In this YouTube video, JJ Virgin explains the hormonal shifts that occur during perimenopause and menopause—first a drop in progesterone, then fluctuating estrogen—and the wide range of symptoms that result, including anxiety, sleep disruption, hot flashes, muscle and bone loss, weight redistribution, skin changes, and irregular periods. She urges women to seek a menopause‑specialized physician and assess whether hormone replacement therapy (HRT) is appropriate, positioning HRT as a primary tool but emphasizing it should be combined with other strategies. Virgin outlines five key action areas: (1) support adrenal health and stress resilience through meditation, breathwork, adaptogenic herbs, vitamin C, and high‑intensity interval training; (2) ensure optimal thyroid function with a comprehensive thyroid panel and, if needed, medication or glandular support; (3) preserve muscle and bone by prioritizing protein, resistance training, HIIT, and a plant‑rich, polyphenol‑dense diet; (4) use targeted supplements and phytoestrogen‑rich foods such as black cohosh, vitex, DIM, soy, garbanzo beans, and flaxseed, while detoxifying excess estrogen; (5) cultivate a positive mindset and consistent self‑care routines—including sleep, yoga, sauna, NEAT walking, massage, and daily meditation—to manage the “storm” of perimenopause. She shares a personal story of navigating perimenopause while caring for a critically injured son, highlighting the importance of a supportive medical team (Dr. Anna Cabeca, Dr. Sarah Gottfried, Dr. Hilah Kass, Dr. Prudence Hall, Dr. Alan Christianson) and disciplined self‑care. The video concludes with a call to action: educate yourself, prioritize your health, and subscribe for more guidance.
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It is absolutely insane to me that with all the information out there, that people are still trying to just survive through menopause. You no longer have to just deal with it. Here are 5 things that I would do if I were heading into menopause. So the first thing is, what happens with menopause? Well, number one, your estrogen and progesterone start to go wonky. Progesterone's the first thing to go. Progesterone starts to go down. What happens when that happens? You are gonna feel like you wanna unzip your body, crawl out and leave because you're gonna feel anxious, like you are, just don't feel good. But the biggest thing you're going to notice is that your sleep gets completely destroyed. All of a sudden, you're waking up all throughout the night. So anxiety and sleep are big signs that progesterone is going down. The next thing that happens is estrogen starts to go down, but it doesn't just go down like progesterone does. It goes up and down and up and down and up and down. How do you know that this is happening? Well, this is a whole bunch of different symptoms. One of the big ones, of course, are hot flashes. And we all know what those are like. However, hot flashes are not the only symptom. Glasses are just one of the small ones. There are other things too. You go to the gym and you just feel like you can't work out like you used to, or the next day you're like, why am I so sore? Maybe all of a sudden you start to notice that your gums are bleeding. You walk into a room and you go, why the heck am I here? Or you just low-grade feel bummed all the time. Or, and this is the worst, you start to notice something that my mom called shifting sands. You notice that your butt's starting to go away, but it seems to be going into your gut, that your fat is being lost off of your hips and thighs and starting to migrate over to your waist. And maybe your weight hasn't changed that much, but where your weight is and what your weight's made up of has changed a lot. Estrogen actually is anabolic. It helps us build muscle. It helps us work out harder. So if estrogen's going down, you're starting to lose muscle. You're also losing bone. And you need estrogen to help you burn fat. So all of a sudden you're becoming, Weaker. You're also becoming more insulin resistant because that's another thing that happens as estrogen goes down. You're becoming more inflamed and you're putting on more visceral adipose tissue. And now that estrogen and progesterone are going sideways, you might know some really weird things going on with your periods. Either you just start to miss them altogether, or they're shorter, or they're heavier, but they certainly aren't what you were used to. And they definitely aren't going regularly like they used to be either. Then the next thing that happens is you look in the mirror and you see your mom's Staring back at you. Now, the first time I noticed this, actually, I was doing a stretch pose, a yoga pose at my gym. And I looked at my legs and I go, what the heck is that? It was like my skin was sliding off my legs. It got crepey. You'll start to look in the mirror and see that with your face. So all of a sudden you'll see that your collagen, and this is, you won't realize it's your collagen, but your collagen isn't quite what it used to be. And your skin looks like it's starting to sag a little bit. Your skin is drier and more saggy. Here's the great news with all of that. The minute you start to feel symptoms, any type of symptoms, run, don't walk, to a doctor who is specializing, certified in menopause treatment. That's not every doctor, and that's not every OB-GYN either. You want to have someone who knows how to work in menopause. Here's what you want to find out. You need to find out if hormone replacement therapy is right for you, because you should start hormone replacement therapy if it is. As soon as you start to feel these symptoms, you do not have to suffer. And when you start to use hormone replacement therapy, you can stop a lot of those symptoms of menopause so that you won't even realize that you're going through it. So hormone replacement therapy is the big needle mover, the big rock that's gonna