33. Dr. Sarah Daccarett: The Women's Hormonal Crisis Doctors Aren’t Talking About

I always equate hormones to a symphony. We rely on having a symphony that's playing within our body. And if one instrument is off, entire symphony becomes compromised.

I think that this is the heart of what we should be talking about. You know, I know there's a lot of attention for perimenopause and menopause, but I think the story is bigger. Like, young women are being put on birth control for non birth control reasons.

Yeah.

And birth control stops the production of your own hormones. It lowers your hormones.

We know what hormones are responsible for what Emotions. Right. And for women, if we have a cycle that's changing and evolving throughout the.

Month, I mean, you talk about moods, how they change throughout the cycle, but our emotions, you know, to prevent anxiety and depression, irritability and insomnia in women, it's hormonal, it's progesterone. I mean, no wonder these young women, we have a huge rate of anxiety, depression.

Doctor Sarah Decorate, I'm so excited to have you on Rooted in Wellness. Thank you for being here.

Thank you for having me. I'm so excited to be here today.

We're going to dive in. But first, you know, we ask our, our guests a series of questions. This podcast is all about becoming rooted in your wellness. It's about ancient rituals in our modern world and really being rooted in who you are and your inner wisdom to heal. So, you know, the first question is, what helps you make. What helps you feel more rooted in yourself, in your life and in your body?

I love that question. And I feel more rooted when I'm really aware of this connection. You know, listening to my body, I don't think that that's common. I think women kind of lose that into you listening to yourself over what somebody else is saying or laboratory tests, for example, which we'll get into. But something like that. I always pay attention to that. First, what is my. Because your body will tell you, it will signal.

And it's funny, I thought that as a woman being, you know, in tune with my body and listening to my body, something that happened naturally. But over the course of a decade, I completely was working against that. I was silenc the symptoms for my body.

I think this is actually really common, that women minimize their own symptoms. They'll minimize. They'll put every. This is something that maybe we do because we're. We take care of everybody else. So we will minimize our own symptoms before. Or just something that's going on with us, we'll minimize it before everybody else's. We'll make sure that kids are taken care of, spouse, partners, everybody else. And so you just. We have to learn to prioritize ourselves. Because you know that saying, when you treat the mother, for example, you treat the whole family. We have to take care of ourselves first and then we can take care of. Yeah.

And I really think that our body holds the answers. So do you have any practices in the morning that help you tune into your body's wisdom?

I really. Physical activity for me is what grounds me. So, like, even just, you know, this morning we took our shoes off and walked along the beach because I'm visiting this, like, fetal city. So something that a lot like physical activity does that I'm able to step out of and into myself. And then it's kind of a move, moving meditation in a way. So I really like hiking in the mornings or something physical allows me to reset.

The more that I hear this from women, what that feels like, the way that I interpret it, it's like, oh, you're moving your energy. Like you're moving stagnant energy and it's making you feel alive and in tune. Is that what it feels like for you?

Maybe. I think it makes me feel more calm and centered. Like, actually I'm able to listen to that inner, like, self a lot more when I'm moving. Yeah, I don't know if people found that, but when I sit still, I'm. I'm not able to do that as effectively. So when I'm moving, yeah, I get that.

And I'm sure you notice, like with me, with my, in my practice, a lot of my clients, they're treating their wellness like a checklist. And often they have so many wellness practices that they're hearing about in the social media that they're not even in tune with the practice. So, for example, getting up at 5 o' clock to do boot camp in fluorescent lights with two caffeine, two espressos first thing in the morning, they're thinking that it's healthy. Right. They're doing hit exercise, which we're hearing is healthy, but I think it's completely working against their constitution. So do you have any practices in your life that, you know, you practice that uproot you.

I like, I do not follow any kind of, you know, if I need sleep, I prioritize sleep over getting up and working out, for example. So I try to listen to what my body needs that week. I do every, you know, say I'm going to do three things for myself that day and make sure that I prioritize Those, even if it's as simple as, you know, drinking a cup of tea or taking a hot bath or something. So it can be something that's very centered around my wellness.

It sounds like you tune in like you're allowing your body. What do I need to tell you what you need? And following it instead of treating it.

Like a checklist, it's too. I mean, I'm already over scheduled. Like you schedule everything else. Like, I don't need to schedule my, you know, body. Like it just need to listen to what it needs.

Um, I say all the time on this podcast that your perfect healing protocol should be as unique as your thumbprint. And like, for listeners, I can't give that to them. And everyone wants the perfect diet, the perfect protocol, and often I'm asking you what makes you feel the best. So it feels really affirming having practitioners on who are. Are saying that they're. They're living that.

And, you know, nobody knows better than you. Like, nobody knows better than me. Like, I can't listen to somebody and maybe I'll take what I like from you or something and incorporate it.

Try it on.

Yeah, try it on. But nobody's going to know better than I need at that moment. So. And women need to learn that that's okay. Like, nobody's going to know better than you.

Well, I'm really excited to talk to you today. One to wear the hat as a practitioner, but also to wear the hat as a woman. You and I are about the same age. We both have children, and we've gone down this road of, you know, hormone imbalances. And obviously this is a big passion of yours. You know, I just want to know from your perspective. Hormonal issues for women are often dismissed. For me, they were for, gosh, I would say, for decades. No one would ever support me in getting to the root cause of what the anxiety was, what the fatigue was, what, you know, sadness that just came from out of the blue and how that could have been associated to our hormones. And this isn't a normal part of being a woman. So what do you think and why do you think these symptoms are normalized and why aren't we talking about that?

Yeah, I think that it's getting more and more attention that we should, you know, that this has been minimized. But you're absolutely right. It's been dismissed for decades. Women are gaslighted by physicians. They're told that everything's normal, or you're too young to be experiencing this, or it's all in your head or you're having a period. So everything's normal with your hormones. And this is a very. This is doing a lot of harm. I think that we could. There's a lot of reasons it could happen. One, there's no training in medical school around hormones. So this is an alternative kind of field where this is the. Potentially the root cause of all disease and pathophysiology that we have or hormones training. And medicine is not about wellness or preventative. It is about acute care. And we need that still. Like, if you get in a car accident or you have an acute illness, we need that. But we can't look to doctors to know everything. And they can't know about wellness and they don't know. And this is more of a. Hormones are about prevention and a young person and making sure they're optimal because they're so important for that. Another reason could be just misogyny in medicine, and that's very rampant. So. And it's not just male doctors that are dismissing women. You know, and doctors don't get. They have. Don't have a lot of time. You know, they're like, hey, just get out of my office. Like, I'm not going to get paid to treat you with hormone replacement therapy. And they don't. There's no incentive for them. So the insurance companies don't incentivize, so they're not going to get paid for it. And then female doctors are also, if they've made it that far in medicine, there's some misogyny. It's just the way the field is.

