What Every Woman Needs to Know about Perimenopause & Hormone Therapy with Dr. Mariza Snyder

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Or maybe you don't even have the energy to exercise like you were. But you just feel like you should not be gaining this much weight. Tell me a little bit about that process and what we can do to help that as well.

Yeah. So I want women to know that this is very typical. And it is not your fault. It is your hormones. It is your hormones declining. So estrogen in particular. And we know progesterone plays a big role too. We just don't know enough because we haven't studied that hormone enough. But we do know that estrogen is a powerful metabolic hormone. And estrogen helps to keep insulin sensitivity. It helps to keep glucose and blood Sugar in check, it allows us to build muscle. So it's great at helping to support muscle protein synthesis and actually building that lean muscle. As estrogen begins to decline, we start to see a redistribution of fat. So the scale may not even move, but all of a sudden it goes from the hips and the thighs and the butt to the belly area and it starts to maybe become more visceral, visceral fat, which becomes very dangerous for us. Also. We know that, you know, again, insulin begins to shift. It's not as sensitive and that is also a fat storage hormone. So with estrogen significantly declining over perimenopause, we are going to see changes in your blood markers, in your metabolic markers, your body composition, your muscle. And if your muscle, which we know is your metabolic sink, your organ of longevity, you losing it isn't going to help your weight loss. It's going to unfortunately lead to more weight gain. And so that's a big player here. Also a decline in testosterone for some of us, it's also playing out in our motivation, our confidence, our getting to the gym. Right, that's going to be a big one. You know, we always think about, you know, testosterone isn't even FDA approved for women, but when we think about a reason to give it to women, it's usually for libido. You know, you have a low libido. But we know that it does so many other benefit, has so many other benefits, including cognitive benefits, muscle recovery and also building muscle. So testosterone may be dropping as well. And then we've got cortisol and I think we, yeah, you've probably had people talk about cortisol on the show and, and how it deregulates. And particularly in perimenopause, with life lifing and these other hormones shifting, we will also see deregulated cortisol levels which if again, if it's deregulated, it's also going to contribute to more fat storage. So there's a lot of hormones as they begin to deregulate that homeostasis of keeping our metabolism in a good place kind of just begins to falter. And we see that in the weight gain. So, yes, we're okay. A little bit more stress, you know, a little bit more mood changes, maybe we can't stand when our partner is chewing and breathing anymore. But when we care is when we start, start to notice that we are putting on weight or weight is moving on our body without permission. And I want you to know that, you know, how we trained and how we ate in our 20s, even in our early 30s just has to shift differently for us when we enter midlife.

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Customers so does hormone therapy help with this also? Like do you see once you get people in a good place with hormone therapy. Do you notice that they feel a.

Lot better with motivation?

Do they drop weight? What does that all look like when they get to a place that you feel they're in a good spot?

I would say absolutely yes to all of that. So if you're taking progesterone and you're sleeping better, you have more hot, deep, quality sleep, you're going to feel more energized in the morning. You take estrogen and she comes back on the scene and your mood's more stable, Serotonin and dopamine are firing again. You're feeling more motivated and more energized. And again, it's giving you that umph, that sparkle to get back into your routines that really were working for you. Also, it's making building lean muscle a little bit easier, if not a lot of bit easier. I'm not going to say that HRT is a weight. Are weight loss drugs. They're not, but man, they really turn the tide on how you're feeling and also how your body is changing and functioning at a physiological level. And then testosterone, which I am a big fan of as well. For a lot of women that talk about bringing the sparkle back, talk about feeling like you're back at your edge, that confidence, that motivation, you know, these hormones will get you back out the door again. They'll get you feeling more energized and more confident and self assured that you are beginning to implement those lifestyle strategies. And it feels a lot less, it feels more effortless. It feels like you're not having to work as hard. So that's what I think they really bring to the table also a physiological level. They are helping to protect your heart, they're helping to rebuild that bone, they're helping to build that muscle, the helping to support your brain. You're giving your brain the fuel that it needs to function. And so we can't not mention those because those are. We're talking about longevity here. We're talking about future proofing your health.

I have a couple of friends on it and they're always like, it's amazing. Just for motivation. Because truly that is, I think that's the main thing I've noticed is even I'll still go to the gym, but I'm dragging myself there and I don't want to. It's like I don't want to be there.

Even though I do want to be there.

Yeah, it's like nothing I could explain because my whole life I've always enjoyed my workouts. And now I'm like, let's get these over with.

That's so interesting.

So is this something that you, like, are women, once you get on, is this something you do for the rest.

Of your life and it kind of helps protect your.

I mean, just your mental health, your bones, all the things.

