Speaking of Women's Health
The Speaking of Women's Health Podcast is excited to bring you credible women's health information from host and Executive Director, Dr. Holly L. Thacker. Dr. Thacker will interview guest clinicians discussing relevant women's health topics and the latest news and tips.
Please consider supporting Speaking of Women's Health with a monetary donation to help us continue to provide free women's health content. Thank you!
Speaking of Women's Health
Expert Advice on Midlife Women's Health with Dr. Madeline Cohn
What happens when your body enters perimenopause? Does hormone therapy cause cancer?
Dr. Madeline Cohn, who recently joined Cleveland Clinic's Center for Specialized Women's Health as a staff physician, brings clarity to these questions. With expertise in menopause care, sexual health, osteoporosis, and general gynecological concerns, Dr. Cohn tackles six persistent menopause myths that cause unnecessary worry.
Dr. Cohn explains how menopause affects sleep, mood, memory, skin, weight distribution, sexual function, and—most importantly—long-term health risks including cardiovascular disease and bone loss.
Dr. Cohn's compassionate approach emphasizes individualized care, acknowledging that each woman's experience with menopause is unique. Her most powerful message encourages women to advocate for themselves when symptoms arise and seek providers who take their concerns seriously.
To make an appointment with Dr. Cohn, call 216-444-8686. Or if you are looking for a menopause expert in your area, visit menopause.org.
Subscribe to our podcast for more expert insights on women's health at every stage of life.
Welcome to the Speaking of Women's Health podcast. I'm your guest host, leigh Klecker. I am the producer of the Speaking of Women's Health podcast and I'm sure you've heard me guest host before. But today I am interviewing Dr Madeline Cohn and we'll be talking about her new role as a physician at the Cleveland Clinic in the Center for Specialized Women's Health, and she recently graduated from the Women's Health Fellowship within the center, and we're going to talk about some of her areas of specialty and her thoughts on a few important women's health topics.
Speaker 1:But first, if you haven't heard Dr Cohn on the podcast before, I'd like to give you a little bit of her professional background. She is a board-certified family medicine physician. She graduated, as I mentioned, in July from the Specialized Women's Health Fellowship at the Cleveland Clinic Center for Specialized Women's Health, and congratulations again, dr Cohn, you're welcome. We've been posting lots of pictures over the summer if our listeners haven't had a chance to check those out. And Dr Cohn graduated with her bachelor's degree in psychology and cellular and molecular biology from Austin College, and that's in Sherman, texas. She attended medical school at the University of North Texas Health Science Center, the Texas College of Osteopathic Medicine in Fort Worth, texas, and she completed her residency at Case Western Reserve University MetroHealth here in Cleveland Ohio and she served as chief resident there, and she's really passionate about becoming an educator and a leader within the field of women's health and she hopes to empower her patients to become advocates for their own health. So welcome Dr Cohn.
Speaker 2:Thank you so much for that introduction. It's great to be here.
Speaker 1:Leigh, You're welcome. We're excited to have you back on again and you will officially be on board in September. Is that correct?
Speaker 2:Yes, absolutely September 2nd I'll be there.
Speaker 1:Okay, great, and so can you tell the audience a little bit about your new role as a physician at the Cleveland Clinic?
Speaker 2:Yeah, so I've been hired on as staff position at the Center for Specialized Women's Health. So many of you know Dr Thacker, have seen Dr Thacker maybe have seen her as a patient. I will be doing pretty much essentially what Dr Thacker does at the Center for Specialized Women's Health seeing patients. We'll kind of talk a little bit about the types of patients I'll be seeing, but I will be there full time as a physician.
Speaker 1:Yes, so excited and I know Dr Thacker's thrilled that you and Dr Novick have joined her team. So what are your areas or what will be your areas of specialty once you are on board?
Speaker 2:Yeah, I think I have a little bit more of a broad range in terms of my areas of interest. I will be seeing patients for menopause, perimenopause, hormone replacement therapy, but I also have a personal interest in areas such as sexual health, osteoporosis and then kind of your bread and butter GYN stuff, so contraception, counseling, annual exams, pmdd, pcos so any of those kind of bread and butter GYN topics that you want to come in and see me for. I'm happy to see you, as well as our more specialized menopause care.
Speaker 1:Oh, that's great. So not just sort of the midlife care, but the even women who are thinking about pregnancy or preventing pregnancy.
Speaker 2:Yeah, yeah, definitely. So I have kind of an interest in seeing all age groups Great.
