26. Dr. Carrie Jones: What No One Tells You About Woman's Hormones and Health

How much does the role of our gut health play during menopause and beyond? For myself, it's like just waking up overnight, and all of a sudden, my digestion is different. For a lot of people I work with, like, our bowel movements are different. How we digest food is different. Our cravings are different.

So estrogen and progesterone both play a role positively, generally positively, in your gut health. Unfortunately, as our estrogens and progesterone decline, our gates become rickety and they start to fall off the hinge.

We can blame our hormones for the anxiety and the depression and the mood swings. Obvious. But we also have to recognize that it's the microbes that are calling the shots, or lack of. We need to diversify those microbes first. This isn't about going on a hardcore restrictive diet. We just need to heal and nourish the gut microbiome. And then, of course, what happens? Anxiety dissipates just a little bit. The moods aren't going from 0 to 100. All right, beautiful. Dr. Carrie Jones, welcome to Rooted in Wellness. Oh, my gosh.

Thank you so much for having me.

This is the highlight of my week. Hormones are everywhere in social media. I'm in denial completely that I'm going through perimenopause. We'll get to that. But I just want to call out the fact that when everything feels like doom and gloom when we're talking about women's health right now, I can go to your page. And I find reprieve. There is humor, there's lightness, there's education. You make everything so tangible. So I'm so excited to have you here just for that. Okay. I just wanted to say that right off the get go, you're amazing.

Love it. I'll take it. I find everything funny, even inappropriately funny, and so I just have to weave it through.

I love it. Okay, so before we get going, this podcast is all about ancient wisdom in our modern world and how we can become more rooted. And it's rooted in our health, but also in ourself and in our life, and also our inner wisdom to heal. So I want to start off the episode by asking you, what are three things that help you feel really rooted in your health and in your life? And. And why?

I would say the very first thing that helps me feel rooted are I bookend my days. So the in between of my day can be very chaotic, depending what I'm doing or where I'm going or what's happening. So the first thing would be my morning Routine, which is around my dog and making my tea and my journaling. And then at the end of the day, just the opposite. It's still my dog, my dog and my husband. And then making my. And then going, winding down for bed. So that's probably the first thing. The second thing would be, and rooted in wellness would be, I think, probably wanting, even though I live in the Pacific Northwest, wanting to see sunlight every day, wanting to get that full spectrum light every day, however that looks, even on the rainy days, because I have a dog, you will find me outside walking and just getting that fresh air, getting my steps in, getting the circadian rhythm balanced has been a huge thing for me. And then. Right. Like we need that. Yeah, I joke all the time that we are essentially houseplants. So we need fresh air, fresh lights, good music, a nice windowsill. We need all those things. And then honestly, within my morning routine of journaling, one of the first things I do are gratitude. And it's just to remind me one to surrender. I read the surrender experiment at the right time of my life and it completely opened up a lot for where I was at and what I was doing. And so journaling about surrendering and then gratitude in the morning has been huge. Now, I may not always remember it through the whole day, but I do try to start out my day rooted.

In gratitude and surrendering intention is what matters. Yeah, I love asking this question, especially for, you know, doctors like yourself who are practitioners in the space in a world that's very complicated. And, you know, I think that because of biohacking and we're making health look very complicated. But, but when I ask this question, they're like these foundational truths to health and to healing. And most people respond with these very inherent things that just make them feel good. And I'm such a fan of all of those. Now on the flip side, we're going to flip that question. You might work with some people like I do, who they have these rituals in their life that they might not even notice are uprooting them. So, you know, going to that boot camp class first thing in the morning might uproot them. Staying up too late, being on their screens, whatever it is. But do you notice are there two or three things that cause you to feel uprooted? And can you kind of course correct when you notice that they come up?

I would say the big one, just because of what I do, is travel. So really trying to nail down traveling. And I know this can stress a lot of people out. So traveling, time zones you know, even just one or two. But of course, if you're doing big time zones and really working to get back in the circadian rhythm, making sure I'm sleepy, making sure I'm eating healthy, you know, not drinking alcohol, staying hydrated, that can be a big one. Speaking of hydration, hydration is a big one for me. Sometimes I get down at the computer, I'm working, working, working hours have gone by and I haven't had a single drop of water. And I think, oh my gosh, I'm a dead house plant. I need to water myself. And even just something like that, I can feel really uprooted in my day and that hour in that time. And so between travel, water and then nutritional choices, if you. If I traveling or holidays or if I feel like I've gotten off course for too long in the things I'm choosing to eat, that will definitely. I'm like, oh my gosh, I cannot wait. I'm going back or course correcting tomorrow. And it's funny how when we were a lot younger, we could do these things no problem. Not a big. For the most part. And now my husband and I were joking last night and we got into bed at like 9:13 and 9:13 and we were so excited. I said, it's not even 9:30 yet, it's 9:13.

That's a good night.

It made me. It made me so happy. I got nine hours of sleep, woke up feeling fantastic, and I'll take it.

Yeah, it's interesting, like, thank you for answering that, because I'm noticing that us as women, there's specific things where if we know that we do them, we feel optimized. And there's also these, like, crazy memes that are going around on social media. Like, I got my water, I woke up early, I got my circadian rhythm, I hydrated, I did this. And it's like, oh my God, have we complicated health so much? But I think, you know, really owning in on two or three specific things that just help you feel optimal or rooted every day, it's okay. We can't sweat the small stuff afterwards if we know we're at least doing those two or three things. So I'm with you on that. So on that, you know, I'm a big believer. And to go back to, like, the doom and gloom that's happening on social media right now. The reason why I'm in denial about perimenopause is that I feel like there's nothing being reflected that I'm looking forward to, like, where's the rite of passage? Where's the wisdom? Where the women in my circle are saying, oh, my God, get ready for what's to come. It's joyful, despite some of the physiological changes that are gonna happen. And, like, for women, where's the crown?

Right? Like, why don't we get a watch? Yeah, something. Where's our prize?

But, like, our hormones are what makes us women. Like, it's our freaking superpower. And, yes, most of us are here struggling with them. We get angry at them, we're blaming them, we're hating on them every single month. And then there's also, on the other side, this lack of education or clarity around hormones. Like, we don't even understand physiologically what's happening to us, further amplifying the feelings of frustration or negativity. And, you know, this is so true for me right now, and I know so many other women, you as well, you share about this. So let's just start with this specific transition. Let's start with the basics when it comes to perimenopause. What is perimenopause and how does it differ from menopause?

It's really interesting because a lot of women are hitting this time in their life, and they didn't even understand their cycling years, their reproductive years, as we call them, let alone what's happening as they make this transition. So we are basically. It's reverse puberty.

We.

