Under the Influence (with Jo Piazza) - Holiday Rage, Hormones, and the Power of No

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00:00:53.020 Hey, y'all.

00:00:54.440 Joe here and you are listening to Under the Influence.

00:00:57.520 How's everyone doing?

00:00:58.560 just take a second to think about the answer to that question how you feeling I'm feeling okay

00:01:06.840 I know the holidays are so much they're so stressful when they're not supposed to be

00:01:13.640 right this is supposed to be a time of joy and a time of rest and yet and yet and yet

00:01:20.120 it always feels like we're doing way too much. And the truth is, this is a hard truth,

00:01:29.000 it is often more exhausting for women. It is often more exhausting for moms. We take on so

00:01:35.000 much more of both the physical and the emotional labor of the holidays. This year, I'm trying real

00:01:43.160 hard to do a lot less. I really am. And I think I'm doing okay at it. I'm saying no a lot more

00:01:49.820 I've done the majority of my holiday shopping and I'm just ready to shut it down too. I'm like

00:01:56.100 everyone's gonna be happy I got enough of the things it's all fine it's freaking fine okay

00:02:01.880 I'm hosting a lot but that's because I like hosting hosting is actually less stressful for

00:02:06.900 me because I'm at my house which means I can easily put my kids to bed I don't have to worry

00:02:11.500 about my kids in someone else's space I get to make my own cheese plate which brings me a lot

00:02:15.980 joy, and I get to choose who's there. One of the things that I actually find stressful about

00:02:20.980 holiday events is going to events and then having to small talk. I freaking hate small talk. It

00:02:27.720 exhausts me and I don't want to do it. So by having people at my house, I get to curate the people who

00:02:34.080 are there. It's sneaky, I know, but it works for me. It does. Today we're talking about holiday

00:02:39.840 stress and holiday rage and particularly how that stress and rage hits women in midlife.

00:02:45.980 My guest is Dr. Kim Einhorn. We've had her on before. She recently launched the MP Collective, and it's menopause and perimenopause care that is personalized for the individual. It's so smart. I think more doctors need to be doing this. 0.99

00:03:02.220 Kim is such a hero in the menopause and perimenopause space, and she's got a lot of great tips from working with her patients about how to deal with the stress, how to deal with the rage, and how to actually have a great freaking holiday season.

00:03:17.720 Because you deserve it. You deserve Youngjoo Law doing Mr. Napkinhead in front of a warm fire with a cozy blanket. You do.

00:03:26.420 Here's my conversation with Kim.

00:03:32.220 Hello, Kim. How you doing?

00:03:36.980 I am doing well, Jo. How are you?

00:03:39.300 I'm good. I'm good. I actually am pretty good right now.

00:03:42.780 But I have to tell you, I think that there is just something about the holiday season.

00:03:48.840 And maybe it's because so much pressure is put on women and moms.

00:03:53.380 Maybe it's because our hormones are going a little out of control.

00:03:58.160 but I have been feeling a little bit of this holiday rage and I know a lot of my friends

00:04:06.120 feel the same way is this normal am I normal Kim I know that's the question I ask you all the time

00:04:11.820 oh my goodness you're of course you're normal we're all normal and I feel like one of the

00:04:17.580 problems is is that we are programmed to think that every time we have an emotion that's not

00:04:23.880 happiness or gratitude, that that's not normal. And it is. And it is. And it is. Because

00:04:31.260 culturally, we are often told that we must be grateful, that we must be grateful for this one

00:04:38.840 precious life that we have, that the holidays are supposed to be the happiest time of the year.

00:04:45.100 And in a lot of ways, they are. I feel great joy right now. And then I also feel rage at the world.

00:04:51.280 i mean i think listen i think we're living in confusing times i think that there's a lot of

00:04:59.100 confusion out there in general about what to believe and what truth is truth and i think you

00:05:06.660 know i think that it i think it's hard to be i think it's hard to be a human being in these times

00:05:11.720 and i think it's doubly hard on on every on us to be a midlife woman in these times you know i think

00:05:18.240 that one of the things that i noticed just in my practice alone where i treat women in midlife that

00:05:24.180 are starting to go through uh the menopause transition is that your emotions tend to just

00:05:29.480 betray you you know things that you could always count on having a calm even temper uh not not

00:05:35.780 having anxiety or depression not having irritability or rage on the on a regular basis that all changes

00:05:42.140 for many women in midlife and you know all you need to do i feel like we're on sensory overload

00:05:47.740 And all it needs to happen is just a little something extra, like the holidays, like being around your family, if that's not always an unstressful situation.