Speaker 1:And so that's, I assume, what you want to focus on as a new physician at the clinic, as sort of all of those areas. Yes absolutely Great. And where will you be seeing patients, if any of our listeners are interested? Because we know if you are a patient of the Clinton Clinic, it's very hard to get into not just Dr Thacker but almost any physician now, so I know I've been on a waiting list for months to see someone. But so where will you be seeing patients at within the Cleveland Clinic?
Speaker 2:Yeah, so whenever I start in September I will be seeing patients 100% full time at the main campus, I believe until about late fall or so. They're hoping to get me about 50% at our Strongsville location, so down the south side. So I will be still half time at main campus and half the time at the Strongsville location coming later this fall.
Speaker 1:Great, and we'll make sure to mention that in the show notes for our listeners out there. And so is there a number. Or are we recommending patients go online to make an appointment, or so what would be, you think, a good step to see you?
Speaker 2:Cleveland Clinic Women's Comprehensive Health and Research Center number. That's probably the easiest way to find me the people who answer the phones, the caregivers there in the center. They are so helpful and so kind and I actually met them recently at a conference. I got to meet them face to face and they're all very well aware of who I am and what my name is, and so you can definitely call their number and make an appointment with me. Their number is 216-444-8686. So that's 216-444-8686. Pretty easy to remember. Or you can always just Google Cleveland Clinic Women's Comprehensive Health and Research Center and you can find that number as well. If you want to go through our center like we've mentioned before, center for Specialized Women's Health you can just go online to their website too, and it'll direct you to the call center and you can request an appointment with me.
Speaker 1:Great, and I'll put the 444-8686 number in the show notes for our listeners as well. Wonderful. Well, is there anything else you'd like to share with us about your upcoming role and or any of your experiences you had as a fellow, any sort of before, because we're going to dive into a menopause topic here shortly, but I don't want to lose, you know, any other insight from you.
Speaker 2:Yeah. So just reflecting back on my time in the fellowship, first of all, it was a wonderful experience. So much learning. Two years flew by so quickly. You know it feels long when you're in it, but after you're done it just flies by, and it really gave me the opportunity to deepen my knowledge in all of these areas we just mentioned, way above and beyond what I learned in residency. So I do think it's really important that if you're looking for somebody to address these particular topics, if you're not feeling comfortable with your typical physician, we do have the Specialized Women's Health Center that can help you with your needs. Like I said, I just learned so much more being in this fellowship than I ever thought possible. It was such a wonderful experience, yeah.
Speaker 1:And just so I know we've had Chad. He was previously in sort of help run the fellowship program and he talked a lot about it, but it's been a couple years. So really quickly, if you don't mind sort of saying what that fellowship is. So is it? You know it's a physician who already has some degree and already has gone to medical school and already has done a residency, and then they want to find an area of interest or, you know, expand on some, like one subject, one field more. Yeah, yeah, that's absolutely right.
Speaker 2:So I, like was mentioned in my bio, I did my residency at Metro Health in Cleveland, Ohio, and many of my friends and colleagues after they graduated went on to be full-time physicians and so they were already practicing immediately out of residency.
Speaker 2:I chose to do additional training through the fellowship program. So by doing the fellowship program I got an additional two years of training focusing particularly on many of these topics that we mentioned before. So particularly menopause, perimenopause, osteoporosis, sexual health, more in depth about benign GYN topics like doing annual exams and contraception all of these things we just spend so much more time, but not just at the basic level, so I don't mean that to say that we shouldn't educate ourselves of how to treat women who have run of the mill concerns your typical menopause symptoms. But we also get extended training on seeing patients that are medically complex, and so I see a lot of patients that are cancer survivors, a lot of patients that have active cancer, a lot of patients with complex medical conditions and kind of seeing the intersection of how that impacts these turn of life events.
Speaker 1:Yeah, it's so great. I mean I think you mentioned something like really important. Just how you know that. Extra training, two years of diving into you know women's health as a topic. I mean there's just not enough wonderful women's health physicians out there. So congrats to you and thank you for being, you know, one of those great physicians. And I know Dr Thacker, yeah, I mean. So I'm sure many of our listeners will be trying to make an appointment with you.
Speaker 2:Absolutely, and I'm happy to see you guys. I would love to meet you, yeah.
Speaker 1:I've already told a few of my friends, so just so you know, awesome, awesome.
