Aviva Romm, M.D.: Finding Balance in Our Bodies

Aviva Romm M.D. Pulling the Thread

“I've spent many years, like med school residency, as a mom, eight books, which is a lot of deadlines. Just a lot of things that have put me behind eight ball in my relationship to time, like never feeling like I have enough time, never getting through my full checklist, always feeling like I should be doing something more, even when I'm relaxing. So for me, it's taking on too many things at once saying yes, when I really need to say no, or maybe say yes, but not all at once. And just really checking in with, am I feeling spacious? Am I feeling unpressured? Am I feeling like I have the capacity to handle what's on my plate right now?”

So says, Aviva Romm, who has the rare distinguishment of being both a midwife and a Yale-trained M.D. She mediates between the world of allopathic and alternative medicine, using the best of both approaches. From where she stands, balance is critical, particularly for women and our complex and sometimes confounding hormonal systems. Though Aviva Romm has written many books about women’s health, her latest—Hormone Intelligence—is somewhat of a bible for many women I know, offering insight into the natural process of shifting hormones during different phases of our lives, as well as advice for treating all-too-common maladies like PCOS.


While we dive into some of these details in today’s conversation, Aviva and I primarily talk about what it is to be a woman today, along with our collective ambivalence about aging, and the necessity of honoring older women—particularly ourselves. We also get into stress and the way we’ve been trained to use hyper-vigilance and anxiety as prods for perfection and what it feels like to let that go, and drop into our own bodies, to hear from them directly on what they need.

EPISODE HIGHLIGHTS:

  • Bridging the gap between how we feel and how we want to feel…(10:49)

  • Hormone intelligence and our innate knowing…(23:33)

  • Embracing the maiden, the mother, (the queen), and the crone…(42:58)

MORE FROM AVIVA ROMM, M.D.:

Hormone Intelligence: The Complete Guide to Calming Hormone Chaos and Restoring Your Body's Natural Blueprint for Well-Being

The Adrenal Thyroid Revolution: A Proven 4-Week Program to Rescue Your Metabolism, Hormones, Mind & Mood

Aviva's Website

Listen to Aviva’s Podcast, Natural MD Radio on Spotify and Apple Podcasts

Follow Dr. Romm on Instagram and Twitter

TRANSCRIPT:

(Slightly edited for clarity.)

ELISE LOEHNEN:

Before, you were telling me about sort of being on vacation and stumbling upon this revelation, that high function, anxiety and inner peace are often conflated in our minds, is that fair?

AVIVA ROMM, M.D.:

Ambition like, so for me, there are sort of three factors, right? There's my deep, innate powerful desire to make a contribution in the world to make everything I touch, you know, make women feel supported, I guess not everything I touch, but like make women feel supported, help women just supported, like, there's that healer in me that really just craves that. And there's also, I have like a, a deep drive for excellence. Like I want to always go the next mile. So to speak, to like really make sure that what I'm saying is accurate. Like there's science, all of that. So there's excellence and ambition for me, that's one sort of pod. There is an increasing desire, especially now that I'm in menopause, I think, and my kids are grown and I'm just at a different phase of my life. There's a deeper desire to value time, quiet, self care time for reflection, time for not doing, and then there's high fun.

So that's another pod. And then there's high functioning anxiety, which for me runs deep and long all the way into growing up in a housing project and using accomplishment as the vehicle for getting out of that housing project and establishing social and financial safety and security for myself. So for me, they're almost like I I've thought of them as competing things and I can't have all of those happening operational at one time. But I, I think for me that the high functioning anxiety is almost like the shadow side of the helper, healer, creative, who also wants excellence. So for me, when I'm in, in the zone or in the flow of creating something or interacting with a patient, or like actually pushing hard to create something sometimes, you know, like a really like creating excellence. I, I actually love that, but when my scarcity mindset or my fear mindset, or I'm just tired and overwhelmed and overdoing, it gets activated, then that high functioning anxiety really kicks in.

So in one sense, the high functioning anxiety drives in a good way, the other stuff, but it doesn't have to be how I create from, and then the inner piece is not like if I'm, if I'm just a human being and not a human doing, if I'm just taking time on vacation or time to watch a movie or read a book or whatever I'm doing or not doing it, doesn't have to be in competition with that excellence with the creation, with the accomplishment. But I think sometimes for me, and I, I know a lot, I, you know, when I teach or when I work with patients, I, I ask this question a lot. Are you ever just watching a movie or reading a book and relaxing, but there's that, you know, 10% of your brain, that's actually kind of loud saying I should be doing something else.

