Marie Kare: Absolutely. I love your podcast voice. It's terrific. So let me start by saying I am not a doctor. I am not a trained medical physician in any way, but I am a human being experiencing perimenopause, and I have a tendency to go all in on things I'm up to. So I've done a lot of research.
So the word perimenopause literally means around menopause, and menopause is specifically the one day that is 12 months from your last period.
So that could be anywhere. I believe the National Institute of Aging said that it's somewhere between eight to 10 years long. It can be up to 14 years long. Yes, it typically happens in your early 40s to 50s. But we are seeing people getting it younger and younger. There is precocious perimenopause, or people getting into this phase of their life in their early 30s, so it is a very interesting experience. Would you like me to give an overall description of what's happening to the body?
Felicia Shakiba: Yes, please.
Marie Kare: Okay, so what's happening, typically in perimenopause, is that your ovaries are producing a little less estrogen, and we need estrogen for everything. Men have estrogen in their bodies, and so that diminishing estrogen is causing a lot of hormonal upheaval. There's a misbalance between estrogen and progesterone, and your hormones fluctuate throughout the day, causing a variety of symptoms, and those symptoms are vasomotor which most people associate like hot flashes, night sweats. There can be urogenital ones. These are ones that people typically are a little shy to talk about, like vaginal dryness, urinary incontinence, just fibroids in the uterus. These are uncomfortable things, but there are real things that happen to people. Sleep disturbances. I mentioned night sweats already, but you can also have insomnia.
There's a thing called cortisol awakening response that gets you up pretty early with a flush of cortisol, which is the stress hormone, and there are psychological ones, mood disturbances, anxiety and depression are frequent, and early symptoms of perimenopause, brain fog can be something. One thing I've read about on forum, sorry, there's so many things, perimenopausal rage. Wow, what a fun, sexy time for us?! And then there's, like, the general physical symptoms, so skin changes, like your complexion can change. There can be hair loss, again. Estrogen is so helpful for all of these things with your soft tissues, mucous membranes, hair loss is a rough one, osteoporosis, bone loss, palpitations, fatigue, and there are a lot of symptoms I can't recall offhand, but I think it's 37 different symptoms associated with perimenopause, and it's because your hormones are changing, and that upheaval is disrupting your status quo, and it's challenging for your body to adapt.
Wow, so it sounds like, there's just a lot going on with women in this but or some women in this age bracket, and that could essentially affect a lot of things, both your personal life and your work life.
Marie Kare (05:13): Yes, I don't want to be a scaremonger. I've listed a lot of potential symptoms of perimenopause. About 80% of women, I understand, will experience some of these symptoms, particularly vasomotor or mood disorders. But yes, there is a lot going on. Would like to say not everyone experiences these things. I was reading very recently in I believe, r/menopause, which is a subreddit that there are some people who had no idea. They had an IUD, they had it up, and they were already postmenopausal. Amazing, no symptoms. And then it's a gamut. Everyone is different. Your mileage may vary.
Felicia Shakiba: Interesting.
Okay, so how did you first become aware that you were going through perimenopause, and what were some of those initial challenges that you might have faced?
Marie Kare: it's very interesting, because I don't think I reflected on it until you've asked this question. I would say there was a point at which I started feeling that there was something wrong, and I said to a colleague, and this was before I was at my current workplace. I said to a colleague, I think I'm having a nervous breakdown. I just felt so wrong. Something was wrong. I felt anxiety for the first time, and I had never experienced this before, and my sleep was weird, and I couldn't figure out what was going on, and the symptoms just cascaded from there. I started getting sleep disturbances. I started getting night sweats. I started getting hot flashes. And it was all very surprising. And of course, if you add things up, when you list it out loud, like I just did, that sounds like perimenopause, but no one had ever talked to me about perimenopause before. No one had educated me about it, so I didn't really know what was going on.
