Menopause Awareness Month with Dr Kavita Desai

About Dr. Kavita Desai, Pharm. D., Revivele Founder. 

As an accomplished hospital-based pharmacist and the founder of the women’s health platform Revivele, Dr. Kavita Desai, Pharm. D. spent 13 years as a clinical pharmacist before pivoting to focus on preventative women’s healthcare. She established Revivele with a mission to fill the gap in women’s healthcare, and also wrote the book “Lady Parts: Putting Women’s Health Back Into Women’s Hands” (February 16, 2023), a handbook that empowers women to take control of their health through easy-to-follow tips and foundational knowledge. She was inspired to make a difference in this category when her mother was diagnosed with early-onset Alzheimer’s disease, which was originally misdiagnosed as menopause. She currently uses her clinical skills to focus on brain health, disease prevention and how chronic illnesses affect women. Originally from Ontario, Canada, she earned her Doctorate in Pharmacy from Ohio Northern University in 2001. As an expert on women’s health, brain health and pharmacology, she has been featured on many national and regional broadcast health news segments.
About Dr. Desai: https://www.revivele.com/about/

Podcast transcript:

Hey, welcome back to the urban monk podcast. It is menopause awareness month, whole month. Why? Because we have misdiagnosed. Misunderstood and mansplained women’s health to them for a very long time. Um, my guest today, Dr. Kavita decipher was a pharmacist worked in the hospital system. No longer, she is helping empower women to. Learn how to navigate this healthcare system, which is not designed to help them. It’s not really helpful to men either, but that’s, that’s a different month. Uh, really provocative, uh, story in terms of how she came to understand that her skillset wasn’t going to get her own mother to the promised land and is on a mission now. To help other women not end up in the same entanglements. I think you’re going to really enjoy this one. Let’s go.

Pedram Shojai, OMD: Okay, Dr. Kavita Desai, welcome to the podcast.

Kavita Desai: Hi. Thank you so much for having me.

Pedram Shojai, OMD: Yeah, great to have you here. I love the story. Um, it’s gonna resonate a lot with my listeners and viewers ’cause it’s an ongoing theme. Um, you know, women not being listened to in healthcare, women, uh, not feeling like they’re being heard in healthcare.

Pedram Shojai, OMD: And, um, your history is interesting. You come from the belly of the beast. You know, , you were in pharma inside the hospital system. And, uh, now you’re not. And so would love for you to share kind of the journey of, you know, how you were in and, and, and why you left. ’cause I think it’s really relevant to what we’re gonna talk about.

Kavita Desai: Sounds great.

Pedram Shojai, OMD: So we are in a system that has, um, lot of constraints built around it, uh, and more and more people every year. Or starting to wiggle. Right. You know, I was in that dude’s waiting room for 45 minutes. He spent 16 seconds with me. He didn’t hear what I came in to say. And here’s your drugs. Bye-bye. Right.

Pedram Shojai, OMD: And so what, what was your role in that? Like what does a hospital based, uh, pharmacist do?

Kavita Desai: So in my case, because I did my pharm d um, we are generally on the floor with the team of the service that we’re on. So I was originally on cardiology and oncology. So we actually round with the medical team, um, make recommendations for dosing adjustments. Um, you know, if they have renal failure we will dose adjust for things like that.

Kavita Desai: Um, reviewing the patients obviously, Um, status and their medication history. But then shortly thereafter, I actually went into a teaching role where I was in the teaching hospital, running the pharmacy department and essentially teaching pharmacists how to go to the floor, read blood work again, assess medications, write in the chart.

Kavita Desai: Um, but very shortly thereafter, I, my interest is, has always been in prevention. So I started a, um, healthy heart clinic where we were screening, um, . You know, just patients that didn’t even know they had risk factors for cardiovascular risk factors and looking for in a younger population who might be at risk for developing cardiovascular disease and trying to catch it early.

Kavita Desai: And it was actually very rewarding because we found people in their thirties that were diabetic and didn’t even realize, ’cause that’s not a population that’s generally going to their physician on a regular basis and looking for, you know, things that might be coming down the pipeline. So that’s kind of where I got started in prevention.

Kavita Desai: Um, And then, I mean, it’s been history since then.

Pedram Shojai: Yeah, no kidding. Well, prevention’s, you know, it’s, it’s, it’s a dangerous word in healthcare, right? Like it’s, um, hospitals, hospitals won’t make any money on prevention. And so prevention means those guys aren’t coming in. Um, you going into prevention probably opened you up to a very different paradigm, right?

Pedram Shojai: And then once you’re in that paradigm, you just gotta, you gotta think differently, right? You have to do things differently. And now you are, you know, you have . There’s a different hand that feeds too, right? It’s a, it’s a different psychology. It’s a different psychographic. Not everyone wants prevention. I mean, everyone wants to be well, but not everyone wants to put in the work for it.

Pedram Shojai: So how did that transit , you know, and that’s, that’s the, that’s the toughest part of healthcare, right? Is, you know, I’m trying to get you to care. Right. Um, and so how did that transition look for you? Like, what does that look like moving into prevention and how long were you, you know, feet in both worlds.

Kavita Desai: So, yeah. To make a story short, we ended up opening our clinic up to more of a pain and addiction center where it was an integrated medical center and we were seeing a lot of pain patients, but trying to reduce narcotic use and use more ancillary treatments, um, so that people would actually get better rather than just bandaid treatment in, you know, with pain medications.

