Six Powerful Ways To Keep Your Perimenopause Brain Sharp

Real quick, before we dive into this episode, I have a little sleep secret I want to tell you about. Look, sleep is crucial for your fitness, but it's crucial for just plain old everyday life and function. And I find I sleep great unless I have a migraine. And I've had more than my fair share since perimenopause all the way through post menopause. My secret weapon was Blue Sky CBD sleep gels. Each gel contains 25mg of CBD and 25mg CBN for deep restorative sleep. Something about it helps to reduce inflammation, which I believe for me was key in helping me get to sleep. But the biggest thing is so many of the over counter solutions, whether for sleep or migraines, can ruin your gut health and liver health. Neither one of those did I want to be problematic for me. So this option is recommended by health care providers worldwide and backed by thousands of happy customers, many of whom come from our flipping 50 community. There is 0thC so it's non habit forming. It's made by a trusted family owned company that we all can feel good about. Third party tested for purity and potency. And if you're interested, you too can try a sample for just $6. But even better, you can get 30% off forever with discount code. Flipping 50. That's flipping 50. Just go to flipping50.com blueskycbd we'll put that link in the show notes and you'll find it everywhere on flipping 50 at my favorites. What are you waiting for? Good night. Whether you or your daughter or someone else, you know the perimenopause brain can be a real thing. If you've been tuning into flipping 50 long enough, you're already familiar with signs of menopause. But those signs and symptoms are not enough to to gauge whether you need some real support in the way of bioidentical hormones or other lifestyle changes. With my guest today, I explore the connections of symptoms to brain health and asymptomatic us to brain health. And we're going to share how bioidentical hormone replacement therapy could benefit not just your brain, but also your car. Cardio metabolic health. And if you're wondering exactly what is that again, we've got you covered. We actually give you the Webster's Dictionary explanation of several different terms related to that. So we're not just flinging them out at you, but just really breaking it down. So it's super simple and I want you to tune in to discover what we can do to improve our perimenopause brain power and cardio metabolic health. But if you're well beyond that, this is also for you. Stay with us. Doctor Marissa Snyder is a functional doctor, perimenopause and menopause expert and the author of eight books. Her recent book the Essential Oils Menopause Solution focuses on solutions for women in perimenopause and menopause. And the number one bestseller billing book, the Essential Oils Hormone Solution focuses on optimizing women's health. Dr. Marissa is also the host of the top rated energized podcast with over 12 million downloads designed to empower women to claim agency over their health. I'm Debra Atkinson, you're listening to flipping 50. I started this podcast over a decade ago to answer questions about fitness in menopause and beyond before you knew to ask them. The goal to help accelerate your results with science and the practical application of proven protocols while living your best life. There's no more powerful health insurance influencer in the world than a midlife woman. And it's not just about you, but the three generations that you influence. My unique 40 year career, including being a university senior lecturer in kinesiology, an industry subject matter expert and an international speaker to founder of the first and the only exclusively Made for Menopause and beyond fitness membership in the world. Every week I interview experts behind the scenes and the science of optimal hormone balancing, fitness and longevity and share answers to our community's questions so you can have the vitality and the energy that you want, need and deserve.

Foreign.

Look who's in the house. Dr. Marisa Snyder, thank you so much for coming back.

Thank you for having me, Deborah. It is such a pleasure to get to see you again.

Yes, always. And it's always something new. So I think we're always down this route and road of menopause, perimenopause, midlife and hormones and all the things. But you girl, we're talking about you. So you're in this unique niche. I think correct me if this is otherwise, but I dawned on me that you are kind of leading the way and I think we're going to see more of this, this blending of perimenopause with almost postpartum, like I'm coming off of this or I have really young children which has got to be a whole nother animal. When I think to when I was 30, you know, and I was with, you know, a young kid who didn't seem to sleep, loved to graze all night, you know, and I was like, I Can't do this anymore. I can't breastfeed anymore because I need my life back. I can't imagine being in the middle of both. So having been a mom to an infant or toddler, you know, what is that like when you're also stacking perimenopause and young children together?

That is such a great question. And it is the journey that I am on that I chose. You know, I had my son at 41, and I'll be 45 in a couple of weeks. So he's almost 4, which is super fun. And I actually breastfed him up until last summer. He was two and a half. And what actually stopped me from breastfeeding him is that I had two epic concussions back to back, and ended up getting diagnosed with post concussion syndrome. And the amount of supplements and medications, all the things I had to do to walk back, this kind of double brain injury forced me to stop breastfeeding him immediately. And even before the brain injury, I would say, you know, probably I would even say about three months prior to that, when in the breastfeeding was winding down. Honestly, it was more for comfort than it was for anything at that point. Right. You know, two and a half years old or practically that he was eating meals and snacks, the whole nine. You know, the amount of food toddlers consume. I mean, some don't and then some do, and he's kind of in the middle. But I knew it was winding down, and I felt like, you know, that postpartum bubble was kind of ending for me. And honestly, a chunk of that postpartum bubble wasn't too bad. My metabolic labs look great. My period hadn't come back online yet. And a lot of the ebbs and flows of kind of the perimenopause continuum or the perimenopause, you know, hot mess kind of situation hadn't really come online. And then all of a sudden, it felt like I went from postpartum to perimenopause in a matter of months. And then the brain injury did not help. All kind of. I went from like 0 to 100 into perimenopause symptoms. And I think because I was still in this postpartum phase, I wasn't kind of preparing myself up for perimenopause the way that I probably should have. It's been about a year since that transition, and I still feel like I am trying to find my bearings in all of it.