I was 23 years old when a female doctor said that my PCOS was so bad that I probably wouldn't be.

Able to have children.

It was a woman, and I believed her. She was in a white lab coat. I trusted her. I'd had a relationship with her for a while, but there was no talk about why that had happened or if it was stress, how could I get out of it, what was happening to my physiology? And back then, we know what hormones are responsible for what emotions, Right. And for women, if we have a cycle that's changing and evolving throughout the month. I always equate hormones to a symphony. Right? We rely on having a symphony that's playing within our body, and if one instrument is off, the entire symphony becomes compromised. Right. And yet doctors still aren't talking about that. And I would say that the beginning of my endocrinopathy, when things just went sideways for me, is when doctors put me on birth control when I was 17 years old. So I got my cycle at 15 and from the beginning I had an irregular cycle, so every three months. Now for the first time we're saying three months could be your normal. But because of that, a doctor said, well, you should go on birth control pill. And that was like the, the beginning of the downfall of everything for me.

I think that this is the heart of what we should be talking about. You know, I know there's a lot of attention for perimenopause and menopause, but I think the story is bigger. Like young women are being put on birth control for non birth control reasons.

Yeah.

And birth control stops the production of your own hormones. It's not hormones. It lowers your hormones.

It lowers your hormones. They're being prescribed for acne. Yeah, acne, acne.

This is not. Not talking about.

So the risk, the McDonald's that you might be eating the.

Right. And so this the site. The risks of birth control in this case do not outweigh the benefits. You know, it is only for like. Yeah, but if you're stopping the production of your own natural progesterone at such.

A young age, at such a young.

Age, that could have led to PCOS and endometriosis. So we know that PCOS is when is a state of low progesterone, which is a woman's arguably most abundant hormone. And you stop that with the birth control.

Yeah.

So you are going to put her in a state of. Where she's at risk for end. For pathophysiology, endometriosis, pcos. Painful periods, heavy periods, neuro. We have a very. Women have a very complex neuroendocrine system. You talk about moods, how they change throughout the cycle, but our emotions, you know, to prevent anxiety and depression, irritability and insomnia in women, it's hormonal, it's progesterone. I mean, no wonder these young women, we have a huge rate of anxiety, depression.

I read a stat recently that with the rise of anxiety and depression, women are twice as likely to experience depression. And for such a long time, doctors have normalized this. Right. Especially postpartum. Oh, it's normal. You're in your fourth trimester. Right.

This is really bad. You know, it's just like. And we. This dismissal of. And women are prescribed a lot of stimulants, antidepressants and antianxiety meds. And this is not, this is not only is it a band aid fix, it doesn't work. And it's not treating the root cause. And you're not validating. She's really, it's a health problem. She has low hormones. This, it's bonkers.

Yeah. So let's just call out the big systems then. So just to get it out of the way and we'll move into the solutions. So you talk about there being a crisis that's happening today. Right. So we can attribute part of this to the patriarch 100% and the dictation around women's health and how that progressed and the lack of studies that were done to support women in times of need. Then we've got the pharmaceutical industry, Right. Which was profiting heavily with the rise of birth control. Pill.

Right, Heavily. And anti anxiety, antidepressant. I mean depressant stimulants like you keep women unhealthy, then you're going to profit off of that. I mean it's not just, it goes beyond birth. Like they make money on all of this, you know, sleep aid, right?

Yeah.

You treat the root cause and give somebody hormones. You don't make any money on that.

Right. And then we now have decades then of women not being given the attention that they need, the support that they need. And we've gotten to a point where hormone imbalance, miscarriages, the rise of depression, the rise of stillbirths. Like there's so many aspects around the pre pregnancy pregnancy and post pregnancy aspect that have just so compromise numbers that we've never seen before in history. Can you tell us about some cases and why you're calling this a hormone crisis?

Yeah, I think that it's. We, it's a crisis because we have had no innovation in decades, decades over 25 years for women in terms of hormone therapies and advancements. And we have convinced women to be afraid of something that their body naturally makes. We have made women fear estrogen, which maybe is sexist, but it's, you know, making them fear estrogen or making them think that estrogen's a problem. But this has been devastating. This is devastating.

Right. We became fearful of hormone therapy. Right.

We haven't come fearful of it. Something that's natural.

Where did that come from?

A lot of speculation because of the studies, the Women's Health Initiative that was published, you know, 20 something years ago, that the, the authors retracted their findings and said actually this doesn't cause breast cancer. But by then, you know, Mark Twain said that, you know, a lie will travel halfway across the world before the truth will even put its shoes on. And this is the case with hormone replacement therapy and estrogen and the media Over. You know, this is fear mongering at its best. The media made it seem that estrogen caused breast cancer. And because of this fear, there's been no innovation. And then doctors and 50% of all women believe that estrogen causes breast cancer. That was this recent statistic and that's not true. And not only does it not cause it, but it protects against it.

And this runs deep. Right. Like even women today who are reading the studies against this are still fearful of hormone replacement therapy and starting estrogen because of those studies.

Yes.

Yeah.

What is a bigger problem? Like you're basically, that's. You're telling women that they're the problem.

Yeah.

That your own hormone's the problem. I mean, this is. You cause this, you cause this. And this is.

And it is so complex. Right. It's not like there's a cookie cutter solution in order to put women on hormone therapy during a specific time at their cycle, during a specific year. Like, it's just, it's such a complicated aspect because there's so many pieces that are contributing to hormone imbalances. What do you think is triggering so many women to have those imbalances today?

I think that we're seeing it younger and younger. Right. So we always have kind of known that as women approach the age of 30 that hormones drop off significantly. Like they're. She doesn't. She maybe produces 20% of what she used to. And it's. Our ancestors were never meant to have babies in their 30s and lived till they were 90. We were meant to have babies as a teenager. And so the ovaries just fail. Like they just don't work. They're hyp, they function not as well. But now this concerning kind of rise in PCOS and endometriosis and heavy periods, painful periods, cysts, fibroids, a lot of pathology, a lot of problems in the younger years, even. Or even just more pronounced perimenopausal symptoms in the 30s. It could be environmental. I think it's largely environmental and diet. We know that there are endocrine disruptors all around us. They. And again, there's a misconception that they act like estrogen. They don't. They block the estrogen receptor. They prevent the production of your own hormones.

Right.