If we remember all the chaos and all the things that occurred to us during puberty, all the signals and all of the, you know, wires that had to get connected when we went through puberty, all of the axes that had to get turned on so we could get our period and we could grow and we could do all these things. We're actually reversing out of that. So we've gone through puberty the first time and now buckle up because we are reversing out and changing as we go through perimenopause. So perimenopause, the classic definition is it's a transitional period that lasts six to 10 years. It generally. Generally hits between our late 30s and our 50s, depending. And it's where we start to back out of our period. It's where we start to back out of what we did through puberty, so to speak. So as a result, if you still get a period, meaning if you still have a uterus, you haven't had a hysterectomy, or maybe you don't have an iud, you may start to notice these subtle changes that soon become not so sad, subtle, such as fatigue, such as maybe some weight gain since maybe some changes in your cycle, maybe worse pms. Your cycle's getting shorter. Your cycle's getting longer. You may notice headaches. You may notice changes in your skin and your hair. You may notice brain fog trying to recall something, your neighbor's name, who you've lived next to forever. All of a sudden you're like, why can't I remember their name? You go to open a tab on your computer, open the tab, and you don't know what you were going to type in. Like, you just have to like, what was I just going to do? And you don't understand what's happening because nobody has coached us through this. Nobody has educated us at large in the media very well. Our mom didn't talk about it much. Our grandmothers didn't talk about it very much. And so we're chalking it up to stress. We're chalking it up to kids. We're chalking it up to our job. We're chalking it up to something else. And while it's true it might be something else, it may be a thyroid issue or low iron or stress. It's also, when you check all those symptoms off, it falls under the umbrella of perimenopause. Our hormones are changing. So our hormones that should have been consistent, like a very specific roller coaster that you went on over and over and over again, month after month, your roller coaster is now changing. So sometimes you have more loop de loos than you did last month. Sometimes the roller coaster is flat. Sometimes the roller coaster is just, like, out of control. Huge, huge, big rises and falls, and then it's flat again. And we kind of get caught in this for six to 10 years until eventually we become menopausal, which is on the 12th month of no period, no cycle, we're considered menopausal. Once we hit the 13th month, we are postmenopausal for the rest of our life, the rest of our decades. So it is a wild experience that we're going to go through for perimenopause for a lot of women.

Do you think it used to be as wild for our ancestors?

I do, I do, because they've written about it. I mean, think of, like, hysterectomy came from hysteria, right? Think of. They coined the idea of menopause in the 1800s. They didn't understand it, and they weren't quite sure what a hormone was or that it was related to hormones, so to speak. But they knew at Some point that women hit a certain age and then, you know, chaos ensued for a lot of them. And so I do think, I do think that it's been going on for a while with the hormone changes depending on, you know, some people view. Well, it wasn't as bad because they weren't exposed to many, as many toxicants, exposure, sugar, whatever you want to call it. Except again, I think when I look back at my grandmother, for my grandmother's, for example, I know they didn't have an easy time. They didn't know how to express it and they didn't know what it was. But I knew it wasn't easy. And I know, again, just based on hysteria and women, you know, becoming hysterical and hysterectomy, a lot of it was hormone driven. We just, we just didn't know it.

We don't have the education, we didn't have the understanding of what they were. Yeah. Feels like hysteria sometimes. It does, yes. We're making light out of something. I know. So let's go through then, what's exactly happening to a woman during perimenopause? You mentioned some of the symptoms, but like, what are the hormonal shifts?

Yes.

Big.

Do you have two big ones? We have two big hormones. One are the. Are progesterone and the other are estrogens. And so when you are having a menstrual cycle in the middle, you ovulate, which is where you release the egg. And after you release the egg, you make progesterone that first starts to decline. Once you get in your late 30s, into your 40s, you may not produce or pump out as much progesterone as you used to. Progesterone is called progesterone because it's our progestation hormone. So it's helpful for fertility whether you want to get pregnant or not. So it helps make your periods easier, helps make your periods lighter, takes away cramps, things like that. But it's also exceptionally calming to the brain. So it's great for anxiety, it's great for anger, it's great if you're impatient. It's great for sleep. Progesterone really helps all those things. So that's the first thing that starts to slowly decline. Women will notice their periods are worse, their PMS is worse, their mood swings are worse, their sleep is worse because that progesterone is going down. Now at the same time, as we move through this transition, estrogen starts to go wild. She's really starting to feel herself. She's up, she's Down. She's all over the place because the signal from the brain is trying to communicate down to the ovaries. And the ovaries aren't really listening as well anymore because they're trying to shut down. They're, they're. They're a factory that's starting to, you know, close out shop, shut the lights off. So because estrogen is sometimes up, sometimes down, that's where she feels these wild swings in the estrogenic symptoms. And then eventually she starts skipping periods, which the usual first freak out is, oh, my God, am I pregnant? Because you skip your first period ever, and that's not like you. And then you skip two, and then you skip three, and eventually you'll skip 12 in a row. And that's when you now have really low estrogen for long periods of time. And when you are deficient or low in estrogen like that, the estrogenic symptoms are the hot flashes, the night sweats, contributes to depression or anxiety, the weight gain, immune system issues, itchy ears, phantom smells, vision changes, the vaginal symptoms, the musculoskeletal joint pain, muscle pains. This can all occur when our estrogen goes down. So we kind of get this 1, 2 effect. First progesterone, then eventually estrogen.

So it's wild. Then you could go through this in your 30s. You could be in the early stages of perimenopause. You can still get pregnant during that time also.

Yep.

And experience these symptoms at the same time.

And a lot of women do. A lot of women tell me that they are 42, having children and perimenopausal. They feel all the symptoms and pregnant. So then it's a double whammy. They have the pregnancy symptoms or postpartum symptoms layered in with the perimenopausal symptoms. It's not uncommon at all.

So you've been in this line of expertise for a while. I feel from my perspective, we're seeing perimenopause and menopause hit at an earlier age. Do you agree with that?

What's interesting is I think once you layer in the other aspects of health, which have quite honestly feel like they've been declining, so people's sleep, people's stress, people's infections. We've been exposed to our nutritional values, our nutritional, you know, content that we have available to us, I think when we layer that in, it does make a lot of women's perimenopause worse. I mean, if we think of the amount of stress a lot of people incurred, like through Covid Is an example. I had a lot of patients who said, man, I thought I was doing fine. And then you layered all that stress in. Or the fact that I got it and got very sick and then more stress. Like, my perimenopause just went from okay and manageable to not okay and not manageable. And the same goes for everything else in our life. So we're at a. We're in a time period where I think a lot of people can agree, like, the world kind of feels very chaotic, very unhealthy. And then you layer in a woman who's going through perimenopause, and it can definitely feel like it's hitting a lot sooner.

Yeah, I feel like, for me, the instigation was twofold. So one, stress. I had mold exposure a long time ago, and then that was just like the downfall of everything. And then now I notice, you know, going through a stressful physiological time or just like an increase in, you know, having to show up for work and show up for family and just life itself. It feels like a lot. But then I find myself questioning, well, is it a lot or is it perimenopause that's making it feel like so much more? Right.

The answer is yes to both.

It is a lot easier then.

I was reading this really interesting research article yesterday about a brain hormone called gaba, which is G, A, B A for everyone listening. GABA is our main inhibitory neurotransmitter. It's very calming. It's the brake system to all the things in our brain. And this specific article called out perimenopausal women or postmenopausal women, and said, when you go through this transition, you are losing progesterone. And progesterone can play a big role in gaba. So you're losing your brake system even more than your male counterparts. This means you're more susceptible to the bad effects of stress. You don't have a break system. You don't have the brake system to even your, like, the filter on your mouth. Right. A lot of women are like, nope, don't have that anymore. That's gone. No break there. And so we feel we're quicker to feel less calm. We're quicker to feel impatient, we're quicker to feel angry. We're quicker to feel stressed out and activated in that way. Because the brake system is, Isn't. Is pressed upon, as we used to when we were younger. And the fact that these authors actually pointed that out in this article of, like, you're not making this up, you're truly not getting the brake system that you used to have. Made me feel so much better and also so mad at our physiology.

