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Welcome to The Modern Midlife Collective—where midlife isn’t a crisis, it’s a rebirth. Hosted by Dr. Ade Akindipe, DNP, and Dr. Jillian Woodruff, MD, this is the podcast for women ready to unapologetically own their power, thrive through the ups and downs of hormones, weight, and self-care, and show the world that thriving at 40 and beyond isn’t just possible—it’s your birthright.
Biweekly, we bring you science-backed insights on hormones, menopause, longevity, and sexual health—real tools to empower women in midlife and beyond. With a fearless blend of functional medicine, real-life wisdom, and no-nonsense empowerment, we’re here to challenge the norms, break through the barriers, and help you step into a life of vitality, confidence, and unstoppable strength.
Ready to rise? Let’s do this.
Jillian Woodruff, MD (00:00)
Mm-hmm.
Okay, let's talk about this scenario. You've printed out your own lab results before a doctor's appointment, you've written down your symptoms on an index card so you wouldn't forget them, and then watch the provider barely even glance at it.
Dr. Ade Akindipe, DNP (00:13)
Maybe you sat in the room and felt the conversation end before it really started, and you're being told, well, that's just aging, or you too young for that. Let's try antidepressant first.
Jillian Woodruff, MD (00:25)
⁓ yes. And
maybe like our guest today, you sat on both sides of that exam room as the patient asking the questions and later as the person who decided someone needed to build a better way to ask these questions. Today we're doing something a little bit different. We're not talking just about perimenopause or menopause. We're talking about what it actually takes to translate this medicine into something patients can use and
Providers can act on.
Dr. Ade Akindipe, DNP (00:56)
Yeah, I'm really excited about this episode. we've invited a guest to help us have this important conversation. Our guest today is Angela Jackson, who recently completed her masters of social work and built a full perimenopause and menopause toolkit as her graduate capstone. And it's wonderful because it's grounded in trauma-informed care, health equity, and her own lived experiences.
Jillian Woodruff, MD (01:21)
And Angela is a patient of both of ours. She has said that we could share this. ⁓ honestly, that's part of why we know this conversation is going to be a good one. So let's get into
it.
Angela, welcome to the Modern Midlife Collective and congratulations. You graduated this year with your Masters of Social Work. Please just take a moment to introduce yourself and tell our listeners what you want them to know about you.
Angela Jackson LMSW (02:45)
Okay, well, like you said, yes, I just graduated with my master's of social work. And as in school, as part of my capstone, we had to think of something that we would really interested in as well as it would be informative to someone else. And so for me, experiencing menopause, perimenopause myself, and just hearing the concerns, I thought, well, that would be the
perfect capstone because it's something that sometimes it's not talked about. It's dismissed as something else. And my whole goal was I wanted to bring awareness because I felt like I was struggling and I had a hard time and I didn't want anybody else to do that when I know that there was help out there for that.
Dr. Ade Akindipe, DNP (03:34)
That is amazing. Thank you so much for sharing that. And the fact that you even thought to think about other people. I'm just ⁓ super excited for to learn more about this toolkit. So let's get right into your creation of the perimenopause and menopause toolkit. Where did this idea come from? I mean, you know you talked a little bit about your own lived experience, but who did you have in mind when you created this? Who is this for?
Angela Jackson LMSW (03:57)
Well, I saw a post on Facebook and it was a young lady and she was crying. She was upset. She felt like she felt dismissed that her symptoms when she explained them, the first response that she got, because sh she's in her early forties, well, you know, you're you're too young for that. You can't be experiencing that. But she was having the hot flashes, she was having the brain falls, she was having the mood swings.
all those things and she was just told you're okay just go home we'll give you ⁓ psychotrophic medication in which i kind of related to that and so i thought ⁓ no something's got to be done there's got to be some type of awareness for women and as a social worker we're more in a role where we care about people we try to advocate and encourage people as because I'm more looked at for this toolkit
Self-empowerment because I think more than anything, it's about empowering you to have a voice and be concerned about your own health. And you can't expect someone else to do for you what you can do for yourself. You can advocate, you can seek out what you need, and it's available.
Jillian Woodruff, MD (05:08)
Yeah. So the toolkit wasn't really just born out of a gap you experienced personally, but rather one that you see other people, those you know and don't even know, have experienced. It's this collective kind of being let down by the traditional medical system when it comes to symptoms of perimenopause or menopause.
Angela Jackson LMSW (05:29)
Exactly. go ahead.
Jillian Woodruff, MD (05:29)
Did you did you feel like the
social work cha the the your social work training, did you feel like that changed what you did with the frustration? Do you think you would have done it had you not had this project that you had to do?
Angela Jackson LMSW (05:39)
Yeah, because
Well,
Dr. Ade Akindipe, DNP (05:43)
Mm-hmm.
Angela Jackson LMSW (05:44)
I think the social work had a lot to do with it because it more about self advocacy, empowerment, and those are things and social justice. And so I just believe wholeheartedly is that we have for so long as women that we just go with what we're told. ⁓ you're fine, don't worry about it. But you're not, you're struggling.
You know, having these symptoms can affect your family life, your marriage, at the workplace, all these things that it can affect. And so no one's talking about it. No one thinks we need to do anything about it. And so the message is we're told we can just suffer with it and and be okay. As we get older, it'll get better. Who says that? Why not? Why not thrive as you're aging?
And so that was my other thing. Why do we have to suffer? Because we're aging. I don't want to.
Dr. Ade Akindipe, DNP (06:38)
Mm-hmm.