Wow. Okay. So for all my listeners, I mean, we have such a wide gamut of ages and stages and really, age can be irrelevant because no woman goes through it in exactly the same way or timeline. But for some of you, this is going to be a great podcast to share with your daughter. By the way, Dr. Marisa is a great person to follow for someone who's in the thick of that just as she is. And I just think that as, you know, more and more of our young women get established in their careers, are maybe going to school a little bit longer because they're deciding they want to be professionals and it requires it, or they're going back, you know, not quite sure when they're really young, what they want. We're going to see some of this, like, delayed and. And 41, and will be normal, you know, to have a baby. And so we'll see more of it. So I'm so, so grateful that we're having this discussion. And then some of you, right here, you're in it right now. And so here you go. This is for you, too. What about you? I mean, anything more specific about your own perimenopausal journey? I mean, the concussion, that situation has to really.

I don't recommend those to anybody, and I definitely do not recommend them during perimenopause when there's already so much upheaval. You don't need a blunt hit to the head, you know, to kind of bring things up for review. And so I don't think it did me any favors.

Was this, like, a really juicy story? I mean, were you water skiing?

I risked, I think, yeah. So the first one, the first concussion was in mid June last year. And again, I'm a mom and I play full out. Like, I, you know, I plan for my son. I have Hashimoto's thyroiditis and a couple of things. So I really planned, especially having a child in my geriatric years, quote, unquote. I really wanted to. That's what they say. I had doctors telling me, like, it may not come naturally for you. You're already almost 40. You've got this autoimmune condition. Like, you know, you know, they kind of. You have no progesterone levels or, you know, like, it's pretty much. At that time, at 39 years, my progesterone was pretty much postmenopausal. So they're like, you know, you need that hormone to maintain the pregnancy. And so I actually supplemented with progesterone to get pregnant because I had a miscarriage the first time. And so I knew that progesterone, or lack thereof, was a part of that equation. And so I'm a playful out mom, and we're at a little beach playground, and my son's two and a half. And it's a ladder. It's this metal ladder that he's got to climb up. And, you know, I don't want him to fall off of it. I wasn't sure if he could do it, but I want to make sure he gets all the way up and he gets all the way to the top at the second level. And he wants me to go slide down the slide with him. And how could I. Absolutely.

Yes.

And. But at the time, I had been doing CrossFit and I'd been doing jump squats, like, onto, like, you know, onto blocks. And I thought, you know, what would be super cool here is to jump squat my way up to the second level. And I have a little baseball hat on. I, you know, sun aging and trying to avoid that. And so I literally box jump and propel myself up with an amazing amount of velocity. And I don't know that there's a metal bar one foot above my head. And I box jump into this metal bar and pretty much fall down the ladder and see stars for a second. I don't fully go unconscious, but it wasn't good. So we decided we're going to keep an eye on me for the rest of the day and just check my symptoms, you know, again, I was already dealing with some brain fog. Things were kind of. So it's. It was hard to tell. I'm like, is it the concussion? Is this perimenopause? Am I in my late luteal phase? And I just. It's all falling apart anyway. Like, I don't know. It was just kind of hard to tell because I was already having some symptoms around my brain not working 100%. One of the biggest symptoms of women in perimenopause is their brain just, you know, it just is not working the way that we think. And that's because we go through a massive remodel in the perimenopausal transition. Well, a week and a half later, I'm playing with my son again in the living room, and we're just messing around, having a good time. And he kind of. He almost loses his balance and he flings his head back, like. And it slams into my nose, and it pretty much breaks my nose. It was black and blue.

Oh, no.

And it was just a brunt force to the face. Like, it was the back of his head. He hit me so hard. I remember it was Shocking for both of us. And I felt everything. You know, when you get hit really hard and you can just feel, especially your face, if anyone's been hitting their face, you know, it gets heated and red and I could feel it, my nose getting big. And, you know, that had been, you know, and I had broken it when I was a little girl, so it was right at that spot that I had broken it before. And I remember Alex, my husband, was upstairs in the office working, and I had Kingston, and I was trying to get my husband's attention, but my son was really afraid that something was very wrong with me. So here I am trying to juggle telling my son I'm okay and I am not okay. Like, and then what preceded that was 14 days of back to back cluster migraines that progressively got worse until I ended up in the error and did a CT scan to see if I actually really broke my brain or not. And the diagnosis was that, yeah, you hit your head twice really hard back to back. And I couldn't drive a car, I couldn't get dressed, I couldn't take a shower. Like, I, it. It was very bad for a little while there, and, and I even wondered if I was going to recover from this, these injuries. But I would say it took me probably a good solid three months of consistent brain treatments and concussion protocols from like, a Navy SEAL doctor working with me, and then another months for me to really come out of the woodworks. I would say I didn't really turn a full corner until January this year.

