The Perimenopause Brain Health Window with Mariza Snyder

what occurs in the brain during perimenopause and why we care no matter what stage we're at after that point. My guest today is Dr. Marissa Snyder. She's a powerhouse advocate for midlife women, leveraging 17 and more years as a practitioner, author, speaker to spark a massive movement for women in perimenopause and beyond with her top-rated Energized with Dr. Marissa podcast. She's got 13 million downloads and a passionate social media audience of over 400,000 and 8 million monthly views. She's a trusted guide and she offers science-backed solutions for perimenopause and metabolic health. We are talking today about her brand new book, The Perimenopause Revolution, and really not the book itself so much as the contents in it and really unpacking Welcome back to the show, Dr. Marissa Snyder.

Thank you for having me.

I am so excited. We're going to talk about this new book. Absolutely. But really why we're talking about this new book is because everybody's talking about perimenopause. We just in the green room kind of gave the good stuff, maybe, but perimenopause is having a moment. You know, I think it was 5 minutes ago it was menopause. We're speaking it out loud. It's no longer taboo, but now really we're digging in a little deeper and I think for women who are in perimenopause, it's they're getting their just moment. So because I couldn't get you on previous to the book release, now that it's out, what are you finding people are saying? Like, what's the aha people are like, wait, what?

I love this question because perimenopause is having a moment and women collectively are demanding to be heard, are demanding to be validated, are advocating for their care, and just looking for a new level of support because we need it. We deserve it. I think the big thing that women are walking away from this book is how practical it is. I am in perimenopause. I am on the journey. I am walking through the fire, you know. And so, when I wrote this book, I was also in perimenopause. And so, you know, and I'm a mom, and life is You know, life is happening to all of us and it's such a messy middle. And so, when I wanted to write the book from the perspective of being a woman in the journey, being in it, and so desperately wanting wins, wanting health wins, wanting energy wins, just, "Can I just get a win?" You know, and so that's how I wrote the book was I wanted every— and I know that every woman who's in midlife and in perimenopause, I think every hand would go up of like, "Yeah, can I? I deserve a win right now." And so, I wanted this to be— be a book that was so practical, the habit stacks, the recommendations, that women didn't feel overwhelmed. They felt empowered because we deserve empowerment. We do not deserve a bunch of things added to our plate, and the plate has been overflowing. And so that's been the thing that people are like, "Thank goodness for a book that actually moves the needle in a practical way versus just kind of spewing information at people.

I think this is such a great conversation. I would love to actually have you open up, and I will open up too, just as illustration maybe of every woman's perimenopause journey is different. And, you know, so here I am, 61, postmenopausal, and I'm looking back, and not— I don't think I was in denial, I just was in unawareness. We weren't we weren't really talking about it. And, you know, I wasn't necessarily having symptoms, but I wasn't having the obvious symptoms. So now that we know so much more, that we talk about openly and we're unpacking, oh no, wait, that probably was, you know, this is why I was feeling that, why I was so emotional that decade. But like you said, it's the messy middle. Life is happening to us too. And so it can get really hard to disconnect with— maybe I'm just emotional because all of this stuff I'm going through in relationships or work or whatever it might be. And it's too easy to think, well, I should just suck it up, buttercup. And, you know, we don't really talk about those things. And so that was my experience.

I—

if I look back now, I think I think I did have a night sweat once or twice, you know, and yet it was kind of like, uh, am I getting sick kind of thing. I— and it never, never dawned on me that it might be literally a night sweat related to menopause, um, until later. But what was your experience like? Because I want to say, like, as a, as a mom right now of a 5-year-old, did you like bump postnatal right up to perimenopause, you crazy person?

