Ageless Beauty: Unveiling the Secrets of Skin and Menopause with Dr. Suzanne Beth Gilberg-Lenz

Trina Renea 00:07

Hey everyone, welcome to Facially Conscious. I'm Trina Renee a Medically Trained Master Esthetician here in Los Angeles, and I'm sitting with my rockstar co-host, Dr. Vicki Rapaport, a Board-Certified Dermatologist with practices in Beverly Hills and Culver City, Rebecca Gadberry, our resident Skincare Scientists and Regulatory and Marketing Expert, and Julie Falls our educated consumer who is here to represent you. We are here to help you navigate the sometimes confusing and competitive world of skincare. Our mission is to provide you with insider knowledge on everything from product ingredients to medical procedures, lasers, fillers, and ever-changing trends. With our expert interviews with chemists, doctors, laser reps and estheticians you'll be equipped to make informative decisions before investing in potentially expensive treatments. It's the wild west out there, so let's make it easier for you, one episode at a time. Are you ready to discover the latest and greatest skincare secrets? Tune in and let us be your go-to girls for all things facially conscious. Let's dive in.

Hello, everybody. Good morning and welcome to Facially Conscious. I'm Trina - the Esthetician co-host and we have Dr. Vicki Rapaport and a special guest today. Hi Vicki.

Vicki 01:39

Good morning. I'm going to introduce this special guest that I can’t wait to tell you that we're going to talk about menopause today. I don't know if you guys have noticed but menopause is hot right now. It's everywhere. We talked about on Goop and the New York Times and in your Instagram feed and we're going to get some juicy info from my colleague and my friend, Dr. Suzanne Gilberg-Lenz. But I really want to give you a little bit of a background so you can get excited that we have such an expert here with us on our podcast today. So here goes; a diplomat of the American College of Obstetrics and Gynecology, Suzanne Gilberg-Lenz, she received her medical degree in 1996, from the USC School of Medicine, and then she completed her residency and OB at UCLA Cedars Sinai Medical Center. Suzanne is involved in women's empowerment, and public education and appears frequently as an expert in women's health and integrative medicine on TV and print and online. And most importantly, she is the author of Menopause Boot Camp, Optimize Your Health, Empower Yourself and Flourish as you Age. A huge happy welcome to you, Suzanne.

Trina Renea 02:54

Hi, doctor. How are you?

Dr. Suzanne 02:59

I'm pretty good. How are you?

Trina Renea 03:03

We’re doing good. We're very excited about this because we had an episode about when people are pregnant and skin. And then we're like we need an expert on menopause and skin. So, I'm so happy to have you. You know I've started your book on Audible. I'm about 10 minutes in. But then I'm traveling on Monday to San Diego for two hours there and two hours back, so I'll have it done hopefully in four hours. I'm not sure how.

Dr. Suzanne 03:33

I'm excited to accompany you on your trip. I hope I’m not too much of a distraction.

Trina Renea 03:41

I don't think so. I also read that other one you told me Menopause Matters too.

Dr. Suzanne 03:47

Estrogen Matters. Yeah, that's a good one.

Vicki 03:51

Ooh, menopause matters could be book number two.

Vicki 03:55

One, I want to say one personal caveat. And part of the reason why we love you so much Suzanne and wanted you on this is because, you know, obviously you've done a lot of TV media print and you are massively respected. But the first time I ever met you, was like within seconds I knew that I liked you. I know that is so strange. But we were in this doctor group and we all seriously stupidly had to go around the circle and tell everybody what our specialty was, and basically, just our names. And I am not kidding, Suzanne, I know I've told you this story before but as soon as you open your mouth. It was probably like a chi energy thing. I don't know. But [Cross Talk]

Dr. Suzanne 04:40

I feel like we have similar energies. Our mutual patients tell me this. At Carries house, right? Yeah, was it Carries house? Yeah [Cross Talk], I remember that. Wow, that was a million years ago, man. Listen, the audience should know, full disclosure, you have been my dermatologist since that moment, and my children's and I think I send everybody to you. You are the real deal.

Vicki 05:10

You are glowing, I realize is the podcast and people can't see your skin, it is pretty gorgeous.

Dr. Suzanne 05:15

Obviously has something to do with you. And that diamond facial that you made me to a couple weeks, it was amazing by the way.

Trina Renea 05:25

When did you start getting interested in menopause? Or have you always been interested in it?

