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00:00:01
E32: “God forbid men not having an erection!”
0 Plays2 seconds ago
Our topic today - one of the biggest, most under-researched, underfunded areas in healthcare.
This is a leadership conversation.
A workplace conversation.
A relationship conversation.
If you’re a man listening—this is your wife, your colleague, your boss, your sister, even your mother. And chances are… you have no idea what she’s going through.
Now it’s time for you to step up. And that’s the only way you are going to keep having this relationship.
This conversation is in the first instance directed at all the men listening. Guys, in case you haven’t yet… it’s time you learnt all about this. You need to know, you must know, take note and act.
And to all women who tune in, we hope you find the knowledge and experience shared here today helpful and empowering. Listen and act as appropriate.
“50. Put me in a closet and throw away the key.”
Days of Confidence
www.daysofconfidence.com
Mentioned: Dr. Mary Claire Haver – US; Dr Louise Newson – UK;
Useful articles on the subject
F.D.A. Will Remove Black Box Warnings From Hormone Treatments for Menopause
Federal Officials Promise to Restore Funding to Women’s Health Initiative
What Menopause Does to the Body
What It’s Like When Your Wife Goes on Testosterone
Recommended
Transcript
Women, Divorce, and Menopause
00:00:00
Speaker
She supported you through all those years, you know, pregnancies, she was there for you. Now it's time for you to step up. Listen, give her some room. Maybe she doesn't want you always, you know, but when she is ready to open up, just be there, listen. And that's the only way you're going to keep having this relationship.
00:00:19
Speaker
Because if you don't, it's not going last. And the statistics talk for themselves. In terms of relationship, 65% of all divorces are initiated by women after 40. So that tells you something about how women are feeling in their relationships and peak divorce time really maps out perfectly.
Introduction to Republic of Insead Podcast 2026
00:00:40
Speaker
This is Republic of Insead in a new 2026 O3D Limited Podcast Edition. I am still Milena Ivanova and will be your host yet again. For how long? God only knows.
00:00:53
Speaker
The 2026 edition is about life that happens while we make plans for it. I am back on air because a bunch of you asked for it. Truth is I love doing these conversations, but another truth is to do them properly takes time. And I don't know about you, but I'm always short on time.
00:01:13
Speaker
In any case, it is a pleasure and a privilege to be able to have these conversations and to be able to share them with all 432 of you, the class of all three d Life happens and time happens. We are hopefully still all the wiser, naturally smarter, and as charming as ever.
00:01:34
Speaker
Welcome to the Republic of Inciad 2026 limited podcast edition and enjoy the show.
Guest Speaker: Frederic Labadie
00:01:41
Speaker
All right. Giving Day 2026 is over.
00:01:45
Speaker
Done with. Excellent work, everyone. Thank you so much for participating. But we continue the podcast. I did tell you it's a promise. And the the topic today ah sending you on a totally different direction.
00:02:02
Speaker
One of the biggest, most under-researched, underfunded areas in healthcare. care I wonder how many listening would guess the topic on first attempt. In the recording room with me today is our own Frederic Labadie.
00:02:18
Speaker
Welcome, Fred, to the Republic of Insead podcast. And... Thanks so much, Milena, for having me today. and It's about time a woman came on this show. About right? but And we're going to talk about a really important subject which not only concerns women but concerns very directly concerns men. so i'm Yeah.
00:02:42
Speaker
And this is another conversation that has been in the making for at least 18
Menopause and Its Impact on Relationships and Work
00:02:48
Speaker
months. we talked We spoke about it at our Christmas dinner in 2024. So that's how long it's taken. And it's not procrastination. It's life happens and work happens and whatever else happens. So but there you go. We have the impulse now. And so today, even though it's two women in the room, and as you said,
00:03:08
Speaker
women about time, but the podcast has been quite balanced in the past, so we we keep that tradition. um The topic also seemingly concerns women, but we are in fact not having a women's cover conversation.
00:03:23
Speaker
We should start with this. um What this is about is it's about leadership. It's a conversation about workplace It's a conversation about relationship, about the health of everyone, 100% of the population and not just 50%. So to all the men listening, and as we well know, men are a majority in our community to the tune of 78%, more or less. So guys, in case you haven't yet,
00:03:54
Speaker
It's time you learned all about this. You need to know, you must in fact know. So take note and act. This conversation is First priority, you, your education.
00:04:08
Speaker
And to all the women who tune in, Fred has a ton of knowledge and experience to share, so we hope you find it all helpful and empowering. Listen and act as appropriate.
00:04:19
Speaker
But before we name the biggest, most under-researched and underfunded area of healthcare, care Fred, let's start with this. On the
Global Impact of Menopause
00:04:28
Speaker
surface, this conversation would appear to be one targeted at women, You and I, however, agreed that we first want the men in the group to hear and listen to all oldest very carefully. So tell us, before naming the topic, why should men be all over this topic? Over to you. I'm not directly concerned because...
00:04:50
Speaker
Most of them share their lives with the women. So ah this is their wives. This is their colleagues going through this. This is maybe they've seen their mothers when they were younger. I mean, their sister, it's every woman around them because, okay, so maybe I get the big reveal. I can do it. So maybe it's clear that not every woman will have children, but every woman who longs who lives long enough will go through menopause. So just to understand that this is a not a niche topic, and we're talking to get it around the scale, we're talking about 1 billion women globally right now are going through perimenopause, menopause. So that is not a niche. When you talk to some some VCs, they're like, yeah, but it's a woman it's a niche women's issue. I'm like,
00:05:41
Speaker
1 billion women with very high purchasing power, that for you is a niche market, it's not for me. So so for men, yes, I think it it will directly influence your relationships. It's it's impossible that it doesn't. So ah you better get educated because if not, your wife won't stick go around.
