The Truth About Perimenopause and Metabolic Health with Dr. Mariza Snyder

Almost 40% of our teenagers are pre-diabetic. You think about polycystic ovarian syndrome, which is affecting 1 in 5 women, and it's the biggest cause of infertility in this country and in the world. That is inherently a metabolic issue. Your cells saying, we can't do this, it's not safe.

I have a repeat guest on today because she's awesome. Yes, menopause is having its moment, and Dr. Marisa Snyder takes a different approach. This is her 9th book, and she has really become a powerhouse advocate for midlife women. And she's got a great podcast you'll want to tune into as well, Energized with Dr. Marisa, and a social media audience of over 400,000 and literally reaching millions of people as this trusted guide because she offers science-backed solutions for perimenopause and metabolic health.

The most vulnerable group of people are women over the age of 45, and the number one reason that is Is.

So menopause is having its moment. Hopefully it's not just a moment. Hopefully it is an extended time period of awareness. And here to help me pull back the curtain on all things around perimenopause, menopause is my buddy, Dr. Mariza Snyder. Welcome to the show.

It's so good to see you, JJ. I always love seeing you.

I am so excited about this next book. How many books is this for you?

This is number 9. Gosh, this is number 9. And I took the smallest amount— I would say that the amount of time I was given to write it was probably one of the most like crunched timelines, but it was probably my favorite book to write to date.

Well, they probably wanted you to write it fast because there's all these books on menopause. And that was one of the questions I asked you because there are a lot of great books out there on menopause. Now, I personally believe like the more information I can get on a subject, subject, especially when I'm in it, the better. But I would love to know, because we're going to unpack your book, but just on the— right now, just for someone listening, they can have a framework as we talk through this. What's different about your approach, or what would they find that they may not find in other books?

Yeah. So this book is particularly— I mean, obviously, the extension of perimenopause is menopause. But when I was deep into the research, and I'm pretty sure you've seen this too, JJ Virgin, is that a lot of the changes that are happening to us that will impact us in our 60s and 70s are happening in our 40s. We're not even in perimenopause or in menopause yet. We are in the transition of chaos. And so a big part of this book is really identifying, because so often I think because women have been told, oh, it's just aging, or it is all in your head, or, oh, you still have a period, so just be grateful.

You know, you're fine, you have a period, you've got estrogen.

Women are like, I am not fine. It is not okay. Something is wrong. Like, I was fine last year. I am not fine today. So I think it's one, recognizing what is the not fine. This is a full body takeover when we're losing these hormones. I think it's really important to understand that full body takeover. And then by the time we're in menopause, that takeover has been happening for years that insulin resistance has been developing. Your muscle, you've been losing it. Bone, you've been losing it. Your brain, it's changing, fundamentally changing. I think it's important to know that. But then how do we feel more alive? How do we future-proof our health now in midlife, in our 40s, so that we, we can navigate menopause on our terms? We're not negotiating what we have energy for. We're not negotiating what we can pick up. We're not negotiating what we have the capacity to take on in our 50s, 60s, and beyond. And that's literally what this book is. You know, so many books are focusing on the symptoms and treating of symptoms and, and the conditions. It's— this book is the pillars for you to feel alive now and 5, 10, 15 years down the road so that you have the freedom to to decide what you wanna do with your life.

Okay, then I think you answered the question as you were talking through that. I went, okay, but wait a minute then, if you're now in your 50s or 60s listening to this, is there still value in the book for you? Or is it, I hate it when I get these questions on social, it's too late for me. I'm like, no.

No, it's never too late.

Will the tools work for someone who's okay?

Yeah, it's never too late. I think that there's, you know, when I find that when women are in what I call the window of vulnerability, the chaos where, where the symptoms are really insane in perimenopause. I call it the window of vulnerability, but the window of opportunity. And I would say that that window continues to extend. At any point we can build muscle. At any point we can protect bone. At any point we can walk back insulin resistance and prediabetes so that we feel more alive in our body. But if we really wanted to stay ahead of it, ideally it's when the shifts begin to change.

Yeah. Well, ideally. We started lifting weights in our teens.

A long time ago. And I was 16 years old.

