Kitty Anderson: Menopause as a Social Justice Issue

Kitty Anderson is one of the few nationally Board-certified health coaches in the U.S. specializing in menopause education and recovery. By her count, there are only seven similarly credentialed health coaches in the United States.

When I first stumbled across her YouTube Channel, Create a Menopause Recovery, I knew that Kitty was someone special. As an ardent researcher myself, and as a woman just months into her own HRT treatment and recuperating from interludes with a medical system with few knowledgeable practitioners, I was immediately impressed by Kitty’s comprehensive approach to sharing information, truly helping women and focusing on multifaceted solutions. Kitty is not only a menopause expert, she has also been using hormone replacement therapy (HRT) to address her symptoms and improve her quality of life for 14 years.

Kitty Anderson graduated from The Mayo Clinic College of Science and Medicine’s accredited coaching program and passed the National Board Certification Exam, the same body that licenses physicians. In order to maintain her credentials, Kitty takes continuing education courses and is bound to adhering to precise ethical rules and a defined scope of practice. She has also completed coursework in health, psychology, neuroscience, counseling, wellness and nutrition, among others, at Wright State University and Sinclair College.

Kitty’s current paid offerings include one-on-one consultations and webinars, focusing on HRT, stress reduction, nutrition, relationships, movement, sleep and more.

I recently caught up with Kitty to discuss how women are dealing with – or rather, not really dealing with perimenopause – with a special emphasis on her concept of menopausal care as a social justice issue. While many online menopause evangelists may have a decided bent towards naturopathic or conventional medical remedies, or may seek to abandon to idea of any treatments since menopause is a “natural event,” Kitty is the first I’ve encountered who adds a socio-political and socio-cultural element to her advocacy.

Why do so few women seem to know about HRT, let alone use it, for their perimenopausal and menopausal symptoms?

Hormones do hundreds of things in our bodies, and that's how the body works. Only three percent of American menopausal women are getting HRT. Many women are denied HRT by their (conventional) OB/GYN. It is NOT the standard of care to offer HRT.  That means we can't sue our doctor if they say no. 

What about alternative ways to get HRT?

A functional medicine doctor or a functional pharmacy will be more generous with HRT, but it is more expensive. They may or may not counsel on diet. We pay extra for these services, and the product quality is lower than the FDA-approved products.

It seems like so many women are on various prescriptions, potions, supplements or unproven lifestyle changes to get relief from menopausal symptoms. Why?

Our algorithms make it impossible to find valid consumer-friendly information. Everyone is selling something to replace HRT. There is just not a logical reason to use these other products in my mind. They are not the identical molecule to the hormones you used to make.

And there aren’t many accessible examples of women successfully navigating menopause in real life either, right? At least not in terms of symptomatic women talking openly about their symptoms and sharing what worked?

Women tend to look to other women, and there are few examples of women thriving on HRT. If you don't have a friend using HRT, you don't see the benefit. It seems unnatural. But the identical molecule is natural, right? Replace what's lost -- in a form that your body uses.  

There are various formulations and preparations out here that are all classified as HRT. How can there by so much variability in the market?

The broad category of drugs called HRT don't all perform equally for sleep, mental health and cognitive health. Our menopause society (North American Menopause Society - NAMS) doesn't focus on brain health. The research outcomes are focused on menopause symptoms and future bone health. Doctors treat all drugs in the HRT category as equal, and they are not. Our medical system allows this.

Research shows that women of color, and Black women in particular, may have a more difficult and earlier transition to menopause. How does this factor into your concept of menopause treatment as a social justice issue?

Women of color and low income women are about 30 percent less likely to have an HRT prescription. Health information and products are not as available. I think that the lesser quality and less expensive oral estradiol is available on Medicare as the first line of treatment. I have heard of some women getting transdermal estradiol, which is better. 

What are some other barriers to women’s success with hormone replacement therapy?

Not all women trust the medical industrial complex . . . for good reason, right? We have some drugs that are worse than the disease. It is a for-profit system. This works to our detriment. Seventy percent of women stop their HRT in the first year without talking to their doctor. And 70 percent of women do not read the directions to apply their HRT correctly. They are under-dosing.
 
Even smart, successful women are having a hard time getting quality information and the right treatments. Many end up with cabinets full of supplements, vitamins, tinctures and herbs. Others are prescribed medications that don’t fundamentally address the hormonal loss.

I have talked with extremely educated women who know research inside and out. They did not figure out that HRT was critical. The information never made it to them. I know female health coaches in their 50s and 60s, and they did not know what HRT does. They were not using it. 

How can they lead women to wellness without it? There are currently only seven menopause coaches with the Board Certification of NBHWC. There is no training for our Board-certified coaches. I created my own training from a multitude of sources.

What does this do to women over time, this lack of informational access and proactive engagement from their healthcare providers?

When a woman over 60 years old comes to me to talk about hormones, she is really broken. She has arthritis, she has autoimmune problems, she has fatigue, she lacks confidence and motivation, and she is fearful. Her body has gone without hormones for a decade. It has changed. In some ways, she will not recover. She just didn't get the right information at (or before) menopause. It's so sad. 

It seems like some of this is socially conditioned as well as structurally induced, within the systems of healthcare, education and media, this lack of open treatment discussions and awareness for women. Hence, this is really is a social justice issue, like you said. It involves equity, access, investment and repairing the fissures in our medical system.

Most women just think they should "tough it out" or “not bother anyone.” Women are accustomed to self-sacrifice and giving the doctor control of the outcome. They don't understand how to work the system to get what they want. No one is telling them that they are in charge of their health outcome. Doctors are looking for compliance typically, but they don't talk to us about whether or not we are getting enough HRT. 
They don't ever phrase this as, “HRT is good for you. You should feel really well.” And for some reason, there are no testosterone products off the shelf for women. Testosterone is a controlled substance. NAMS doesn't even cover testosterone in their training. (Editor's note: The International Menopause Society does address supplemental testosterone for women.)

I feel like we have to know more than our doctor to get this to work well. All three hormones – estradiol, progesterone and testosterone – are important and all are low at menopause. You can't expect your body to work with 1/20th the amount of reproductive age hormones at menopause.


You can learn more about Kitty Anderson at https://www.jumpstartaip.com/. She offers paid 1:1 consultations and webinars.

Highlights from her YouTube Channel are:

Perimenopause and Menopause HRT for Infection, Weight Loss, Alzheimer’s, Diabetes
Higher Dose HRT Works Best for Mental Health: How HRT Works
100 Ways Hormone Loss Gets to You: HRT Prevention and Recovery
HRT and Personality Changes: What to Expect – My Story, My Clients and Universal Laws of Hormones
No Rules for Menopause? Well, Guidelines, Yes.

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