Oh, my gosh. Do you feel like you're firing 100% or do you still notice I've got some issues going on?

My brain isn't 100% what it was. And that a lot of women feel that way at 40, 45 years old. You know, their brain doesn't feel. And so it's kind of hard to discern. Again, the brain injury definitely didn't do me any favors, and it led to more migraines. I've been dealing with a lot of chronic pain and chronic migraine pain. What we know, the research is clear, and this is recent research, is that, you know, there are three instances in a woman's life where our brains completely get pruned back and get reorganized, and it's puberty, postpartum, and perimenopause. So you can imagine women who are in postpartum, in perimenopause we're talking about. We don't have the research for the level of brain reshifting and reorganizing that goes on, add a traumatic kind of brain injury into the mix and then who knows what you're going to get. What I can say is I am really grateful that my brain is working as well as us being able to have this conversation because this time last year I would never have been able to have this conversation with you. And it's been a beautiful lesson in me really checking in with myself a lot. I think a lot of women in this transition, you know, checking in with ourselves, seeing where we're at, what we have capacity for, is so important and really honoring my body enough to take care of it. I don't try to take it for granted how far I've come and the knowing that it required a lot of consistency and diligence to get here today. I love it.

Okay, so given all of that, have you made changes in like the way that you work, like in blocks and then breaks or the way that you sleep or guard that?

Yes, absolutely. Up until about a month ago, I wouldn't do more than one or two interviews a day. You know, I was really mindful. I was probably only working five to six hours a day and taking blocks of time. How I talk about sleep is that I treat it like a million dollar meeting. It's probably the most, I think, you know, when you, when your brain is really struggling, you really begin to notice the things that either move it forward in a good direction or move it in that backwards direction. And so one of the most Prof. Things that I noticed was the sleep. You know, at the time we were still co sleeping with my son and my husband took that over 100%. So I sleep by myself now and that still remains. My son's asleep by 8 o'.

Clock.

I am in bed at 9, I'm 9pm and I am lights off at 9:30. Like I my sleep routine starts when my son's sleep routine starts. And once he's asleep and that's taken over, then I am full force into mine. Like you can't have a conversation with me. Don't talk to me about a TV show you want to watch. Do not bring up work like my brain. My brain is done. Our logistics about the next day is obviously as a mom, there's many, many, many logistics that I'm managing. Like it is a full body stop. And so, because I know quality of sleep is so, so imperative. And it's not until I think we are at that moment where we know what it feels like to have a sleep deficit do we really begin to prioritize how critical that is.

Yeah, you know, my wake up call to the importance of that. I think this could happen to anybody. But when you're in a good zone, like you sleep really well, there's no real issues. You know, I got a puppy about a year ago and I was like, oh my God, there's a reason women in their late 50s can't have babies. Because I could not function. I was like, oh my gosh, this is bad.

Yeah. Being woken up multiple times at night for water or a potty break or whatever it is, you know, just needing to cuddle. Yeah, no, thank you. Like, it's a lot.

It's tons. Yes. Okay. You mentioned. Yeah, you were doing progesterone prior to. So what are you doing bioidentical hormones now?

Yeah, I am. I'm on both. And that's one of the things I really want to advocate for women. My, you know, as I mentioned, even before I had my son, even before, you know, the average age women start to notice perimenopausal symptoms is usually like early 40s. I would say that off the cliff moment, usually 42, 43 from most women that I talk to. However, some can again, if the menopausal window, natural menopause happens between the age of 45 and 55 and perimenopause is these 4 to 10 plus year transition prior, it's safe to say that women are going through perimenopause in their late 30s, easy. And so if you were tracking my progesterone levels on a serum or a Dutch test, whatever, they had been low. And so I knew that I needed to get enough of it in my system. So I was supplementing with 100 milligrams of compound of progesterone back then. And I had known that I needed progesterone last year before the brain injury. And that's the thing about being a mom, is you sacrifice. So I thought, okay, I really want to breastfeed my son longer, but if I start taking progesterone and I know I don't got it, it's going to get into the breast milk and it's going to probably stop that journey. Progesterone does have a way of like ending your breastfeeding journey, it'll kind of slow down the prolactin. And so I knew all that. And so I was like, well, I'm just going to stretch this out. I'm just going to kind of white knuckle it for as long as I can. And then the Brain injury happened. And one of the cool things about progesterone is it's really a powerful anti inflammatory for the brain. It's a go to recommendation or tool for people with concussions or post concussion syndrome or any type of, you know, any type of brain injury. So progesterone is usually recommended at least 200mg, if not more to help mitigate it acts as allopregnetolone in the brain and basically it lowers inflammation in the brain because that's basically what you're dealing with with a concussion or a brain injury is increased inflammation.

Yeah, for sure. And I want to break some terms down here. Just I don't want to assume that any listener. So we're also not being condescending to any listener, but in doing this, I think we can go back to square one one and maybe have a vocabulary lesson. So if we were going to talk here about cardiometabolic health and the brain and the benefits of bioidentical hormone replacement on both, I think first before we do that, let's talk about these terms that are probably a little bit more familiar to women and then get into all of them. So let's talk metabolic flexibility. Talk metabolism as women are probably used to hearing both of those and knowing this is something I need to pay attention to. And then cardiometabolic health. I know women listening, you know, cardio is going to be related to heart. But let's break down what's the definition of each of those.