And I just wanna impress upon everybody, like, wherever you are, if you forgot to lift weights your whole life, if you, like, if you went through menopause and thought you were just under stress, like, we gotcha. This stuff will work for you. Yeah. But I was telling you again offline, as I was going to an event last year and seeing one of my good friends who I was not, couldn't, didn't really recognize her. I was like, what has been going on? And she goes, it's just, I'm just so stressed. And I'm thinking, I know your life and you've been through a lot of stress. Like, you know, and what you're going through now is like no big deal compared to the stuff you've been through. Now, I don't know if it was tipping you over, but I doubt it. So what's just happened that you can't sleep, you've got anxiety, you just gained weight. And I'm like going, how old are you? And again, you find so often that you don't think think about this. So how— because the other side of this is hearing that lab tests don't work and all this stuff. So, so what's the, the best way and the definitive way to figure out what— where you're at?

The second you do not recognize yourself anymore, the second you're like, what the heck is going on with me? Um, that's probably perimenopause, and you're 40 years old. Like, let's do it, we're gonna do the math. No, it's— I think for so many women, we're blindsided. And I would say that a lot of us coming into our late 30s or early 40s. I would say 42 seems to be like the age where women feel like they're falling off the cliff and they're just like, wait, I used to feel sharp, I used to feel stable, I used to fire off everything, I was fine. I'm not fine. I can't seem to do the things. I have to over-effort to get the same stuff I used to get done. And that's what it felt like for me. I remember I went from postpartum to perimenopause, and a lot more women are doing that, just jumping from one low hormone state to another one. And I think I had a good 6 months where I felt pretty good. And then I started to feel off. I started to not recognize myself anymore. And I think initially, because I've gone through a lot of stress in my life, I have an autoimmune condition, I've dealt with things before, other health issues in the past, probably had insulin resistance at one point. And so when I started to experience these kind of destabilizing symptoms, I started to think, oh, it must be those things. That kind of— it kind of felt like when I was stressed, it kind of felt like when my thyroid was not functioning properly. And so I remember going down all the rabbit holes and trying to identify, is it one of these health issues? And many of us come into peri already kind of dealing with things health-wise. And so I find that perimenopause tends to just accelerate a lot of those symptoms or amplify those symptoms. And it can be very confusing, be like, okay, what is this? Is this these other issues or is this something else? And, and often it's both. And I think that's why it's so hard to identify at times. And so when I'm thinking about it, you actually, I call diagnosing or at least recognizing that it's perimenopause. One, it's the age. You know, if natural menopause is between the ages of 45 and 55 and perimenopause is an average of 8 years, let's say give or take for most of us, I reverse engineer. I'm like, okay, if you're 44 or 43, You're in perimenopause. It's pretty rare that you're not at that point. Next, it's cycle changes. You know, maybe you're still running, you know, a consistent cycle, but it's a little bit shorter, it's heavier, it's lighter. Um, that would be also a, you know, recognizable trait that you're in perimenopause. And then the other thing is symptoms. I always tell women, track your symptoms along with your cycle. Back in the day, maybe your PMS symptoms were just 2 days, but now Huh, they're like 5 or 6. It's all kind of blending together. That's, that's a sign of perimenopause. So if your symptoms seem to have just exaggerated, um, and you're noticing more brain-related symptoms, again, progesterone and estrogen, those two critical reproductive hormones that are declining, have a profound impact on your brain. I would say some of the most common symptoms of perimenopause are brain-related, including hot flashes and night sweats. Those are brain-related symptoms.

Yeah. It sounds like too, like you wouldn't think about this in your early 40s, but probably, you know, before things start to really fall off a cliff, the volume just starts to get turned down a little bit. Yes. So that's always a bigger challenge, don't you think? Because all of a sudden you're like, oh, I'm walking into a room and I can't remember why I'm there. Or, oh, I just can't recover from my workout quite as well as I did before. But it's— subtle. It's subtle. And so you think you're losing it.

Yeah. Well, and that's what everyone's telling you too. That's what your doctor's telling you. You're fine. You're nor— your labs look normal. You know?

So you're, you know, are there any indicators in your labs that you should be looking for? And I just have to push it out there again. Please don't look for your lab work to be normal. Normal is sick in our country.

Agreed. Normal is sick. Like we look at those metabolic labs, those those 5 biomarkers, by the time you're out of normal range, you're in trouble.

Yeah. Yeah.

We're talking about system-wide inflammation. I'm looking at everything. You know, I— lipids can tell me a lot about your perimenopause journey. Your fasting insulin, which is an indicator of insulin resistance and overall how we make energy in the body, can tell me a lot about your perimenopause journey. Inflammation markers like highly sensitive CRP, can also tell me a lot. I'm also looking at hormone markers. I'm obviously looking at estradiol and progesterone in a total testosterone panel. I'm looking at the full thyroid panel. But I mean, I will tell you right now, at 45 years old, my hormones on labs look pretty darn good, JJ. I just keep finding the best day to test them, obviously.