00:06:00
Speaker
yeah As easy as that. All right. And we mentioned workplace as well. Implications also at work, whether a man as a leader or as like a co-worker, a team player, etc., etc. ah So it affects really all aspects. In terms of workplace, it's one out of three women who think about quitting their job because of menopausal symptoms. And 7% of women actually do. So this is, you know, not understanding why your a colleague is suddenly she forgets her words in the middle a presentation because she has to run out because she just went through, know, she a hot flash and just like has her shirt is completely wet or because she comes in in the morning late because basically she had only two hours of sleep. These are all things that if you don't know why it's happening, you can't have any you know you you can't have any empathy. and And that's what women feel. and Basically, they're not being supported by by the
Menopause and Career Decisions
00:06:59
Speaker
workplace. And so they often leave. And people are like, well, it was a lifestyle choice. No, it wasn't a lifestyle choice. I mean, they couldn't deal with that anymore and they chose to laugh to leave. That's pretty dramatic because women employees who are leaving at that moment in their career, in terms of what it costs to the companies, I mean, usually their package would be 50% to 200% their salary. And we're talking about women who have tons of experience. So this is like a really ah big business issue. It's not a female health issue. It's financial issue for companies. And with the aging population on top of that, losing people with experience. Exactly. yeah exactly So we we always think about, you know, ah the pipeline when women are coming in the company to make sure, you know, that fertility benefits and and you know when you get pregnant and you have your maternity leave, which is great, I mean, and it's essential, but those are your usually young-ish employees. Well, when we're talking about menopause, we're talking about women around 45 to 55, and those are like at the top of their game. When you're losing somebody like that, it's a lot more valuable than losing somebody that just came in the pipeline.
00:08:10
Speaker
And that's what's happening. So let's let's start from the beginning. And again, this is targeted at the men. So what is menopause? What is perimenopause in terms of the practicalities?
Understanding Menopause Symptoms
00:08:23
Speaker
How would you describe it? So everybody focuses just to understand a bit what the the terminology is. So menopause, everybody goes menopause, menopause, menopause is one day of your life. So it's the day where it's been 12 months, you haven't had your period.
00:08:38
Speaker
and So what really actually is important is perimenopause, which is less discussed, but it can be like it's seven to 10 years ahead of that single day where all their all the symptoms start. So, I mean, you have to understand menopause is a hormonal storm that can last up to a decade in a woman's life.
00:09:03
Speaker
And as a man, you're going to live with the kind consequences of that, whether you want it or not. So that's why understanding it and understanding how you can support your partner is so so essential because in terms of relationship, 65% of all divorces are initiated by women after 40. So that tells you something about how women are feeling in their relationships and peak divorce time really maps out perfectly with perimenopause. So we're talking 45 to 52. Most couples in therapy, you know, think this is a psychological issue. It's not a psychological issue. Often, you know, that the fact that they're not getting along, it's a hormonal issue. And I think when you reframe it that way, and there are solutions and we'll get there later, it's very different because I think lots of lots of times men are completely lost and you have to understand that what's happening is not her personality.
00:10:00
Speaker
It's her physiology. So once you get that and you're like, it's not against you, you know, the fact that she's like snapping more or the fact that she's anxious or the the rage, the sudden rage, you're like, she doesn't love me anymore. She's struggling. And that's what you have to understand. Where does the struggle come from? How you can help her? What are the solutions? Sometimes she doesn't even know herself. And that's the real problem because we've been educated as women. You know, you have your period and your mother told you, this is honey, this is going happen around 13, 14 and blah, blah, blah. and ads And here are the tampons. Okay, great.
00:10:35
Speaker
And then you get pregnant and the whole world
Stigma and Self-Worth in Menopause
00:10:37
Speaker
is happy for you. Menopause, nobody wants to talk about it. There's such a social stigma around it because basically you feel like as a woman, you have no role anymore. So, you know, you made the kids. What happened? What's happening now? I mean, you're not sexy. You're not fuckable anymore. I mean, you're 50. It's like, put me in little closet and throw away the key. Because usually, I mean, in the rest of the history, women didn't live long enough, you know, or barely to reach menopause. So it wasn't an issue. The problem is now we have another 35 years to go after menopause. So it's really important to know how to deal with this. So these 35 years I'm still to live will be, you know, I'll be as functional and as, you know, can can contribute to society and and just feel like myself and alive and in shape. But you mentioned that men don't know, but the truth is women also don't know, right? Exactly. That's the biggest issue. yeah Women do not know what's happening to them. So just to understand, people talk get focus a lot on on hot flashes because that's the one which, you know, in comedies or makes you know on film, you're like, okay, well, she just, you know, she's she's
00:11:49
Speaker
and suddenly something happens and you see the heat coming off. or Literally, you can see the heat coming off sometimes. But I mean, hot flashes are one of more than 35 menopausal symptoms. And actually, when you ask women, there's been surveys about that. It's not the one that that most concerns them. One of the things that most concerns them is rage, irritability. These changes unexpected of, oh I'm happy. Oh, I want to cry. Okay. So this, you know, times 10. And basically in a relationship, it's very terrible. It's terrible because you're like looking at your husband going, why are you breathing?
00:12:27
Speaker
Why am I hearing you breathe? Why am I, you know, and and all these things, you know, why are you looking at me that way? And he's like, I didn't do anything. Yes, you did. and what you have to understand is we talk about hormones, but all these hormones start in the brain. So menopause is really neurological event. So there are physical changes in your brain, which lead to all these changes. For example, when we talk about Hot flashes hot flashes are what we call the vasomotor symptom and they start in the brain. So there's the prefrontal cortex, the amygdala and the hypothalamus, which are all influence and physically change the sign of your life. So this, and also when we talk about the hot flashes, it looks like, okay, it's you know something that will eventually leave. There is an association between the frequency of hot flashes and Alzheimer's later in life. So these neurological changes for women can have pretty dire consequences if they're not treated. So it's, it's as I said, there's so so much things that we're finding out right now. Why? Because this is something that affects women. um Yes, um it's my little feminist streak
Women in Medical Research
00:13:39
Speaker
that you're going to hear about, but women's health is historically underfunded, underinvested. Just a few facts, there no women in any clinical studies until 1993.
00:13:50
Speaker
So most of the drugs we use today to treat women and men were never properly tested on women. Women were considered small men in clinical studies until 30 years ago. And still to this date in clinical studies, we are not at parity. There are not 50% women in clinical studies. So for example, statins that lots of men use for heart issues do not work as well on women. Asthma medicine does not work as well on women. And so this is a huge issue. I mean, basically, you know, we've institutionalized sexism
00:14:26
Speaker
in research funding. And to this day, still happens. So is there a male equivalent of menopause? that What happens with men? Because, okay, women, we have the issues, we become these up and down emotional roller coasters, all the physical symptoms, hormonal mess. What happens with men? Okay, so there is, I really struggle to say the equivalent because it's really not equivalent, but we men do have something called andropause. So women have estrogen, progesterone as as their main sexual hormones and men have testosterone. So testosterone will drop about 1% a year and from the from when they're 40. Okay. And there's a whole pharmaceutical industry built around that because I mean, God forbid men not having an erection, that would be really terrible.