Dr. Suzanne 05:31

You know, I've always been interested in the things that are mysterious to others. And honestly, I think I've always had an interest in, I'm very curious, I always want to learn, and I'm not much for like boiler plate cookbook, algorithm-based medicine, to be honest, not that I don't follow the evidence because I am very attached to practicing as evidence-based as I can, okay, because we live in a much bigger world than evidence. And I will just say that, look, science is important. But you know, we can make science a religion too, you know, things change, and things evolve. So, I have sort of a broad perspective. So, I always was interested in like other things and things that nobody else seemed to be into. And so, I sort of, ultimately, a couple of things happened here. One was that as I was aging with my patients, and I think I like Vicki, I've been very fortunate to be in the same community over the entire course of my career, with the community that we both grew up in. And I think that that does have an impact on the way we practice and how we are viewed within the community. We are members of this community. So, people stay with me, people have been with me for 20 plus years. And as we have all aged together, you know, if I'm going to serve them, I need to understand what's going on with them. So that was part of it. I was getting older, they were getting older. But the other thing interestingly that happened was early in my career. One of my mentors at Cedars was actually an Oncologist named Philomena McAndrew, she was close with another one of my mentors, Dr. Beth Karlan. And when I graduated and started seeing patients, she started sending me; she's a breast cancer specialist, and she started sending me her young breast cancer patients. So, these are women in their 30s and they were going into menopause early because of the treatments and they needed a new gynecologist. And she was sending them to me, and I was like, ‘Philomena, I don't know what to do with this.’ She's like, ‘Well, you’ll figure it out.’ Because I realized like, we hadn't really been trained in this and I just started really delving into the literature and sort of educating myself and working with her and working with them and learning a lot. And then, ironically, so that's honestly how I started learning about menopause. I had to teach myself.

Trina Renea 07:47

Right, and there's so much. I mean, menopause has so many people saying so many different things, it is so confusing, and so complicated. I have gone down the rabbit hole in this.

Dr. Suzanne 08:00

it's complicated and it’s not. It's complicated, because we haven't done a good job as a culture overall of honoring and understanding and educating ourselves and our people, our humans about what's coming. We're doing better with puberty than we used to. I think, when I went into puberty, we didn't get a whole lot, honestly, like, we had some weird health class that was probably taught by the like, shop teacher, or one of the coaches, and it was so awkward, and they showed a video and everybody was cringing, and we had already gotten our periods and grown hair anyway, so why are they showing this shit to us now? And then there was some cringy conversation with my mom, that was like, you know, probably too little too late. God bless her. My mom really… well, Vicki, my mom was also obsessed with Vicki Rappaport. And, you know, that's the way I was raised. So, we did better with our kids with books, and we talked about it, like not a mystery. And that's what's happened with menopause. So, some of it is just culturally, we don't talk about it. And it's because there's just a lot of stigma around aging in general, aging and women. You know, and that, okay, but in medicine, we've done an atrocious job of managing women's health issues, making women into sort of small men with ovaries or uterus or whatever, is not it. Like we’re biologically not the same, and we respond differently, and we process differently. And we have different experiences, hormonally, obviously. So, we don't do a good job learning about that, and even in a women's health specialist. So, the data is pretty clear. Some of this is old data, but it's still relevant. I think maybe like within the last decade, there was a survey done of OBGYN residency program directors okay. So, these are the places where people are getting their women's health specialty, postgraduate education four years intensively and like 85% of grads came out saying they didn't feel competent dealing with menopause. There's just no attention. Listen, if you're trying to squeeze in all of gynecologic surgery, you know, pelvic health, obstetrics, you know, prenatal postnatal, for all of it. And for years, I mean, obviously, some stuff is going to fall, by the way. But there's also again, this ignoring of aging and women, there's so much misogyny, and so much ageism in the culture, and it's so baked in, and it's baked into our educational systems, people don't know what they don't know. And there are amazing leaders in the field and there's a lot of academic interest in this, and there's the menopause society, and there are people who devoted their careers and education to this, but there just has not been enough attention, in general. I think it is getting better. It's having a moment, when you see multiple articles in the New York Times, The Wall Street Journal, and the lay press is into it. You know, something's happening, and I will tell you that my experience in medicine has been in general, the changes that occur when it comes to this kind of stuff is really more going to come from the public and from grassroots than from medicine, Vicki can, I'm sure, validate that, you know, medicine is a very conservative, very slow moving. And I liken it to, you know, turning a cruise ship, it's going to happen, but it's going to take a real long time. So, demanding the info, and that's helpful. But it is confusing, because what's happening is in the vacuum of academic medicine, or the vacuum of science, everybody else floods in, some of which is legit, and some of which is utter nonsense and predatory. I’m telling people I'm talking about you.