00:05:59.280 And it's just kind of enough to put us over the edge for a little while.

00:06:03.360 And that is all normal.

00:06:05.840 Why are so many of us experiencing different levels of rage, which is a very real thing, as we start to approach midlife?

00:06:14.580 How are our bodies and our hormones changing right now?

00:06:18.740 Well, what studies actually show and what we kind of know is that our brains really like

00:06:25.260 regularity and predictability in our hormone levels and our neurotransmitter levels.

00:06:32.240 So, you know, even so we see we see fluctuations in our hormones in many different periods in our

00:06:38.640 lives. First, it happens during puberty when, you know, if you had a teenage daughter,

00:06:43.400 this is a little bit of a time when you're not really going to be sure who's walking down the

00:06:46.920 stairs in the morning and then it happens again to us during postpartum period when our hormones

00:06:53.580 are absolutely in fluctuation and postpartum depression and anxiety become an issue and then

00:06:59.240 it happens to us again when we're having pms which tends to become exacerbated in that perimenopause

00:07:06.360 time and it's the ups and downs of our hormones that our brains don't like we don't they don't

00:07:12.320 it doesn't like it cognitively with like brain fog and word recall and forgetfulness and memory

00:07:16.920 issues. And it doesn't like it mood wise. So it can affect us in all different ways. All of the

00:07:23.460 above are pick and choose. It can happen with irritability and rage and loss of patience. I

00:07:29.520 have patients that come in here that are like, I cannot stand to listen to my husband chew or

00:07:35.360 breathe. And patients that come in really upset with themselves and blaming themselves because

00:07:40.400 they're losing their temper with their children more often. And then it can also happen in ways

00:07:45.980 that present anxiety and depression when they've never had it before. And absolutely, I see an

00:07:51.280 exaggeration of that PMS, that premenstrual syndrome, or PMDD, premenstrual dysphoric

00:07:57.640 disorder, where it can be very, very dramatic. And what are the ways that you're treating this?

00:08:03.940 I love that you are focusing on women in midlife now. I wish that more doctors were doing this.

00:08:09.940 There's a lot of us. What are some of the recommendations that you give to your patients?

00:08:15.080 So I try to approach it really from a holistic approach. You know, obviously my specialty and

00:08:21.240 what I what I do really well is I can help to, quote unquote, balance your hormones, meaning I

00:08:28.180 can I can calm this fluctuation down because, you know, as an aside in menopause, when our hormone

00:08:35.500 levels start becoming like much more dependably in a steady state where they're not having the

00:08:41.200 ups and downs, that's when our mood starts to clear up. So there is a light at the end of the

00:08:45.520 tunnel. But until that time, I helped to bridge that, you know, I helped to bridge those highs

00:08:51.320 and lows. So whether that's, that is usually in the form of hormone therapy with menopausal

00:08:56.680 hormone therapy that comes in in small amounts and acts as like a buffer between those highs

00:09:01.260 or even something like the birth control pill, which actually is in a much higher dose than

00:09:06.820 menopause hormone therapy. And that kind of helps to come in and suppress what your own

00:09:11.440 body is doing and then just give you a steady daily dose of hormones that really, really help

00:09:17.500 with mood. And I don't and I stopped that placebo week through the birth control, you know, that

00:09:23.600 last week of the birth control path so that women don't have to then drop down in that last week of

00:09:28.680 the pill and experience, you know, somewhat of a high and a low. They just have to take that pill 0.94

00:09:33.020 continuously, giving themselves steady doses every day. And mood is much improved that way.

00:09:38.460 And then the other things that I really like to talk to my patients about is not forgetting that

00:09:42.760 there's so many other things that we can do in a non-medical way that actually really help us

00:09:49.520 find our calm again. And whether that is exercise, whether it's finding a quiet space, you know,

00:09:57.080 for like 30, 45 minutes a day when you do something that you enjoy doing, like whatever

00:10:02.140 brings you peace and joy and gives you a moment to just like let just take a breath is something

00:10:08.400 that I encourage my patients to find and schedule in their busy days every single day.