Jillian Woodruff, MD (06:40)
That's exactly
right. And many times people don't get better as they get older if they're doing nothing. Kind of have to make that happen.
Dr. Ade Akindipe, DNP (06:48)
Absolutely. Yeah, I agree. And then that conversation really needs to happen more often. I think Angela, just bringing the tool, and I'm sure we're going to get more into that toolkit and what's in it, but it changes when you go to a provider and your provider tells you everything is fine. You know, being able to advocate for yourself, like you said, is important. So I guess my the next question now is how does that show up in the way you'd want a provider to actually open up that dialogue? And how would you want someone like myself
Or Doctor Jill to want to speak to you regarding these symptoms.
Angela Jackson LMSW (07:20)
That's the thing, open up the dialogue. I always believe, and as a patient, I believe that it is a two-way conversation. It's not just the provider says you do this, this, and this, and then I say nothing. You don't know everything that's going on with me if I don't tell you. And so just bringing that to the forefront, it is a two-way conversation. Your provider's not gonna know everything that you're experiencing if you don't say anything.
And especially if I don't know what I'm looking at or what I'm experiencing is important. You know, just things like the brain fog, you know, people wouldn't think, that's just not the you're just getting older. No, it could actually be a symptom. And so it's just causes you to look at these symptoms as, well, you know what? I am experiencing that. Maybe I should bring that up. And so
I hear a lot of women and even today since I've created the toolkit and they said, Well, I didn't know that, and I didn't know that. You mean I can have start having symptoms even younger? Yes, you can. And that detail is hidden. And in working with the toolkit, I worked with another provider, and she mentioned that one even getting older, I'm getting the old woman's, you know, symptoms. No, it's not.
Jillian Woodruff, MD (08:24)
Yes.
Angela Jackson LMSW (08:39)
And we should realize that it is just a natural transition of life. It's not that we're getting old. It's not that we can't thrive. It's none of those things. It's just a natural change in our body and we can change with it. We can thrive in it if we choose to.
Dr. Ade Akindipe, DNP (08:57)
Absolutely.
Jillian Woodruff, MD (08:57)
Right.
Just like any change, any transition, right? With there's many transitions for for humans and for women. And as we go through these other transitions, we change along with them. We educate ourselves about those transitions. There's when you're going through puberty, you understand what's happening with your body, right? It's not like right. You educate yourself and you there's symptoms that can occur which aren't typical or which are painful or, you know, in
Dr. Ade Akindipe, DNP (09:12)
puberty. That's what actually came to my mind. I'm like, it's like, you know, any other part in your life. Yeah. Yeah.
Jillian Woodruff, MD (09:26)
you get help for those things. No one wouldn't would ignore you if you're saying that, you know, maybe your transition isn't occurring in the typical manner or your period is painful. They're going to deal with it. But when it comes to this transition to menopause, oftentimes it's like, that's just aging. The end. Conversation stops.
Dr. Ade Akindipe, DNP (09:44)
Yeah. Yeah.
Yeah. Clarity matters during this during this phase of life because I I had a patient today and just said, you know, I just need to know what's happening. you know, I may not necessarily like what I hear that, you know, I'm losing my hormones, but it is a transition, but I want to know how to thrive during this transition. So very important conversation.
Jillian Woodruff, MD (10:04)
Right. And there's symptom checklists, right? Symptom checklists tell you what's happening. It doesn't tell you what to do when you bring that checklist to an appointment and you still don't feel heard. So what happens then, Angela? Do you address that in the toolkit?
Angela Jackson LMSW (10:21)
Well, yes, I do. When you're going to a provider and you're bringing these this is what I'm feeling, this is what I'm going through, and it's just dismiss, then you have the option that you can seek out what you need. You don't just have to stay, you know. There are many providers and there are providers like you that provide the the tools that we need and and I think that women should feel like
Jillian Woodruff, MD (10:23)
Yeah.
Angela Jackson LMSW (10:49)
If I'm not getting what I need, then I can go somewhere else. And it's just like anything else. If you hire somebody to do work and they're doing a crappy job, you say, you know what, they're not doing what I hired them to do. I'm gonna go somewhere else. Same way. This is our body, this is our temple. It's up to us to take care of our body to thrive. You know, I've been working in the healthcare field for many, many years, and in my profession, I see a lot of
Dr. Ade Akindipe, DNP (10:52)
Mm.
Angela Jackson LMSW (11:15)
people that are really sick. And so you think, well, what can I do? And this is just like anything else. This is a part of your life that you have to seek out. And especially it's not like there's help, there's not help out there. There is. And you think about like our parents and grandparents, you know, they, you know, if there wasn't much research known and so they just struggle. But now we don't have to. And so that's why I wanted to bring that
We don't have to suffer. We can seek out what we need. Is there a perfect way to do things? No, but there's just like anything else, you have a headache, you take aspirin. You know, there's things that we can do. And so having feeling empowered to have those conversations, this is your body, this is your life. You can do this, you can agogate for yourself. And that's
Dr. Ade Akindipe, DNP (12:03)
Yeah.
Is that is
that what your toolkit was built out of? Is that like walk us through what that like what it took for you to actually build it? Was it built on some of the things that you experienced? give us a little bit of example, a little preview into this.