And you can't see anything with like, you know, sex horning—

Oh yes, obviously sex hormone binding globulin. Yes. And so I'll see a drop in that. I'll see a drop in testosterone sometimes earlier than I'll see it in estradiol. Often I see a drop in progesterone, you know, even in women in their 30s. And so those are usually, I'm looking at a composite of things, but also I'm looking at the metabolic labs. I can sometimes see perimenopausal shifts in the overall cellular longevity labs than I'll see them in the hormone labs. So I go a lot by symptoms. I go a lot by cycle changes. And I'm taking in the labs as well.

All right, so what do you think's going on? Are the hormones driving the metabolic issues, or the metabolic issues driving more of the hormonal problems? Like, is it just a circle that goes round and round and round? Because you talk about, you know, really menopause being more hormonal chaos. So, you know, can you, despite being in perimenopause, fix the hormonal chaos?

Yeah, you can fix it with hormones. That's what I would say. I would say hormone replacement therapy is where we start on that.

What would you say to someone who said, but I want to do this naturally? Hmm.

I think it's important when someone says, I want to do this naturally, to educate what it means. I think for a long time what we believed menopause was, was that we don't have a period anymore. We're not cycling anymore. But what inherently does that mean? I don't think that women realize that that means that their hormones are down to bare minimum, down to the lowest of low, pretty much nothing, right? You know, when some people say, oh, my adrenals will take on the load. No, your adrenals will never make enough hormones for you to physiologically— your body to physiologically functioning the way that it did. You know, I think we have to get past the fact that these hormones— this isn't bikini medicine. This is— these hormones just don't control our boobs and our uterus and ovaries. They are whole body hormones. As these hormones decline, and in perimenopause it is erratic, it's not some slow leisurely stroll where hormones are slowly declining. No, it is, it is, it is chaos. And we know that when these hormones are not binding to those receptor sites, that we are losing muscle, we are losing bone, our cardiovascular protection is compromised. Our cellular protection is compromised, our brain is massively remodeling. We know that we are, we are losing and decreasing about 25% of the energy in our brain during the perimenopause transition. So I think it's important that women understand what inherently is happening. It's not just a period loss. It's not just no more cycles. It is a full, complete remodeling of your body without these hormones. And the research is clear, it's not going somewhere good.

Right. I would argue too, like when you hear about the women in Okinawa, that in our modern day, with the way that we have trashed our adrenals with the excess stress, um, that we actually probably have lower hormone than a person would've maybe 1,000 years ago and look at that. Yeah.

Lifestyle isn't helping. Environmental stressors are not helping with that.

And the xenoestrogens, all the stuff.

All of it. Or even, I mean, if let's just walk back our teenagers, we have almost 40% of our teenagers are prediabetic. You think about polycystic ovarian syndrome, which is affecting 1 in 5 women, and it's the biggest cause of infertility. In this country and in the world, that is inherently a metabolic issue. That is your cells saying, "We can't do this. It's not safe. You know, there's an energy problem." And so if you fast forward now to us heading into our 40s, you know, I believe it's like 12% of us, if not more, are the only ones that are metabolically healthy in this country.

I think it was 7% last—

Yeah, yeah. So based on the NHANES data, back in 2016, it was 12%. And the research has been updated where now it's down to only 7% that are metabolically healthy. And the most vulnerable group of people are women over the age of 45. And the number one reason that is, is because of the loss of estrogen, which inherently is helping to protect us to be more insulin sensitive. If we're already coming in metabolically, you know, busted, and we lose kind of the last protection we've got, estrogen, it puts us at a more vulnerable state. And what that ultimately puts us at is it becomes, we become more at risk for cardiovascular disease, stroke and heart attack.

It's really clear in labs, by the way. I used to work out of a doctor's office in Rancho Mirage and they would send their patients in for me to put them on, you know, a nutrition and fitness program. And I wouldn't, before I'd see them and their health history, I'd see these labs. You knew if they were on hormones or not, just based on the labs, you could see it. Oh yeah. So, I mean, it's incredible. Again, just like what you talked about, HSCRP and fasting insulin and LDL. So basically your margin for error goes way down. So someone, someone's hearing this, they are working with a doctor who, or a practitioner who understands menopause, has gotten trained in it, which I'm still blown away, Marisa, that That's not part of OB-GYN school.

No, no, 20% of OB-GYNs currently feel comfortable supporting women in perimenopause and menopause. Yeah.