00:10:15.020 Yeah, I think that that is such a good reminder. And during the holidays, it is harder and harder

00:10:21.880 for a lot of us women, and I'm just going to say it, just us women, to take care of ourselves

00:10:29.280 properly, right? Like we are prioritizing so many things that I think taking care of ourselves by

00:10:36.000 by eating the right meals, by working out, by getting our bodies outside, that falls by the

00:10:43.200 wayside during the holidays for a lot of us. I've got to tell you, like I haven't left the house

00:10:47.780 yet today. And I know that's not good for my body. I know it's not good for my moods.

00:10:53.620 Are you seeing this in a lot of your patients? I see it. I see it in almost everyone. And it's

00:11:01.540 with holidays and it's without holidays, because I do think that women, you know, I don't want to

00:11:06.680 generalize men. There are plenty of caring, you know, wonderful men out there. But I do think

00:11:12.200 that men do seem to have more of a built-in mechanism to do self-care, you know, take time

00:11:18.200 out to do things that they love and enjoy. I think women tend to really be overburdened because 0.97

00:11:23.100 they generally take a lot more of the responsibilities in the household, even if 1.00

00:11:28.160 they are full-time working outside of the house. You know, they tend to take a lot more kid

00:11:32.620 responsibilities, be the heads and the CEOs of their homes. And so I find that women get a lot 1.00

00:11:38.760 less time to take care of themselves. And women seem to be a lot more willing to just give up 0.99

00:11:43.660 that self-care, which is really something that, you know, I've found I've done. I'm guilty of 0.99

00:11:48.780 myself. And I have found that at this stage of my life, that is not something that I can afford

00:11:54.800 to do anymore. You know, we as we become more concerned with our health and the trajectory of

00:12:00.380 our health, we definitely start paying more attention to what we're doing now to keep

00:12:06.260 ourselves healthy for the long run. So I do, you know, I do tell my patients and I'm trying to do

00:12:11.660 it myself, you know, schedule your time outside, schedule your meal prepping, schedule your time

00:12:18.600 with your trainer or your time at the gym, like you would schedule a doctor's appointment or like

00:12:22.780 you would schedule an appointment for your kids. Just put it in your calendar, do it weeks in

00:12:27.420 advance and don't deviate from that unless an emergency comes up because there's so many things

00:12:32.560 that we can allow ourselves to get busy with and just put ourselves on the back burner.

00:12:38.040 But really, the only way to keep our calm and our peace is to just give us, it doesn't

00:12:41.920 have to be an hour, two hours, but it can be a little bit of time through the day to

00:12:45.680 get done something that's going to make us feel better.

00:12:48.680 That's so smart.

00:12:49.420 It really is.

00:12:50.240 And I think a lot of us hesitate to put those things on the calendar because it feels superfluous

00:12:55.740 or not as important.

00:12:57.640 And I would say it is probably the most important thing.

00:13:01.360 Yeah.

00:13:01.480 How many times do you, I have so many patients that come in and are like, I don't even remember

00:13:05.360 the last time I took a bath or something, but my husband goes out and golfs like every

00:13:10.180 Sunday for hours, you know? 0.99

00:13:11.400 And so I think, I do think it's, it's, I think that women have a little bit of, you 0.94

00:13:16.940 know, a little bit of just a brainwashing in the back of all of our heads that say that

00:13:21.340 if we do things for ourself, we're not a good mom, we're not a good person, that's selfish.

00:13:26.160 And I really don't know where this comes from because I don't really see men suffering from

00:13:30.760 this much myself. I mean, granted, I have a gynecologist and I don't spend tons of time

00:13:35.440 talking to men in my office, but I hear what goes on. I see what goes on. And I think that

00:13:41.780 we just have to change this mindset of self-care being selfish. It's not. It's really what we have

00:13:48.880 to do to keep ourselves healthy, which is the goal. And if you want to think of it in an

00:13:52.860 unselfish way, which I hear most women then kind of rephrasing it, like, I want to be healthy and

00:13:58.160 live long for my kids for my grandkids now we shouldn't have to justify it but if you need to

00:14:04.040 that's the way to think of it if you need a justification because as women we love a good

00:14:09.800 justification we do we just do i know and we shouldn't need it we should be we don't have to

00:14:16.860 be listen taking care of yourself is nothing that we need to apologize for we're not hurting anyone

00:14:21.940 we're just helping ourselves and we should be setting this example for our children our daughters

00:14:26.860 too you know what i mean like i don't you know i think my children definitely saw me grow up

00:14:32.500 doing a lot of self-sacrificing i was a single parent i was raising my kids alone from the time

00:14:37.800 they were one and three i had a very demanding career i i've been through phases of my life

00:14:43.220 where there was zero meal prepping going on there was a lot of weight gain there was a lot a lot

00:14:47.640 less exercise going on because i was kind of in survival mode and they came first and that's okay

00:14:52.760 But now I think I'm happy that they're starting to see me prioritize exercise, prioritize my sleep, you know, doing a change of my career in midlife at 52 years old so that I could do something to not only just give back to other people, but also give back to myself.