Angela Jackson LMSW (12:21)
Yes, well I started off it was the the post that I seen on Facebook, but it related to my own experience is that I was struggling. I was having a hard time. I was miserable. It was the weight gain. It was all those things. And nobody told me that, you know, well, let's look at the the menopause. Let's look perimenopause. Nobody checked my labs. And so when I saw that you can check your labs to see where you are, I was like,
Well, why nobody told me? I felt very dismissed, very disappointed, very let down that nobody said anything. It's only when I said, this is not enough. I deserve better. And that's the other thing. You have to decide for yourself, I deserve better. And that's the point that I got to. This this doesn't work for me. I don't feel well. I'm not thriving. I'm I'm miserable. I'm hot. I'm frustrated. I was forced frustrated more than anything.
And so I thought that if I was feeling that way, how many other people are feeling that way as well? And so I was thinking, I said, well, it how I got to the toolkit after seeing that, I was like, that's what I'm gonna do. I'm gonna provide education, empowerment, advocacy, which that's my in social work, we do a lot of advocating. So, but advocating, you gotta start with yourself. Advocate for myself, help advocate for others.
And that's where the toolkit came into start developing the toolkit is to teach women that you have a choice. You don't have to wait on someone else. You can advocate for yourself. There are providers that are knowledgeable about these things. We're not in the stone ages where we're just taught, just be okay. No, we're not just gonna be okay. We're gonna seek out what we need so we can really be okay. And throw
This thriving thing, I'm really on that. I believe it's thriving.
Dr. Ade Akindipe, DNP (14:14)
Yeah.
Jillian Woodruff, MD (14:18)
I
like that word, thrive, yes. We like to use that a lot too.
Angela Jackson LMSW (14:22)
Yeah. I I
learned to age in place and so that means aging but feeling good about it, not aging and my God, I'm just not doing well.
Jillian Woodruff, MD (14:33)
Right. Take the there's positives to aging. With every stage, there's going to be positives and negatives, but the negatives, we actively try to reverse those or to improve them, right? And this stage is unlike, you know, it's the same as any other stage. We can improve the downsides and optimize the upsides, right? ⁓ one of the things I really liked about the structure of your toolkit is that you have a provider facing side and a patient facing.
Dr. Ade Akindipe, DNP (14:53)
Absolutely.
Jillian Woodruff, MD (15:01)
Side, you know, well, they're side by side. These two sections are side by side. I think that's really ingenious. And how did you come up with that idea?
Angela Jackson LMSW (15:10)
Well, I have to give credit to my professor. Who when we were working on the toolkit, I mean she sent it back many a time, but she said that would be important. So sometimes when people look at a book, you know, because it's a few pages and so they kind of flip through. But if you specific, this is for providers to really think about hearing your patients, listening to what they're saying, providing what they need, education. This is more for women, the patients.
empowerment, advocacy, what am I feeling? What's going on? And then there was the joint together, provider and patient. This is what we can consider together. And that creates that dialogue of the conversation, a two-way conversation, not just one-sided. And so that was how we came about that section because we thought that was important because we wanted our participants when they looked at the toolkit
If they skip the other part, they skip, okay, but this is for me. Let me look at that. And then maybe they will be interested in looking in the other parts, but specifically what they do. You have to catch people like when they're looking at a book, you gotta catch their attention. So if they say, Well, I don't want to look at the provider, I just wanna see about the patient. Then from there, you know, ⁓ they can look at the provider and say, this is what my provider
maybe should be doing for me. And then jointly, this is what we should be doing. This is how we should be conversating.
Dr. Ade Akindipe, DNP (16:35)
Yeah, that's amazing.
Jillian Woodruff, MD (16:35)
But it's educational for
the provider side as well.
Angela Jackson LMSW (16:38)
Yes, because I did research and so just the history of even for ⁓ women of color, how they experience menopause symptoms, some kind of more severe or even longer. And so I I didn't know that prior to doing the research. So that is something of concern as well as that women, younger women thinking, well, everything is fine and they never even consider.
Maybe this is what I'm going through because there's not a set age. Because in the research it says that it can start earlier. It's earlier than just in your fifties. You can start in your thirties. And so, you know, women need to be aware and just saying, ⁓ well, maybe so. Maybe I should seek out and see, you know, what else could be going on and so.
Dr. Ade Akindipe, DNP (17:08)
Yeah.
Yeah, yeah. I really love the thought process behind it. It definitely shows that you put a lot of thought. You you used research, learning about ⁓ how that impacts different people depending on, you know, their ethnicity as as well. So that's that is amazing. It respects that both people in the room, you know, you have the provider side and you've got the patient side. It both matters. So very intentional. So ⁓ I one question I do have for you is how did you figure out
to make how to make it make sense for the person that is using this toolkit because like you said, people might not be able to connect all the dots, right? So how can this person say, I'm gonna be able to use this for whatever symptom? Or is it geared specifically for women who are navigating, they know that they're in perimetopause or menopause, if that makes sense.
Angela Jackson LMSW (18:14)
Well,
I did a survey which for my capstone I actually did survey questions and I sent them out and so there was a range of people from thirty to forty to fifty and so just hearing the the feedback from their surveys, they said, I wish I'd had this sooner. This may be something that I need to look at. How can I get a toolkit? So therefore when I go to my provider, we can have a conversation and so people are asking, Well, I didn't
You know, because there's so the thing is there's so much research out there. Every time you turn on a video now, there's something about perimenopause, there's something about menopause. And sometimes a lot of information can be a little overwhelming. So I wanted to kind of streamline the important things to look at. You know, like the symptoms, like, you know, I keep saying the brain fog, the the vaginal dryness, all those things. And so just kind of compile it so women can say that.
Dr. Ade Akindipe, DNP (18:52)
Right.