00:15:19
Speaker
However, in a decade, women will lose 90% of their estrogen. and you know, just that's normal and power through. So that asymmetry tells you everything about whose discomfort medicine was designed to treat. All right. And if men understood just one thing about menopause, what would save the most marriages, would you say? I think they have to understand that this is...
00:15:49
Speaker
It's not women suddenly don't love them or, you know, become unrecognizable. it's just, it's a physical change. And as such, they they need to give her leeway. They have to educate themselves with her. And if they do that, I think it's really an inflection point for lots of couples. Either you feel supported and I think you can get to a better place in your relationship. But if you're, you know, with a husband, because what um I mean, we talked about hot flashes, we talked at about i but irritability. I mean, let's talk about sex because, you know, 78% our listeners are men. So I think they're directly concerned.
00:16:29
Speaker
What happens usually for women after 40, first of all, there's a loss of libido. So, and there's often vaginal dryness, which are two things that are classic in perimenopause women. And how does that translate? Well, she doesn't want to have sex with you anymore because one of she has no desire and when she does have sex it hurts so for both of these reasons usually you know sex frequency will will go down and so you have two choices as a man you can look at this as she doesn't love me anymore
00:17:00
Speaker
because she doesn't have sex with me. Or you can ask the right questions. For example, what's happening? You know, are you okay? Should we? And try to open up the conversation. Because this is, you know, for women, as we said, there's not much education. So first of all, they don't know what's happening. And it's a sensitive issue and you know it's not easy to open up. So you really, i think for um for men, this is the occasion, this is the opportunity for them to try to, they they can do the work on the communication because it's not always easy for a woman who, for example, another thing we don't talk about is weight gain.
00:17:37
Speaker
Lots of women will gain around six or seven kilos in in those 10 years. And sometimes these kilos will actually come within one year. So you're in the position where she doesn't recognize herself physically. she She has no sexual desire. And like in terms of psychology, she's also not understanding what's happening, why she's depressed right now, why she's, you know, feeling anxious, why everything is happening.
00:18:05
Speaker
So honestly, i would say open, listening, and just empathy. And that goes a
Navigating Menopausal Challenges as Partners
00:18:12
Speaker
long way. Thank goodness we are not recording video. no yeah see that My eyes are watering a little bit because like I'm listening to you and you say, is she talking about me?
00:18:24
Speaker
So there you go. There you go. But and then back to the men, um there is a third option. And I finally understood the phenomena of men in their 50s getting divorced and and getting a much younger partner.
00:18:40
Speaker
And I now understand that, you know, if you lose your sexual partner at home and you don't talk about it. And I think I heard it on a podcast or it was Hal Berry talking with Trevor Noah. I think it was a very good podcast a year and a half ago. I listened to it. And he was saying that friends of his, a couple, almost divorced because they were no longer having sex. And the man thought, well, she's no longer interested in me. And then it transpired that the symptoms of perimenopause were what were causing these issues. And then once you know, you can deal with it. So... It's a vicious circle. It's a vicious circle. one thing happens, then the other thing. And so there's silence, there's miscommunication, you misread the signals, you start having, you know, feeling very alone, having parallel lives, and you're like, okay, well, why am I still here? However, to all the men who are thinking of, you know, divorcing their wives to get a younger one, She's going to go through the exact same thing 15 years later. might as well understand what's happening to your present wife, rather than thinking that the solution is just dropping her for a younger model, which will happen again. So it's, I mean, there's no, it always happens. That's life. I mean, you, she will go through it as well. Yeah. And so you mentioned the hormones. So it's estrogen that drops.
00:20:11
Speaker
Basically, there's three main hormones we have. So women have estrogen, women have progesterone, and most women usually know about this through going through their pregnancy.
Hormonal Changes in Menopause
00:20:21
Speaker
They've heard about these hormones. Women also have testosterone, and that women don't know about, I mean, or know less about. So we have three times more testosterone in our body than we have estrogen. So testosterone is really also a female hormone, and and i'll I'll get back to it. It's a very important hormone also for sex drive, mainly sex drive muscle. cognitive and also function. So what happens in perinopause, so this can happen as early as 36, 38. Literally, I have i have patients who are on HRT who are, and we'll get back to what HRT is for 38. So it can happen much, much earlier than you would think. And that society thinks, because I dare you to ask Claude or Chad GPT what a menopausal woman looks like. And they will come up with a picture of a 70-year-old with white hair who looks like your grandmother. And this is not a menopausal woman. I am a menopausal woman. Okay, we don't have video. I do not look like that. You are also, so we do not look like that. Okay, so it happens much younger than than you would think. And so what happens at the beginning is progesterone is usually the one that drops quicker. Progesterone is what we call the chill hormone. So it's responsible for you feeling relaxed, you sleeping well, not having anxiety. So these are the first symptoms in early parinopause that a woman will feel.
00:21:40
Speaker
So this this sudden irritability, you know, these ah i'm I'm changing, my I feel like this, I feel like that. I don't understand what's happening. Those are the first. And just to be clear, while all this happens, your period is perfectly stable and regular.
00:21:56
Speaker
So progesterone goes down first and then estra estrogen will just like go up and down even in the same day, even within an hour. So what's very difficult about perimenopause is, you know, women constantly come to me and they're like, okay, can I have a, just a blood test to check where my estrogen and progesterone levels are? I'm like, you can, but if I do it on the Monday and if I do it on Tuesday and a Wednesday, you'll have three different results. So this will not tell you if you are or not. So there's no test to know if you're in perinopause or not. I'm just, what we look at is we look at how old you are. i mean, from 38 onwards. And we look at your symptoms because these symptoms are basically, this will tell you much more than a blood test.