I mean, and it may even be less than that, but it, it's so weird. So, so let's assume now that someone is getting the help with the hormone side of it. What's the other side then? What are the other things that they can do so that they can reduce that margin for error, feel as great as possible, get that cellular health and metabolic health back together.

Yeah, absolutely. So yeah, I would say the hormones are kind of the light switch back on. It's— hormones aren't necessarily a weight loss drug. I know there's a lot of talk about that right now on social media. And, you know, I made a comment recently that hormones won't, won't lift the weights for you, but they'll give you the motivation to get back in the gym. They'll help you with the sleep so that you have enough energy to get back to moving. But I would say number one is starting your day with a metabolically healthy meal, prioritizing protein and fiber. And so if we're losing muscle, which we are, um, you know, hormones or no hormones, part of that is having the building blocks, the amino acids, to actually build that muscle. And out the gate, I think you and I both agree, like, I have to have something before I work out in the gym in the morning.

I do too. I— well, what I've found for a hack, because there's the—

yeah, I want to hear your hack.

Yeah, like My perfect world, which for some reason does not seem to be working right now. I'm like, I know what I want my schedule to be and it's not quite there, would be, you know, wake up without an alarm around 6:30, do some meditating, go in the sauna, do some red light, have breakfast about 90 minutes to 2 hours later, digest for a bit, go to the gym. Like, I sound totally leisurely, but I was working.

It's very leisurely.

I love that.

I don't— I don't see that.

Yeah, and it's so like, but I'm working in the sauna and I'm like, you know, but this hasn't been working well. And there are times when I travel, I feel way better. I've tracked it. And I think this is where N of 1 comes in. You've gotta do your research. I can't eat and go work out. Like, you know, if I'm at a hotel, if I'm waking up at 6, the only time I can work out is right away. I'm not gonna eat and go down and work out. That would be like, yuck. But what I do, is I put some collagen in my coffee, and then I put some essential amino acids, chiotine, and electrolytes in this big old jug. As you can see, this big jug—

is that— what is that, 60?

It's a 64-ounce jug.

Literally, I mean, honestly, that's your workout, JJ. You just— it is like— no wonder you've got those arms. You can just do upright rows all day long.

And I go through the whole thing and add more to it at the gym. So Tim— Tim's like, sipping on one.

I mean, you know, as a mom to a 4-year-old who, you know, wakes— he wakes up early in his own right. I'm usually up around 5:45, 5:30 so I can get something in, right? Sneak out of the house before he wakes up and finds me. And, um, I actually, because I'm again still running in Perry, running on fumes— not that I'm not on my hormones and doing all the things— but it's— I make a protein coffee with, with, um, with collagen and 30 grams of protein in my coffee. I put it in the fridge the night before, and I'm a big proponent of everything's laid out. My water's ready, my gym clothes are ready, my shoes are at the door, the protein coffee is in the fridge. I grab and go and head to the gym and do a heavy— usually do a— either it's a heavy workout or sometimes it's HIIT training. But one of the biggest things that I have learned in not only wearing a continuous glucose monitor for myself, so tracking my blood sugar throughout the day, and with my patients, is that if we can move consistently throughout the day we can stabilize our blood sugar, we can support our metabolism, we can feel more alive. And one of the things that I've been integrating that I am just shouting from the rooftops, and you've talked about it too, it may even been you I heard it from, I'm going to give you all the credit, is exercise snacks. If you find me in the wild, I am doing jump squats. I am jump squatting, I'm squatting probably 4 to 6 times a day. I try to get that one workout in the morning. But I remember growing up, I used to think that that's all you had to do. I do the one workout and then I sit on my butt for probably 5 to 6 hours a day, give or take. And I remember thinking that, you know, if no pain, no gain. So, if I wasn't lifting the weights, if I wasn't strength training or HIIT training in the gym, it wasn't worth it. So, me knocking out 10 squats or doing some jumping jacks throughout the day, it wasn't the big thing. It wasn't the big workout. So it probably didn't count enough. And if there was— if I could go back to my younger self and be like, girl, you should have been jump squatting that entire time. It all counts.

Girl, it all counts.

It all counts. And if anything, it counts more. You moving consistently throughout the day, whether it's a walk or it's an incline hill or it's jump squats or it's jack squats or it's jumping jacks, Or it's walking up and down your stairs 3 to 4 times. I don't care what it is, like, as long as you're moving throughout your day consistently. If you couldn't get that big workout in, again, strength training is mission critical as well, but let's say it's a day that it just doesn't work. Let's say it's a travel day, or it's a day where you are running your kids around everywhere, whatever it may be. There's no excuse to not get in these little mini snacks where you're revving up your heart rate. It's like little mini HIIT workouts for 1 to 5 minutes throughout your day.