Kavita Desai: Um, and in that population is where we started to see . I would say thousands of women that came in that were perimenopausal and happened to have fibromyalgia. So these are women that gen generally, like legitimately feel unwell, and they were coming in looking for help anyone to listen to them because often they’re told they’re just

Kavita Desai: Crazy, right. Or that their symptoms are made up. Um, and so that’s where my interest became very focused on women’s health because I think that’s a very under service population and a very grateful population. People in pain are incredibly grateful to have help and someone listen to them and actually maybe reduce their pain where they can go one day and function normally.

Kavita Desai: Um, and so, That’s where it was, around that same time where my mom was diagnosed with early onset Alzheimer’s and happened to be in that same age bracket. She was in her early fifties when she started showing, I. Um, signs of something. The problem was her symptoms were not, you know, the stereotypical Alzheimer’s symptoms.

Kavita Desai: She didn’t have memory loss initially. That’s not what I saw. It was more personality changes, which is exactly what perimenopausal women complain about, is that they start to feel moody and irritable and, you know, they just don’t feel like themselves. So it was missed, right. Her diagnosis. Um, I knew something was wrong because I was very, very close to my mom, but I know that my family members around me.

Kavita Desai: You know, we’re like, no, no, she’s fine. And that was, you know, how she was kind of treated until we finally did an M R I for her. And her brain had atrophied or shrunk by 50% by the time she was officially diagnosed. That’s a huge miss because she couldn’t possibly have been functioning anywhere close to normal for her at that time.

Kavita Desai: So, My focus became on women’s health and helping women prioritize their health. ’cause I think women know when they don’t feel well. That is definitely a, a section of the population that will admit that they don’t feel their best and, but they’re, I don’t think they know where to go or what to do. And I think that’s what we’re trying to do now.

Pedram Shojai: Yeah, I love that. I mean, there, there are words in our lexicon that, you know, most people don’t even know not to use. You know, you, she’s just hysterical,

Kavita Desai: Mm-hmm.

Pedram Shojai: she has a uterus, right? I mean, these, these are words that have worked their way into, and they’re, you know, incredibly offensive. I. , but they were very much, you know, you’d have hysterectomies when you, when you had, you know, anxiety disorders.

Pedram Shojai: Like they, like they did this to women all the time, right? Like it was part of the system. And so what was missed? I mean, I know I, look, we’re going into menopause awareness month. We’re, we’re in it now and it’s a big deal because, you know, those changes, um, dramatically impact the health, wellbeing, uh, you know, mental state of, of women, you know, in, in that broad age range.

Pedram Shojai: Right. Um, But was that what was missed in your mind? What? Like what? What could you have done better? What drove you to say, man, I gotta swim upstream and avoid this pain for other women? I.

Kavita Desai: Yeah, I think . Seeing my mom’s plate. ’cause she was somebody who was otherwise healthy. Right? Non-smoker, non-drinker, ate relatively clean, you know, had no other risk factors, no family history. Um, so I don’t, in her case, sadly, I don’t know why she got this and no one else in her family had ever had this.

Kavita Desai: Um, but for women in general, You know, we need to be focusing on the fact that going through menopause, yes, it’s a natural occurrence. We can’t help it. Our hormones are going to diminish whether we like it or not. But what we do know now is that the loss of those hormones is leading to a lot of disease or chronic illness or risk of chronic illness, not just potentially dementia, but also, you know, cardiovascular disease, osteoporosis.

Kavita Desai: We end up with mood disorders and you know, . Sleep disorders and gut microbiome, you know, imbalances that we’re not addressing, and for every other, you know, imbalance in our body. If we have a loss of any other hormone, we treat it. If you have a problem with your thyroid or you have a problem with your insulin, we treat that and yet we don’t look at an entire system that’s failing in women and think, oh, maybe we should actually be addressing some of these things and educating women on what they can do, whether it’s with hormone replacement or just lifestyle changes.

Pedram Shojai: Yeah, it’s, you know, there’s schools of thought as you are well aware, right? There’s, you know, kinda the A four M model, which is, look, we’ll just replace it all. Don’t worry about it. You don’t even have to age. We’re just gonna. Give you the hormones and you know, there’s the kind of traditionalists on the kinda holistic side that are, no, you could do everything with food and nutrition and supplements and you know, Tai chi.

Pedram Shojai: Um, and somewhere in the middle is kind of the reality where some people need hormones. A lot of people need some sort of interventions, um, but not full h r t. And so just curious where you fall on that spectrum. There’s a lot of schools of thought.

Kavita Desai: Yeah, I fall, I would say somewhere right in the middle, and I think it’s partially because I 100, uh, percent believe in a holistic approach to medicine and a preventative approach to medicine. Um, I believe lifestyle plays a very, very significant role in . You know, the prevention of long-term disease, but I also do come from a medical background, so I do feel that there’s a place and I, the research is increasingly showing that hormone replacement with bioidentical hormones, so the topical estradiol and oral micronized progesterone are actually showing to be

Kavita Desai: Um, preventative and slowing down the risk of our disease. So do I believe in both? Yes. Do I believe H r T is the end all, be all? Absolutely not. I do believe there’s a place for many, many lifestyle changes in conjunction too. But it’s like you said earlier, I think we have to wanna put in the work because it is work.

Kavita Desai: It’s a, it’s a very multifaceted approach to our long-term wellness.

Pedram Shojai: Well, and, and therein lies the problem, right? And that’s why we’re at this party is who’s got time to talk to you about that, right? Like, you go to your traditional provider, the system is, is really configured around single complaint, single diagnosis. You know, let’s go, let’s go. And, you know, bunch of well-intentioned people in the system.

Pedram Shojai: I don’t hate on the medical providers ever. I, you know, they’re all hardworking trying to do their jobs. It’s just, We’re not geared up for a system that looks at complicated arrays of an ecosystem of hormones and, and, you know, and, and so how do you fix that, right? Like, so how are you looking at that now?

