Meeting Dr. Nagel

james_picMeeting Dr. Nagel.  Late winter of 2002, I was looking for a physician to manage my prescriptions. I was new in town so I asked one of my clients if they could refer me to a physician and that’s how I met Dr. James Nagel.  My client told me if I followed Dr. Nagel’s recommendations, I would feel terrific. In all the referrals to physicians I received over the years, this was the first time someone mentioned feeling good or better by going to a doctor.

I have been to about 50+ providers over the years to “manage” my depression.  I’ve been on every anti-depressant and anti-anxiety medication on the market.  I maxed out on doses for every medication doctors could think of to prescribe but not one of them could tell me “why” I was depressed.  To be honest, at that time I didn’t think about “why”, I just knew I was and always would be.  That was depressing to me, and over the years the depression grew worse.  I felt doomed; like I was stuck with this condition, disease, or disorder.  I didn’t really know what it was, and no one gave me a straight answer, all I knew was  that it controlled me, the life-changing decisions I made, and the daily choices I made throughout my adult life.  It was not a very good life to be blunt about it.  I was outright miserable and a daily struggle to survive.

Going to Dr. Nagel’s office was like no other experience I ever had with any providers, including specialists.  Everyone was telling me the same thing, starting with the first physician I went to when I was 17—“You are severely, clinically depressed.  You will be depressed for the rest of your life, and you will need to be on medication for the remainder of your life”.  When I naïvely asked the doctor how he knew I’d be depressed for the rest of my life he responded, “Because your mother is a patient of mine and she has been severely, clinically depressed all her life, and she said her mother had always been depressed and crazy”.

Part of me was relieved someone gave a name to the emptiness and despair I was feeling but I went from feeling empty, to feeling nothing at all on Prozac.  For a while I was okay with that.  I was okay with feeling nothing.  I began living my life around my depression.  That was how I identified myself to other people.  I thought having depression, or at least the official diagnosis gave me the right to check out and require less of myself, because that’s what I thought of myself and was worthy of.  This was easy to do on medication.  I checked out and went through the motions.  I was content to not feel and participate.  I grew up in a painful environment so this was a welcomed mental vacation.  [icon color=”#f6a0af” size=”20px” hover=”fade” name=”awesome-user-md”]

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50 Symptoms of Menopause

seven50 symptoms of menopause.  Suzanne Somers talks about the Seven Dwarves of Menopause but really there are many more than seven. We’re finding there are more symptoms to menopause then we once thought. I’ve been working with menopausal patients for about ten years in a menopause specialty practice, and have heard and seen symptoms of menopause than are not recognized by organizations such as the Menopause Society. There are about 50 symptoms most women experience due to declining estrogen and eating the Standard American Diet (SAD). We’re seeing that estrogen deficiencies are at the root of many diseases among aging women.  Let me make a note by stating that not all women experience all symptoms, or any at all.  The severity of menopause symptoms will fluctuate according to the diet a woman chooses to eat, the lifestyle she chooses in regards to physical activity, recreational alcohol and drug use, medications, surgeries, and sleeping patterns.  A woman may also have menopausal symptoms and not be in menopause. Another thing I’d like to add is there is no particular age a woman could be in menopause.  A woman in her twenties could experience symptoms of menopause if her estrogen is low enough. No matter the age, if estrogen is low enough, a woman will experience some symptoms of menopause. The following is a list of menopause symptoms I have found to be the most common:

  • Acne
  • Anti-social Behavior
  • Anxiety
  • Bleeding Gums
  • Bloating
  • Body odor changes
  • Breast tenderness
  • Brittle/splitting nails
  • Cognitive decline
  • Constipation
  • Controlling behavior
  • Depression
  • Diabetes
  • Dizziness
  • Emotional disconnect
  • Lack of motivation or drive
  • Facial Hair

  • Fatigue
  • Feelings of lethargy 
  • Fibromyalgia
  • Forgetfulness
  • Hair Loss
  • Headaches & Migraines
  • Hot flashes
  • High Cholesterol
  • High Blood Pressure
  • Incontinence
  • Insomnia
  • Irritability
  • Irregular heartbeat
  • Isolation 
  • Itchy all over
  • Joint pain
  • Loneliness
  • Low libido
  • Memory Loss 
  • Mental decline
  • Mood swings
  • Muscle Loss
  • Night sweats
  • Not wanting to be touched
  • Osteoporosis
  • Painful intercourse
  • Panic attacks
  • Sugar addiction
  • Tingling extremities
  • Vaginal atrophy
  • Vaginal dryness
  • Weight gain

    As you can see, there are much more than seven symptoms of menopause, and some women experience additional symptoms not listed above. These are the menopause symptoms we saw most in our clinic.  We also saw most, if not all of these menopause symptoms disappear after a woman optimizes her hormones by a provider who knows how. ~Moxie.    [icon color=”#f6a0af” style=”none” size=”20px” hover=”fade” name=”awesome-user-md” url=””%5D 

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    Why Moxie?


    Welcome to my first post. I’ve been waiting for this moment for a long time. I’m not close to being finished with the site but I wanted to start blogging as I build it so you can see how it evolves. I’ve been working hard designing this website, and as I’ve been constructing it, I’ve been getting pretty excited. Since this is my first post, I’m going to start at the beginning of my journey with PMS, perimenopause, a hysterectomy, menopause, and hormone replacement therapy. This post will answer the question, “Why Moxie?”

    On October 31, 2012, I was browsing the Internet on the topics of menopause and hormones like I’ve done so many times over the past nine years. I don’t know why it was this day that was different but it was in regards to deciding to do something about the lack of information, misinformation and truth on menopause, perimenopause and hormones. Everything I was reading was false or inaccurate. “Menopause experts” were saying things like “take only the lowest dose of estrogen”, “Estrogen causes cancer”, and “Just go talk to your healthcare provider” when asked what to do about hormones. The more I read, the more upsetting it was at the inconsistencies in answers to the questions women were asking about menopause. Not even doctors were being honest as to what they’re saying to their patients about hormones.

    I created this website for the purpose of providing the most accurate information on menopause, perimenopause and hormone replacement therapy options. Everything I write is my own opinion based on my years of research, clinical experience, personal experience and education. Feel free to check out my background and education in the “Moxie” section located in the top menu bar.  If it’s not there now, it will be soon.

    I will discuss my personal experiences with and without hormones over the years. You can find these posts under “The Story of M.” located in the lower menu bar.

    This is going to be a great journey.

    ~Moxie.  [icon color=”#f6a0af” size=”20px” hover=”show-color” name=”awesome-user-md”]

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