Speaker 1:So let's dive into this menopause topic. It actually was suggested from one of our head nurses, who gets a lot of calls from patients from the center, and she really wanted us to sort of as she worded it bust a few menopause myths. These are questions or statements that she gets from patients on a daily basis, and so I thought, now that we have Dr Cohn here and she's one of our menopause experts, there's no one better than to bust these myths for us and give us the truth.
Speaker 2:Yeah, absolutely.
Speaker 1:So I'm going to start with myth one here. This is you know, this is actually a quote. So menopause happens suddenly. One day your period stops and that's it. So is that true?
Speaker 2:Yeah so not exactly so. For some patients who are what we call the lucky ones, who aren't very symptomatic and don't have a lot of things going on, it may appear that menopause happens suddenly. But it really doesn't. It is a very long, slow process. So perimenopause can last five, 10 years before you ever go into menopause and it starts with these gradual hormonal shifts. Some of my patients experience the symptoms of perimenopause. There's lots of dramatic changes in the levels of your hormones which can cause both high estrogen symptoms, which can be things like headaches, breast tenderness, nausea, and then low estrogen symptoms, which are kind of our more classic symptoms like vasomotor symptoms or hot flashes, hot flashes. And then this can last several years until your hormone levels kind of slowly eventually drip off and stabilize at a low level.
Speaker 1:I'm going off topic here for a quick second Because I'm in that perimenopause and all most of my friends are as well, and they say so many things to me that I'm like, oh my gosh, that's just not true. But anyway, they talk a lot about now, you know, testosterone and progesterone and they think they have low testosterone. They think they have low progesterone but you know their symptoms are sort of broad still, I mean because we're still on the lower end of perimenopause. So I mean, mean, is that something? Obviously you would just have to see a patient, you'd have to talk with them about their symptoms and their family history and go from there.
Speaker 2:Yes, it's extremely individualized and I tell my patients that whenever you come and see me, that whatever your best friend is getting may not be necessarily what you need and what you should get for your symptoms. And so I do a full kind of checklist of all of your symptom, kind of a symptom inventory if you will, to determine what is going on. I determine what tests need to be done and then go from there, based on your symptoms, where you are, whether you're in perimenopause or menopause because there's a big difference in the way that we treat those two different life phases and kind of determine what your best regimen would be from there.
Speaker 1:So do you recommend then, before a patient sees you or any other physician, to sort of keep track of their symptoms for a certain amount of time or, you know, sort of keep a diary or journal of that?
Speaker 2:Oh yeah, that's always helpful if you kind of keep track of what your symptoms are. And I'm going to ask a lot of questions. I have a lot of times where I ask a patient they're experiencing a particular symptom and they go oh yeah, oh my gosh, I haven't even thought of that. Yeah, absolutely, is that related to perimenopause? And I ask it to every single patient. And so keeping track of your primary symptoms and then, importantly, keeping track of your cycles, that is so important. I have a lot of patients who do a really great job of tracking their cycles using an app or something like that, but then a lot of times they don't keep track of their cycles, and one of the kind of earliest symptoms of perimenopause are menstrual changes, and so we do kind of want to know what's going on with your menstrual period. How frequently are you getting them? Have you stopped having periods? And if you did, how long ago? Was that Okay?
Speaker 1:that's great, thank you. So I'm going to get off topic there a little bit, yeah, so the second myth is it only causes hot flashes. It being menopause or perimenopause, the only symptom is feeling warm.
Speaker 2:So yeah, absolutely not Like we were just talking. There are many, many, many symptoms of perimenopause and menopause. I mean it affects pretty much your entire body. It can affect sleep, it can affect mood, it can affect memory and brain fog and difficulty with word finding. It can affect your skin. Patients complain of dry skin or itchy skin. Hair Hair loss is a really big one I see a lot. Weight is also a really big complaint I see a lot and then changes to sexual health. But the things that we really are primarily concerned about is things that affect, like your longevity and so your heart health. In particular. There's a big change in cardiovascular risk with the menopause transition bone loss, so risk for osteopenia and osteoporosis, as well as overall life expectancy and longevity. Those are the big things that I worry about. Of course, I want to address your symptoms, but I want to do it in kind of a whole body way where I'm taking care of your symptoms and also improving these comorbidities that are associated with menopause.
Speaker 1:Absolutely Right. It's not just, like you said, the weight gain, you know, and all those other things, even though they really really, really stink. But you know, you don't think about like I could be saying this improperly, but you know, right, lower estrogen can. Then, if it's not protecting our heart as much and obviously not protecting our bones and so like, if sometimes maybe you're going to the doctor and, oh, I've got that, what is it called? Like that doctor blood pressure thing, I get that.