Yes, absolutely. You know, it's interesting, especially, you know, so many moms having children later. I was just at a party, uh, Dia de los Muertos party, and it was a bunch of preschoolers and like TKers and, and kindergartners, and then it was 40-plus-year-old moms. And so it was basically a bunch of perimenopausal mothers with a bunch of little kids running around. And I got an opportunity to talk to a lot of them and how so many of them have felt the same way I felt, which was, you know, we put all this energy into getting pregnant because when you're priming for a pregnancy at 39, 40, 41, 42, you're putting in some effort. It's like, you know, I remember growing up and my grandmother, my mom used to say that, you know, you better be careful because someone could just sneeze on you and you get pregnant. You know, that was also another prevailing narrative I grew up with that I just want to address, which I think is really speaking to the suck it up buttercup, was that women suffer. I remember just being like, hey, you were born, you know, with the female chromosomes. Like, you're just— you're slotted for suffering. And that was very much— and not just suffering, like, and also suffering is going to get worse as you get older. And Persevere at all costs. Like, suck it up and get through. Like, that was just kind of what I heard, you know? And I was like, okay, all right, well, I'm gonna strap my big girl underwear on and I'm gonna get to living this life and kind of suffer through it, you know? And so, when I was prepping for Kingston, I mean, I primed to have Kingston 39, I would say 38, 39, 40. I was really preparing. I got pregnant at 40, had him at 41. And then that next 2 years, you know, I would say postpartum, most women I feel really don't feel like they come out of the haze of postpartum until their child turns 2, especially if you're in midlife. You know, it's one thing to like recover at 20, it's another thing to recover at 40. So, I remember being 43 years old, finally turning a corner, Kingston had just turned 2. And I'll be honest with you, Debra, I was feeling amazing. I was feeling so good. And I remember thinking, Ooh, maybe I've got, like, amazing reproductive longevity. Obviously, I had a kid at 41, and I've got energy, my brain's firing on all cylinders, I'm sleeping again. Like, oh, sleep, to actually get, like, 7+ hours of sleep at night. Like, I was like, I'm a new woman. And I had a runway for about 5 months, I would say, give or take. And then— You've got a good 5 months. Good 5 months in me. Like, halfway through 43, I just fall off a proverbial cliff. It was so— the disparity between how I felt a month prior and how I then felt when things started to kick up, I started to doubt myself. I was like, "Oh, this has got to be my thyroid. It's got to be stress. Maybe I overdid it." You know, like we kind of talk ourselves out of— no, maybe it's perimenopause. Like, maybe it's a big hormone shift that you're going through. It's finally catching up to you. And I believe that it was all the things. But it took me about 6 months to really reconcile the fact that I was actually in perimenopause. And how I finally knew was it was fall, finally, almost— I had just turned 44. I mean, most women are in peri, and I had rage 3 months in a row like clockwork. And that's how I finally knew that I was in perimenopause.

Oh my gosh.

It's so easy to tell ourselves Oh, well, you're a new mom. All the things that everyone's telling you. You know, your doctor's like, oh, you know, you're doing too much. You're too stressed. It's just aging. Wah, wah, wah, wah, wah. And I was like, yes, and. It can be all of those things and hormones are— I don't know if my hormones had ever recovered, to be honest. Maybe they had like one final big boost, you know, with that 5-month stretch. And then they were like, okay, we're done. We're going to start declining.

Shoot.

Oh my gosh.

All right.

Well, you know, I know that every woman here—

into a little bit of—

yeah, go on. Sorry, go on.

I was just gonna say you tapped into a little bit of like brain, and, and I think this is a huge distinction. There's so much that changes with the brain, but I don't think you realize— I think that was probably tied to, you know, my, you know, emotions and reactions to things was so different when I think about it now. I, I didn't see it when you're in the storm, you don't. But tell me how brain changes really impact women in this. I mean, in— and on average, so every woman's journey different, but you know, between 40 and 50, what's going on?