help you with a lot of the symptoms, but it should be used in conjunction with a lot of other things. And of course, you may decide you don't wanna do hormone replacement therapy, and so you're definitely gonna wanna focus on these things. Here's the reality, whether you do hormone replacement therapy You're not, you're going to want to make sure you're doing all of these things so that you can use either no or the least amount of hormones needed. So the first thing that you want to think about as you're preparing to go into perimenopause— and remember, perimenopause can start from 40 to 60. Now, generally it's in your later 40s, but it's got a pretty wide range and can last for 4 to 6 years or even longer. So ideally, if you're listening to this now and you haven't started going into perimenopause, you're in the perfect time period because you want to start all this ahead of time. First thing you want to do is focus on your adrenal health. Adrenals are how we produce our cortisol, our stress hormones. And here's why this is so important. When you go through menopause, this is also how you're going to start to produce your estrogen as well. And when we go through menopause, lower estrogen and progesterone actually causes your body to produce more cortisol. So before you ever get into that, ideally your body learns how to handle stress well. You've got a good meditation practice on So maybe you're doing meditation, breathwork, tapping. You found your bliss. You know what works for you to lower your stress hormones. I'm going to give you a little benefit here too. Vitamin C can be amazing. So can be some of those adaptogenic herbs like ashwagandha and rhodiola can be super helpful here. Restorative yoga can be helpful. And also this might sound counterintuitive, but high-intensity interval training where you go really hard for 30 seconds to a minute and then recover and do it again and recover and repeat this for like 5 to 10 to 20 minutes. This actually teaches your body how to do something hard and recover. So it helps your sympathetic nervous system learn how to handle stress better. So the very first thing you're going to want to do is really get your adrenal system on board. So think about what you need to do to be able to handle stress really well. The next thing you're going to want to make sure of is that your thyroid is functioning well. Do not Go along with the typical thyroid tests that you would have if you went to a traditional allopathic office where they'll look at your TSH, look at it in a range of 0.5 to 4.8 and say it's in range, it's normal. That is not true. That's not the case. You want to look at your thyroid total panel, which is TSH plus free T3 and T4, thyroid antibodies, reverse T3, and make sure they're all in optimal range with your TSH being somewhere between 0.5 and maybe 1.5, and that you don't have any of the symptoms of low thyroid function like losing the outer third of your eyebrows, slightly orange hands, you're cold, you're depressed, you're losing your hair, your cholesterol is elevating. All those can be signs of low thyroid. They can be signs of other things as well, but if you put that together with any of those numbers not being where they need to be, you may be benefiting from a little bit of thyroid medication or a thyroid glandular. And here's the reality, you can't balance your sex hormones, progesterone, estrogen, if your thyroid's not working well. So, and if you're adrenally stressed, if you're, if your cortisol is high, it can push down on your thyroid and make it hard for your thyroid to convert T4 to T3, and that's the active form of thyroid. So all of these things work together. So that's the first part. The second thing that you're going to want to make sure that you're doing is doing all of the things that help support your body being able to hold on and build muscle. And also build bones. So eat protein first, lift heavy things, move more throughout the day, do your high-intensity interval training so that you're continuing to burn off that visceral adipose tissue, and eat a plant-rich diet— lots of polyphenol-rich rainbow color foods to help reduce inflammation. All of those things can help as well. And then there's some supplements that can be super helpful here too. And this is where I would also be working with someone to help you target the right ones for you. But things like black cohosh, vitex, DIM— It helps detoxify estrogens, can be helpful along with some of the phytoestrogen-rich foods. And that can be things like soy if you don't have thyroid issues and you're not intolerant to it. Could be things like garbanzo beans, tahini. I would do a shout out and listen to Lisa Mosconi. I did a great interview with her in Well Beyond 40 where we talk about what you can do in menopause, the menopause brain, and all the phytoestrogen-rich foods. So I would look at those as well because those can be super helpful here. So here's the most important piece of all of this. You know, you would think that for me the most important piece is diet or exercise, but actually I'm going to always tell you that the most important piece of this is your mindset, because thoughts create and perceptions become reality. If you look at this time of your life and go, this is going to become the time where I step into my most powerful self, where I feel my very best— first of all, let's be real, you're not going to have to have periods anymore. Yay for you. That's fantastic. No more of that, like, cycling throughout the month where there's a couple days that you feel crappy every month. That's going to go away. So I can tell you, once you get to the other side, things are so much better. They're fantastic. You just need to know how to manage the storm. I think a lot of this comes with that decision of, I'm going to do what it takes to make this the best time of my life, to have a positive attitude about it, to have a positive experience with