And that's where the problem. And they. And so then you're basically making a young person infertile. And this happens to both men and women. We focus on men or these younger. But this is really happening to women. And this is where, you know, it's, it's in the food. It's. I mean, you know, more than me where all these are, but this is.

Yeah. So the food we eat, the water that we. That we drink, the environmental toxins and pollution that are around us, the chemicals that are literally lingering in the fabrics, the clothing that we put on, the fragrances. The fragrances. So I've shared this so many times on this podcast, but I stopped getting my cycle when I worked in the cosmetic industry because I was spraying rooms with fragrances and, like, inhaling them every day. And then I was slathering a mask of makeup on my face from those products that also had fragrances and dyes in them. And it's like, no one even thought to ask, like, oh, yeah, that could be contributing to you not having your cycle anymore. And it's just wild still now. It's almost been, gosh, 15 years since I left that industry. There's still, you know, lineups of little kids at Sephora to get the fragranced lotions and lip balms. And what is that other store? Bath and Body Works.

Oh, we walk by and you can smell the. Like, the fragrance, and you're just like.

No, I know, but, like, how do we know what we know today? My hands over my face. How do we know what we know today? Those stores are so still legal.

I don't. I won't allow that in my house around my son. So fragrances, like, even the laundry detergent, we use a fragrant free. The phthalates are real. They definitely disrupt this cycle. And so women are not ovulating, and we have to ovulate in order to make these hormones.

For sure. There's a meme that. That goes around for people who still use Tide detergent. It's like an assault to your senses when you give them a hug these days. I remember that I was so nostalgic as a kid, but now if I smell Tide, it's like, oh, my God. It's like, so chemically. So, yeah, do your best to clean up at home. And, you know, as we're speaking, I can really understand that for people who are just new to wanting to dive into this, how it can feel so overwhelming, like, whoa, whoa, whoa, whoa. Where do I start? They're talking about pollution. Food, water, cosmetics, clothing, everything. Pick one category. Maybe the thing that, you know, could be causing the most impact. I think in our house, it was all the personal care products, because there's so many of them. And just. And start there.

I think that's a good idea. I mean, especially if you can do it this way first. Yeah. And try to remove the problem. You're going to be better off. If you can't, then you can all. There is always. Hormone replacement therapy is not, you know, it is, it isn't a safe. Like, especially if you're over the age of 30. And even if those women remove all, you know, they do everything right, they're getting the diet, they remove the plastics, they remove the phthalates and they're still having problems. Hormone replacement therapy is okay. Like you can replace the progesterone you're not making.

So let's talk about that a little more. So you and I, around the same age, were there specific symptoms that you noticed happened that were waking you up to like, oh, it's happening. Oh, this is perimenopause. Like have you gone that route yet?

Definitely. So I mean, I always say like I invented my inner balance because I needed it. I mean it's like it was always a solution for me to begin with. So after I delivered my. He's now nine. But after I delivered my son, like I never recovered really. And I mean I probably recovered, but I never felt, I didn't feel like I should have. Like, I wanted to feel great. I was in my mid-30s and I, well, I deserve to feel great. I want to like be vibrant. And I already had done all the eliminating of everything I had. Everything's clean, right? My diet's clean and there was no reason why I shouldn't feel my best and I wanted it. This is something that I deserved. And so when I realized that everything on the market, that there had been no innovation, I had not learned about it in medical school. Nothing for a 35 year old. I mean, there's nothing. Right? So the patches and the pills and the low dose vaginal creams, they're really meant for that era where we feared hormones. They were micro, they're microdoses. The patches are tiny micro doses for women potentially over the age of 60 to stop hot flashes or over the age of 55 to stop hot flashes for a 40 year old, it's like a drop in the ocean, if that makes sense. Right? So like women really need, I mean we. And when I, So I realized that some of the first presenting symptoms that I see in women are anxiety, depression, irritability, insomnia, they start to hate their partner, they start to like not tolerate their children. No, I mean it's just they, they realize that they're off, that they don't. Are not like the happy, vibrant person that they Used to be. And I think that's one. And it's not. It's not about, you know, it can be later if you let it go for longer. It can be about weight gain, hair loss, skin if you. If you don't address it. But, like, those first symptoms can be as easy as, like, this, depression, anxiety, or not having that zest for life anymore.

Yeah, yeah, it's. I feel like just because of my profession, working in wellness, working in nutrition. Well, I'm not going to go through that. I shouldn't have to go through that. I'm doing so many things. And for my mom. My mom was born 1945, and when she went through menopause, she's like, oh, it's like I sneezed. Like, she was so lucky. She didn't experience any of that. I'm sure there's some emotional stuff that she's not sharing, but, like, the. The hot flashes weren't there. She didn't notice any massive shifts to her sleep or anything like that. But for me, now, I've shared so many times on this podcast. A couple years ago, I had mold exposure, and that was, like, the onset of everything. So after having my kids, I was so lucky to have great pregnancies. I feel like my literally healed itself from the hormones. For me, maybe. Yeah. For the first time in my life, I actually had a regular cycle after my daughter was born. It was amazing. And then I got mold. And after the mold was a long recovery. Plus I have terrible detox pathways. Then onset stress, and then it was just like cyc, cyclical. And for me, I would say the first symptom was definitely an increase in irritability. And then my sleep score. My sleep score started to decline drastically and my point of entry. And we were talking about this before we started the show, doctors put me on testosterone as the first hormone. And I thought, well, great, my hair's falling out, I have no libido, I've got low energy, my sleep is shitty. I want more energy at the gym. I want to put on more muscle mass for longevity, because that's what we're talking about now. Great. Let's go on testosterone. And sure enough, the dose was too high. I felt for a glimpse what it was like to be a man for a second. My husband Craig was really happy for a few weeks.

Yeah, it can, like, be pretty dramatic.

It was dramatic, like surge of energy, but completely unnatural to a woman's physiology. And a lot of my symptoms didn't go away. In fact, I found myself going from 0 to 100. So 0 being calm and then 100 to rage at the smallest things. And I'm trying to explain it to doctors and the doctor that put me on, it's like, oh, just give it some time or we'll lower your dose. Dose. No recommendation of doing a Dutch test. No recommendation of understanding my gut. No recommendation of progesterone or estrogen first. So talk to me about what you're seeing today, because testosterone for women right now is all the hype and we're not looking at the symphony of what it takes for women to get into balance.

You're absolutely right. And I think that we're not, we're not just tiny men. You can't just Give us 1/10 of the dose of testosterone, expect us to get better. We're practically a different species than men. And so this idea, when we look at what the relative concentrations are of the hormones, if we put everything in the same units, for example, in lab tests, and the part of the confusion is the way labs are reported, progesterone is actually magnitudes larger in its amount. It's just that it's so much more that they change the unit so that when you read the report, it says two. That's actually 2,000.

