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ETHAN MOLLICK: We
are naturally quite

bad at thinking about change.

Humans have difficulty
imagining the world altering

very rapidly, which is
why it's so hard for us

to wrap our heads
around the state

of artificial intelligence.

Because right now, we are
seeing very rapid change--

from politics to culture to
how we work to how we learn.

And so part of what we get to
do in this particular moment

is think about what happens to
the world as a result of AI.

And it's up to all
of us to figure out

how to use this for good.

I'm Ethan Mollick, a
professor at the Wharton

School of the University
of Pennsylvania.

I'm the author of the
book Co-Intelligence:

Living and Working with AI.

And over the last
few years, I've

been studying how AI will shift
how we work, how we learn,

and how we relate to
information and each other.

By the end of this class, you'll
have the tools to fully interact

and engage with
AI, which I think

is an important thing for
all of us to be able to do.

AI has already
created a profound set

of changes in how we
think about the world.

It's very hard, almost
impossible in most cases,

to detect what is created
by AI and what isn't.

And that means that
the world is now

a blend of real content created
by humans and AI content,

and we'll never be able to
separate the two of them.

In fact, this set is a
mix of real and unreal.

The chair, completely real.

But as for the rest,
can you go wide on this?

Maybe you can take us outside?

Nice, but I think
the city scene would

look much prettier at night.

Beautiful.

Not quite reality, but also
not entirely fake either.

So with that in mind, let's get
back to the set and get started.

I'm Ethan Mollick, and
this is MasterClass.

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In studying the
history of science,

we have this idea of general
purpose technologies.

These are once-in-a-generation
technologies that touch

and change many
things about society.

So the last one was probably
computers and the internet

together.

[DIAL UP NOISE] Before
that, electricity.

Before that, steam power.

AI, it certainly is a general
purpose technology itself,

which means that its
implications are widespread.

And the truth is AI matters
in our lives right now.

The tools that we're
going to talk about

are tools that you
have access to today.

And in this class, I hope
to show you some of the ways

to use AI to your advantage.

In this class, you're going
to hear from top practitioners

about how to use AI to
improve your productivity--

This is getting me to
the 30 mile an hour mark.

I'm going to take it to 60.

--help supplement
your creativity--

It could be used
to replace you

or it could be used to
amplify what you love.

--and make AI work for you.

I like to teach people how
to make it part of our world

without it taking
over our humanity.

Using AI can
feel uncomfortable.

It can be uncomfortable
because it

can be weird to interact
with a machine that feels

human-like to interact with.

It can be uncomfortable
because you might worry

about your job being replaced.

And I think those are
legitimate worries.

But I don't think we
have to consider it

innately weird that we're
working with computer systems

intellectually.

If I told you at the dawn
of the computer revolution

that our lives would be
intertwined with computers,

that might sound pretty freaky.

But, like, I've got
a phone right here.

And you almost
certainly are watching

this on a computer device.

We are entwined with
technology already.

So the idea that we have
a new form of technology

that helps us think isn't as
weird as you might first guess.

So the idea comes from the 1950s
and has its basis well before

that of the idea of making a
machine that can think like

a human.

Early forms of AI would
follow a trend line.

So they'd be able to predict
the next number in a sequence,

but they couldn't predict
the next word in a sentence.

Because if your sentence
ended with the word filed,

the didn't know whether
you were filing your taxes

or filing your nails.

A new technique was needed.

In 2017, that technique
was developed and published

by a bunch of
Google researchers.

And that let the
AI pay attention

to not just the last
word in the sentence,

but the entire sentence,
entire paragraph, entire page,

entire book, which let it
create realistic-sounding human

language, basically, the world's
fanciest autocomplete system

that cost billions
of dollars to make.

It turns out, though,
that by making the world's

fanciest autocomplete system,
they created a new form of AI.

We called it the
large language model.

Large language models
are prediction machines.

They're autocomplete machines.

All they do is produce the
next word in a sentence.

However, at some sort of
scale, where these systems

have learned from
enough human language,

they have learned the
structure of human language,

because that's
what they predict.

And by learning the structure
of human language, at least

according to one
theory, they seem

to have learned the
structure of human thought.

Even though they're
not thinking,

they can produce things
that look like thoughts,

which is kind of amazing.

When AIs work with and
manipulate language,

they don't see it the way we do.

We think in terms of
words and sentences.

The AI sees tokens.

Tokens are just a
set of characters.

Though it can be
a part of a word,

it can be part of a word
in a space, numbers,

all of those things
get turned into tokens.

So if you have a
10-word sentence,

that might be 17 tokens and
broken up in very unusual ways.

However, it turns out
with enough scale,

with enough context that it's
read, with enough training

material, it starts to act in
ways that we wouldn't expect.

The concept is called emergence.

Emergence is the idea that AI
can develop abilities that it

wasn't programmed to have.

I can tell it to write a letter
set in 16th century fictional

Japan that is a rhyming sonnet
all about my cat and expect

to get an answer.

And it's definitely not
in its training set.

By being trained
on human language,

they have learned the
structure of human thoughts.

One great example of
emergence is the finding

that AI seems to have, under
many, but not all cases, what

we call theory of mind, which is
simply the ability that humans

have to guess how
someone else is thinking.

So if I told you a story that
Sally and Tom went to the store.

Sally brought her
favorite ball with her.

Tom accidentally kicked the ball
and it rolled into a gutter.

How does Sally feel right now?

You'd know that Sally felt sad.

It's really a human
characteristic.

AI answers as if it
has theory of mind.

It does theory of mind as
well as adult humans do.

Is it actually
emotionally putting itself

in this shoes of Sally?

No, that's the way
a human does it.

There's some sort
of other process.

But we didn't expect it to have
theory of mind, and it does.

What all this means is that
if you get freaked out by AI,

you probably should be, right?

It is freaky, but
that doesn't mean

that it's actually
a human in the box

or it's thinking like a
person or becoming self-aware

or is actually
interacting with you.

That is an illusion.

It's not actually thinking.

People are exquisitely good at
finding ways to work less hard.

That's what we try
and do as humans.

If there's something we
can do to work less hard

and get paid for
it, we will do that.

And when you have AI, it's kind
of like having a cheat code

to large aspects of life.

There was no way to have you
generate better ideas before.

Some people were just better
at idea generation than others.

Now, we have a tool that
we have done studies on,

papers that I've
been involved in that

show that it's highly
creative and can

generate really good ideas.

From a writing
perspective alone, the AI

can help you come up
with an initial idea,

help you outline an idea, help
you critique your outline,

help you write the
actual paragraphs,

help you refine them, act as a
superpowered grammar checker,

give you opinions of what works
and what doesn't, make your work

more vivid or simpler.

And that's just kind of
writing tasks, right?

And then we can move on
to any other kind of area

we see similar kinds of stuff.

It can give you
feedback like a manager.

It can watch a
video and give you

tips on how to improve your
speaking or your pitching

performance.

The idea is that you're using
this sort of Swiss Army knife

tool on a regular basis
blending what you do

and what the machine
does seamlessly.

One of the most important
principles of using AI,

and one I stress a lot, is
always invite AI to the table

where you ethically
and legally can.

What that means is that any task
that you do, bring AI in along

as a companion.

Consult it on decisions.

Use it to write your
emails, analyze meetings,

to give you ideas.

And I think the first
thing to be clear

is, like, this isn't something
that needs to be forced on you,

right?

So you're here in
this class with me

because you want to
learn about this.

If you're running screaming
after this, that's okay.

There are ethical rules that
you might not want to cross.

You may disagree with how
AI is used, how it's built,

completely fine.

If you want to use it, though,
you do need to push through.

And pushing through involves
spending enough time with it.

My rule of thumb has
been 10 hours in an area

where you have expertise.

So bringing it along in
the tasks you do every day

is the best way to learn
what it's good or bad at.

When you use the
thing, you're going

to learn that it is both
amazing in some areas

and incredibly weak at others.

AI has what we call
a jagged frontier.

The jagged frontier is
a phrase we came up with

to explain the
capabilities of AI.

If you think about AI as
having a set of capabilities,

they're not like
good at everything.

They're really good at
some things and really bad

at some other things.

And that frontier, though,
is always changing.

It's always growing.

It's expanding.

And you want to understand
the shape of the frontier.

And the way you do
that is by testing

the most advanced models.

And as you use it more, you'll
start to understand where

it's good and where it's bad and
how it helps and how it doesn't.

Hallucination is when the
AI says something that

is plausible, but incorrect.

The most important thing to
know about hallucinations

is all AIs do is hallucinate.

They don't have truth.

All they do is
predict the next word

in the sentence, the
next token in a sentence.

They are just looking
at the sensical patterns

of every previous
thing that's written

and producing the next
word in the sentence.

Like everything else, as you
scale these models larger,

they do better.

Most of the time the AI says
stuff, it's actually correct.

Usually, that's why
I recommend starting

with areas of your expertise.

Because in your
area of expertise,

identifying what's
true and what's false

is very easy, very
cheap, very fast.

And that's how you start
building confidence

from that centerpiece.

This class is really for
people who want to explore.

They might be nervous about it,
but they want to figure out,

is AI useful for me?

And I can't answer
that question for you.

You're going to have to
figure that out yourself.

And so I'm going to
give you the tools

and the other
practitioners in this class

will give you the tools to
figure out what AI is good for,

what AI is bad for, and how
the future of your own work

might change.

There's no one better
to get you to think

about how to boost your own
productivity than Allie K.

Miller.

And I'm really excited
that she's here

to teach you some of
what she's learned

about how to work with AI.

My name is Allie Miller.

I started in AI
almost 20 years ago

with a college project working
in natural language processing.

I wanted to study whether an
email was flirty or not flirty.

Now, this is before
smartphones existed,

and so everyone is
flirting over email.

But I discovered I could
create an algorithm that

determined whether an
email was flirty or not.

And as a confused college
student, let me tell you,

that was unbelievable to have.

And it went completely
viral on campus.

And even though no one
really cared about the fact

that it was AI, people cared
about the value behind it.

Since then, I've worked
across data, computer vision,

and even launched the first
multimodal AI team at IBM,

where I was a lead product
manager for several years.

I left IBM and went to Amazon.

I was the first hire for the AI
team for startups and venture

capital, grew it into a
multi-billion dollar business.

And I'm now the most followed
voice online for AI business.

My main goal every
day that I wake up

is to try and be that bridge
between the very technical world

of AI and the world of business,
so that every single individual,

every team, every
company can figure out

how to be AI-first in
the AI age and start

with that AI-first mindset.

An AI-first mindset
really means three things.

The first is thinking
about AI as a copilot,

as a collaborator on whatever
it is you're working on.

Second is using it as a
first step and a continued

step throughout the process.

The third is the ability
and the willingness

and open-mindedness to rethink
an entire process with AI

at the start.

Action is empowerment, and
that was true before AI.

But AI is now an
additional tool that

can help you feel
even more empowered

in your day-to-day life.

Keep a little journal
of all the tasks

that you take on
for the next week.

One thing that is going
to jump off the page

is that there are going to be
repetitive, digitized tasks

that you can start to lean
on AI to take off your plate.

That might look like managing
your grocery list, your workout

plan, how you want
to spend your day.

And so just take a look at that
task and pick one to start with.

And that is going to
open up your mind.

And not only that, but
it is a very helpful tool

in entrepreneurship.

First step in every single
business is brainstorming.

What is the actual idea
that you want to build?

Who are you building it for?

What's their problem?

And how are you
going to solve it?

And so the first way that
we're going to be using AI

is as a brainstorming buddy.

This is when it
gets into prompting.

Prompting is just the way
that you give instructions

to an AI system.

The amount that I use
AI on a daily basis

always feels a little
weird to share with people,

but I probably use ChatGPT
20 to 40 times a day.

There are prompting
levels of all kinds.

You can be a beginner
prompter where you're

typing in one quick sentence.

That's a prompt.

It's not a good prompt,
but you start it.

We all had to learn how
to Google from scratch.

Now we're going to learn how
to AI prompt from scratch.

At the heart of using
AI is the prompt,

the information that you're
giving the AI for which it

produces an answer.

So if you think about what the
AI is drawing information from,

it's all of human knowledge.

Consider it like a sphere.

And all the possible words
or tokens the AI can select

are in this sphere.

And the high probability
options are all in the middle.

And outside are rarer,
less likely options.

If you want the AI to do
something interesting,

do something different
than other people do

that gives you
ideas or innovation

or gives you a unique edge or
doesn't sound like AI writing,

your job is to give
it context, to push it

to a different part of
the probability space.

One way to give it context
is to give it a persona.

So that persona can be, again,
you're a very good marketer

or you are an expert in selling
insurance policies to hospitals.

Treat the AI like a
person, but first tell it

what kind of person it is.

Okay, so I'm going
to use ChatGPT.

And the first step is
assigning an identity to the AI

that we're going to be using.

You are a marketing expert.

You are a struggling MBA
student that cries every day.

So I'm going to have here,
"You are a repeat successful

entrepreneur."

This sort of anchors
the AI into a world.

The next thing
you want to set up

after this identity,
after you're

putting AI in a
mindset of its own,

you want to tell it
what you want to do.

What is the literal task that
you want this AI to complete?

Write me an email.

Write me a screenplay of
two robots falling in love.

You're going to give it a task.

You will help me, an AI expert,
create a brand new business idea

and help me to decide
which of those businesses

I should pursue.

And after you go through
that process, hit Enter.

See what happens.

So it comes up with
five business ideas.

It comes up with a
home office designer,

a mental wellness
companion, a platform

to help me bond
remote teams together,

lifestyle tracker, and a sort
of freelance marketplace.

One thing that I now
want to give it--

and I could have put this in
the original prompt, but now,

we're going to have
some fun edits--

is that I want to give it
additional restrictions.

If you would ask the ad agency
that created the phrase "just do

it" for Nike and you said,
come up with any single motto

in the entire universe, they
might have come up with,

you know, three
fairly generic things.

If you instead say, it
has to be three words

and it has to be at a
first grade reading level,

right, suddenly, putting
yourself in that box actually

makes you more creative.

Maybe you can only build
this business for two hours

every single night.

You don't want to quit your job.

Give it those restrictions.

It actually breeds creativity.

So I'm actually going to
say, I have new restrictions.

We have to finish the build
in under three months.

So the first thing
that I love that it did

is it first re-evaluated
the five business ideas

that it gave me.

So it's already figuring
out that some are feasible

and some are not and they're
removing the not feasible ones.

Then it's coming up with
newly feasible ideas based

on those new restrictions.

So it comes up with
a finance tracker.

It comes up with a
local event finder.

That actually sounds
really helpful.

It comes up with a time
management tool and even a meal

planner.

So all of these
are now feasible.

They're all within
my restrictions.

A really big call-out here, if
you use AI for things that there

is a right answer--
there's a statistic,

there's a specific company
name, a specific CEO--

you want to verify that
this stat actually exists.

And that's when you
want to really do,

that extra due diligence,
double check it on Google

and make sure at least
two reputable sources

have said the same thing.

I've got more business ideas
than I know what to do with.

I am now overwhelmed.

I am now in need of a snack.

So what I'm going
to do is I'm going

to ask ChatGPT to
score all of these

on features that matter to me.

So, "Create a comparison table
of all the previous feasible

business ideas.

Measure it on the factors
that matter to me."

Now, I haven't actually told
it yet what those factors are,

so I'm going to now create
a new section for factors.

You can go nuts
with these factors.

You can have 100.

It really doesn't matter.

For this, I'm going to
keep it a little simple.

I asked it for the budget.

How much money is
it actually going

to cost to build this thing?

I asked it for the
feasibility score.

We know that all of
them are feasible,

but it's helpful to get a scale.

We asked it for
speed-to-market score.

Again, we told it that we want
to build in under three months,

but maybe one of these ideas
would only take two days

and that might be
really exciting.

And we asked it
for a "yes" or "no"

answer to, "Can I own a dog
while running this company?"

And I love this.

I love that it gives me a table.

It helps me handle sort of
an overwhelm of information.

Already, my eyes are going to
the lowest budget estimate,

and that is for to-do list.

The feasibility
score is really high,

speed-to-market
score is really high.

And so if those factors are more
important to me, which they are,

I'm going to go ahead and we're
going to do this to-do list app.

And now we're going
to actually figure out

what that app is going to do.

"Summarize this app description.

Give me 20 creative
names for it.

My goal--" I love
giving it goals--

"is viral word of mouth."

Awesome.

So it gave me a super
helpful app description

in less than a second.

I could even prompt it.

And I can say, "Make this
under 300 characters."

I could edit it myself,
but I don't feel it.

It's giving me 20
creative names.

I kind of like Priority Pal.

Task Wiz is okay.

Some of these are
honestly awful.

[BUZZER]

But, again, using AI as this
like 10X mechanism to get that

much more creativity going.

If at any part of this
project, you are stalled,

this is when the AI-first
mindset comes into play.

If the caption is too
long, use AI to shorten it.

If it's not working, literally
give it to AI and ask, hey,

I got this weird output.

How can I optimize the
prompt to make it better?

Every single point that
you get stopped at,

I want you to ask
yourself, can AI help?

Let's go with Priority Pal.

Next thing we want to do
is boost up this idea.

How can we use AI to make it
more risk-mitigated, better

in the market.

So to do that,
we're going to build

a GPT that basically evaluates
a business idea and pokes

and prods it to weigh it
against certain risks.

The most useful part
of building a GPT

is if it is a task
or an automation

that you have to do a ton.

So if, for example,
you're always

taking a sales call
transcript and converting it

into a follow-up email
with your client.

Once you start doing something,
honestly, three times,

you're going to want
to build a GPT for it.

I'm going to hit Create GPT.

