Dec 18, 2023, 3:00 AM ETInterview

The No.1 Menopause Doctor: They’re Lying To You About Menopause! Mary Claire Haver

The Diary Of A CEOMary Claire Haver, Dr Mindy Pelz, Dr Mary

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Dr. Haver predicts 1.2 billion women will be affected by menopause by the end of the current year, representing 50% of the future population, with 47 million new women entering perimenopause or postmenopause annually.
She states perimenopause symptoms can begin as early as age 35, starting 7 to 10 years before the average menopause age of 51 in the U.S. and Europe, and notes that a 30-year-old's egg supply is approximately 10% while a 40-year-old's is 3%.
Dr. Haver predicts that women starting hormone replacement therapy (HRT) in perimenopause or within the first 10 years of menopause will have a lower incidence of new-onset depression, suicidality, cardiovascular disease, and dementia.
She predicts women initiating HRT within the first 10 years of menopause can decrease their risk of diabetes and cardiovascular disease, while estrogen-only therapy may result in a 20% decreased relative risk of breast cancer and a 40% decrease in relative mortality.
Dr. Haver states that 50% of females will experience an osteoporotic fracture before death but predicts this is almost completely preventable with estrogen, exercise, protein, creatine, and Vitamin D.
She predicts that if women prioritize sleep, many menopause issues will resolve, noting that sleep disruption spikes cortisol and insulin resistance, while lack of sleep prevents the body from restoring itself.
Dr. Haver predicts 10.5% of women are receiving treatment for menopausal symptoms in 2023 despite 85% complaining of symptoms, and predicts the 16-hour fasting window is a target, though 14 or 15 hours may suffice.
She states she expects 85% of patients with menopause to be Vitamin D deficient, which she links to hypertension, diabetes, stroke, and the top ten causes of death in women.
Dr. Haver predicts women will lose 10% to 15% of muscle mass in the first 10 years of menopause but expects combining nutrition, exercise, and HRT to reduce body fat and gain muscle mass.
She predicts 30% of women who break a hip during menopause and undergo surgery will die within the first year, compared to 70% who do not undergo surgery.
Dr. Haver predicts vaginal estrogen is safe for everyone, including those with breast cancer, and expects it to be the most likely treatment for recurrent urinary tract infections, a major cause of death.
She states that 40% of patients on menopausal hormone therapy will experience vaginal bleeding that is usually self-limited, and approximately 10% may have an allergic reaction to estrogen patch adhesives.
Dr. Haver predicts oral estrogen increases clotting factors and causes liver toxicity, whereas non-oral forms like patches bypass the liver.
She states that women with uteruses require progesterone alongside estrogen to protect the uterine lining from endometrial cancer.
Dr. Haver predicts fatigue, night sweats, and weight gain can mimic hypothyroidism, and autoimmune diseases like rheumatoid arthritis present similarly to menopause symptoms.
She predicts testosterone may help women with desire issues, often requiring compounding medication since there is no FDA-approved option, and estimates testosterone levels in men stabilize at age 35 to 40.
Dr. Haver states she expects the medical system to fail menopausal women, predicts menopause research funding is only $15 million (0.03% of women's health funding), and predicts women are more likely to be prescribed antidepressants than HRT in 2023.
She states that the Women's Health Initiative study showed an absolute breast cancer risk increase of 1 out of 1,000, with a relative risk increase of 25% in the estrogen plus progestin arm, and an average patient age of 63.
Dr. Haver predicts the conversation around menopause will explode on social media, leading to greater validation and dismantling stigma, and expects sleep apnea rates to rise in women during menopause regardless of weight.
She predicts the "window of opportunity" for HRT to reduce disease burden is within the first 10 years of menopause or starting in perimenopause, and that lack of estrogen acts like removing a protective anti-inflammatory blanket.
Dr. Haver predicts the "grandmother hypothesis" provided an evolutionary advantage for post-childbearing survival and states women must advocate for themselves by utilizing provider lists from the North American Menopause Society.
She states she has started a private equity fund, "Flight Fund," with the objective of creating Europe's best-performing fund and believes supported companies will become the next European unicorns.
Dr. Haver states she will publish a new book, "The New Menopause," in 2024, which she expects to address multi-organ system failure and symptoms currently not discussed in the medical field.
