, you can come and join the group if you mentioned that you heard the podcast. We have been trying to keep it Canadian based, but I’m going a little bit more international because I’m going to be in a book called Women of Purpose in the fall. Yeah, so we’re going to open it up a little bit more for international. you know, we were keeping it Canadian because we wanted that clarity because we’re going to talk about the Canadian medical situation. So as long as you’re okay with that, then it’s fine to join. And I just don’t think that it’s… Don’t put up with…

Whitney (48:53)

Nice. Congrats. Yes, right, Yeah.

Jessica Eriendson Van Remmen (49:12)

good enough, right? Like if it’s not working for you and you need to be heard and you need to be validated, keep talking about it till you find someone who’s gonna listen.

Whitney (49:22)

Yes, thank you. Yes. I love that. And you, before we met today, you shared a lot of resources, which I’m going to include in our show notes, the links to the group. I was gonna ask you when you’re starting a group that the people in the US can join. So I’m excited to hear you’re gonna open it. You’re going to open the borders. So that’s great. But how can people connect with you?

Jessica Eriendson Van Remmen (49:23)

Yeah. We’re just opening it up. Yeah. Well, I’m pretty easy to find online. I’m on Instagram as perimenopausesupport and there’s the CPMS on Facebook and I also have a Canadian perimenopage on Facebook and my website, thecanadianperimenop .com. And I try and share like really quality, like we have like book recommendations, right? So if I see on the page that people keep talking about a certain book, I’ll make sure to link it. These are books that we love. These are podcasts that we like, you know, these are really good resources for people. Cause you know, I was just talking to someone about an app today. They’re building an app and they want to maybe get me on board as a consult, you know, consultant. And we were talking about that whole, how do you get the information out to the people and what does it look like? And I said, you know, you can’t just link articles because not everybody loves to read. I like to read, but a lot of people like podcasts listeners. They want to hear the information verbally and honestly, it comes in here a lot easier for me because I’m dyslexic. So let’s give them the podcast. Yeah. Let’s acknowledge that. Isn’t that inclusivity? Come on.

Whitney (50:53)

And we all have different learning styles, Invert visual, hands -on, absolutely. Yes, it’s all coming back to meeting the person, understanding their needs, supporting them in achieving what they need. Wow.

Jessica Eriendson Van Remmen (51:07)

Exactly. That’s my main thing, right? Is it actually supportive because that’s very important to me.

Whitney (51:14)

Well, thank you for what you’re doing. It’s amazing. You know, here I am, a woman, a cisgender woman who really is right on the cusp of, you know, experiencing perimenopause. And I knew nothing. And I still need to educate myself a lot, but I know a lot more. And I know more of what knowledge to pursue.

Jessica Eriendson Van Remmen (51:34)

Mm -hmm.Mm -hmm. Yeah. Yeah, that knowledge is power.

Whitney (51:41)

So I know I learned a lot and I appreciate that. It absolutely is. Thank you so much, Jessica, for coming on, taking the time, opening up your group for others who are going to be able to benefit from you and the other women in the group. That’s what’s really amazing. It’s women supporting women. So thank you for your time. I really enjoyed it.

Jessica Eriendson Van Remmen (51:49)

Yeah, it is. Mm -hmm. Yes, thank you for having me. It was lovely to chat.

Whitney (52:11)

Yes, absolutely. And all of you listening, I will include all of the links so that you can follow up, learn more, share the resources, and share this episode. Maybe you are not yet ready to talk about it yourself, but you’d like somebody to know the information that was discussed today. That’s one way to show that you care or that maybe you are in need of some support. Just pass it along, right? Jessica just said it, knowledge is power. And this episode can be a source of knowledge for some. So thank you all for listening. Keep on coming back, subscribing, liking, sharing, and visiting our guests such as Jessica and supporting her work. Thank you all and have a wonderful rest of your day.