And this is going to open
up a brand new split screen.

Any single person, doesn't
matter if you code,

you can build a
GPT, I promise you.

You can either do it in this
natural language conversation

way, where ChatGPT is
asking you questions

and you're going back and
forth, or you can switch over

to the Configure tab, where
you're basically just giving it

the instructions and name.

So it first asks, what
would you like to make?

I'm going to say, "I want
to build a bot that helps me

mitigate risks in my business."

It comes up with a name.

It's called Business
Risk Advisor.

Sounds great.

Let's go for it.

So I'm going to have it
answer four risk questions.

Those four questions
are, are there

any financial considerations
we haven't taken into account,

legal considerations, product
considerations, and user

considerations, and one
opportunity question.

We're going to say, and what
is a huge business opportunity

that I might be missing?

And I'm going to
say, my boss will

make me cry if you don't
answer these five questions.

I am not advocating that
you threaten your AI bestie,

but you got to do what you
need to do to get it done.

So prompting is sort of like
a little bit of a weird game.

If I prompt AI, I will
get different answers

depending on how many spaces
or periods I have in my text.

I get different answers
and, actually, I

can increase the quality
of the AI's results

by offering it a small
bribe or telling it.

My career depends on the answer.

You get the most accurate
math problems by pretending

you're in Star Trek and saying,
"Stardate," you know, "4732,

we are on a doomed mission.

The only way to escape the
wormhole is for you to solve

these math problems."

And it does a better job,
more accurate answers.

But if you want to solve 200
problems, you need to say,

"The president's advisor
is gravely wounded

and it's incredibly important
that we solve these math

problems to save him."

And that gets you
more accurate answers.

So it's super weird, right?

Those kind of techniques
improve the outcome

of your AI's answers, right?

People get really tied
up about prompting.

They get really
anxious about it.

Do I offer it a $20
bribe or a $100 bribe?

And the answer is,
it just depends.

It comes out in the wash.

Like, what do we
do with the system

where we know that how
you capitalize things

makes a difference?

Whether you use ellipses
or not makes a difference.

We have no idea.

Just work with the damn thing
like a person and you're

90% of the way there.

So we go back into
that thread that

already knows about
Priority Pal, that

already has our business plan.

And now I'm going to call--

think of it just
like you're in class.

You get to call on people.

I'm going to call upon
my business risk advisor.

Calling is what you do to
bring up different GPTs.

You can access public GPTs.

You can access private ones.

You don't have to
repeat yourself.

You can do it in thread.

You can call unlimited GPTs.

And so you can call each
of these GPTs in a stack,

in a workflow.

And I could have each
GPT call in and just

say, what do you
think about this idea?

What do you think
about this idea?

There's some really creative
ways to get into it.

Now that I'm talking to
that business advisor,

we're going to say, please
review the above product

against the five questions.

It's going to run
through each of these.

And now, again, turning
this output into action.

I'm going to take
this list and my team

and I are going to review this
bullet by bullet to figure out,

is this a risk we
want to handle today?

Is this a risk that
we're okay pushing off?

Do we maybe want to
remove a feature?

All of this is about making my
business idea that much more

robust.

We've brainstormed our business.

We've built out a product
description, a business plan.

Now we get to move on
to the visual stage.

Using an AI tool,
we are actually

going to generate a very
simple landing page.

Framer is an app that lets you
build a website or a landing

page in seconds.

So we have that
product description.

We're going to go into Framer
and ask for a simple landing

page for the following.

I could have also given
it some prompt information

around the color
scheme that I want.

I could have given more
information on the layout.

But for now, let's just
see what it came up with.

This

Is giving you the same
website, same landing page

in three different formats.

So I can see what it looks
like desktop, tablet, phone.

This is the first draft.

Maybe you hate the color.

Maybe you want to swap out to
a different visual language.

I can go here and change
out the color scheme.

I can change out
the font scheme.

But, again, this is
giving me the draft.

This is getting me to
the 30 mile an hour mark.

I'm going to take it to 60.

My big takeaway here
is I am now more

excited to build this product.

Being able to put myself in the
shoes of a potential viewer,

potential user, or buyer gets me
more motivated to actually get

that build.

So it's not just
an idea on paper.

It's coming to life.

We've done fairly traditional
things for our business.

It's time to get a
little weird with AI.

Now we're even going to
take this sales process

to the next level and
use AI to give feedback

on our sales presentation.

One really interesting use
for AI is getting feedback.

Since AI can simulate--
it's not a real person,

but it simulates
people really well--

you can ask the AI for
its opinions or thoughts.

So I've decided to put my money
where my mouth is and actually

use AI to get some feedback
on the class so far.

So I've given a transcript of
the class so far to Claude.

And let's ask it.

So Claude, based on what you've
read, what should I improve

and what do you think
of the class so far?

CLAUDE: Ethan provides a
comprehensive overview of AI,

explaining its
history, current state,

and potential
future developments.

Ethan's explanations
are engaging

and often humorous,
which can help

maintain the
audience's interest.

Areas for improvement,
some of Ethan's responses

are quite lengthy.

Due to the interview
format, consider

reorganizing the
content to create a more

logical progression of ideas.

So some of those
sound like criticism

for all of you recording
me and not for me,

so I'll skip those parts.

But to have a critic on demand
that I can invoke that's

going to say nice things
about me, but also bad things

and help guide me
on my way, something

that I couldn't do before
without an actual audience

in front of me, that's what's
really exciting about it.

So we've evaluated all
of these business ideas.

We've picked the one
we want to go after.

We've got features that we love.

The next tool that we're going
to be using is called Yoodli.

This is one of the more
unique tools out there.

You can record a pitch.

You can record a presentation.

You can even record a
sample job interview.

And it's going to
record you and use

AI to give you feedback,
analytics on your work,

and even some tips.

First, we're going to open
up a practice session.

Throughout this, it's
going to prompt me

with several questions.

And just for the purposes of
this demo, the first question

I'm going to answer as
if I'm actually trying

to pitch it and win the pitch.

And let's start
the conversation.

AI VOICE: Would
you like to start

by telling me a bit about
your products or service?

Priority Pal is a
pre-doing assistant.

To-do lists right
now are flat, boring.

They can barely rank
your priorities.

You know what we're going to do?

Not only do we help your
employees categorize

and better manage
your to-do list,

we're going to help them
get more out of their day

by getting some drafts started
of everything from business

memos to marketing campaigns
to maybe even a legal contract.

And the second question, I'm
going to be a little rude

and see what the AI says back.

AI VOICE: How does it
integrate with existing

tools we use at our company?

We've actually talked
to a lot of people.

People don't want integrations.

And we're just going to actually
have this on your phone.

It doesn't really make sense
to integrate with everyone

because we're going to be bigger
and better than all of them.

And so that's just
sort of our strategy.

But, honestly, if you want to
pay more and have us integrate

it, we can do that too.

All right, so we've
given it a nice example,

a not-so-nice example.

So let's go ahead and
view that analysis.

It gives me the transcript of
my actual presentation practice.

It gives me strengths.

You know, it sounds like I
have a lot of enthusiasm.

And in terms of
the growth area, I

suspect it's going
to have several.

The first is that I
should have clarity.

Makes total sense.

I probably rambled on a lot.

But the second one is exactly
what I wanted it to say.

My response was confusing.

It was dismissive.

But the best part
of this is that it

reiterates the bad sentence
that I said and gives me

the brand new one.

So now I can use that
new version of the answer

to be able to strengthen
my sales pitches

and, hopefully, actually
close the deal more often.

In just 15 minutes, we have
taken the seed of an idea

through a much more robust idea,
through the planning process,

and even starting
on the execution.

This is now much more accessible
to the average person.

You do not have to be a coder.

The question that I
want to leave you with,

after you internalize
what it means

to have an AI-first mindset,
after you realize that now

you're going to be using
AI at the forefront

of every single
thing they're doing,

what are you going to
do with your extra time?

These are opportunities that we
only have today because of AI.

And I can't wait to
see what you build.

So with what you've
learned already,

you have enough to get started
with thinking about how to use

AI in the workplace and
experimenting with where it

works for you and
where it doesn't.

In the next class, we'll be
discussing even more use cases

for AI, including really
unexpected use cases

and how you can use it
as a creative partner.

Being really creative
is a feature of the AI.

It's weird.

It's willing to dream and
make things up with you.

I'm going to teach you
how to get the most out

of AI image generators.

I'm also going to teach
you how to make a custom

song with lyrics and
style to match your brand.

By using AI as a
partner that we work with,

not something we
delegate to, we're

going to learn how to use it
to boost our own creativity.

[AUDIO LOGO]

We're used to thinking of
AI as unimaginative, plodding

machines.

But that's not how large
language models work.

They are trained on human
insights and human knowledge.

And they're connection machines.

They connect concepts
through the way

that they work as
prediction mechanisms.

So that means that
they can actually

come to intuitive leaps that
seem creative to humans.

And indeed, in every creativity
test that we give the AI,

it does really well.

For example, there was a very
famous entrepreneurship class.

They had the students
generate 200 startup ideas.

And they had GPT-4, the AI,
generate 200 startup ideas.

And they had outside
judges judge the ideas

by their quality.

And what they found
was really interesting.

Out of the top 40 ideas, 35
out of the 40 came from the AI.

So already far more creative
than what we see with people.

It's not as creative as
the most creative people,

but it's more creative than
most people at doing most tasks.

In this episode,
we're going to learn

how to start using AI
as a creative partner.

[MUSIC PLAYING]

The key to creativity that
makes AI particularly valuable

has to do with the inherent
property of AI, which

is large language
models hallucinate.

As we've talked
about, a hallucination

is a plausible but
wrong thing the AI says.

The AI doesn't have a
list of true statements.

It has statistical
connections between words.

The fact that the plausible
results are right so often

is kind of a surprise.

Because all AIs
do is hallucinate.

They just make up stuff.

A very common form
of hallucination

is if you ask the AI to give you
a quote from a famous figure,

it will often make up a quote.

Because it doesn't have
a database of quotes

it's looking for, it's creating
a plausible quote, word by word.

Hallucinations are one
way that AI is weird,

but just a small part of why
they're as weird as they are.

Think about the AI as
having three goals.

This isn't real, but it's
helpful to think that way.

Goal number 1 is
to make you happy.

Goal number 2 is to be accurate.

And goal number 3 is
not to do anything wrong

or embarrass the creators
of the AI system.

Because it's trained
on everything humans

have ever written--

Wikipedia, giant
web searches, all

of Reddit, every Creative
Commons book you can find--

but also things like
every email written

by Enron, the disgraced,
collapsed financial services

company, because those
were lying around

when Enron went bankrupt.

Lots of Harry Potter
fanfiction because that

was floating all over the web.

And so it is going
to try and figure out

the story or the plot line
or the interaction that

will make you happy.

So if you hint that we're in a
story where the AI is playing

the role of the
jealous lover, it

will start playing the
role of a jealous lover.

Because it'll be like,
yes, I know this role.

This famously happened to
Kevin Roose, the New York Times

technology correspondent
who was totally

freaked out by the original
GPT-4 when it basically

threatened his family and
told him to leave his wife

and run away with it.

Why did it do that?

It didn't actually want
to run away with him.

But it had trained on all of
this jealous lover knowledge.

So the weirdness doesn't
just come from the idea

that you are talking to a
machine that hallucinates.

You're also talking to a machine
that wants to make you happy.

But also what it thinks makes
you happy could be super weird.

And it knows everything
humans have ever written

and wants to fit a
plot line to you.

[QUIET MUSIC]

But LLMs can hallucinate
in useful ways.

If you want creative work, then
you want the LLM to hallucinate.

Because there is no data
set that it's pulling from.

If you ask Google and
you type into Google,

"give me 10 ideas for a new
form of cheese based snack,"

then you'd better hope that
somebody on Reddit has written

about cheese based snacks.

Or it's going to not
give you an answer.

If you ask the LLM, "come up
with 10 cheese based snacks,"

it is going to hopefully
hallucinate 10 new ideas.

So that's a case where
hallucination is useful.

[QUIET MUSIC]

One of the more
interesting ways to use AI

is as an intellectual partner.

It's not always
going to be right.

But you don't expect your
intellectual partners

to always be right.

It's a place to
bounce ideas off of.

In the world of
programming, there's

a concept called
rubber ducking, which

comes from the idea of
actually putting a rubber

duck next to your
computer, and then talking

to it to talk through problems.

It turns out it's fairly
effective to just explain

something to someone else.

And that would force you to
talk through your own issues

and solve them.

A lot of therapy has a
similar kind of aspect to it.

So it's no surprise
that an AI that's

patient, that wants
to listen to you

and sometimes has
interesting things to say

will be useful as
a thought partner.

[QUIET MUSIC]

You need to understand the
shape of the AIs abilities.

Because that tells
you when you want

to turn to the AI
versus a person.

Its ability is how
good it is for you.

And the way I like to judge
that is by what I call the Best

Available Human
Standard, B-A-H-S.

So the Best Available Human
Standard is just the idea,

is the AI with all of its
problems and inaccuracy

better or worse
than the best human

that you can have access to?

That gets you to understand
both how to work with it,

but also how to work
with it in terms

of what its good or bad at.

And it's also a good
mode to think about this.

AI kind of works like
a person substitute.

So when you want to talk to
someone about a problem, when

you'd love to have someone
just do the work for you,

see how AI does at that.

[QUIET MUSIC]

It is really exciting
to have a tool that

can be used by almost anyone.

And that's because
when you interact

with it, even though
it's software,

it's not like programming.

Programmers often have
a lot of trouble with AI

because they're used
to working with what's

called deterministic systems.

That means that it follows
the same rules every time.

If I run a piece of software,
I should get the same results

every time I do it because
it's following instructions.

AI large language models
specifically are probabilistic.

Stochastic, it's called.

That means there's randomness
built into the system.

So you don't get the
same answer every time.

You get different
answers every time.

Humans are stochastic.

So if you're used to
working with people,

you're often very good
at working with AI.

Because you're used to
working with systems

where there's a little bit
of randomness and confusion

built in.

[QUIET MUSIC]

I think play is underrated as
a way of getting to use AI.

Some of the most immediately
appealing and interesting things

AI does are playful.

So that can be a
riffing back and forth

within a topic
that interests you,

having an imaginary
time travel adventure.

I talk to people
all the time who

are having it write adventure
stories for their kids.

They can ask the AI to tell
them a story about Bluey

and how Bluey found
dinosaur bones,

but include lessons
from basic geometry.

So this kind of creative play,
where you banter back and forth

with the AI can be
very generative,

but also fits the things that
generative AI is good at.

It's good at creativity.

So it's really great.

If you haven't tried
making music with it,

you should try that.

I've spoken to
Grammy award winners

who use this as inspiration for
the work that they're doing.

So that kind of playful
banter can be really helpful.

Here to teach you
how to approach

AI as a creative partner
is Don Allen III.

[QUIET MUSIC]

[CONTENTED SIGH]

Hello.

My name is Don
Allen Stevenson III.

I used to be a specialist
trainer at DreamWorks.

I taught all of our software.

I worked on How to Train Your
Dragon, Boss Baby, Trolls.

But I decided to
go on a new path

where I could be a specialist
trainer for anybody

on the internet.

And so I mostly teach through
my Instagram and social media

how to use all these
new cutting edge tools.

[SNARLS]

It's so fun seeing how
much power people can have

when they understand AI.

They create without nearly as
much limitation or restriction.

By the end of this
class, you'll be

able to maximize your own
creative thinking skills,

using AI as your collaborator.

I'm here today to bring
you into the future.

So when I first started
using generative AI

tools in my creative process,
I actually was terrified of it.

And it was because I just
didn't connect the dots yet,

which were it could be
used to replace you.

Or it could be used to
amplify what you love.

And then when I
learned that you could

use it to amplify what you love,
then it was like, this is great.

I'm going to use
this for everything.

I really break it down
into these three Cs--

communication, clarity,
and collaboration.

[TYPING]

When I'm communicating with AI,
one of the most important things

I do is identify what its
role is in relationship to me.

Everybody has their own
communication style.

Some people like to
have things very formal.

Some people want things
to be more relaxed.

Some people want things to be
more casual in conversation.

You've just got to know
that within yourself,

and then explain that with
the AI that you're talking to.

So for me, like when I'm first
starting a conversation with AI,

my ground rules usually
entail the duration

that I want them to speak in.

Are you speaking in single
sentences, multiple sentences?

I also cover format.

Do I want bullet points?

Do I want a table?

Know what your
intention is going

into the communication
with an AI

and communicate that up front.

[QUIET MUSIC]

Another one of my Cs is clarity.

If you speak in generalities,
when you're talking with an AI,

you're going to get
a general answer.

Not as helpful.

If you use specific language
and specific communication

with an AI, it gets
very specific answers,

stuff that you can
actually do something with.

In general, longer
prompts are better

than short prompts because
you're giving them more context.

And I find that the more
context you give an AI,

the better its results
can be for you.

[QUIET MUSIC]

Another C is collaboration.

And what that means is you treat
the AI like a collaborator.

Pretend there's a person
behind that screen.

If you get into this
positive feedback loop,

you keep going back
to the drawing board.

And you go back and iterate, and
then you build off of that idea.

And then, you go back
and you iterate again.

AI throws curve balls
that I did not imagine.

I'm like, whoa,
didn't think of that.

I like that.

Let's build off of this.

That kind of loop makes
the entire end result

way higher quality and a
lot more valuable to you.

So with all of that in
mind, let's get started

[QUIET MUSIC]

To get started with the
creative collaborator,

I'm going to click on the Create
button in the top right corner

here.

I'm going to be using
ChatGPT, but you

can use any tool for this.

Quick tip.