I know that we all have our kind of our own very nuanced version of that. But how I describe metabolism, it's how our cells convert substrates like fat and sugar and into energy like ATP. And it's what every single little cell in our body uses to do the jobs that they need to do. Whether that's synthesizing proteins or that is breaking down, you know, organelles in the cell or it's, you know, allowing the mitochondria to work. And so it's how well we can turn what we eat into the energy that we use to do everything every single day.

Perfect. Let's talk about metabolic flexibility. Just to throw that in there because it's just sounds like. And I don't want anybody confused.

Absolutely. So we use, as I mentioned, different substrates to convert that food into energy. And one of the biggest substrates that we leverage is sugar is glucose. And we, it's particularly the brain. The brain loves glucose. And so that's kind of our default type of substrate to turn into energy. We store it in our muscles, we store it in our liver, it can be stored as fat, it can be converted as fat into our adipose tissues, but basically glucose. And then the other substrate that we use kind of our deeper storage, not our immediate storage, but our deeper storage is going to be fat. And so someone who's got metabolic flexibility can vacillate between burning sugar and burning fat, depending on what the body is needing at that time. And that ability to have flexibility, especially for women in midlife, is very, very critical, you know, in terms of, you know, having capacity to make energy anytime. So that's what I would define as metabolic flexibility. And that's what we want, it's what we're trying to achieve, is that we're not just burning sugar sources at all times, that we are able to put the brakes on sugar and move to that deeper fat storage and burn that deeper storage of energy when, you know, while we're sleeping or in the early morning of the day when, after we're working out, you know, that's going to be the time where we'll tap into some of those stores.

Beautiful. Okay, now let's talk about cardiometabolic health and what that is to a woman, why it's important to her.

Absolutely. So there is a beautiful connection. Obviously, cellular energy, you know, met, which is, again, metabolism, as far as I'm concerned, plays a role in every, again, every single cell in the body, including our cardiovascular health. And most importantly, what we have found in relation to the transport of sugar from our bloodstream into our cel, when that is running really well, we keep our blood sugar pretty stable. I have a continuous glucose monitor right now where I'm tracking all of that. But during, you know, if indeed we're seeing our metabolic health start to move in an unfavorable direction, we'll start to see biomarkers like insulin resistance or a fasting blood glucose go up, and that causes inflammation on the body. We know that insulin resistance. Again, insulin is that hormone, that signaling hormone that tells the our cells, our muscles and our liver to bring glucose into those cells so that it's not inside of the bloodstream so that we're using that energy. Now, if for some reason the cells are just over capacity, they cannot take on any more glucose, we start to see insulin rise up in our blood to really shout the signal. It's like a train pusher. It's really trying to push that glucose into the cell. And so we'll see elevated insulin. And what we know is that the number one risk factor for cardiovascular disease is insulin resistance. And so that is the connection between our metabolic health and our cardiovascular health, particularly in women. And unfortunately, as we head into later perimenopause and post menopause, we, due to the loss of estradiol as a protector, we start to see an increase in that insulin resistance, which is not fair.

I know, right? You just punch.

It's not fair.

Yes. All right, tell me some things. What are you learning that are surprises to you? Like you, you know things, you know, and I think that too. And I'm wearing one of those continuous glucose monitors and it is just like, are you kidding me? What have been some surprises for you? Hey, this is Debra Atkinson. And there is one thing you can't do in the gym at your age, and that's get all the protein that you need. You've got to do that in the kitchen. To make it easy for myself, not only to get the protein, but the fiber, the fruits and vegetables I want daily. I started drinking a smoothie a day 30 years ago. But when I realized all the junk, the sugar and the extras that you don't want, that I don't want hiding in most protein powders, that's when I finally caved in after years of saying I will never, ever, ever sell supplements. Stop skipping skimping and sabotaging yourself in the morning after workouts by always being prepared. Look, Yep, I agree. Real food first. But it's just not, not convenient to carry a turkey sandwich Sometimes the protein, and don't forget the fiber, they kill cravings and they boost satiety. And you've got to make it easy to do the right thing. You can use code podcast for 10% off your first order at flipping50.com today.