I should be doing something more and you may have a specific task in mind or tasks on your to-do list. Or you may just have that as an anxiety, but that actually does not help us be more successful or more creative or more productive that getting into that quiet space allows that creative flow to bubble up. So I've been playing with, what does it really feel like to pay attention to, to, to define how I want to feel, have a touchstone of that, which is actually, I really enjoy feeling calm and spacious. And as a writer, you know, that having a deadline, isn't always a good feeling. It's often not a good feeling. How do I feel to not continue to create stress for myself and spend more time between that deep calm, creative well, and that creative accomplishment. So that's what I'm playing with right now.

ELISE:

Head nods all around. It's so deeply resonant. I wanna sort of tease out that idea of that anxiety and how that drives excellence and how I, I recognize that that's a myth. And yet I subscribe to that too. If I'm not that somehow I won't be motivated to achieve anything or do anything, unless I'm on that edge of almost making myself ill with anxiety breathless for me. And they're so entwined and I'm sure they're entwined for a lot of women. So I wanna go into that deeply and even how that impacts our health and our hormones.

AVIVA:

I mean, it's really interesting because there's actually a, a chart that was created in the, I think it was the 1920s, actually it's a bell curve. And the original impetus was to study the impact of stress physiology on our wellbeing. And it's continued to sort of stand the test of time. So on the Y axis, let's say you have creative accomplishment, you have flow, you have functioning. And then on the X axis you have stress. And this has been born out in mood and mind. It's been born out in exercise performance and also exercise performance in relationship to viral infections. We know that for example, high intensity athletes or marathon runners often train and train and train. And then when they stop, they get sick, right? Or we all have had that experience of being in undergraduate or graduate school. And we like push, push, push, push, push for the final exam and our final papers.

And we're fine. Then first day of winter break, you get sick, right? Hopefully not COVID, but in the past, we've all had that experience of a cold or flu. So on this curve, the idea is that when we are actually under-stimulated our performance, our accomplishment, our excellence, our mood, our creative flow overall performance in every area, health physiology, and like externally is really low. We also know that when we're over-stressed, same exact thing. So the sweet spot where we're actually the most effective, where we feel the best where our immune systems are at their highest functioning actually is in the middle where we have a wee bit of stress and that stress doesn't have to be a negative thing. It can be like a project we're working on that is causing us to like noodle a little bit, or a project that gets us into flow state.

That's when we're optimized. I think a lot of us, and especially women, have gotten so accustomed to this idea that we're supposed to multitask, have it all, do it all that we end up actually in the over-functioning state. And so we're, you know, struggling with a lot of immune dysfunction, auto immunity, fatigue, overwhelm, anxiety, depression, and it's like, we've pushed too far out on the curve. And actually what happens is our happiness, our creativity, our effectiveness, our overall peak goes down. So if we can move actually more to that middle on the other hand, if you're really under stimulated, if you're bored, if you're unhappy, if you're not feeling like you're getting into flow state with your work at all, for example, then you may similarly experience some of that depression, anxiety on we, your immune state may go down. It's really, really interesting. How do we tap in on a daily basis to how do we want to feel, how do we feel and how do we bridge that gap?

So for me personally, I've spent many years like med school residency as a mom, eight books, which is a lot of deadlines, just a lot of things that have put me behind the eight ball in my relationship to time, like never feeling like I have enough time, never getting through my full checklist, always feeling like I should be doing something more, even when I'm relaxing. So for me, it's taking on too many things at once saying yes, when I really need to like say no, or maybe say yes I'll, but, but next not all at once. And just really checking in with, am I feeling spacious? Am I feeling UN-pressured? Am I feeling like I have the capacity to handle what's on my plate right now? And when I am able to check in with that and create that, and of course it ebbs and flows, right?

I mean, we all end up sometimes saying yes, or you may have little kids and it is all a lot. Even the things that are like the few things you have going on, but how can we continue to check in? So for me, right now, I am deeply committed to one, not taking on more than one major thing at a time and going to deep with it instead of having so many competing things and the other is, well, the other two things are giving myself enough time. We actually know that we tend to underestimate how long any given task or a project is gonna take by at least 30%. So giving myself more time for each thing and not an announcing to the world that something is coming before I have it substantially close to being finished. Because that's something I'll do. Like I'm so excited to share what I'm working on or what I'm going to offer next. And then if something happens or it takes me longer, then I feel badly for not meeting a commitment that I've made. So those are some of the ways I'm playing with this.