Like, why?

Like, who designed this?

We need a redo. We need a. Yeah, we need an updated model.

We need to upgrade. Our phones, get upgraded. I'd like a iOS now.

You know, to get an upgrade. Do you take GABA before you go to bed?

I take progesterone before I go to bed. So one of the things when you. When you swallow progesterone. So it does have to be oral of some sort. When you swallow progesterone, when it breaks down, one of the big breakdown products, stimulates the brain to. For gaba. And so I do half the month, take progesterone.

Okay.

And there are other supports, too. You can take gaba. Now, GABA is a big molecule, is an. Is a neurotransmitter. So in theory, GABA should not cross up into the brain. GABA as a supplement should not cross into the brain. But for some people, they notice great effects taking GABA as a supplement. And also the stomach nervous system, the nervous system you have down there, called the enteric nervous system, talks to your central nervous system. So if you swallow gaba, then your nervous system down there, through a little nerve called the vagus nerve, talks to the brain and can help support GABA as well.

There's a great supplement. It's GABA with L Theanine that I find is like a game changer at night before I go to bed. Yeah, progesterone.

And L Theanine is a stimulator for GABA as well.

Yeah. So let's throw some beauty on that. So, you know, you get to that. That point where you feel there's no filter anymore. It feels like you're speaking up a little bit more. And a lot of that can feel like anger or rage or resentment. And something that I've been going through this past week just trying to, like, understand my symptoms, journaling on them a little bit more. I also feel the sense of. Of liberation. Like, there's this woman inside me who's wise, and she's ready to come out, and she's ready to just, like, tear off all this shit that's bothering her. And, like, you know, the chains that she's been attached to, she's just, like, ready to come out. And so when we put the hormonal lens on that, it's like, oh, my God, it makes so much sense. It doesn't have to all be, you know, Upsetting or fear mongering, it actually can be pretty beautiful. At the same time, it can be.

Amazing when I joke about the break being off our mouth and having no filter. The amount of women who say, yeah, but I need that, like, I want that. I have never had that before. Or my people pleaser friends who say, I don't people please anymore. I'm done with that. I say, no, I don't care. No is a full sentence. I'm stronger. I set boundaries. And if you're not happy with it, I really don't care. And the great thing is we really don't care that our give a damn is out is gone. We have zero of that left. And we also, just as you said, now have decades of wisdom over somebody much younger, even our much younger self. So we become this even cooler version of ourself. We were cool and now we're cooler because we're quick to set boundaries, we're quick to say no, we're quick to be mouthy, we're quick to not put up with stuff. And we just know, we just inherently no because we have the wisdom behind us.

Oh my God. Yes. Yeah, so I'm literally, I'm trying to just flip the lens of like, oh my God, it's happening again to. Oh, she just wants to be heard. She wants to come out. Okay, there she is. Let's let like, let's let her out.

Yes.

From the symptoms that you've gone over so far when you're working with your patients, are there perimenopause symptoms that just aren't normal? So like for example, I sent you the SOS on frozen shoulder. Are there things that should, shouldn't be happening? We're like, you know what? This isn't normal. This can be course corrected.

So, well, thankfully, like pretty much all of it can be course corrected, which is great. So we're talking about all of these symptoms. But what in the, in the olden days, so prior to the last couple of years, when education wasn't there, a lot of women were told, welcome to this stage of life. Good luck. Like, there's nothing we can do. Or here's an antidepressant. It sounds like you're going crazy, you know, like best, like you're. Everyone just pushes through it. Whereas now we have so, so many ways to support all our foundations to work with, like our sleep, our eat, our exercise, our stress management, our hormones, our nutrition, our nutrients, et cetera. That wasn't widely offered before. So if somebody comes to me and says, I'M having these symptoms. Even frozen shoulder. It's like, okay, there's actually not. There's a lot you can do. It just wasn't being broadcast to the masses like it is now. And I think it has a lot more broadcasting to go, of course. But I'm loving the fact that a lot of medicine is catching up and getting quick perimenopause and menopause education. Now, I will say one of the big key, maybe symptoms that I don't. I mean, I don't. I don't like any of them for women, but it's the excessive bleeding. So just, you know, like, let's get real doctory for just a second. I have had women that are like, I just bleed and bleed and bleed and bleed. It will not shut off. And there is, again, a lot you can do, but I want you to do it. Some of our perimenopausal symptoms, we just deal with. Your ears itch all the time because the estrogen changes. Like, we just, you know, we do what we can. Or you're more agitated, you have less patience, or you're taking or trying things for your sleep. Not so much life or death. But when you're bleeding, when you notice that your periods are just so ungodly heavy, so many clots. Definitely get that evaluated. Don't feel like you just need to suck it up and get through two or three weeks of bleeding, because that is not good. And that's one of those symptoms I really want to point out, because it is common in perimenopause for women to have these prolonged bleeds. It is not good. Let's go get. Go get evaluated asap. Don't wait. Don't think. You just need to wait it out.

Yeah, there's a lot of suffering, right? I say if there's too much suffering, then that's your indicator that something else has to be taken into account. I can't tell you over the past year alone. So as doctors are kind of stepping into more awareness around this, the amount of women in their 40s who've come my way where their doctors have recommended antidepressants first or sleeping pills first, rather than getting to the root cause. And I think it's also through, like, lack of awareness on how to properly test for these women or for some of these women who've had an irregular cycle their entire life, it's like, well, this is. I don't even know what's normal because it's always been kind of irregular. Right? So no suffering. Let's Just leave that as like, no.

Yes. And it's okay to either add to your medical team or subtract the unhelpful parts of your medical team. So for example, my OBGYN actually said the words to me, I don't do hormones. I went, I'm sorry, what? You're an obgyn? She said, no, I don't do hormones. I mean, if you want the birth control pill, I can do that. If you want an IUD inserted. But beyond that, I don't do hormones. And I. Okay, thank you for being up front. But imagine all the number of perimenopausal or fully postmenopausal women that have probably gone to her and said, I'm struggling. What do I do to be told, oh, I don't do hormones. So in that case, if you like your practitioner, maybe they're a great ob, they give the best paps ever. Keep them for that. But then it's okay to add to your medical team and find somebody who will hear you out, who does understand these hormones and can work with you.

I love that I'm such an advocate. One of the first questions that I ask my clients is, who's part of your care team? Like, who do you actually have in your corner? Who's looking out for you, who's not prescriptive, or if they are prescriptive, helping you understand why and how to get unprescripted. Right. If that's even possible. So that's great advice because I think that there's a lot of fear or lack of awareness or availability on where to go, you know, shopping around for doctors. I'm Canadian, so this is like a completely different ball game coming to the US and looking for doctors here.

Right.

But yeah, it's not always easy, but I think it's something that is so worth it. So for these doctors then, like, are there any myths around perimenopause that need to be debunked?