A big surprise for me is you know how late I eat at night. That was a big one. I, I know that we're a little bit more insulin resistant in the evening. We're not as we're not in a thermogenic state in the evening, mainly because our bodies are meant to wind down. If you think about our biological clock, we're burning fuel in the daytime and then we're, we're relaxing and resting and gearing up for sleep so that we can repair at nighttime. And what I Learned wearing a CGM and I've worn one on and off for almost 3 years now, is the later I eat, the worse my blood sugar gets. And it could be the same meal. So let's example, let's say I'm eating salmon and a salad and we do a lot of salmon, lots of fiber in our household, a lot of metabolically healthy meals. We're very much a big family of that. And I. We Normally eat by 6 o', clock, you know, because we have a little. And he gets to bed earlier than we do. And so we want to support him too, in that process. I feel like we should start this early, you know, the earlier the better, I think, for all of our family members, especially our children. So we eat early. And if I eat that meal, the salmon and the salad, at 6 o', clock, my blood sugar will stay. Honestly, it'll stay under 100 milligrams per deciliter. Like, it looks really darn good. Wow. Yeah. Now if I eat that same meal at 8:00pm, which I, I used to eat at 8:00 o' clock every single day for years, now all of a sudden I'm at 120mg per deciliter. And so that was a big lesson for me, is that my biological clock, you know, in terms of the meal timing, which is so important, really favors me eating earlier and definitely having a three plus hour gap between my last meal and going to bed. Yeah, that's a big one. I don't test it off because we always eat that early, but occasionally it'll happen where I eat later and I'm like, oh, oh goodness. Yeah.

No, I think that's such a great point for a lot of women here listening. It's not just the foods stuff. And we've talked so much about, like, the sequence of which you eat your protein, your veggies or your carbs having a difference too, but the time of day that you eat it also so important. I'm so glad you said that.

Another one is naked carbs. N. No, it's a full body stop for my body. My body is like, oh, you want to eat a naked carb? Let me jack up your blood sugar. So it's immediate, you know, and so I've. I've learned that naked carbs, at least for my little. My perimenopausal body is a no go. And. And obviously I pr. Prioritize protein and fiber above all else. And so, yeah, you're not going to see me just chomping on some grapes and crackers or something like that. Like, I'm always pairing all of my carbs with protein.

Oh, yeah. And do you not think about, oh, the things I used to do?

Oh my gosh, the things like, you

know, we would pack up bags of grapes to go and lounge by the pool. And I'm like, yeah, no, couldn't do that anymore.

The other big win I found on cgms, this is one of my favorite. This is what keeps my blood sugar stable all day long is I move throughout the day. Yes. I do the big strength training workout. I find in terms of my scheduling for my family and my life, morning is where it's at for me. So I do my resistance training. I work out to failure. You know, I'm lifting heavy and usually 30 minutes is my max in the gym. And then I move throughout the day. I do exercise snacks so little like jump squats, mountain climbers. And then I also walk, even if I have only a 10 minute break right before it your interview, I had 15 minutes and that meant I had 10 minutes before I had to sit my butt in this chair. And so what that does over time throughout the day, I probably do it four times a day. And if I can't, I do have actually a treadmill right here, a walking desk or I can just bust out some squats real quick over here on this other side of me. That will keep my blood sugar steady the entire day.

So good. Yeah, great research.

My body loves movement all day long.

Yeah. I think almost anybody listening, the same is true for you. Right? So find something that works. What else do you recommend? What it's, I mean, you had to discover a lot. So for a woman who's listening and really thinking, you know, how do I help myself improve my resilience, my strength, you know, and maintain my cardio metabolic health through perimenopause or post menopause. And, and it's ironic, isn't it, that some women can be pretty asymptomatic during perimenopause, but actually have it strike later.

Yes. So I want to share really quickly, I want to speak into that real fast. And then I want to go into kind of my big pillars. And also I think when we have conversations a lot, it's consistency. It's really about that consistency. So yes, some women feel like, okay, because when we think about defining menopause as of up until recently, hot flashes, night sweats, maybe some insomnia, right. Maybe a little weight resistance and vaginal dryness, you know, low libido, those were like the main symptoms. And what we're beginning to discover is that hormones, if I don't know how we didn't know this, but they are a total body affair. They estrogen and progesterone, estradiol specifically, and progesterone, even testosterone, we're talking about receptor sites on every organ system of the body involved in metabolic health, involved in brain health, involved in our bones, in our skin. I mean, everywhere. But particularly, we're talking about metabolism, a big player there. And so what? A lot of women won't notice because, you know, we're not running labs every single year, or maybe your doctor's not running all the labs and you're not seeing this. But what I'll find is systemically, our bodies are changing without permission, whether you have the classic symptoms or not. Right. Because there's a lot of symptoms to me are subtle symptoms of metabolic shift shifts in. Not necessarily in the right direction or subtle shifts in. In higher levels of inflammation. And so a lot of women were like, oh, I don't have these signature symptoms. I must be good. And then they'll start telling me all the things that are going on. And I was like, you don't. You don't think that's perimenopause? Like I was, you know, and that's just. It's. Again, there's a knowledge gap, even with what our doctors know for this transition, but especially for us. And so it's. No, it's not hot flashes and night sweats, which, by the way, are vasomotor symptoms, which are very related to our metabolic health and our cardiovascular health. And so, you know, this isn't just an. A nuisance that we're dealing with. It's a bigger symptom towards a bigger problem.

I'm so glad you said that. And that brings us back to really kind of full circle with bioidentical hormone replacement, because I think a lot of women think, well, that choice is something I would do if I were suffering with the, you know, said visible, obvious hot flashes, night sweats, you know, and otherwise, why would I want to do that? Used to be the thinking. We're starting to turn the corner and realize, no, no, no, this is about the long game.