00:15:11.960 I like them seeing that example.

00:15:13.780 I want them to emulate that.

00:15:15.560 I want them to emulate self-care.

00:15:16.920 When I see them taking care of themselves, I don't ever tell them anything about being selfish.

00:15:21.960 I just applaud them for it.

00:15:23.360 They should.

00:15:23.980 Because if you don't take care of yourself, who is really going to take care of you?

00:15:28.920 Preach.

00:15:29.460 I mean, seriously, this is the absolute truth.

00:15:32.900 It truly is.

00:15:34.000 Okay, let's take a really quick break.

00:15:35.740 And when we get back, I just want to talk a little bit about lessening the mental load.

00:15:45.980 I don't think I can be your friend, Isabella said.

00:15:49.340 Rebecca's stomach flipped.

00:15:51.360 This is the love story of real hinge couple Isabella and Rebecca, written and read by me, Temi Denton-Hurst.

00:15:57.580 Listen to the free audiobook now.

00:16:06.520 Okay, we're back. 1.00

00:16:08.400 Women already shoulder nearly 75% of the mental load of the household. 0.99

00:16:13.220 But at the holidays, this is often much, much more. 1.00

00:16:17.580 Some of that is by choice.

00:16:19.500 some often by necessity. How can we manage to take away some of this mental load for ourselves?

00:16:28.100 You know, I think that there has to be a lot more shared responsibility in the household

00:16:36.500 through the holidays, through every day. And sometimes I tell, you know, sometimes I do talk

00:16:43.220 to this with my patients a lot. And finding out what the dynamic is, you know, sometimes like

00:16:49.100 it's not that you have an unwilling partner you know maybe your partner is willing to help but

00:16:54.220 he just doesn't know what to do and i i have my i think lists work really well a list where you

00:16:59.280 have you you of course you are the ceo the woman's the ceo you have to make the list and you have to

00:17:03.420 delegate but even just seeing that list on the refrigerator or on the whatever shared calendar 0.61

00:17:09.800 you have of like okay i'm i'm gonna cook the dinner but you're going to do the food shopping

00:17:14.140 here's what you need to do I'm going to you know like and and helping to like um you know really

00:17:19.920 try to get other people kids your husband involved so that you don't have to be shouldering all the 1.00

00:17:25.980 actual burden of labor and you know I think that helps a lot and because you know a lot of women 0.51

00:17:31.540 are just like tired of doing the quote-unquote nagging that has to be done to get people to do 0.57

00:17:36.480 things but you know if you have a list that's in clear sight and you know you have a checkbox and

00:17:40.860 these things need to be checked up it really really helps the division of labor and then there's just

00:17:45.560 less for you to do and more time for you to actually like think about you know um you know

00:17:50.460 more space in your head basically yeah i've got to say i think that nagging is just it's such

00:17:57.480 sometimes i'm like it's a boner killer man like it is the least sexy thing in the world if i'm

00:18:04.760 nagging someone. I just it is very hard to see them as a romantic partner in contrast to someone

00:18:12.760 who just does the stuff who, you know, you ask once and it gets done. And I don't know why that

00:18:19.340 is, but that like for me, it's just the it's just the biggest libido downer. It is. I deal with

00:18:27.320 libido with a hundred percent of patients that come into this office. And, you know, it's a

00:18:33.540 really long discussion because there's so many different causes for low libido but a hundred

00:18:38.980 percent absolutely one of the biggest causes is feeling like you are at odds with your husband

00:18:45.020 and sometimes that has to do with the load that they're pulling or not pulling around the house

00:18:50.660 and you know men i think can be a little clueless about it there are going to be some partners that

00:18:54.940 absolutely just aren't going to do it and that's that's them and then you have a whole nother issue

00:18:59.980 there but some are just clueless and will do it if you if they know what to do and you know getting 1.00

00:19:06.340 them in that rhythm so it's the list making it's the communication and i think women tend to just 1.00

00:19:11.380 be tired of doing that make a shoulder at all you know and just decide you know it's harder just to

00:19:16.140 like tell people what to do so i'm just going to do it but that just fosters more resentment and

00:19:20.500 resentment is a total boner killer you are right so you know like i have a husband who's totally

00:19:26.420 willing to help me with everything that I ask. But sometimes I do have to ask that he's really

00:19:30.680 good at doing things on his own, too. But like sometimes I just have to let him know what I need.