Yes. Okay. Once you're on them, you're going to want to stay on them, because once you get off of hrt, all of the protection that they were providing begins to disappear. You know, if. Because it's. If you're in menopause and you're not taking estradiol, your body's not making it anymore. Not. Not to the degree that you need to protect your bones and protect your brain and protect your heart. And so, you know, I would say write it until the wheels fall off. And the sooner we can get on it to mitigate symptoms and again, to create a better health span for you, the better. And so I think we're beginning to realize that it's not menopause that is the window of intervention with hrt. It is sooner than that. I don't understand why we feel like women should suffer needlessly and, you know, six years prior to menopause with all the symptoms, but because she's not in menopause yet, we're not going to recommend hrt. Like, that doesn't make any sense at all to me. And so it's. We have got a little bit of a ways to change that way of thinking, but we're getting there. And women are demanding it. They're just like, I'm not. I'm not going to suffer like this. I'm not going to feel like this. The amount of responsibilities that women have at this time of their lives, particularly midlife parents that are aging and struggling, they have a. A family member, a parent right now who had a really bad fall, and we're managing that at the moment. Even siblings that may be having a hard time, children, careers. I mean, the endless to do list of all the things that are going on. And then, not to mention now we're talking about you're struggling with symptoms and health issues that are popping up. Like, it's just a lot. And so we deserve all the tools in the toolbox, including hormone replacement therapy, so that we are feeling the most alive in our body, not only today, but 5, 10, 20 years out.

Okay, so what do you think of mental health and hormone therapy? Because I feel like from everything that I've experienced from women in their 40s and 50s, and conversations. It's kind of like we're not necessarily feeling. It feels like life feels like a lot. And you know, the depression and anxiety I feel like goes is a lot higher amongst the people that I know around that age. Do you feel, feel like this is something that can be controlled with that as well? It sounds like it is from the conversation, but have you noticed that that really does take a big turn for people when they start it?

Yeah. I mean, if we look at the Women's Health Initiative study that happened in the early 2000s, where the big scare was that we saw one extra case of breast cancer, it was relative risk, it was almost nothing. And we just got blown up, it got sensationalized and everyone was super scared of HRT. And so it's been 20 years since that study halted. And what we have seen is one, we're now down to only 6% of women on HRT. At the time it was around 40%. But the uptick in in medications for depression and anxiety have significantly soared in those 20 years. And we know that because women don't have adequate hormones in their body, particularly for their brain. Right. That they are being put on antidepressants and anti anxiety medication to manage a lot of the mental health issues that they're struggling with in perimenopause. Over 60% of women in midlife are going to struggle with mental health issues and that is not okay. And so with hormone replacement therapy and again, lifestyle, it's a yes. And it can really be so helpful. Again, if better sleep improves your mental health, that is such a big win. And if you can get better sleep with progesterone, then it's a full body yes. If bringing estrogen back on the scene before she falls off a cliff to help stabilize your mood and your brain, then why wouldn't we do it? Right? And we need to be looking at the types of lifestyle interventions, you know, things that I recommend again, besides getting that deep restful sleep, is going to be spending time with the women that matter to you, having safe friendships that you can connect with, having community. This is the loneliest time of a woman's life is in midlife where she is feeling a lot of shame about the symptoms that she's dealing with. She's feeling like she's not getting a lot of answers, so it must be her fault and she doesn't know where to turn to. She feels like she's on this journey by herself. I a little vulnerable share. For the past two and a half weeks, I have had A migraine every other day. And today would have been the migraine day. And I prayed two days ago that I would not have a migraine today. And in those days where I have migraines, not only do I still have to show up to some degree, but it is such an isolating and lonely experience because it's so painful and it's so just. It's so isolating. Even no one in my family understands what's going on. And obviously there are millions of women who have migraines all over the world, particularly in perimenopause hormone. There's a hormone connection that we don't fully understand. But even still, gosh, on the days where I can't function or I feel like I'm half of myself, it is just so lonely, and it's so hard to communicate that to everybody else. And so you can imagine a woman who's having leakage issues, issues, or she's having horrible hot flashes or migraines in this time. It can be so hard to know who to turn to or to have those really safe conversations. But it is the time. I know as uncomfortable as it is to double down on the. On the. On your friends, on the people that matter. I'd say probably one of the biggest longevity hacks that we can implement is spending time with the people that we love in real life. And if I was to double down on that longevity hack, I would say walking in nature with your besties. Like, be outside in nature with your girls, walking or hiking or doing whatever you love. Right? So community is so critical in this time where we're really struggling with our mental health. And then the other thing I think is really important is carving out time for you to take care of you. Whether that is, you know, breath work, or it's meditation or it's walking outside or it's listening to a really great fiction book or reading or being in your sauna. I don't know, whatever it may be, carving out time to do the things that you love. So the question I always pose to women is, do you know what you love? Like, what would you love today? What would you love this week? And the more clear that we can get about what we would love, we can start scheduling that into our lives. And I believe that when we're living in gratitude and enjoy and doing the things that we love, man, it changes our chemistry, it changes our sparkle. It really shifts us and motivates us to just tend to ourselves even more. And so in the mental health journey, I would say get really clear about what you need to prioritize, how to help yourself feel good. Along with the supplements and eating well and reducing inflammation and getting on hrt. I think all of that is something we need to consider and, and think of it as something that is very mission critical. We deserve to have good mental wellness and we deserve to feel amazing not only in our body, but also amazing mentally and emotionally.