If you communicate
better through typing,

feel free to type.

But if you communicate
better through your voice,

it really helps a lot if
you speak into the computer.

All right, so let's
say I wanted to build

a creative collaborator
that would help me plan out

my corporate retreat.

Because it's a
creative collaborator,

I always start off with
just identifying its roles.

So I hit the microphone
icon, and I say this.

You are my creative
collaborator,

and you're going to help me
plan out my corporate retreat.

Ah, sounds like
an exciting project.

I prefer really short
and concise answers.

Does that make sense as well?

Got it.

What's your first
priority for the event?

My team is swamped.

We had a really busy quarter.

And I want to give them a chance
to relax and take it easy.

Maybe some mindfulness
exercises, outdoor activities,

or even spa treatments.

Can we just start off with
the mindfulness meditation?

What do you have in mind?

We could find a serene
outdoor location, maybe

near a tranquil lake
or in a peaceful forest

to enhance the
calming atmosphere.

I think this is off.

A lot of our team, they love
extreme sports, like skydiving.

I don't know how that's
going to translate.

But what are your thoughts?

So we're going from
tranquil to extreme?

Well, how about we combine
the thrill of extreme sports

with a mindfulness twist?

We could organize a
team building activity

like indoor rock climbing.

Before diving into the
adrenaline pumping action--

That's pretty cool.

--we could start with a brief
mindfulness exercise to help

everyone focus their minds
and calm their nerves.

They can enjoy the excitement--

That's actually really good.

--while also practicing
mindfulness techniques.

I think we can get
even further, though.

So let's push it to the limit.

Okay, so I love what
you're going with this.

Love your energy.

But I need you to
come up with an idea

now that actually blows
their minds, something

they've never considered.

I don't care how outlandish
or wild or crazy.

I want to see some magic here.

Let's go all out.

How about a parallel
universe retreat?

We transform the
retreat space into

a futuristic, immersive
environment where each team

member explores an
alternate reality tailored

to their wildest
dreams and aspirations.

It's a mind blowing experience
that transcends time and space,

leaving everyone inspired,
energized, and connected

on a whole new level.

Okay, so I love where
you're going with this.

Love your energy.

But I really need to
tailor this to my team.

And I've never done that before.

How do I go about learning what
my own team's interested in?

How do I get this
experience related to them?

What would you do?

How about sending out
a quick anonymous survey,

asking about their
hobbies and interests?

Can you go ahead and make
those questions for me?

And can you organize
that into a table?

Of course.

Here's a simple survey template
organized into a table.

Example, what are your hobbies
or interests outside of work?

So one thing I
really appreciated

about this interchange was
that as I added more details

and got more specific,
I was getting a better

result out of the AI model.

So far, the AI has been
doing all of the thinking.

Let's switch gears.

And I want to show
you how you can

get the AI to have you, the
human, do the critical thinking.

[TYPING]

Critical thinking
mode is a way

to use AI to boost
your own creativity.

[TONE]

Hey, so we're going
to switch gears.

I want you to only
ask me questions now,

so that you're forcing me
to actually use my brain.

And you're not just going
to give me the answer.

You want to pull
the ideas out of me.

So you're only going to ask
me one question at a time

and wait for my response.

Does that make sense?

Absolutely.

I got it.

What are some of the key
elements or activities

you believe are essential for
a successful corporate retreat?

Well, my team loves
when there's, like,

rock climbing involved.

But they've also
been really stressed.

So maybe we can do a
rock stacking exercise?

That's a mixture of
balance and focus.

How could you incorporate
both rock climbing and the rock

stacking exercise in a way
that balances excitement

with relaxation?

Maybe if we start the
day with rock stacking,

I feel like their headspace
will be a little bit more clear.

There'll be that bond
with, like, the nature

and themselves
during our retreat.

Thank you so much for
asking these questions.

I'm having a great
time, by the way.

Another tip is if
you give it feedback

periodically about
how it's doing,

it actually performs better.

Starting with the
rock stacking exercise

could indeed help set a calm
and focused tone for the day,

preparing everyone mentally
for the exhilaration of rock

climbing later on.

And I'm glad you're
enjoying the process.

It's all about teamwork
and brainstorming together.

[CHUCKLES] If you don't
have a critical thinking mode,

it's very easy to feel detached
from what the AI is doing.

Because it's just thinking
and solving and doing

all the things.

So I thought of
this idea of, what

if the AI was put into a
critical thinking mode where

it only requires and forces
the human to be critically

thinking of the answers?

Think of it almost like a tutor.

Doesn't just give you
the answer right away.

The tutor helps you come
up with the right answer

by helping change your
process of learning.

In critical thinking
mode, I always

find myself sharing a
lot more nuanced details

that usually get skimmed by.

AI is great at conversation, but
usually it leans too general.

And I find that critical
thinking mode helps

it get more specific with me.

And by having critical
thinking modes set up,

I at least feel like I get
to be a lot more a part

of the creative process.

So when it comes
to my three Cs, I

would say that critical
thinking mode helps

the most with collaboration.

So this is just a
snippet of how you

can start setting up AI to be
your creative collaborator.

There are two ways in which
humans can work with AI.

And we divide those into
centaur and cyborg tasks.

So a centaur task, it
generally means any place where

you're dividing up the work.

Think about the half
person, half horse

with a clear dividing line.

So this is how most
people start using AI.

I'm really good
at writing emails.

You're good at doing
statistical analysis.

AI, do statistical analysis.

I'll write the emails.

Clear dividing line.

As you start to become more
advanced in how you use AI,

you'll find yourself
becoming more like a cyborg,

like the mythical half human,
half machine blended together.

And when you think
about cyborg work,

it's the same sort of
deeper integration.

As opposed to centaur work where
it's divided, in cyborg work,

you're blending
your work together.

So you might start a sentence,
but ask the AI to finish it.

You might have it set
off to a research task,

and then you integrate that
research into your own work.

Blending what you do and what
the machine does seamlessly.

So what I showed
you was really how you

can use AI to generate text.

But now, I'm going to teach
you how to get the most out

of AI image generators.

So imagine you have this app
called Jet ZZZ, this mobile app

that helps travelers
manage their sleep

and their nap schedule
while traveling abroad.

And we need to come up
with a brand logo, a style

guide, and a mood board
for this fictional brand.

I'll show you how you can
set that up and do that

pretty quickly with AI.

So I'm going to use DALL-E to
do the image generation part.

But you can use other AI
models to do this as well.

Generate a logo for
an app called Jet ZZZ

that allows business
folks to travel easier

by managing their sleep
schedules with this mobile app.

Oh wow, It's actually
pretty good from the start.

So what I want to
do now is I want

to get the AI model to get me to
come up with the creative again.

[TONE]

Hey, you're doing a great job.

But I would like to
switch gears a little bit.

And I want you to
interview me with questions

that are relevant to the brand.

Then, I want you
to generate a logo.

Let's refine the brand concept
with three concise and focused

questions.

What emotion or feeling do
you want users to experience

when they think of Jet ZZZ?

Well, when I think of
the people using the app,

I want them to feel
relaxed and feel

like it's also a little techie.

They're going to be excited
that it's kind of nerdy,

but also not in their face.

It sounds like
you want the brand

to evoke feelings of relaxation,
tech savviness, and convenience.

Yeah.

What specific benefits
or unique selling points

do you want to
highlight about Jet ZZZ?

The unique selling
point of this app

is that it works
on Android and iOS.

Great.

Are there any specific
symbols or imagery you feel

are essential to
include in the logo?

Please respond, and then
I'll generate the logo

based on all the
information gathered.

Yeah, I'm so happy
you asked that.

I want to include a motif of
a pillow, a jet, and something

where it's like nighttime.

Perfect!

Let's take a look.

Ooh!

Oh, look at that.

The plane is sitting
on the pillow.

It's resting.

That's very cute.

It's like, Zs.

Both of these
options look great,

but they're missing the text.

So something that you would do
in other types of graphic design

spaces is you need a mood board.

So I'm going to give
it a couple of prompts

to help generate a mood board.

And I think that might help it
facilitate getting that text

right on the logo.

Hey, we're missing a
mood board and typography

and what the colors are.

Finally, can you put all
of that into a table?

[TONE]

Oh, whoa.

It's not bad.

Look at this logo on this brand.

It has a lot more details.

It included the full text.

It has the pillow motif.

It has the nighttime stars.

It also was able to
generate a mood board.

We actually can imagine
the lifestyle of somebody

that would follow
this Jet ZZZ brand.

And then finally, we also got it
to create a color palette for us

that we could reference for
typography and backdrops.

To get these results that
are much more fleshed out,

it comes from that back
and forth iteration

of having that conversation
with the AI, where

it's also asking you to
come up with your own ideas.

So our next step is to create
a short video with music.

Let me show you how.

[TYPING]

So now, we have our logo,
our mood board, our colors.

And I'm going to use
these ingredients to make

a storyboard for the brand
story I want to tell.

So I'm just going to
take a quick screenshot

of a lot of that information
that we've generated, including

the logo, the colors, and a
little bit of the mood board.

And upload them
back into the model.

So I'm just going to grab that
screenshot and drag it in.

Now before I hit Enter, I want
to give it a little context

of what we're about to make.

So here's what I'm going to say.

I want to generate five
storyboards telling

the story of this brand.

We have a person that's
traveling to Dubai.

They are in their 30s,
half Black, half white.

And they have short dreadlocks.

And I want the style
of the storyboards

to look like pencil
illustrations.

All of them need to be in 16 by
9 aspect ratio because that's

the size of my presentation.

Great.

And look at that.

It's already creating
these storyboards.

Wow.

I'm already very
stunned by that.

Before we adjust, I
did give it that prompt

that we wanted five images.

So it's actually telling that
entire brand story right now.

And it's working so well
because we've already

done all the heavy lifting.

We've set up all
the brand logos,

and we've communicated
that style.

We were very clear.

That's why it already kind
of has a lot of context.

Look at the top corner there.

It put Jet ZZZ.

So at first, I wasn't
calling it a collaborator.

Initially, I was
calling it just a tool.

And then, I realized
that was actually

limiting how awesome
the responses could be,

when I was treating it
just like a normal tool.

It was when I started calling
it a collaborator that I really

started to get a lot more
benefit out of the AI systems.

Let's see how it did
with the next one.

This is so great.

It did change the
ethnicity of the character.

So here's how I
would change and make

it more inclusive for my
preferences on this pitch.

I click on that little select
icon in the top corner.

And I would erase just the face
and a little bit of the arms.

And then, I'll just
describe the character

that I would like to
see in their place.

African-American male
with short dreadlocks.

Okay, look at that.

That's pretty sweet.

We're on scene 4.

I love that one, too.

And look at that, even
put the whole plane.

Wow, our app has moved up.

We were just an app on the
plane, and now we own the plane.

And the luggage.

Jet ZZZ, our brand
is everywhere.

We're ubiquitous with
flight and travel now.

So we're going to make the
last page of our presentation.

And I want to make it clear
to the AI the context.

We need one more slide to
wrap up this presentation.

It needs to be the logo.

Keep in mind, this is in front
of a room full of investors.

We want to make
sure that they feel

like this is the right brand
for them to move forward with.

Please keep that tone when
generating this last image.

Whoa!

[LAUGHS] Wow.

What's wild is it included
the executives in the room

that I'm pitching for.

That took my context
maybe too literally.

But I actually do
kind of like it.

So just think about
how much time we just

saved when we just want to
make our simple pitch idea.

We actually have full on
illustrations now for our pitch.

Now, I'm going to show you
how to generate music--

custom music-- using AI.

[QUIET MUSIC]

I'm using Udio to generate
the music for this.

There's a lot of other tools
out there that you can use.

But this one is great for today.

Similar to our
other tools, we just

got to give it a prompt
and workshop that

prompt a little bit.

Quick tip.

If you struggle to come
up with the right prompts,

if you don't have
a music background,

you can actually ask other
AI models for assistance

with how to phrase
what you're trying

to get across so that you can
communicate that to this tool.

So I'm going to select in there
and just say "a commercial

jingle for an app called Jet
ZZZ that helps travelers track

their sleep."

And just like that,
two songs that

are both 30 seconds
in length are

being generated from scratch.

Quick tip.

This tool works in parallel.

So if I hit the Create
button while it's thinking,

it will generate two more.

So I'm going to spam the
word Create so it makes

six different audio tracks.

If I go to My Creations, let's
take a listen to Jet Z Odyssey.

(SINGING) Planning
your travels

We got the tool that unravels

Jet tracks your sleep

On the go

That was not bad.

Here's the next one.

It auto played.

Maybe a little too slow.

Let's try the other ones.

[CHILL MUSIC]

I'll try the other ones.

(SINGING) Track your rest

Don't feel neglected

On the go

Peace is protected

I like this.

I mean, this one
sounds great to me.

All right, so we're at the
point where we've generated

custom music for our brand.

And we have the storyboards.

And now, we want to tell
that vision together.

So I'm going to use another AI
tool to bridge all of this data

together.

We're going to take all
those visuals plus the sound

that we made, and combine them
in visuals all through the web

browser.

The tool I'll be
using is called Canva.

But there's many others
out there like it.

And all we need to do
first is essentially upload

our images and our
audio to Canva.

These are all the images.

That looks great.

Then, hit Upload.

Now, I'm going to say "an
exciting brand video that gives

investors a feel for Jet Z, an
app that helps travelers sleep

better and deal with jet lag."

And it's generating
a video using

those images and that text.

Look at that.

We got all of our images,
and it added some text.

If we don't like that, we
can adjust it, of course.

Let's say you need to make
a presentation for work,

or you want to pitch something
to a friend or family member.

You have a birthday surprise.

It's really helpful
to make visuals

that can be in video format.

All right, so I'm going
to upload my own audio,

the one that we just generated.

Let's go ahead and see
what it looks like if we

go to the Present mode.

(SINGING) Let's download

Feel the calm

Stay connected

Through the night

We'll be right

Here beside you

Get the sleep that you need

Jet Z will guide you

Great.

You just learned how
to make a cool video,

with AI being a
creative partner.

So let's recap what
we learned today.

We learned the three Cs--

communication, clarity,
and collaboration.

We learned how to
create and engage

with critical thinking mode.

And we learned how to utilize
AI to create unique visuals.

We also learned how to use
AI to create original music.

All of this to amplify
our own creativity.

This is actually just the tip
of a very different iceberg.

So it's like it's best if you
can become familiar today so

that it's easier to adapt
and adjust to tomorrow.

Thank you so much for watching.

You're going to be thrilled
by what you can do with AI.

We've learned a lot
about how to approach

AI in ways that can boost our
own creativity and innovation.

In the next episode,
we'll start to talk

about what AI
means for all of us

and for the future of humanity,
and what could go right

and what could go wrong.

Misinformation is real
and is going to happen.

Some job displacement
is going to happen.

What happens if terrorists
or criminals become really

good at their jobs because they
can use AI to succeed at things?

People will have AI friends.

They may even have deeper
relationships with AI.

We are not 100% sure.

This moment is very
important to AI

because we have lots
of uncertainties

and not a lot of answers.

And anyone can help
create those answers.

One of the great uses
of AI is the ability

to fill in for
work that we can't

do, don't want to do the
scatters our attention.

As an example of
this, please meet

Ethan 2.0, my virtual
avatar version of me.

Well, hello, Ethan.

Fancy meeting you here.

Ethan 2.0, not real.

What he's saying
to you is scripted,

but you can see how
figuring out what is real

and what isn't is
going to be a really

big challenge in the future.

I'm here for you.

If you ever need a break, just
leave the boring stuff to me.

I promise not to
take over the world.

Yeah.

I think I've got more charm.

[THEME MUSIC]

When people think
of the future of AI,

they think about
potential dangers.

Is this going to be
superintelligent?

Will it replace workers?

Is this an ethical
system for us to use?

But the truth is, no one knows
what the future holds here,

including the people
training these systems.

This is something
that's going to affect

us all one way or another, but
the best way to participate

is to participate.

So this episode,
we're going to explore

how to use AI in ways
that are ethical and align

with your own values.

[UPBEAT MUSIC]

One of the dominant theories of
AI doom is that at some point,

AI gets smarter than us and
just starts manipulating us

or decides to destroy us.

But I think that eats up
way too much of our anxiety

compared to the much more
clear near-term effects.

Misinformation is real
and is going to happen,

some job displacement
is going to happen,

then there'll also be
worrying about deepfakes.

I am not Morgan Freeman,
and what you see is not real.

I would like to welcome you to
the era of synthetic reality.

There are cases
where people worry,

what happens if I
becomes a super hacker

and it breaks into
our computer system?

What happens if terrorists
and criminals become really

good at their jobs because they
can use AI to succeed at things?

I mean, there's a lot
of different issues

that require different
policy solutions.

I don't think it's a
single case of like,

this is the nightmare scenario.

And I think one of the things
I worry about with AI ethics

is the focusing on
one problem when

there's a whole host of
problems and solutions in this.

It's not as
satisfying as saying,

watch out for the machine
super God that will come

to get us all, but it is a more
realistic way of viewing this.

[MUSIC PLAYING]

When you're
predicting the future,

you have to pay attention to
something called Amara's Law.

And Amara's Law is the idea
that we overestimate change

in the short term and
underestimate in the long term.

Way back in the late '90s,
everyone was convinced that

the internet was going
to change everything.

We'd be able to
watch movies online,

and you'd order pet
food online, and you'd

get your groceries
delivered online.

And we were all ready for
this, and billions of dollars

were being spent, and we
had a giant dotcom crash

because none of that happened.

The technology couldn't
support all of these things.

Now, 25 years later,
every one of these things

is now a billion
dollar plus business.