ELISE:

I also tend to over-commit and I work with this woman sort of as a tangential therapy practice occasionally. And she was like the way she did. She looked at my Human Design Chart, which is a whole ‘nother thing, which I love, I love Human Design, but she was like. I'm a manifesting generator. And essentially she was like, your whole time is a pressure for you. Like you feel that intensely. And you know, you were talking about deadlines. Part of making progress in my book has been letting go of deadlines. I've never missed a deadline. I'm missing my deadline and that's okay. So part of moving forward, I had to let the deadline go. And then I actually started to move much more rapidly, which was interesting. But she said that I, and I think this is good advice for every woman. I am no longer allowed to respond in the moment when I'm asked to do something. It is, let me get back to you. Yes. Let me get back to you. And then I feel it energetically, is this a yes or is this a no? And that gets

AVIVA:

Down to like, are we paying attention to how we feel in our bodies or wherever it is? Like I think we each have a place where we know when we're in alignment and when we're not right. So it may be, somebody has a part of their body that aches when they're not for me, I feel this like almost like a motor in my diaphragm. It's like a motor like that. It's just agitating and causing me, that's my anxiety feeling. It's like a motor in here or like an overwhelm, like, oh my God. So I try to pay attention to that. But it really does mean dropping in and paying attention to how we feel, what our thoughts are. Like if your brain is screaming, no. Or your body's screaming, no getting in alignment with saying no or no thank you. But we don't always pay attention how we feel or trust it when we do know it well.

ELISE:

I guess we can move to, to hormones because I think the, sort of the great sort of crime against women is we are these highly sensitive beings, far more complex than men in terms of, I mean, maybe that's not true. You can fact check me, but it seems that way a lot more.

AVIVA:

I think we are, we have more cycles. I think we're more prone to the good and the difficult sides of connectivity because of oxytocin and awareness of others. I think we have, we have a lot of complexity that they don't have.

ELISE:

But yet we've been told that we're hysterical. We all know that etymology of that word and that idea or that it's all in our heads. You know, so many us have been severed from that inner knowing of, I don't feel right. I don't feel good, obviously autoimmune it's what 80% affects women. It'll be interesting to see the impact of, of long COVID is that, you know, has been sort of a crisis for people's immune systems, men and women, but a lot of women. Right. And yeah, we've been dismissed, denied. And obviously you, a lot of your work is about how these hormonal signals are the canary in the coal mine, that something's going out of whack, and typically to get like an, autoimmune diagnosis, right? Like your thyroid has to be gone. Like you have to be pathologically ill. There's no, not a lot of awareness or acknowledgement of the spectrum as we're sliding towards that diagnosis and can still climb our way back. But we've been severed right from that inner knowing. So how do you teach women to reconnect? Both? Not to pathologize everything, right? Like our, we do cycle, we go through these significant shifts and changes in our lives that are completely natural. So how, where's the line for you? How do you get women back in their bodies?

AVIVA:

Yeah. I mean, it's really complex in a lot of ways, right? Because for so many women being in their bodies, isn't actually, it doesn't actually even feel like, like a safe place because of trauma, vulnerability, physical discomfort. I mean, so many women feel their bodies have betrayed them. Even women who have experienced an external assault sometimes blaming themselves often blame themselves and our culture blames women. So for me, it's about how do we identify, where we do feel safe in our bodies where we don't feel safe in our bodies and then how do we actually drop in and feel our bodies? So it can be any number of ways. One of the practices that I really love guiding my patients with and my students through. And I actually talk about this in Hormone Intelligence. And I also think in Adrenal Thyroid Revolution, but what I call a body scan and you can do it kind of quickly, like we could do it right now where we each close our eyes and just take a few deep breaths and just kind of quickly let our minds wander through our bodies and notice, where am I comfortable?

Where am I uncomfortable? What can I do to, you know, shift that? Can I breathe deeper? Can I change my posture? Am I hungry? Do I need a pee? You know, what is it? But then there's a deeper way to do a body scan, which is to do it. Like you can either do your own guided visualization or find one where somebody is guiding you through or trade with a friend. And I do talk about this in, in Hormone Intelligence, but you get really comfortable. You can lay down, I prefer laying down or sit up and then slowly begin to breathe deeply throughout your body. I use this. I'm very visual. So, so I use an image of as if you can imagine, there's this like golden, like if you could imagine like molten gold, like molten pink, gold, and as you're breathing in that gold is kind of like going through your, and it's warm and it's cozy and it's comfortable and it's kind of going through your arms, it's going through your to, or so it's going through your pelvis.