Yeah, perimenopause is a neuroendocrine transition, and new research is really demonstrating that yes, we, we're having you know, ovarian senescence. That's what's happening as well. But also our brains are massively reorganizing and recalibrating to the point that it's being argued that the early stages of perimenopause is really more of a brain reorganization or neuroendocrine transition than it is a, you know, a reproductive transition. And a lot of what the symptoms will look like in the beginning of perimenopause, again, cycles, often like clockwork still. And how we defined perimenopause even a decade ago was typically late perimenopause. This was how we defined it, was you're skipping periods more than 60 days. Basically crime scene periods is what we're talking about, because you, you kind of know then, you're like, okay, something's going down, you know. Crime scene periods, low libido, vaginal dryness, sleep issues, night sweats, hot flashes. These were the classic symptoms of perimenopause. What we didn't realize was that there were a lot of other symptoms that were, that were in the early part of peri that we dismissed. And so, low stress tolerance, irritability, ragey, raginess, right? Rage, rage in, in the middle of their cycle, sleep issues. I would say, I said irritability, but I would say cognitive changes in terms of alertness, low mental energy, lack of word recall, even just feeling like your ability to do high-level functioning, you know, like solving big problems or project managing, you know, things that women do all the time. I feel like women are CEOs of so many different fields, their household, their family, their work. I mean, so many areas, and all of a sudden things are requiring requiring so much more effort. Those 100 tabs, you can't effortlessly handle the 100 tabs the way that you used to. And so, this is a lot of what begins to happen in the beginning of perimenopause. It's the brain-related symptoms that, you know, often women say to me, "I just don't feel like myself anymore. I don't understand. I used to feel stable. My brain would fire. I could do all these things. I had more stress tolerance. I never snapped at my kids. Like, I don't recognize myself." I'll never forget what my mom had said to me when I first encountered perimenopause really truly 17 years ago. I remember her telling me, she's like, "Marisa, I feel like a shell of my former self." And that, I mean, and I could tell, I could feel that from her. I was like, "Gosh, this woman was always just a freight train. She could handle everything." And all of a sudden, it was like it rocked her world.

Amazing.

Yeah.

And that, that you and your mom have that conversation, I mean, that's big because a lot of women don't. They don't have anywhere to go. They don't have anybody that they maybe can talk to or trust, and they don't trust it themselves. I think I want to talk about one other thing. So let's unpack for, for anybody listening who still may be asking though, tell me about neurotransmitters. What exactly are those? Yeah.

Yeah. I love that question. Well, let's break down a little bit about what hormones are doing, because I think when we think about reproductive hormones, we're thinking about bikini medicine. We're thinking about, well, the only difference between men and women is the parts between bikini areas. And we now know that these hormones are not just driving reproductive health and your breasts. They're doing so much more than that. And we, you know, and really the reason, I know you're a mama, I'm a mama, you know, our reproductive system, in order for our reproductive system to work, and for us to cycle every single month, like that is a whole body, like, experience, like a metabolic experience, the immune system, other hormones are involved, the brain is deeply embedded into that experience as well. And so, when these hormones begin to erratically decline, we know that they are also in their own right neurosteroids. They're regulating the brain. Estrogen being the master regulator of the brain. It's regulating energy metabolism. It's regulating neurotransmitters. And neurotransmitters are basically chemical messengers in the brain, kind of similar like hormones are. And we could argue that hormones are neurotransmitters in their own right because they're also chemical messengers in the brain. Basically, those neurotransmitters are binding to receptor sites on other neurons or other parts of the body, and they are eliciting a response. And so, for example, I think we always hear about dopamine and serotonin. And how these particular hormones are driving motivation and they're driving kind of that feel-good excitement, joy. They kind of give us that burst of like that feel-good energy. That would be serotonin and dopamine. GABA would be kind of the opposite, kind of putting the brakes on, you know, overdoing. So, like, it's kind of. It's modulating worry and anxiety, and it's helping us to get good sleep. It's modulating the wired and tired part of our brain as well. And so, we know that progesterone in the brain is allopregnenolone, and allopregnenolone has the ability to activate GABA-A receptors that allows for GABA to do its job. And so, as these hormones are declining, we are seeing that they are not able to regulate neurotransmitters the way that they used to. And as a result, we do feel less motivated. We do feel more anxious, we are having sleep issues, our brain doesn't feel like it's firing the way that it used to, and that has a profound impact on our life, on our work, our productivity, our families, our relationships, how we show up in the world. And I think that's why it's so destabilizing. It begins to rock our identity and who we thought we always were.

So agree. And I think for those listeners who are exercising and feeling like you don't get the same high in regard to neurotransmitters, the lack of dopamine from the workout, you don't get as much. So it feels to a lot of women who are still committed, still doing it, feels flat. It feels like— and it feels like you did something wrong, like you didn't work hard enough. And then we get into this cycle of, okay, well, overdoing harder. Yeah, yeah, yeah. Because you and I don't at all do that, or never, never, never did that.

Never.

Okay, good. Okay, glad we've settled that. Uh, yeah, so I love this. What can women do? I mean, so we pointed out all the problems. If we can counter, what can they do to take control, to help their brain health, or at least not make it worse?

I love this question.