00:19:35.240 You know what I mean? I have to let him know that it's time to like, can you put the load of laundry

00:19:38.740 in? You know, that kind of thing. And you know what? It does it does really help. But that

00:19:43.160 communication has to be there. And there's nothing that like kills that feeling more than than

00:19:49.400 feeling like you're taking care of your husband like you're his mother. That is not sexy.

00:19:54.260 It is absolutely not sexy.

00:19:56.380 I mean, I didn't know if we were going to get into libido today, but I guess we're getting into libido.

00:20:00.620 What other things do you recommend for your patients in midlife who are like, I love my husband.

00:20:06.220 I want to do it, but I'm tired.

00:20:08.140 Once we're doing it, it's great.

00:20:09.820 But, you know, just like getting started.

00:20:13.240 There's a difference between spontaneous libido, which is just like, you know, you're just like driving in your car and you're thinking about, oh, I can't wait to get in bed with my husband tonight.

00:20:22.780 versus responsive desire,

00:20:25.800 which is something that like once you're in it,

00:20:28.680 you're like, hey, I remember this feels good.

00:20:30.420 I do kind of like this.

00:20:31.320 I liken it to like going to the gym.

00:20:33.220 A lot of people don't really want to go to the gym

00:20:35.180 and work out, but once they're there,

00:20:36.680 they're happy they're there

00:20:37.540 and they feel good that they have got that workout in

00:20:39.480 and they remember the benefits of exercise

00:20:41.320 or they remember the benefits of sex,

00:20:43.320 you know, that closeness and things.

00:20:44.960 So I do go down a list with my patients

00:20:47.300 trying to figure out what it is.

00:20:48.640 Like, is it, how is your relationship with your husband?

00:20:52.180 are you having any pain or dryness with sex are you having are you stressed out are you tired

00:20:58.680 fatigue is huge like are you trying to have sex at times when you that used to always work for

00:21:03.620 you in your 20s or 30s before kids like at night mainly and now you're still trying to have sex 0.74

00:21:08.760 that same time but life is different like you just got home from work then you shut up the kids

00:21:13.200 around then you made dinner then you cleaned up after dinner then you helped kids with their

00:21:16.200 homework and then you're supposed to flip that switch and just expect to have you know be ready

00:21:20.860 to go. That does not happen. And that's not a realistic expectation. So once we kind of get rid

00:21:26.920 of all those other confounders, things that are really going to be libido killers, like we cure

00:21:31.840 the pain, we know the relationship is good, we're trying to do it maybe Saturday morning instead of

00:21:36.660 like Thursday night. And I tell them, what happens if you go away for like a weekend, just you and

00:21:42.880 your husband, you know, and you have none of the problem, none of the busyness of your day-to-day

00:21:47.060 life. How is your libido then? And some will say that is the best weekend of the year. And some

00:21:53.260 will say, I still don't find myself able to like really come up with desire. And then I talk to

00:21:59.660 them about the medical treatments for that. There are three FDA approved treatments for

00:22:06.500 low sexual desire. It's actually a condition called hypoactive sexual desire disorder, HSDD.

00:22:11.840 And for postmenopausal women, the one that's proven to work in the literature is actually

00:22:15.580 testosterone transdermal therapy like it's a daily gel that you rub on your inner thigh

00:22:19.740 and that's been shown to work for women in 50 percent of the cases it improves arousal desire

00:22:25.260 and orgasm even and feelings surrounding sex and then you know i do give that to pre-menopausal

00:22:31.800 like women in peri also but there are two other fda approved treatments for pre-menopausal women

00:22:36.980 um one is a daily kill called adi or flablancerin and another is an injection that you give yourself

00:22:42.860 before you have sex called VIBC or bromelanotide.

00:22:47.300 So, you know, those all have a lot of data.

00:22:49.560 You know, the latter two increase your dopamine.

00:22:51.800 And dopamine is like, you know, the sexy hormone desire.

00:22:54.740 This is so amazing to me because clearly we have had medications to help men with this

00:23:01.000 since just the realization that at a certain age,

00:23:05.100 men might be having lower libido or have difficulty having sex.