She states she expects 40% of patients on HRT to experience unexplained vaginal bleeding, which she reiterates is usually self-limited, and predicts that over 50% of patients suffer from genital urinary syndrome of menopause.
Dr. Haver predicts her clinic waiting list will be longer than her office wall due to the inability of women to find care locally, and expects a significant percentage of divorces during this timeframe may be related to menopause.
She states her personal diet is protein-centric with an eating window ending by 8 p.m., expects to include nuts and seeds daily for anti-inflammatory benefits, and predicts fasting improves mental clarity and work output in the mornings.
Dr. Haver predicts creatine supplementation combined with weightlifting results in bigger gains in muscle mass for post-menopausal patients, and expects to lose up to 15% of muscle mass in the first decade of menopause without intervention.
She states fiber intake should be at least 25 grams per day to feed the gut microbiome and produce oxybutyrates linked to less dementia and coronary artery disease.
Dr. Haver predicts women will need to break up frozen shoulder with about two years of therapy involving strength training, and expects meditation to help mental health and brain fog.
She states her daughter plans to never be without estrogen and start HRT in perimenopause, and Dr. Haver expects her own exercise routine to focus on resistance training and lifting weights to improve bone density.
Dr. Haver predicts that women who are thin and healthy are often dismissed when gaining weight during menopause despite hormones being the only change, and expects the misrepresentation of the Women's Health Initiative to continue causing fear.
She states she expects 85% of her patients to find better care by utilizing recommended provider lists, and predicts the medical field would respond differently if menopause affected men.
Dr. Haver predicts the 1.2 billion women affected will represent 50% of the population in the future, and that the best way to help men understand is through listening and conversation.
She states she expects to outlive her parents to see her grandkids, predicts she survived three of six brothers (one died in 2015 from a stroke, another at 57 from esophageal cancer, and one from leukemia), and expects her genetics to influence her nutrition and sleep choices.
Dr. Haver predicts the 16-8 fasting method should be tried for a six-week trial to see if the body adapts, and expects sleep disruption to be an easy fix with hormone replacement if caused by hormones.
She states she expects vaginal estrogen to be safe for everyone, including those with a history of breast cancer, and predicts that the average age of perimenopause symptoms can start as early as age 35.
Dr. Haver predicts women will be able to prevent the majority of bone density loss through estrogen replacement and exercise, and states that she expects the 16-8 fasting schedule to become a normal part of life if slowly integrated.
She predicts that the lack of estrogen causes faster aging by removing a protective anti-inflammatory blanket, and expects women to be able to prevent the majority of osteoporotic fractures through her menopause toolkit.
Dr. Haver predicts that women can find good menopause care online through her compiled lists, and states that she expects the medical system to fail the menopausal woman unless they advocate for themselves.
She states she expects fasting to lower insulin levels and reduce systemic inflammation for most people, though it is not suitable for everyone, and predicts that brain function may decline once the fast is broken.
Dr. Haver predicts that women who take estrogen only will not see an increased risk of breast cancer and may see a 20% decreased relative risk, and states that she expects patients to lose up to 10% to 15% of muscle mass in the first 10 years of menopause.
She predicts that estrogen-only therapy resulted in a decreased risk of breast cancer and mortality, and states that she expects vaginal estrogen to be the most likely treatment for recurrent urinary tract infections.
Dr. Haver predicts that 40% of patients on menopausal hormone therapy will experience vaginal bleeding which is usually self-limited, and states that she expects approximately 10% of women to have an allergic reaction to the adhesive on estrogen patches.
She predicts that women who are thin and healthy often get dismissed when they gain weight during menopause, and states that she expects the misrepresentation of the Women's Health Initiative to continue terrorizing women regarding the fear of breast cancer.
Dr. Haver predicts that the study showing estrogen causes breast cancer has been walked back, and states that she expects the absolute risk of breast cancer to be very low (1 out of 1,000).
She predicts that women in the estrogen-only arm of the Women's Health Initiative had a 20% decreased relative risk of breast cancer, and states that she expects women in that arm to have a 40% decrease in relative mortality.
Dr. Haver predicts that over 50% of patients suffer from genital urinary syndrome of menopause, and states that she expects recurrent urinary tract infections to be a major cause of death for women.
She predicts that vaginal estrogen is safe for everyone, including those with breast cancer, and states that she expects oral estrogen to bump clotting factors and cause liver toxicity, whereas non-oral forms like patches bypass the liver.