No way.

If you were to put it in picograms per milliliter, which is what estrogen's measured in. So like for example, in pregnancy, you felt better. Pregnancy, progesterone gets up to 300,000 picograms per ML. For progesterone, estrogen gets up to 40,000 picograms per ML. Women need a lot of hormone to, they can tolerate it. Right? It's literally what helps them be pregnant and birth. But testosterone's the third most abundant. So if, if progesterone in an ovulating healthy 25 year old is around 20, 20,000 picograms per milliliter, testosterone is 60 times lower, it's around, you know, 400. And estrogen's around 1800. Right. So that gives you like an idea. So these ratio, like not only do they have to be in the right amount, but the right ratios. And if you give a woman testosterone and her only testosterone at first, she is going to feel like a surge of energy and probably a surge of libido and be like, wow, is this what it's like to be a man? Because they definitely think about sex all the time, but over time that you're not addressing these other root. So there's no receptors in the Limbic system for testosterone, for example. So you're really not getting at the root of her sex drive. Which sex drive is more complicated in women? It needs to be linked to vaginal dryness, for example, and you can only address that with estrogen, the vaginal microbiome. If you give her only testosterone, we found in the transgender population that their vaginal microbiome gets completely disrupted.

Can you talk about that for a second? Hover there. Okay, so the microbiome, okay, so that.

Lactobacillus acidophilus is the primary bug or organism that's there. Like, when we talk about, you know, microbiomes, like, in the gut, we want diversity. In the vagina, we do not. We want, like, one or two strains because those organisms maintain the proper pH. Like, this is really important for women as we age. Like, it helps prevent infections. And it's not just yeast infections. It is like, hpv, bacterial vaginosis, any type of infection. It also prevents urinary tract infections as well as yeast and then urinary incontinence. So, like, pelvic floor maintenance, like, able to, like, you know, go to the bathroom without having pain. Like, this is really important as we age. And so Lactobacillus acidophilus needs estrogen in order to make its food. So if you have only testosterone or you give somebody, like, a testosterone vaginal cream, which is really popular for libido, you are completely disrupting her microbiome and introducing a possibility for bacterial vaginosis or something else for her, and you have to maintain. This is really, you know, this infection is important right here. This, like, a health concern. Doctors should be like, this is really important for quality of life for women and also lowering health. We can talk about healthcare costs and all this stuff. Like, we need to not have infections.

This is the kind of information that I want to be hearing. So right now, there is so much doom and gloom about around aging, around getting. Becoming 40, moving into paramenopause, moving into menopause and beyond. It's doom and gloom. Watch out. Just wait for it. It's coming for you. We're gonna have together. Yeah. Instead of, like, you know, here's the details of what things should look like and understanding the body's physiology and the education for women to really understand and take ownership of their physiology.

You're in complete control. Like, if you, you know, this mood change and all of this doom and gloom is a choice now. You actually don't have to do. You know, menopause is optional. All of these Symptoms are optional when you're younger. Endometriosis and PCOS are optional. These lifestyle changes that year or if that doesn't work, there are, you know, you can replace progesterone and estrogen and feel better. So it's not, it's actually like this is the time where you could feel better. Like I feel better now than I did in my 20s. Like I'm healthier because I'm also implementing the diet and the exercise lifestyle, but I also have the hormone replacement therapy, you know, so it's like you have the opportunity, like you have your kids, you have your job, you have your, your set. You're not in your 20s. You know, you're, you're actually midlife.

Yeah, sex could be better after age of 40.

It should be. Yeah. This stuff like if women really need to take ownership and control because they need to know that everybody's always going to be about controlling their health. I mean, how it's not surprising that we, we control reproductive, you know, issues in women that they would, people would want to control this hormone replacement therapy in women as well.

Yeah. So look, I think, think testosterone is definitely important. It's one small piece of the puzzle. And let's get the word out that it maybe shouldn't be the first or the only or the only. And even when I was sharing that story with you, it's like there's this inner, like, oh, I did it again. Like I bought into the system. Like I went into my masculine. I wanted to fix something really, really quickly. And so I went for the testosterone because I wanted the immediate feeling of healing.

They also tell women that it helps them lose weight. But what I found is that actually when you look at, at picot states of pcos, for example, those women gain weight and their testosterone's elevated.

Right.

So for testosterone, like for women can actually make them lose their hair, acne, irritability and gain weight and feel bloated. And it does disrupt this like their immune system. So we need progesterone to prevent autoimmunity, for example.

Not to wild that you say that this is the first time since recovering from my heart surgeries that I've had any issues with my gut microbiome. Isn't that wild? Yeah, I think I definitely did put on some muscle mass, but I was doing, I was using the testosterone with the intention of lifting heavier weights also at the gym. Right.

Oh, so yes.

Yeah.

Because there's. Honestly, estrogen will help women gain muscle. You know, it is our. It's like we're we, we have our own hormones we don't need. Testosterone is important. But progesterone, if I didn't mention it, progesterone converts to testosterone. So your body will make what it needs. Needs. So you'll make plenty of testosterone. Gosh.

Okay. It's all just such incredible news that we have to keep talking about. So I know that you're passionate about educating women on outdated aspects of perimenopause and menopause. So when we think about like, age wise, why are these imbalances in our hormonal cycles only they're not reserved for, you know, when you're 50 and 60 and beyond anymore. Why do you think that is?

I think it's always been that way. We've just not been addressing or telling women. I don't think that's something necessarily new. I think that women have been suffering for decades. Yeah, this has probably been happening. It happened to our mothers in their 30s. They just put up with it. They minimized.

We didn't talk about mental health back then or no.

And we don't prioritize. Like, for example, women are just now I've seen the younger generations doing a much better job of prioritizing sexual health. Health, for example. Whereas, like, I have women come into the clinic and they're. It's never about vaginal dryness, but I don't really ask about it, you know, but I help them get started and they'll come back later and be like, wow, I didn't realize I was so Sahara desert down there. Because they didn't even recognize that about themselves because they're not prioritizing that. So even if they're going through these symptoms in their 30s, it's. They always say it's something else. Oh, it's because my diet's really bad or I'm not sleeping because of the kids, or they always have an excuse like, oh, my hair is falling out because of. Of maybe I'm allergic to eggs. I mean, I hear it all right. Like I hear these kind of allergy thing, but it's. Everybody always has an excuse or a reason. And I think that that's why also they. We keep pushing it off until, oh, now your 40s. And they would blame it on other things. Not not only do women do it, but definitely doctors or. I mean, that's why they say that, the hot flash. Because you can't blame that on something else.