Oh my gosh. So one of the biggest myths that I think everybody was ingrained for so long came out because of the Women's Health Initiative study, which is the one that made all the headlines two decades ago. Hormones cause cancer. You have to stop all hormones that these, those cause cancer. And while not everybody is a candidate for hormones, I'm not saying that the direction reason for breast cancer is your estrogen has been debunked. The estrogen single handedly is not cause of the breast cancer. And in fact, in the study in the Women's Health Initiative, the estrogen that they used, that section of the study actually didn't cause any increase in breast cancer at all. But that didn't make the news. What made the news is hormones cause cancer. The combination of using the synthetic estrogen with the synthetic progesterone called the progestin, that's what had the slight increase in breast cancer. And so, but everyone's takeaway for the last two decades was, oh, I can't do hormones that causes cancer. I'm like, ooh, that thankfully has come. We're not quite 180, but we're getting there. As far as what people understand and what we're seeing in social media and the subsequent research and the books that have come out in support of, you know, helping your hormones and how to help your hormones has been excellent. But that's probably the first myth to bust is that estrogen single handedly does not cause cancer. Cancer is way more complicated. Absolutely. Than that.

Just that there's so much stigma around it though. Also, like a lot of women that I speak with are like, no, no, no, I'm going to hold off as long as possible to even go down that route or consider it. I'm not there because of the fear that still exists. So yeah, we still have a little bit more way to go.

Yeah. And actually to talk about the stigma, I love that you said that, you know, there's, there's no medal for waiting. Like, and I mean like an award, like you don't get an award for holding off hormones. If, if you are a candidate for hormones and you want to go on hormones, not everybody does. And I understand and respect that, but at least should be an option for you. But if you're like, oh gosh, no, I, I, I'm going to hold off as long as possible, but eventually I'll go on, I'll wait till I'm in my 50s or my 60s. There's no award for that. And in fact what we're seeing is the longer you wait and the less hormone you have, it's totally possible, like to the more detriment that it is.

Absolutely, yeah.

If you're just waiting and waiting and waiting, that means less and less progesterone, less and less estrogen, that could mean more and more symptoms, less and less sleep, potentially increased risk of certain chronic diseases, heart disease and in, in diabetes or osteoporosis, you know, things I'm actively trying to prevent with my patients.

Right, exactly.

So just keep in mind I completely understand women's concern because the concern has been there, unfortunately for, for decades at this point. But also, don't miss out. If you're a candidate, you want it, don't miss out.

But this is part of our wisdom, right? Like women think ahead, we are prepared, we think about the future. How do we, how do we make sure that we're set up for success? This is one of those areas where we have ownership ourselves. Do you want to hear something crazy?

Yes.

The last thing I ever expected. So I'm with my incredible acupuncturist. He is a traditional Chinese medicine doctor and he said to me, Mona, he's like, look, we can go down this route of acupuncture. I can put you on these herbal formulations that will support your body in boosting estrogen. I was shocked to hear him say that. That would be incredibly irresponsible for him as a doctor. And if we're going to change the trajectory of women's health and how they move through perimenopause in the future, he would even suggest putting every woman on estrogen in their 40s. Like give them some relief, give them an upper hand in going into this era as a precursor. Like help them be prepared. Isn't that crazy?

I, I, I love it. I love it. And I love that it's part of his plan, right? Like he's still pro acupuncture, he's still pro herbs, he's still pro all the foundations which all women need to be. Hormone replacement or hormone therapy doesn't single handedly save the day, but it can be a huge player for a lot of women. A lot of women. And there's a, please remember when it comes to this transition, there is a spectrum. If we think of the bell curve, you know, there are women at one end who sail through no symptoms, feel great, not a thing. And it seems to run in their family. God bless them, they're God's favorite. And then there are the people at the other end who are just absolutely in it, struggling in it. Like absolutely. They're crying in my comments in the DMs and your comments and DMs and I have so much empathy for them. And then the majority of women are somewhere in that middle. Like some things are working, some of the foundations they're working on. Hormones have played a massive positive role for a lot of them. Sometimes the hormones are too much or a different route and it's caused side effects. But I'd say the majority of women are right there in the middle of that nifty little bell curve. And just to Be able to have the option for hormones, for a practitioner to say, you know, you're at that age, you're having these symptoms, let's consider hormones. However that looks, that is going to be the next big step in medicine that I'm looking for. Hallelujah.

Let's just get ahead of it. No more suffering, More suffering. So what about some other lifestyle changes or preparations that women can go through? If they're not going to go down that route, what can they do to really support their bodies through this transition and even add on to that? Like for you, you know so much about this world, are there any holistic remedies that you found with your patients to be like supportive or helpful?

Yeah, absolutely. So we talk about the foundations and this is the time in life, if you didn't in your 30s, now, in your 40s, or even if you're listening to this in your 50s, like now, you need to double down. Now you need to dial in. And that's all the things which can make it a little overwhelming and hard. When you're trying to get good sleep, when you're trying to eat enough protein, when you're trying to get enough fiber, diversify, you know, get all the vegetables and fruits, when you're trying to drink enough water, it's it. I under, I joke at the, I laugh at the memes that are like this. It feels like a full time job just trying to, you know, do the foundations in this age, in life. But what's sad is they didn't teach us these earlier. Imagine if we'd been taught these foundations as teenagers in our 20s, then it would be everyday nature. Like it's everyday nature for me. It's probably everyday nature for you, but we've been doing it a long time. Whereas if you just come into this at 45 going protein, oh yeah, I had to eat more protein. Like I have to lift heavy. I don't even, I don't lift anything. What do you, what does that mean, to lift heavy? I totally get it. And so these foundations, as I said, it's the sleep, it's the nutrition, it's the exercise, it's the stress management as best you can, it's the hydration, it's even the looking at your environment and the environmental toxicants, it's the fragrance and the plastics and the parabens, it's the phthalates, it's all that you're layering with your makeup, your skincare, your detergent, what you clean your house with, your clothing, candles, everything. These things layer in and can disrupt or make for a rougher perimenopause. So when I see just observationally, myself, my friends, when I read all the hundreds and hundreds and hundreds of comments all through social media, thousands of comments of women who are doing a lot of these things, I notice that their perimenopause is, quote, easier. It doesn't mean it's perfect. It doesn't mean they don't need hormones per se. But I definitely have a lot of women that are like, oh, I changed a lot in my life and my perimenopause is so, so much easier because you're taking all that pressure off in the body. So I want at least get that part out there that it can. Nailing these foundations can be big. I'm aware. But also we should have been taught them a long time ago and they can be huge.

Oh my gosh. Yeah. I only got a full grasp and understanding about my cycle when I got pregnant because I had to. And then at that point, when you become pregnant, you're so, so attuned to what is healthy, what is not. Your environment, the toxins, my internal environment, what are my thoughts, how am I speaking to myself? Like, you're just honed in on treating your body like this vessel. That's magnificent, right? Yeah. And so now it's like, shit, I just caught up to this and now we're changing again. Right? It's, it's a lot. So for those women, then, when you're noticing they're lowering their toxic burden, they're aware of their environment, Are they do. Are they also adding in, like, are these people who are adding in specific herbal formulas, are they taking out caffeine, are they adding in herbal teas?