Angela Jackson LMSW (19:11)
You know what? I need to have a conversation. I need to make a call. And rather than sit there in silence, because the research shows that not addressing these things affect different parts of your life. And so your home, just an example, you're home with your kids, and you're just so frustrated, you just can't, you know, nobody wants to be like that. You want to be able to enjoy your family, but you don't understand what's going on with your body. And so bringing awareness to
Pay attention to those things and say, hey, something's going on with me. I need to make an appointment. And so that's yeah, just doing, just surveying and talking to I've talked to many people and doing the, you know, trying to say what would they most be interested in? And they were interested in the symptoms and how it affects, you know, maybe different races and just different things. You know, women were really interested in it, even younger.
Dr. Ade Akindipe, DNP (19:46)
Yeah.
Angela Jackson LMSW (20:07)
women were interested in it as well, not just women, older women, but all women. And so even even in that, you know, wow, this could have been what I was going through all along. And I just sat there and let it go.
Dr. Ade Akindipe, DNP (20:19)
Yeah.
Yeah.
Jillian Woodruff, MD (20:21)
I appreciate how the toolkit really cites disparities data as well. And you mentioned this, and it's based on the Swan study, the study of women's health across the nation, which found that black women on average experience more severe and longer lasting hot flashes. You mentioned that, and night sweats than other groups and other ethnicities.
Angela Jackson LMSW (20:37)
Mm-hmm.
Jillian Woodruff, MD (20:44)
And those symptoms are less likely to be documented or treated, probably because, you know, you're told it will only last for a short time or, you know, that this is normal and this is just something you deal with, right? And Doctor Day, you know.
Angela Jackson LMSW (20:53)
Yes.
Dr. Ade Akindipe, DNP (20:57)
Yeah, yeah.
Of course. And that same body of research shows black women may be less likely to be offered hormone replacement therapy and more likely to be offered invasive interventions, like you talked about. You might be given antidepressants. ⁓ I know someone who was given ⁓ medications to help with nerve pain at one point. ⁓
Angela Jackson LMSW (21:06)
They said that, yes, yes.
Dr. Ade Akindipe, DNP (21:18)
You know, so that age piece is also significant. Average age of women among black women is about forty nine, forty-nine years old compared to the general average of fifty one. So that conversation often yes, yeah. So often needs to start earlier than the standard for everybody else because you know, they're going through these things much earlier than others. So
Jillian Woodruff, MD (21:28)
for reaching minute pause. Yes. Mm-hmm.
Mm-hmm.
Angela Jackson LMSW (21:34)
Mm-hmm.
Jillian Woodruff, MD (21:39)
Yeah. So if your provider's running on that typical timeline of average age age of menopause is fifty-one, then they genuinely can miss the window where a patient needs to hear this information the most.
Angela Jackson LMSW (21:39)
Yes.
Yes, and that's probably a lot. So more more often, yeah.
Jillian Woodruff, MD (21:56)
Mm-hmm.
Yes. Let's talk about some of the case, you brought like some case examples into the toolkit so people could really see themselves in having a need for the toolkit. You know, they you need to kind of visualize yourself to see how something could be helpful to you. So one of the case examples that I read in your toolkit was about ⁓ you know, it wasn't, I don't think that these are real people, but they're real scenarios for sure.
Can you walk us through Danielle's story from your toolkit?
Angela Jackson LMSW (22:28)
let's see, Danielle's dirty. Yes. she exp you know, I haven't looked at this one in a while, Danielle Story, but yeah, she I it's just if this not a real person, but yeah, she was just experiencing some symptoms and she felt like she wasn't hurt and her symptoms were just dismissed. And so when your symptoms are dismissed and you're not hurt, that means you just struggle and suffer in that and
You know, what c 'cause I think one of the questions I put, what could the provider had done when she shared all the symptoms and how she was feeling?
Dr. Ade Akindipe, DNP (23:03)
Mm. Mm. And we know we see a lot of the Daniels, right? It is it looks different for different people. And some women just don't understand. A lot of times it's they don't have the clarity around what's happening. either the changes are very subtle and you know, it's like, yeah, I'm just really tired to of course hot flashes and night sweats, to mood issues, you know, feeling depressed.
So it's it's a it's such a you know, it's it's really important to find clarity and make sure that it's distinct. You know, the stress and the hormonal shifts aren't competing explanations. They can both be happening to the same person at the same time. so what was the turning point for Danielle where what got her from this is just, you know, whatever's going on with her, whether it was stress, whether it was hot flashes, to actually considering perimenopause?
Angela Jackson LMSW (23:50)
Well, I think with her, I think the example I put that, you know, the doctor they did her laps. They looked at her laps. And so maybe that conversation was not happening before, but they decided to look at her laps.
Dr. Ade Akindipe, DNP (23:56)
Mm. Okay.
Jillian Woodruff, MD (24:05)
Yeah, the thing that's interesting about Danielle, she's early 40s and she was not having those typical the typical if you had hot flashes or night sweats, I think that makes it so much easier. You know, you know what's going on. You're like, yeah, I know what this is. But she was having sleep disruption and she was having mood changes, you know, and and now hopefully people are associating that more with perimenopause, but with her, you know, it was attributed to work stress and
Dr. Ade Akindipe, DNP (24:16)
Mm.
Jillian Woodruff, MD (24:33)
Caregiving responsibilities, you know, all the things that also pile onto us at midlife. And so that was the difficult part because you're saying I have problems with sleep. And so you may see somebody that's focused on the sleep or just telling you, you know, that take some magnesium and do some meditation, you know? So I think that was like the the difficult part about this woman. She was on the young end for when you're thinking about menopause typically and
having things that weren't associated with the period and weren't associated with the typical, you know, what people think are typical symptoms of menopause.