The research is really clear on it. The research, and I'm gonna give the credit over, we were messing around with exercise snacks, and then I saw this research paper from Rhonda Patrick, 'cause I subscribed to her Found My Fitness thing, and it was about VILPA, vigorous intermittent lifestyle physical activity, and how 4.5 to 10 minutes total a day done in 1 to 2 minute bursts reduced all-cause mortality by 40 to 50%. And so what it really has done, and I think this is so important that you just mentioned this, is you've heard like, oh, you go to the gym 3 times a week for 30 minutes and you sit on your butt the rest of the time. Well, if you look at the difference in your metabolism, like, you know, your metabolism is your resting metabolic rate, thermic effect food, and then your activity. Your activity is your non-exercise and your exercise activity. The reality is the non-exercise activity actually is the bigger lever. Yeah, because there's only so much you can work out. And one of the things I've noticed at 62 is that I have to be very careful about my recovery because I will overdo it and then you're just trashed. So, you know, it's only so much you can do, but you can do a lot of just moving more.

I think, well, for a long time, HIIT workouts, those 45-minute or 50-minute HIIT workouts— those aren't HIIT.

Those aren't HIIT.

Those are burnout. That's just burnout workouts. That's what we call it. But I was doing these burnout workouts I remember that was what triggered my Hajjis ultimately, was what kind of spiraled me out at 36, 37 years old. I did— I was going to Orangetheory competing with like 24-year-olds, and I ended up burning myself into the ground. But I've always loved the high-intensity training, except that I— what if we only do it for 2 minutes at a time, right? Wouldn't that work?

The reality with HIIT training is it's not a 45, 50-minute thing, and it's not something you can do every day. So the fact that there are these workouts that have you doing what they call that. It's like HIIT training done right, you're done in 20 minutes or less. Like you can kill it in 8 minutes.

Yeah, and, or even break it up into 2-minute bouts multiple times throughout the day. And so I, after this interview, I've got a half hour between this interview and the next, and I'm gonna knock out some mountain climbers, some jump squats. I'm gonna walk up and down my stairs with 20-pound weights.. And then I'm gonna, you know, give myself a little moment, uh, an emotional lap is what I like to call it, a little walk around, grab my emotional support water with my essential aminos and my chiatine. It's not as big as yours, girl, but you know, um, and so, and then I'm gonna get into the next, the next conversation. That's, that'll, that's what it looks like.

The, um, buzzword out there that I'd love to address. Yeah. Because it's like the biggest thing you hear about is balancing hormones. Ah, balancing hormones. And like, you listen to this and go, what on earth is balancing hormones? Like, is it even a thing? What does it mean? And right alongside it, Marisa, is this whole idea that don't do all these things because they raise your cortisol. That's the other one that makes me insane. But like, could we— let's start with unpacking the balanced hormones and then maybe we can just talk a little cortisol in perimenopause too, because I feel like that's also It's getting a little out of hand.

I think balancing hormones— I was talking about this in 2010. That's kind of what we thought initially. One, we weren't even recognizing perimenopause in 2010. That's how far away we were from taking care of women. I think really what the intention was is helping women feel more alive in their body so that they weren't as symptomatic. So maybe it was if someone had polycystic ovarian syndrome, like, we got their insulin under control and more sensitive. Or if progesterone wasn't where she needed to be in the second phase of your cycle, okay, what can we do lifestyle-wise and maybe potentially medication-wise to get that level back to a reasonable range? And so I think that was originally the way that we were talking about it, you know, 10, 10+ years ago. And when we're talking about perimenopause and menopause, there's no balancing hormones. And I think, again, that's the confusion. If a lot of women are like, well, menopause just means no period anymore. And I'm like, oh no, it means so much more than that. We already talked about it. And so I think it's, it's, it's, there's an inherent misunderstanding based on the knowledge gap. Again, if, if only less than 20% of OB-GYNs even know how to tend or take care of women in perimenopause and menopause, there's just a great knowledge gap in terms of what it means. I think we need to change the term into hormone optimization or restoring hormones, because I think women need to understand it's— it's— you're heading into a low hormone state. That is what it is. You don't— you can't balance hormones in perimenopause. You can try to start replacing them, you can start supplementing them so that you're kind of back to where you were at, but without the medications, you're not going back there. It's not happening. It's not— our physiology isn't built that way.

So these people who— because you still see it out there, like the foods, the foods you can eat— I'm like, what? I don't know. Unless you're going to just live on soy, I don't know how you would actually impact your— what are you gonna do, eat wild yams and soy?