00:23:10.040 I mean, it was just, you know, just totally normal.

00:23:12.480 I cannot tell you how many Viagra commercials or Cialis commercials I remember.

00:23:18.360 The fact that it was just being advertised all the time back when we had television advertisements.

00:23:23.160 And yet and yet and yet we ignore this condition in women for the most part. 0.99

00:23:28.240 Because for women, it's not necessarily a performance issue. 0.98

00:23:32.280 It is a desire issue. 1.00

00:23:34.280 Women have, you know, they don't have an organ that needs to have an erection. 0.97

00:23:38.500 but we ignore the fact this is really now this is a really sad fact we ignore the fact that women 0.61

00:23:44.040 still do need to be sexually aroused and they need to be lubricated and they need to have the

00:23:48.360 physiologic changes that happen when they're aroused and i can't tell you how many of my

00:23:53.640 postmenopausal patients when when viagra became approved for i was put on the medicare formulary

00:24:00.760 so that it was covered by insurance for men how many women came to me and they were in absolute

00:24:07.060 pain because they had, you know, they had what's called, you know, bobovaginal atrophy. Like with

00:24:12.740 low estrogen, they kind of, you know, the tissue becomes more frail. It can break. It can tear. It

00:24:17.880 can be painful and dry. And guess what's not covered on Medicare? Vaginal estrogen that cures

00:24:23.500 it. So, you know, it is a sorry statement about the treatment, the gender disparity in medicine.

00:24:30.220 Just one in a sea of gender disparities in medicine, honestly.

00:24:35.380 Well, I am happy that we do have these FDA approved products. I can't say that I feel at this point they're still underutilized. They are hard to get covered by insurance. We're dealing with that. But even testosterone has no actual female approved dosage version of it in the U.S.

00:24:57.520 So when I have to give my patients testosterone, I have to tell them, you're going to get the

00:25:02.100 male dosage form.

00:25:03.260 You have to go to the pharmacy, pay for it in cash, which costs, once they get a coupon

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00:25:33.060 All right. Let's take one more quick break.

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00:26:45.520 Okay, we are back. I want to focus on the joy of the holiday season. And for me, what I am trying

00:26:54.180 to do is say no more often. And I think that that is harder said than done. My husband, Nick Astor,

00:27:01.900 doesn't believe that I'll do it. But I am. I'm saying no to social engagements. I'm telling

00:27:09.420 my work colleagues that by the end of this week, I will be slowing down a lot, which means I am

00:27:18.380 rushing to meet a lot of deadlines. But this is the first holiday season that I think is my season

00:27:24.420 of doing less. And so far, that feels really good. You literally took the words out of my mouth

00:27:31.880 because I was thinking about this when I was actually just listening to a podcast the other

00:27:35.620 day. And they did mention the power of no. And it is something, again, that I think most women

00:27:41.160 don't do. I personally am terrible at it. Like even thinking about, you know, taking a day off

00:27:45.880 or like scheduling myself a lunch break during my day hardly ever happened for, you know, for a

00:27:51.040 very long time. But no is very liberating. And again, you don't have to make it. It's not a

00:27:56.860 selfish act. Self-care is not selfish. But the power of no, it's like knowing your limitations

00:28:01.500 and respecting those and then, you know, not worrying about what other people are going to

00:28:06.400 think. And I think we're our own worst enemies. We are the ones that are not saying no. We're

00:28:10.580 being critical of ourselves. We're judging ourselves harshly. And all that negative self

00:28:15.040 thought just needs to stop. And I agree. I think that like saying no is like a powerful thing

00:28:21.600 and we have to recognize it as something that's healthy for us, not something that's hurtful to

00:28:26.640 others? I find it the hardest to say no to my children. It's gotten a lot easier for me to say

00:28:34.500 no to social situations. But when it comes to my kids, I'm very much a yes person. And I want to

00:28:41.460 get better at just kind of modeling those boundaries for them. And things like I volunteer

00:28:48.880 at almost every school event. And I like doing it, but it does take up a lot of time. And especially

00:28:56.500 because i did it for the first one now the second one who like really she is just a little accountant 0.97

00:29:02.500 when it comes to how much time i spend with each child she's like that one got more than me

00:29:06.860 so i feel very obligated and find it difficult to say no do you hear this from other women

00:29:12.260 oh universally joe universally and i've experienced it myself your kids i mean you know you picked a