Angela Jackson LMSW (25:08)
And also too, you know, a lot of symptoms there is it's it's like it's not talked about because it's associated with you're getting old. And so these things are not talked about at all. And so it's very oftentimes that it gets dismissed because nobody wants to talk about it because it's associated with you're old because you're having these symptoms and that's
Dr. Ade Akindipe, DNP (25:26)
Yeah. Yeah.
Yeah. I mean, you know, having that conversation and attributing these symptoms to perimenopause and menopause takes that self-blame out of it. Like you're you're just lazy. you just don't feel you just don't want to do the things that you need to do, right? There is actually a physiological change that's happening in every woman. So can you walk us through how those work and how you you would want someone to actually use this toolkit?
Angela Jackson LMSW (25:54)
Well, I want women, and it's and it's not because sometimes they're they come on so subtle that you don't even know you're experiencing these symptoms. So I just when they start coming on and you start noticing and you're just not feeling right, you're not feeling yourself, I want women to be able to look at this toolkit and say, hey, you know, I'm experiencing this, you know, I'm experiencing that.
And this too, you know, maybe, maybe, maybe so. Maybe I should go and make sure that I'm not experiencing this because I don't and that's one of the feelings. I don't feel like myself. Something's not quite right. I just can't put a finger on it. I'm too young to be having this, you know, or so I was told. And so it just gets dismissed. And so, especially women, you know, having the
the things going on and the weight gain and it's just it's just compiles and so you get to the point where you just want to scream because all these things are occurring at one time. And so it's it's like, ⁓ well, you're just having some stress problems or you're just and it's more than that. And so just
Dr. Ade Akindipe, DNP (26:53)
Yeah, yeah.
Yeah. No, this is really
great. I mean, you've built something really special. I mean, we have something similar called the menopause rating scale, which I'm sure Dr. Jill also ⁓ uses in practice. And it's tell us how this is not necessarily replacing it, but what how is this supposed to be used in addition to something like the menopause rating scale, which I'm sure you're aware of as well.
Angela Jackson LMSW (27:22)
of the scale that I have in my book. Yeah, it's we looked at a trauma informed approach. So we're looking at the the mental part of it, how it affects you. How are you feeling? And how often does people, you know, just people out in general, and they ask you, well how are you feeling? And you start to tell them and it's like they totally dismiss what you said. They never heard what you said. And so it's getting you the person to look at, you know.
Dr. Ade Akindipe, DNP (27:25)
Yes.
Angela Jackson LMSW (27:51)
I am feeling this way. And it's sitting down, acknowledging, really taking the time to evaluate how you are feeling and to know: hey, this is not normal, and something's not quite right. And I need to seek out help because why should I just keep going through these things? And nobody knows how I feel, and nobody even hurt me. And that's a horrible feeling when.
You're telling someone just like you someone asks you how you doing, you tell them and they didn't hear what you said. And they said, let me tell you about me. I never heard what you said. It's one of those experiences. And so the toolkit is just to bring awareness to say, Hey, I can't exactly say for sure this is what it is, but I know that I'm experiencing some things that could make me think that I need some help. And that's the other part to admit that.
Maybe I need some help. That's a hard thing because as women, we gotta get stuff done. We got to keep going. We got to do this, do that. But it it puts you in a place where you can stop and say, you know what? Everybody else, they're gonna have to take care of themselves right now. I need to think about me right now. Because I'm a freight train right now running and I'm gonna crash and burn if I don't stop and take the time to address these things. Because that's what happens.
Dr. Ade Akindipe, DNP (29:10)
Yeah.
Jillian Woodruff, MD (29:10)
Absolutely. And I think your the toolkit is more than just, you know, awareness. It's more than awareness. Awareness is super important, but it is significant education on both ends. So with your patient, you're teaching self-reflection. So not just a list of symptoms, but how are these symptoms affecting me? How do I feel about this? And and sometimes that's really difficult to process, you know, and
Dr. Ade Akindipe, DNP (29:21)
Yeah.
Jillian Woodruff, MD (29:37)
You alluded to that, it's just really difficult to process and recognize it, and you're giving them the words to use and a way to think of it. That's education and empowerment. And then on the other hand, with the provider aspect of it, even if somebody is well-versed in hormones or menopause care, the trauma-informed care aspect of it is pretty significant. It's something that I think clinicians, providers should have.
The ability to provide, but often don't. The training, I think now people who are coming up probably have more trauma-informed care training than people who have been providers for quite some time. But you gave the framework for not only how to ask questions of the patients, but you break trauma-informed care down into a few core pieces, and it's making the person feel safe, building trust.
Dr. Ade Akindipe, DNP (30:16)
Yeah.
Jillian Woodruff, MD (30:31)
giving them real choice and voice in their own care. And those are really important ways to, you know, you're not teaching the provider how to think about, you know, you can't teach them menopause care, but you're teaching them how to approach that person in a framework that will give them what they need to provide the best care, which is education as well.
Angela Jackson LMSW (30:55)
Because some women have been dismissed and nobody paid attention. And so there is trauma there. Or they went to a provider that did, and so there's tr trauma there. And so there are a lot of two, there are two kids out there, but they more just concentrate on the physical aspect of menopause or perimenopause, but not the emotional side. And that's kind of what I wanted to capture. I wanted women to feel like
It's it's a safe place. And plus they need to feel safe when they talk to their provider because sometimes they're telling them very personal, intimate details that it takes a lot to share because most some cultures are taught, no, you can't talk about that. you know, you can't talk about that. And so people need to feel that it's a safe space that I can talk about this here, and you're really gonna
be concerned about what I'm saying, even though this is intimate and very personal to me, that I trust you, trust as well, to have this conversation because that is exactly what women are doing when they provide this information, how they're feeling, or even how it's affecting their life. You know, it's like you're taking something so precious and you're sharing it with someone else. And that's sometimes difficult for people to do.