Pedram Shojai: What is your approach that is proving to be more helpful for the people that are coming to you?

Kavita Desai: Yeah, so for, I mean, as many people as I can help, um, we are trying to educate. Um, so I, I wrote a book that’s actually been given away right now because I want women to just educate themselves on what isn’t and, and be aware, I think of what is normal in their bodies. I. Only you can say, right, what is normal for you and what is not.

Kavita Desai: Nobody else can tell you that. And it’s different for every woman. What we experience is very, very different. So I think I want women to be aware of what is normal for them and when there’s changes and when those changes aren’t, are something that they should be concerned about. So it’s kind of like a foundational book where.

Kavita Desai: I just wanted women to know that we’re all in the same boat. It was actually based off a survey that I did when I first started revival that I asked women where they feel, you know, are they getting enough care? If not, why are they not seeking care? And there was a lot of very similar responses from women of.

Kavita Desai: You know, very multifaceted demographics and locations, and yet it’s almost the same. It’s that they feel guilty for putting themselves first. They also don’t know where to go, and they were told it was normal. So I think it starts for me with education. I think you need to be aware that it’s not normal and you should be seeking care now.

Kavita Desai: Finding the right healthcare practitioner. Yes, it’s very difficult right now. I think there’s not enough, um, practitioners focusing on women’s health. But one of the things that we’re trying to offer is not only education, but coming down the road. I’d like to bring in like at-home diagnostics that can be looking for some of the risk factors that women, you know, are experiencing.

Kavita Desai: We’d like to bring in telemedicine so that women can access a physician for H r T specifically and their hormonal needs. Um, but I think it starts with you knowing. Everything you can about your own body and what could possibly be going wrong during these years.

Pedram Shojai: It’s funny. Um, I, we have a sleep program that’s been going for a couple years. Uh, mostly women who can’t sleep

Kavita Desai: Mm-hmm.

Pedram Shojai: and I kept running into this wall, right? Being like, Man. Um, This is doctor stuff, right? There’s only so far you could go online. Now you have to cross over into telemedicine. So I went into this deep discovery going, look, I need to find telemedicine providers that can help me with women’s hormones.

Pedram Shojai: And, um, they went running for the hills. No, it’s, it’s, it’s complicated, right? Like it’s really easy to send pills for erectile dysfunction or, you know, uh, you know, some sort of, you know, Version of the GLP one, stuff for weight loss. And all these people are just, you know, they’re, they’re all kind of, you know, robodi telemed thing.

Pedram Shojai: The, the business is not built around people that are gonna stop, look, think,

Kavita Desai: Mm-hmm.

Pedram Shojai: care, work with you, right? So even telemedicine is, you know, uh, the, there’s the long line of Costco get in it, right? And so that’s, uh, it’s commendable that you’re going into that. ’cause that’s not easy. And you know, to do it in 50 states is hard, you know, because of all the med-legal.

Kavita Desai: exactly. Yeah. So we are trying to work all of that out is how can we offer this to as many women as possible. But you know, interesting that you said it’s, it’s hard. It’s actually not, especially for a woman who’s. Over the age of 40, it’s symptomatic treatment. We don’t have to do blood work. Blood work isn’t accurate anyways for hormones.

Kavita Desai: Um, we can do it to get a baseline, just to have an idea if your medications are working or not. But really over 40, like the progesterone, if you have a uterus, is the same dose for every woman. And estrogen is just something that you can trial and you keep increasing. Maybe change of formulation if it’s not working.

Kavita Desai: And if your symptoms start to go away, that’s the right dose for you. It’s actually not as complicated as I think we’ve made it out to be. There was just a lot of misnomers around it, right? The older formulations I think scared everybody to death that we shouldn’t use hormones at all. And then I feel like lifestyle changes, we don’t talk about that at all.

Kavita Desai: Of how we should be actually changing what we do in our late thirties into our forties, that, you know, what we used to do in our twenties doesn’t work anymore and our bodies are not the same anymore. And I think that’s a big, a big component of the education that I end up providing on a regular basis.

Kavita Desai: ’cause I think women just don’t know where to start.

Pedram Shojai: Yeah, and there’s a certain degree of sacrilege in what you’re suggesting here in the wellness industry because in medicine and wellness, it’s kind of. Been assumed at this point that no one’s gonna change their lifestyle, they’re not gonna do it. So what do we do now? Right. And, um, I’ve personally been stomping my feet saying Uhuh, right?

Pedram Shojai: Like, we can’t do that. You can’t not change your lifestyle. It doesn’t work. Right. And I think a lot of people have just kind of given up and been trained by, you know, the, the sugar cereal eating audiences to say, you know, I just want that. And I appreciate you holding that line because making the lifestyle changes is really

Pedram Shojai: You know, night and day. Um, and yeah, you can intervene, but you’re not gonna get the results that you’re, you’re really wanting without

Kavita Desai: there’s no magic bullet, right? I think . We have to give up on that idea that there’s gonna be that one pill, that one drug out there that’s gonna make everything better for us, that doesn’t exist. If it did, we’d all be taking it and we’d all feel a hundred percent. So I think the work has to be put in, and yes, I will get the backlash occasionally, right?

Kavita Desai: Where they’re like, oh, you know, you want me to just give up everything? Where’s the joy in life? And I guess it depends on your perspective. Like I watched my mom die from an incurable disease, and I don’t know how she even . Brought that on herself, right. Or what she was doing that may have triggered this gene in her.

Kavita Desai: So for me, that was, you know, frightening. And I’m very concerned about my own long-term wellness now and my kids. And I think for, I, for me, it outweighs the, the, you know, the sacrifice that I might have to make to avoid some of my favorite things.