00:22:38
Speaker
So your estrogen is basically and going up, going down. And this continues until menopause, where you have no no longer any estrogen in your body. Oh, it's gone. It's fully gone. 90% of it is gone. So there's like very few left. Why is that an issue? Because menopause, usually people were, you know, the idea is, okay, so women, you know, their ovaries no longer work and they can no longer have children. but if If it was only that, we would be happy with it. It would be like, yay, no longer need for any contraception. However, women have estrogen receptors from their brain to their little toe, literally everywhere in their body. Okay. So when estrogen leaves the room, this is no longer a party. This is like really a dire crisis. So, I mean, you can have, what happens is then, for example, heart health goes down. So we come from before 50, women have very few heart attacks. And so
00:23:34
Speaker
people are like, men have heart attacks. After 50, one in three women will die from a heart attack. Why? Because estrogen is anti-inflammatory, protects your heart. When it's gone, the protection is gone and then everything goes goes haywire. Also, for example, talking about heart attacks, which is one of the main causes of death for women after 50, one of the issues is we've been trained, i mean, doctors have been trained to recognize heart attacks in men. So I think everybody will you know tell you, well, it comes with this sharp pain in your in your shoulder, and then you feel this pressure in your chest. And so, yeah, this is how a man has a heart attack.
Heart Attacks: Gender Differences
00:24:11
Speaker
So if he goes to the ER, the doctor will recognize you're having a heart attack, sir.
00:24:15
Speaker
However, a woman does not present with the same heart attack symptoms. Usually, it her heart attack is in in in much smaller veins and and arteries than so men And it will present in a much more diffuse way. Often she'll be very tired. And so what happens, and this is, I'm not making this up, is women will go with a heart attack to an ER and they will be sent back home.
00:24:40
Speaker
because they don't write doctors were not trained to recognize heart attacks in women. And so they will be sent back home where they die of it. So this is a big issue. I mean, osteoporosis is a huge issue. More than 60% of women will have a bone fracture after 50. And because our bone density starts going down from 40 and then it will lead directly to a bone fracture. These are all things, your heart, your bone density that you do not feel. So when we get to HRT, which is one of the solutions in terms of
00:25:15
Speaker
of hormonal health for women and the biggest longevity hack that women have people always focus on the fact of on the symptoms you can feel so the you know the the soft the the hot flashes or the you the rage but everything that's happening inside your body which you do not feel for me is the real reason why you want to take hormones to protect against all that because there are no signals to tell you everything that's happening in your body from 50 years old
Hormone Replacement Therapy: Myths and Benefits
00:25:42
Speaker
on. So, which brings us to the topic of HRT, and that's becoming more practical also for women. Although I would say the men should should definitely listen and if they can help their partner and share the knowledge, because not everyone knows. And by the way, in
00:25:59
Speaker
yeah Difference is huge between US s and Europe and then in Europe, UK and the continent. so um So let's talk HRT. And you're saying you're talking about protection, but there's this whole previous history of scare with breast cancer, et cetera, et cetera, which is why, for example, in Bulgaria, I struggled for three years chasing different doctors and would not get anything prescribed because all hormones are scary and they're so bad. So...
00:26:28
Speaker
Yeah, so let let through this let me explain why that happened. So and what happened is when we were in the ninety so HRT, so this is hormone replacement therapy, also called menopause replacement therapy. Okay, so this actually is something that's been around for quite a while. So this started in the 70s. And it was marketed at the time, quite interestingly, as the fountain of youth for women. So it was, a keep have nice skin, have beautiful skin, have beautiful hair, take HRT, we'll make you young forever. okay So that was the marketing at that time. We weren't very but correct.
00:27:06
Speaker
um And at that point, in the eighty s early ninety s almost women were taking a chart tea Okay. For them, never as well system symptoms. So at some point somebody said, okay, well we should, you know, have a study about this and see whether it really helps women or not. So we had what's called the WHI. So the women's health initiative, which took, I think it's like 60,000 women and studied them to see what were, what were really, what HRT was doing to their bodies. What happened there is the study was stopped.
00:27:38
Speaker
abruptly after six months, basically because they found a correlation between HRT and breast cancer. What happened is at that point, that conclusion of that medical study, the fact that it was linked to breast cancer, was relayed across every single newspaper across the world. Okay, so Everybody, so it's screeched to a halt. So from one day to the next, HRT gives you breast cancer. Medicine and medical schools stop teaching about HRT. Women from one day to the other are not prescribed HRT because of course, I'm not going to view cancer. I don't want to do that. So for 25 years, we have this kind of ban on HRT. What happens is that when people looked at the data again, they realized that for...
00:28:22
Speaker
many reasons, namely that the women in the study were much older than when we usually give HRT. So they were past 60. They hadn't been screened previously for breast cancer. Breast cancer, we know does not appear in six months. It usually takes seven years, you know, to to progress. So you can actually see it on a scan.
00:28:40
Speaker
And they were given them synthetic hormones. Whereas now we only give body identical or what we body or bio identical. It's the same thing. hormones so for all these reasons the conclusions that they came to were wrong okay so we know this we've been we've known this for the last three four years there's a i think somebody on the chat actually one of the women sent this great article on from the new york times saying why we've been misled about hrt and it's really it's an eight page article i'll send it to you again but it's really worth reading to understand the details of it. But so fast track to now, we went from 30% prescribing you know women getting HRT to about 6% now.
00:29:21
Speaker
It's a bit higher in the UK, they're around 10, 12. Continental Europe is around six. and the US, and I'm not even talking about the rest of the world, where the concept has not arrived yet.
00:29:33
Speaker
So what happened during these 30 years, you know, where there was no HRT prescription, it's not like suddenly the women did not feel these symptoms. What happened is we started prescribing antidepressants like they were candy. So giving out antidepressants is not an issue. And if you look at a graph, actually, of when HRT, we stopped prescribing HRT in the last 30 years, I think Now almost 20% of women, something like that, are antidepressants. Oh gosh. Sleeping aids, things like things, medicine, drugs that actually have lots of secondary effects, which are not very good for your health. so And they are not cheap either.
00:30:11
Speaker
No, they're not cheap, whereas hormones are actually cheap. okay So what happens is this whole 25 year ban on hormones resulted in the fact that now the doctor who is basically in medical school, you know, 20 when he was 20, 25 is now a 50 year old gynecologist, which perhaps was great delivering your three kids, but know strictly nothing about prescribing HRT. So to understand that the crisis, less than 20% of all gynecologists are trained on menopause. And when they are trained on menopause, it's actually a few hours of training. So they know nothing. So you go there thinking this person will help you.