They can't. A lot of them can. I mean, yes to all of it. And it depends on the person. What I do, I want to point out, is that you maybe you've seen on social media where there is a spectrum of health and a lot of it falls on budget, of course. But I will have women say to me, should I get a sauna? Should I spend thousands of dollars and buy a sauna or should I buy a cold plunge? I'm like, you can, except you just told me you're not sleeping and you're having a glass of wine every night and you know, doom scrolling on your phone. Let's start there. That's actually going to save you a lot of money and be better for your health than doing those things and then trying to cold plunge or trying to sauna. And so, again, it's going like when we're evaluating, when you're. Be careful of the shiny objects that you see on social media. Make sure you have the foundations dialed in. Once you have those, then you can expand up from there. Now, as far as supplements goes, Yes. I find a couple of things. One, a big one that I'm a big fan of, are like, omega 3s. I don't eat fish. I don't like fish. I wasn't raised to like fish. And so I understand nutrition and try to eat through diet. I'm not going to eat a whole lot. I can handle, like, a little bit of salmon. Sometimes it's just a preference. It's nothing. There's nothing wrong with fish. So I take extra Omega 3s because we've been, you know, we know Omega 3s can play a role, of course, in our brain and inflammation and our skin and all. All of this beneficial part of our body. And I don't eat. I don't eat it. So I actually added Omega 3s. And I find that a lot of women do well when they add in omega 3 fatty acids also. In fact, a good friend of mine, Dr. Kate Kresge, said, you know, there's a study on humans that when they took 3 grams, 3 grams of fish oil, it made them not angry. And I was like.

I'm going to be adding a gram.

Yeah, okay. It can also lower triglycerides in some people. And of course, cholesterol tends to go way up in this transition, menopausal transition. So Omega 3s is a big one. The other thing that I've been doing a lot, because I'm reading this research on the change of our hormones are changing our gut microbiome for the worse, unfortunately, we're becoming more inflamed in our GI tract. And so what can we do? What kind of, you know, foods or supplements can we add in? So I actually take what's called a short chain fatty acid. Short chain fatty acids come from fiber or resistant starches like jicama, which is my favorite. I eat jicama every day. But you can actually taste like a probiotic, but it's called a postbiotic, and it's called butyrate. And I take butyrate almost every day to try to support my gut health, knowing that it's making this big change right now, which is crazy. And a lot of women are like, oh, my gosh, this makes sense with the GI tract. I also take creatine. I do 5 grams of creatine. Creatine, which we used to think with the bros for muscle building. It's also good for the women for maintaining muscle and for our brain. So I do creatine as well. And then I also add in extra B vitamins. Just genetically. I take a B complex because I know I struggle in some of the snips for B vitamins. I feel so much better, especially B6, B12 with multivitamin. And then lastly is my most most important and most favorite is magnesium. And so I take magnesium. Now, magnesium is needed to activate vitamin D in a lot of the areas. So I take a blend magnesium, vitamin D, K2 that I will alternate with just magnesium powder every day. But magnesium is needed to activate ATP, which is ATP, our batteries, our energy in our cells. And it's involved in some several hundred processes. It's the CO factor. It's like the missing link for a lot of our body. And so. And we need more as we get older, it seems. So I take magnesium every day.

I'm so with you on those. I call those, honestly, the staples or the non negotiables also because we're just, we're not getting them from our diet. And honestly, if you are eating a lot of fish with the quality of the fish that you are getting, you have to look at that too when it comes to toxicity and stuff like that. And thank you. I wanted to hover on that because, like, I think we are all intrigued by the shiny objects. And for me, when my health has been at its worst or when I'm not feeling my best, of course I want the thing that's going to be like fast and immediate. How can I get there faster? Just give me everything. And all of a sudden we're doing so many things or putting so many things into a system that's already like calling out for the sos like, hey, hey, no more in here. Just like give me what's going to help me calm and soothe and ease and with supplementation, because we're not getting that from our diet anymore, like, it just makes sense. We're taking the elements that nature needs to give us in order to function at our best.

Yeah, I mean, even sulforaphane, those are definitely the basics. If anybody were to ask me, what are your top basics? Those are absolutely, without fail, my top basics. Now for individual people, they may need or want something extra, depending on what's going on. So for me, for estrogen detoxification, my genetics, there is a product ingredient out of broccoli sprouts. It's called sulforaphane, and it helps to basically open up several hundred what we call phase two detoxification enzymes. So think of it like a bunch of doors to a house. Like, you got a bunch of trash, and you put the trash in front of the door, and then you eat broccoli sprouts. Or you take the product called sulforaphane, and all the doors magically open and you can now take the trash out. So it's sort of the same idea in your body. So when I take sulforaphane, because I am genetically and prone to having higher estrogen and estrogen receptor issues, and I feel it, trust me, I feel so much better. Like, I don't have any breast pain, my periods are way easier, My PMS goes way down. And so I love growing my own broccoli sprouts. But I also travel a lot, so I take the supplement as well. Kind of go back and forth so you can do food, but sometimes it's not always convenient. And so then I add in the supplement.

You're so good at analogies. Yeah, that just completely all made it make sense in our house. So I buy broccoli sprouts every single week. I should 100% just grow them. But for my kids, I put them on the table, and they just, like, they now know it's a ritual. We take just a bite of them before we have our dinner because the benefits are just, like, so profound. And why not, right? With spreading huge. So you mentioned some key things, and obviously we're talking about these supplements and whether you know you need them or not. How often are you looking at biomarkers for your patients?

So when it comes to hormones, in particular, when you're in perimenopause, the guidelines say that you don't have to test because the theory behind it is your hormones are all over the place. How would you know when to test? And I fully agree and understand that. But that's not the only biomarker I'm looking at. When women make this transition because of the changes in progesterone and estrogen, their other biomarkers, their thyroid, their cholesterol, their glucose, their insulin, some of their nutrients start to go haywire. So I do at least yearly. I'm looking at their thyroid, I'm looking at her lipids, including some of the specialized, like the apolipoprotein B, which is thankfully now coming into the light as being an important marker. Beyond your basic cholesterol panel, I check glucose, which is usually part of what's called A metabolic panel. But I also add in insulin because I know insulin resistance is part of the diagnosis for metabolic syndrome and a big risk factor for women. I don't want women to get metabolic syndrome. I don't want women to get diabetes or, you know, anything else related to metabolic health. I want. I want all that dialed in and healthy. So I do at least yearly. And I know it can be hard or frustrating because women are like, carrie, I just had my cholesterol checked, like, two, three years ago. It was fine. I'm like, then it was. But your estrogen has changed since then, and estrogen plays such a key role in your cholesterol and your glucose and your insulin and your hemoglobin A1C and all these other markers. I don't want to miss it. Why would I let 2 years, 3 years, 5 years go by just because it was, quote, good back then? You're a whole different person now. You're that much further into the perimenopausal transition. We need to stay on top of it. I'm all about preventative, so let's do it.

Absolutely. I do a lot more coaching with my clients. So whether we're meeting weekly or biweekly, I recommend twice a year, if possible. And for listeners, you know, they're probably saying, oh, my God, you know, I don't even have the doctor who would run these labs for me. But this is probably another one of those sentencing scenarios where you've got to find the right person, because otherwise, you're doing all these things, you're trying all these modalities, you're supplementing, you're eating the right foods. Like, we're doing this all for the end goal of aging really well and adding life to our years. And I think for a lot of people, if you're like me, like you and I have probably tried so much like all that. We've tried all the things because we have to think about them. Right? We're speaking about them to our clients. But for me, I want to know what works. And often, like, this is the gift of modern medicine where we can actually understand our biomarkers to see what's taking and what's not. So, yeah.