Pedram Shojai: It is interesting. I interviewed, uh, the, the pilots, you know, all these studies came out in the last 5, 10, 15 years around the gut microbiome and the scientists who did some of the pivotal work outta Caltech Sar Tasmanian, um, around Alzheimer’s and. How it shows in the gut and how it moves up, nodules along kind of the, the vagus nerve.

Pedram Shojai: Um, Had some really interesting data to suggest that you can see Alzheimer’s in the gut microbiome 15 years before you even get into that symptomatic threshold. And so what we know now, uh, you know, it might be too late for, frankly, the, the generation of our parents. For us, we stand a chance of riding, you know, the ship, but at least for our kids, damn, we better get this right.

Kavita Desai: Yeah.

Pedram Shojai: we we’re messing it up,

Kavita Desai: Even for us, like we don’t know, right? We don’t just like, you know, there was that story where Chris Hemsworth was tested. He has the A p O E four gene. The thing is, we don’t know. Yes, it, it can potentially increase your risk of developing Alzheimer’s, but we don’t know. What actually flips that gene on, because I like to, you know, liken genes to a, a light switch, right.

Kavita Desai: That something turns it on, what that is, or it’s like a book in the library that something pulls it off the shelf. What that is, we don’t know. So it’s almost like you have to be trying as much as you can. Right. Whatever is at least reproducible for you over a long-term basis, um, to make those changes and, yeah.

Kavita Desai: It’s only, we can’t look at it as . A punishment, right? Like, I feel like it’s when the seatbelt, seatbelt laws became stricter. When we, when I was a kid and, you know, everyone was up in arms, they’re like, oh, it’s so restrictive. But I was like, well, it’s to keep you from going through the windshield. Well, lifestyle changes are gonna keep you from going through the windshield, right?

Kavita Desai: Like it’s, it’s in your best interest. I like, I think that’s how I feel about it.

Pedram Shojai: If you’re ever around people who quit drinking at first, there’s that peer pressure to be like, oh my God. Like, what are you gonna do? It’s so, you know, so boring. Have some wine with us and then, you know, . They have the, the, the last laugh every next morning,

Kavita Desai: Mm-hmm.

Pedram Shojai: they don’t have a headache, they’re functional, their skin looks better, they don’t feel like crap, they’re not moody.

Pedram Shojai: And after a while, like the biofeedback of life is just like, wow, I, I think I’m better when I’m not drinking.

Kavita Desai: Yes.

Pedram Shojai: Right?

Kavita Desai: Yep.

Pedram Shojai: But those first few awkward weeks, uh, like those first couple parties, it’s like, I, I feel like I am, you know, punishing myself. No, they’re all punishing themselves. you.

Kavita Desai: Yeah, I know. It’s the only drug we question people when they don’t use it. Right. We don’t ask someone why they don’t use heroin, but we’ll ask them why they don’t use alcohol. It is interesting.

Pedram Shojai: It’s funny, I, I like, I’ll go to parties and people will, you know, pass some wine and be like, oh no thank you. And there’s that immediate thing where they’re like, oh, this guy might be like an anonymous guy. Like this guy probably had problems and all that, right? Like, you know, oh, you can’t do that, you know, tell me about your history.

Pedram Shojai: I’m like that, excuse me. Headaches, man. I don’t. I don’t, I don’t want headaches. Right. Um, and, and that, I think that’s starting to rattle, right? Our generation, my generation had that still kind of bully peer pressure around drinks and partying and all that. And now I, I think it’s changing and you could see it in the next couple generations where, you know, they’re, they’re actually having problems with bars and nightclubs.

Pedram Shojai: No one goes, it’s bad for you. I don’t wanna go do that stuff.

Kavita Desai: I mean, we have dry January now that we’re normalizing it. There’s celebrities coming out that are, you know, openly talking about it, which is wonderful ’cause it really does normalize not needing to drink at every social outing or at every function for every celebration.

Pedram Shojai: totally. Totally. And so what is that for someone, being that we’re in menopause awareness month, what is that for someone who’s starting to feel the changes? Someone who’s, you know, the, the, the light on the D H E A or the 1708 or all these, you know, kind of baseline hormones are starting to flicker.

Kavita Desai: Mm-hmm.

Pedram Shojai: Um, what happens when you absolve from that?

Pedram Shojai: You don’t eat up your liver anymore, right? Like all these little lifestyle

Kavita Desai: your gut microbiome. Yeah, because women, as, as our estrogen goes down, it all, it automatically almost throws off our gut microbiome to begin with. So the less we’re throwing down there to inflame the gut further and kill off that microbiome, the better. Um, So yes, I generally recommend, you know, at least limiting your alcohol consumption and also, especially at night, because now we already have sleep disruption.

Kavita Desai: So now we’re throwing in a chemical that 100% ruins our deep sleep, so we sleep even less well. Um, so in general, yes, is it best to avoid alcohol or at least limit it to, you know, and for women, the amount per week is actually very, very low. Um, And then trying to replace some of that, right. With a good probiotic or probiotic foods, prebiotic foods, um, it’s very simple to have a healthy gut if you put the right things into your body.

Kavita Desai: MID BUMPER

Hey, quick interlude. Hope you’re enjoying this podcast as much as I have, um, wanted to let you know that the help you seek is out there. I have, um, very specific courses. We did a 10 part series on women’s hormones called hormones, health, and harmony. Uh, masterclass called hormonal health on women’s hormones. Um, all inside the academy, you can check those out. Uh, 10 part series on gut microbiome called interconnected six part series called gut check. Look, we’ve been having these conversations for a while. Welcoming Dr. Decide to this party. Um, adding to the body of work that is there to help and support you. Uh, so check it out. Um, education will get you across the line. There’s no magic pill. There’s no silver bullet supplement that fixes this, but you are the person that fixes this. So inside of the context of menopause awareness month, There is help. There is information, uh, check out doctor to size resources. Of course. Um, And then check out what I have in the academy for you. Look, we’ve done a lot of work to help you not be alone in this.