And I remember just Googling for a while, 'What are these symptoms I'm having?' and someone suggested perimenopause in one of the forums I read, and I went to a doctor, and unfortunately, as is the case, sometimes she was rather dismissive. She said, You're too young, you probably just need to lose some weight, even though, by the age I was then, my mother had already completed menopause. She was post menopausal, so even with the background, even with the symptoms, she just dismissed it. And so I for a while just thought, 'Oh, I've developed anxiety and depression,' and I went to psychiatric care for that and started taking medications. So it took a while for me to actually come to this conclusion. And luckily, I found like a physician who was like, 'Oh, have you considered that it's perimenopause?', and the treatments since then have been tremendous.
Wow. I'm very happy that you found a doctor that was able to pinpoint what the challenges were coming from, and thank goodness for that doctor. And so I want to go into a couple other things, which is one, being once you realized what this was, how did you approach having open conversations about your perimenopause experience with your colleagues? What were their reactions?
Marie Kare (08:28): It's so interesting. Not everyone has this luxury, but I very much enjoy being myself at all times. I find it very challenging to pretend or obfuscate subterfuge is really anathema to me, so I didn't have an approach. I simply continued to be myself, and myself, especially at my current workplace, is welcomed. I don't know how familiar you are with Reddit's mission, which is to bring community, belonging and empowerment to everyone in the world, but it is a workplace that very much welcomes one's authentic self. So I was very active in our ERGs, like Ability Reddit, Asian Network, Women of Reddit. And so what I did was continue to be myself, but now in perimenopause, which is posting to our Slack channels, women have read it.
"Period-yelling," which is one of my favorite Slack channels, where you just post.
Felicia Shakiba: I love that every organization should have that Slack channel.
Marie Kare: Yes, 'period-yelling' is amazing. And I just started posting there in Slack about what's going on with me, and I got support. People who were experiencing the same things. People from different sides of the organization that I would never meet in my day-to-day were coming like, 'Me too, Sister, this is happening,' and it was so great to just know that other people were experiencing it, hearing from them and also, surprisingly, it was really validating to hear from people who were not experiencing it, but were curious about it, because it might happen to them or someone they love. And that was so helpful. Because I think there is this massive stigma around being in this age range, even though it can happen quite young that to experience perimenopause or menopause, and it really helped diminish that perceived stigma, because I was hearing so many positive things from other people, maybe not positive. Let's get real. Some of it was terrible, but people were responding in a positive way to knowing each other, knowing our own experiences.
I think it's fair to say that most people know at least one person going through this, whether it be their mother, their wife, their sister, their best friend, you know, so I feel like it's really that type of communication is not just for people with perimenopause, it's maybe people who are like, 'How do I handle this with my colleague, or my best friend in the organization?', and so what did that do for you when you got that feedback and that community and that feeling of belonging, it sounds like what did that do for you?
Marie Kare: Well, I think I am not alone. This will sound ironic. I am not alone in feeling that perimenopause is an isolating experience. It feels like something has come over your body. It's so physical, you don't understand what's happening. And sometimes I feel like a stranger to myself what is happening. My body's betraying me. And so when you're feeling this isolated, having that response, having those people share with you breaks down that isolation helps you feel connected. And we're a remote company, primarily there are offices, but I'm connecting with people internationally, different departments, different locations, and they're there when I'm there, online, sharing our experiences. And I can't say enough about how much it helps just to know someone else is going through this with you.
It really does heighten that sense of belonging, what it sounds like, and sense of belonging is really important, not just in your personal life, but at work. If you don't feel like you belong at work, there's a pretty good chance you're going to leave that organization fairly soon, and I can only imagine how much that community or that feeling of community, has really allowed you to thrive in your own space at work.
Marie Kare (12:34): I think that we've discussed this on our previous call, but the impact economically to women is huge during perimenopause, and I can imagine that some of it is this isolated feeling, as though you can't share with other people what you're going through and not being accepted for what you're going through. 23% of people in perimenopause will leave the workforce. I don't have the number in front of me, but it's quite a lot of women, and I know that right now, there's an estimated 47 million women in the US alone who are menopausal or post menopausal. And forgive me for reading out a stat, they're estimated by 2030 the world population of menopausal and postmenopausal women will be 1,247,000,000 people who've had uteruses at some point will become part of that group every year. That's a huge amount of people who are not connecting, not feeling they can be themselves at work, feeling that they have to leave the workplace because of their symptoms. And that's a tragedy.