Speaker 2:Yeah, you're always nervous or anxious.
Speaker 1:White coat hypertension, yeah, but I'm like maybe it's not, and especially now, you know, if I have lower estrogen, that's something I probably should. You know, just have a better look at.
Speaker 2:Yeah, absolutely so. It's from a full body perspective. Like I said, we want to address your symptoms, but also we want to address your general health and some of those core morbidities that come along with it.
Speaker 1:Yeah, great, Okay. Myth is you can't get pregnant during menopause. As soon as cycles become irregular, pregnancy is impossible.
Speaker 2:Yeah, that is also a myth. Like we said, I've been telling my patients. There was this article I saw recently and I may be misquoting the age, but there was a woman in Germany in her 60s who got pregnant naturally without IVF, and so, while that's obviously like Guinness World Book of Records breaking, that is not the norm. I tell that to my patients to tell them it is never impossible.
Speaker 2:Until you are fully in menopause 12 months without a menstrual period you can still have ovulation, and the most tricky part about it during perimenopause is, as those periods start to change, they start to become irregular. That means ovulation is becoming irregular and unpredictable as well, and so, with unpredictable ovulation, it makes it more difficult to use things like cycle tracking to track your periods, and so it's even more important that if pregnancy is not within your goals and you don't want to become pregnant, that you're using something to prevent it, because I think that most of the patients I talk to when I mention that they absolutely not. I'm done with that phase of my life, I do not want to become pregnant, and so, yeah, it's very much still possible.
Speaker 2:So when you say ovulation is irregular, meaning it's not that every 14th day, like it was when we were younger, exactly exactly and the difficult part about ovulation if this kind of goes a little bit into the physiology of menstrual cycles, but the trigger for you to have a period is ovulation. So ovulation this kind of goes a little bit into the physiology of menstrual cycles, but the trigger for you to have a period is ovulation. So ovulation occurs, in a textbook world, about 14 days before your period occurs. Now, if your periods are stretching out, they're becoming really difficult to predict. You don't know when that ovulation is occurring because it's happening before the period occurs. And so say you're going 45 days or one month, you're going 30 days and then 45 days and then 28 days. It's very difficult to track exactly when that ovulation is occurring. Yeah, Interesting.
Speaker 1:Okay, moving on to our next myth, menopause means you'll automatically gain weight. Weight gain is inevitable.
Speaker 2:So a little bit of a myth, but a little bit more nuanced, I'll say, is probably what the answer to that is. And so I heard this point a couple years ago. I believe it was one of the menopause society conferences I went to that. As you approach perimenopause, there is a significant change in our metabolism, so your metabolism reduces by. You know. They say 25%. I don't know if we can fully quantify that, but approximately 25%. So whenever I tell my patients this, that means that you have to work out 25% more, eat 25% less, just to maintain. That is just a maintenance.
Speaker 2:That's not even for the weight loss aspect, and so it's incredibly frustrating for my patients who come to me complaining of weight gain. And it's not that it's inevitable, it's that it's extremely difficult for all of our patients, and so we have to take into account the way that the hormone changes shift, the way that fat is stored. So when you're gaining weight during perimenopause, a lot of my patients gain it in what's called an androgenic distribution, meaning like a male-like distribution. So that's typically around the stomach and the midsection, and most of us do not want to gain weight there, and so it just becomes more noticeable when you gain weight through perimenopause, and so I really emphasize things like major lifestyle factors diet, physical activity, making sure you're sleeping well, making sure you're treating your body right. Those play the massive role in overall weight gain throughout the perimenopause and menopause transition.
Speaker 1:Yeah, I mean I can speak, you know, and I'm sure there's so many listeners out there, but yeah, and it kind of comes out of nowhere. It really comes out fast. I'll say I mean, and I'm working so hard and you have to work even extra hard, I mean, and it is, it's really frustrating. So, listeners, I'm with you and I mean I've had to up my game, but it's like there's only so much time in the day as well, and uh, yeah, yeah, don't I get it?