00:29:19.320 really bad example of where you say no um you know because it is it is definitely that's the

00:29:24.520 hardest thing to say no to literally the most important people in your life and the people that

00:29:29.960 depend on you for everything. And I think there, I just think what I hear so much from my patients,

00:29:36.600 from friends, from me, like, is that there's so much guilt involved in being a mother. And I don't

00:29:42.540 know why this is, you know, I think it's our protective instinct. I think that's how moms are

00:29:47.560 built to be, you know, this is how we, you know, but like saying yes to everything. Also, you know,

00:29:53.000 if you think about it, it's not like it's necessarily helping our children. Our children

00:29:58.980 should definitely understand that we do everything that we can within our power to keep them safe,

00:30:06.000 to keep them happy and healthy. But do they need us to say yes to everything? Probably not.

00:30:11.220 Is there probably some benefit to them understanding that there are some boundaries

00:30:16.660 and limits with even their parents? I mean, I think so. I think if you're doing a good job as

00:30:21.320 a parent and you're giving of yourself, which I'm sure most mothers are doing, then they're

00:30:27.480 going to be healthy, well-adjusted people for understanding that it's not unlimited.

00:30:33.160 You don't get a yes to everything.

00:30:36.120 That is such a good point because, yeah, if we're training them to think that it is unlimited,

00:30:43.000 then when they encounter it not being unlimited, which it will be in most of the world, they're

00:30:49.020 not going to take that well.

00:30:51.320 We're absolutely not. Like, you know, I can't even remember how many times I said to my own kids, like, wait till you get out there in the real world. They're not going to accept this at the job, you know, in the workplace and everything. And then I'm like, why wasn't I teaching them that myself at home? You know, I'm guilty, you know, I'm guilty party number one for absolutely spoiling my kids. You know, we tend to overcompensate personally, even being a single mother or being a working mother.

00:31:18.820 Or, you know, I feel like there was so many things that I needed to make up for, which I don't really know if that's true or not, you know, but I definitely I definitely think that, you know, these kids tend to, you know, grow up with these rose colored glasses and then have a rude awakening once their friends don't treat them like that once and once once the boss doesn't treat them like that.

00:31:42.940 You know, I see it happening with my own children.

00:31:44.780 My compensation definitely comes from being a working mother, which is patently ridiculous because I love my job. I love the work that I do. My kids also know that and they respect it. And I know that they do. And yet I know that's where my guilt is coming from. I'm like, I was in New York for two days.

00:32:05.440 Now I have to completely overcompensate for doing that despite the fact that they were with their dad and their grandma and they're doing great and doing fine.

00:32:19.020 I do think we just put so much of this burden on ourselves and I'm trying to deprogram myself and yet and yet and yet it is still really freaking hard.

00:32:31.880 I mean, think about that, how, how much deeper of a relationship your kids will form with your husband, with their grandmother, by not having you be there running interference. You know what I mean? Like, even as a, as a divorced parent, I've seen many examples of children having a closer relationship with their father, because when their mother's around constantly 24-7, they do go to the mother. You know what I mean?

00:33:01.420 And so, you know, there are benefits to being a working mom.

00:33:05.060 I know that my, you know, the time that I have with my kids, I can tell you 100% was

00:33:12.200 so much more appreciated by them when, because I worked and, you know, it's hard, it's hard

00:33:19.640 to, it's also hard to understand, to like really feel good about that fact because you

00:33:25.200 just automatically feel bad that you can't be there for them every second of the day.

00:33:29.020 but like when I was actually able to make that play during the day at the school or when I'm

00:33:34.420 home on the weekends like my kids just run to me and they truly appreciate that time that I have

00:33:41.240 to spend with them because I'm not always there at their beck and call you know what I mean so

00:33:44.700 and they told me that themselves and I think that there's a lot to be said for providing that

00:33:49.180 example of someone who can support themselves be self-sufficient be independent you know make their

00:33:56.080 way in the world. And so I just keep that in mind, too. Both my children have decided that

00:34:00.540 they are going to have careers. And I think that makes me really happy. It means that maybe working

00:34:06.000 wasn't the worst idea. You know, it wasn't the worst thing for them. You know what I mean? If

00:34:10.420 they're choosing to do what their mother did, then, you know, maybe that's maybe that's a good

00:34:14.780 example that we showed them. I think I think it's absolutely a good example that we showed them. I

00:34:19.640 I mean, I want all of my kids, the boys and the girls, to want to work, to want to have some kind of purpose outside of the home, and to want to be a caregiver.