Pedram Shojai: Yeah, which is, you know, the, the challenge too, right? If you’re driving through the country and Applebee’s is the best place you can eat, you know that that does happen. Um, but you know, for the most part, most of us can control set and setting, and I. Go to the grocery store and cook. Right. Um, you mentioned one thing that I wanted just before my brain leaves that just, you know, someone heard what you said maybe five minutes ago, and it’s like, what about, you know, estrogen specific cancers and all that?

Pedram Shojai: Like, how do you not test, how do you not know that there’s the risk of, you know, all these things? Like we got very afraid. H RT because of a couple studies that came

Kavita Desai: Mm-hmm.

Pedram Shojai: to some of the cancer risks, and now you are saying something that’s in the face of that. I just, you know that for the person who scratched their head five minutes ago, please.

Kavita Desai: Yeah, so interestingly the contraindications for estrogen have changed where a family history is no longer a reason not to use estradiol. Um, if you have had, if you personally have a history of breast cancer, then yes, we still don’t recommend it, although . They’re not sure. Right? There may come a day where it’s still safe.

Kavita Desai: But for now, if you have a history of blood clots or a history of breast cancer or personal history, then we don’t recommend it. But if you have a family history of any of those things, it’s, it’s considered perfectly safe. And they’re thinking it may actually help reduce the risk of breast cancer rather than causing breast cancer, which was the original thought on estrogen.

Kavita Desai: So, you know, and again, it’s a personal choice. It’s not something I . Insist every woman do, but I like women to have their choices. Right? I want them to be educated on it, and then it’s up to them if they feel comfortable to do it or not.

Pedram Shojai: Totally, totally. And just be informed, right? Everything comes with something, right? There’s, there’s always a little bit of a downside you gotta think through. But I, I’ll tell you, I was a, how do I say this? Hippie naturalist, purist for a, a part of my career. Um, and the results in some areas were just, Lacking.

Pedram Shojai: And you see some of the results with H R T and you see complete turnaround of life and, you know, not just sex life, but you know, sleep is back and health is back and all, you know, it’s, it’s undeniably positive for many, many people. Right. And so how you go about it, sure. We could talk about, you know, the nuances of how you do H R T and bioidenticals and all that, and doctors, you know, fight about this.

Pedram Shojai: But the, the idea that, you know, You should never supplement because it’s unnatural, I think is, I think that ship has sailed. We’ve seen enough positivity around that. Now, someone who’s listening to this, who’s like, holy crap, is this me, you, you had, um, you know, you’d mentioned that it’s, you know, earlier that, you know, age 36 and up, you start to recognize some of these symptoms, but you have to know what to recognize.

Pedram Shojai: So I would love for my listeners to hear what it is that could be the, the, the alarm signals to say, Hey, this could be you.

Kavita Desai: Yeah, so this is where I feel we’re very, very undereducated because we, you know, we have these stereotypical . Symptoms that we’ve associated with, with menopause or perimenopause, which is, you know, the hot flashes, the weight gain, hair loss. You know, we, we expect those things and when someone has that, we’re like, oh, she’s 100% perimenopausal.

Kavita Desai: But there’s so many others, um, that I think women aren’t aware of. And if you start to have a cluster of them 100%, you’re in that phase of your life and you can’t be told you’re too young because. There is no, you know, definite start and definite finish to menopause, but it’s things like joint pain, muscle pain, um, tinnitus.

Kavita Desai: So some women get like a ringing in their ear, you know, dry skin, vaginal dryness, um, mood disorders, like a lot of irritability and. Just changes in personality. Um, we start to see gut microbiome, you know, disruption and reflux. So just digestion. Digestion in, in general tends to be disrupted. Um, sleep disorders, uh, I mean, you name it, even like glucose intolerance, right?

Kavita Desai: We start to see a lot of blood sugar issues, which is why diet becomes so imperative, um, that our bodies just aren’t functioning as optimally as they were right before our hormones started to fluctuate.

Pedram Shojai: You know, it’s interesting, um, it’s kind of become more central now, is this mental health crisis, you know, since Covid in particular. It’s just, holy crap, this is bigger than we. Um, there’s a, a, a very significant tie in with hormones and mental health. I mean, personally, I’d see this all the time and, you know, patient, she’s just down and sad and blue and doesn’t have what it takes to be the mom she thinks her kids deserve, and the wife and the this.

Pedram Shojai: And then, you know, juggling 27 balls. And then you look at the hormones and you’re like, yeah, a little testosterone, a little estrogen, a little whatever. Boom. She’s back, she’s, you know, rocking it. She’s back. She’s, she’s not only is she not blue, she’s owning it and she’s like managing her household in like, as a professional, as a mom, as a all of it. One change. Right. And, you know, years of therapy didn’t do it. So that’s also an area where I’ve seen a lot of leverage in understanding that your mental health, um, challenges might also be hormonal. How do you, how do you, I mean, I don’t wanna say self-diagnose, but how do you know, how would you know if your mental health is potentially being compromised by the hormone deficits that you don’t know about?