it, and to do the things that I need to do to take care myself because self-care is truly selfless. So I'm on the other side. However, what's crazy for me as I started going into all of this is I actually went into perimenopause at probably the most difficult time of my life. I was starting to go into it when my son, who was 16 years old at the time, got hit by a car and was left for dead in the street. So I really got hit hard by that because my adrenals took a massive hit. And I remember being in the hospital with my son bedside in a coma, teetering between life and death. And I reached out to my friends and I had some hormone docs coming into the hospital with things to support my adrenals, with things to support my thyroid, with estrogen, with progesterone, because I was like, I can't do this. And I, I could not afford to suffer because I needed to be there completely for my son. I am now on the other side of this, but honestly, if I could get through one of the most difficult times that a parent could get through, while going through perimenopause, then we should all be able to do this. And the real thing that helped me there was having the right doctors around who I could ask. I had amazing doctors on board helping me. Doctors like Dr. Anna Cabeca, Dr. Sarah Gottfried, Dr. Hilah Kass, Dr. Prudence Hall, Dr. Alan Christianson were all doctors who were supporting me through this process. I've done interviews with all of them because we may not all have access to be able to call up Sarah on speed dial, but you've got access to all of their information. So that's the first thing is I was able to be on the hormones from the start. But I also, even at that time when my son was in the hospital, was one of the most difficult times of my life, I put my self-care at the top of the list. I made sure that I got my sleep every single night. And I was taking progesterone to help me sleep at night, which can be a game changer. I was getting in my exercise every day, even if it was just running up and down the hospital stairs up to the 6th floor where he was. I was making sure I was getting in resistance training and HIIT training, and I was doing something for my own meditation, self-care every single day. A lot of times it was tapping because that was really helpful at the time, and Nick Ortner from The Tapping Solution gave me some tools to be able to use there. Tapping is interesting because it can lower cortisol by as much as 27%. Breathwork can do the same thing. And then I was using a lot of adaptogenic herbs that Hyla Kass gave me for cortisol to help me get through all this. Once you're on the other side, it honestly gets a lot easier. Now that I'm on the other side, what I do is I cycle in progesterone a week or 2 a month. You have to see if that's something you feel better on, steady state or cycling. And I take it at night. I do an estrogen patch, an estradiol patch, 0.1 grams or 0.1 mL, I think it is, twice a week. And then I do a testosterone shot. Now, I just did a podcast interview with Dr. Kelly person who recommends doing higher doses of testosterone. So I'm playing around with how much I'm doing right now on that, so stay tuned. I do sauna to help detoxify. I also do a flaxseed meal, which is rich in phytoestrogens and can help detoxify, because part of this too is you want to make sure you're detoxifying those estrogens. I do take thyroid, and I work with Dr. Alan Christianson with my thyroid, and I take a special NP thyroid that he makes along with a little Extra hit of T3, and then I do some extra adrenal support as well. And then I do my resistance training. Generally, it's three to five times a week. I do high-intensity interval training, and I get a lot of NEAT non-exercise activity thermogenesis. I walk around a ton. Ten thousand steps is kind of my minimum each day. And then I do yoga, hot yoga at least once a week, and a massage generally once a week or once every other week. So those are all the things I put. Every morning I wake up and I also do some meditation. It took me a while to get to that routine. I'm about 90% on it, but I will tell you, once you get to the other side, it's way easier to be stable on that. And as you're going through, when you're in perimenopause, think of it like you're out on a boat in the ocean and the waves have kicked up and you kind of have to keep redirecting and balancing throughout it. And just give yourself a little grace. Here's the thing, I know everything I've just said sounds like A lot. And I didn't come to all of that overnight. I came over time, but I would love you to have this information now because I had to dig through and find all of it. I think now there's so much at our fingertips. And so what's your most important action step right here is to educate yourself, is to know this. You do not have to suffer, nor should you suffer. Starting with learning about hormone replacement therapy, finding a really good doctor who specializes in menopause, who can cut through the noise of the stupid Women's Health Initiative BS that did a disservice to so many women, so you can really make the right choices for you. And putting yourself as your top priority on your to-do list. You got to take care of yourself at your— this time. I know for us women, for so many years, we put ourselves at the bottom of our to-do list, if we even get on there at all. The biggest thing that you can do, the most important thing you can do, so you can do So everything you wanna do for everybody else, 'cause we always wanna do that, is to start with you. Put yourself at the top of your list and make this a priority because this is that wake-up call time when you're going through perimenopause where you can't ignore yourself anymore. Best news, you are not alone in this process. I'm sharing information so that you can age powerfully. So make sure that you hit the like button, subscribe to the channel, and I've got more where this came from.