Right, Right.

But that's actually really. You're in a bad state if you're having hot flashes. That's when the hypothalamus doesn't even have any estrogen to it and you can't even maintain your own body temperature. Nobody should be waiting until they have hot flashes.

And is that also related to nervous system regulation, do you think? Because I remember with the testosterone when things were getting really, really bad, I wouldn't have hot flash, but my body temperature would elevate a lot through the day. And I didn't realize that it was.

Happening before you started testosterone during testosterone.

And I didn't realize until I was the one that was going to open the windows when traditionally like I was always the cold one. But then all of a sudden I started getting really hot or sleeping. I used to always sleep in pants, but now I have to sleep in shorts and a tank top. And it's just like, I know it's something to do with my hormones.

Yes. And it's largely most likely hypothalamus like dysregulation. That's starting to happen and we need hormones to, to bathe these, you know, processes and hormones to help with that, that.

So let's do two parts here. One, let's just really own in on for the women listening who are going down this route of hormonal changes, maybe on the road to perimenopause or menopause. One, we're going to take away the doom and gloom. But what are some of the symptoms that you ask women to. To keep an eye out for?

I think that some of the first things that women see are subtle like but it is really, it's not subtle be to them but they minimize it. So this depression, anxiety, irritability, insomnia and skin changes. Like they'll see their skin not looking as great or glowy as it used to. Hair loss, I think and then weight, weight gain. I do think definitely we need hormones to maintain our weight. But like these are not what normally what we might associate with with perimenopause.

Right, right.

So I mean even just low energy brain fog, I can't focus anymore, I can't concentrate. I don't have like motivation. Maybe I'll go get and see if I have adhd. You know, this is really good. Like they're getting a diagnosis for this or anxiety or something else. And they're trying to really sidestepping the root cause, you know, and they're getting all of these other.

That is so good. They're sidestepping the root cause and they're looking for something that is diagnosable. We're also Looking for the label.

Yes. Yeah. And then also the quick, quick, you know, fix or something or, you know, but really, the. It's not. That's not the easy way out. I mean, if you really want to be healthy without all the work.

Yeah.

Replacing hormones is the easiest way to be as healthy as possible. It literally takes, like, seconds a day. And you can maintain health for longer, you know, go longer without disease, push it off, and that's doing it without any work.

It's almost like there's still a stigma, though, right? Because even hearing you speak, I'm like, oh, but then I'm admitting to going into perimenopause.

There's no badge of honor.

You know what I mean? Like, nobody knew that I'm aging, and then I'm gonna have to go on hormones when it doesn't feel good.

It's not.

We don't celebrate that in our women.

To just, like, we need to normalize it. So for men, it's like, we have done that for them. We normalize, like, erectile dysfunction. Hey, this is normal. Here's the treatment. Viagra. We normalize. Low t. Hey, you have low testosterone, we'll pour testosterone on you and make you feel like you're 20 again. I don't think they have the same stigma of taking hormones that women have. Like, we're not supposed to. Supposed to get older. We're certainly not supposed to do it in our 30s. And I don't. We think that this is getting better, but we need to just be more accepting of this and that, whether we actually need to recognize it and get on top of it. Because hormones are about prevention. We want to prevent heart disease. Heart disease. We don't treat it very well. We actually need. It's. You want to prevent heart disease. You want to. You got to start in your 20s to prevent heart disease.

Yeah, I don't. You wish. I always talk about, you know, the way that our ancestors lived. Don't you wish that there was a rite of passage that we could go through? It's like, okay, you're a woman. You've gotten to a point in your life where you're not gonna have children anymore. For me, that felt like grief. Right? And going back to my point now, admitting to you is like, oh, shit, I'm aging. I'm going through perimenopause. Like, okay, this is like a next chapter for me. And, yeah, I wish that there was more of, like, a celebration around it or a rite of passage. And maybe this does go back to media. Like. Like, we have to do more to celebrate the shifts that are happening in women's bodies, because we're going to get to talking to that too. There's so much beauty on the other side, right?

So much.

Yeah.

It's not about loss, actually. I really think that you can feel better over the age of 40 than you did before.

Right.

If you do it right. So I think this is just an opportunity. This should be an opportunity for women to learn and like, grow into all of the things that may. They may not have felt comfortable growing into, like their sexual health or their. Their wellness in general in their 40s that they'd never did in their 20s.

Okay. So until we get to your belief system, because obviously this is what you practice and preach and share with so many other people. How can we help women just step into that new groove, like, to really take ownership of their well being? Like, okay, here we are. I'm gonna say yes to understanding my hormones and recognizing that I don't have to look for the band aid solution anymore. But I'm really going to honor whatever this symphony is communicating with me. How do we help them reclaim their well being?

I think you're. You're doing it. You know what I mean? Like, just like all the work that you do, this is. This is it like telling women. I mean, I think the more we share our own stories too, and we talk about, you know, we all talk to each other. It's like this is a universal thing. We all go through it. It's all, you know, stuff that we're starting to talk about. The more we talk about it, the more we normalize it and the more we can celebrate. I really think it's happening is we're kind of in this paradigm shift. Like the pendulum is swinging the other way. But it's. It's like women really have control. They need to feel like they have control over this. And I think even with their treatments and plan, like, I think that's probably, you know, a good avenue is just starting to shift that I have control over this. I don't. Nobody's going to come save me. I don't need to wait for a doctor to do this. I can figure this out.

Yeah, I could see how that could be the really beautiful thing about social media. Right. I would say that there's like, there's a handful of practitioners out there who. Painting a really dark lens on menopause and like, the. All the problems from the patriarch and it's a patriarchal system. And like, I get it, but I'M solution focused. Me too. And I'm sick and tired of feeling like crap. And I'm sick and tired of, like, focusing on all the things that didn't happen. Right. And now I just really want to align myself with women like you and have those women on the show. So to really create, like, a documentary of, like, all of these incredible practitioners who are sharing their story and Dr. Mindy Peltz, who's been on. We say that we're going through this journey for a reason. It's like, I already had two heart surgeries. I've already been through the heart stuff, and here I am going through it again. And she's just like, well, if you weren't going through it, how would you be able to share about it? And I think that it's our responsibility to continue to share and talk and ask questions instead of saying, oh, it's normal. Oh, you're going through that. Yeah, just wait for what's to come.