And so I just wanted people to feel like, but can I find a provider that I can do that, that I do feel safe, I do feel heard. I'm not going to be judged or, you know, talked about or ridiculed, but heard and really they have my best interest as well.
Dr. Ade Akindipe, DNP (32:35)
Yeah, that healthcare and advocacy section feels like it's doing the quiet work, important work though. like I feel confident asking questions about my care. That's almost like its own vital sign, right? So why did you include that alongside the more body focused items?
Angela Jackson LMSW (32:53)
talking about these the self-care or the mean the self res Well like I say my toolkit was more focused on that aspect instead of just the medical because that's the part that gets dismissed because it's easy to talk because that's a lot that's out there. ⁓ they have these memes and everything all the woman with the sweater feeling like a bucket of water has been poured and that's cute and that's comical but we're talking about really
Dr. Ade Akindipe, DNP (32:55)
Okay.
Angela Jackson LMSW (33:20)
How are you feeling? How is it affecting your day-to-day? And I think that's more important than anything. How it's affecting your day-to-day. How are you showing up for others? How are you showing up for you? And knowing that you are somebody special too, not just for everybody else, but you are just as important as all the people that we care for, that you take care of. And I deserve to be heard.
Dr. Ade Akindipe, DNP (33:22)
Mm.
Angela Jackson LMSW (33:49)
I deserve to be cared for. I deserve to feel like that somebody is hearing me what I got to say and I'm my needs are being addressed.
Jillian Woodruff, MD (33:58)
I think in other specialties we are trained more to take those things into account. Like if you have pain, how long have you had the pain? When what makes the pain worse? How do you are you able to do your activities of daily living with this pain? You know, how does it affect you? And and also with pain, they we are looking into or we have, you know, psych pain providers, mental health providers that are that help you with pain. But when it comes to
Angela Jackson LMSW (34:12)
Mm-hmm.
Jillian Woodruff, MD (34:26)
women's health care or men of cause care, this is so needed. It's not just do you have hot flashes or how many do you have? It's, you know, do you feel like yourself right now? Because really that's one of the biggest complaints that I get is I just don't feel like myself anymore. I'm not reacting the way I normally react. I don't know who I am. And, you know, as you're a woman in midlife, you should very well know who I
Who you are. So I think that's in, you know, that's an emergency that needs to be addressed if you're not feeling like yourself or you don't recognize yourself. You want to get back to that. So I I love that. And then moving on to the advocacy side, equally important because yes, you may recognize that you're having symptoms, signs of perimenopause, of menopause, but if you and you may recognize that you need
Angela Jackson LMSW (35:00)
Yes, yes, yes.
Jillian Woodruff, MD (35:16)
To get help but not know where to go from there. So the advocacy part to make sure you get the help you deserve is important. You sell you talk about tracking symptoms, writing them down, ⁓ asking for the on the provider side, asking questions about lifestyle, about hormonal, non-hormonal options, discussing that with your patient. And then for the patient, you also say seek a second opinion if you're not getting the care that you deserve. And you know.
Doctor Day, we've talked about the advocacy part a lot too and advocating for yourself. When we did the fatigue episode, we talked about how to frame questions and and ask them and this is no different.
Dr. Ade Akindipe, DNP (35:56)
Absolutely. Yeah. I think knowing how to frame in fact, I was just talking to someone today about, you know, what what the next step would would be like. You know, even if you don't necessarily qualify for the standard of care, you know, what what is your next step? You know, knowing how to phrase those those conversations, knowing how to advocate for yourself, using toolkits like this, can really go a long way, even if you're not getting hormone replacement, right?
What are some things that you can do outside of hormone replacement? the goal is again advocacy and figuring out what that personalized care will look like for you. And I think, man, I think it this toolkit, I don't know what you need to do to kind of get this out there, but I think it can really help women who who just don't know where to start. You know, ⁓ maybe they don't really understand, they don't know the right words for for where to go. So I think.
the the patient advocacy piece in this toolkit is is huge.
Jillian Woodruff, MD (36:52)
And getting it into other ⁓ providers' offices, you know, probably ⁓ the primary care, you know, because that is a place where it should be in front of women and in front of men as well. You know, not just for women, but for people who love women. And the first stop that somebody may come to with a symptom that may be a little not fitting in a box somewhere.
Dr. Ade Akindipe, DNP (36:56)
Mm-hmm.
Yeah.
Jillian Woodruff, MD (37:18)
Like this is just something to consider, not that this is the cause of every issue that you'd have in midlife, but it's good to have this be a consideration like you would rule something else out.
Dr. Ade Akindipe, DNP (37:19)
Yeah.
Yeah, absolutely. And that kind of brings us into provider, the provider kind side of things, right? Because we know how many of our listeners are also clinicians. So if ⁓ provider listening today takes away exactly one thing from your toolkit, Angela, and uses it in their very next appointment, what should this be?
Angela Jackson LMSW (37:51)
Say for providers is just to take the time to listen. I I work in healthcare now, and one of the biggest things I see is sometimes just to listen, just you know, to know that I am being heard. That is the worst feeling in the world. I'm pouring out to you how I feel, and it's just being dismissed like I didn't say anything. That I think that is the worst feeling in the world. And then that's how we have.