Vicki 11:46

I know, yeah, and, you know, I know, there are so many aspects of the body that changed with the menopause. But today, you know, we're more interested in the skin changes, can you go over a little bit of how menopause effects the skin? And maybe what specific changes they can expect to see in their skin? And whether it's cosmetic or just, you know, on their legs

Dr. Suzanne 12:11

But not besides, it's not. I mean, that's a big thing. So, the thing is this, I mean, I know it's alarming. But the good news is you guys have a lot of things you can do for us, right? The major issues here are that as our estrogen levels decline, so we have something called ovarian aging, our ovaries are aging like the rest of our bodies, and our ovaries are where most of our estrogen, not all of it, but most of our estrogen is coming from, so we're producing a lot less estrogen and declines until we get into the actual menopause where we're no longer making that estrogen. But estrogen receptors are not just found in the reproductive tract. So, it's not just a sexual health issue, it's not just that your period stops, that you have vaginal dryness. There are estrogen receptors everywhere, your brain, your heart, your blood vessels, your skin. And those hormone changes have a really big impact on skin specifically, we see less blood flow because of it. We see then less oxygen and nutrition being delivered to the skin, the integrity of the skin changes. It thins, we have a loss of collagen and elastin, which give that balance and that youth and that fullness to our skin. We have a change in our microbiome. So, I think everybody's talking about the microbiome and the gut. But you know, you guys know that the skin microbiome is really important too. So, we live symbiotically with bacteria. I mean, there's probably more bacterial cells in a human body than human cells. And the bacterial counts shift and change in the skin on the skin. So, all these things contribute to that wrinkling, sagging, thinning, inflammation. I'm sure you guys see lots more rashes, weird stuff. You know, because I'm a menopause person, people tell me they're having like, everything from ringing in their ears to new onset of asthma or eczema, and it's a thing. To me, it is definitely hormonally mediated, it has to be. So, these are some of the things that we're facing. And it sounds like doom and gloom, hair loss, but then also Roque hairs, hair growing elsewhere. And that's because the most abundant hormone in women is testosterone. Now, we don't make more than men, but we actually make more testosterone than any other hormone at our reproductive age, which is surprises people, more testosterone than estrogen. Now you have an even bigger shift and you have this sort of relative hyperandrogenism, you have more testosterone than you did before. This is not a disease guys. This is physiology. This is like genetically programmed. But that's why you get those pin rogue hairs, on your skin, your ears. But we pluck them out. When I had a daughter and I told her when she was really little, I said, when mommy gets old and cannot remove these hairs, your job is to take care of that.

Vicki 15:27

Suzanne, when I see my mother, I bring a tweezer. Every time I go see my mother, it's just part, it's in my bag.

Trina Renea 15:35

I cut my dad's eyebrow hair when I see him, they're like longest thing ever.

Dr. Suzanne 15:39

It is a real thing. So, that's one solution. If you don't have a daughter, don't worry about it. So, these are the things now that made it sound horrible. But these are real things. Hormone Replacement can assist with some of it, it's not going to fix everything. And there are some interesting studies, I actually give a talk on this, oddly enough, at an aesthetics conference in February, I really dug into the literature, I'll send you my slides, it was interesting. But I found some really interesting things, there are some data showing that, you know, the collagen and elastin loss is pretty rapid within the first five years. And then it continues to go like go from there. So, starting hormone therapy can assist with that, because we know that hormone therapy can help us at least stabilize those levels. It's not going to like return you to 25, that's not real, and I don't think we should be selling that. And I think we should also be questioning why do we feel like we need to be 25. That's a different podcast. But that is part of my thing, by the way is self-acceptance and self-love, if it means getting a facelift and you should get a facelift. I'm not anti-facelift or anti aesthetics. I do use device therapy in my own office, not for faces, but I feel like we should use the tools that are available. But I think we should look at the bigger picture why are we hating on ourselves so much? Because we got here and we have so much wisdom to offer. So, there are things to do, and it looks like initiating hormone therapy could be helpful. The data on specifically skin and hair, and hormone therapy is not really robust. Okay, so I always tell my patients, if you're coming in to do hormone therapy for aesthetics, let's like talk about what really makes sense here. But I have we all seen it help? Yes, we have. We have.