One of my friends is a longevity expert, Dr. Eve Henry, and she describes the four Horsewomen of longevity, of thriving, of health span. And so it's cancer being one, cardiometabolic disease. So heart and blood sugar, diabetes. It's diseases of frailty. So falling, breaking a hip. Don't want to do that. Osteopenia osteoporosis, and then we have neurodegenerative disease, so dementia, Alzheimer's. And while I'm very aware of and don't want you to have the symptoms you're having now, hot flashes or night sweats or itchy ears or waking or whatever it is, I'm thinking of that. And as you said earlier, women are planners. I'm also planning for the future, which is I don't want you to die of a heart attack, and I don't want you to develop diabetes, and I don't want you to be stuck in a wheelchair really early in life, but yet you're going to live another decade or two longer. I want you to be doing what you want to do whenever you get to your end goal. And for me, my family tends to live a long time. We hit 90 easily. So I saw right away with my grandparents, wow, I need to address this. I don't want to be immobile. I don't want to be inaccessible. I don't want to be in a wheelchair because I've broken a hip or because I have, you know, something going on where I can't be active. Maybe my heart is an example or dementia that's happening. I'm trying to prevent that actively now versus waiting till later when I start to notice symptoms or when things start to go haywire.

Amen. Honestly. And is there anything scarier than Alzheimer's? Also? And I just think, like, the science right now is so, so fascinating when we're understanding the physiological changes of women's brains that could potentially be reversed or prevented if we get ahead of our hormones.

Like, yes, yes. Lisa Moscone, her book the Menopause Brain, and her book before that, the XX Brain. Absolutely. And all the other amazing researchers who are finally studying the female brain. Like, let's go. Absolutely.

Yeah. And like, for women, understanding that alone will completely change the trajectory of our decision making. And I think from my experience with my clients, it no longer becomes around. It no longer becomes about dieting anymore. It's about prevention, it's about optimization. It's about getting that juiciness and flow back into our bodies. Instead of that decade, two decade, three decade long cycle of being convinced that we need to diet in order to be a certain way. It completely just throws the, that lens out the window.

And I've seen it on social media. And I love this to the creators who say it, you know, they're, they're going for strength instead of, you know, I'm going for diet or a particular Body size. Like, I'm going for strong. I want my. I want my muscles. I want my bones healthy. I want my brain healthy and sharp. I want my mood and attitude healthy and sharp. Like, I want all the things strong and like, I love that. Yes, let's. Let's do that, too.

I literally visualize myself at 90 or 100 with a grandkid on my back in. In a backpack, like, just having my posture and mobility. My mom had rheumatoid arthritis. She still has it, obviously, but her whole body, like, her life was taken from her because of these deformities. So for me, it's a. It's also a big priority.

Absolutely.

With that said, so you brought up something hugely important that's also trending is the role that the gut place. And for myself, it's like just waking up overnight, and all of a sudden my digestion is different. For a lot of people I work with, like, our bowel movements are different. How we digest food is different. Our cravings are different. So how much does the role of our gut health play during menopause and beyond?

Huge. And I think that's going to be the new frontier of medicine, of research. Medicine and research, I should say. Yeah. Oh, my gosh. And when. So estrogen and progesterone both play a role positively, generally positively, in your gut health. So if you think of your intestinal tract from your mouth all the way down to the other end, think of it like a big. Just one long straw, right? It's one long tube, and it's only one layer thick, believe it or not. And it does a lot in there. So if you think of it like a straw, but now think of it as a fence around your house, and you have a gate. So you want your fence to be fenced. You don't want to let your kids out, you don't want to let your dog out, and you don't want wild animals in or stray people that you don't want your backyard in. But you don't want a gate. You want the gate because you want to be able to go in and out as you need out of your backyard. Your intestines are set up the same way. So each of the fence posts and are the cells in your tube. And then you have gates through the whole thing. So the gates allow your nutrients to go from inside across into the bloodstream. So when you eat meat, it's like, oh, cool. Iron and B12. Thank you very much. I will pass you through the gate and go. Unfortunately. Unfortunately, as Our estrogens and progesterone decline, our gates become rickety and they start to fall off the hinge. And now any old thing can go back and forth in the gates and all of a sudden our kid has wandered away and there goes our dog or things we didn't want to wander away out of, you know, keep moving. And then things come in that we don't want to come in. And the same can happen in our GI tract. So because we get this, it's called leaky gut, because these literal gates that are in our intestines are letting things through, they shouldn't now when they let things through, just like if something comes through your gate, you don't want you to call the police, your immune system gets called. And when your immune system gets called, they throw up inflammation because they have to now deal with the thing that got out of the gate and it shouldn't have gotten out of the gate. Now do this every minute of every day. And now you have this chronic low grade inflammation because your immune system is always involved. And now you have chronic low grade inflammation in your body. Not only that, but your digestive things change because you've got the immune system always involved and how you aren't digesting. And it's going to change your bowel movements, it's also going to change maybe foods you didn't used to be sensitive to, you're now sensitive to. Or you didn't used to get heartburn and now you get heartburn. It's like, what the heck? And so just by the shift in estrogen and progesterone, we get these structural changes. Not only that, but we have trillions of of microbes in there. It's our microbiome, they change. Estrogen plays a big role in the diversity of our microbiome. We love diversity in our microbiome. We want a whole lot of the good, healthy bugs down there to do their job well. It gets less diverse as we lose out on hormones. And so again, those microbes play a role in how we make certain nutrients make neurotransmitters. Our cravings, whether we do or don't lose weight even, it even handles things like our glucose and cholesterol. And so just by that little summary of what I've seen in the literature so far should be mind blowing to people of like, why isn't anyone talking about the GI tract and this transition? Because I think this is going to be where research is really going to take off. How can we support the gut as women are making this transition to support her whole body.

And we know so little still about the gut microbiome. And this is what gets me excited also, because we can blame our hormones for the anxiety and the depression and the mood swings, obviously, but we also have to recognize that it's the microbes that are calling the shot, or lack of. So for a lot of my clients, they'll come to me, and, you know, a lot of people will suggest, for example, a food sensitivity test. I'm like, okay, yeah, we can totally do it, but chances are if you have digestive issues, it might come back with, like, a hefty list of things that you should avoid. And all I take away from that is like, we need to heal your gut. Yeah, we need to diversify those microbes first. This isn't about going on a hardcore restrictive diet. We just need to heal and nourish the gut microbiome. And then, of course, what happens? Anxiety dissipates just a little bit. The moods aren't going from 0 to 100, but they're really just. It's almost like mothering your microbiome.

Right?

Mothering the microbes. Let's call it. Let's do a course on that. How do we mother our microbes? I love it.

Yes. And because the microbiome isn't generally taught in conventional medicine, you know, your primary care or your ob gyn, they're not talking to you about your gut, your gut health, your microbiome or anything. Or they're just saying, you have ibs, you know, best of luck, or here's some pills, when. That's why I think that this new frontier of research is really going to be pivotal, because there's so much we don't know about the microbiome, but there is so much we do know and we've seen work like you and I in our work with our clients and patients. Right. When it comes to how do we nurture it, how do we restore it, how do we get rid of inflammation, how do we eradicate a parasite? You know, how do we help clean it up, crowd out the bad, keep the good, so that it can run efficiently and we can feel better.

Do you do stool testing for your new patients?