Speaker 2:Um. So I refer a lot of my patients if they're struggling with weight. I say this to all my patients anybody who has a complaint of weight, I am more than happy to get you a referral to one of our weight management specialists that can assist you along the way. And if lifestyle alone is not enough, they do have medications. I think I talked about that in our last podcast that can be helpful for weight loss. I personally don't typically prescribe weight loss medications only because if I did, my whole practice would become weight management, and I'm not a weight management physician and so I'm pretty educated about these weight loss drugs, being family medicine trained. But I want to make my focus be on hormone therapy and those types of prescriptions and those types of medications, and so that's whenever I grab a buddy and say, hey, I need some help in co-managing this patient, and that's where our weight loss specialists come in.
Speaker 1:And I think it's also just like at least I can only speak on my. You know what I'm going through, but I just had to change from being a runner, walker, to lifting more weights and trying to do. Yeah. So it's kind of changing things up and and give yourself time and just stick with it, Right, and then maybe there's that option B if need be.
Speaker 2:Absolutely. If need be, that's always there. But yeah, definitely, lifestyle is number one.
Speaker 1:Okay, so we're actually. We just talked. You just mentioned this. Hormone replacement therapy is dangerous for everyone. All hormone therapy leads to cancer or heart problems All hormone therapy leads to cancer or heart problems.
Speaker 2:This is my favorite myth to bust. So whenever I'm giving lectures to young learners or residents or other physicians, this is kind of one of the big highlights that I spend a lot of time talking about is that hormone therapy is actually pretty safe. Hormone therapy is actually pretty safe. There are very few, very, very few reasons why a patient cannot be on hormone therapy. The list is only about 10 or 12 things that really prevent somebody being on hormone therapy, and even then there are exceptions within those things.
Speaker 2:So all of the recent evidence that has happened since the 2002 WHI has shown that hormone therapy is safe and effective for the vast majority of women, and the research looked at something called the timing hypothesis, and so what the timing hypothesis is is that when hormone therapy is started within 10 years of menopause or less than the age of about 60 to 65, that is the primary patient population that is going to have the greatest benefits and the lowest risks, and so benefits are kind of what we mentioned earlier. So heart health, bone health, overall longevity I mean I could go on and on about this.
Speaker 2:But if started early in menopause or in perimenopause, hormone therapy for the vast majority of patients is extremely safe. And so I would say, if that's something you're interested in, talk to your primary care doctor, talk to your OBGYN, talk to your internal medicine physician, and if they're not comfortable with that, come and see us, talk to us at the Specialized Women's Health Center or any of the physicians that work in conjunction with us across the Cleveland Clinic system, and we can definitely talk to you about if hormone therapy is right for you.
Speaker 1:Great, all right. Myth is menopause kills your sex drive permanently. Your libido is gone forever.
Speaker 2:Yes, another thing I hear quite commonly, especially as somebody who has an interest in sexual health the biggest organ in our body that is responsible for sexual that impact, sexual health are really multifactorial. There's a lot that goes into it. So, yes, through the menopause change we can have loss of hormones which can affect desire, which can affect things like vaginal dryness and discomfort, which can cause sex to be painful or uncomfortable. And obviously nobody wants to have sex if it hurts, and you shouldn't. But it's a lot more complex than that. So things like intimacy, emotional connection with your partner, feeling comfortable in your own body, things like that all go into sexual health and sexual desire. So usually when I'm addressing those topics with my patients, I'm addressing is there any aspect of pain here? Are we addressing the hormonal aspect, but also are we addressing the brain aspect, which is a?
Speaker 1:big one, yeah, and so just kind of goes back into having that discussion about like hormone therapy and because, as you mentioned, it not only helps, you know, our bones and our heart, but can also help all these sort of extra beauty things and our sexual health, yeah.
Speaker 2:Yes, absolutely.
Speaker 1:Okay, and our last myth is menopause only affects older women. It's a late life event.
Speaker 2:So yes and no no is probably the take-home message here. So average age of menopause in the United States is about 51, 52. But I tell my patients anywhere between 40 and 60 it can occur, and so menopause less than age 45 is considered to be early menopause. So I emphasize to my patients when I'm doing annual exams, for example, that if you're starting to have symptoms, if you're starting to have period changes and you're on the younger side, that's actually even more important for you to come and see us, because there are additional risks associated with early menopause.
Speaker 2:But menopause can even and I'll use the term menopause lightly here can occur when you're younger than age 40. When you're younger than age 40, it's classified as something called premature ovarian insufficiency and what that means is that basically your ovaries are having difficulty producing the right amount of hormones and it's premature, so less than age 40. And that's actually a pretty significant medical condition that can cause lots of comorbidities, lots of increased risk for things like heart disease, osteoporosis, dementia, shortened lifespan, and so those patients in particular definitely need to be seen and chat with one of our menopause specialists about being on hormone therapy, so kind of like. We mentioned anything from like medical conditions to genetics, and then another one that goes in here are things like surgical menopause, right, so your ovaries are taken out as part of a surgical procedure, like a hysterectomy, for example. That can also put you into artificial surgical menopause, and so that can occur at any time, if that occurs, and so we would want to see you and get you on hormone therapy.