Vicki 17:25

I know this is obviously a skincare podcast or skin. But the article about HRT and hormone replacement therapy years ago that freaked everybody out, and the increased risk of breast cancer. Can you just touch on that and give us you know, I know that's been sort of new information is being sort of regenerated from that. And I'd love to hear what you have to say about that.

Dr. Suzanne 17:50

It’s the worst study ever. It is the biggest disaster ever on the planet. It's insane to me that a billion dollars was devoted to women's health and to looking specifically at how does hormone therapy help women? What a great idea, right? Bernadette Healy, who I believe was the first director of the NIH, a female director of the NIH, she spearheaded this study. And then the study sucked, the study wasn't looking at people in transition, it was looking at people well past menopause, the average age was like over 60, which is a decade past menopause, many of whom already had heart disease, or at risk factors for heart disease. And so of course, these women had heart attacks and cancer and stuff like that, and then they blasted it out. They did a big PR push, which is political. Now we understand and scared everybody and everybody and their sister went off hormones. All our colleagues freaked out and the gynecology community was like, wait, wait, wait, this is not really what the data says. We knew that data was bad from the get go. This was two years into my career, by the way. It was a disaster. So now it's of course all been walked back, and meanwhile we've had two decades of fear and everyday people come in, I can't be on hormones because my grandmother had breast cancer. No, that's actually not true. So that book that I had Trina read, Estrogen Matters. That is what that's about. It's a takedown of the study, and I really highly recommend it. It's a big book to read. But if you read or read, okay, The New York Times just made a podcast I think last week that was based off of Susan Dominus, the author, the journalist’s article in February called - “Women have been misled about menopause” and Avraham Blooming, and Carol Tabriz, who wrote Estrogen Matters, weigh heavily in that conversation. So, they talk about the data and a lot of other experts in the field, academic experts talk about what this really meant. And there's a lot of politics to it. It's going to make you mad when you listen to the pod or read the article, because you will realize that you've been denied accurate information. I'm not saying everybody needs to be on hormones or shouldn't be on hormones, but I think everybody needs to know why they should or should not be on hormones. And it’s far more beneficial than I think detrimental in a health way. You know, like I'm talking about dementia, cardiac disease, bone health, and for sure symptom management. Now, again I said this already, do we have the data to support that is beneficial for hair and skin anesthetics? Not really. So, let's just be clear about that. But anecdotally, we've all seen it. And my hope is that if we can re-devote resources to studying this, that somebody is going to be interested in looking at whether or not hormone therapy or what the impact of hormone therapy is.

Vicki 20:38

Dr. Gilberg-Lenz is just my favorite. And I know that she probably doesn't do a lot of recommending of skincare routines, but do you do anything special or recommend anything special skincare wise, or ingredient wise for your patients in menopause?

Dr. Suzanne 20:53

Well, lifestyle, yes. Sleep is so key, because your body is not going to repair and you're going to have all your other symptoms are going to be worse, your metabolism is going to be worse, your moods going to be worse, your digestion is going to be worse, it's not pretty in any way. So, sleep is always maybe something that surprises people, but it's going to have an impact downstream at some point on your skin. Hydration, diet, getting enough fats, healthy fats, getting enough fiber, anything that's good, because here's the thing, and I'm sure you talk about this, but if your gut is not healthy, your skin isn't going to be healthy. So, I know this just from like living life. And I think that it's been very interesting. One of the things you didn't mention, Vicki is that I have a background in ayurveda, which is Indian medicine. So, it's a holistic, traditional system. And you know, they were talking 6000 years ago about gut health, in fact, the way I was trained in the classic system, is that you when you assess a patient, when you assess a client, you're always looking at their mind health and their gut health first, no matter what their complaint or issue is, you always, always, always start with the gut in the mind, you we would create herbal formulas for gut and mind. And we would tailor it to whatever the specific issue in a specific precision medicine. This is the original, by the way, lifestyle and precision medicine, which is just a side note why when I look at Western empirical science, and I talk about thinking critically about it. This is stuff that people poopoo and yet 6000 years ago, these people had it down. So, I don't know, you tell me why you are rejecting medicine from 6000 years ago. It’s also very colonial and white supremacist.