00:30:53
Speaker
And usually he'll go as well, this is a natural phase. You're strong. Get used to do it. And you're like, okay, thanks. And women are basically, you know, have a lots of respect for doctors who they think are really well educated in and know about this stuff.
00:31:08
Speaker
That's why it's so important women and men to get educated about yourself, for women to advocate for themselves, literally. And for a men to maybe, you know, if they have a wife that doesn't know to push her to actually not take no for an answer. and you know ask for these things and i i tell my girlfriends oh he you get you go to gynecologist tell him you have this this this and that so i test the gynecologist to see how he's gonna you know how he's gonna answer that because if he tells her no ah you know this is just a natural part of aging i'm like okay you know what he was great for your kids now for your babies now change gynecologists you know and that's what we're trying to menopause train gynecologists so
00:31:48
Speaker
HRT right now, how we're prescribing it is giving back to your body the bioidentical hormones that it's no longer producing. So giving back estrogen in transdermic, progesterone as a neur role of something you take early at night, and even testosterone, which unfortunately a woman's testosterone products only exists in two countries right now in the world. So in Australia and New Zealand, it's coming to the UK. It's We know this is something which is super, which really helps women, but still the pharmaceutical industry has not decided it's worth having women's products. So we use we we use men's testosterone and we use a tenth of the physiological dose you would give to a man. That's what women have to do to get testosterone.
00:32:33
Speaker
<unk>ster Just so you understand also how long this this black and let's say you know cloud on HRT lasted until three months ago, there was still a black box on estrogen products saying it was you know it was linked to to breast cancer until three months ago. So women, you know even though we know, we've been we known for the last like five years at least, it wasn't true, it was still on on the products. And so women are scared to death of taking HRT, which is a shame because if there's one thing that can save their lives, it is HRT.
00:33:06
Speaker
And they think it's going to kill them. But actually, you know breast cancer will kill less than one out of 40 women. So it's a very frequent cancer. It's one out of eight, but it's highly treatable. Whereas, you know, heart attacks will kill one out of three. So we're, you know, we're worried about our breasts when we should be worried about our heart health, about our brain health, about our bones not breaking. Those are the things that HRT protects you again. So to paraphrase Peter Attia, and which is a very famous doctor, which now has been linked to Epstein. So I would rather not talk about him, but still he considered it the biggest medical problem.
00:33:40
Speaker
mistake in women's health bar not the fact that hrt was demonized for so long because we have a whole generation of women who didn't have access to it and we're now seeing how they've aged and it's not a pretty sight yeah so So for me, there is no single question. I mean, there I was talking to a gynecologist who said we're at 5% and 95% of women are not taking hormones. I think in the future, it's going to be 95% women taking hormones and 5% of women can't take
HRT and Quality of Life
00:34:07
Speaker
hormones. Because of course, some women cannot take HRT, but there are very few of those women. Basically, if you have ah a hormone-dependent
00:34:15
Speaker
breast cancer, you can't take HRT. Or if you have ah blood clots, you yourself, not in your family, you have blood clots, then we're going to watch out on HRT. Those are the two single cases. So when people say, I have breast cancer in my family, I'm like, that doesn't prevent you. i have blood clots in my family, that doesn't prevent you. I'm a smoker, that doesn't prevent you. However, doctors who have no education will steer you away saying, no, no, you can't take it. No, it's not for you.
00:34:40
Speaker
And I'm like, why are you saying that? I mean, it's 20 to 25 euros US dollars a month. We spend thousands on things which are not useful. And this is the single biggest longevity hack for women. So there you go. So it's a longevity hack. I like this. it's It's all about the framing and then and then the risk management aspect, which is the risks. here that you are mitigating against are so much bigger against the risk that has been scaring people off. The risk of breast cancer from HRT is equivalent to having a glass of wine a night.
00:35:18
Speaker
Try taking alcohol away from women. They'll kill you. They're like, I need that. I need to in wine. Don't take away my glass of white wine. I'm like, fine. But just so you know, that's the same risk your health, you know, to breast cancer as HRT. So you're fine with your glass of wine, but you don't want to take HRT because it'll give you breast cancer. I'm like, no.
00:35:38
Speaker
So we've just just to just one thing, because we've talked about h t A few things I'd like to mention for the women out there. HRT is great. a However, there are other things you have to work on as a 40-plus women, nutrition and working out. So these are also non-negotiables. HRT is not your magic. It is a magic wand, but it works even better. If you work on your nutrition, so protein intake and working on, on developing muscle muscle is considered also the organ of longevity for women. It protects your bones. It helps you be functional much longer. So for all the women out there, you have to lift weights. which is not Pilates, not yoga, lifting weights. That's the only way that you'll develop muscles. So maybe the guys out there can help if they have weights at home and you can start training together. That's a good good couple like to cook cup activity, which will help your relationship and help your wife's health. What other you mentioned when we spoke, so alcohol, a lot of women have a problem. What happens with alcohol and lots of women I talk to, we're like, don't understand. i mean, I used to go out and I was fine the next day and now I have a glass of wine. I feel like shit the next day one glass of wine. What happens is your liver, when it metabolizes alcohol, it's not metabolizing what few hormones you still have left so the hangovers are get worse and worse and you're like it's not worth it anymore to me so lots of women stop drinking and the ones that do continue drinking feel like shit so i decided not to drink anymore i have a glass of wine maybe once a month but honestly you know all that french bullshit about yes red wine is so good heart health no actually alcohol was we know now, has no value health-wise whatsoever. Yes, it's nice. Yes, it tastes good. Have some if you if you really want to, but just don't self-imagine that this is going to help you with your heart health. It won't. Good thing we had all this champagne when we were on campus, I Exactly, exactly. Then was the time. Now, not so much. Now I'm like, every time I go to a restaurant, I'm like, do you have kombucha?
00:37:46
Speaker
And they're like, what? I'm like, yeah, I mean, come on, give me something else to drink that's non-alcoholic. I don't want a mocktail. It's full of sugar. And I'm tired of having only water with with lemon in it, you know. and And actually, the young generation is drinking a lot less. So they're pushing for non-alcoholic alternatives in restaurants. And you mentioned creatine and any other supplements that there's the Indian herbs. So is there anything else that's a good thing to add in terms of supplements? Okay, so that's a good question. So I would consider just just to reframe this, women's health for me is ah a pyramid.