And, you know, I mean, there's a ton of— I don't know, a significant misunderstanding. Yeah. And not to say that soy, or, you know, can, can be somewhat supportive, but it's not Soy isn't going to bring your brain back. Soy isn't going to help you become more insulin sensitive necessarily. Like, yeah, sure, it can help a tiny bit, but it's not gonna be the same as you bringing on estradiol.

Yeah, which it's so easy to do it that way and be able to really manage it and kind of go, oh, when I use this much, I feel this way.

Yeah, exactly. And then there is no, with HRT, there's no cookie cutter approach. There's no, especially in perimenopause, your hormones are gonna continue to change. Like, what your perimenopause journey at 42 is isn't going to be what it is at 49 or even 51. And so just know that on the HRT journey, my HRT protocols have changed 2, 3 times already, and I'm almost 46.

Yeah, mine started— and it's funny because people ask, well, okay, I want to know what you're taking. I'm like, why? You're not going to be taking what I'm taking. I can promise you.

Different body composition, different lifestyle, maybe different age. Yeah. I know. I, I think that again, we're, we're very much sold the one size fits all, the one pill fits all. It's, it's just not that way.

All right. Let's, let's like jump into the cortisol battle out there online. Um, you know, I'm kind of coming from the look at this of, yeah.

What's your point of view?

Well, what drives me nuts is everything now avoid everything that raises cortisol. I'm like, well, if your cortisol doesn't go up, you're dead.

Yeah. No, it is a, you need it in the morning. It's called the cortisol awakening response. Yeah.

Like get outta bed.

Like if you don't have it, you're not getting up. Or you are crawling to get into your day. Yeah, you— we absolutely have to have cortisol to function. Cortisol is a neuromodulator. Cortisol is helping to support your metabolic health. It's helping to support your thyroid and insulin. Um, and yes, yes, absolutely. We could be— we could have too much stress in our life. Sure. Absolutely. We can overdo it. We talked about 50-minute HIIT workouts, the burnout workouts. Yeah. You know, if, if after that workout you can't function in the rest of your day, we need to change the workout, the quality of your workout. And so I think that's more the conversation. I, and I would say that a lot of what we think is deregulated cortisol is really a fundamental issue in our, our energy in our body, our energy in ourselves, and in living a life where we're probably burning ourselves out. Um, and so, you know, I think it's really knowing your body and attuning to your body to see what you can do. Like I can do a 10-minute HIIT workout and be fine. I can't do a 50-minute workout 4 days in a row and be okay on the back end of that. And so I think it's really important to know like what you have capacity for. I, I don't do really great cold plunging. I, but I can do a 50-minute sauna session. So I think it's important to just know what your body and what you have capacity for. But I think villainizing cortisol isn't the answer, right?

Yeah. Thank you for that. Looking at, and I kind of have this love-hate with hacks because I feel like—

I love a good hack though.

Okay, well, but here's when you can use a good hack. When you've done the foundational stuff, where hacks make me a little bit nutty is like you're not doing any of the things.

Not the fundamentals.

Yeah, it's like someone going, "I'm tired, you know, what do I need for energy?" I'm like, "Sleep." Yeah, circadian rhythm optimization or a consistent bedtime and wake-up time every single day.

You know, a consistent eating window. No, not snacking past 7 PM. You know, these are consistencies. Yeah.

But you do have some things that you love. You have your non-negotiable perimenopause hacks. So, I got to hear a couple of them.

Okay. So, number 1, we talked about the first one that I am obsessed with, which is the exercise snacks. What I've noticed, I've been consistent with those all year long. I started them last fall when I was writing the book. And because I wasn't able— I mean, the timeline was so tight. I was like, okay, what can I do? What can I do multiple times during the day to just break up the monotony of research and make sure that I'm moving my body? And I track all my, my data on my Whoop. And so exercise snacks were the thing. But then this year, I started this year in 2025, and I'm like, I will consistently do 4 to 5 exercise snacks a day. And there were 3 major things that I noticed. One, I had more mental energy and clarity. And to me, it's probably the most valuable asset that I have is my brain and perimenopause. Was hijacking it. And I was like, how do I get my brain back outside of using hormones? Yes, that's— I did that. So exercise next was the number one thing. So mental clarity, more energy, but more importantly, more deeper quality sleep. Because my— I was moving all day, my body, you know, I was deeper. And I lost 5 pounds. So I'll take the bank, I'll take— so that's—

well, and you lost 5 pounds, I'm sure, of fat.