Dr. Haver predicts that 40% of patients on hormone therapy will experience unexplained vaginal bleeding, and states that she expects about 10% of women to have an allergic reaction to estrogen patch adhesives.
She predicts that fatigue, night sweats, and weight gain can also be signs of hypothyroidism, and states that she expects autoimmune disease and rheumatoid arthritis to present similarly to menopause symptoms.
Dr. Haver predicts that testosterone might be helpful for women struggling with desire, and states that she expects women to need to compound testosterone medication if they cannot find an FDA-approved option.
She predicts that a patient combining nutrition, exercise, and hormone therapy can lose body fat and gain muscle mass, and states that she expects her menopause clinic waiting list to be longer than her office wall.
Dr. Haver predicts that women will be able to find good menopausal care online through the lists of providers she compiles, and states that she expects sleep apnea rates to bump up in women during menopause, even in those without weight problems.
She predicts that the medical field will have a different response if menopause were a condition affecting men, and states that she expects women in 2023 to be more likely to be prescribed an antidepressant for menopause than hormone therapy.
Dr. Haver predicts that meditation and apps like Headspace will help mental health and brain fog, and states that she expects if sleep disruption is due to hormones, it will be an easy fix with hormone replacement.
She predicts that a woman can be thin and still have sleep apnea during menopause, and states that she expects her own exercise routine to focus on resistance training and lifting weights to improve bone density.
Dr. Haver predicts that she has lost the window of opportunity to gain muscle easily in her 20s and 30s due to focusing on being thin, and states that she expects her personal diet to include nuts and seeds all day for anti-inflammatory benefits.
She predicts that the new book "The New Menopause" is the culmination of many decades of hard work, and states that she expects to leave a message of "I love you" to loved ones in a final conversation.
Dr. Haver predicts that the podcast sponsor Huel will provide high-protein bars that are now improved, and states that she expects to be able to eat most of the Huel bars if they are left on the counter for five seconds.
She predicts that her brother's death from leukemia drove her to pursue medicine, and states that she expects her brother Bob to have died in 2015 after suffering a stroke.
Dr. Haver predicts that her brother Jude died at age 57 from stage four esophageal cancer, and states that she expects to survive three of her six brothers.
She predicts that the genetics she has will influence her choices with nutrition, exercise, and sleep, and states that she expects the 1.2 billion women affected by menopause to represent 50% of the population in the future.
Dr. Haver predicts that the best way to help men understand menopause is to encourage them to listen and have conversations, and states that she expects the menopause toolkit to help prevent the majority of osteoporotic fractures.
She predicts that the 16-8 fasting method is something people should try for a six-week trial to see if their body adapts, and states that she expects fasting to be a normal part of life if slowly integrated over weeks.
Dr. Haver predicts that the lack of estrogen is a "protective blanket" being removed, leading to chronic inflammation, and states that she expects women to be able to find help through multiple pharmacologic forms of estrogen, including patches, rings, and pellets.
She predicts that the average age of perimenopause symptoms can start as early as age 35, and states that she expects the majority of women in menopause to be suffering, not just from weight gain but from musculoskeletal issues and mental health challenges.
Dr. Haver predicts that the "grandmother hypothesis" explains why humans are one of the few species to go through menopause, and states that she expects women to be able to prevent the majority of bone density loss through estrogen replacement and exercise.
She predicts that the relative risk increase in the Women's Health Initiative was a "statistic that set the world on fire," and states that she expects the absolute risk of breast cancer in the study to be very low (1 out of 1,000).
Dr. Haver predicts that estrogen-only therapy resulted in a decreased risk of breast cancer and mortality, and states that she expects vaginal estrogen to be safe for everyone, even with a history of breast cancer.
She predicts that oral estrogen increases the risk of blood clots due to liver processing, whereas non-oral forms do not, and states that she expects 40% of patients on hormone therapy to experience vaginal bleeding that is usually self-limited.
Dr. Haver predicts that about 10% of women will have an allergic reaction to estrogen patch adhesives, and states that she expects fatigue and night sweats to be symptoms that mimic hypothyroidism.
She predicts that autoimmune disease can present with symptoms similar to menopause, and states that she expects testosterone to help women with desire issues, though it often requires compounding.
Dr. Haver predicts that a patient combining her program's elements can lose significant body fat and gain muscle, and states that she expects her menopause clinic to have a waiting list longer than her office wall.