In this segment of the Sexual Energy Series, Dr. Somi Javaid and host David Sinclair discuss practical intermittent‑fasting protocols tailored for women at different reproductive stages—fertile years, perimenopause, and menopause. Dr. Javaid shares her clinical experience, noting that younger patients typically fast 14 hours daily, while perimenopausal and menopausal patients often require 16–18 hours to maintain metabolic health and weight loss. She emphasizes daily (seven‑day) fasting for most patients, but adjusts duration based on individual lab results (CMP, insulin, HbA1c), weight‑loss goals, and tolerance. The conversation covers how to introduce fasting gently (starting at 12 hours, eliminating evening snacks, coffee without cream), the importance of multidisciplinary support (nutritionists, weight‑loss specialists) to monitor for hair loss, vitamin deficiencies, or cortisol‑related symptoms, and the role of patient education (PCOS‑focused book, a general fasting guide). Dr. Javaid references a study by Dr. Murad (Australia) showing metabolic benefits from 12‑plus hours fasting three times a week without immune suppression. She also discusses the balance between strict fasting and flexibility (weekend meals, occasional pancakes) to sustain long‑term adherence. Overall, the dialogue blends anecdotal clinical data with emerging research, offering a nuanced, patient‑centered framework for women’s intermittent fasting.
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Give me the fasting schedule you like. For women in their fertile years, women in perimenopause, and women in menopause. How does it change? Oh, I can't wait to hear this answer.
Oh, God. So this is not based on data, right? This is just based on what I'm doing.
Well, clinical experience is data. It's precious data. It's actually the most useful data. It's just not like double blind placebo controlled, blah, blah, blah.
Okay, okay. Yeah. So 14 year, 14 hours for my younger patients. 16, 18 for. As you're getting into perimenopause and menopause. And personally, I'm finding that, you know, 14 no longer works for me anymore. I have to push it to 16 and 18, and depending on whether they're trying to maintain or whether they're trying to lose weight. And so when they've lost the weight or gotten to their goal weight, then we back down again and let them go back to 16 hours or 14 hours, whatever was working for them.
Do you do this every day?
Do I fast every day? Yes.
Or do you recommend it for patients? You're seven days a week.
I'm seven days a week right now.
Wow. And that works for most of your patients?
Yes. Although I will tell you, I'm seven days right now. You didn't ask the question because Covid was not kind to me. So I'm not at my baseline right now.
Oh, so you're losing some weight. So you're pushing it.
Okay, yes, I'm pushing it. Yeah. There was too much wine in pasta, you know, in 2020.
So it happens sometimes, especially if it's really good wine. Right. The, the, the studies that I've seen, There's one from Dr. Murad out of Australia who's just on the show, she was finding that even three days a week of 12 plus, ideally, you know, 14 or 16 hours for women was having very meaningful effects on their metabolic rate, and it wasn't suppressing their immunity. But a lot of women I've seen go into this, okay, 14 hours a day is amazing. And I feel really good. So I'm going to go to 16, and I'm going to go to one meal a day. And at a certain point, and this is almost like really predictable, I wake up and I don't feel good. I feel like I didn't sleep enough. And then even if they did sleep enough or they wake up in the middle of the night and then they say, well, now my cycle is, is not what it used to be like. Like things are getting irregular and then they're getting thin hair and it feels like they're getting too much cortisol. They're not eating often enough. How do you. I mean, seven days a week is pretty aggressive for a lot of women. How do you recommend they start fasting versus once you're used to it, is there a gentler approach or do you just like, go for it?
No. So it also depends on. I have the ability. So I have their labs in front of them. Right. So I have their CMP. I know their insulin levels, I know their hemoglobin A1C. I also have their objective data with their weights and everything else that helps. Yes. So if they're pre diabetic or heading down a disastrous route then. Or if they're very resistant or they're scared, I'll tell them, start at 12. Like just stop snacking after dinner, stick to water, and in the morning have coffee with no cream in it. So small steps, baby steps. Right. Because I treat women with eating disorders, I don't want that to develop that because they're so fixated on this. And then I tell them, as it becomes palatable and they're feeling okay to increase. I also, like you said, we have this multidisciplinary approach. I have providers who specialize in weight loss, and I also work with nutritionists, so to make sure that we're not seeing hair loss or we're not seeing vitamin deficiencies. So because we have all of that available to in our office, we're able to make sure that they don't fall into a negative pattern or end up causing more damage by trying to fix the underlying issue. But the feedback I get is the cravings are better. Like they actually feel better. They don't feel like they're in carb comas anymore. They're not craving foods, they have more energy. So for sure. And with my polycystic ovarian patients, the PCOS plan is a book that I recommend that they've read. And so then they know that even during their eating hours, what choices are better for food and staying away from calorie counting or points, I feel like that puts too much pressure on patients. And so hours seem to be a little bit easier. But yeah, during weight loss, I will recommend seven days and then maintenance, obviously back down. And then obviously weekends, you know, let them have fun, let them relax.
But absolutely, I recommend in the book that, you know, Saturday morning or Sunday morning, have breakfast, right? You don't have to fast every single day and, and that it doesn't have to be the same every day. Some days it's 14, some days it's 16, depending on how well you slept, depending on your readiness. And there's something I think is kind of magic about saying I'm have the pancakes, maybe they're gluten free, hopefully, but I'm going to do that every now and then because it, you know, there's a ritual and a nourishing thing that happens there that's important for men and women. But the kind of militant fasting, unless you're doing it for a limited amount of time, just trying to lose weight, seems to be sustainable. And what you said about energy, that's why I wrote a book on fasting that's, you know, the typical book on fasting is step one, don't eat for a while. Step two, it's good for you. But most people won't do that for a long period of time or they over fast after a while and then you end up with all the stuff that you've seen in labs. So the idea that you're working with data is cool.