Kavita Desai: Yeah. I think if it’s something that you’ve struggled with your whole life, then there may not be as much of a tie into your hormones. But if it’s something that’s starting to happen at the same time that you’re starting to experience other perimenopausal symptoms, and they’re milder, right, in the sense that, you know,

Kavita Desai: You’re still getting through your day, but you’re feeling more irritable or you’re feeling moodier or you’re feeling a little bit blue or depressed like you said. Um, then I think it’s worth having your hormones checked to see if they are on the lower end and then it can 100% be reversed with replacing some of those hormones, um, or making lifestyle changes.

Kavita Desai: But that’s a little bit harder, right when it’s, um, when it’s based on a hormone insufficiency.

Pedram Shojai: Yeah. And the challenge obviously is, you know, I gotta feel like getting out of. Bed to feel like walking and feel like go to the store to get the stuff for the green smoothie. I mean, there’s a lot of things downstream from, you know, getting up and starting with the initial motivation. And I think that’s where a lot of people also are getting stuck, right?

Pedram Shojai: It’s just they don’t, they don’t have the mental, physical, emotional wherewithal to take on the day. And that’s also potentially a sign around perimenopause, right?

Kavita Desai: Yes, definitely. And it happens to just also be . , it happens to women probably at the worst time too, right? Like if you had to think the age bracket where this is happening is also when women are probably very busy in their career. They may have young kids, they may have teenagers, right, who are also now going through their own hormonal fluctuations, which is its own game.

Kavita Desai: And then, you know, you may have aging parents that you’re now having to take care of. And that’s a lot of stress at a time where you’re now, now not feeling a hundred percent and you still have to function and take care of everybody around you. It’s a lot.

Pedram Shojai: So there’s a few levers we can turn, right? Obviously H R T adjusting hormones, that’s doctor stuff, right? So you have to see a qualified healthcare practitioner to make those adjustments. Uh, Lifestyle. We started talking about, um, you know, obviously stress management, moving your body, eating better. Uh, the obvious stuff that we talk about on my podcast all the time.

Pedram Shojai: But what specifically can we talk about for women and supplementation that you’ve seen? I mean, you have a very colorful history in, in a way where you came from farm and now you’re kind of a supplement person, uh, which is, which is, you know, really revealing. Right, and we all know supplements work, but we all know that it’s also a dumpster fire out there, and there’s a lot of hyperbole and a lot of people that lie.

Pedram Shojai: So from someone who’s, you know, got a solid education has been around the block on this, what supplements do you like and why for this category?

Kavita Desai: Yeah. So for me it was coming at it from two different angles, just me personally when my mom was diagnosed. Um, and I started researching a lot about what I can be taking to kind of add to my prevention or my prevention strategy. So I like to, I like to kind of liken our risk of disease to. You know, the hull of a ship, right?

Kavita Desai: That if you’re, you have the, you’re a boat and you have numerous holes in the hull of your ship. Now if you plug one or two of those, you know, you can stay afloat for a little bit longer, but you’re still going to sink. Um, so my strategy for myself personally was to start addressing . Those risk factors.

Kavita Desai: So I, those, those holes in the hull of my ship are my risk factors for chronic disease. So for me, that’s not only cognitive decline, but it’s also what perimenopause is, is going to bring. So I like to address numerous things and I. So reducing stress is huge. We know that that’s linked to chronic disease as well as Alzheimer’s.

Kavita Desai: So I like to take things like adaptogens, um, turmeric, you know, things that can help reduce the stress on my body. Um, I like to address inflammation because we know during our perimenopausal years we become very inflamed, hence the joint pain and the muscle pain. Um, so I like to take a lot of the anti-inflammatory type supplements.

Kavita Desai: So again, turmeric, the omegas, um, We know that vitamin D is linked with a lot of chronic disease, so I like to make sure I’m getting enough vitamin D. And interestingly, in our practice, we tested almost every patient that we had for vitamin D and they were all low, every single one. So I think we’re all probably on the chronically low level of our Vitamin D and my goal is to, um, try to increase that and.

Pedram Shojai: Sorry, sorry. There’s, uh, sorry. Real quick. There’s some real likes. Serious banging noise in the background.

Kavita Desai: That’s not me.

Pedram Shojai: is that you? It’s gotta be al. She’s muted, but she’s coming through. Hold on a second. Allair, um, Allair. I don’t know what happened, but I have you muted, but I hear all the background noise all of a sudden.

Pedram Shojai: On on. Okay. Shoot. So let’s start at the vitamin D again. Um, So just, just, I don’t know how far back that went. So we’ll just start a vitamin D. Uh, yeah, it went away. There was like dishes and stuff in the background, so, yeah. No, it’s, it’s clean now. Yeah. You were on mute. I don’t know why. It just, it gave me a warning about your storage space and then suddenly it, like, lost the script on your, on your, on your mute.

Kavita Desai: Okay, thanks

Pedram Shojai: you’ll hear the recording. All good? Yep. Thank you. Yeah, no problem. No problem. Okay, so yeah, we’ll go back to just vitamin D and hold on a second. Edit team. Uh, we’re cutting back in about three minutes. Okay.

Kavita Desai: Um, so we know that vitamin D is linked with a lot of chronic disease, so I like to make sure I’m getting enough vitamin D. Um, and in our practice we actually tested numerous patients and they were all low, um, their levels. So I always advocate for taking enough vitamin D, um, and then addressing sleep. So I like to take like, you know, magnesium and healthy and even in the evening to make sure I’m getting a good night’s sleep.

Kavita Desai: Um, And then gut health. So I do take a probiotic every day. So my approach is kind of very multifaceted. I’m trying to address, again, all my risk factors.