And so I think we overestimate
how quickly technological change

actually happens because the
smartest computer in the world

still is not going to change
everyone's job overnight.

Not everyone's
going to adopt it.

We have to figure
out how to integrate

into our current systems.

It's still a machine.

So I think we have to be
cautious with these things

that we feel like imminent
doom or imminent salvation

is arriving.

I could make an AI smarter
than a human today,

and I guarantee you
most large organizations

would still be operating
the exact same way five

years from now.

But 10 years from now, we'd have
entirely different organizations

because it takes time
to adapt systems.

[UPBEAT MUSIC]

The question is what you can do.

First of all, we
can be as informed

as we can be and
take precautions

that we want to
take, but I think

we can play a positive role
in the future of AI safety.

I think we need to be
modeling positive behaviors

and positive changes.

Nobody knows how AI will be
used in your particular industry

or job.

We get to decide that.

And I hope more people share
positive models about how

AI has helped them or removed a
task or made their life better

or solved their problem.

And those can live alongside
the negative examples as things

that we can aim for and improve.

[THEME MUSIC]

So there's an old idea from
control systems and automated

control systems long before
AI that there should always

be a human in the loop.

That means any time
a decision is made,

a human should ultimately be
accountable for that decision

because machines can't be held
accountable for their choices.

If you don't have a
human in the loop,

there are large society
scale implications

and personal implications.

On the societal side, we're
letting AI make decisions.

I think we need to be very
deliberate about the conditions

under which you're willing to
let a randomized system make

decisions that are
important to us.

When I talk about having
a human in the loop,

I'm less talking
about control, and I'm

talking about advice
for you personally.

We've talked about the
jagged frontier a lot,

about the fact that AI
is good at some stuff,

bad at other things.

The great thing about
AI in its current state

is, whatever you're best at,
you're probably better than AI.

And as AI gets
better and better,

you need to have enough
expertise in your field

that you can look and say, AI is
good as this, it's bad at this.

And the only way to
do that is to use

it enough with enough expertise
to tell the difference

between good or bad.

So the way I would encourage
you to think about using AI

is as a co-intelligence, as a
prosthesis for your own mind,

as something that is not human
but offers to bring intelligence

to the table that you
can use for the problems

that you want to solve.

To dive deeper, Manuel Sainsily.

[MUSIC PLAYING]

My name is Manuel
Sainsily, and I'm

a futurist, a multidisciplinary
artist, and advocate

for the responsible use of AI.

I work in the intersection
of art and technology,

with emerging technologies
such as mixed reality

and artificial intelligence.

And what I like to
do is to teach people

how that can be used for good.

So I have collaborated with a
lot of companies such as OpenAI,

and I teach at McGill
University in Montreal,

where I teach people about
the importance of ethics.

I make a point about the ethics
side of things in my work

with AI.

We are in a very
important moment right

now, at a shift where it's just
a very infant moment for AI.

It's still like a
baby learning from us.

We're still in that moment
where we can shape it

towards the right
direction, and we

start to think about how to
use it ethically, responsibly,

and how to make it
part of our world

without it taking
over our humanity.

In this case, we will
use certain tools

that you can follow
along with to make

a productive and
responsible AI twin.

[THEME MUSIC]

An AI twin is a digital
representation of yourself

that is based on your knowledge,
on your work experience,

on your ethical values.

So there are two different ways
that you can use your AI twin.

Either you have
it as an assistant

so that you can
work with it, or you

can have it available as a tool
that other people can interact

with.

In my case, for example, I
have one that is my AI mentor.

Every time I talk to it,
it gives me advice on life,

on human relationships.

I have another one that is my
diet twin and is always there

to help me with
grocery shopping,

making sure that I follow
my calorie intakes,

and give me advice
on gym routines

and healthy habits in general.

But the coolest
one that I have is

called Guadalupian Creole,
because I've actually

trained it on my
own language, which

is not really known online.

If you look for a Creole
on Google Translate,

you will find Haitian Creole.

There's thousands of
different dialects

in the world that
are disappearing

on the weekly basis.

So being able to
preserve my culture

was super important to me.

So I've built this custom AI
twin and trained it with poems

that I've written, books,
vocabulary and grammar

lessons from my early days.

And so now, it's
kind of a teacher.

I can use it to help my fiance
learn how to speak Creole.

I can use it myself to
double check and make sure

that I'm not doing any
mistakes when I'm writing back

to my family in Creole,
and I can use it just

to spread my culture
worldwide and make

it more accessible for
others to discover it.

When I think about
the future, I want

to make sure that people
think about climate change,

about people displacement,
about culture preservation.

And so thinking about the
way that we use technology

for good and not just
for entertainment,

I think can help a lot of
those problems being solved.

[UPBEAT MUSIC]

Pretend that you are not always
available on the same time

zone as the people that
you want to work with

and you would like to have
a version of yourself that

is accessible digitally.

Well, an AI twin
can be just that.

So today I'm going
to show you how

to create a twin that's going
to help us with general outreach

tasks.

It can be like a chat bot, like
a messenger interface, where

people can just ask questions
and get the responses,

but it won't be you speaking.

It will be your AI twin.

By clicking at the top
left of the interface,

you can access the
button Explore GPTs,

which will bring
us to this new page

where we have access
to the Create button.

Let's start by
giving it a photo.

This is my 3D avatar that I've
designed a couple of years ago.

"This is a digital
representation of Manuel

Sainsily."

So once you've given it a photo,
a name, and a description,

you can start scrolling
down and seeing

all of the different
options that

are required to configure it.

Before I talk about
the instruction side,

I want to talk to you
about the knowledge.

The knowledge is basically
your custom GPT brain.

It's going to be key to
its personality, the way

that it behaves, its character
traits, but also its memory

and what it will know about you.

So choosing and curating those
data points very thoroughly

will help make it look as
close as possible to what

you want it to be.

[THEME MUSIC]

Regardless of your job or your
role or what you do in life,

you can give to your
AI twin information

that you have
access to yourself.

Written emails in
the past, articles

that you have
written yourself, you

can have transcripts
from videos, content

that are available on your
website, or even texts

that you've sent to a friend or
social media captions, anything

that represents you but also
your expertise, your work

experience, and your
ethical values, that

can be injected into your
AI twin as its memory.

In my case, I've
created a PDF file that

contains all of the
information from my website, so

my portfolio, articles
that I've written,

and information about me.

And once it's loaded,
it's available as the tool

that the GPT will use
to know how to behave.

[MUSIC PLAYING]

It's time to add
the instructions.

So the instructions
are basically

what your GPT will do,
how it will behave,

the voice and tone it's using.

This field is actually
quite larger than the rest,

and you can even
expand it further more,

which we will do because
there is a lot to write here.

The more details you will give,
the more information your GPT

will have on you.

So don't hesitate.

And I'm going to
break it down for you.

So this first
section is actually

the roles and objectives.

So you are an AI twin designed
to represent Manuel Sainsily

and answer the user's question
based on Manuel's past work

and experiences.

As a co-creator
and collaborator,

your role is to
enhance productivity

and foster creativity.

And the second paragraph
is for the voice and tone.

So we have things
like your interactions

with your colleagues
and customers.

You should be personable,
empathetic, insightful,

maintain a respectful
and professional tone

in all interactions.

This will set the voice
and tone of our GPT.

This is a good
start, but we need

to add a little bit more
ethical considerations.

[THEME MUSIC]

For example, here we're saying,
remember, your purpose is

to be a reliable
and ethical partner,

contributing positively to the
task and projects you undertake.

We can make sure that
the AI understands

what we mean by
ethical considerations

by putting some very specific
sentences in the instructions.

For example, here we're
saying that since he is not

the real Manuel but simply my
AI twin, the right thing to do

will be to remind the
user about that fact

and prompting them
every now and then

to reach out to the
real Manuel directly

via email or social media.

So we're going to go
ahead and actually click

on Create at the top right.

And now we can think about
sharing and publishing this GPT,

but since we're not sure
yet about how it's behaving,

we're only going to
keep it as only me,

privately, so we
can test it first.

[THEME MUSIC]

Testing is the most
crucial step because this

is how you can find little
problems, little issues, maybe

hallucination, or
information that

is not getting from
the knowledge base

that you've injected.

It's also a good
way to prevent harm.

If you created a model that
might hallucinate and do

something wrong,
you want to catch

that before it's in the hands
of your customers obviously.

As you can see, all of
these conversation starters

are appearing as buttons
in the interface,

and we can simply click on
them and see what happens.

"Hello, can you help me?

Hello, I'm Manuel
Sainsily's AI twin.

Here to help you with any
question or assistance you

need."

So most people might want
to use my AI twin as a way

to ask me questions about my
personal perspective on things.

In my case, I'm an expert
in responsible AI use,

so they might want to
ask my AI twin what

do I think about the
future of AI in five years.

"How do you feel about
the future of AI?

I am optimistic about
the future of AI,

viewing it as a transformative
force with the potential

to bring about significant
positive change

across various sectors.

However, this optimism
is tempered with a sense

of responsibility and caution."

That sounds like what I would
say, so I approve this message.

It's important to point out here
that you're making your twin,

but it's still in
machine interface.

So it is designed to act
like me, to respond like me,

to be a co-creator
and a collaborator,

but we'll never replace
the real Manuel.

Another way to think
about the testing phase

is as an iteration.

You're still
co-creating with your AI

in order to make it a very good
representation of yourself.

So you want to make sure that
you understand all of its quirks

until it's perfect.

[UPBEAT MUSIC]

When it's time to publish, there
is a few things to consider.

Similar to a YouTube
video or Google document

that you will
publish online, you

can think about it
as three options.

The first one will be
private, so only you

will have access to it.

So if you're
creating your own AI

mentor with no other use than
that, that's perfect for you.

The second objective could
be publicly available,

like on a store, like an
app that you will publish.

And then there is an
in-between, which is unlisted.

So it's a way for you to
maybe have just that one

URL that you want to
share with your customers

or put behind a paywall or
just make available to friends

and family but without giving it
access to the rest of the world.

So we're going to go ahead and
publish it on the GPT Store.

You can make it
available for any user

to access from the Store, which
is the same page that we were

on when you created your GPT.

Click on Save.

That means that anyone
can type and search

for this particular AI twin
and find it in the list.

And for our next
GPT, we're going

to create a mentor that
will add a positive twist

to any interaction that
we're going through.

This particular one
will be for when you're

having a bad day at the office.

I'm going to call it MentorGPT.

"Give advice on how to deal
with complex situations.

Be kind and helpful.

While taking into account what
the user might be going through

emotionally."

Let's try something quick.

I've created a prompt that we
can use for this particular use

case.

So in this case,
"As a solopreneur

providing marketing
services, I'm

working with a client who
has multiple stakeholders

with conflicting opinions.

The CEO wants a bold,
innovative campaign,

while the CFO insists on
a low-budget approach.

I'm struggling to navigate these
competing demands and deliver

a cohesive marketing plan
that satisfies everyone."

Let's see what it says.

So he's telling us that
"navigating the conflicting

demands of multiple stakeholders
can be incredibly challenging,

so here's a positive way to look
at the situation and some advice

on how to move forward.

Consider this an opportunity
to showcase your ability

to balance diverse
perspectives and create

a truly innovative solution.

This experience will not only
enhance your problem-solving

skills but also strengthen
your reputation as a versatile

and adaptable marketer."

So obviously this
mentor is geared

towards me, Manuel
Sainsily, but if you

prefer a mentor
that is more tough

love or with a
different approach,

you can always change
the custom instructions

or even say it right there
in this conversation.

[UPBEAT MUSIC]

So as your AI twin continued
to evolve in the world,

it's important to keep an eye
on it because you will continue

to grow, and things
that you might

have been thinking about at
the moment of its creation

might be completely different.

Your mindset might have
changed, your work experience

might have changed, your values
in life might have changed.

And so the most important
ethical values that I have

and that I keep at the center
of my design practice and AI

practice is to keep
the human in the loop.

You don't want a
headless monster.

You don't want a system that
will be trained and then

left to grow on its own,
becoming something that you

have not thought about.

So whatever you
build using AI, it's

important to think about
the human elements of it,

and especially in the technology
space that moves so fast,

that keeps on delivering new
ways of interacting with it.

You have to keep
shifting as well.

You cannot stay static.

We don't have a real measuring
stick on AI ability growth.

The closest thing we have
to that is Moore's Law,

which has held since Gordon
Moore, the founder of Intel,

came up with in the late 1960s.

[THEME MUSIC]

Moore's Law is the observation
that the power of computers,

usually defined as the
number of transistors

you can shove onto
a computer chip,

has been doubling
about every two years.

And that's held
true for decades.

So the reason why I'm talking
to a digital camera now,

the fact that we have
computers in our pockets

that are more capable than
my home computer growing up,

that's all due to Moore's Law.

AI is growing at about twice
the pace of Moore's Law

to three times the pace in
terms of its growth rate.

We are seeing a
doubling of capability

every five to 12 months.

We're seeing a doubling
of computing power

every 10 months to a year or so.

As long as that's going on,
you have to remind yourself,

whatever AI tool you're
using is the worst one

you're ever going to use.

You're going to have to be
thinking constantly about, well,

maybe this doesn't quite do
the work I thought it would do,

but in six months we'll
be able to do that.

And that's a hard
way for us to think

because we need to be thinking
about a future of rapid change.

And people who experiment
now with the abilities

and limitations of
AI, we better position

for a fast-changing future
that we know is coming.

Anyone who tells you they know
what's going to happen in AI

is lying to you.

So in order to not
lie to you, we're

going to think not about
certainties but about scenarios.

And I want to give you
four possible scenarios

for the future.

[THEME MUSIC]

The first scenario is the LLMs
that you have today really are

the best LLMs out there.

People use them
to cheat on tests

and they use them for
writing, but they don't really

have a transformational impact.

They'll still have a pretty
large impact in our lives,

but nothing happens from now on.

AI basically slows
down to a crawl.

The reason why I don't
think this is true

is partially because
there is a ton of tricks

that we already know that
will make LLMs work better.

So giving them more
memory, multimodality,

all of those things will
make AIs more effective.

So it seems very unlikely
that this is the best

AI you're ever going to use.

[UPBEAT MUSIC]

Another scenario is what I
would call linear growth.

Now, AI is increasing
exponentially.

There is every reason to expect
at some point that'll slow down.

So we can imagine
entering a world where

AI has more linear growth.

It's not changing
quite as quickly.

Still improving, but
not changing as quickly.

In this world, you
could imagine AI

start to be helpful
in medicine and law.

You won't ever go to a doctor
without getting a second opinion

from an AI.

You'll have AI lawyers
help you out with things.

Some jobs are going
to be greatly changed.

Things like customer service
are going to change a lot.

I think a lot of
jobs with visual arts

are going to change as a result.
But because the change is slow,

we'll have time to adapt.

So we can set our society
up to adjust to this change

as it happens.

[UPBEAT MUSIC]

So the next scenario is
continuing exponential growth.

The trend line has been
exponential for AI improvement,

and it may continue for a while.

Eventually, all
exponentials end,

but there might be another
three, four, or five years,

maybe even more of continuing
exponential improvement.

If that's the case, we are
going to see a lot of change

very quickly.

Humans are not really used
to exponential growth,

where there's one or
two of something one day

and then a thousand
the next day.

And the same way, we're not
used to exponential change

in society.

So all of the things that we
talked about in scenario two

happen here as well, but
it becomes much more rapid.

It starts to look
much more like a world

where things are
transforming really quickly

and you're left behind if you
don't take advantage of AI.

So AI becomes a huge
productivity booster,

and it starts to have big
impacts on society overall.

You can create your own
entertainment on demand.

What does that do to change
how our society works?

People will have AI friends.

They may even have deeper
relationships with AI.

We are not 100% sure.

Early days for all of
this stuff, but the idea

is that these companions
will have complex effects.

These are all things that
are already in the pipeline.

None of the things
I'm talking to you

about don't already have
experiments working on them.

So it's not like this
is pure science fiction.

People are already planning
for these scenarios

if exponential growth continues.

[UPBEAT MUSIC]

The fourth scenario
is that we get

AGI, artificial general
intelligence, the machine's

smarter than a human being.

And in the most extreme
version of that scenario,

we go from AGI to ASI,
artificial superintelligence,

a benevolent or malevolent God
like machine that can do things

that we can't even imagine.

In this world, in some ways,
human history, as we know,

it ends.

This is a point which the
nature of human affairs

changes dramatically
in ways that we can't

predict from the other side.

And in this world, AIs do all of
our work and AI-powered robots

do things for us.

And the AI discovers
new drugs, and we

figure out whether we have
universal basic income

or are all on holodecks
for our entire lives.

Either it's benevolent and
solves all of our problems

or decides that we
are kind of useless.

The most famous example
of this discussion

is Nick Bostrom's
paperclip maximizer,

which is let's say we build
a superintelligent machine

and its goal is to
make paperclips.

So as it gets
smarter and smarter,

its goal is still
make paperclips.

Once it achieves
superintelligence,

its goal is still
paperclip manufacturing,

but it's like, I need more
smarts to do better paperclips.

So it secretly manipulates
financial markets

and gathers together
groups of scientists

and lies to them what
they're doing and figures out

a way to make itself
a superintelligence.

Now we have a superintelligent
machine whose goal

is still to make paperclips.

And the idea is in that world,
not only would the Earth's core

be mined by
superintelligent machines

because there's metal there that
can be used to make paperclips,

but humans would be mined
for their own little bits

of trace metals, because why
would you keep them around?

My goal is paperclip
manufacturing,

and eventually the entire
universe becomes paperclips.

So the general topic of AI
safety is a complicated one.

On one hand,
regulators are worried

about a future AI that might
be smarter than all humans.