Fat, my muscle.

Yeah.

So I just got my DEXA results back and my lean body mass was so sexy. I was so happy. And I had like very little visceral fat. I was just so excited. So, I was like, "Come on, Exercise Snacks, let's go." Walking after meals is my next one. That's like, I feel like the most underrated longevity hack that we can do. And if you're thinking to yourself like, "I don't have time to walk after a meal," Exercise Snacks. You have time to do 10 squats after dinner, okay? The next thing is what I would— my hack, my favorite hack is spending time in real life with your friends. I would say that one of the loneliest, most isolating times in our lives is in the middle of perimenopause and menopause, because I think we've all been meant to feel ashamed about the symptoms that we're experiencing. I think a lot of it's your fault. I went to a doctor's appointment about a year and a half ago after my brain injury, and I just, I was feeling depleted, exhausted. I, something wasn't right. And this was about 6 months after I got hit in the head a couple times. And I remember I wanted specific labs looking more at my energy capacity. And so I wanted a full iron panel, thyroid panel. I, I had the list. I took my little piece of paper, and my doctor, um, who had been a doctor of mine for about a year, she looked at me point blank and she's like, you know, you've been trying to figure this out for about 9 months now. And she's like, I really don't have anything for you. And I was like, I didn't come in here to have you figure this out. I know, I get that I'm still trying to figure this out. I need you to run these labs so that I can function.

Health to the rescue. Exactly.

Exactly. Function Health to the rescue. Or all our direct-to-consumer labs out there. There's so many different companies that are doing it. That will give you that information. But I just was like, you know what, thank you for this experience for reminding me how many women come into their— the doctor's office in perimenopause or menopause and are told it's their fault.

Yeah.

So spending time with friends, the people that feel safe. The other hack I would say, again, I think this lands more in the consistency of good lifestyle habits, is being consistent with your going to bed time and your wake-up time. So that consistency is such a powerful longevity hack that the research is becoming more and more clear. If we can just be consistent about going to bed, maybe around 10 o'clock, getting up around 6 or 7, whatever works for you, that you'll start to see and feel more energy throughout your day, and you will help to support your circadian rhythm. And then the last hack, my absolute last favorite hack, um, is eating earlier. Eat?

Yes. Oh my God, we become our parents.

I know. I'm like, they knew what was up.

Although my parents ate at 7:30 at night. I used to be like dying to eat at 5.

Yeah, 5 o'clock, please.

I was like, please, please, please. I know we are.

I am like, if I haven't eaten, ooh. Yeah. Like, you know, so we, we eat before 6 and that's it. I say anything after 6 or 7, whatever your cutoff is, I call it late night eating. I just, I mean, it is what it is. Let's, I mean, it's not, guess what? It's not going anywhere good.

Yeah. If you listen, I, I love, uh, Dr. Satchin Panda and like when you look at his, um, circadian code, he is so clear about eating at the same times each day, getting up, going to like, just your body is meant to be in a rhythm.

Yes. Yes.

And the more you can do that. Yeah. Especially when things are dysregulated.

Yeah.

Get your body in a rhythm.

Well, and like, I don't wake, I don't need an alarm to wake up at 6 o'clock in the morning or 5 o'clock.

You have an alarm, I think, don't you? Built in. It's called Kingston.

It's called my kid. It's called my son. Yeah. Yeah. No, I beat him to the punch, but my, I just, I, my body knows 10 o'clock lights off. Yeah. You know, I'm reading before bed. Um, I always say treat your bedtime routine like it's a million dollar meeting. Don't let anyone interrupt it. Like unless it's your kid. I mean, I get that. Like if you got a kid, you, you know, 4-year-old, you gotta do what you gotta do. Yeah. But like don't let your partner interrupt you with something. Don't let Netflix hijack your million dollar meeting.

Don't. Definitely not Netflix. Yeah. Sometimes a puppy may do some, some puppy action.

A little puppy action.

Yeah. Yeah.

But like, my body is synced. Like, it knows the protein, when I'm gonna get my protein, when I'm gonna get my, my breakfast. You know, it knows when I'm working out. Like, it, it's, it's on a rhythm. And I will tell you, the more that you can honor that rhythm, your body is going to feel more alive. You're gonna feel like you have capacity. And I think that's what all of us want. We want capacity to show up for the people and the things that matter most to us. When that starts to get hijacked and we feel like we are untethered and we're not able to show up the way that we want, that's when it becomes a problem. That's when we start having issues. And I think that's when we start really being really hard on ourselves about what's going on with our bodies. So yes, get on the hormones, understand what's happening to your body, but please honor your body by maintaining those rhythms.