Vicki 22:49

As we get older ourselves, even as a medical doctor, we start to investigate these herbal remedies and think, oh, maybe our patients weren't that crazy all along, like I get it. And I hear you. And I think it's sort of beautiful if you can grow your own garden and your own herbs and all that stuff too and not always have to buy a product, you know, just like have a garden in there people.

Dr. Suzanne 23:14

I mean, we say if you know, you know, 30% of Western pharmaceuticals are derived from plants. We know this is powerful stuff. So, I happened to be like a backyard herbalist, but I have it like I'm trained, and I grow stuff. And I post about it. But I always tell people, like if you don't know what you're doing, it's one thing to mess around with rosemary or mint, you know, but like I grow valerian, I don't know that you should grow valerian. Like, I know what to do with it. So, we're getting a feel, but I think that people's digestion, people need to understand what a big impact it has. And as we age, it has an even bigger impact in terms like hydration, hydration, hydration, I am now a person who's like a serum oil. Everything is oil based and serum based. If you would have given me this 20 years ago, I would have been like a big acne. I'm not anymore. And I really am like a lot of vitamin C, I experiment. Let's be honest. People send me stuff all the time. I tend to, but I do listen to my dermatologist. And I’m very gentle cleanser like I'm not over soaping, and I find that to help you know, the hair thing has been a journey because I have a lot of hair, and people like there's something wrong with your hair. And I'm like, well thank goodness I had a lot of hair because I definitely lost at least a third of my hair maybe probably more, probably more. So that's one that I do intermittently use some of the supplements I think that like neutrophil and Viviscal. Like I think the data is pretty solid. But I'm going to be honest with you it is so complicated for me to do all that that I never really do it completely.

Trina Renea 24:54

We were just talking about this on our hair loss, like isn't there just a pill you can take it fix it. There are so many things you have to do, so much maintenance with the hair.

Dr. Suzanne 25:02

Yeah, it's a lot. I mean, what do you guys think about like some of the topicals, like rosemary and that kind of stuff? Is that just like stimulating…

Vicki 25:12

I don't know the specifics of how the rosemary works, but that is getting a lot of play. And, you know, again, natural, I'm okay with that. We'll see. We'll see how well it works. I don't know if they'll ever compared to Rogaine, but I think that Rosemary is really getting some information out there and it's safe.

Trina Renea 25:33

So, when your patients come to you and ask like, what do I do about my skin is wrinkling so much, it's so dry, it's paper thin, I'm getting bruising. Do you send them to the dermatologist? Or do you to give them ideas of what to do?

Dr. Suzanne 25:47

Yeah, I mean, I can give them some basic ideas.

Trina Renea 25:50

But what are some of the things you tell them?

Dr. Suzanne 25:55

Like what I'm sharing with you, what I do, you know, but I'm not treating, like, I'm not prescribing Rogaine or any of that stuff. I'm not… if it's getting that complicated, like they deserve to have a specialist. One of the things that I do is I do have like a year-long program where people can work with me for the entire year and they get a lot more time with me, because I can't do a well woman visit and then talk about their skin. I mean, that's just not realistic. So, for my patients who do that we do have, like, more time to sort of dig in, and look at what they're doing, what they could be changing. And then I have my resources and referrals like Vicki, and you guys, because I am a gynecologist. I am not a dermatologist.

Vicki 26:37

But I do love the way that you've described how you transitioned from certain products when you were younger, to like the oils. And as soon as you get older, like you actually see yourself buying oils and thinking – Whoa, I cannot believe this happened to me. So, I think the same thing goes for the inside, topical, you know, oil cleansers and oily serums. And then orally, you know, the, as you said, like the really healthy fats. I love that. Like, that's a really good guideline, simple guideline. More oil everywhere, inside and outside.

Trina Renea 27:04

Yeah. Because we lose that oil when we age, right. And when you got into menopause, we dry up.

Vicki 27:11

Yeah, and I think that, you know, if there any last details or expert advice you'd like to share, that'd be great. And then I'm going to share a tip that I have for the world when you're done.

Dr. Suzanne 27:21

I love it. Well, like I said, I think I touched on it. But I think, one of the great things about menopause is that you kind of stop caring so much about what you think other people think about you. Because spoiler alert, they're not thinking about you. They're thinking about themselves.

Vicki 27:43

They are not looking at you, unfortunately.