Bioidentical vs Synthetic Hormones
00:38:25
Speaker
Okay, so the the foundation of the pyramid is your hormonal health. That's why HRT is so important. On that, you build with your nutrition, you build with your training, and the top of the the top of the pyramid is supplements. So yes, there are a few supplements which we know we don't we don't have much in our system as women. For example, vitamins D3 and K2 are essential for bone health. And D3, I mean, I live in Spain. It's very sunny. Still in Spain, 80% of women are lacking and vitamin D. Okay, so this is something universally women can benefit from. Magnesium can be also, lots of women miss ah don't have sufficient magnesium. If you're going to take magnesium, the most bioavailable form is bisglycinate magnesium. So that's something that can help also. And a creatine is something that, but again, people associate with gym bros who want to develop muscle. But what's the latest research is when it's one of the most useful supplements.
00:39:24
Speaker
supplements for for women in terms of, yes, muscle development, which we said is really important, but also cognitive function. So it works on your brain and it keeps you sharp. And so creatine is something I've added because I have my own supplement line. So I'm pretty well served on that part, but I didn't have creatine. So now every morning i have creatine, which actually has no taste. It's just a white powder. Just careful. I travel line my little bag of creatine wherever I go in there and I'm like, it's not Coke. It's, you know, that age. Yeah. It's protein. And so you can taste it if you want. It won't give you the same buzz. But it's tasteless. It's great. You just put it in your coffee in the morning and and that's very useful.
00:40:05
Speaker
In the coffee. All right. And anything else? if If a woman is starting on this journey now because she heard the podcast and she's like, oh, okay, I'm 42. I thought it's too early. But what else would you advise people check? You had mentioned the Texas can and... hi Yeah, very important. Lab work, bone problem. So usually your doctor will always talk about a mammography, which is fine.
00:40:30
Speaker
But having your bone density measured, you shouldn't wait for too late. i mean, i I meet tons of women who are 49.50 and already have osteoporosis. Just so you know, once you have osteoporosis, which is you know a problem of bone density, you can't reverse it. You can't.
00:40:46
Speaker
you know, you can stop it, but you can't reverse it. So it's very good to start early. So at 40, that's why the weight training is really essential because this will protect your bones. Weight training, jump training. So which sounds like, what? You're going to make me jump? Yes, because How bone works is bone works, but you need to micro breaks and then micro it it builds it back up. so so So jumping impact is great ah and and weightlifting is great. And having a DEXA scan, DEXA scan is basically something that measures your bone density at the hip and in your femur. And this will give you an idea of when, you know, where you are on the, if you have, you know, good but good bone well good bones, not good and bad, but just denser bones or bones that are more more prone to brood break it. So I wouldn't leave it to 50.
00:41:37
Speaker
I would try to get, particularly if you know that your mother, and that's another thing that women don't do. Please talk to your mother, ask her when she had her menopause, because this will also be an indication. And when, when you're going get yours, it's not perfect, But if she had an early menopause, watch out because that's probably something that's going to happen. And ask her, you know, how she went through it. how Probably she didn't take anything. But, you know, how how were her symptoms? We don't talk about that. and And this is our mother. She, you know, she gave us life and we don't talk about basic things. And ask her, it check if there's osteoporosis in your family. If there is, try to not leave your DEXA scan until you're 50 and try to have it a bit earlier. Because once you know, you you can actually start to do some things. and detect your bones. Yeah.
00:42:20
Speaker
All right. Bio-identical versus synthetic. How has science evolved? And why are bio-identical better? Or what are the things? What does it actually mean?
00:42:31
Speaker
So synthetic hormones, because, you know, I think hormones have a bad rap various reasons. so One of the reasons is this infamous study. But another reason is basically that lots of women have been on on the pill. So the contraceptive pill for years. They felt kind of crap. I mean, I was on the pill for 15 years, 15 or 20 years. I think, I mean, honestly, contraception options for women are, you can you know you can count on one hand what what you have as contraception options. So it's not a big choice. Those are synthetic hormones. And for most women, I know it happened for me. What so synthetic hormones do is they, blu well, they have a lot of secondary effects and they blunt, for example, your normal cycle. So I didn't discover that I actually had a libido and you know a cyclical libido when you're ovulating, you you you want to jump everyone. and then when you're be before you're... But I mean, synthetic hormones will just, you know it it makes it all the same every single day. So you're not really, you know you don't have your real cycle. So we've had that for a lot of years. So people equate HRT. They're like, no, I don't want to take hormones anymore. I want to do it naturally. And I'm like, okay,
00:43:41
Speaker
These are, so what are bioidentical hormones? They're the same hormones you were producing. So in terms of your brain receptors, you know they recognize them. And so you don't have the same secondary effects. as you would do on a contraceptive pill. Plus the dosage is important. There's HRT is three times less hormones than what they gave us when we were 15 on a contraceptive there's a huge difference on the on taking hormones.
00:44:08
Speaker
I understand women who say, I want to take it naturally. I'm like, you can't get more natural than that. Those are the same hormones you had in your body, you know? And just so you understand where the science is heading, I mean, in the States, there are some studies on extending the life of your ovaries. Not so women can have you know a baby when they're 70, but just because we were recognizing the crucial role that our hormones have in the health of our hormones.
00:44:37
Speaker
of our whole body. So for me, I mean, there's no, you know, natural does not mean, you know, they're like, yeah, but hormones are, I'm like, you wouldn't take, you know, if you have an infection, you wouldn't take antibiotics. Think about that. I mean this saves your life and you're like, no, I want to do it naturally. I'm going to, you know, not take anything. And the thing is you cannot, that's, I think crucial because I love, you know, nutrition is super important to me. Sports also super important to me, but As Mary Claire Haver, which is a very well-known us gynecologist, which I all encourage you to follow, says you cannot out-train or out-diet menopause. This will not happen. so so There's no natural way to recover the estrogen that just drops off a cliff. So as simple as that. Unless you take HRT. So what, and then what I heard, I was talking with Sophia Argao who lives in Copenhagen and then she said in Scandinavia, they are starting to basically talk about women being on HRT for life. Of course.