This is longevity. Yeah, yeah. You know, I think we all know at this point that our menstrual cycle is a vital sign. And, you know, what standard of care, if you were to go into menopause before the age of 40 or even before the age of 45, standard of care, especially if it's because of cancer or it's surgical menopause, whatever it may be, standard of care is we put an estradiol patch on women, we get them on progesterone as well. And the reason for that is that we know that if women are losing those hormones you know, 41, 40 years old, and they're at menopausal levels, that their mortality rate increases, that the risk for cardiovascular disease, dementia, disease of frailty and cancer go up exponentially. And so I don't understand where, you know, here at standard of care that we give women hormones because we know that it's going to impact their longevity and their health span. But natural menopause, at 50 years old or 48 years old, they meet women who go through menopause in their late 40s all the time. That is natural. And we don't supplement up or replace these hormones. And that's what's heartbreaking to me, is that it's. This is. We're talking ovarian failure. And more than that, we're talking about losing these hormones means we're losing their protection on the brain, on the heart, on the bones, on the general urinary system, on our metabolism, on our insulin sensitivity. These have profound impacts. And so I'm a big proponent that we don't wait till it's ground zero. We would never wait. Like, I'm on a thyroid medication. I'm on armored thyroid. No problem admitting that. And my doctors who I worked with have amazing thyroid doctors. They were never like, you know what, Marisa? We're going to wait until that T4 and T3 are at zero before we start to put you in a thyroid hormone. Like, no, no, that was never the conversation. It was like, hey, you're losing. Your thyroid levels are low. We can see that there are some symptoms here. And let's get you back to optimal range. And it's the same with. With hrt, you know, especially when we're talking about. I'm only talking about bioidentical hormone replacement therapy, by the way.

Right.

Like, if I have the symptoms, I've got brain fog. I'm dealing with some night sweats. My mood is massively changing. I am noticing that I'm putting more weight on in the belly area. My energy is tanking, you know, and you start to check, check, check, check the box of all these symptoms. Yes. Is lifestyle critical. It's mission critical. And I deserve hormone supplementation, too. So I'm on. You ask me if I'm on it. I mean, I'll be on. I am on a patch 24 7. Yeah. And, you know, and I'm still working out my dosage because. Because, you know, I'm still perimenopause with estradiol. So we're trying to figure it out. And I take 400 milligrams of oral micronized progesterone in the 12 days after. Well, whether I ovulate or not the 12 days, I'm still cycling. I'm still in early perimenopause, so like a 26 day cycle. But I have migraines and they've gotten, it got worse after the head injury. And so that combination of estradiol and progesterone has taken my migraines from about 15amonth to about three. And I, my quality of life is so much better. You know, I can function, I can take care of my son in a different way. They have been a godsend and they have been profound for my brain too. I would say that once I started taking hormone replacement therapy earlier this year, my brain was firing so much better.

Yeah, you know, I just unpacked this coincidentally yesterday with somebody and tried to look at all the things related to my own migraines and we were just like, are they headaches, are they migraines? All of that. But then looking at, oh my gosh, there's a definite link with estrogen here for you. This is where it's coming in. So now we just have to dig a little deeper and figure it out. But for so many women here it is most definitely whether you're cycling still, you're not cycling still, it still can have a relationship with what it is that you're going through. So I love, love up. Okay, talk to me about your pillars, babe.

Yes. Okay, so pillars, yeah, so we, So I think one of the things that you and I both agree on is resistance training. Please don't lose that muscle mass. I mean, it is your organ of longevity. It, you know, if there was, besides hormone replacement therapy, if there was something to double down hard on, it is maintaining your armor, maintaining your muscular armor because it's going to be one of the only thing that's going to protect you as you navigate into our, into your 60s, 70s and beyond. And I know that I'm preaching to the choir here. I know this is literally all, you know, so I don't need to belabor that. So, you know, again, if good, get a trainer. If you're afraid of weights, like, you know, obviously be with Deborah. Deborah's got incredible programs. She's got a YouTube channel. I mean, she is where it's out. This is literally what she does every single day. She is probably the best trainer you could have. So that would be my advice, number one. Number two is prioritize protein. You could be in the gym all day and if you don't have the substrates to build that muscle, then you're just kissing it away. So I start my morning with 40 plus grams of protein to kick off that leucine threshold and to make sure that I'm coming out of a catabolic state into a break to it. Yeah, from a breakdown to a build up state. I do not work out fasted. So I have a little snack before my workout. I have my workout and then I hit my protein numbers on the back end of that as well. But I pretty much aim for basically 1 gram to 1.2 grams per pound of lean body mass. So that is my goal. And I find everyone's got to kind of find that perfect kind of formula for yourself.

Hey, yeah, I'm going to interrupt you right here because right now there's somebody thinking I can't get it. I can't get it.

It.

I hear this a lot and I'm guessing you probably do too.

I do.

I hear the words, it's really hard for me to get that in. And I, I often reach a little deeper and say, what's hard about it? Is it wrapping your mind around it or is it actually you don't like salmon or chicken or what is it?