Sometimes, sometimes. If it warrants it, yeah. Sometimes I don't need to, because just based on symptoms alone and the amount of experience I have, you know, I know what to do or where to start and getting things back into balance. But sometimes I do definitely do stool testing because I want to. I can get that. I can one see how Maybe how bad it is or two, I can really fine point some of the bacteria. So, for example, I was just reading a study about estrogen in one of your microbes called Akkermansia. And Akkermansia is very popular right now, with good reason. Akkermansia is responsible for. We have a mucus layer that lies, basically a snot layer, and it does exactly what you think it does. It traps bad things in the snot so that your immune system can take care of it. So Akkermansia is helpful for, like, turning over and cleaning up a mucus layer that's not that healthy. But Akkermansia also plays a role in metabolic health. Blood sugar, glucose, diabetes, things like that. And I've read several papers recently that as our estradiol goes down, so does our Akkermansia. And what happens for women, a lot of women, well, their blood sugar goes up, their weight goes up, their triglycerides go up, their metabolic syndrome goes up. And while that's not the only reason, it can be a big reason and one of the pieces to the puzzle. And so I like to know, hey, where are we at with some of these key microbes, with some of this inflammation? When I'm doing stool testing, in that.

Paper or in any other studies that you've looked at, have you seen effectiveness with supplementing with Akkermansia?

Yes.

Yeah.

Yeah. And a couple years ago, I was at a conference where I believe they're Italian. Apologies if they're not, but I think the original Akkermansia researchers are Italian. And he came and presented about using Akkermansia and the amazing outcomes that were happening in the microbiome and in metabolic markers. And that was a couple years ago, and now that sense has really quite exploded as well.

Yeah, I want to say, like, beware of the extremists online. For people who come out and say, that's something, this is the next thing, or this absolutely doesn't work. Like, look for the data or find a doctor like yourself who has your hands and eyes and ears just like so in this world of studies, so that you understand whether it's worthwhile or not and at the same time, diversify. Right. So I've been really big lately on in a smoothie. Every single day, I will literally throw a kitchen sink of veggies and some coconut water and wild blueberries and blend it up until it pure liquefies. Tastes amazing, but you're really getting probably bigger diversity of fruits and veggies than you typically would in a Busy day, Right? That's another way to incorporate it as well.

Plus, it's an easy way. If you do protein powder, right, we add, throw in protein powder. And now we know is women get into their 40s, we need to be doing a lot more protein than we thought we did, that's for sure. And to, if you incorporate protein powders and that's a great way to add in, sneak in an extra 20 or 30 grams to your day if you're a little deficient here and there.

You got it. So let's continue on on this lab. Let's continue on on this lab aspect. So if somebody is going to, they're going to ask their doctor for lab testing, you know, what's the best outcome? What should they specifically be looking for or asking for?

So if it's blood testing, then you're going to want all the fasting markers. So you're going to ask your practitioner, like, I would like to get my cholesterol ch, but I would also like to add in some, maybe extra or advanced cholesterol. And some practitioners already have that panel. So if you say, I'd like to do advanced testing because of my age, I'm perimenopausal, they may know what that means. But if they don't, at the very least ask if they can add in something called an apolipoprotein B, they're probably going to run your red and white blood cells. That's called a complete blood count. They're going to run what's called a metabolic panel. That's your liver enzymes, your calcium electrolytes. It does include a glucose, so you've got that covered there. I add in insulin. It is not part of a basic panel for a lot of practitioners, but given what I know for women going through perimenopause into postmenopausal transition, their insulin tends to go up. Insulin resistance I want to catch right away. So what is going on with your insulin? I check thyroid, tsh, thyroid stimulating hormone, but I also check the other markers as well. Free T4, free T3. We look at the antibodies, such as for Hashimoto's. We know women are more prone to autoimmune thyroid and we know this age range is more prone to developing it. So let's test it and see where we're at. Now we can get into some other hormones, even in the blood work. We can look at your testosterone if you want to. So total and free testosterone. We can look at dhea, which is another what we call like a pro Hormone for androgens, your testosterone, etc. If you still have regular cycles, let's say you're listening to this and you're 40, you're 43, and you still have absolutely regular cycles. We can still test your hormones. We can still see what's going on with your progesterone and your estrogen. We can do that in blood work, we can do that in saliva, we can do that in urine. We have a lot of options for your hormones. Once you're really irregular, you're not ovulating like you should. I don't test. I don't. Because if you're all over the place, then it. The results are not going to make much sense, so to speak. It's because you're kind of on this roller coaster. And it just depends on the day of the roller coaster, where you're at. Then that leads me to cortisol. I low testing cortisol because it helps me understand, is it low, is it high? Is it high at night? And that's why you can't sleep, Is it high in the morning? And that's contributing to anxiety or panic or whatever is going on. And so I do like to do cortisol testing through the day, which is usually through a specialty test, if we get to that. When we're talking saliva test. Yeah, I do saliva. Or urine.

Or urine. Okay.

Yeah.

And at what point does the Dutch test come into the mix?

The Dutch test is great. So for those who don't know, the Dutch test is the dried urine test for comprehensive hormones. So it's four or five collections in the day. You pee on these pieces of paper, let them dry, mail them off to the lab. So you get your hormones, you get your testosterone, you get your DHEA s, you get your three estrogens, E1, E2 and E3. You get progesterone. But then you get additional markers. You get what are called metabolites, and those are the breakdown products of your hormones. So where's your hormone going? You make testosterone. Is it going down the pathway that causes hair loss and acne and anger and chin hair? Like, it's helpful to know that you make estrogen. Is it going down as it's getting broken down? Is it going down a pathway that's going to increase the risk for potential cancer or heavier periods, or is it going down a better pathway? So I do love the Dutch test to assess that, and I prefer to do it early on because, again, once you're in that erratic cycle part, it's tougher. To when we're, we're looking. I then err on the like, well, let's just do blood work and let's just look at the other things versus trying to figure out where in the midst of perimenopause your hormones might land. But the Dutch test does also have the 4 point cortisol on it as well to give me that sort of stress cortisol feedback for you. So it's pretty comprehensive.

It's very comprehensive. I look at labs. It's very comprehensive. I look at labs every single day of the week. And this lab was like Fort Knox for me, like, which again is wild, like an aspect to our health that we should really understand. So for listeners, you can order the Dutch test yourself. However, you'll need a trained practitioner to translate those results for you and give you a direction to best optimize. Right?

Yes.

And when we're looking at that direction to best optimize, optimize, then this is when HRT comes into play. So hormone replacement therapy, we started talking about that. At what point should a woman consider hormone replacement therapy? Are there natural alternatives that she should start prior to. I'll be completely honest, I'm very much pro hrt, but for me, I started it all wrong. I started with testosterone. I started doing testosterone first and I think that, that it was too much for my system. I think I boosted the androgens in my body. So now I'm kind of backtracking a little bit. But take us through for our listeners. At what point in perimenopause should they consider hrt?

Usually what most people start with is progesterone because they start to realize progesterone is the first hormone that goes down. But what you feel is, I can't sleep. And what you feel is, I'm not calm and I'm having more anxiety or I just feel more agitated. And so usually that's the first thing. If you're just going to dip your toe into hormones, we start there. When we get to estrogen, there are two camps on starting estrogen. There is the camp of, oh, you're having all the symptoms, even if you still have your cycle or you're starting to skip cycles, let's go ahead and start estrogen and help basically kind of like soothe it out, smooth it out. The other camp is, oh, you shouldn't start estrogen until you are fully postmenopausal. You have to wait 12 months of no period before you can start estrogen. And then on the 13th month we can go ahead and start estrogen. I am not in that camp.