It's going through your legs. It's going up your back, your neck, your head. And you're slowly actually watching it flow through you. And then you start to pay attention to where there might be blocks where you feel like it's not actually flowing and then notice those parts of your body. And then there are a number of things that you can do in different ways of this practice. One is just to notice it another is to breathe deeply, relax. Imagine that you're kind of like letting that flow, move past any obstacles until you can imagine the flow happening. Another is to notice where in your body, when, when you have that flow, you start to have negative thoughts. And I mean, like, I hate that part of my body or, oh, I can't go there. Or this is a danger zone. And then when you, you can visualize healing and there are lots of ways you can play with this, but then when you come back to consciousness, oh, and when you're doing that, also notice one power spot.

Like for me, because high functioning anxiety is my thing. I've been very fortunate to be in amazing physical hormonal health, but high functioning anxiety. I can start to spin out mentally, like I be doing this or someone else is more accomplished or like the compare and despair thing. And so for me, my power spot is to feel my feet on the ground because when I feel my feet on the ground, it brings me back into my body and outta my head where so much of that anxiety gets centered for some women. It may be, there are arms, they may feel strengthened their arms. I've had women say, it's my hips, where I carried my babies. You know, it's, I'd hear her all kinds of things, but find that place that also is your strength. So you're not just only looking for what is the sore spot, metaphorically speaking, and maybe physically.

And then a beautiful thing is to bring yourself back to consciousness, set up, have some tea, light, a candle, and journal and journal out those parts of yourself that you're hating or not loving on. And then journal out those parts that you, or a part that is your strength that you can pull back to. So I do this with patients as appropriate. I have an exercise women can can do, and it really is transformative. And you can do it as you're going to bed each night, you can do it, you know, as a new year's thing September, like you can do it on your birth. They just take a time. And it's really powerful.

ELISE:

I love that, you know, even I should journal, but even just the conversation that I have with my body sometimes where I'm like, oh, that… it hurts. Like maybe it's muscle fatigue, but you start talking to your body and just asking questions and then seeing what comes up can be shocking. I love that. And do you deeply emotional, you know, where it'll guide me back to like, oh, I feel I'm so lonely or, you know, whatever it is like that's, that's there that hasn't been acknowledged. Yeah. Because we're so busy covering up all of our discomfort and your book. I mean the latest one is called Hormone Intelligence. And when you think about, I don't know whether you think of it as mind, body spirit or hormones as their own intelligence within the body, and then as we sort of come together, how do you, like, how do you, how do you imagine the system?

AVIVA:

Yeah, so I think of Hormone Intelligence as two things. One is this very, very deep innate knowing. I mean, we, we really haven't altered from our biological programming, if you will, since we became humans on the planet and you know, we menstruate, we cycle, we get pregnant, we give birth, we go through menopause the same way, all people with women's body and women's tech go through those changes pretty similarly. So I think of how do we live in harmony? So I think of that as the innate intelligence, but then I also think of hormone intelligence as the decision to pay attention, to and live in harmony with and support that innate way. Our body is meant to not, not to be biologically reductive. I'm not a biological reductionist in the sense that I don't feel like everything we do is like driven by our hormones.

And I don't feel like everything is just yeah, like predetermined, but there are aspects of, you know, menopause is predetermined getting a menstrual cycle for a healthy female body is predetermined. So how do we understand what those cycles are and how we can best support ourselves through those cycles? So just, you know, some simple examples are like in our menstruating years, we do know that when we're ovulating, our estrogen and our cortisol and our adrenaline are at levels that actually healthfully easily support us in being more intense in our exercise and having more muscle healing. So you, you know, if you wanna do, you know, cycling or running or something, I mean, it doesn't mean you can't do it at any time of your cycle really successfully, but let's say you're trying to start a new program to get on like a cycling program or jump rope program, a yoga, whatever.

That's an easier time. It's more harmonious physiologically, where as premenstrually we know that our inflammation is inherently a little bit higher, our muscle repair is a little bit lower and we actually are more likely to injure ourselves. Premenstrually so maybe that's a more natural time to think about restorative yoga or a gentle yoga program or a gentler Pilates program then, you know, hitting CrossFit. And again, not biological reductive. You can do it any time, but if you start to notice like, yeah, I'm not really feeling like hitting the mat right now. And you're like three days before your moon time. Maybe that's why, instead of thinking all the thoughts we think, which is like, I'm lazy, I'm punking out. I should push myself. And we have those flows with all kinds of things around our sexual desire, around our creative and intellectual flow, not capacity that doesn't change our, our intellectual and cognitive capacity.

We know does not change across our cycles or life cycles either. So you're not less smart when you're pre much done. You're not less smart when go through menopause, but our hormones and our brain changes and our mood changes are affected. So how do we learn to learn how do we learn those? And then be more in harmony and compassionate with those. And how do we also pay attention to the many social disruptors that interrupt our hormone flow, whether that's you using blue lights at night and, you know, being on our screens in the couple of hours before bed disrupting our cortisol, which then disrupts our sleep, which then disrupts our metabolism and our mood and our immunity and all that, our cravings. So that's what it's really about to me.