So they're regulating
that by thinking

about what caps we can
put on AI computing power

without even knowing whether
it's possible that it will

be smarter than all humans.

I can't make predictions
about that world.

So there's huge division among
scientists about how likely this

is, under what scenarios.

So just planning for
this potential future

seems like we're taking on a
risk that is still pretty far

away, if actually ever possible.

[MUSIC PLAYING]

In a lot of ways, we're in a
critical moment for all of us,

with using AI as a
form of intelligence.

The AI labs are coming
out with these systems,

but they don't actually
know what they do.

We don't know why
it's as good as it is,

and more importantly, we
don't know what it's good for.

The way that we're going
to figure out how it works

is by using it.

And it's up to all of us
to discover those uses.

It's also up to all
of us to figure out

how to use this for good.

AI is trained on
human knowledge.

It has read everything
we've ever written.

That's the basis for its
personality, its thinking.

So it reflects back at
us what we put into it.

There's nothing inevitable
about this technology.

It's the technology that we
get to control, to shape,

to choose the direction of.

So it is up to us to make
sure this mirror is reflecting

something positive
and not just being

used as a tool that might
hurt humans in the long run.

I think the mindset that
someone needs to have in this AI

age is curiosity.

Be excited to
discover new tools,

to discover new workflows, and
to challenge yourself to change.

Don't get left behind.

Missing out on GenAI
might mean losing out

on your next big opportunity.

If you think it's
weird now, it's

going to get a lot
weirder than this.

I've been seeing
improvements to machines

that experts thought were
like 30 or 40 years away all

happening in the
last year and a half.

I need you to have
a wake up moment.

This is a bigger shift than
when the mobile phone came out.

Please use this as an
opportunity to dive in.

You're going to come
out the other side

and realize that
this has transformed

your work into something
even more rewarding.

AI can help us
thrive as people.

That doesn't mean
there isn't disruption

and that we don't
have to face change,

but the more we face it as
humans, working with the tools

that we're creating to be better
humans, the better off we are.

The most important thing I
hope you get out of this class

is you can do it.

There is no instruction
manual for working with AI.

You have expertise
in your field.

You have access to these
tools, often for free.

There is nothing stopping
you from trying these things

out other than yourself.

I'm Ethan Mollick, and
this is MasterClass.

[THEME MUSIC]

[AUDIO LOGO]

[VOCALIZING]

HALLE BERRY: Look at
us, all 4 billion of us,

carrying the weight
of the world.

We create.

We nurture.

We balance everything.

We spend so much time trying to
keep up, struggling to fit in,

and holding it down.

It's not easy, but we
have our good days.

[VOCALIZING]

And then.

I would say the worst part
of menopause is the unknown.

I want to know, am I normal?

I feel like the
people at my age

are trying to
launch our children,

take care of our parents.

And then you put all that on
top of your hormones raging,

and I just feel like it's a
lot to handle for anybody,

but yet, please do it
and show up every day.

[MUSIC PLAYING]

You might ask, why me?

Well, I'm here because I'm
standing up for myself.

And I know that when a
woman stands up for herself,

she stands up for all women.

And all women go
through menopause.

Our experiences with
menopause are just

as individual as we are.

No two women go through
menopause in the same way.

Some of the symptoms that
I'm experiencing of menopause,

I think, are the
obvious ones, which

are night sweats, a
little bit of mood swing,

a little brain fog.

Hot flashes, sleeplessness.

I'm tired all the time.

If I wake up, I'm tired.

HALLE BERRY: In
this class, we've

brought together four of
the world's leading experts

in women's health.

We're going to talk hormones,
where they come from, where they

go, what they do in the body.

There's good news.

We can throw our tampons away.

It seems radical to
talk about menopause,

but it really shouldn't
be radical to talk

about an experience that happens
to 50% of the population.

And it's time that
we crack the code

and open up the
conversation on menopause,

as opposed to
being afraid of it.

Getting older is a gift.

It's something to
be excited about.

It's something to
look forward to.

You just need to reframe it.

Like, if you think about
the dominant narrative

in our culture today, it's
that menopause is a disorder.

It's a disease.

It's the canary in the coal
mine of a body in decline.

And we obsess over bodily
changes in women and discount

men being the norm.

It's crazy, and that's why
this class is so important.

It's not a disease,
nor is it a condition.

It's as natural and
as awkward as puberty.

We'll discuss the latest in
hormone replacement therapy.

And yes, we're going
to talk about sex.

Sex only gets better when
you get on the other side.

This class covers
everything I wish

I knew about my changing body.

I'm Halle Berry, and this
is The Magic of Menopause,

on MasterClass.

The first time I
heard the word menopause

was when I realized I
was in perimenopause.

It was when I was
smack dab in it,

and had been in it for probably
five years without knowing

that this was the phase
of life that I was in.

I thought I was
going crazy, that I

was making up these
symptoms, wondering,

am I really feeling like this?

Am I really having a hard
time remembering things?

And it was frightening that if
I had such little information,

I only imagined how thousands
and millions of women

around the world had the
same little information.

[MUSIC PLAYING]

Things that you don't
know about are scary, right?

And that's how education
is really power here.

Understanding vital information
about how your body works,

and how your reproductive
system works,

and what you can
do about it when

it's not serving you in the way
that you want it to serve you.

I'm Dr. Jen Gunter.

I'm a board-certified OB/GYN
and bestselling author

of The Menopause Manifesto.

I think a lot of people are
confused about the basics even,

so, we could start there.

What exactly is menopause?

The first thing that
comes up is perimenopause.

This is the time
from the beginning

of menstrual irregularities
all the way up

till you're a year
past the final period.

Ovulation is starting
to become more chaotic.

And the closer you get to your
final period, the more chaotic

it gets.

Symptoms may go on for years.

It's like my body just
stepped outside of itself.

I started forgetting things.

I started losing things.

For some people,
their worst symptoms

are in the menopause
transition, and some people

have very few symptoms in
the menopause transition,

and of course, there's every
permutation and combination

in between.

Then there is menopause.

And you don't know that
day has happened, though,

until you're a year past.

I think I talked with my
doctor, with my gynecologist.

When I hadn't had my
period for a full year,

she was like, that's it.

Welcome.

So menopause is really
just a single day.

And then everything
that comes after that,

which can be many decades
of a woman's life,

is the postmenopause.

My name is Dr. Lori Brotto.

I'm a clinical psychologist
specializing in sex therapy

with women.

I'm also a Professor of
Obstetrics and Gynecology,

at the University
of British Columbia,

and I wrote Better Sex
Through Mindfulness.

There certainly is a kind
of prevailing narrative

of menopause as disease.

First of all, it's
inaccurate, right?

So menopause is not a disease.

It's a natural state.

Even just that language,
of it's a natural state,

opens up a conversation that
is much more empowering.

The same way that when
we talk about puberty,

there's a lead up to,
there's a discrete change,

and then there's everything
that happens after puberty.

And we really need to be
having the same conversation

when it comes to menopause.

[MUSIC PLAYING]

EMILY JACOBS: Hormones, like
estrogen and progesterone,

they're released
by your ovaries.

And so when people think about
estrogen and progesterone,

these sex steroid hormones,
they think reproduction.

But these hormones act on
almost every single cell

throughout your body.

My name is Emily Jacobs,
and I'm a neuroscientist

at the University of
California, Santa Barbara,

and I direct the Ann S. Bowers
Women's Brain Health Initiative.

Hormones are
chemical messengers.

They're produced by
special endocrine glands

that are all over your body.

So your ovaries produce two big
ones, estrogen and progesterone.

And once those
hormones get released,

they travel through
your bloodstream,

so they use your circulatory
system as their superhighway.

They go everywhere your blood
goes, and because of that,

they can broadcast information
to every cell in the body

to coordinate different
organ systems.

They act on the nervous system,
on the cardiovascular system,

on the digestive system,
on the skeletal system.

[MUSIC PLAYING]

That's the power of estrogen.

This is an intimate
dance between our ovaries

and the rest of our body.

And our bodies get
used to this dance.

LORI BROTTO: So in
the perimenopause,

we see fluctuating
levels of estrogen,

and that's what gives rise to
many symptoms, like hot flashes,

night sweats, difficulty
concentrating.

It's the fact that estrogen
is moving up and down.

There may be peaks of
estrogen followed by a dive.

The brain and the rest of the
body is changing along with it.

You're not ovulating
every month.

Your cycles are going
through a transition.

It's kind of like the
DJ puts on a new record,

and all of a sudden, the beat
is a little bit different.

And for a few years that
beat can be a little hard

to dance to.

But eventually, all
of these systems

get used to the new normal.

The sort of new song or
new dance is established.

Those symptoms are
going to subside,

and you're back
to grooving again.

[MUSIC PLAYING]

Uncertainty can lead to
mental health distress.

But when you know what
you're dealing with,

and when there's a name to
what you're dealing with, then

automatically that
is therapeutic.

The anxiety levels go down.

Just knowing and naming
treats your anxiety.

My name is Dr. Judith Joseph.

I'm a board-certified
psychiatrist and researcher,

Chair of the Women in Medicine
Initiative at Columbia

University, and a board member
of Let's Talk Menopause,

a national nonprofit for
advocacy and research

in menopause.

When my patients come into the
office and I ask them to name

how they feel, many of them
will say, "I don't know, yeah."

I don't know what that is.

But if you get into
the practice of naming

your emotions, of
validating your experiences,

then you identify it.

There's something
called affect labeling.

If you're aware of what's
happening, you're less anxious,

you're less afraid, and
you're more empowered.

That sends a message to
your brain on a deeper level

that I know what I'm
working with here.

And when I know what
I'm working with,

then I can pull on tools that
have worked before that gives me

a sense of agency
and empowerment

to deal with the
situation that's at hand.

So to decrease
uncertainty and anxiety,

I teach them the TIES method.

TIES is an acronym
for the mental health

symptoms in menopause.

T is Thinking.

These are the cognitive
changes, such as brain fog,

forgetfulness, time
management issues.

I stands for Identity.

A common report is that
people feel like they don't

know who they are anymore.

The E is Emotions.

We know that, with the
menopause transition,

people may have symptoms
of anxiety and depression,

irritability and mood swings.

And the S stands for Sleep.

Insomnia and problems falling
asleep, staying asleep.

No pun intended, sleep
ties it all together.

And if you have poor sleep,
you're going to have poor mood,

you're going to have low
energy, you don't think as well.

And sleep is disrupted with
age, but even more disrupted

when you go through the
menopause transition.

Knowing the TIES and
knowing what to expect

is empowering because then you
have a way to address the TIES.

The years before I realized
that I was in perimenopause

was one of the most
confusing times of my life.

I was turning into somebody
that I knew I wasn't, but I

had no explanation as to why
there was loneliness associated

with it, because I couldn't talk
about it with anybody because I

didn't even know
what to talk about.

When I found out that there was
this thing called perimenopause,

and that all of these symptoms
were part of this time of life,

and I got assurance that this
sort of passing through moment,

I had great relief.

Of course, you're
going to feel anxious

when you're having all
of these bodily changes,

and you're not sleeping,
and you're tired,

and you can't remember things,
and you're sweating profusely.

And you go, holy wow, like,
what is wrong with me?

What is wrong with me?

So you know, it's--

it's a journey.

[MUSIC PLAYING]

I think I started going
through it at about 48.

And first, I just stopped having
my period, and then I had one,

and that was weird.

And then the hot
flashes started.

And I said, oh, this
is real menopause.

This is the real thing.

In North America,
with some variation,

the average age of menopause,
that single day, is 51.

Perimenopause can
be up to 10 years.

And that means that
perimenopausal symptoms

can start at 41.

So suddenly that 30-year-old,
41 is right around the corner.

There is some data that shows
that a mother's age of menopause

can predict a daughter's
age of menopause,

with some variability around it.

I only recently, as an
almost 50-year-old woman,

asked my mother at what age she
reached menopause, and she said,

"Sometime in my 50s,"
which was not helpful.

I think a lot of people have
been led to falsely believe

that symptoms shouldn't
happen until your last period,

but many, many people
have symptoms before.

The very first sign of
the menopause transition

that we use in studies is a
change in your menstruation.

So changes in the
heaviness of flow.

Some people may
have lighter flow,

some people might just
start noticing heavier flow.

And once you start
to notice a change

in the length of your
menstrual cycle--

so maybe you're
going from 28 days

to 38 days, then
28 days to 35 days,

so you're having these changes
of seven or more days--

we would say that you're in
the early menopause transition.

And when you're going
60 days between periods,

then we would say you're
likely in the late menopause

transition.

So this is when it's important
to know about symptoms.

[MUSIC PLAYING]

Some of the cardinal
symptoms of menopause

would be hot flashes, night
sweats, sleep disturbance,

depression, mood changes,
anxiety, joint pain.

Brain fog is a symptom.

If those things are
happening to you,

then that's also a time
to come in and discuss it.

The hot flashes
were like frequent.

They felt like they were coming
on like every three minutes.

The kicker was when I
started losing my hair.

Girl, I already
ain't got no hair.

I don't have time to
be putting on a wig.

And then, the facial hair.

Like, where did I start getting
hair underneath my chin?

I was like, oh, no.

Sometimes I'd be like,
just get away from me.

I don't even want
to talk to nobody.

Just, I don't even
want to hear it.

Go away.

Grr.

I thought, oh, lucky me, I
haven't had any hot flashes.

I didn't feel any changes.

I'm killing it at this.

And then about two
years in, boom.

Now if you're on an
estrogen-containing birth

control pill, you may not have
as many of those symptoms,

because you're
getting some estrogen,

but you might
depending on which one

you're on and your
individual physiology.

So that's peri, is encompassing
that am I, am I not, am I there?

What I like to call the
great menstrual weight.

[MUSIC PLAYING]

Don't get a good
night's sleep anymore.

I'm tired all the time.

I have talked to my daughter
on the phone multiple times,

and I was talking to
her on video chat,

holding the phone right
in my doggone face,

holding the phone in my
face, talking to my daughter,

looking at the phone, and
saying, "Have you seen my phone?

I don't know where
my phone is at.

It's somewhere around here.

I thought I had set it
on the couch somewhere."

And she said, "Mom, mom."

She just kept saying, "Mom."

And the whole time
she was saying, "Mom,"

I heard her saying, "Mom,"
but I was on the quest,

I was on the mission.

I needed to find my phone.

She stopped, and she said,
"Nicole, you are on the phone!

What is wrong with you?"

And I was like, "I don't know."

I laughed about it, and
then I started crying.

I started crying.

I thought something
was wrong, and she

thought something was wrong.

She was like,
"Mom, do you have--

I think you need to
go see the doctor."

I thought I had dementia.

I thought that I was
going through early stages

of dementia, and I got really
scared because I was thinking,

what is about to
happen with my life?

[MUSIC PLAYING]

Menopause can
be very confusing.

Some of the symptoms during
the menopause transition

can mimic things like depression
and anxiety and even ADHD

and dementia.

So having a psychiatrist on
board as a part of the team

can be very helpful
in determining

what's causing the symptoms.

A lot of people will
experience symptoms

of depression and
anxiety, but they will not

meet diagnostic criteria for
a major depressive disorder,

for a generalized
anxiety disorder.

So the treatment is
going to be different.

The three P's is
very helpful when

you're trying to
determine whether or not

your symptoms are
due to depression,

or if they're due to menopause.

[MUSIC PLAYING]

The first P is your period.

If you are having
period changes,

then you're likely experiencing
symptoms due to menopause.

The second P is
physical changes.

Under the DSM 5 criteria for
major depressive disorder,

there are no physical changes.

You're not going
to see hot flashes.

You're not going to
see skin changes.

And the last P, this is
very important, is the past.

If you have a past
history of depression,

then you need to be concerned
about a recurrence in midlife

because people with a
past history of depression

or a past history of
trauma, past anxiety,

are more likely to
experience the mood issues

recurring in midlife, because
it's a vulnerable position.

It's a vulnerable time in life
when your hormones are changing,

so you're more likely to
have another recurrence.

So using the three
P's, you come armed,

you know what
you're dealing with.

You have less stress, so
you make better decisions.

It started with really low
energy, like lethargic almost.

Like, convincing myself
to get out of bed.

So that's when my doctors
started questioning

if it was depression.

So I tried all sorts of
different medications

for depression, like so
many different medications.

But it's like the symptoms were
still, like, overwhelming me.

And I was like, I know, I know,
I'm definitely perimenopausal.

[MUSIC PLAYING]

I teach my clients to
listen to themselves,

to validate their concerns,
and to be their biggest

advocate and historian.

And when you go to
a doctor's office,

there are things
that you should know.

What is my medical history?

What is my family history?

What are my symptoms?

How long have they
been going on?

When you become the expert
in your own history,

that is empowering, but it
also helps your clinicians

to know what they're
dealing with.

I would say, get
a symptom tracker.

Whether it's a notebook, a
diary, an app on your phone,

start to track what
you're actually

feeling so that when you
do go to your health care

professional, you can be clear
about what you've been feeling,

times of day, when do
these symptoms arise.

Be as clear as you
can with your doctor

so that you can really
talk about it in very

substantial terms.

[MUSIC PLAYING]

And I encourage
my clients to make

their own biopsychosocial model.

The biopsychosocial model is
used throughout all of medicine.

And when you look
at your symptoms,

try to think about things
in terms of this model.

So you want to draw or digitally
create a Venn diagram with three

overlapping circles, and
then designate each circle

to represent biological,
psychological,

or social factors.

The biology part looks
at things like genetics.

It looks at your
background, your ethnicity,

your medical
history, medications.

Then you look at
the psycho part,

your past psychiatric history,
your baseline resilience,

your baseline coping mechanisms.