I'm not in that camp. I was just gonna say. Right.

Why would I make you go 12 or 13 months with no estrogen?

Yeah.

That just seems crazy to me.

Right.

So I usually will start estrogen when women start to tell me about their symptoms. Their symptoms are really interfering with their life. Once women start to say that they're having pretty significant estrogen symptoms. So once women are like, it's affecting my brain, it's affect the hot flashes, night, sweatshirt, it even can roll into sleep. Vaginal issues, dry vagina pain with sex, urinary issues, infections, the joint pain, the muscle pains. That's when I'm like, ooh, your estrogen is really low. Even if she's having regular cycles. I know plenty of women who have regular cycles and still cycles. Their estrogen's quite low.

Oh, yeah, that's me.

Right. And then when she starts skipping, you skip your first month, you skip two months. That's two months with no estrogen. So we can start.

And what type of estrogen are you a fan of? Patches?

Yes.

Or vaginal creams.

Yeah, I can, I, I, I'm a fan of it all. I'm, I know what the guidelines say. I'm very aware of the guidelines and I like the patches for consistency, especially if a woman is never done hormones and she's just starting, you know, we can do a really low dose patch and work up, see how she feels, see how she responds. I have women that love their cream and you know, they need different doses because of the cream. I have women that do injections. I don't do pellets, but I know women who do. Some women who do pellets and love them. I'm not the biggest fan of pellets, but I know some women who absolutely swear by them, so good for them. So there are some really great options out there.

Okay, great. Yeah. I often wondered if you're using a vaginal cream for estrogen, if there's more receptor sites because it's closer to the, the area of need versus something that's like a transdermal patch.

So the vaginal estrogen goes in two different doses. We have low dose estrogen that is vaginal only. And then we have the higher dose that absolutely can be systemic. Yeah. So it kind of depends. And not all estrogens on the route of administration are what we call FDA approved.

Great. Okay. That's a big deal. So how do we know? What are we asking for then when we're looking for the right type of estrogen.

Most practitioners will start with a patch and they will start with oral progesterone called prometrium.

Yeah. Okay, great. That's an amazing clarification. And okay, so for women who are heading down this route, then if they're not ready to go into hrt, order some natural alternatives then instead that could really support them.

One of my favorites, when they're in the early stages and they're starting to notice some progesterone symptoms, I'll use the herb chase tree. I don't know if you've ever used chastry.

Yeah, yeah, yeah.

So chasery can be really helpful at regulating progesterone, regulating ovulation. It doesn't work so well the further you're into perimenopause, but I have seen it work in early perimenopause.

Okay.

I've also seen other oils such as evening primrose oil, borage oil, the Omega 3 can be also really helpful. There's mixed on the estrogenic herbs, we have black cohash, we have the red clover. Sort of hit or miss, depending on the person. But lastly, there's one called maca. I don't know how often you use maca, but there's a. Maca is a tuber like root. Maca has been shown to be really helpful.

Oh, maca. M A C. Sorry. Yeah. Oh, my God. Maca is incredible. Yeah, Maca is great for a boost, I think with a lot of these herbal supplements. Here's that frustrating part, but also a gift, is that they don't work the same on all of us. So a lot of it is trial and error and working with dosages and really kind of tuning in to what feels best for you. So. But also speaking up when something doesn't feel right for you. So that's a great tip. So maybe, you know, after going through all this, to sum things up, for women who are preparing or currently going through menopause, are there a few takeaways, like three takeaways that they could really use to support them going through this.

Naturally, Going through perimenopause, I can't emphasize enough the foundation. That's probably one. So where are you with your diet? Where are you asleep? Stress, exercise, building muscle. Where are you finding joy in your life? Are you taking the supplements? Are you hydrating? All of these role and how women perimenopause. So from a natural like holistic, you gotta nail both.

So good. Get the foundations first before you go trying adding in all these other things. Make sure that your body can function at its best and something too. With that said, you know, when you're considering these modalities, are you supporting women in detoxing prior to. Yeah. Oh, yeah, yeah, yeah, yeah. We think that our bodies are naturally doing this and they are every single day. But I think that for a lot of women, we mentioned this briefly before, but like your toxic load, if that's elevated, throwing more things into the body often isn't going to work or it'll take you a lot longer to reap the rewards of the protocol itself. So consider detoxing also.

Yeah, absolutely.

This is so good. I could talk to you for hours and hours. You're going to come back on the show. I want to wrap this up by just asking you some rapid fire questions that we ask everyone. Ready?

Yes. Okay.

What are the most common mistakes or misconceptions that you are seeing women make with their health?

Oh, the more cardio, the better.

Yes. The addiction of cardiac. The addiction, Yep.

I mean, I'm just guilty. It took a lot to get me to change it.

Yeah. That's so great. Yeah. And it's going to ebb and flow throughout the month. Right. So, yeah. Tune into what you need most. What is your favorite ancient healing remedy?

Acupuncture. I think it helps that I'm obsessed with my acupuncture.

I agree. What is one way that women are making healing and health way too complicated?

Thinking that they have to spend a lot of money on all the things when again, going back to the basics, the foundations of self care. It doesn't have to cost money, if any money at all, you know, And I think we overcomplicate everything social media tells you and you just don't have.

To maybe turn down the noise on social media for a little bit. Like you be the CEO of your health. Take back control and tune into what feels best for you. If you had to pick something about modern medicine that excites the you, what would it be?

Oh, I think I've said it already. All the GI research.

Yeah, yeah, same. What are the top three things that we can start doing right now to optimize our health?

You can take magnesium glycinate before bed because one, it's going to help your mood, your ATP and your sleep. You can treat yourself as if you were a plant with party said. So make sure you're getting some sunlight, hydrating, listen to good music, be on a windowsill. And what we do, find joy. Find joy. This transition is chaos. Find joy. Anchor yourself and the funny things, the joyful things, the things that your heart.

Go for, that beautiful. If you could leave our listeners with just one takeaway on what you're most passionate about right now, what would it be?

I'm definitely most passionate about on all the data that's coming out on HIV and whole and our brain and our GI tract and our immune system. So, like, how do I take that information and then educate, get it out, make those fun analogies so that we can all understand it.

You were the queen at that. And I'm so seriously. You're so good at it. I'm so, so grateful for you. I'm so glad. Grateful for you. Your voice as a woman, for taking, like, a very unique path to educating women to optimize. It feels different. And I just, I want you to know that you have a power of translating that through screen, through social. All right? So for all the women listening, please pass this on to other women, even men. I genuinely believe that men want to help women. And whether it's the symptoms of, you know, being annoyed or being sad or. Or feeling crazy or feeling manic, it's time to really own in on. You can take control of your own health and to be proactive. And from what I'm there's so many, gosh, golden nuggets today. I especially love be the most beautiful, luscious, happy houseplant in the world.

Yes. Amen to that.

Be the plant in the sun that is thriving. What a gorgeous way to think about your house health. Dr. Carrie Jones, thank you so much for being here today.

Thank you for having me.