ELISE:

Feels like life it's like the two branches of life or under in your own unique story. Right. And your own specialness to, to sort of a corny word. And then the context of these bigger patterns, right? Yeah. These inevitable, we're all gonna die.

AVIVA:

All. And it's not just me. Like, there's not like, you know, my daughters have talked about, I learn all the kinds of words from my daughters who are in their twenties to mid-thirties. And, and they're like, you know, they talk about exceptionalism, like thinking we're the only one. And it's been used in kind of a way of like Americans or I think we have exceptionalism, but also this idea of like, I'm the only one going through this. I'm the only one experiencing, this can also be very isolating and lonely making another corny word, but lonely making. And I kinda like that actually. And because as women there's so much, that's not talked about that. We just don't talk about with each other that have historically been taboo or considered hysteria. I'm doing air quotes around hysteria, but that feeling like we're going through something alone or we're the only ones, rather than understanding our bodies in that context, our moves our minds, everything, our lives are experiences, our choices in that bigger context, it can really give us perspective and self compassion.

ELISE:

Totally. And then you're talking about these natural rites and we won't be able to get into sort of PCOS and, and all of the disorders that you tease out in the book, but sort of tracking your own experience, which I think so much of us will to the parameters of normal or what to expect like perimenopause. I think for women, which I don't know, it feels like kind of recently has even become something that's discussed as actually there's something that starts to happen to you before you get into menopause and menopause has been under discussed, but what you, what do you want? Like what, what are those changes that we should welcome and understand as being completely not pathological and normal and, or potentially strengths? I mean, so much of I'm, I'm not quite in perimenopause, I'm inching my way there sort of shutting the door and, or having any other children, et cetera. I'm like right at the cusp of that moment. But what I hear from so many friends around perimenopause is like, they're like, I am just getting started. You know, my kids are functional. They need them in some ways more, some ways less. And then they feel derailed by their bodies at this time. Yeah. When we are also kind of the most powerful that we've ever been like in our forties and fifties, so what's happening there and how do we make it more gentle?

AVIVA:

Yeah. So, oh, wow. Let's unpack all of this. So one, I think we live in a culture. That's very ageist. Yes. And I, so I started with natural medicine and understanding my body and eating healthy, all that stuff when I was 15 and I'm 55, I've had four babies at home. I, I didn't even have makeup a few years ago. Like, didn't actually have makeup. I'm like, I'm like miss uber-organic. Right. Even though I'm a Yale-trained MD, I'm like actually miss uber-organic, crunchy on some levels. And I went into menopause two years ago. And so I'm fully in menopause and what's been astonishing to me is how much pressure I feel internally to do something like Botox or filler or get my chin, you know, jaw tucked a little bit. And I I'm like, I, like, I barely haven't have had a Tylenol since I was 15 years old.

And so if I'm feeling that way, right? Like what are most women experiencing in terms of like what our culture expects of us and how we're supposed to look and be? And there's so much, that's so profound about getting older, especially in a culture where I know 30 I'm like I know 30-year-olds who are models or look like models and are in the wellness space and kind of are models in their world, 30-year-olds who are already doing Botox and filler. And I'm not judging. I mean, I understand why women do all the things they do and I've chosen not to do those things. At least at this point, I don't anticipate that I will. But like, so starting with that place of like, we're already judging and rejecting the processes that we're going through, it's scary to get older. Right? You're in a different phase of your life.

A lot of women, um, I've been reading a lot about plastics and gentle things that women do like Botox, I don't even think it's gentle, frankly, Botox and filler. There can be from a medical perspective, they're not always gentle. They can have serious consequences, but the reason that women do it, because as they get into their mid-fifties in their careers, they get aged out, right? Their appearance becomes part of their career trajectory and they get aged out for younger people. So there's a lot of economic pressure tied into aging. And then on top of all of it, of the is not all enough, like in the gestalt of the whole thing is very real hormonal changes. So perimenopause is the eight or so years leading up to menopause, menopause by definition is having gone one full year with no blood coming out of your vagina.

No spotting, no period. It's nothing like, boom, no periods, no nothing. So one year of that, and you're technically in menopause. So what's happening during that time in our lives is we are having a massive decline in the form of estrogen that creates a lot of juiciness in the body. So estradiol, which creates full breasts and hips and makes us fertile and all juicy and juicy down there. And like all of that that's declining dramatically. And then we're experiencing estrogen, just coming from something called E2. So it's just a, it's a lower, it's like a less potent. It is a less potent estrogen. And it doesn't give us all of those feelings. Estrogen. The E2 that I was talking about, the real juicy one also keeps our joints well, lubricated. It, it actually keeps our metabolism a little bit higher. It distributes our weight more on our hips and our boobs.