This is so power powerful for making people feel hopeful. Because the, the conversations that I heard growing up is kind of like, this is what happens. You're getting older, your life's done. Just wait till you. I mean, the amount of times I heard just from random people all through the years of, first it was wait till you're 30. Then it's wait till you're 40. And it's like just waiting, you know, for your life to fall apart. Like, wait until you feel like you're falling apart. Just wait till you're 40. You're gonna feel depressed or overwhelmed or anxious or all of the things. And it's, it's so good to hear that there's so many things that we can do to help ourselves.

Absolutely. Again, we talked about signals earlier and how it's the opportunity to listen to our body and to say, you know, what my body's telling me, listen to me, tend to me, take care of me. Well, the beautiful thing about this journey, this midlife journey, is that, yes, it's a time of vulnerability. I'm not going to pretend like your body isn't changing, because it is. Absolutely. But it's an also. It's a beautiful time of opportunity. And in this opportunity, you get to decide the life that you're going to want to. That you want to live, that you're excited to live. You get to decide, like, what matters to you, what are your priorities, what are your boundaries, how do you want to live this part of your life and the second half of your life? Because that's what we're looking at. And so I think, you know, it's really about our mindset. Yes, we can get so caught up in how we're feeling. Yes, I can get caught up in how horrible my migraines are. But also I think it's my body telling me, like, hey, it's time to listen to me and take, take note in terms of what you need to do to feel more alive, what you need to let go of the obligations, the relationships, the habits that are not serving you. So I think that this is a beautiful time. I call it the reckoning, but it's really. It's. Everything is up for review. It's the opportunity to be like, you know what? I'm going to reevaluate how I've been living my life. I think I've been living it for everybody else. And my body's like, you know what? That, that time is over. We get to now live it for you. And when we step into that empowerment of saying, I am going to take care of me, I am going to get clear on what I love. I'm going to get clear on my non negotiables. Not only my health non negotiables, but the things that fuel me up. I think it's such a beautiful transformation and awakening. You know, perimenopause is not the beginning of the end. Perimenopause is stepping more into you, more empowered and more just more taking no from people and just stepping into your Yes.

I love that so much. I just want that whole clip every morning. But it's. It's so true. I think perimenopause can kind of serve you in the beginning, which, which I feel like if it's done, if me getting older has done anything, it is that there is like a. You have less tolerance for things that maybe you were tolerating in your 30s and now you're like, when your hormones go down, you're just like, actually, my actual ability to tolerate this is no longer here. So it is a super powerful time. I feel like when people in their 30s, like, ask about turning 40, I'm like, honestly, it's so much clarity on what you won't put up with anymore and how you want to live. And I do think we have this whole. I've been just talking a lot about it and thinking a lot about it because it's. It's very here and real for me right now of how do I want to live the second half of my life? It's. It's very like. I feel like the beginning is. Is like building, and you're building this career and all of a sudden you hit your 40s and you think, think maybe it was supposed to feel a certain way or look a certain way. And you never really thought how you want to live your late 40s, your.

50S, and your 60s.

Like, we never stop and do that. We just think of the building phase so much. But what happens when you've kind of built that, you know? And I don't think the conversation is. I don't think there's enough conversation around it yet, because I think that has Felt really lonely for me of like, how do I want to live this? I hate to say the back half, but the back half better than the first half.

Yes.

We're not talking about that.

No, no. And we need to be talking about it. You know, the average age for women is 81 and 76 for men. So we live longer than men. And yet, you know, if we're in default mode and we're not clear about how we want to live our life, we end up really struggling with our quality of life in that 25% of menopause. And that is not okay. But if we can get clear on how we want to live, we want to age powerfully, we want to. I don't want to negotiate with myself when I'm 70 about what I have energy capacity for. I don't want to have to get help to get off the toilet. I want to be able to shop, put my suitcase in the overhead compartment, you know what I'm saying? And so when we can get super clear about how we want to live our 50s, our 60s or 70s and beyond, then, you know, a lot of that maps out itself about the level of consistency that I am going to tend to me, the level of consistency that I'm going to spend time with, the people that nourish me and love me and that fill me up, that I'm going to get super consistent about honoring my body so that I can do the things that I want to do in my 70s and beyond. And you have, if you're looking for permission today, you have full out permission to do that to get that clarity. And I feel like that first question really is, is what would you love? What would you love? You know, and start thinking about your future self. What, what is your future self doing? What kind of activities? Where is she traveling? How is she nourishing her body? How is she moving her body? That feels really good, you know, that you're excited about. What is she saying no to, what is she saying yes to? You know, who is she bringing on to support her? Who's her support system? And you know, how does she want to live her day to day? And these are very rich questions that we can get a lot of clarity on. And once we have that clarity and honestly, again, you could use ChatGPT, you know, to get some of this clarity. You can honestly reverse engineer the roadmap on how you want to live.