Yeah, I love the, the approach you're taking. And again, that was what I really wanted to bring out of this interview is that you are looking at this from a different lens with some different ideas. And so I think a lot of women out there are like, okay, another menopause book. I'm like, no, this is, this is the perimenopause book that will probably become the foundational book that will help you look beyond menopause to how do I really optimize my metabolic health so I can have an amazing— it's so weird to think of this like next couple of decades. I'm like, you know, it's weird to look at endpoints.

I know. You're like, don't, right? I think it's more so how do we want to function? You know, I don't want to have to ever need support to get off a toilet. No. You know, when I have a grandchild, I don't want to say I can't pick up this little sick baby off the floor because I can't get down on the floor and get back up. Or, you know, I'm 5'2", as we've stood together many times. And, you know, and I'm usually in tennis shoes on the flight. You know, when I've got my check-in, my bag that I'm bringing on the plane, people always want to help me because I'm short.

Do you do a snatch?

What do you do?

Oh, I snatch that sucker.

I'm vicious about it too. I'm like, let me show you how I train for this. Like, I do a little thruster and I pop that sucker up. And when I grab it, when we're leaving off the flight, like someone always tries to help me and I snatch it. I do a one-arm snatch. I snatch with 50-pound weights at home. And I do a one-arm snatch. I slowly bring it down and then put it on the floor.

Don't mess with Marisa.

I don't. Like, I may be little, but I'm little and mighty. I don't look like you can mess with me on the streets.

Well, the book's The Perimenopause Revolution. Yes. And you are also going to give everyone listening the Thriving in Perimenopause Survival Guide. Again, I wanna just make sure that everyone understands that perimenopause is not limited to perimenopause. Like, don't think, oh, I'm out of perimenopause, like I don't need this. This is all the stuff that works in perimenopause, postmenopause, like it works.

This is about future-proofing your health.

That's what this is about.

Yes, yes.

Future Proof Your Health. I'm going to put that at jjvirgin.com/perirevolution since we've done multiple podcasts, other things out there. What's in the Perimenopause Survival Guide?

Yep. Number 1 is a symptom tracker. So if you're trying to figure out what the heck is going on with you, it's there. All of the labs that I recommend, plus optimal reference ranges. So if your doctor is telling you, oh, everything looks normal, you can, you can reference against these reference ranges very easily.

Find a new doctor.

Yes. Or find a new doctor. Absolutely. But if you're like, maybe you kind of believe them, but you kind of, you wanna double check. I've got everything there to double check. And then the, a lot of the non-negotiables that I talked about today about optimizing your energy, um, and what you can do, all my favorite hacks, a little bit that we talked about today, but so much more, um, with recipes. So it's kind of like a, a little mini kit and caboodle. I want you to know that you can get started today.

Great. So the minute you, you sign in for that, you get it. You can get started while you're waiting for your book to show up. Exactly. The book is definitely one you want for your health success library. So again, that book is The Perimenopause Revolution. So grab that. And thank you again, Dr. Marisa, and congratulations on your 9th book baby.

Thank you. Thank you.

Thank you. Hey, I wanted to come back up and give you a couple key takeaways because there were so many things that came up during the interview, and I was like, oh, I want to give a link for that and for this and for that. So first of all, I created 10 Minutes to Win It, my exercise snack challenge that gives you what you can do each day, like Dr. Mariza was talking about. So we'll put a link to that in the show notes, and it is also at jjvirgin.com/snackchallenge. Now, if you are looking to do labs and you don't want to be faced with what happened to Mariza, where she went to the doctor who was like going, I don't have anything to offer you. I am all over Function Health. My buddy Dr. Mark Hyman founded this company, and it's the best deal I've seen out there— $499 a year for 2 rounds of comprehensive lab tests. When you first do it, you actually do 2 sets of tests right off the bat, like within 10 days of each other to validate, and then it's every 6 months, and it shows your improvement and what things you need to shift. And you can also take it over to your functional medicine practitioner for more support. So big fan of this. There's There's a huge waiting list, but I have the special code and link to jump the line. So we will put that in the show notes as well, as long with Dr. Marisa's Thriving in Perimenopause Survival Guide and a link, of course, to her new book, The Perimenopause Revolution. So be sure to grab all of that at jjvirgin.com/perirevolution and Honestly, I think with all the information out now, this literally— I know for me it is, and I don't think I'm a unicorn— that this can really be the best time of your life. And that's what we all want for each other and for you.