00:45:36
Speaker
Not just like 10 years or whatever. who said 10 years. Okay. So that's the, I didn't say 10 years. So that's what you that's why that's why i do what I do. So days of confidence and we'll get back to that. So again,
00:45:49
Speaker
yeah We've pivoted to Femtech, we have a team of doctors that prescribe, which I fought to find because I wanted doctors who shared my my philosophy on prescribing, which in in Canada and the States is much more open-minded than it is in Europe. So in Europe, what happens often is that they will wait until you're in full menopause before they give you more, which is...
00:46:08
Speaker
Again, bullshit, pardon my French, but it's much better to start in perimenopause when you still have hormones and you just you know tweak it rather than waiting until you have nothing in your body to give it back. And so they'll say, okay, we'll wait till you're menopause and give it to you five years and then we stop. And i'm like, why would you stop? So you've gained these five years of having hormones in your body. But the moment you stop, um everything just happens again, just five years later. So the idea is people are like, so how long do I take menopause? And it's exactly what Sophia said. Forever, my 72-year-old mother is still on on hormones, you know, and my gynecologist put her seventy four or her started her mother, who was you know of another generation, at
00:46:48
Speaker
four So there's no, this is something that will really change the way you live and you age.
Potential of Lifelong HRT Use
00:46:55
Speaker
So why would you stop something that's working and that's particularly expensive and that has no secondary effects? I just don't understand. So so I think we're coming around to it. Another great, for all the UK women out there, another great gynecologist to follow is Dr. Louis Newsom, who's done tons of work also on drugs. educating women and society at large on the importance of HRT and that it's never too late to start HRT. Of course, the window arbitrary, it's best in perimenopause. So don't wait till you're for menopause at all. But even if you've passed that point, you made it if you need you you may need a few more exams, but you can still take HRT later. So...
00:47:34
Speaker
It follows you for the rest of your life. So a woman who is 60 can start at this point and course there will still be more benefits than risk of cancer or whatever. Okay. All right. I would encourage her to. So guys, you can also talk to your mother. Well,
00:47:52
Speaker
I mean, my mother had me very young, but we're 50. Their mothers are kind of getting all old. Really old. Not genopause old, really old. All right. Well, there you go. So, but tell us a bit more about Days of Confidence. I've been, Victoria would share with me, oh, Fred is in town and she's doing the presentation and it's been 10 years or something like that, that you more?
00:48:18
Speaker
no no, it's been five years. Really?
Shift to Menopause-Focused Supplements
00:48:20
Speaker
With the whole business from the beginning? Okay. So it started in the pandemic. Okay. All right. ah But you started with... I started with cosmetics and supplements. So skincare and supplements, because this is what I knew. I came from a marketing background, Procter & Gamble, and I wanted to do organic skincare and supplements. And I started with that. And it was ah i had the i had somebody who who basically was my co-founder at that point who was very adamant on it being a beautiful brand, me not talking because nobody wants to know what I think. Just like let the product speak for itself. And it was okay, but anyway we we had lots of, some sell-in in in very design like Le Bon Marché and nice nice points of sale. But then there was not a lot of sellout because basically people didn't understand what the brand was about. We were very On our formulas, we were like organic certification requires 20%. We were more than 80%. So we had really qualitative products, but skincare is such a saturated market that if you don't have millions to shout about what you're doing, it's very difficult. So we hadn't raised money and at some point we were just not selling enough. And so we didn't agree on them on the direction the the company was taking. And so he left and I started thinking and I started talking to the people who were buying the brand.
00:49:35
Speaker
and asking them what was happening, why they were buying and and really putting the focus more on the supplements. I realized that lots of women were using my supplements to relieve their menopausal symptoms. And I was like, okay, so what is this? What is perimenopause? And at that point, my...
00:49:51
Speaker
It's also starting to change. So I was 47, started in having irregular periods and just decided to deep dive into something nobody could tell me about, which was what is perimenopause. And so I started talking to one doctor, next doctor. i did a training at Harvard Medical School and I said, oh my God, this is what I want to do. And I think for women and probably for men also, when you reach you know midlife, work for me, you know it has to make sense.
00:50:18
Speaker
And and meaning I couldn't sell skincare. It was hard for me because I thought it was very superficial. I wasn't going to walk around going, look, I have nice skin because of my creams. I thought that was completely stupid being influenced. or I thought was completely stupid. However, educating women about health care, which is a type of influence also. Yeah. but to me felt so needed. And so, you know, I thought I really really could change, not skin deep, but really the health of women. So when I started into this, I'm like, okay, this is where I want to go. So we kind of re, we looked at the our our product range. We kill some products, we launch new products and we we changed our whole focus in terms of how we were expressing ourselves. So in in terms of the French Instagram and the the Spanish Instagram, we hadn't launched and we started launching. And then six months after launch, one of my videos talking about, because then I, then yes, I said, okay, i no longer have a co-founder. So yes, I'm, you're going to hear me. You're going to see me and I'm going to be the face of it because my team was 24. You know, there were 25 who's going to talk. I can't talk about perimenopause if you're 25. So like, well, whether I want to or not, I'm going to put myself forward. I'm going to talk about this because nobody else will. So, um, I did that. And one of our videos went viral and had more than 2.7 million views to this day, then another and and another, and then our, our. community in Spain went from having, you know, 6,000 followers to 80,000 in three months.
Building a Brand and Community
00:51:40
Speaker
And now, you know, 117,000 on Instagram, another 60,000 on Facebook. So quite a big community. And what happened is from one day to the next, all these women were writing to me and saying, I have this, this, this, this is that, what do I do? And I was saying, okay, great. I have supplements. which are okay. I mean, they're good supplements, but still, they're not going to, as I said in the pyramid, they're not the foundation of what's going to help change your health.
00:52:03
Speaker
And so I said, I have to, you know, give these women to IT. I'm not a doctor, so I can't prescribe. So the first, you know, step was finding a team of doctors that shared my philosophy, as I mentioned, and then building a platform where they can come and they can have their doctor-led consultations. So we've been doing that for a couple of months now and and it's been going well. I mean, it's still, there's still, there's a lot of barriers to still to overcome. For example, we do telemedicine, which in the U S is like, of course, I'm going to see my doctor on the screen. And in Spain, it's still what I'm not going to have the physical expiration. I'm like, you don't need a physical expiration for me to, you know, to give you hormones because menopause for that is great. You don't need, it's not like pregnancy. You don't like, you don't need to have a physical expiration. But still, you talk to women who are 40 to 55, who are not very tech literate. So sometimes, you know, okay, so we're going to have a doctor consultation with Google Meet. They're like, what is Google Meet? I'm like, oh shit. Okay, we're starting. Okay, let's do WhatsApp. So WhatsApp, they usually know. So it's marketing to um to women. I mean, there is clearly, the problem is there. We get hundreds of messages a day. Now it's really... about trust.