It's an astounding number. And so being at Reddit, I'd love to learn more about what type of support have you received to help manage your well being, and is the support that they're providing working for you? I know you mentioned the Slack channel, and that sounds like I said, every organization should have 'period-yelling' at one point, what's working for your well being?
Marie Kare: I think a huge part is my boss. So I have a boss who is in my age range, and when the symptoms got really bad for me, I got very self critical. I am used to performing at a certain level, and I'm tired and I'm moody and I'm hot all of a sudden, and just didn't feel like I was doing well. So I went to her, and I'm like, I don't think I'm doing well. I think I'm failing. And what was helpful about that was getting outside your perspective. She didn't think I was failing. She thought I was doing a good job. Hey, maybe my hormones and what's going on with me. My lack of sleep are impacting my judgment and my self assessment. So that was really helpful. It was also helpful to have a person who is an authority figure share with me that she again had very similar experiences where she was going through some hormone challenges. The doctor was dismissive, she insistedon treatment. The treatment helped her tremendously, and she said she would go on record as an advocate for the treatment she received.
So I hope everyone can have a supportive boss. Maybe they won't necessarily have a boss that can relate to their specific experiences. I was very lucky there, but that was helpful. I did reach out to my HRBP and just see what kind of services are available to me. And we have Carrot and Lyra. And so I think a lot of companies have Carrot, but everyone I know associates it with strictly like fertility, but the menopausal transition is part of fertility, and they have services for perimenopause and menopause. Had no idea until I spoke to HR, and then I haven't used carrot. I haven't used Lyra personally, but just being armed with this knowledge, people have reached out to me because I'm so open about it, and I've been able to help them get hooked up with Carrot. Get hooked up with Lyra, because it's so overwhelming you need support, and thankfully, we have services to support here
What do you think men's roles are in these situations? How can they best support the women that they work with, with whom might be having the same experience?
Marie Kare: Well, I certainly can't speak for men on behalf of them. I want to say that I hope that men's roles are similar to everyone's role in this, which is be a good human, be a supportive colleague and be open to the experiences of others. I think I did have some tips in general. First, let me say that some of the most engaged people, most supportive people, when I've been open about perimenopause, have been men, male colleagues. I briefly... Oh, go ahead.
Felicia Shakiba: No, really, I'm just...it's my surprise face.
Marie Kare (16:59): Yes, there was a brief period where I considered having my own podcast about perimenopause in the workplace, but unfortunately, it's rather taxing. The stories that women shared were not all as positive as mine, and it was very disheartening to hear some of the struggles that people had gone through, but I was posting about those openly on LinkedIn, which I was told later, felt like a really dicey thing to do, but the most active engagement came from men. I remember, David from Supermoon, reached out, and he was like, I am so grateful you're going to do this. My wife is experiencing this, and she works, and no one is talking about it at all, and I can consistently received really positive feedback from men. And interestingly, a colleague told me she felt that women weren't engaging with this content because she they would be outing themselves because of the stigma. They might be letting people know how old they are, letting them know that they might be experiencing something with their mood or physical health, where men didn't necessarily run that risk, but then could express their support on behalf of others. So yes, men are surprisingly supportive that I found.
Felicia Shakiba: That's fantastic, and I think that men do have a very important role in this type of situation, like the like I said before, like those who have wives and colleagues and sisters, men are also surrounding this type of experience, and can be the ones to have that empathy and remind you to be good to yourself, even when you're not always going to be at the top of your performance 24/7. We're human, and we have things happening to us and to our body, and especially at this age.
How have you coped with the emotional and psychological impacts of perimenopause at work?