It's usually two things. I think it is a mindset shift and two, I think what we've been taught by society, especially as we start to see that weight shift, that body composition shift, that we need to get smaller. We need to get smaller, we need to eat less, we need to intermittent fast. And it's a lie. Like that is not the time to get smaller. Thin is not the goal. It's resilience, it's strength, it's power. That's the goal. It's maintaining your longevity. If the tide turns, just note that you're one. Perimenopause is the tipping point. I always tell people, you can go one way or the other other. Now, at any point in your life you can build muscle, but in order to dial that, you know, really get your metabolic health locked and loaded. Perimenopause is the opportunity because where I start to see things fall apart for women. We're not talking 70s, we're not talking 80s, I'm talking early 60s is when I start to see women having a hard time picking up their grandchildren is when I start to see women having a hard time throwing their bag in the overhead compartment. It's when I start seeing women have a hard time, you know, lifting any kind of weights. And so it's not that far away, you know? And so I just really want to emphasize that it's not about getting small. I know so much of what we were taught growing up, especially if you're in midlife or older, that it's, you know, we grew up in the cardio era. My first workouts when I was a teenager was on the elliptical reading my Cosmo. You know, that's what I learned. I maybe did a little bit of weights, but I was cranking that elliptical for 45 minutes, and I. It was about getting smaller. That was the mindset. Then it's a different mindset. And one of the things, I was interviewing Dr. Stephanie Estima yesterday, and she's like, become a protein shake diva. And I was like, girl. And I was like, you. I'm like, you're right about that. And I. You know what? I do a lot of protein shakes, especially in the morning. We call them smoothies, call them whatever you want. And I'm a double scooper. I mean, I'm getting that 40 grams right out the gate, you know, and then I'm also having eggs and a couple other things, too. But, like, I think it's more the mindset than anything. If you really start to give yourself a week, challenge yourself for a week to track this and to see where you're at, and you're going to find it's a lot easier than you think.

I love that. And I want to say to anybody who feels like they've got a condition that inhibits them from lifting as heavy as they want to, first of all, there's most generally something that you can do. Get to the level you can safely do without injury and setting you back. But the good thing about protein is it. It is independently still a muscle protein stimulus. So by eating more protein, even if you can't lift, you, at least here you've got another insurance policy. Now, if you can put the two of them together in your life, you're much more golden. But, you know, one and or the other, both together, really important.

Thank you. Thank you 100%. The next next pillar of mine is getting out in nature as early as possible in the day, but as often as possible throughout the day as well. Walking again, have that strength training piece, but just moving your body throughout the day but out in nature, I think makes the biggest difference. It helps to regulate your circadian clock. It helps to reduce stress levels, especially if you're listening to a podcast or a really great book, or maybe you're sending voice memos to a bestie. I Literally do all three, all day. You know, it's one of the. I'm usually listening to a book or sending voice memos to a bestie or listening to a podcast. And, you know, so. So I'm being efficient about it. If you're that kind of woman who's like, I need to be efficient about it, you absolutely can. Or maybe you can just enjoy being out in sunshine. But circadian rhythm optimization is so important to honor. And being out in sunshine. Plus your mitochondria love to be outside and they love movement. And anything we can do to boost our energy, I think is a win. Another pillar for me, again we talked about it earlier, is prioritizing your sleep like it's a million dollar meeting. Just hard stop. So have your routine in place. Mine starts with my supplements. The second I take my supplements, it is. Do not try to interrupt. I'm on, I'm on the bed. I'm on the bed train. I'm on the sleep train. And so I'm very consistent. My supplements are out on the kitchen counter. I fill up my water and then I head to bed. I've got my book, I've got my dim, super dim lighting. I've got my essential oils that I'll use. I'm just, it's just I'm in my zone. You know what I'm saying? And so I totally do. Yeah. And so I don't mess, ever mess with that.

You know, I will tell you that I hosted a retreat in June and my photographer flew in. She got there late and was, you know, we were wrapping up and I was just kind of finishing some things in the kitchen. And she said, you know, we should do a quick like run of show, like, what do you want pictures of before? And we did that like from 8 to 8:30. I didn't sleep at all that night. It was terrible. I was like, I know.

You're like, my brain, My brain came online and my brain's like, okay, all the things we can solve right now.

Right? Right, yeah, yeah. So whether it's something good or it's something bad, it doesn't really matter. But anything that's going to stimulate you and get you going or thinking is no good. Have a good book, not a great book. It's really. These things matter.

So true. We talked about blood sugar regulation and how important that is. And so, you know, eating to honor your blood sugar I think is equally as important. But then the last pillar for me is community. This can be a very lonely time. You can feel like you're really in it. And maybe no one understands and feel so heavy with the obligations and what has brought so much levity to my life and just safety to my little mama heart. My perimenopausal heart is connection. So I see friends in real life every week. I also have them on voice Memo and on FaceTime. I hug a lot of people all the time, boosting that oxytocin levels. I'm just trying to manage cortisol. I rarely find a woman who comes into perimenopause without a deregulated stress response system and so managing that with self care. But I find one of the best, best remedies is really having people in your corner that you feel safe with, that you can just be fully you with. Like I told you I'm having, today is a. Not an easy mental health day for me, my period starting today. And I, I just. Why does everything feel so hard? Why does, why do things feel so insurmountable today? And so I, I'm able to reach out to friends and then just let them know where I'm at and feel like I'm really held in that space. And so that would be another, I think, a very critical pillar. We know that connection is directly connected to our health span and longevity.