This episode is sponsored by the Flipping 50 Menopause Fitness Specialist. It is the framework that we designed our entire membership and program based on since 2013, I've been developing that after 30 years of working with women in midlife. That was born, and in 2018, we rolled out the Menopause Fitness Specialist to train other fitness and health pros on how to actually prescribe exercise. Here's where we're going next, in case you wanna get started now, that we're actually training physicians on exercise prescription, knowing they get very little of it in medical school and hoping that it also bridges the gap for you who may be a fitness or health professional or want to be, who works with women in menopause, because there is so much demand and so much room for you right now. If you are working with women in menopause but not getting all the results, don't have a reliable, predictable framework that gets you results over and over that people know, like, and trust, come and talk to us. We'll put the link in the show notes for today. That's the Flipping 50 Menopause Fitness Specialist. And if you want to head on over to Fitness marketingacademy.com. It's where we have all of the content dedicated to you, health and fitness pros.

I think the first step is, is really understanding your body, knowing your normal. So I always tell women to track your menstrual cycle, especially in early perimenopause, where again, we feel— we can feel more the brain-related symptoms and definitely the physical symptoms. And yet cycles are still relatively— like, if we're not paying attention, they kind of seem like they're the same. But there's a good chance that in that luteal phase of your cycle, that's when you're experiencing a lot of these symptoms. So you may still feel like in the follicular phase, you're still doing okay, right? And, you know, I always joke that, you know, you're always upset with the decisions you made in the follicular phase. Once you're in the luteal phase, you're like, "Why did I—

who—

what version of me said yes to this, you know, 2 weeks ago?" So it'd be nice, like, paying attention. Like, Are you still just having 2 days of PMS, or is it now 5 days of PMS? And so, is that rage like clockwork on day 22 or day 24 of your cycle? You know, what are some of those symptoms? How is your normal shifting and changing? That data is really important, not only for yourself so that you're aware, and because one, you can start having the conversations with your partner and your family about like, hey, you know, This last week of the month, I just need more time to myself. I need more alone time, more solo walks, more, more self-care. Like really advocating even with your family what you need when you're noticing that you are less resourced because you just— it's shifting, right? You just— I always say that there's a big distinction between capability and capacity. And particularly as we track our cycle, for a lot of women, they'll notice that they've got great capability and capacity. And capability meaning like I know I can do this. Like, I did this in my 20s and 30s, even in my late 30s. What the frick is happening? Like, I know me, but capacity shifts. But it may be only capacity has like dampened, you know, day 20 to day 28. Like, it'd be good to know. So the more that you've got that data, you can reschedule life and reschedule with your family and your partner about, okay, these are the days where I'm noticing I don't have as much capacity. Also, when you have a timeline of what's going on with you and you notice that symptoms are deeply connected to your cycle and hormones erratically shifting, at some point, it all just blurs together, Debra. I'm not gonna lie. By the time we're in late peri, it's all just one garbled mess. But in the beginning, we really can finesse things and you can advocate more strongly. You could have the conversation around hormone replacement therapy. The next thing is, is really is movement. You know, if we're— one of the best ways to protect our brain and really, you know, optimize BDNF and neurotransmitters and really energy metabolism for the brain, and even just reducing the stress response system, which can feel like it's out of control in perimenopause, is moving. And it doesn't have to be, again, the big HIIT workouts, the big strength training sessions. It could be walking. It could be exercise snacks. Like, what is working for you? Tailor it to what you've got bandwidth for. But movement is one of the best ways that we can mitigate symptoms and support our brain. I do think we should be lifting weights. You and I are very much in alignment with moving our bodies, but moving our bodies in a way that protects our muscle and protects our bone, but more importantly, protects our brain and our metabolic health. Right. Also, movement with friends. You know, you talked about, you know, again, not knowing who to talk to, you know, feeling alone in the journey. You know, so many women, because they do feel alone and they've been meant to feel ashamed of what they're experiencing, they've been blamed for their experience. A lot of women don't talk to their doctors because they feel judged. They don't feel like they're going to get any answers. They're just going to be pissed at. And so, it's important that we are connected with our friends or make friends that are in this journey with us. And, I'm not talking about like going and getting cocktails with your friends, having a wind down with your friends. I'm talking about hiking with your friends, walking with your friends, having workout buddies, having movement buddies, you know, doing a walk and talk on the phone. I would say if you want to massively habit stack your way through PERI, it is moving with the people that you love and having conversations about what you're experiencing. Like, that's the triple threat right there for more longevity and feeling more like yourself.

