Tap the ❤️❤️❤️ if you're already playing holiday music and planning on decorating early this year. (I’ll be lucky if I get my tree up by mid-December, but go for it if it brings you joy!)
A couple of weeks ago, I promised that I’d soon be introducing you to the brilliant women who make up the Phosis advisory board. I’ve picked these changemakers not just for their expertise spanning multiple fields, but because of the ground-breaking way they’re empowering women by making education their mission.
Heather Bartos, M.D. is a friend, a podcaster, an author, an unforgettable speaker, a fellow bee-lover, and unlike any doctor I’ve ever met before. When she’s not treating patients in her private practice in Texas, or making straight-shooting TikTok videos about hormone health, you might find her blasting 80s hard rock (specifically The Scorpions) in her car to blow off steam. She’s a Gen-X bad-a** who’s loudly rejecting the narrative that women have to quietly suffer through their symptoms. In fact, according to Dr. Bartos, menopause rocks (which, by the way, is the name of her virtual consultation program).
There’s certainly a lot to fan-girl about when it comes to Dr. B, but the first time we met we bonded over a different – and surprising – part of her bio. In addition to her extensive training in Western medicine, she’s also a Reiki master and energy healer, which helps her be a more intuitive advocate for her patients. You’ll be hearing more from her (she’s a secret skincare enthusiast), but for now, enjoy this recent conversation and stay tuned as we introduce more incredibly accomplished women in the menosphere.
Q: What are some of the common stereotypes about perimenopause, menopause, or midlife, and how do you bust those stereotypes with your patients?
A: A lot of the concepts that have been fed to us about women in midlife and what that means have been patriarchal ideas — things like because we’re not in our child-bearing years we've lost our value as women. It’s just not true, and the proof is the list of women who are enjoying even more success in the second half of their lives than they did when they were 20 or even 30. Michelle Yeoh just won her first Oscar at 62. Angela Basset is in her 60s. Think about it: Stevie Nicks is still rocking out in her 70s on SNL. For some, menopause is when we're free for the first time to pursue whatever we want.
Q: What’s the most common complaint you hear from women when they suspect they might be in perimenopause?
A: Everyone thinks about hot flashes as the stereotypical symptom, but the most universal complaint I hear is this: “I just don’t feel like myself.” There’s a shift that tends to start in your early 40s. All of a sudden you’re not sleeping well, your energy is off, maybe you’re worried about your weight, maybe you have brain fog. It’s a sense of unease that’s multifactorial — women are exhausted for lots of different reasons, and shifting hormones can make it undeniably worse.
American culture tells us that we can work our way out of it by putting more things on our to-do lists so we can get the short-term dopamine hit of checking something off. At a certain point, women realize being busy is not the solution – and that’s when they typically end up in my office.
This is exactly what happened to me: My journey started in my early 40s and there was even less menopause care than there is today. I just thought I was overworked and overwhelmed with young kids and a demanding job delivering babies. I had a wake-up call when I landed in the hospital with significant pneumonia – my body was sounding an alarm. It made me realize that I had to change my life to take better care of myself. I left corporate medicine, opened my own practice, and started to educate myself with self-study about perimenopause. Yes, I’m an OBGYN, but we as doctors get very little training in medical school about hormone health for women in midlife. Needing help led me to what I do now: Educating and inspiring women about menopause. I believe we deserve better care and a better message.
Q: What kinds of things did you change about your lifestyle when you realized you needed to focus on your health?
I stopped drinking alcohol when I hit my mid-40s because my body couldn’t handle it biochemically. One glass of wine gave me hot flashes and made me sluggish for three days. A lot of women will give up alcohol just because it doesn't work for them anymore.
Sugar is another big one. I have dark chocolate. I eat cake. I just don’t do it frequently. In general, I tell women that 80% is a B in school. So if you can eat healthfully 80% of the time, that's a B student — you're going to go to college, you're going to do okay. Perfection isn’t the goal.
Q: What’s your first order of business when you’re evaluating someone for hormone health to get them on the road to feeling better?
The first thing I usually will say is, “You're not alone. Women are going through this all around you — they’re just not talking about it. You’re okay now and you’ve met your people.” That’s what we need as women – we need community. Usually, there’s a big sigh of relief; you can see their shoulders drop.
Next, I like to check lab work on everybody — not all doctors do — but it gives women a data set to work from. (And by the way – even if your results are unremarkable, that doesn’t mean we can’t treat your symptoms.) Then, together we come up with a truly bespoke treatment plan. Some women don't want hormones. Some women do. Some patients want an aggressive approach, and some prefer to try lifestyle interventions before medication. It really has to be the woman guiding the journey, and I’m there to support them.
Q: You’ve talked about how women often tell you that their confidence takes a hit in perimenopause – sometimes related to their complexion. Their skin may be more dull, reactive, or red. What are some ways they can get their confidence back?
Personally, I’m all about looking fresh – maybe five years younger instead of trying to look like I’m in my 20s. We need different products and ingredients to protect the skin barrier as you head into your 40s. Finding the right products for what your skin is doing now is the secret sauce — not what worked 10 years ago, not what you see an influencer doing, not what’s on TikTok or social media. You have to find what works for you and then stick with it so your skin has stability. Simple is better by the way. I like that the barrier repair cream from Phosis doesn’t have a scent – I find fragrance irritating — and it’s a really nice effective product.
Q: You’re passionate about better care for women in menopause. Can you talk a little bit about how women can ensure they’re getting the best care from their medical team?
A: Some real talk: Our medical system is just not set up to care about prevention. Hormone health is complex and insurance pays doctors for a 15-minute block of time. It’s an impossible ask to take care of a perimenopausal woman’s symptoms and make her feel loved, heard, cared for, and accepted in that amount of time, though I certainly try every single day. What you end up with is fractured care – you get your mental health over here, your hormone health over here, your heart health over here, etc. It’s set up badly for both men and women, by the way. It’s frustrating for doctors and for patients.
So what do you do about it if you’re the patient stuck with the system we have today? First, make sure you’re going to either a primary care doctor or OBGYN with experience in treating menopause. (This list is a good start.) Next ensure that any specialists — your psychiatrist, cardiologist, neurologist — are aware of what’s happening with your hormones and how your symptoms might be connected. Ask your PCP or OBGYN to confer with your specialist if necessary to make sure you’re getting holistic, integrated care. What’s unfortunate is that it puts something on the patient’s to-do list when they’re already overwhelmed.
One thing I’m passionate about is advocating for more of my colleagues to join me – to get training in menopause care. If you’re treating women in midlife in your office you have to understand how declining estrogen levels affect different systems in the body. For the time being, though, it’s important to empower women with the knowledge they need to get the care they need.
This Week’s Movement Snack
It can be challenging to feel motivated to build core strength, especially if you’ve been diagnosed with osteopenia or osteoporosis as both spinal flexion (forward folds) and spinal rotation (twisting your spine) are contraindicated. This movement snack takes those conditions into consideration and offers various modifications to improve your overall core strength. Appropriate for anyone looking for a quick ab series. Enjoy!
Cheers to looking and feeling your best,
Susan
Susan Campbell
Founder & CEO, Phosis
This doc sounds rad! The more we keep talking about perimenopause and women's midlife health the more of her ilk we'll generate I believe. I definitely can relate to everything Heather says here: the not feeling like myself, to the noticing skin changes, and also feeling like I'm just beginning as I enter my second act. Menopause can rock! Thanks for this sweet interview, Susan. Glad Substack has brought us together.
What an eye-opening interview. I wish she were my gyn! What a gift you are and how glad I am that I found you.