Marie Kare: Oh, it's been very challenging frankly, I would say. I struggled, and I struggled a little less, and I continue to struggle a little less every day. So I think at first there's the denial, because there is that stigma about age, and then you just like, this isn't happening to me. I'm young. I still want to believe that's not me. It's just been hard. I have therapy, I have support, I have friends, I have family, I have support at work, my physicians, now that I've gotten all my ducks in a row, are incredibly supportive and responsive. Have been open to discussing therapies that I've been interested in, and for me, hormone therapy has been a game changer, especially for the mood disorder stuff, it's an incredible difference that for me, if I may be incredibly frank and possibly TMI about it, one of the possible symptoms I mentioned was like fibroids.
And I had surgery earlier this year, and that surgery helped tremendously, because the..so things in your uterus, unfortunately, can impact your hormones, and the hormone fluctuations you experience daily impact your mood. And so you're going through this roller coaster every day, and I think just the anxiety of what the roller coaster is is so challenging that surgery terrified of it. Primo, excellent. Literally, would do it again. My first surgery ever I was terrified and was such an incredible help. Again, I'm not a doctor.
No, but I think that there's going to be women that are like I said, are experiencing the same thing, and to know that they have that option, ask questions and be curious. I think it's really important to mention, in your opinion, what's the biggest misconception or lack of awareness around perimenopause that really needs to be addressed?
Marie Kare (20:48): Lack of awareness is the biggest lack of awareness. People simply don't know that this is a thing. Women within my age range, that with whom I work are like, what's perimenopause? Never heard of it personally, until it happened to me. My perception of menopause was, one day my period will stop and I'll have hot flashes, maybe. And that was not a very robust picture of what actually goes on. Only when it happened to me did I understand, like, the full picture of what could go on. So just awareness in general seems to be lacking. But I will say not to be very negative, there is a huge increase lately. I don't know if you've seen it, like people openly talking about the menopausal transition, a femtech got like wicked money over the last several years in startups, there are a lot of incredible startups with like telehealth, even IRL clinics that specialize in the menopausal transition.
I know the North American menopause society rebranded to be menopause.org There are just so many things, like an old research study that suggested that hormone therapy was highly associated with breast cancer was shown recently to be overblown, and that unfortunately, a lot of women were denied hormone therapy based on not the best positioning of research, because the incidence of breast cancer as a result of hormone therapy was largely overblown. There are a lot of good things happening. People are talking about it. Celebrities are talking about it. Woo. And people are making big investments. It's a big audience that you can market to. So people are like VCs are and funding startups.
Felicia Shakiba: I'm very happy to hear that the word is getting out there, and to be quite honest, I didn't even know what that was until you mentioned it to me. No, I'm very thankful for you to share that.
And what do you think organizations should be doing to better support women experiencing perimenopause in the workplace?
Marie Kare: Education, clearly, there's a lack of awareness. So if there can be educational programs purely opt in, not mandatory, where they could just give people the option to learn about reproductive health in general, amazing, or maybe give them this episode, yes, absolutely, it's just put it in one of the trainings, and they have to click through. But absolutely, just education, certainly, we have all kinds of different options at work. I know that we have an education session about, like, infertility treatments once, but haven't seen anything about permenopause quite yet. So I would love to see that. It's weird just talking about it in our benefits training, or when you're talking about benefits, because I did know that we had carrot and I did know that we had a stipend for fertility and reproductive health, but I didn't know that perimenopause was part of that. It didn't even occur to me until I spoke to an HRBP about it.
So if they could be more open. So absolutely education. I know that we've had educational sessions in the past at Reddit where we learned about like different infertility treatments. But wouldn't it be wonderful to have like, perimenopause sessions where we can learn about perimenopause and what to expect? We have Carrot benefit. We have a stipend, in fact, for reproductive health. I wasn't aware, and I've been here almost six years. That included the menopausal transition, which is part of reproductive health.
So habituating the information, making it available to people, letting people know right off the bat when they're onboarded, reminding them of every time our benefits change at the end of the year or renew that would be incredibly helpful.