I love that. Talk to me about what you think, and basically after digging through all of the research about— so women in their 20s to 30s or 30s to 40s, what if we could go back and, and tell ourselves, you know, how to help themselves prepare to be one who, who skates through a little bit easier outside of those things that we can't control?

What would that be? Number one, I would go back to really understanding our cycle, you know, tracking your cycle as long as you can, because then you really know you.

Is there an app?

There's so many great apps. Clue, there's a lot of apps. I mean, if we're looking at 20s and 30s, Flo, and then there's even ones that are more adapted to perimenopause and menopause. And so, there's a lot of different options. Yeah, I mean, I track mine on an app. So, you don't have to track— by no means track it on a paper. But, I love what's great about having an app is that you aggregate data about yourself as well. Also, I think it's, I think it's nice, especially at a younger age, that we build our life around movement. Like, not build movement around your life, like build your life around movement, whether that is walking, it's yoga, it's Pilates, absolutely strength training, a little bit of HIIT, whatever works for you. But just thinking about how can you be more physically active for like every day, like that's the name of the game. And then I think it's important for women even in their 30s to have a timeline their labs every year and to be looking at, you know, what are my lipids, what are my— what's my blood sugar, hemoglobin A1C, fasting insulin, highly sensitive CRP, some of those really important markers that really give us a window into our overall metabolic health and cellular energy. And as we progress, what, what happens with those labs?

Love that. And you mentioned something I don't want to skip over because I think a lot of people will think, oh, that's just a blood test with my doctor. But out of what you just said, there's one or two that aren't typically asked for, like fasting insulin. You have to ask for that. Yes.

Yeah. Right now, one-fourth of our children have type 2 diabetes. Scary. One-third of our children have prediabetes. This isn't a midlife or post-menopause problem. This is developing. You know, one in five girls have polycystic ovarian syndrome. And we know that 80% of those women it's rooted in insulin resistance. And so if we can look at insulin, what we know about insulin particularly, so asking for that fasting insulin is that we can have insulin resistance or hyperinsulinemia 10+ years prior to our blood sugar changing. I want women to know that a hemoglobin A1C, which is the collective blood sugar over the course of 3 months, or a fasting glucose, which is the glucose we would take after you fasted 10 to 12 hours the night before, first thing in the morning, those are reactive numbers. We should have been on top of those numbers changing a decade prior. And so, if we know that women in perimenopause become more vulnerable, I call it the metabolic inflection point, because estrogen and insulin are so bidirectional. Insulin is so tied to estrogen sensitivity. And, if that begins to erratically decline, which is going to happen in perimenopause, that's what perimenopause is, these hormones that are wildly fluctuating, but not just fluctuating, they are declining. That's what— that's the inevitability of it all. That if we are becoming more vulnerable, right? By 45, more women than men are overweight or obese, and up to 88% of us have at least one marker of metabolic dysfunction. Not 55, not 50, not menopause, 51, you know, wherever you land. 45.

That's—

most of us are in peri at that time. I'm 46 right now, right? And so, if we fast, we reverse engineer that and we know that all of a sudden, you know, blood sugar is going out of range, we see higher rates of prediabetes for even for women. We know that we probably start to see some of those changes happening in our late 20s and early 30s if it hadn't been happening sooner, right? With, again, with the numbers that I shared with children earlier. And so, you know, metabolic health isn't a midlife issue. It's happening earlier on. But what makes it more vulnerable, what makes women more vulnerable, is the fact that our protective shields, our hormones, as they decline, we become more, more metabolically vulnerable, and we see more cardiometabolic issues.

Mm-hmm. So crazy. So if you were you know, looking back, is there anything different? Lifestyle? I mean, you were in health, you were in medicine, and yet, you know, we may not have unpacked it all even, even then going through it. Is there anything you would have done differently in your 20s or 30s?