00:34:34.780 And I think that's especially important for my son.

00:34:38.480 My middle daughter, you ask her what she wants to be, and she says, I want to be an astronaut and a mom.

00:34:44.480 And I'm like, love that.

00:34:45.920 Love that for you.

00:34:46.780 no i i do think that being a stay-at-home mom is a job like it is a job that never ends i don't

00:34:56.100 want anyone to ever misinterpret me saying that like you know the only job is actually having a

00:35:01.780 job where you earn money outside of the house i think that one of one of the hardest jobs is

00:35:05.820 actually you know a job where you're not getting compensated potentially not being appreciated and

00:35:10.160 it really never ends but you know i do and i so i think that both are both are jobs but i i definitely

00:35:15.860 feel like, you know, whatever example you set, whether it's a job outside of the house or a job

00:35:20.820 in the home, it's something that I hope, you know, I hope women are happy with. I hope that they

00:35:25.000 feel like they made a good choice. And I hope that they understand that there's value in both

00:35:29.660 ways of living. I totally agree. We're actually going to have my friend Nia Roosh on in a few

00:35:36.440 episodes to talk about how one of our goals for 2026 is eradicating the language stay-at-home mom 1.00

00:35:42.860 because no one is saying it is work, it is labor. 0.95

00:35:46.940 And when we discount that, we are doing everyone a disservice.

00:35:50.740 I know we really do need a better term, a better term for it.

00:35:54.100 Because every time when I encounter with my patients at work every day, I want to know

00:35:58.700 what they do.

00:35:59.580 Like, it's more than just, you know, checking off boxes on a physical exam.

00:36:03.680 Like, I want to know what their lives are like, what they do.

00:36:05.900 Part of that involves me asking, you know, what they do as a career or, but I don't know

00:36:11.520 how to use the word, like asking them if they have a job. I don't want to use the word stay-at-home

00:36:16.320 mom for some reason. Every time I use that, I do feel like it's a little bit, it can be

00:36:22.240 misinterpreted, a little bit negative. I'm not exactly sure why. Because I think that it makes

00:36:28.860 you feel like you're, it's just the word, the word stay. Meaning bonbons or something. Exactly.

00:36:34.980 Exactly. It's a terrible, terrible phrasing. I want to eradicate it. And one of the things I

00:36:40.300 realized this morning is because my husband and I have worked really hard on dividing the labor of

00:36:47.760 the home equally. And yet we're still doing both putting in so much work. I don't even think one

00:36:54.120 person. I think it takes two people to run a household. It is so much labor. And maybe that's

00:37:00.400 because we are also both working and we're running a company together. But just the labor of running

00:37:04.800 the home is so so much that we just no one is staying no one is staying in one place

00:37:11.820 no it is a lot of work to run a household i i'm sure that my household was just running at

00:37:19.800 half speed basically my the entire young life of my daughters but yeah it is and especially you

00:37:26.400 know if you have certain standards about how you want that run you know what i mean if you if you're

00:37:31.920 not okay with having things be a little messy you've got a lot of work to do but yeah i think

00:37:37.260 i think it's definitely you know it's definitely a full-time job and potentially could even be a

00:37:42.740 full-time job for two people absolutely absolutely kim can you tell me where people can find you in

00:37:49.520 your practice and all of the incredible things that you're doing well you can find me on instagram

00:37:54.480 at kim einhorn md k-i-m-e-i-n h-r-n md and you can find me at my practice i run a concierge g-y-n

00:38:03.200 menopause perimenopause um practice here in brinmar pennsylvania right across from brinmar

00:38:07.980 hospital and i am taking i'm seeing patients here every day i love that i love that thank

00:38:13.220 you so much for being on i feel calmer already i'm glad joe have a happy holiday

00:38:24.480 Thank you.

00:38:54.480 you're vibing then her energy completely changes what do you do I'm Raven Smith and I wrote and

00:39:01.780 read a real love story about this exact sitch listen to the free audiobook now before you

00:39:07.620 knew what a stock was you traded snacks cards turns that instinct to trade didn't disappear

00:39:14.020 it just grew up with no minimums no monthly fees and 100 free trades TD Easy Trade taps into that

00:39:20.500 Because you are made to trade, and TD Easy Trade is made to help.

Under the Influence (with Jo Piazza) - December 16, 2025

Holiday Rage, Hormones, and the Power of No

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