No, I actually don't like that approach. I don't want to be. And honestly, I don't believe in that kind of community, like, because it's like. Like, I don't want to be sitting talking about all my problem. I want to solve the problem. I don't want the problem anymore. I want the problem to go away, you know? Like, I want to solve this so that I feel amazing, and you should, too. And then that's what we can talk about is, like, how great that's. That is.

I love that. Okay, so what are the main hormones that we need to be looking at as we age and why?

The first hormone we need to look at is progesterone. So it is. And it's. Nobody's talking about this.

No one's talking about this.

Because all.

The labs that I look at every single week from all of my clients, it never comes up.

So. And it is, though, it is embarrassing that it's for the lab community. So I'm working with academia right now in order to get this to change, right? So we need to report everything in a standardized unit. The UK does it. Canada does it. And if we put everything in an international standardized unit, it's obvious that progesterone is the dominant hormone in women. Right? Just. Just because, like. Like, the. It becomes, like, 20,000 instead of 2 or whatever. 20. 20 is what it would normally reported as. And so even in the concept of understanding how much progesterone. You know, and then I also think that we treat men. We've established optimal reference ranges for men. We've done this like it's been a decade since we've done this. And we know what it takes, like the dosing and regimen in order to make them feel like they're 20 and also to have the levels of a 20 year old. So this is what we're working on doing for women. Right. So we know that the brain can tell us this. So when we look at men, we give that, we gave them enough testosterone until we started suppressing LH in men. And that is what marker that the brain is saying too much. It's too much. Too much testosterone. Right. And so we can also go off of the patient. The man will be like, I feel like enough. This is enough. Right. So you can also do the combination of the two, can give you and tell you what, maybe an optimal reference range. And so this has not been done for women age 30 to 50. We know the extremes. We know pregnancy, we know menopause, we even know something about puberty. But this entirely ignored group between age 30 and 50 has been completely ignored. There are only five papers in the entire world.

Wow.

On what is an optimal reference range for progesterone in women. 5. And none of them are published in the U.S. and this, there's literally thousands of papers on testosterone on.

So this means that the lab ranges that we're seeing today are still based on men.

So for example, that. Yes. So that cut off. So look at, if you look at estrogen, for example, there's a cutoff of that upper range that labs report of 400. Okay, so where did that come from? So manufacturers of instruments in the labs will determine these. That number 400 was based on 49 women and 100 men.

Men.

So our very own reference range is. The bulk of it was based on men.

This is the first time I'm ever.

Hearing this, which is embarrassing. I mean this is really like. So not only is it. It's inappropriate so. But more modern studies. So if you look at more appropriate instrument, lab instrumentation, like we call it mass spec, it's more accurate. They've done studies where they look at women age 20 to 30 who are ovulating and they take their hormone levels every day to look at how it cycles. So we know that there's a peak during ovulation and this peak mid cycle during ovulation, estrogen can get up to 1800. Right? It can be. It's mostly like around 500 in a lot of women. But 500, 1800, this is all normal. Right. So it's variable. That's a pretty big range, but it's not 400. Right. So this idea that 400 is high or that. No, it's too crazy. We know that estrogen gets up to 40,000 during pregnancy.

Wow.

So these. This is. So doctors are under the impression that this has been established and this has been researched, and that's not true.

True.

There is no research. There's no establishment of this optimal reference range. And we can do this. We can establish this because I know that I can measure FSH and LH in a woman and give her estrogen and progesterone, obviously. So progesterone and estrogen, and then her testosterone will raise and then we can measure FSH and lh and the brain will say that if FSH and LH are still within a normal range, her brain is telling us that that's not too much hormone. Her brain thinks that that's an okay amount for her. If it starts to suppress, like we're suppressing it, then that's like too much. We're probably giving too much hormone. So there's an actual way that we can do it in a personalized way, just for you, that you know, what is exactly your right amount of hormone, does that make sense? And then we can do that for hundreds of women. So we. There's a lot of data that we can look at and establish what is an optimal range. And it's not going to be 400 is the cutoff.

No, it's closer to.

To a thousand, probably. But when you look at testosterone in men, their optimal range is a thousand to fifteen hundred picograms per milliliter for testosterone. So it's not that surprising that women would be that high, too. And when you have a woman who is getting hormone replacement therapy and she still has symptoms. Right. She's still like, I still don't feel like I'm 20 again, what's going on? And her doctor is saying that she's at 200, you know, picograms per milliliter for estrogen and that that's. We're not going to give you any more because that's too much. That's too high. This is the practice these days, and it's based on this lab value, if they even get labs, let's be honest, like, if you know what I mean, like, so a lot of doctors won't even get them. But yeah, so even. Even some of the better testing, there's still outdated reference ranges. Does that. Yeah, kind of make sense. And where the problem is, where we. But we have an opportunity here, so we know how to do it. We did it for men, and we'll do that for women.

So if you're really dialing in with someone, then are you. Labor agents are one thing, and it looks at a specific slice in the women's cycle. Are you using Dutch tests in your practice?

So urine testing is not the gold standard for hormone replacement therapy. So blood is still gold standard. And Dutch, you. I did laboratory medicine for a long time, and you really need to compare it to a gold standard, which is blood. And so urine does great job of measuring metabolites. So if you have individual on oral progesterone, then the Dutch test is great because you can measure those concentrations of metabolites. But oral progesterone has a very low bioavailability. It's only 20%. So the liver, like, gets to it, chews it up, destroys it. Right. And then it just makes women sleepy. It gives them a side effect. Some people like it because they're having a hard time sleeping, but you're like, this is an artificial thing, right? We were taking a bun. We're making a bunch of metabolites that are making you fall asleep. It's not progesterone that's making you. Progesterone shouldn't make women sleepy. It should make them sleep. Sleep like, they should be sleeping just fine, but they shouldn't be, like, anesthetic sleeping, which is what oral progesterone does. So oral. We know that oral formulations are not that bioavailable for hormones, but yet oral progesterone is very, very popular, and it's not the best form. Wow.

I'm on it. And I just increased my dose.

And you sleep because you're not. Because really, 200 milligrams of oral progesterone is actually only 20 milligrams after the liver gets done with it.

Wow.

I mean, it's just. Just the liver just destroys the. Because it has to be metabolized that way. So if you. The Dutch testing can be used to monitor that therapy. But I don't know how, you know, valuable it is because you women should always, again, you are in control, and you should always be believed over a lab test. So for practitioners still kind of chasing lab tests and, like, chasing this value for you and, like, trying to get you perfect. Perfect and. But not listening to, like, hey, I still can't sleep. I still have a low sex drive. My gut's still bothering me. Yeah, my hair and skin don't look quite what I Want them to. This should be the primary thing that you're treating too, and not a lab test anyway. We can use labs as guidance. Right. Like, they're really helpful in that. If we can establish this range and we kind of aim for it so that we can get started.