Instead of around our waist, it helps us sleep better. It helps with cognitive function. So as that estrogen goes up, keeps our vaginas not feeling dry. It helps our sex drive and our mood. So that goes down. We may experience any of the symptoms that are associated with perimenopause and menopause. It also regulates our temperature through our brain. So we may experience hot flashes, vaginal dryness, lower libido, some decline in our mood, partly as a result of decline in sleep or sleep disturbances. And we may find that we put on on five or seven or 10 pounds, even though we're doing all the same things. So lots of changes. And for some women, those changes last a couple of few, some women just go through it, right? Like some women have really easy periods. They just, they menstruate. They might not like love the experience of menstruating, but they don't have a big lead up with cramps.

And some women go through menopause that menopause like that. But for other women, just like some women have periods from hell. Some women have, you know, perimenopause and menopause from hell. So what, where to embrace it as natural and normal really is a function of how you experience it. It's like labor, right? Women variance short of complicated births where there's the baby's in a funny position or something like that. Some women experience labor as actually pleasurable, sexual, and orgasmic. Some women like just are like, gimme the epidural, you know, the first three contractions, because they experience it as to so painful. It's not a judgment on their capacity as humans or women. It's just people experience things differently. So for the woman, who's like, this is awesome. This feels good. And I've midwife people who have said that they might not need anything, but, and it's just like feels completely easy and breezy and normal and natural and a rite of passage.

And they're like, wow, this says magical. But for the woman who's like, gimme the epidural at three centimeters. She may need that. And similarly, a woman who has some hot flashes here and there, or like doesn't really experience much vaginal dryness or urinary symptoms or any of that, she may just go like, this is not a big deal for me. And I'm yes, I'm probably still gonna be experiencing changes in my facial, or the experience of gravity or collagen declining. And maybe there are things she does or doesn't wanna do, but for the woman who's experiencing this as really uncomfortable that isn't supposed to hvea it's, I don't wanna say it's not supposed to happen in the sense of pathologizing, but you know, one of the things I say in Hormone Intelligence is that being a woman is not a diagnosis. It's not a disease and we're not supposed to suffer contrary to biblical proportions of saying that women are supposed to suffer.

That's not my belief system. And I feel like that's where choice comes into play much like the choice to have a natural home birth with not thing or a natural birth with an epidural or a C-section. It's like you get to choose when you're in menopause, based on how you feel and how you do or don't enjoy it or how it is, or isn't affecting the rest of your life and your capacity to live and feel your best. I sometimes feel that think, get really polarized. Like it's all or nothing like it's, I'm going all natural. So I can only do herbs, but I'm gonna suffer my way through this. Or, you know, menopause is a disease and every woman should take hormone replacement therapy. Neither is actually necessarily the best answer. So we'll have to kind of assess for ourselves. And from a, um, life perspective, I, I was listening to my oldest daughter.

She loves podcasts. She listens to them all the time. She's so she was telling me about a podcast with Krista Tippett, you know, On Being. She was telling me about a recent episode that I listened to called Wintering.

ELISE:

Oh, Katherine, I love Kathryn.

AVIVA:

So I was listening to it and she talks about how we go through these ebbs and flows in our life that society doesn't necessarily support, but we're still going through them. So for me, you know, as I was sharing, when we first started talking about like high performance. I've had like last year, I had 18 months of truly some of the most intense work continually that I've ever had. And it wasn't like, I felt burnt out at the end of it. It was like an experience of I'm just done. I don't have any more to spend right now.

And if I spend more emotionally or, or energetically right now, I'm going to get depleted. So now's the time to hit pause. And I gave myself what I called a sabbatical and I really hit the breaks on so many things. And it's a little bit like what she, what she talks about in the concept of Wintering. Like when we need to step back, go within, feel the feelings. And I think a lot of us, we recognize that premenstrually, I think most of us have some periods, menstrual cycles where for some of us it's strong. I know for me when I had never had cramps or problems, my period, but premenstrually, I always wanted to retreat a little bit like that. Wasn't at my social time, that was when I wanted to journal or do something creative at home, not out in the world. And I think when we go into perimenopause and menopause , if we feel that we need more time for self-reflection and self-care and exploring where we're at now, it's really important to give ourselves that it's an incredibly important time to be deeply, deeply appreciative of and deeply gentle with our bodies, because like Wintering or like PMS or that premenstrual time, we're going through a transition, sometimes for a long time, where we are experiencing something that is not valued by our society.