Pedram Shojai: Yeah, and that’s kind of, you know, the challenge is, People today, if they listen to any of the advice out there, are taking 20 supplements a day. Right. And then you start to, you know, get to the place where you’re like, holy crap, do I need all this? And the short answer unfortunately, is yes, , right? Just ’cause there’s so many systems that have so many challenges in our, you know, modern world between the toxins and the lack of nutrients and all that.

Pedram Shojai: Right. Um,

Kavita Desai: Yeah. And that’s the thing,

Pedram Shojai: go ahead. Go

Kavita Desai: ahead. No, I, I agree with you. I think that’s part of the reason it sounds insane, right? When people hear how many things I take, but, and I eat a fairly clean diet. We try to eat a lot of vegetables and, you know, a varied diet. Um, however, The way our water system is now, the way our soil, um, our, the lack of nutrients in the, I don’t think our food is the same as it was in generations past.

Kavita Desai: So I can’t take that chance, right? That I’m getting everything I need from the food I’m eating. Can I even get clean sources of every, you know, item of produce that I’m buying? Probably not, right? Or the proteins that we buy. So I think for me, it’s, it’s worth addressing it all from as many angles as I can.

Pedram Shojai: Yeah, and, and it’s a free roll. I mean, there’s, you could overdo it on vitamin D, but I’ve never really seen someone. I’ve seen there’s . One guy, a personal trainer I met who was uh, doing so much, I think he was coming out of his ears. He’s fat

Kavita Desai: Yeah.

Pedram Shojai: You know, there’s issues, but most of us are just, you know, really, really severely deficient and that that will persist given all of the, you know, the arrows that are flying at us.

Pedram Shojai: The system needs more help.

Kavita Desai: And that, you know, At normal doses, like up to about 5,000 units a day. It’s not toxic. Right? And you, but you can easily treat with a blood level too. If we’re worried about that, that’s actually one that’s very easy to test and see how low you are. And as I mentioned, most people I know are low. In fact, I was supplementing kind of low dose supplementing and my blood levers came back low.

Kavita Desai: So I think it’s a, it’s a common and pervasive issue.

Pedram Shojai: Yeah. Okay. So for the time we have left, I really wanna come back to this starting point of how healthcare treats men and women differently, and why you believe women are slipping through the cracks in a system that. Isn’t designed or at least optimized for their care.

Kavita Desai: Yeah, I think, you know, there’s no gender bias from my perspective. I don’t think either gender is being properly treated because again, like as I, as I said, I do believe in prevention. I, we don’t wanna get sick. ’cause then all you’re doing is you’re backpedaling and your body can never function the same again.

Kavita Desai: Right. Once you’ve already had. An occurrence of a chronic illness. So I think both genders are at a disservice. Our medical system needs some work, but I think for women, what makes it particularly challenging is that our system is just so much more complic complicated. So we’re not studied. Right. When clinical trials are done, they’re not specifically looking at women.

Kavita Desai: That would be far too hard. Our bodies change on a weekly basis, right? We’re are hormonally, we’re, we’re not the same from day to day. So it’s hard to extrapolate to women. So there’s kind of this like . General consensus that’s made in healthcare. This is how we treat everybody, but it’s not always correct for women.

Kavita Desai: I think for some disease states, yes, it’s fine to generalize like that, but as we know for women, we have a massive meltdown of an entire hormone system in our body that’s essential for, for us to function normally. So I think that’s where we’ve slipped through the cracks. We’ve normalized it. We’ve told women that to suck it up and you know, endure.

Kavita Desai: Um, and I think . I don’t think we’re quite at the point yet where women can outwardly talk about it and still not be considered crazy for, for discussing their menopause.

Pedram Shojai: We’re hysterical, right? It’s still, it’s still a thing. Uh, you know, although the words are being used less, it’s still an energy right? That’s out there. I. I’ve, I’ve seen cases with men, with gynecomastia. I’ve seen hormone disruption in both genders. How much of it through, say, the soaps, the detergents, the, the, the soy and everything, and the xenoestrogens, are you seeing, uh, pushing, uh, especially the female side of these pathways into places where they’re just, you know, not normal anymore?

Kavita Desai: You. Yeah, no, I’m a hundred percent concerned. Right. And I think . It is a problem. It’s in everything. It’s everything we touch. I was actually reading an article once of, um, you know, the writer decided to try to go 24 hours without touching anything plastic, and it was impossible. He couldn’t do anything. He couldn’t turn a light switch on, couldn’t turn the knob on his stove.

Kavita Desai: So we’re very, very, like, we’re just surrounded by toxins and there’s not much, I mean, again, not to be, you know, An alarmist. We can’t change everything about our society, but I think if we don’t take care of our inside, we can’t even release those toxins, right? Then. They’re just gonna build up in our body and they’re forever chemicals.

Kavita Desai: They’ll be around and there’s simple things we can do, like be filtering our water, choose glass over plastic, like some things, like those kinds of changes are easy and I think easy to implement.

Pedram Shojai: Yeah. And listen, I think we all have this kind of initial instinct to wanna run for the hills, right? Circle the wagons, protect the cubs, you know, it’s just get away from all of it. And, and it’s not, it’s not to your point, it’s the literally the knob on your stove. Um, you can’t get away from the plastics.

Pedram Shojai: So what can you do? And then the question becomes, okay, what do I do to build my resilience? What do I do to support my detox pathways and what do I do specifically to give my body the best fighting chance it can have? Right? And those are

Kavita Desai: can do.

Pedram Shojai: it. That’s what I got. Right? And so that’s food, it’s diet, it’s sleep, sleep, it’s stress management, it’s supplementation, it’s, you know, whatever we talked about.