Because honestly, even if they had told me that there was support for perimenopause, I might not have thought about it until it came time for me to need it, at which point I wouldn't even know where to look. So just keep putting that message out there that support is available. There are so many women in this workplace, and so many people who have had uteruses that is going to affect them at some point.
For those who are men, or those who are maybe not at that age yet, for them to just be aware how they can be supportive to their colleagues who might be going through this is also important.
Marie Kare: Absolutely. I think we just need to start that open discussion. And I do think about this every time I post, like someone will ask about it. I posted, I think last week. This is so timely, and 'period-yelling,' perimenopause, was kicking me in stuff, and it was so hard. And a younger colleague were like, Hey, tell me more, and I, in all caps, told her more, like several paragraphs, because it is 'period-yelling' and you must yell, but never put an exclamation mark, it's all caps. Anywho. Then there's like responses to that. Maybe someone is shy about asking, but someone is out there and asking, and then other people see the information. The more they see it, the more comfortable they get around it, and we'll all be better off if we could just talk more openly and be ourselves.
Is there any other advice that you would give to women who may be going through perimenopause but are unsure of what's happening or hesitant to speak up?
Marie Kare (26:31): I'll first say, if you're hesitant to speak up, that's okay. You don't have to. Whatever you're comfortable with is what's right for you. You are going through an incredibly uncomfortable experience.
Make yourself comfortable, give yourself whatever comforts you can. It's hard if you're not sure what's going on. There are so many resources out there that you might not know of. Of course, I'm gonna plug subreddits like we have several subreddits that you could go to here are just like three that were helpful to me. R/menopause. Who'd thunk it? R/2xchromosomes. You know, that's a dicey one, but r/witchesvspatriarchy was, surprisingly, a very helpful one. And then there are, you know, there's a wealth of information.
Like the Mayo Clinic has some wonderful information, the North American menopause society, which is all called menopause.org they post on Instagram. There are startups and apps that femtech explosion is out there ever now, Perry, MIDI, Genev, Winona, there are so many more than that. So you can have telehealth. You can meet with someone when you go to the NAMS website, NorthAmericanMenopausesociety.org. You can find a certified NAMS practitioner.
Risa Kagan is a physician in San Francisco and has been working in gynecology, obstetrics for her whole career. She told me that most physicians that are practicing today probably spent maybe a half an hour to an hour learning anything at all about menopause during their general training. And her feeling was that practitioners now are about 10 years behind the actual science. That's incredible. She is really on, like, the front lines of it. So if your physician is dismissive, you feel like you're not being heard. You can push back, you can find help you need. And I'm not saying see every doctor. I know. That's not feasible for everyone, depending on their health care plans, et cetera, but there are things like telehealth available to you where it might be possible to find a practitioner or a healthcare professional who's more educated about specifically perimenopause.
Is there anything else that you want to share before we close this convo?
Marie Kare: Just thank you so much for having me, because I'm so passionate about this topic. I really want people to start feeling comfortable with going through perimenopause. Okay, absolutely, you may not feel comfortable physically, emotionally, it's rough, but like talking about it cool. Let's do it. Let's talk about it, because feeling less isolated is amazing, and we live in an increasingly isolating world. Connect, talk to people. It's so powerful. It really boosts your mood. It helps you cope in really hard times. I'm rooting for you people. Good job.
Felicia Shakiba: I love that, Marie. Thank you so much. You are so brave, and thank you for sharing something so personal to you. And I think that because you have shared, you have likely made so many more people in general, not just women, but just people help understand what they can do both personally and professionally at work, and I'm hoping that this reaches as many people as possible, so they learn and they're more aware of what's going on. So thank you.
Marie Kare: I hope so too.
Felicia Shakiba: That's Marie Kare, Head of Creative Global Business Brand at Reddit. If today's episode captured your interest, please consider sharing it with a friend or visit cpoplaybook.com to read the episode or learn more about leadership and talent management. We greatly appreciate your rating, review and support as a subscriber. I'm Felicia shakiba. See you next Wednesday, and thanks for listening.