So we have to redefine it with each other, like in conversations like this and for oursevles. We have to really truly own it. So some of the things that I think are important are looking for female role models that fucking kick ass. I hope you don't mind he's cursing on your podcast, but like just really kick, you know. Whether it is Michelle Obama at almost sixty wearing a like cutout peekaboo top on a evening talk show, as you know, the former First Lady. Or it's Helen Mirren, you know, just crushing sexuality in a way that is like so powerful in her 70 and saying, if there's anything I would've told myself when I was younger is to give a whole lot less fucks about what other people think. Or just in general, whether it's Ruth Bader Ginsburg, if that's your person, or whether it's Audre Lord, if that's your person. Who are the role models of women who either embrace power? I think Audre Lord, I reread Sister Outsider this past year. And she really talks about, she talks about the Black Mother and she's not only speaking about the Black mother for Black women. She's speaking in a really deep, universal place about the..

ELISE:

The Black Goddess.

AVIVA:

Yes. And how we are taught as women to smile and be positive and be pretty and like give and give and give. And how do we embrace that more Kali, that more powerful force that isn't always happy and positive as we're reckoning with our power.

ELISE:

Just thinking about what you're talking about. And I wanna talk about Wwintering too, but this aversion, this cultural aversion to aging that's been passed on to women as like once you're desexualized, we venerate the maiden, we venerate the mother to some degree, and then we've excommunicated the crone. These, these older women who we desperately need, because they are one part of the triumvirate, they're the completion of the cycle and they hold the wisdom and they're the initiators and the holders of ritual.

AVIVA:

Yeah. I also feel that we have this concept of the triple goddess, right. Mother, maiden, crone. And I feel that, and I don't know if it's a reflection of the fact of having longer lifespans, although some of the issues around lifespans and women have actually been debunked, like people have lived long lives for, you know, in many cultures.

ELISE:

It gets, it's confusing because of so many children and babies dying. So that's why the, the, the median was why our lifespan has increased, on average.

AVIVA:

So I, I, I have come to identify and I haven't written about this yet, but a third passage. So there's maiden, there's mother, there's call her queen and then crone. And I think that if we go maiden, that's that very young, fertile, nubile kind, kind of sexuality and body that we have identified as sort of like, desired in our culture. And then there's the mother who is venerated, not so much as the mother, but as the vehicle or vessel for the baby. And then we've got the Crone. But I'm not a Crone yet. You know, and I think the historical, even visual image of the crone, if you look at that classic book The Crone, right? The cover, um, we think of a crone as wizened, not just wise, but wizened kind of leathery skin, lots and lots of wrinkles, more. We stoked with age. I'm not there yet either.

So when I start to identify myself as a crone, it actually makes me feel older than I actually am. But if I identify myself in this new phase of my life, as a queen, a mentor, a leader that redefined everything for me. And so for me personally, when I start to get a little bit pulled out of myself by these thoughts of, you know, I'm not young anymore as if that's a loss. I mean, of course it's a loss. We grieve difference. We grieve our non mother. So out sometimes when we become mothers, because we are making a transition and we don't fully have that same being as before, but, but she's integrated into us. And so, yes, I'm not 34 anymore. And sometimes I look at my daughter, my oldest, daughter's turning 34 and I'm like, oh my gosh. I mean, to have to have skin like that or, you know, whatever it is. Just to have your whole life ahead of you to make different choices, it can be daunting and it can even be filled with regret and grief and, and it's okay.

I think we have to feel those feelings, but to say Crone, it makes me feel like I'm so old. And so when I start to reframe for myself, this idea of queen, of leader, of mentor, I really love that feeling. Like it's really embracing the power of the fact that I have lived for 55 years. And, I'm a maven, I'm an expert. I am wise. I am confident…usually. I am accomplished. I have, I have arrived, right? I have, I have arrived and I can use that inner feeling to then inspire and to support and help understand women coming behind me and also understand a little bit of what maybe women in the years ahead of me may look toward. The other thing is that I wrote this post when I was on vacation about our bodies and how like when we're in our thirties, we're like, you know, culturally program to think, oh, I wish I looked like when I was in my twenties, when I was in my, for when you're in your forties, you're like, oh, if I were only in my thirties and I'm in your fifties, you like, you know, rarify your forties.

And I think to myself sometimes now, like if I were 65 or 75, I would be thinking, oh my gosh, my body at 55, I wish I was back there. So like real, really, really checking in with myself to love myself and finally like be here embody and accept who I am. So those are some of the things.