⁓ people that don't trust providers because they're not gonna do anything they never heard what I said and that is the biggest thing is listening to your patients and being saying that you know it's not just what I say as a provider but it's how we work together to bring you to a place that you are comfortable that you're okay that you are stable you know and that's the thing.
Is to get to a place that we come together and we can talk about the plan moving forward together, not just one-sided. Because if it's just one-sided, but they didn't know about this and they didn't know about this, or something gets missed. And so just being able to identify those gaps of the two-way conversation. So therefore, your patient feels heard. And so therefore, when there's something new.
well they listened to me there. I can come back and tell them about this. You know, this is going on. And sometimes, you know, because working in healthcare feel I feel sometimes you don't really get to the the what it really is, and it takes a couple of times. But if you have that relationship and that patient feels comfortable, they'll keep telling you these things. It's like, you know what? I thought that, but now hearing this, now I know for sure. And so and that helps the providers as well when
patients feel comfortable enough that they can share those additional details because it happens all the time. You go home, I forgot to tell them this. I forgot to tell them that. And so it's just for providers, I would say, you know, just listening to your patient and just making them feel like or letting them know that they're heard.
Jillian Woodruff, MD (39:58)
Yeah, Miss Angela, that sounds like just proper communication strategies, right? We should be listening more than we speak. And it seems like sequencing matters. You gotta build trust and to do that, validate, validate their experiences before you move on to the education part. Because if they don't trust you or know you, then you know, they're not going to receive what you're when you're giving them because you didn't receive what they were telling you.
Dr. Ade Akindipe, DNP (40:21)
Yeah.
Yeah, absolutely. That's an extremely practical reframe for a busy clinic day. but I guess my question now is is does that change the actual time a provider spends with a patient? Because things like this, you you really need the time to really listen, right? And sometimes that can be a barrier, or is it more about how that time gets used?
Angela Jackson LMSW (40:43)
is how that time gets used because if your patient is have these things already talked about it cuts down a lot because it's not like you're having to pull it out of them they already have okay I'm experiencing this this and this and you know not that you know because I'm sure sometimes you have to try to pull it out but I wonder are they experiencing this? I'm wondering are they but if they're pre you know this like being prepared
for your appointment as well. Not just you go and show up, but you are prepared. These are the things that I want to make sure, the top things that I need to make sure to mention to my provider today. And that could save time because you're not having to ask all these questions trying to pull it out and it takes forever. But you know, it's it's like just like if you're gonna take a test, you get prepared, you read and you're, you know, you
Dr. Ade Akindipe, DNP (41:30)
Yeah.
Angela Jackson LMSW (41:37)
Study your material. Same thing with your appointment. You know, you have these are the top three things I will say. We know that your time is limited, but I would make my appointment, my time so much more impactful if I already have these things that I need to discuss with you.
Dr. Ade Akindipe, DNP (41:53)
It definitely makes a lot of difference. I love when they bring out that little note, you know. And there's bullet points of what they want to talk about.
Angela Jackson LMSW (41:57)
Ha ha ha.
Jillian Woodruff, MD (42:00)
Yes, I I do, I love that. You said so many important things right there. And I love that top three. I did start adopting that. You know, in in school, we're told, you know, what is the most important thing you want to talk about today? Right. But when it comes to hormones, there's there's 5,000 symptoms. There just is. So I did start adopting a, because you kind of know where the conversation's going to go, but what are the top three issues that if we could
solve this problem that it would make such a huge impact on your life. And I wanna know I want to know all the things, but I want to know one, two, three. I want to hear your priorities. What kind of what how do you address this, Dr. A Day?
Dr. Ade Akindipe, DNP (42:33)
Mm.
You know, there's something that I started doing because, you know, I work a lot with metabolic health and sometimes all the symptoms are all connected. So I'll ask, you know, if you were to work with me in the next three to six months, what would optimal health look like for you? And that and the first thing they'll say is, ⁓ energy. I just need my energy back. So that really gets me to understand their mindset, is like, my energy really is the problem. I'm so fatigued, I can't do anything else.
So that shifts the focus into okay, we're gonna deal with this because you you already know all of this is just, you know, they have body aches and they've got bloating, they've got all these other things, but they're all part of it and it's going to help improve their energy levels versus I'm listing all of these symptoms and I need treatment for each, every single one of them. So that usually helps a lot too.
Jillian Woodruff, MD (43:26)
Love that framework. I love how you did two things with that. You set them up to know we're not solving this problem today. This is going to take time and work on both things, right? And so I like how you said the next three to six months. So they're already framing it in a different way. And then what does optimal health look like? Because they may not, you know, you may see the symptoms as being connected by a patient who doesn't have a clinical background, may not.
Dr. Ade Akindipe, DNP (43:34)
Right. It's gonna take some time. Yeah.
Yeah. Yeah. Yeah.
Right.
They may not. They just want they want to feel better. They want energy. Yes. Yeah. Yeah.
Jillian Woodruff, MD (43:55)
Right? Mm-hmm. And they may not bring something up because they may think it's not related.
So I like that. I like that. Mm-hmm. And you know what about another thing that's in the toolkit is just about ⁓ connecting culturally. And you know, we know that there's different ethnicities that may have a different ⁓ exacerbation of sys symptoms, different symptoms, different timelines.
Dr. Ade Akindipe, DNP (44:03)
Yeah.
Jillian Woodruff, MD (44:20)
How does a patient bring up their cultural or religious concerns about menopause with a provider who doesn't share their cultural background or their ethnicity? Angela, you you kind of talked, you talked about this in your toolkit and you gave some really tangible advice. Can you tell us about that?