Yeah, yeah. I mean, I bought into the Cosmopolitan magazines and the Shape magazines, the Self magazines, uh, like the quick fixes to lose weight. Like thin was where it was at. Like I was— I, and I will say that I've always worked— I'm curious, Debra, honey, when did you start working out in the gym? Like I was working, I had a great coach in high school. I played soccer, varsity soccer, and so he had us in the gym in the weight room since I was 16 years old. So I just was indoctrinated into the weight room really early in life. How about you? I'm just curious.

You know, we, we played with it in high school certainly, but I didn't I didn't, like, self-initiate regular strength training until I was probably 22, second year of college. Okay.

Yeah, me too. Okay. So I was in the gym at school too. We didn't have a soccer team, so I didn't continue soccer in college. But, and I know you were in sports, whereas I was just in the gym. I was just in the gym. But I did a lot of— I mean, I was still— I mean, I lifted weights, but I spent probably more time on the cardio machines than I was on the weight machine, than I was doing weights. I still was strength training. But, I remember, you know, if I gained 5 pounds and maybe it was the holidays or whatever it was, I would just restrict. I would do maybe a juice cleanse and I would spend more time on the StairMaster, you know, because I was like, "That's where the juice is worth the squeeze." Like, let's— you know, I would spend an extra 30 minutes on the StairMaster any given day of the week. And, I was training to be thin. I was also training to be strong, but still thin was the prevailing kind of goal. Success, right? Yes. That was the success. Like, I kept myself within that little range, right? Yeah. And, I wish I would have known that I was training for good metabolic health. I wish I would have known that I was training for power and resilience and endurance. That's what I wish I would have known I was training for. And, I think a lot of us heading into our 40s. That's what we were brought up with, yeah, that we were training for thinness. And that is not— that is not the— that is not the name of the game.

Like, and I, I want to say this too to anybody listening, that I mean, I'm, you know, what, 15 years on you? And definitely true for, for us, we were all cardiovascular and aerobic bunnies.

And I mean, Jane Fonda was when Right.

When I look at it, right. I mean, and can you— you look at those videos now, it's like, I think my fingers would touch if I put them around her waist. But I know how I was exhausted.

But like all the classes, what were they? I mean, like, what were the classes where you were jazzercise?

Right. But we were tired, right? I mean, so truth be told, while I was doing all that cardio, I was drinking a lot of Diet Coke and I was You know, having a lot of sugar-free treats or whatever to snack. Well, right, because that made me hungry. I needed to fuel to do that. It was a vicious cycle. And really, you know, nothing good was happening. Nothing good, right? Yeah.

No, we were just chasing— I mean, let's be honest, I remember it being in my 20s, and I drank a lot of— I remember stopped drinking— I stopped drinking Diet Pepsi at 24, 25 years and I've never had a soda since. I remember being in med school and I remember one of my doctors was like, "Not only is it destroying— one, it makes you eat more." The research was becoming more clear, but it destroys your enamel. And I just remember being told by my family— so funny the things you hold onto, like protect your teeth at all costs. And I was like, "Okay, I'm stopping." I just was like, it's like a line in the sand, like no more Diet Pepsi. But I remember crashing and burning by 2 or 3 o'clock in the afternoon, even in my 20s, and I thought it was cortisol. I thought it was cortisol. I realized, you know, finally in my late 30s and 40s that I was on a blood sugar roller coaster from the moment I woke up, and then I was just crashing and burning by the time, you know, I would— by 3 o'clock. And what I would do with that crash and burn is I would get a coffee and I would eat a Kind bar or something, something like that. And I was just like, yeah, no, that was insulin resistance.

Wow. Okay. Such a great—

I spent a bunch of time on a cardio machine or working out trying to burn the amount— my— the sugar burning situation I was in. Yeah. And I think a lot of us just didn't know.

Yeah.

No, I—

and I think still true today if left to default. Even, even an intelligent young woman will tend to go that way. Just habit, gravity, the continual messages. We're still seeing, you know, as much as we think perimenopause is having a moment and we are talking more about it, revealing more of the science about really what's going on, there's still a lot of messages that get replayed and replayed that still keep a woman trapped in that that desire to be smaller, burn it off, you know, muscle, you know, may make you bulky, all of the old things. So I'm so glad to start seeing that change. Yeah, strong women.