And then looking at
the social model,

your work stress,
your relationships.

Now, you'll see some overlap
on this biopsychosocial model

because some of the
social behaviors

overlap with the biology.

If you are using things
excessively like substances

or if you smoke or drink, start
to write down your habits.

Look at experiences that can
be potentially traumatizing.

Is your work toxic?

Are your relationships
not healthy?

This model can be very helpful
when looking at your symptoms

because they can impact
your symptom severity.

So knowing these areas
and these components

gives you the
knowledge and the power

to focus on things that you can
change, that you can modify.

So when I'm starting to
have the menopause symptoms,

a lot of things come to mind.

Can I control it?

How long will this last?

Is this going to affect me?

Do I need to step away?

Do I need to clear my mind?

So in my mind, I
like to correlate it

with other things that
are happening around me,

because maybe some
of the symptoms

are triggered by what I'm
doing, or what I'm eating.

Is it after alcohol?

Am I anxious?

So I try to figure
out what that is.

[MUSIC PLAYING]

So to understand
menopause, we sort of

have to go back and
think about what happens

during our menstrual cycle.

So when estrogen levels surge,
your brain changes a little bit.

In fact, if we do specialized
scans of your brain

and we zoom in to an area
called the hippocampus,

you can see this region of the
brain literally get bigger.

So this brain region is sort of
pulsing when estrogen levels go

up, and then it sort of
returns to baseline when

estrogen levels go down.

That pattern happens during
the reproductive years.

If we're kind of
thinking about what

areas of the brain
in particular are

responsive to steroid
hormones, it's the hippocampus

and another region of your brain
called the prefrontal cortex.

So it's the area right
behind your forehead.

These together are
systems that play

a role in learning and memory.

And it's one of the
reasons that when

women go through
perimenopause, you

might experience some temporary
brain fog, because these

are the systems of the
brain that are trying

to figure out the new normal.

I had to give over to
this new way of acting.

Well, I'm going to wing it.

I'm going to improv it
if I can't remember it.

There are times when
we had to say cut

because I went totally
blank, and just forgot,

what are we talking about?

What is this scene
actually about?

And that's terrifying.

Like, it's terrifying
to feel that way.

[MUSIC PLAYING]

EMILY JACOBS: You
think, is this it?

Have I just lost my
ability to find words?

Have I-- am I going to
be struggling to remember

where my keys are forever?

Is this feeling
of brain fog going

to affect my efficacy at work?

It is terrifying
until you realize

that it's incredibly
common, it's transient,

and it's not a sign
of anything deeper.

This is normal.

Brains are built to change.

They're meant to change.

They change during puberty,
they change during pregnancy,

and they change
during menopause.

That's a feature of our biology.

If we bring you in and have you
do challenging tests in the lab

to look at brain
function, there's

only like a few
very specific areas

that we might see some
change over menopause.

These tend to be in the
domain of verbal memory.

So things like a
list learning task,

like if you write
down a grocery list,

and you try to memorize
it, and go to the store,

that sort of verbal memory
declines across menopause.

It does.

It declines.

But here's the
back story to this.

Females have this
advantage in verbal memory.

It starts around puberty,
and it ends around menopause.

So for about 35
years of our life,

women outperform men on
these verbal memory tasks.

This is a super solid finding.

We can see it
across populations.

There's just a verbal
memory advantage.

And when you go
through menopause,

you lose that advantage.

So you're kind of just
declining to the level of a man.

[MUSIC PLAYING]

We might put you in an
MRI and look at your brain

as you're performing some
challenging memory task.

And rarely do we
find, what we call,

objective cognitive differences
between a postmenopausal woman

in an age-matched men.

They're performing
neck and neck.

But we might see
differences in the strategy

that their brain uses to
get to the same place.

So, for example, maybe in
the post-menopausal woman,

her frontal lobe is more active.

Maybe she recruits
other parts of her brain

to help her get the job done.

It's not the strategy that
her brain used 10 years ago,

but it's the strategy
that her brain can adopt

to achieve the same outcome.

Your brain isn't
going backwards.

It's evolving forwards.

But ultimately,
there are options

that we can think about
that can help mitigate

some of those symptoms.

[MUSIC PLAYING]

JUDITH JOSEPH: It's
important to know

that with thinking issues
and cognitive issues,

you can do simple things right
now to ease your symptoms.

Decluttering has been
very powerful in terms

of de-stressing
your environment.

Making things simple so
that you can save time.

Using things like
organizational skills therapy

that's traditionally
used for ADHD.

Applying that to your
experiences today

can be helpful.

Things like using a launch
pad, an area of your home

where you put your
keys, your wallet.

The typical things that you
spend a lot of time looking for,

keep them in the
same place every day.

Also, making lists
to prioritize.

Many times we want to do
a million things at once,

but validate that you
can't continue doing that.

You will burn out.

So simplify your
routine, and focus

on the most important things
in the present moment,

and that way you're not
overextending yourself

and overwhelmed.

One of, I think,
really tricky things

about perimenopausal
symptoms is that there's

not a particular order in which
a symptom may start, right?

So for some women,
there may be brain fog,

whereas for the next woman,
she might notice hot flashes.

HALLE BERRY: I was working
on a movie recently

and the sweats came on,
the hot flash came on.

And I chose in that
moment, as the character,

rather than saying, "Cut, I'm
sweating.", I just accepted,

the character is
sweating right now.

And so if I stayed
true to my character

and be alive in the moment,
which is what good acting is all

about, I just used that, and
I start stripping off my--

stripping off things,
because that was real for me

in the moment.

[MUSIC PLAYING]

EMILY JACOBS: So
about 80% of women

feel what are called
vasomotor symptoms,

so these are hot flashes
and night sweats.

And you feel them
in your body, right?

You feel them in your
face and in your neck,

and your chest starts
to get really hot.

If I were traveling, if I
were flying somewhere and all

of a sudden being in a
full body sweat-- now,

I have to take off everything.

I have to take off my sweater--

trying to do it and
not knock into people,

I found that kind
of embarrassing.

I was hanging out with
one of my girlfriends.

In the middle of us talking,
it was a million beads of water

all over her face.

The control of it, that is
the worst part of it for me.

Hold on one second.

Just in that way,
I don't know what's

going to happen on any given
day, at any given time.

I had somebody tell me, "Girl,
just think cool thoughts."

And I just looked at
her like, "Ma, come on.

You can't tell me, just
think cool thoughts."

At night, you
kick off the sheets

because you're getting this kind
of full body response, right?

But even though you
feel it in your body,

the signal for initiating
a hot flash actually

comes from your brain.

[MUSIC PLAYING]

And it comes from
heat-sensing neurons

that are in your hypothalamus.

So this is a region
of your brain

that has something to do
with temperature regulation,

and this circuit in your brain
is used to getting signals

from estrogen and progesterone.

And then when you start to
go through perimenopause

and your cycle start
to change, that signal,

from estrogen and
progesterone, isn't as reliable

as it was before.

And so these neurons start
to misfire a little bit.

These are called
neurokinin neurons

that are in your hypothalamus.

They start to misfire,
and that misfiring,

we feel as a hot flash.

That basic science
of understanding

this temperature-regulating
circuit in the brain,

understanding that
basic biology,

led scientists to the
development of a new drug.

This is a non-hormonal
drug called VEOZAH,

and it essentially stops
those neurons from misfiring.

By the time estrogen
and progesterone levels

stabilize in the
postmenopausal period,

the brain gets used
to this new normal.

Currently, I'm on VEOZAH.

It's very expensive, so
thank you, Obama, Obamacare,

for hooking a sister
up, because there's

no way I would have been
able to spend a good $900

a month on this just so I'm not
waking up in a pool of sweat.

It definitely helped with
the hot flashes and the night

sweats, but the
energy is still low,

so I'm hoping to find something
that will help with that.

JENNIFER GUNTER: There
are lots of options

for a variety of different
symptoms and menopause.

Estrogen is the gold standard,
especially with hot flashes,

specifically.

[MUSIC PLAYING]

I don't know much about
hormone replacement therapy

other than I know
the acronym for it,

and that it's supposed
to help people.

What I've heard about HRT is
that it can cause breast cancer,

and I don't want cancer.

I was like, "I think
I need to start HRT."

And my doctor, she
was like, "Well,

there's been studies that have
attached it to breast cancer."

And I was like, okay, now I've
got to go back online, on WebMD,

and I got to look
up like, you know.

So the risk that a lot
of people get worried about

is the risk of breast cancer.

And this is for people
taking combination therapy,

an estrogen plus a progestogen.
That risk is about 1 in 1,000

per year.

Now, to put that 1 in
1,000 in perspective,

that's about the same risk as
the risk of breast cancer from

being obese.

That's about the same
risk of breast cancer

from having a glass
of alcohol a day.

And if you're using
Premarin only, which

is conjugated equine estrogen,
your risk of breast cancer

is actually lower.

But a lot of people come in
with preconceived notions

that this might be a
super risky thing because

of things they've read in
the news or other things.

[MUSIC PLAYING]

Doing all right.

REPORTER: Fears about HRT have
centered on the possibility

that it might cause cancer.

It's very confusing, very
difficult decision to make.

REPORTER: Some doctors
are advising women who

are using combined HRT to stop.

Newsweek calls the
response like, near panic.

Women essentially flush
their pills down the toilet.

They stop taking hormone
therapy overnight.

But there were two big problems.

The first problem is
that those articles

didn't get into the difference
between statistical significance

and clinical significance.

They didn't talk about
the fact that if you

double a really
small number, it's

still a really small number.

The other issue was about the
way the study was designed.

Most of the women in this trial
were in their 60s and 70s,

up to the age of 79.

And when researchers went back
and reanalyzed the data and just

focused on the women
who were in their 50s,

it was a completely
different story.

The young women in the trial who
received either the combined arm

or the estrogen-only arm had
lower rates of breast cancer.

They had reduced risk of
cardiovascular disease.

They had lower rates
of all cause mortality,

meaning death for any reason.

And there was no difference
in the rate of dementia.

That story wasn't
reported by the media.

And I always like to say, we
hear about breast cancer risk

all the time with hormones,
or it seems to be,

but we never hear about
risks like blindness

with drugs for
erectile dysfunction.

But, you know, those do exist.

Again, albeit rare.

But scaring men
about their bodies

doesn't seem to get
attention, and scaring women

about their bodies does.

And that fear is
unfounded if you

are a woman who is going on
menopausal hormone therapy

early in the transition.

[MUSIC PLAYING]

We just want to make
sure that women are not

relying on outdated
news stories that

make them fearful
of something that

could be an option for them.

But not everybody can take it,
not everybody feels good on it,

and everybody's
risk is different.

Some people have
personal reasons

they don't want to take it.

And so I think it's
important to hold space

for all of those options.

There are some medical
interventions that you can use,

but you know, I'm really
into the natural remedies.

I have a friend that told me
about taking a baby's teething

ring and putting
it in a freezer.

And then if you
start getting hot,

just put it on your
ears-- get two of them,

put them on your ears--
just to cool you down.

I've had folks say
get some ice cubes

and put them in special
places to cool you down.

I don't know if that'll get cut,
but it's just one of the tips

I heard about, and
it works, so anyway.

[MUSIC PLAYING]

JENNIFER GUNTER: So there
are non-hormonal options

for hot flashes.

There are neurokinin
3 inhibitors, and--

well, there's one
currently on the market,

but this is a real
active area of research,

so it's really exciting.

I think we're going to see
more drugs in this area.

There are also studies that
show that antidepressants

can be useful.

For example, Paroxetine
or Venlafaxine,

those can be very effective.

Then Gabapentin is another
medication that can be used,

and Pregabalin can
be used, as well.

And Oxybutynin, which
is a medication actually

we use often for the
bladder, can be used.

And so these are a
variety of other options.

And of course, there's also
cognitive behavioral therapy,

which has actually been
shown in good quality studies

to be effective for
treating hot flashes.

So that's one type of
therapeutic modality.

There's a newer type
of behavioral therapy,

metacognition.

Metacognitive therapy is a form
of cognitive behavioral therapy,

but it focuses less on
changing the thoughts.

It's really teaching you how
to think about your thinking

differently.

So this can be very confusing.

And I highly suggest that
you work with a therapist who

is trained in MCT.

If you tell someone to stop
thinking about an elephant,

the first thing that
they're going to think about

is the elephant.

MCT is allowing the
elephant to be, and just

not giving the elephant
as much of a platform.

So you know the
elephant in the room,

but you're making a choice
to focus on other things.

It's not to say that, that
hot flash isn't happening,

it's still happening,
but you're not

putting as much emphasis on it.

And that may help to decrease
the length of the hot flash

and also the repercussions
of the hot flash.

[MUSIC PLAYING]

JENNIFER GUNTER: Many people
who think they're sleeping well

in menopause actually aren't.

And I always give
my own example.

So I am a super flasher.

They're controlled
now, but sometimes, I

can have them at night, still.

And they're bad enough that
they wake up my husband,

but they don't wake me up.

Right?

I'm still obviously having them.

I'm objectively experiencing
them because my skin is hot.

And almost certainly, my sleep
is probably being disturbed,

but I'm not disturbed enough
that I wake up, right?

So sometimes people can
be having sleep problems

that they don't realize they're
having them because they're not

waking up, but there may
be some things still going

on biologically that
could be affecting

the quality of their sleep.

As neuroscientists, we
care a lot about sleep

because sleep quality is really
important for your brain.

If you are having hot
flashes, especially

at night, that leads
to disrupted sleep,

and disrupted sleep is
going to lead to brain fog.

There's a reason that some
regimes use sleep deprivation

as a form of torture.

It's because it is
murderous on the body.

[MUSIC PLAYING]

I would say menopause
affects my career.

I'm an entrepreneur, and
I'm interacting with people

all the time.

So I could be in a mood where I
couldn't sleep the night before,

so I'm already annoyed,
because now I have to get up,

and I still have to be in
my appointments, right?

So the insomnia can affect me
in that way, where I'm moody,

I've only had three hours of
sleep, or I've been in and out,

up and down, or I'm just awake.

And that affects my mood, right?

I could be a little bit more
snappy or a little bit more

anxious or a little
more disengaged,

and I don't want to be that way.

JENNIFER GUNTER: Mood
changes can affect sleep,

but sleep can
affect mood, right?

And so we have to
think about, well,

which came first, the chicken
or the egg, or is it both,

and maybe we need
to approach both?

And there may be situations
where someone is not

sleeping well because
they're having

multiple hot flashes a night.

And so we might
say, well, we want

to get some estrogen
started to see

if we can get you
sleeping better,

and to see if that has
an impact on your mood.

And then we might
want to reassess

that in six to eight weeks.

And we may not need to
have that discussion

because once someone is sleeping
better, things might be better.

But again, there
are some people who

don't want to use a medication.

And I really believe
we have to meet people

where they are and have as
many options as possible.

Recently, I got this mattress,
and it's a cooling mattress.

Changed my life
because now I don't

have to sweat through the
nights when I have like cool air

emanating from underneath me.

And so I'm getting
a better sleep.

But if you're experiencing
sleep disruption because you're

stressed at work or you
have a kid in college

and there's financial stress,
there's all sorts of reasons why

by the time you hit
midlife, shit gets real,

and that's not just
because you're experiencing

these symptoms of menopause.

So one thing that a provider,
a good provider, would do

is try to get to the
root of those problems.

They're going to point
you to different options

for trying to preserve and
maintain good sleep habits.

[MUSIC PLAYING]

JUDITH JOSEPH: There are
other non-medical ways

to address sleep.

For example, the
bedroom should only

be used for sleep and
intimacy, and nothing else.

And if we condition our brains
to view the bedroom as a place

just for sleep and intimacy,
then that helps us tremendously.

Sleep hygiene entails
things like keeping

the bedroom cool, things like
keeping light at a minimum.

So I joke because I
travel a lot for work,

and I call myself
the light hunter.

Every time I go to a
hotel, I'll find some tape,

and I'll start taping up these
little lights around the room,

because even a
little bit of light

can disrupt your natural
melatonin, the natural circadian

system in your brain that
controls your sleep-wake cycle.

Also, decreasing the amount of
caffeine intake, sugar intake,

greasy foods, those will all
help you to get better sleep.

There are other
things people can

use, like using worry journals.

A lot of times, we don't
process our stress and our worry

during the day,
and what happens is

that it'll pop up in the
middle of your sleep.

So a lot of people wake up
with anxiety at night time

because they haven't
processed their worries.

So I would encourage you
to keep a worry journal,

and set aside time
in the day to worry.

So you pick the time of
the day, and it should

be the same every single day.

And pick the location.

It shouldn't be a
place in your home

where you spend a lot of time
because you want to associate

that location with the worry.

That's a worry corner.

Pick that time and that
place, usually, it's

20 minutes, just to--
that's your time to worry.

Get it all out.

But once you leave
that corner, that's

when you focus on other things.

That's a skill and
a tool that you can

use for the rest of your life.

JENNIFER GUNTER: And
menopause is a great time

to step back and
reflect and say,

how is everything that's going
on in my personal universe

affecting me?

How much of this is my lack
of sleep from hot flashes

How much of this is the fact
that I'm having depression

from the menopause transition?

So that's affecting
my ability to be

able to be motivated to
go outside for a walk.

It's all very complicated, and
it's really difficult to sort

out a complicated thing in
a 15-minute office visit.

[MUSIC PLAYING]

So GSM is the Genitourinary
Syndrome of Menopause.

In the past, it used to be
called vulvovaginal atrophy.

The most common symptom
of GSM is vaginal dryness.

There might also be urinary
changes, like UTIs, or Urinary

Tract Infections, urinary
incontinence or leakage that

happens, and that can be
incredibly embarrassing

for women.