00:53:11
Speaker
So establishing the trust that sometimes we answer and they're like, oh, you're not, or we have a video call. They're like, oh, you're not AI. I'm like, no, I'm not AI. I'm a real person. But, you know, so it's really establishing that trust. And mean, the patients we have really like come back and say to me, well, why didn't anybody, I'm feeling so much better. Why didn't anybody tell me about that earlier? And I'm like, yeah, well,
00:53:36
Speaker
That's what we're here to do. So the idea is to expand. So the supplement business is still you know going strong, but to expand that telemedicine business first in in Spain and eventually France and Italy. So all of Southern because UK has some options. Scandinavia is starting, but Southern Europe is like...
00:53:57
Speaker
medical desert for menopause. So there is really an opportunity to do it. And for me, it's really aligning what I feel very strongly about when you hear me talk about it. I can talk, my kids are like, please change your, change subjects. I can't hear about perimenopause anymore, but I mean, there's so much to say about it. And so aligning your, your interests and your, and your, and your business together, I think is the best way to do it because yes, I spend lots of hours on this, but at least It's something I believe so you know deeply to change women's health. I think now is the great moment to do it. There's a lot of activity in the States. People are really waking up. Women are waking up. I think this generation saying, you know I'm just not going to accept somebody who tells me this is natural. No fucking way. Or get used to it, right? Yeah.
00:54:45
Speaker
Yeah. Get used to it. It's just a phase of life. So since you know me and you know how I'm not afraid to talk, I do lots of public speaking, women's networks, just
Supporting Partners During Menopause
00:54:55
Speaker
in general. I get out there and I tell them my point of view because I'm like, for all the women who do not want or do not have the capacity or i do not have, you know, don't feel don't feel they can do it, I'm like, I have to talk for them.
00:55:07
Speaker
So I will. Awesome. So if you have to ah give one line to the guys listening, what is it on the topic? She supported you through all those years, you know, pregnancies, she was there for you. Now it's time for you to step up.
00:55:24
Speaker
Listen, give her some room. Maybe she doesn't want you always, you know, but when she is ready to open up, just be there, listen. And that's the only way you're going to keep having this relationship.
00:55:36
Speaker
Because if you don't, it's not going last. And the statistics talk for themselves. So I get
Women Advocating for Health in Menopause
00:55:43
Speaker
goosebumps. And to the women, the ones who haven't yet gotten there.
00:55:47
Speaker
Advocate for yourself. It's not normal to suffer. I think as women, we've internalized suffering. Society thinks that women are meant to suffer through you know our period, our pregnancy, endometriosis, whatever women are. Just take it, take it, take it. It's enough. Don't take it anymore. You have a right to feel 100%.
00:56:05
Speaker
So go out there, ask for some help. If you don't know where to start, write me. Exactly, I was going to say. But do something. I mean, there is another way to age. You have 35 years to go. So think about how... At least. Yeah, at least. I'm going for 120.
00:56:23
Speaker
I've always been ambitious. I'm like 120. But ah you're at least going to get to 85 if all goes well. So how do you want to live this year? You want to you know you want to be able to take your grandkids in your in your arms and to you know travel and put your suitcase above your head. All of those small things that we take for granted are not that easy when you age, depending on how what you choose to do now. The decision you take now will influence the rest of your life. Very good. I'll have to cut those and and put them all over, you know, like message, message. Awesome. Fred, listen, that was a ah great conversation. You have helped me and this dinner in London with all the other girls was very helpful um on a very personal level because I have struggled um and Bulgaria is very backwards on this topic. Yeah, yesterday, just just for a fun fact, yesterday, one of my neighbors, Said, Fred, can I talk to you? And I'm like, sure. And I'm like, okay, so let's meet up when we have coffee. And I'm like, so what's happening? And I knew she was about, you know, she was a bit older than me. And she's like, listen, I'm not feeling great. And I went to my gynecologist and he told me everything was fine, which is classic.
00:57:33
Speaker
And I'm like, okay. Let's talk. And basically, she started her program. It was a very easy sell. She was like, why didn't anybody tell me that before? I'm like, yes, it's a systemic social issue. And that's what we need to change. And the good news is that when you start, it goes very fast. Yeah. Within three months, you see a real difference. No, I...
00:57:56
Speaker
It's been three weeks for me. well Okay, so I'm giving three months. I'm giving some margin. But yes, I agree. you see it You see a real difference very quickly. Fred, so you can do this 200% of the fee, I guarantee. And I pay back 200% if it doesn't happen in three months. Right? Yeah.
00:58:15
Speaker
one of these marketing there you go super thank you so much for for this i hope it helped the guys and the girls the women in listening and if anyone wants more from fred you can text her and then of course days of confidence.com yeah days of confidence.com or we have an instagram account so days of confidence dot france or dot spain You can reach out there and and for the people who know me it just or the people who don't know me, you can give if somebody reaches out to you, give them my WhatsApp. All right. And we'll post the articles in the text below the podcast so so ah people can get more resources. Thanks so much for bringing till're bringing some light to this topic, which is not the most sexy maybe for some women as some people, but I think it's very necessary. Very important. Very Great. Thank you, Fred. I'll see you soon.
00:59:11
Speaker
You were listening to The Republic of INSEAD now in its 2026 O3D Limited Podcast Edition. It is my hope to remind everyone what an interesting and dare I say colorful bunch of people we are and how much we can contribute to each other, be it through life experiences, ideas, knowledge or mere inspiration.
00:59:34
Speaker
The podcast is inspired by the original Republic of Inciad yearbook produced on paper now 23 years ago by Oliver Bradley and team. Thank you, Oliver and team for this contribution to our class's memory and for letting me continue in the tradition, title and inspiration included.
00:59:52
Speaker
Creator and author of the Republic of Insead 2026 Soul 3D Limited Podcast Edition MI, Milena Ivanova. Original music by Peter Dundakov with help from Dare Film Productions.
01:00:04
Speaker
Stay tuned for more as and when it comes. Thank you for listening.