It's, you know, it's hard because I, you know, I keep— I'm gonna just share two stories really quickly that happened to me in the last month. Um, first one, we were on our way to a pumpkin patch and we bring all of our water. My son, man, he has only had good water from our house. We have a purification system and he knows when he's not drinking. He's like, that's, that's yucky water. That's tap water. So we— it's really hot. We're out. We're not in a food desert by any means, but we drove out to like the country area, you know, where, you know, pumping patches exist. And we're not in the big city, and I didn't bring enough water. So I go into the grocery store. It's this massive grocery store, and I'm looking for hopefully glass water, you know, which I'm like, I have no idea. I am like, cross my fingers. I doubt it. It's probably gonna be all— I am like 10 aisles down, and every time I look down, it is just We're talking about tens of thousands of ultra-processed food products. And by the time I get to the 10th aisle, I am so overwhelmed. I feel like I'm having a bit of a panic attack because I'm like, one, I'm never going to find this water. And two, how does any mother or any family member, any adult get through this store without just feeling so overwhelmed? I mean, 90% of the store is just ultra-processed foods. This is a massive store. I finally find the water, but I have to go down an aisle of Powerade and Pedialyte and every colored fake water thing you could possibly— or an energy drink you could possibly imagine. Finally find the water. And I just remember, I just was like, how do we tackle this? How do we even overcome this? So true. So true. Then the next time, I'm a couple weeks later, I have a horrible migraine, but we are I don't even know what we're— oh, it's my book launch party. I have a migraine on my book launch party. Oh, shoot. And I'm in the store just buying like a couple extra snacks and I'm trying to check out. And if you've ever had a migraine, my brain is just fracturing and it's scrambled. And the woman's like, "You need to do the thing." I think it's pay. And I'm like, "I'm so sorry. I have a migraine. I'm like doing the best I can." with full conviction is like, "You need to drink Coke." Like, you— and I was like, "Huh?" And she's like, "Coca-Cola. Like, you need— that's gonna get rid of your migraine." Like, I tell all of my friends all the time. And she's like, "Not the big 2 liters. It needs to be this size or it needs to be a can." And I'm— and man, she is trying to give me her Coca-Cola. And I was like, "What is going on right now?" And I know I'm not changing her mind, and I don't even have the bandwidth to even have a conversation about Coca-Cola being a migraine solution. And I was like, "Yeah, no, we have a lot of work to do." And here's just a little bit about migraines. 80% of migraine sufferers are women, and a lot of when they develop is in perimenopause. Because perimenopause is a default inflammatory state where we see more inflammatory issues. And I was like, and I was so grateful, I was so, bless her heart, for wanting to help me. I felt her love and support, but I was like, Coca, I'm like, ultra, you mean corn syrup and caramel and I don't even know what else is in there. But, you know, I just was like, that ain't it. But I just was like, yeah, we have a lot of work to do even just within the blood sugar situation, you know, of navigating our grocery stores and navigating solutions, or even just trying to feel like ourselves and have energy to get through our days. Like, that's so much of why I wrote this book, The Perimenopause Revolution. Women deserve to have energy, but they deserve to have real cellular energy that propels them into the most powerful chapter of their life. We've got to get off the blood sugar roller coaster. We've got to do the things that are going to protect our future brain.

Amen, amen. So the book, everybody, is called The Perimenopause Revolution. Yeah, everywhere books are sold.

Everywhere books are sold.

Beautiful. So awesome. Tell everybody where they can find you too.

Yes, so I can— you can find me, um, again, books are sold, um, Audible. It's even available on Spotify if you look listen to. If you have a premium Spotify account, you can listen to it for free. And here's the thing, this is how I know, like, this is my perimenopause audience. Audio to hardcover is 2 to 1. Because women, if you're a busy woman in midlife, which what woman isn't, no one's got time to read an actual book. Like, if you want me to listen to something or read something, it better be on audio. So, I read the book. And if you want all the bonuses, which I I stacked these bonuses for the most incredible wins, more recipes, more workout videos, more everything you could possibly imagine. DrMarisa.com/book. And the best place to really connect with me besides Instagram is on my podcast, Energized with Dr. Marisa.

Awesome. Love it. So love it. And thank you so much. And I totally agree. And what a better way to reinforce the learning that you're going to do by than by walking while you're listening or working out while you're listening. It's so good for you in so many ways. Thank you so much for being here again.

Thanks, honey, for having me.