ELISE:

It’s so funny. And, and it's important to remember, you know, we think about cultural programming, the paragon of mature beauty is like a 20-year-old model, right? It's Kendall Jenner, whomever like these things…it’s a strange way that we have of venerating again, that maiden. I was with a teenager this summer and who I love amazing, you know, just like sort of becoming a woman, amazing body. She was like, I just like we, whatever I do, I, I never gain weight and I weigh 115 pounds. She's just slamming Cool Ranch Doritos, and it was actually really good to be around her because I'm having sort of the opposite experience where I look at things and I gain weight and she's, I was like, good for you. And like, that's so sweet. Like that idea of, I don't know, for some reason it helped me really unhook from this idea of like that I'm not in that stage. It's her time. And this idea that as a 42-year-old woman, I would idealize or imagine that I should have the body of like an unblemished, you know, child—is perverse and strange but that's how we've been been programmed.

AVIVA:

And that we are teaching our daughters, the young women in our culture, but boys and men too, but we're, we're inculcating our daughters and young women with the thought that where their value is, is in their appearance. Yes. And appearance changes over time. We're not gonna look at 55. We're not gonna look at 55 the way we looked at 40, we're not gonna look at 65 the way we look even with best plastic surgery and you know, in the world, you're not going to, and you still, you're still older. Like you're still carrying the mantle of, of changing. So as women, what if we, yes. I mean, beauty is wonderful and I, I love beauty too. And you know, that inner, like beauty from the inside out, especially, but how would our culture be different if we valued intellectual-knowing or spiritual-knowing, or let's say it, if emotional intelligence were part of beauty, how we treat each other, like our own inner self worth is part of our beauty, because that is what is also going to last.

So if we basically based our value on our appearance and on youth, by the time we are at an age where that is shifting, we, how to, we still value ourselves, what is it that we want to value about? So for me, this idea of thinking about legacy, thinking about, you know, hopefully having many, many decades ahead of me, what can I, how can I use this time? And again, allowing myself moments or days of Wintering, if you will, you know, days of just stepping back and reflecting and letting new things bubble up, you know, I wanna just say one thing too, something that's really bothering me in the wellness and the menopause world is people writing about menopause. And so, first of all, there's like, there's the idea that menopause is hell on wheels. Like I hear so many women saying I'm terrified of menopause and it's not something to be terrified of.

It’s not. It's like, that is part of the Hormone Intelligence. That's part of the body intelligence. Like it's nothing to be terrified if it's really hard, it's really important to look at root causes and see what we can heal, whether that's getting better sleep, or nourishment, or whatever, whatever, or using therapies, whether you know, more integrative or more conventional to feel better. But one of the things that's really bothering me is this kind of almost meme that menopause is a second teenager-hood. And I'll tell you why it really bothers me. First of all, I'm no teenager anymore. I am a sexually, life, career, experience, badass powerhouse, 55-year-old. I wasn't that at 15. I was not what I am now. And so comparing myself to what I was at 15 feels or comparing women to where we were as teenagers feels inaccurate, but also it's insulting, because our cultural meme of teenagers is irrational, difficult, moody, unpredictable. So we're actually casting aspersion on the emotional and intellectual and maturity capacity of women. It's a completely different life cycle.

ELISE:

Well, we could have gone for several hours. I love talking to Aviva in part because she doesn't compartmentalize herself, and feels comfortable swimming in a lot of different lanes. And I wish more doctors, healers, et cetera, did that. Because I think that that's how we arrive at the best and most healing outcomes. And it's just wanted to touch on Wintering. Katherine is coming on the podcast soon. She's also one of my favorite conversation partners. But I think that that book, which is so beautiful, what it touches on is that we started this conversation today about this, that innate knowing that so many of us have and the way that we try to corral ourselves into the confines and structures of an hour, a day, a week with this continual output and treating ourselves more like machines, really more like men than women. And I think gifted with that innate understanding of cycles and birth and creativity that women carry, what Katherine, and what Aviva, what I think we're all being called to do is to honor that more in our lives and to recognize that we might have fertile periods, fertile weeks, fertile days, but that trying to corral ourselves to input equals output is a recipe for disaster and that we have to all sort of honor that call back to following our energy, finding that flow, moving in ways that are less direct and a little bit more free. That's what I feel called to do. Obviously I've been in several cycles pushing on my book, or working on various consulting project,s and my energy is not linear and nor is the way that I think. And really this is something I think I share with all women. And I think we all are built this way, men too. But getting back into that to really listening to ourselves feels essential. Otherwise we're gonna drive ourselves to disrepair and disease.

Previous
Previous

Ian Kerner, Ph.D: Understanding Our Sexual Potential

Next
Next

Elizabeth Lesser: Challenging Our Old Stories