Right.

Something to aim for.

Yeah. And a lot of people just, they need to see something. Right. It just helps people to like, quantify.

What'S moving or like. Okay, it's okay.

Yeah.

Like my, you know, everything's all right. Yeah.

But it's really refreshing because I honestly know maybe a handful of doctors who actually even know how to read a Dutch test properly. It's the most complicated test, especially if you're somebody who has an irregular cycle. It's complicated to do. The results are really challenging also. Okay, so progesterone first and then estrogen and then estrogen.

Estrogen is the main feminizing hormone in women. So if you only give somebody. And there's. There's this confusion about what's estrogen dominance? I hear that all the time. I don't know if you've heard it. So estrogen dominance does not mean that you have too much estrogen. It means that you don't have any progesterone. Because progesterone really needs to be. The ratio needs to be a lot more than it's really about progesterone estrogen ratio. And so actually, in all of the estrogen dominant women that I've ever seen, their estrogen is way low. It's below 400.

A lot of the clients that I had in their 30s were diagnosed with estrogen dominance and then put on diminishing. Right. To reduce that.

And did they get better?

No. And then they get to their 40s and go through. There's still imbalances.

It's because they're low and we keep. And you know, I like that we use imbalance because it seems softer.

Right.

But it's really just a deficiency. It's a deficiency, like low in all. If, if you're not making any progesterone, you're not making any estrogen or testosterone either. You know, practitioners will say, well, your testosterone's zero. Well, if that and zero, then the rest of them are too, because that's like the lowest of. You know what I mean? Like, we would. We make testosterone from progesterone. So it's like if testosterone zero, then we're not making any progesterone. And I think this estrogen dominance also confuses women. And they still reported on Some of the lab tests. And so women fear estrogen even more because they think I have too much estrogen. I don't need it. And so really, this is not true. Their estrogen is not optimal. It's low. And it's just that they're having symptoms because everything's low and their progesterone's low. And taking dim doesn't make it better. And taking. And if you give them progesterone only, it's. A lot of patients will. And if you give them progesterone only, they don't get better either. And it's because they need all three hormones. Hormones you need to address, like you said, the entire symphony. And especially with hormones. You cannot just give one and expect her to get better. You've got to replace all three. If she's at the. The state where she needs hormones, she needs all of them. Does that make sense? 100.

This is just so helpful. Tell me what you think of this. So I'm just sharing everything. So I was diagnosed with frozen shoulder also. So I'm like. I'm checking all the boxes.

That's actually really common. Like, kind of this. Yeah.

No, but it's just funny because in my mind, I'm like, no, it's not happening. My body's like, here it is. Here it. So I go to see my phenomenal traditional Chinese medicine acupuncturist. And he's like, mona, if I told you the amount of women that I see in my office who have frozen shoulder, who just need to go on estrogen, and he even said I can be a little irresponsible and put them on a series of Chinese herbs that could take months or years to rebuild. Or every woman, when they turn 40, could just go on estrogen, and it would just alleviate a lot of the.

That I like him.

Yeah.

No, I mean, like, I love, like, I love it because, like, when we have musculoskeletal or, like, joint or, like, frozen shoulder estrogen. We need estrogen to build collagen, elastin, and hyaluronic acid, all of them. And so hyaluronic acid are, like, in the joint spaces. And so women will get, like, joint pain, frozen shoulders, like, achiness. And this goes completely away on hormone replacement therapy. Right. I mean, it's like, if you're optimal, you shouldn't have. Like, you should be able to do all this stuff with free movement and flexibility.

And he really described estrogen as, like, the juiciness of a woman's body. And the collagen and the glow and the moisture and like, everything that makes us kind of like yummy Feminine. Right.

When you think of a woman like.

Estrogen, I was like, oh, my God, no one.

I like him. Right? No, but he's right. And it's intuitive. And he's not like, getting bogged down in what cultural, you know, issues in society have, like, made us think about estrogen. But when we think about this feminine beauty, this is estrogen doing that.

All right, well, shout out to Dr. Adam Griffin from Accutonics. He's amazing. I'll give him away. He's just, he's incredible. And that just made everything make sense to me and also made me understand why I feel like I've aged the most in the past year more than ever before. So the mistake was starting those, those hormones first. So what is the best way, the optimal way of taking. You said progesterone. We're not going to take oral progesterone. We're going to do creams. And where are we doing the creams?

So it's a great question because this is also this misconception or there's not been a lot of advancements. We still give women oral or like, if you put progesterone through the skin, it doesn't absorb. It's a really large molecule.

Okay.

And it just is not great. Like, the skin is a barrier. Like, we don't want to absorb our lotions and stuff. Right. So it's not really great to try to absorb a hormone through the skin, skin. So. But vaginal mucosa absorbs drugs, which we know really, really well. And it's kind of like the really porous. There's a lot of blood flow. It's like doing an injection without having to do an injection. So if you think about how great the vaginal. When you put cream or something vaginally, it absorbs into the entire bloodstream. And there's something called uterine first pass metabolism instead of liver. So it actually goes. The uterus. Uterus gets to metabolize at first, which means that your intrauterine concentration gets high, which you could treat PCOS and endometriosis. And like our, you know, the uterus needs a lot of progesterone, like as we know from, you know, so. But it's not the only thing that needs it. Like your whole body needs progesterone, as we talked about earlier.

Yeah.

But it will allow the uterus to make metabolites that go to the brain that regulate bleeding, stop heavy bleeding, helps with anxiety, depression. Women have side effects on oral progesterone. Sometimes it makes them irritable or depressed breast. Virtually nobody has side effects on vaginal progesterone because you don't have these liver metabolites.

Wow. And the uterus. Can we just go back to, like, the magic of the. Of a woman's physiology? Yes. It's nothing about that.

So, I mean, how amazing when you actually step back and think about what estrogen and progesterone do for a woman and how amazing the process of be what she can do to get for pregnancy, delivery, and recovery. It is literally like life. And I mean, testosterone didn't do that. It doesn't do that for women. So although testosterone plays a role for us, you know, there's receptors in the clitoris, for example. There's some receptors that help with cognition and like, maybe a little bit of drive, you know, there. It certainly plays a role, for sure. But when you think about how. What progesterone and estrogen do for women, it is our main hormones.

Testosterone for me, feels like all drive all. Yeah, let's do it. Let's make it happen. Without the wisdom of intuition and flow and knowing what to do first and how it's going to lead and trusting myself again. It really felt like it took that away.

I love that you noticed that.