Angela Jackson LMSW (44:39)
Yes, that is an interesting which I want to say too with the toolkit, I tried to make it very simple. I didn't go a lot of heavy medical medical or psychiatric. I tried to keep it simple. So that was one of the things that my professor really recommended that anybody can do that. But with different cultures, it's called ⁓ cultural competence. So I'm not the expert.
in your culture so with that you'll have to help me and so being upfront with that and so is there anything that you know I should know and so I've learned that myself cultural you know is that I'm not the expert in your culture you are so share with me things that I need to know so therefore in our treatment plan that I'm not you know stepping over into something that you know would make me very uncomfortable.
So
Jillian Woodruff, MD (45:35)
I love
that framing as well. Yeah. Very important. Cause we're not, you you know, we don't have the same backgrounds as everyone. That doesn't mean that you can't provide appropriate care for people from many different backgrounds. But yes, they may have to help you to understand the things that are ⁓ significant to them or things that they do not want. And ⁓ and you may have to educate yourself too, you know.
Dr. Ade Akindipe, DNP (45:36)
That's awesome. Yeah.
All right.
Yeah, absolutely.
Angela Jackson LMSW (46:01)
Yes, yes.
Mm-hmm. That too. Yes. that was, you know, that was one thing too that, you know, yes, I did talk about that because it's everybody's experience. That's one thing we all do, you know, all cultures. And so in some cultures it's talked about, some cultures it's not. They don't really discuss it. And so I read that ⁓ one culture
Jillian Woodruff, MD (46:03)
Yeah. Yep.
Angela Jackson LMSW (46:26)
They don't really see it as a problem. They just said there's just a natural transition and they just but all cultures don't think like that. So I have to respect that and just feel like okay, well you explain to me what do you think? And so and so yeah, that is that is something too.
Jillian Woodruff, MD (46:43)
Right, that's true. Well, before we let you go, if someone is listening today that's in the thick of it, they're having all the things, they're feeling all of the things, but they haven't found the words yet to explain what they need, like you eventually did. What do you want them to hold on to?
Angela Jackson LMSW (47:00)
⁓ that you it's it's it's okay not to know. Just communicate as best as you can and hopefully that you know we can get this toolkit out to give people the words to say this is what I'm talking like brain fall. Because that was one of the things in the toolkit I struggle with, making sure that it is something that they can understand what I'm talking about. Because to me
I understand what brain fog is. Someone reading this toolkit may not. So I tried to take those words and explain them a little bit more where maybe with brain fog, maybe you're having where you're not thinking like you sh you know, just something simple. And so that's kind of what I did. Or vaginal dryness and you know, those kind of things. People, well, what is that? you know. So I tried to simplify it and so I actually went and
add it a little bit more to simplify it as much as possible because, you know, everybody's doesn't know the medical terms. And so I want it to be simple so that they can have that conversation.
Jillian Woodruff, MD (48:04)
Right. Or with vaginal dryness, sometimes they many times actually I shouldn't say sometimes, people think that it is an intimacy issue. And if they're not intimate with a partner, then they don't have to worry about vaginal dryness or they don't need treatment for vaginal dryness. So I that's fairly important to put into this toolkit because there are in me, Dr. Davis probably have it in another episode about specifically about the vagina, because
Angela Jackson LMSW (48:12)
Uh-huh.
Jillian Woodruff, MD (48:32)
The treatment of this of of vaginal dryness is not just for intimacy, but it's for the vagina, the health, preventing of infections, preventing bladder infections, just things that people wouldn't even put together. Which why would they? You know, so I like that you bring that up.
Dr. Ade Akindipe, DNP (48:47)
Exactly. Yeah.
Angela, thank you for turning your own hard one clarity into something other women, every woman, no matter where they're from, ⁓ and other providers to get to use. And that's really, you know, the whole thoroughline of this whole episode. It's not just about the clinical transitional transition, it's a relation one too. Like how do you
you know, approach your provider, how do you advocate for yourself and between the systems that are supposed to support both? So thank you so much, Angela.
Jillian Woodruff, MD (49:20)
Yes, thank you. It was a great talk. Thank you. And before we go, if this episode gave you something to hold on to or something you want to bring into your next appointment, we generally we genuinely love to hear from you. We want to hear about it. We want to hear if this helped, how this helped. So head over to www.modernmidlife collective dot com and you can find the show notes from today and also a link to the toolkit.
⁓ Angela's full ⁓ Unspoken Transitions menopause toolkit. And if you want to reach us directly with questions or topic requests or feedback or your own story, you can do so through the website or you can email us at connect at modern midlife collective dot com.
Dr. Ade Akindipe, DNP (50:06)
Yes. And if you're listening on Apple Podcasts or Spotify, leaving us a quick rating or review genuinely helps other women find this show. So it's often the single biggest thing you can do to help this podcast grow.
Jillian Woodruff, MD (50:20)
Yes. Okay, this is the last bake. Share this episode with a friend or a colleague or a sister, a loved one, anyone who you think wants to ⁓ know more about this unspoken transition, this transition to perimenopause or menopause. Send them the link, tag us on ⁓ Instagram. Word of mouth is what helps this show reach the people who need to hear it the most.
Dr. Ade Akindipe, DNP (50:45)
All right, ladies, until next time, remember you're not becoming someone else. You're moving through a transition. And now you've got a few more tools in your toolkit for the road. Goodbye.
Jillian Woodruff, MD (50:54)
Yes.
Goodbye. Thank you.