I love that. And I just want to say shameless plug. For a community that I lead or Marissa leads, we can find it. Fortunately, no matter how much you love or hate the Internet and online and social, you know, there are groups though, that we can connect with that may feel more like our people than the people you know in our immediate environment. And that's, I think, the beauty of online. It's ironic, but not, you know, sometimes we can talk more openly to who was a stranger yesterday than to people who know us deeply and we're going to see at the grocery store every day. So take advantage of that and realize you may find a tribe in someone who is across the country or around the world in a group, in a community of people, you know. And I want to share something that I know you have coming up because there's we tapped into maybe a superficial level of all things related to perimenopause. But you have a summit coming up where you are deep diving with it. So tease it just a little bit and I'll make sure that the link is in the show notes for everybody. But talk a little bit about, you know, who you're interviewing, what is your goal for attendees?

Yeah, absolutely. It's just, well, you. I'm interviewing, you yeah, I'm interviewing Dr. Stephanie Estima, Dr. Gabrielle Lyon, Dr. Casey Means, Dr. Susan Gilbert Lentz, JJ, VA. I mean, the list is extensive. I was just interviewing Dr. Tom O'. Brien. And what really the theme is is building resilience and increasing health span for women in midlife and beyond. That's really it. Like, yes, symptom management so critical because no one deserves to suffer needlessly. No one, especially women who are caring at all. But then what do we do to not only navigate what we're dealing with right now, but how do we set ourselves to win five, 10, 15 years down the road? Because we know, you know, we think about cognitive, you know, decline that starts decades, you know, before we think about, you know, diseases of frailty. Many, many, many, many, many. Osteoporosis starts in our 40s. And so we think about all of that and that's really the come through with this is actionable steps around hormone replacement therapy, like how do we supplement with that or how do we replace it? You know, what does it look like to supplement in testosterone? How do we build that muscle? You know, how do we prioritize our metabolic health? What lab should we be looking at? How do we look at inflammatory markers and how do we shift those in a positive direction? And so that's what we're going to be talking about. How do we move our bodies in a way that is going to really offer us gains down the road, you know, that we can do with without feeling overwhelmed? And so that's what these conversations. How do we expand our cellular energy, you know, because that's our brain energy. A lot of women, when I talk about fatigue, it's mental fatigue that they're dealing with, you know, and so we're going to be getting into all of that perimenopausal thyroid issues, name it. If you've got an issue or a situation that you're dealing with right now, I promise you, I've got an expert. That's literally what they do all day.

Love, love, love it. Okay, so if you happen to be moving this way, it won't stick, and that's okay. But it is flipping 50.com/forward/perimenopause summit. And that's where you can learn more about Marisa's event, what's coming up, how could you get in, get involved, It'll always be there. But I've got you covered. So everything will be in the show notes so you can get it there too. And so that they could follow you. Yes. Social media by the way the event

is free, it's completely free. Like pick and choose what you need, get in and get out, like, and it's going to be audio. I, I don't have time to look at stuff, stuff. So you know, like watch a video, like you can listen to it wherever you're at, doing whatever you want. And I'll have more details. You can follow me on insta at doctormarisa D R M A R I Z A My podcast is energized with Dr. Marisa with over 12 million downloads. And then, you know, again, this event is going to be, I mean it's going to be heavy hitters who are really going to be bringing the business for you that's very action driven.

Love it. So this is for you listeners and it's for your sisters, your colleagues, those younger women that you influence because the sooner we capture them and let them know, here's what's coming down the road, let's be proactive because you know, we are all just a little envious of. Had I known this when I was 30, you know, I gotta tell you what, I am like the mother in law of all mother in laws. I'm giving a bone scan to my 30 year old daughter in law. How cool am I?

You are so cool. That is so amazing. Yeah. I mean we didn't even talk. I mean bone scans, like how critical that is, running labs, you know, how critical they become. So I love that. Yeah. I mean millennials are in perimenopause now.

Wow.

You know, so there, you know, there's that very wild.

Thank you so much. Can't wait to see you on this summit and thank you for hosting it. Thank you for listening to listen to a decade of episodes and together. Get the show notes, visit flipping50.com where you'll be able to find all the previous episodes. And I made it super easy to make the most of your listening time and get exactly what you want to listen to as top priority by getting the top 10 episodes in the areas you most care about. Like how much protein do you need? Weight loss and other three ultra important topics we've identified as our community's top five. There's no more powerful health influencer in the world than you midlife woman. So go and listen right now. A question for a podcast, a question you would love to ask or maybe a story you want to tell. Did you know we have a special group just for podcast question roundups and the answers. My community coaches and I provide answers daily inside of this group. But it's also where I go when I occasionally say, okay. Open call for podcast questions or tell your story. Would you like to be a guest? So if you're looking for a community of women who are also interested in optimizing their health, strengthening their mindset, and looking forward to every new year, join the flipping50insiders group that's flipping50insiders on Facebook.