Speaker 1:Yeah, Is there any risk if you do get, don't go through menopause until like after 60? I worked with somebody in the past, a friend of mine, and she was 61, 60, and mid mid 60s anyway 61, 60, and mid mid 60s Anyway and she was still getting her period regularly. And so you know I, you know, at the time before this was before I worked for Specialized Women's Health, so I had no knowledge of any of this. And but is there a risk or anything you know, of concern when you are at a later age?
Speaker 2:So there are a couple of slight risks with going through menopause later. So the more you ovulate, for example, the longer you ovulate, there's slight increased risk for certain types of cancers. Now, I'm not saying this is a significant like major risk, this isn't the one thing driving it, but there are certain increased risks for certain types of cancers. But for the vast majority of patients a later menopause is not an issue. It's not a significant problem that we particularly worry about or that we would say you need additional screenings. So, for example, if you were to have, like, a breast cancer risk assessment, they're going to ask you the time of menopause, cancer risk assessment, they're going to ask you the time of menopause. But typically it's those patients that go into them a little bit earlier that are going to increase your risk or that have menstruation at an earlier age. So, yes, a little bit, but that's not the primary driving factor.
Speaker 1:Yeah, I. She always said it was because she had. This is her. She had kids later in life. She was in her 40s when she had at least two of her children. She's like oh, I'm sure that's why.
Speaker 2:But I'm not so sure. But you know, everybody's very individualized. A lot of it runs in families, so like if you have a family history of patients or your family members going into menopause later in life, you're more likely to. But yeah, yeah, okay.
Speaker 1:Well, that sort of wraps up all of our myths, and we'll actually have this information as a column on speaking of womenshealthcom, if anyone wants to, you know, read that for themselves as well. But while we have you, dr Cohn, do you have any final thoughts or tips or anything you'd like to share with our audience?
Speaker 2:My biggest tip and I kind of mentioned this in my introduction is really about self-advocacy. So if you are having a concern, if you think something in your body is changing, if you think that you're going through perimenopause and you're struggling with your symptoms or even stuff that's unrelated to that, but basically I implore you to advocate for yourself, to speak with your girlfriends. If they have physicians that they're going to that they've had positive experiences with you know, try to get in to see those physicians. Talk to your primary care doctor, talk to your OBGYN. If you feel like you're not getting anywhere, there are other places that you can go. So just really be diligent in your health and seek care if you're having symptoms is probably my biggest tip for my patients.
Speaker 1:Yeah, I mean absolutely. I mean just don't settle for a doctor I'm speaking of experience who just says well, here's some, you know, low dose estrogen, because you say you think you're in perimenopause and then I'm having a bad reaction and they're just like sorry, that's not acceptable and no, and there are really good doctors out there who are now trained in this and in. You know, menopause and women's health that are you know can be resources for you.
Speaker 2:So yeah, and if you're not local to the Cleveland area, there's a couple ways that you can find these physicians. So the menopause society, formerly known as the North American menopause society they actually have a kind of a registry online of those physicians who are certified through the menopause society to be menopause practitioners, and so these are patients that have or, excuse me, not patients these are physicians or nurse practitioners or APPs that have done their online course and have done their online test and have gotten that certification, and so if you want somebody who has a little bit more experience in that area, that website's probably a good place to start to find somebody. That's great.
Speaker 1:Thank you All, right. Well, that wraps up our episode with Dr Cohn and, as we mentioned, she is now a full-time physician with the Center for Specialized Women's Health at Cleveland Clinic and we will have her information of where she will be seeing patients here in Northeast Ohio, as well as a phone number to make an appointment. And if you're not in the Cleveland area, as she just mentioned, you can go to menopauseorg and find menopause experts in your area. So thank you all, and thank you, dr Cohn, for joining me on this episode of the Speaking of Women's Health podcast, and we hope that you all will subscribe. It's free and you can find our podcast on Apple Podcasts, spotify TuneIn or wherever you listen to your podcasts. So thanks again for listening and we will see you next time in the Sunflower House. Be strong, be healthy and be in charge.