I have loved this whole conversation. I want to answer for anybody who's, who's thinking about this right now. Is there an Age that's too early, Is there an age that's too late to start?

Two stars.

Hrt.

Hrt. Great question. That is such a great question. I would say that on average, and again, we use hormones for women who need support with fertility. So I think it depends. It's a different kind of conversation there. But I would say you usually, you know, having the HRT conversation probably at 40, just start having the conversation based on your symptoms. Now if you're not symptomatic and you're doing great, probably don't need them. But if you're noticing some major shifts and changes and your quality of life is shifting and not in a great way, then start having that conversation. Even if it's just bringing in progesterone, you know, just to help you kind of ease out some of those PMS symptoms or ease out the mood changes and the sleep issues. I mean, that all gets to get addressed. You get to feel good in early perimenopause with a little bit of progesterone. And then right now, based even on the Women's Health Initiative study, we know that the kind of, the, the best window of opportunity is 10 years around menopause. And again, I think earlier is better. But between, let's say menopause is 51 years old. Between 51 and 61 years old, we really see no contraindication. But even, even 10 to 20 years out, we don't really see a lot of contraindication. So if a woman is 62 or 68, it's still a worthy conversation. We should be looking at your cardiovascular numbers. We should be scanning your carotid arteries for any plaquing, and we do our due diligence, do the screenings that are necessary for, for a woman to decide if she's still a great candidate for HRT. And then it's only until a woman is 20 years out do we see some, some issues, some contraindications, particularly around your cardiovascular health, around stroke and heart attack. And so again, by the time you're 70, hopefully, you know, you're on HRT. But there are still providers that if a woman in her 70s has beautiful arteries and low inflammation and no diabetes, that it's still a potential not only a conversation, but that she can get on it.

Wow, Interesting.

Okay.

What do you want to leave everyone?

I want to leave everyone with that my deepest desire is for you to feel alive in your body, that at any age you deserve to feel that and that you deserve a wellness team to support you on this journey. And that Right now, I know that you're hearing a lot of information, a lot of content around perimenopause. And the reason for that is that it is truly a movie movement, that it's truly a rally cry, that we are tired of being dismissed, we're tired of being ignored, and that we are demanding better for ourselves. And so I want you to know if you've been feeling a shift in a change and you're thinking, gosh, maybe I should investigate this and get some support. Yes, please. And you deserve it. Don't settle for anything less than you feeling amazing. And that is really what I want to share today, is that there are tools and there are resources out there and that if something feels not right, you are always the CEO of your health. Trust that intuition deeply.

So good. I loved, love, love this conversation, you guys. We can grab her book wherever books are sold.

Wherever books are sold.

We're gonna put that in the show notes. If you want to grab her book, it is called the Perimenopause of Revolution and you want to go get it. Because if you love this conversation, she goes so in depth into everything. And when you know and you have the knowledge, you can really. I feel like that's really going to help people walk in and ask for what they need.

Yeah, exactly. That's the goal. It is a revolution, it is a movement. There's so many goodies that I built alongside of this book to get you started so that you feel like you have everything that you need to, to feel again, to feel amazing.

And you have, you have a gift for them.

Yes, I have a gift. So also I have an amazing toolkit. Okay. So while you're waiting for your book to show up, right. This toolkit will walk you through. It has a symptom tracker, it has all the labs, reference ranges, everything you need, and all of my non negotiable lifestyle habits to move the needle in you, feeling amazing in your body. And you just, you know, as you're reading this and going through this, you just pick the thing that you're like, okay, this is the one thing I'm gonna do. Because even one change, one shift, one little mini habit, whether that's a couple squats after dinner or walking outside in the morning to get sunlight, or it is, you know, taking a moment, just having your own moment with yourself or with your friend. Like these are simple things. These shifts can add up over time to make profound changes. So it doesn't have to be complicated. And there's always a beautiful, beautiful place to start where you are feeling like you are winning. Amen.

Well, I'm so grateful for you. Thank you so much for coming on today.

Thanks, honey.

And like I said, everything is in the show notes for you guys. So grateful for all of you. Make sure you share this. Share this with a friend that maybe you feel has been struggling because I just think this conversation needs to get out to everyone that we know and thank you guys for tuning in and we will see you next week.

Bye, everyone.

Sa.