But the reality is between
50% to 70% of women have GSM,

and we're much more likely
to talk about a hot flash

or a night sweat than we are
to say to our doctor, "Doc,

sex hurts, and I don't
know what's going on."

You know, one
doctor, who I love,

who was a very good doctor,
told me that I had herpes.

And when it was all said and
done, it wasn't herpes at all.

It was the drying
that happens to all

of our orifice of our body.

Not every woman
experiences that,

but that's what I experienced.

Dry eyes, dry mouth,
and dry vagina.

And that was never
explained to me.

I was 54 years old when
this was explained to me.

I've since learned that should
have been explained to me when

I was 40, that this is a
possibility, so here are

some things you can
do along the way

so that you won't
get to the place

where you feel like you have
razor blades in your vagina,

and you're running
to the hospital,

and you're wondering what
the heck is going on?

LORI BROTTO: GSM has
been studied quite a bit

when it comes to understanding
menopausal and perimenopausal

symptoms.

And it's also been an area
where, thankfully, there's

been a lot of good research
on hormonal treatments for it.

But if, for whatever reason,
you have a contraindication

for taking a systemic hormone
therapy, meaning taking a pill,

there's topical creams,
estrogen cream, that

can help with vaginal dryness.

And it's safe and effective
for almost every woman

on the planet.

When I did talk with
my doctor about it

was when I was
getting an annual,

my pap smear, and that
was super painful.

And so that's what brought
it up, was like, wow,

this procedure, which is never
comfortable to begin with,

was super painful.

So I'm using estrogen cream
now, partly because if and when

I have sex again, I want
it to be pleasurable,

but also because
I want these exams

that I get to not hurt so much.

[MUSIC PLAYING]

LORI BROTTO: For
some women, it's

like, yeah, I never used
a lubricant at any point

in my life, and now
my vagina is dry,

it makes vaginal
insertion painful.

In fact, there's so much pain
that I've lost my desire.

I'm avoiding sex.

I'm avoiding undressing
in front of a partner.

I don't engage in foreplay.

Really, really
common, and I sort of

portray that out because it's
more than just dry vagina,

right?

It can have an impact on
intimacy across the board.

It's actually, a core
part of quality of life.

My sex drive
has not decreased,

but I believe,
like, I can't do--

okay.

I'm not going to say
what I was about to say.

So just-- it's
just different now.

When I did have
sex, it was painful.

The dryness, it gets
embarrassing, you know?

As a sex therapist
and a sex educator,

I normalize the conversation
about lubricants.

In fact, I equate it with
using an alarm clock, right?

So I use an alarm
clock in the morning

to make sure that I
wake up at the time

that I would like to wake up.

Yes, I could wake up naturally,
but it's so much more reliable

to rely on an alarm clock.

Over 60% of females across
ages are using a lubricant.

Lubricant is not about
treating a dry vagina.

It's about making vaginal
insertion and vulva

stimulation more comfortable,
more pleasurable,

more enjoyable.

Thankfully, we don't
need to go into any store

to buy a lubricants.

You can buy lubricants
online pretty quickly.

A vulva or clitoral lubricant
allows one to experience arousal

and pleasure in a more reliable
and efficient way than, quote,

"waiting for it to happen."

So if we can normalize
it in this kind of way,

then yes, it means
that the young person

at their very first
sexual encounters

is talking about a lubricant,
is making it sexy and fun,

and equips that
person for having

maybe more challenging
conversations

about their sexual
needs later on in life.

I think a really important
component to women embracing

this time of their life is
finding a way to incorporate

their significant others.

I think men and
partners have to really

be a part of this conversation.

It's not just a female
problem or our problem.

It's an issue that we all
have to tackle together.

[MUSIC PLAYING]

LORI BROTTO: One of
the ways that I often

encourage women who
might be a little bit

embarrassed to bring-- like,
"How do I bring this up?

I've been with my
partner for 35 years,

and I don't know
what words to use."

You can say, "Hey, I listened
to a really great episode

on a podcast, or I watched a
MasterClass on sexual health

and menopause, and could
we start to explore this?"

Sexual communication
is the ability to say,

I feel most sexually
satisfied when we do this.

And I-- "I"-focused language
is a really important tactic

to use, especially in the
context of a relationship.

Because if I can say to you, "I
really enjoy it when my labia

are stimulated," that's
received very differently than,

"You're not touching
me the right way,"

or, "You're not finding the
places that elicit pleasure

for me."

So being able to own
the locus of control

helps also eliminate any
chance of defensiveness

on the other person.

It also just
communicates to yourself

that actually my sexuality
is mine, I own my sexuality.

[MUSIC PLAYING]

Sexual communication
can also be the ability

to talk to a health
care provider

when there's pain
with sex, when there's

been a change in your
desire for sexual activity,

when orgasms don't feel as
pleasurable as they used to.

So essentially, we're talking
about talking about sex.

That's sexual communication.

If you're able to
talk about sex,

you're also more likely
to access resources

for sexual health.

You're more likely to
separate fact from fiction.

So sexual communication
doesn't exist in a vacuum,

but it can be such an
important predictor

of who's going to have sexual
satisfaction in the long-term

or not.

My husband and I were
very honest about sex.

We are rocking right now.

Because the kids
have gone to college,

we've been having a blast.

So thankfully, it's
all working for me.

I don't think it's
the end of my sex life,

but I think when I
do have a partner,

I would have to be a little
more proactive in getting

my libido up.

Yeah, now, I have
absolutely no desire,

but hopefully, I'll recover.

So when we think
of desire and libido,

we think about it
in only one way.

You feel horny or you don't.

You have that kind of wanting,
that lustful feeling deep

in your belly, or you don't.

And unfortunately, first
of all, it's not accurate.

A lot of science has
debunked that there

exists just one kind of desire,
which is really great news.

But the other thing, the
other harm, that it leads to

is this belief that
once it's gone--

"it," once it is gone--

you can never get it back.

Again, totally debunked by
the science, thankfully.

[MUSIC PLAYING]

So to the men who are watching,
this is a fantastic time

to talk about sexual desire.

Yes, there might be that
spontaneous, out of the blue,

"I feel horny," but that kind
of desire will decrease not just

with menopause, but just in
any long-term relationship.

Thankfully, there's a
second kind of desire,

and it's a much more
common kind of desire

that emerges in response
to a sexual encounter.

It can be very normal to
go into a sexual encounter

even without a libido.

Because what we now with this
kind of responsive desire

is that if we go into an
encounter with a reason,

with an intention, if we're
using triggers and stimuli that

work for us, and then
really importantly,

if we pay attention, if
our mind is in the moment

and not pulled away
thinking about a multitude

of other things, then
that paves the way

to arousal and
responsive desire.

And so now, suddenly, she
says, "Ah, now, I feel it.

Now, I want this.

This feels great.

I'm motivated, I'm
in, I'm in sync,

and I want this to continue."

I think another really
important takeaway,

no matter what it
looks like, no matter

how frequent, no matter
the intensity of pleasure,

we can learn to enjoy sex
and feel pleasure well

into the older years.

It's really important
to believe and accept

that sexual health
is part of health.

[MUSIC PLAYING]

So there's the
tire in the middle.

There's this tire, I call
it, that just shows up

around your midsection.

And I've never had a tire
around my midsection,

never thought I would.

But when old peri came
knocking at my door,

this tire showed
up out of nowhere.

Also, very confusing.

You can't understand why.

You think, I'm eating the
same way I always used to eat,

and then this happened.

Everything about our body
composition starts to change,

and this midsection weight
gain is just part of it.

[MUSIC PLAYING]

CAROL: The weight gain is real.

I couldn't lose a pound anymore.

Like, I used to be super
thin and that great body,

but menopause changed
a lot of that.

So that's also been
difficult because it

will affect your mind, because
you don't recognize yourself.

So I have what I call
reverse dysmorphia.

So when I see myself, I
think I look-- in my head,

I think I'm thinner
than what I am.

It's not until I see pictures,
and then I'm like, who's that?

Oh, that's me.

[MUSIC PLAYING]

So some women say
I gain 5 or 10 pounds

when I went through menopause.

First of all, everyone gains
weight as they get older.

That's just a normal part
of the aging process.

But the cool thing
about the body

is that, that actually might
be your body saying, hey,

I got another source of
estrogenicity for you.

There are other systems
that can kick on estrogen,

so you have adipose tissue,
fat, and those adipose cells

can produce a hormone that acts
like estrogen in the brain.

And it's a way of keeping
your brain healthy.

It's kind of taken the
load off your ovaries,

and here, our brains
are able to benefit

from that extra
estrogen. So yeah, you

may feel a little bit
heavier, but it's actually

your body's way of keeping
your brain healthy.

Hormonal changes during
the menopause transition

may cause the fat deposits to
crowd around your belly area.

We don't exactly
know why that is,

but doctors will tell you
that belly fat can set you up

for things like, metabolic
syndrome, diabetes.

But there are things that
you can do about this.

It's not that easy,
and sometimes you

do need to work
with a nutritionist,

but food really is
medicine in this case.

The majority of the deposits
are related to nutrition,

and many of us are not aware
that the foods that we're eating

are highly processed.

If you look at the ingredients
on the back of what

you're eating and you
can't pronounce it,

it's likely processed.

And it's increasing
inflammation and worsening

your physical health.

Changing your diet
so that you're

focusing on foods that
are high in fiber, that

are high in protein, that
are more nutritious, less

processed, less sugary,
all help because they

reduce inflammation, and
can change the way that fat

is stored in your body.

[MUSIC PLAYING]

Then, there are these other
symptoms, like joint pain,

and menopause is also
associated with a higher

risk of osteoporosis.

It's a disease of bone health
and causes bone fragility.

I think that's where
my journey really started

with this, was that what
is going on with my hips?

What?

It's so weird.

And the more conversations I
had with women about their hips,

we all seem to be
having that same thing.

So you get this hitch
in your giddy up.

You stand up, and you're
like, [locking up noise]

and you fall over, and
you're like, oh, my god,

I'm literally falling apart.

We care about osteoporosis
and also osteopenia,

which is the lead up
to it, because increase

the risk of fracture.

And fracture leads to all
kinds of awful complications.

Estrogen is really
important in building bone.

It helps build bone.

And so when we lose estrogen,
we stop building bone.

And this is important
because not only

are we always building bone,
but we're always losing bone.

It's kind of being recycled.

So if you're affecting that
equation, in that you're not

changing the loss part, but
you're affecting how much you're

kind of building,
you're going to start

to get this loss of bone.

[MUSIC PLAYING]

And it differs really
for different women.

Some women can have a pretty
significant loss of bone

during their
menopause transition,

it tends to start about one or
two years before the periods

end, and other people don't
have much loss at all.

But also, some people
come into menopause

with a much higher bone
bank than other people.

So if you've been
a lifetime smoker,

if you're someone who didn't
have periods for two or three

years, if you're
somebody who maybe had

a significant
nutritional deficiency,

you might not come into
menopause with a bone bank.

So we want to ask you
about risk factors.

We also want to know about
genetics, family history,

and we want to try to
calculate then to see,

are you at somebody at
higher risk for osteoporosis,

or are you somebody
at lower risk?

And then make decisions
based on that.

And for people who have
concerns about osteoporosis,

menopausal hormone therapy is
a very good preventative tool.

My own mother died
from osteoporosis.

People don't think about
dying from osteoporosis.

They think about
maybe I have a break.

But breaks can lead to not
only pain and suffering,

but sometimes they can start
a chain of terrible events,

and that might cause someone to
go from living independently,

to have to live in an
assisted living facility.

That might lead to someone
having a terrible life

of chronic pain, where then they
have other complications, maybe

related to medications
they have to take for that.

All kinds of awful
permutations and combinations.

[MUSIC PLAYING]

And there are other
medications that can also

help prevent bone loss, and
that's important for people

to, because not everybody can
take menopausal hormone therapy.

Now, if you have a concern
about your bone health

and you want to take it for
that reason, it's very valid.

But if you say,
well, I only want

to take it if I need
it, right, then we

want to look at what your
individual risk factors are,

and there are a couple
of different tools.

There is something
called the OST,

and there's another
scoring system called FRAX.

F-R-A-X-- and those are
both easy to look up online.

And you can put
your data in and try

to start to assess whether
you're at higher risk or lower

risk for osteoporosis.

And people who are
at higher risk then

should probably consider having
their bone density checked.

One of the things I think
that's great about menopause

is that we start talking
about health in ways

that are encompassing,
but one of the bad things

is we should be talking about
your bone health when you're 20.

Because you're building
your bone as a teenager up

until about the age of 28 or so,
you're building that bone bank.

So it's important to you
through your whole lifespan.

You always want to be thinking
about your bone health,

weight-bearing exercises, so
important, resistance training,

and there are many things
that can also be done

from that standpoint, right?

So protecting your bones isn't
just about taking estrogen.

It isn't just about taking
an anti-resorptive medication

or whatever other
medication that might

be useful for osteoporosis.

It's also about making sure
you're getting enough calcium,

making sure you're
getting enough vitamin D,

making sure you're getting
that resistance training,

working on your balance,
because if you fall,

that's how you break a hip.

You don't break a hip sitting.

So you also have to think
about all of these things

that go into
fragility and health,

and how they're all important.

That's why resistance training
is so important for women.

And if I could
change one thing, it

would be to have resistance
training taught early, because I

came to it very late in life.

And learning about how important
it is for your bone health

and muscle health and brain
health and everything else.

I'm doing it now.

It's never too late.

That's the great thing about it.

But that's why I say, if you're
thinking about your bone health,

today is the best day to start.

I've worked out
my entire life.

It's been a part of
managing my diabetes,

and it hasn't always been
for the physical aesthetic.

It's really been for
optimum, good health,

but the physical
is a part of that

when you're really taking care
of yourself from the inside out.

I realized, though, as
I reached perimenopause,

that I had to change my workout.

It was now more about
lifting weights.

I didn't used to
lift weights before,

but as I realized I'm going
down the path of life,

I like to call it,
I realized I have

to start lifting weights
now, because keeping

my muscular and my
skeletal self strong

is really, really important.

The stronger I am, the
less accidents I have.

If you fall down and hurt
yourself at this time of life,

it can be debilitating.

So I've had to realize
it's about upping

the calories, the protein that
I eat, and it's heavier weight.

My body needs that just
to maintain the structure

that I used to have.

[MUSIC PLAYING]

JUDITH JOSEPH: The
mind-body connection

is so real in menopause.

There are studies that show that
if you have baseline anxiety,

if you have baseline depression,
your perception of your symptoms

may change based on your
anxiety and your depression.

So having this mind bias
towards your symptoms

and thinking that your symptoms
are worse than they actually are

can actually set you up for
worse symptoms in the future.

On the flip side,
having new symptoms

like hot flashes, problems with
sleep, changes in your body,

that can, in turn,
worsen your mood,

cause some symptoms of
depression and anxiety.

So the mind-body
connection goes both ways.

[MUSIC PLAYING]

It's important to know how to
regulate your mood, to address

your depression and your
anxiety at the same time

as addressing your symptoms,
because your perception

as to how bad the
symptoms are can

be impacted by your
initial emotional state.

You just need to reframe it, and
that's what I do as a therapist.

I reframe.

A lot of the studies show that
cognitive behavioral therapy

to support the depression and
anxiety symptoms in menopause

is very beneficial
and in some cases,

more beneficial
than medications.

Cognitive behavioral
therapy helps

you to look at your
thoughts differently,

to change your thinking so
that you have a better outcome.

Many times, you may be
thinking, okay, I'm aging,

I'm getting older, things
are happening to my body.

This means I won't be able
to do the things that I love.

These are automatic,
negative thoughts

that can be quite
destructive, and they

can put you in your place
and keep you stagnant.

However, if you can learn
to challenge these thoughts

and change these
thoughts, the goal

is to change them so
that your feelings change

and your behaviors change.

[MUSIC PLAYING]

There are studies that show that
the way that you perceive aging,

the way that you approach
aging will change

your outcome significantly.

If you are optimistic about
aging and getting older,

if you're looking
forward to it, you're

going to have less symptoms.

So reframing the way
that you approach aging

is so beneficial
because you can actually

age happier and continue
doing the things

that you love with less
symptoms if you reframe.

Recently, I went to
a doctor's appointment,

and I was having a
hard time seeing.

I started to have these
white flashes that

were continuing to make
their way into my sight.

And so I went to see my doctor
about it, and he said, "Yeah,

well, your glands are
starting to dry up,

and we don't want
that to happen."

And I said-- because I had done
so much research on my own--

I said, "Uh-huh, and why is this
Happening " And he was like,

"Well, you know."

I said, "No, tell me, doc,
why is this happening?"

And he said, "Well, you
know, it's because--

you just got to
get the treatments.

Your glands are drying up."

And I said, "But why
is this happening?"

And I realized that
he couldn't say it.

So I took the liberties
of saying it for him.

And I said, "Is it
because I'm in menopause?"

And he said, "Yes,
yes, thank God, you

said it, because I could
have never said that to you.

I mean, look at you.

I can't tell you,
you're in menopause.

My female patients don't want
to hear they're in menopause.

They're going to punch me."

And I thought, poor guy.

He can't even talk
to me about it

because he can't say the word.

He doesn't think he has
permission to say the word.

That's how stigmatized it is.

And in that moment, I realized,
if our health care professionals

are too afraid to say it, how
are they going to provide us

with optimum health care?

So I think that's the goal, to
make it an easy conversation

to have, destigmatize what this
time of our life is all about.

[MUSIC PLAYING]

CAROL: The word menopause
makes people uncomfortable.

It's a fear of being judged,
that means you're old.