Pedram Shojai: Um, and yeah, sure, go lobby your congressmen. If they’re not busy, you know, screaming at each other and fighting over stupid stuff, we could pass legislation to potentially start getting these things outta the supply chain. But right now, immediately sitting in your chair right now, . You’re gonna, the grocery store, you are doing these things in your life.

Pedram Shojai: Clean up your own supply chain, clean up what goes in your body, and give your body as much resilience as you can. And that’s, I think what I’m hearing under all of what you’re saying is, you know, you have to live this way.

Kavita Desai: Yes, it has to work for you. You have to make the choices that work for you, and I think you know, . No one can make 100% of the changes that I will recommend. Right? This is a take. What works for you. Try to have an 80 20 rule and do as much as you can, um, that fits into your lifestyle, right? Because I think that’s all we can do.

Kavita Desai: We don’t actually know what’s gonna happen in 20, 30 years to our bodies, so I think we just have to give it, as you said, the best fighting chance.

Pedram Shojai: Yep. And so you’ve been, uh, working for a minute on formulating supplements for women specifically. You have, uh, been, uh, you know, you got a dog in this race. Now you’ve left pharma, and now you’ve . Built, uh, an entire business around this, uh, and have been helping a lot more. Frankly. You know, at scale you’re helping a lot more people.

Pedram Shojai: What are you seeing? What’s the downstream effects that you’re seeing with customer testimonials and all that? Like, I, I’m sure it’s just, you know, we get flooded with it with everything we do because no one’s out there trying to help people. On the prevention side, you do it, you’re twisting a dial. That gives you a lot.

Pedram Shojai: A lot of leverage, right? A lot of positive changes. Would love to hear what you hear from the people you’ve helped.

Kavita Desai: Yeah, so, so far we haven’t actually officially launched our supplement system, but of the women that have trialed it for me, the number one thing I’m hearing is that they wake up with a much clearer mind. Because brain fog is something that a lot of perimenopausal women experience, and they’re sleeping better, which, you know, if you sleep well, you’re gonna feel so much better during the day.

Kavita Desai: So I’m hoping. That in time if more women, you know, try this or prioritize their, their health in whatever way works for them, um, you know that I’ll be hearing more and more of that. And if nothing else, the education component that we’ve been providing for the last couple of years, like women are just grateful to have somebody that’s actually responding to their questions and, you know, kind of giving them some insight onto what they should do next.

Pedram Shojai: Yeah. And it’s hard because by the letter of the law, you can’t practice medicine and give health advice online and people will come, you know, it’s like you open yourself up to help people and then all of a sudden they’re like, here are my labs, right? And they’re go, no, no, I can’t, I, I can’t, I can’t do that.

Pedram Shojai: I’m so sorry. I, you know, literally, legally I can’t help you like that. And so, you know, our hands get tied. As

Kavita Desai: Mm-hmm.

Pedram Shojai: and physicians in how we can help. And so we can educate and we can, you know, really kind of come forth with the best wisdom and the knowledge. But then that’s where telemedicine, that’s where good functional medicine, that’s where all these other kind of places where, you know, no one slips through the cracks can go.

Pedram Shojai: You know, the challenge obviously with that is, you know, cost money. Cost

Kavita Desai: Yeah, that’s the thing.

Pedram Shojai: number one stressor, right?

Kavita Desai: That’s very, very true, and I guess that’s the thing. You have to do what works for you, right? It’s easy for me to say, you know, take the handful of supplements and see a telemedicine practitioner. If that doesn’t work, there are very, very simple things that you can do at home.

Kavita Desai: Right? To make yourself, to help yourself feel better. I,

Pedram Shojai: Totally, totally. I have people that have just swapped out, you know, leafy green vegetables and fer, done their own ferments and just basically hack their kitchens into a much healthier, you know, environment and seen, I mean, game changing, like doctor calling saying We need to rerun your labs. These must be wrong kind kind of cases.

Kavita Desai: Yeah, and just being active, and I think you can reduce stress just by being mindful or journaling or going for a walk in nature. Like those are all, you know, cost effective and, and very effective.

Pedram Shojai: Totally. Totally. Uh, listen, what a pleasure. I appreciate the work that you’re doing. I’m excited that you are, um, stepping bigger into this world. Um, how can people find you? What’s your website? What’s the best way to find your work?

Kavita Desai: Yeah, you can find us@revivele.com , and our Instagram platform at revivele dot inc.

Pedram Shojai: Love it. Thank you so much. This has been great.

Kavita Desai: Yeah. Thank you.

Pedram Shojai: ENDING

Pedram Shojai: Okay. That’s a wrap with Dr. DSI. Hope you enjoyed it. Uh, her website, revivele.com . Uh, she has a women’s specific supplements that have been catered to the specific needs of the audience she’s been serving. Um, and you know, again, if someone’s going to be talking supplements and has a pharmacology background, I’m interested in hearing what they have to say. So. You want to work with experts? You want to work with people who know what they’re doing. Um, I like the work that she’s doing. She has a book called lady parts, putting women’s health back into women’s hands. Um, February 20, 23. So, um, you know, look, she’s, he’s got a lot to say, and I think she has an important piece of this that she’s contributing to. So follow Dr. work. Uh, menopause awareness month, help another person out. What you know now. He has to carry through what, you know now has to move through you and help you and help others. So, you know, help yourself help another life. This is how we break free of a broken medical system and get back to true health. Hope you enjoyed it. I will see you in the next podcast.

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Dr. Pedram Shojai

NY Times Best Selling author and film maker. Taoist Abbot and Qigong master. Husband and dad. I’m here to help you find your way and be healthy and happy. I don’t want to be your guru…just someone who’ll help point the way. If you’re looking for a real person who’s done the work, I’m your guy. I can light the path and walk along it with you but can’t walk for you.