Dr. Suzanne 27:48

And if they are, they need to get a life. So, that's a gift. And I really want people to reframe menopause as like this horrific thing. If anybody who's had a baby, it's kind of similar. It's a big transition. There's like the pink cloud. It's so amazing. You're so into it, then you feel like shit, you want to die, like what was I thinking, it was the worst idea I've ever had, then nothing has to come out of your vagina or belly or something, you're like, oh my god, it's just keeps ratcheting up and getting worse, then you go home with this little love bug and you have to keep it alive and to your own detriment. But somehow you get through it, and you're stronger and then you're really like – Whoa, I am really resilient. I am badass. Like, I mean, hopefully, and, and I didn't do everything perfectly. I don't need to do everything perfectly. But I'm kind of amazing. And you develop a stronger sense of yourself. If we could look at menopause as another transition like that, I think we'd be in better shape. Is it going to be difficult? Any transition is difficult. But when you get through it, you're at the other side, you feel a lot better about yourself and you sort of see yourself a lot more clearly, when we destigmatize it, we stop shaming ourselves and other people about it and we come into community where we can be resourced and supported. Because asking ourselves to go through something difficult alone is insane and dangerous and mean. So, that's why I wrote a book, I do boot camps why I do the work I do. When women and humans come together and support each other. It's a very different scenario. So, I want people to come into this not with fear of like I'm going to dry up, I'm going to never have sex again. My life is over, I'm invisible, and realize like no, you're stepping into your power. I'm having some of the best, most powerful creative time of my life and I'm very fulfilled on all levels, because I was willing to state it out loud and seek help. And for me being of service and educating others is really what makes me feel good. So, find that thing, find help, know that some of it will suck but know it'll be good at the end. That's my message.

Vicki 29:53

I love that. I'm so stimulated and honestly you know if anybody out there who's listening wants the complete guide to menopause written by this authority. You really need to get Suzanne's book called the menopause bootcamp by Dr. Suzanne Gillberg-Lenz. I mean, I'm honestly like shocked. I haven't read it yet, Suzanne, but I'm going to get it this weekend.

Trina Renea 30:13

Dr. do you see tele meetings with people who don't live in Los Angeles?

Dr. Suzanne 30:20

I do. Right now that is still okay to do. So, I do, yes.

Trina Renea 30:25

That's good to know. Okay, incase somebody does want to meet you.

Dr. Suzanne 30:29

I have a number of people starting the pandemic, from outside of LA. Yeah.

Vicki 30:35

And do you agree that with my tip, my tip is the following. – We need a menopause Barbie.

Dr. Suzanne 30:43

Oh my god. I love that. Oh my god, that's amazing. Is she going to have wrinkles?

Vicki 30:52

Everything she's going to have heart disease.

Dr. Suzanne 30:56

She will have little muffin top but it's going to be cute. She's going to still rock her bikini. Be super creative.

Vicki 31:06

She's hot.

Dr. Suzanne 31:09

I was at a retreat last week. And now granted, it was for midlife people and the guy who was the founder, who's this huge person, by the way. He's gay. So, this is part of it. We were doing some stuff at the pool. And I had my bathing suit. It's plunging. And he was like, ‘Oh, girl, look at your cleavage.’ And I was like, ‘That's right. But if you were straight, you would want to tap that.’ [Cross Talk]

Vicki 31:45

You have to send us a picture. I want to see it now.

Dr. Suzanne 31:47

Of the bathing suit?

Vicki 31:50

Yes. So, it's going to be Barbie bathing suit. Barbie should wear that bathing suit. And she might be sagging a little. Okay, whatever. Have you seen, Barbie?

Dr. Suzanne 32:05

I haven't. I need to see it.

Vicki 32:06

I mean Suzanne, It's like right up your alley at the ending. One of the best things that ever happened to cinema. We want to thank you so much, so enlightening. I love it. You are hilarious and educated and all the things wrapped up in one human. I'm so happy to have you on our show.

Dr. Suzanne 32:25

Thank you so much you all, I really want a beautiful experience. I love talking about this. And you guys are amazing. Thank you for doing what you're doing.

Trina Renea 32:34

Thank you. Thanks for sharing with us. And hopefully we'll have you on again soon because we could talk about menopause all day.

Dr. Suzanne 32:41

I'll come back anytime. See you guys in the office. Bye.

Trina Renea 32:51

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