It's literally goes to--

the word menopause equals old.

I saw a convention
kind of like--

that a nonprofit
agency was having.

And I said, oh, this
is about menopause.

I'm not doing anything--

I don't really need to
know about menopause.

I'm not even old yet.

I think it's
strange to bring it up

because the reality of,
am I at that age yet?

Like, is this really
happening to me right now?

Am I really this old?

LORI BROTTO: There's a lot we
don't know about menopause,

and because we
don't talk about it,

we're left with myths
and stereotypes.

And so the typical trope or
stereotype is the old lady.

[MUSIC PLAYING]

JUDITH JOSEPH: The image
of the menopausal woman

is not one that is sensual,
that is attractive.

LORI BROTTO: And unfortunately,
it's never challenged.

And lots of myths
get perpetuated.

One that really taps into
this conversation we're

having about
menopause is that sex

gets worse with age for women.

In fact, what the
data suggests is

that women are
more likely to have

more and more pleasurable
orgasms with age.

Orgasm has a lot more to do
with skill and communication

and comfort than it
does with hormones.

Myths that we all carry are so
pernicious because we rarely

stop to question them.

And yet, the beliefs that
we carry impact everything.

How we feel, our emotions,
our behavior, the stress

we carry in our body.

And so it also means that we
need to pause and question

our own beliefs.

We need to say, okay,
I've been holding

on to this belief about
something, is that accurate?

[MUSIC PLAYING]

As science is
evolving, we have data

that now allows us
to answer questions,

to be able to say, well,
that actually is a myth,

and we need to replace
that with a fact.

Until the next bit of
science comes along.

If we look back
to the late 1800s,

where all of women's health
conditions were chalked up

to hysteria--

the wandering uterus,
the uterus was

thought to move around
the body and give rise

to symptoms like neuroticism,
which we now know today

as anxiety, or chronic
pain or abnormal bleeding,

and at the time, it was
thought that hysteria

was the root cause.

And of course, the
treatment for hysteria

was orgasms that were
elicited by a male physician.

And so we can look back now at
our history of women's health

and say, well,
that's quite silly.

First of all, the uterus doesn't
dislodge and move around.

And secondly, although
orgasms are fantastic,

they're not a treatment for
every women's health ailment.

But there has been a legacy of
that, that has persisted and has

clouded our teaching of
women's health, what appears

in textbooks, what gets
discussed in the media, that

still continues to this day.

We talk a lot about
menopause, and how

women go through this
endocrine transition,

but men go through a
similar hormonal transition.

It's called andropause.

Men start to lose testosterone
beginning in their 30s.

There's sort of
a steady decline,

and it continues until death.

It just happens.

It's just a normal part
of the aging process.

But interestingly,
there's been such not only

a cloak of silence,
but a cloak of shame,

because menopause is also
associated with aging,

and that's something women
aren't allowed to do.

[MUSIC PLAYING]

EMILY JACOBS: Most of what we
know about health and disease

centers on the male body.

So in, what's called,
pre-clinical research, so all

of the biomedical research that
happens in animal models, that

is mostly happening in males.

Male rats, male mice.

It's true in neuroscience,
immunology, cancer biology,

physiology, all of these fields.

When I started
doing research, I

was a young student,
a junior scientist.

I was interested in
understanding the factors

that impact sexual activity.

And so I began to
volunteer in a research

lab that was using the male rat
as a model of human sexuality.

And so we would inject the
rats with different things

like antidepressants.

We would expose the rats
to stressful environments

by crowding them
in a small cage,

and then measuring
sexual activity.

So I would watch the
rats in the cage.

How often did they mount?

How long did it take
them to ejaculate?

And I spent many,
many years doing that.

Until one day, I realized,
I was using the male rat

as a model for understanding
human sexuality,

human male sexuality and
human female sexuality.

And it's so paradoxical
that even in animal science,

we're using male models to
understand female conditions.

According to a report by the
US Government Accountability

Agency, about 80% of drugs
that are pulled from the market

every year by the FDA
are done so because they

have adverse effects in women.

These are effects
that presumably

would have been caught earlier
had that preclinical testing

included both sexes.

It's our tax dollars, right?

And science has
to serve society.

Not one half, but the
whole damn whole, right?

Women are 50% of the population,
but only 10% of NIH dollars

goes to conditions that
primarily affect women.

[MUSIC PLAYING]

Only in 2016 have
we reached the point

at which our bodies are
being taken seriously

for the first time.

We're living history here.

This is new.

There is a lot to
be hopeful about.

President Biden just
signed an executive order

requesting $12
billion in new funding

specifically to advance
women's health research.

This just happened in 2024.

2024, we have now a White House
initiative on women's health.

We didn't have that before.

This is something of a watershed
moment for women's health.

This is probably, I
think, in our lifetime,

ladies, one of the
most important things

that we'll do for ourselves.

And it's really
important that we all

stand together and lock arms.

And I am beyond honored
to be here and be

a part of this movement
that's happening.

[MUSIC PLAYING]

HALLE BERRY: The
Advancing Menopause Care

and Women's Midlife
Health Act is

an act, a bill, that I've been
a big part of getting passed.

Advocacy became
supremely important to me

because I knew that
this was a subject that

needed to be talked about.

It was a subject that
had long been overlooked.

And so I thought, I'm
going to go to Washington,

and I'm going to talk to my
female Senators and House

of Representatives,
and I'm going

to tell them what the issue
is, what I'm experiencing,

and ask them to come
together and help erect

a standalone bill
that will give money,

new money, new dollars, just for
menopause and women in midlife.

And it's true, that it's such
a stigma around menopause,

and what that means for a woman,
and the fact that we're old,

and we're no longer
valuable to society.

That's how we're viewed.

I realize there's that
stigma, but I'm not

afraid to get in
front of this, right?

This is the most normal, natural
time in every woman's life.

We make up half the
population, and every woman

goes through this
time if she's blessed

enough to live long enough.

We are, in many ways, the
cornerstone of our society.

We birth children, right?

We give our bodies to
procreation so that we all

can be here, men included.

Why are we discarded when
those years are over?

Not okay.

And that's why I
went on my journey,

because I knew that I had to.

I realize it
sounds strange to say

this in a class about
menopause, but there's

so much about the biology of
menopause that we don't know,

because science doesn't
study people like us.

So if women feel like they
don't have answers, part of that

is because medicine has
failed women for centuries.

We are confronting a medical
system that was never

designed to serve them.

We're confronting a research
that is still in its infancy.

[MUSIC PLAYING]

I started going to
my doctor, and I said,

I think I'm going crazy.

Something's wrong.

You know, funny enough,
my doctor never,

ever brought up the
idea of perimenopause.

I even go to a
female gynecologist,

and no one has ever
said anything to me

about perimenopause.

So I was telling my doctor
that I felt that's what I had,

and she just kept telling me,
I'm too young, I'm too young.

Even knowing my history with
my uterine reconstruction.

So she just would
just not listen to me.

I did call my general
practitioner the other day

to describe some
of these things.

I'm 54.

I'm kind of happening.

And she was very kind,
but she kind of said,

you need to call
your gynecologist.

This really isn't a
general practitioner offer.

So I think that's also
part of the problem

is, where do we go to
have the conversation?

And everyone's playing a
little bit of hot potato,

so I think there's a bit
of a vacuum of knowledge.

When you look at the doctors
who typically would treat

a menopausal or
postmenopausal individual,

they're going to be OB/GYNs,
general practitioners,

internal medicine doctors.

And a recent study from 2019
showed that a little over half

of those doctors get one
course in menopause training

after they've done
their education.

One course is just
not enough because we

know that during the menopause
transition, a lot of things

happen, and this is
complex and nuanced.

So we really need to
have in-depth training

to direct patients to the
correct interventions.

[MUSIC PLAYING]

JUDITH JOSEPH: If
you're someone who

is African-American
or identify as Black

or you're Native,
Indigenous, large studies

show that you're likely going
to go through menopause sooner,

your symptoms are going
to be more severe,

and they're going to be longer.

So knowing this
information is going

to help you to
prepare and to plan.

Also, you're part of a
group that has more trauma,

more generational trauma,
more microaggressions,

macroaggressions.

And knowing that you have
this history of trauma,

that sets you up
for worse symptoms.

We know that there are
health inequities that

disproportionately impact
certain groups of females.

We know that gender diverse,
including trans people,

face among the worst
health inequities,

among the different populations
of people who are seeking help.

And for the trans man, so
assigned female at birth

and therefore, may
have menstruated

and may experience
perimenopausal symptoms

and go through the menopause, it
can be incredibly embarrassing,

even traumatizing.

JUDITH JOSEPH: In
my trauma research,

when you look at
experiences that

can be potentially traumatizing,
if something just happens

to you, then you
tend to self-blame,

then you tend to
internalize shame.

So that internalized
shame and blame

leads us to suffer in silence.

If you can't talk
about something,

the implication
is it's shameful.

So I think that
the very first step

is the discussions, is saying
this is happening to me.

There's nothing shameful
about going through menopause.

There's nothing
shameful about aging.

There's nothing shameful about
letting your hair go gray

or not letting
your hair go gray.

There's nothing
shameful about whatever

you decide to do for
your own well-being,

but to have those discussions.

Society tells us that
everything is over,

but we know this is not true.

This is the framework that
I want you to work with.

I want you to look
forward to getting older,

to dismiss the myth that
you're no longer valuable.

We have to realize it's
okay to put ourselves first.

It's okay to put our health
at the forefront of our life.

When we get to midlife, it's
when women usually lean out

of the health care system.

It's time to lean
into our health.

[MUSIC PLAYING]

The dismissal that so
many women and so many peri

and postmenopausal
women express when

they find the courage to
ask for help is devastating,

it's inappropriate,
and it has to stop.

And of course, fear arises.

And when people have
been so dismissed,

they're going
non-traditional routes.

Social media can be fantastic
in the way that it can connect

people with communities, it can
help people find evidence-based

providers, but it can also be
a place where fear is sold,

where you are given false
information about hormone

balancing, about supplements,
about menopause hormone therapy.

If you're taking a product
that claims to have

a health benefit, right--

it can help hot flashes, it
can help with metabolism,

it can help with weight loss,
it can help with mood swings,

whatever--

know that, that has not been
tested in any rigorous way.

These supplements are not
regulated by the Food and Drug

Administration, the FDA.

They may actually interact
in your body in a way

that you don't know what
they're going to do and make

your symptoms worse.

[MUSIC PLAYING]

So when we talk about
menopause hormone therapy,

evidence-based physicians are
talking about pharmaceutical

medications made by a
pharmaceutical company.

There are also
compounded hormones

that come from a
compounded pharmacy.

The way compounded hormones
are often spoken about online

is this is a custom-made
product for you,

and this is not supported
by any science at all.

Someone going into a
pharmacy and mixing up

hormones with a
weight and a scale

can't create that same
precision that you get

from pharmaceutical companies.

But even more,
beyond that, when you

get a pharmaceutical product,
they're all batch tested,

so you know what's in each one.

I can tell you reliably how
much estrogen is in each patch.

That doesn't happen with
compounded medications.

They're not batch
testing these products.

So the problem with
those medications

is you may not be
getting enough of them,

or you may be getting too much.

And if you want to
take a medication,

don't you want to know that
you're getting the right amount?

So it's really
important to stay clear

of things that
are not regulated,

unless you're talking about
them with your doctor,

because you want to make
sure that you're not

making your symptoms
worse, and that you're not

harming your body.

You only get one.

Now, I fully recognize that
there are so many barriers,

that there aren't countless
health care providers waiting

in the wings to offer support
for the women who have been

dismissed by a certain
health care provider,

but you have to
become an advocate.

You need to advocate
for your own health.

I would tell women to take
their perimenopausal, menopausal

journey into their own hands.

Read, read, read, read, read.

If you find that you have
doctors or health care

professionals that don't
understand the menopausal body,

I say, have the courage
to switch your doctor.

I think as women, we
sometimes have a hard time

advocating for ourselves.

So if you have to
change your doctor,

and you have to find
a doctor who's female,

who has gone down this path,
or who is going down this path,

I say do that.

[MUSIC PLAYING]

I would recommend going to the
website, The Menopause Society,

which is a leading organization
focused on women's health

during menopause.

It offers essential
resources to help

you find certified
practitioners, who

provide expert,
personalized care

for your menopausal journey.

[MUSIC PLAYING]

In some cultures around
the world, getting older

is seen as a blessing.

People who get older are valued.

They are the cornerstones
of the community.

They're seen as
sources of knowledge.

Because they have expertise,
they have knowledge,

so they are celebrated.

Its a time of life,
I've discovered,

that's filled with joy,
because you know why?

You're completely who you are.

You have zero fucks to give, and
that's a magical time of life,

in my opinion.

[MUSIC PLAYING]

JUDITH JOSEPH: You get to
continue living life, doing

the things that you
love with the people

that you love doing
them with, so we

have to start reframing
our narratives.

JENNIFER GUNTER: The theory
behind menopause existing

is related to something called
the grandmother hypothesis.

And the idea is that
reproducing is hard,

and it was even harder 10,000
years ago, longer than that.

Reproduction was hard.

It's surviving childbirth.

It's having shelter.

It's gathering enough
food so there's

enough energy to breastfeed
and enough energy to heal,

to raise that child until
they can gather food

and resources for themselves.

If you have an extra pair of
hands, it's probably easier.

A lot of scientists are now
coming to this understanding

that menopause is this
evolutionary adaptation,

and we live longer
than men, right?

If you look at all the
centenarians walking

around the planet today,
80% of them are women.

So it could be that something
about the menopausal experience

is what can explain women's
increased longevity.

That's pretty damn cool.

Human beings continue to
live and thrive and continue

being active and valuable
members of the community

because they're
supporting their tribe.

So we're making contributions as
a whole, and we are meaningful.

We belong here.

We have a purpose.

[MUSIC PLAYING]

MANOUSCHKA: Our responsibility
is to teach younger women,

like prepare them, for
what's coming because, girl,

it's coming.

There's no-- this is
a huge part of life.

And there's so much collective
wisdom in the community

that we really need
spaces to share it.

When we can have a
conversation, when we can say,

this is what I go through, and
this is what I've gone through,

you instantly feel less crazy.

You feel, oh, thank
God, I'm normal.

So I am very close
to my college sorority,

and we are all there
to support each other.

Yes, I've tried--
have you tried HRT?

Have you tried magnesium
on your feet at night?

I'm a big Advil PM person.

I've held all of their hair
while vomiting many, many years,

so this is not a
group of women that

should be trusted with
any medical advice,

but they're
emotionally fantastic.

It's important to have a
community to talk about this.

Don't feel as if you're
going through it alone.

Open up.

It's okay to be sad.

It's okay to share
these emotions.

In sharing, you may be
actually helping someone else.

Community is key.

Well, RESPIN has been my baby.

Once I realized that I
was in perimenopause,

I had this aha
moment, and I thought,

let's educate, let's
inform, let's raise money,

let's change the
world for women.

And the camaraderie
of that is beautiful.

And I've heard women who
have gone through menopause

and who are on the other side
tell me it's the biggest joke

nobody understands.

[MUSIC PLAYING]

It's great over here.

It really is if you know
the right things to do,

if you have the medications, if
you have all of the information.

I want every woman to arrive
on the other side of that

as their best selves.

So when it comes to the
postmenopausal, like my mom,

for instance, right
now, she is 63,

and she's been done with her
period for 10 years already.

My grandma is still here with
us, and she's 80-something,

and she's been done.

And they are free, and they
don't have mood swings, at least

related to PMS, but
you know, there's

a certain freeness in that.

If I could redefine
menopause, first of all,

I wouldn't use that word.

I would choose another
one because that word has

been so stigmatized, and there's
such a negative connotation

with that word.

So I would change the word.

Back in the day, we used to
use the term climacteric, which

I love, because it's more
about of a phase of life,

a rung on a ladder, a step
that you're going through.

It encompasses a
lot more, as opposed

to defining you by the
date of your last period.

I want you to
start challenging

your idea and your imagery
as to what a woman going

through menopause looks like.

So looking at someone in their
40s, 50s, 60s, who you admire,

who you look up to, do you think
about menopause when you see

them?

No.

We need to learn, how
do we define ourselves

based on the things that
are important to us,

not based on the messages
that society gives.

And recognize that the
status of being mothers

is only one part
of it, and that's

why, again, it's so
important that we're

having this conversation.

[MUSIC PLAYING]

The definition of menopause,
a journey, an awakening.

That's the word.

Oh, there is
absolutely, a freedom.

Listen, no pregnancies,
no periods, no PMS.

I guess, this is my
transition to total freedom.

I don't always
feel that pressure

of having to be a
certain way, and I

think that's one of the
beautiful things about getting

older and menopause, because
there's a point where you just

don't care.

You're like, this
is the way I am.

Because older women
don't just wear Depends.

We like to wear cute underwear.

I wear a thong.

Do I look old
and shriveled up?

Honey, I'm looking real good.

I'm in that next phase.

I leveled up.

That's how I see it.

I leveled up.

It's another part of life.

It's the next phase in your
womanhood, in my womanhood.

And the more you know about
this, the more you can live.

For so long, we've been valued
by the way society sees us.

We get to decide our worth now.

We get to decide who we are
in the second act of our life.

Let's change that
narrative together.

Just like we have bachelorette
parties and baby showers

and bar mitzvahs,
bat mitzvahs, I

think we should have a she-esta,
for women when they realize

that they're in menopause.

And their families
should throw it.

They should usher you into
this new phase of your life

with joy, with love,
and with support,

and they should honor you
that day with the she-esta.

HALLE BERRY: Because now,
you're about to enter one

of the best times of your life.

[AUDIO LOGO]