Yeah, I really did. Because after pregnancy, I was like. One of the gifts is, like, really turning on your intuition. You get so in tune with, like, the magic of how your body holds all the answers to direct you. And so coming back into the kind of, you know, logical drive side of myself, I completely lost that. That wisdom.

We don't need to be like men.

No.

And we're better. Like. Right. We offer something that's like, entirely better.

Yeah.

And so focusing on what are. I mean, it's. I love that you said that. Or you noticed it. And we bring other things in to the table.

I think just we're at a time in history where it's that magic that the world needs most of. So this is probably why women's hormones are getting so much attention. We've got to get this down.

We've got to get it down. We've got to figure it out.

We've got to figure it out.

Which we are. We aren't. But I mean.

And okay, testosterone, then I'm sure a lot of listeners are going to be, you know, oh, I'm doing testosterone pellet therapy. I'm doing creams. What do you prescribe to your. Your patients?

I prescribe primarily progesterone and vaginal in. In a vaginal form with estrogen with it, you know, so it's easy.

You do that first before you do.

That first, and then you find like after six months that actually testosterone levels become optimal. Like they'll get into that perfect range because progesterone just converts. And in fact, some women over convert, they make too much testosterone. You have to kind of block it with. And honestly, Chinese herbs are the best. We have no pharmaceuticals that block this. These pathways.

Right.

But they've figured it out. So eastern medicine is way, way ahead of us in terms of progression, like women's health in terms of, like being able to block these and lowering testosterone to like a more appropriate level for women. Like green. Green tea is like a perfect example of this. So we have a lot of ways that we can help with that. Does that make sense? So I don't think testosterone for some individuals, you can add more of it. You know, you way want to raise their testosterone, whether they want a different look or bodybuilding or what? I mean, whatever. Just some people want to try it. Then you can add it later and then give it a try.

Right. And not breaking too, you know, everything else.

Or. Yeah, or add it on top and see what it makes you feel like and see if you like it.

Okay. No estrogen patches. Ladies, like, noted all the notes I'm taking today. Good lord. So, okay, let's keep diving into that wisdom because I think you nailed it. Ancient wisdom holds so many secrets, and I really think that they. I honestly think that women tended to be the healers in the villages, and there was a lot more awareness and reliance on that. And I really hope that this isn't a type of wisdom that's dying. This is really why I wanted to merge these worlds together. So when we merge those two together, are there any ancient healing remedies that you recommend for balancing hormones?

Yeah, I mean, I still, I just. I always rely on these as a way to balance women. So I think that berberine is my favorite, as well as green tea extract. So just green tea? Matcha tea, Green tea. So women that are tea drinkers, green tea are found to be. Be 80% less likely to have ovarian cancer, for example.

80% less likely to have ovarian cancer.

So there's a chemical in green tea that's completely toxic to ovarian cancer cells. I mean, we know that it is highly protective of the ovary and prevents the pathology, like the cysts and some of the stuff that goes on and prevent testosterone can really cause problems. So it lowers that, it helps with immune balancing. So these are just, should be staples for women, you know. And I think that berberine is another one that's really, really great.

Yeah, I have a lot of clients on berberine specifically for just more glucose management.

But it's, but it does more than that. So it raises ampk, prevents colon cancer, it reorganizes the gut microbiome. It also lowers testosterone if it's inappropriately high. So it helps like because we think that a lot of these hormones could be essentially made in the gut microbiome, that it might even be an endocrine system. Right. When you look at this progressive way of looking at the gut microbiome, so being able to balance hormones within the gut, you know, as well, I guess it might be a way to say it, but even just nutrient deficiencies like iodine, like we don't eat seaweed or things that are full of iodine and everybody essentially has breast tenderness and fibrocystic breast disease and dense breasts as they get older, it's iodine deficiency. So even holding onto some of these like the diet, diet, you know, practices and of this ancient like wisdom, we should be, yeah, should be just a kind of a everyday thing for women.

Do you take berberine? I do, yeah. Supplement once, twice a day.

I take it with my dinner just because that's when I remember, you know, like I can't remember to take it throughout the day. But I love, love berberine.

I think I took it this morning. Yeah.

And does essentially this raising GLP1, you know, and so does estrogen. So if you take it together with estrogen, you can synergistically raise a GLP1 for this glucose management. And it works, you know, in a way similar to these fancy injections that are out, you know, and if you don't necessarily need as much weight loss but you just need maintenance or something or this longevity.

Yeah.

Then berberine is great.

So those are great. Berberine, iodine and green tea.

Green tea, yeah, I think so. And then just other essential like micronutrients obviously. And then.

And at what point for you do you incorporate modern day medicine then just.

The hormone replacement therapy. So I am very alternatively I rely, I think that we should use the mechanism in the body that we have. Like so there are pathway. I mean hormones are the some. Somebody said that hormones are like the CEO of the body, which I love because it's like they govern everything. But we can harness the, the body's natural way to heal. Right. So if there's a pathway there and treat it with like a peptide or a hormone, then you're just using the body's own way and you're just giving it that foundation or you're giving it like the micro environment it needs to heal. It'll heal itself. You know, the body that the power that created the body will heal the body. Yeah, right. So it's like you're just giving it what it needs. And I think that that is a better, more gentle approach and it's actually the right approach as opposed to, to like a pharmaceutical. I am not a fan of. I mean, I just found that they never worked. Like, I just feel like they. I don't actually prescribe anything else but hormones and peptides.

I love that you combine the peptide therapy with it. There's an amazing book. Have you read Quantum healing by Dr. Deepak Chopra? I have to send you a copy. I read it a long time ago and it's kind of like the first areas that really ignited this belief that our bodies can heal themselves if we help them remember how to do it. And I think that a lot of the things that we've been talking about today, they're really just all these assaults from our modern day world that are complete mismatch for a female physiology. And especially with all of the things that we're filling with our to do lists and our schedules and the feeling that we have to show up every day and like the step of, you know, feeling masculine and powerful and not honoring that femininity and that flow. So I really appreciate that and I really hope that, that I say this all the time. You are your healer. And the more that you can remember that you are your healer, maybe you can unlearn a lot of your symptoms that you've been diagnosed with, or maybe you can unlearn all of the diagnoses or maybe unlearn that menopause has to look a certain way or that aging for women has to look a certain way.

I love it.

Let's do some unlearning.

I love it. No, I think that you nailed it.

So if you had to put together a protocol for women who are entering perimenopause, what does it like, look, look like?

Well, I definitely. I start with just this easy 32nd a day. Like, hey, I make it. I want to make it as easy as possible for you. Like, I know you're busy and just to try this. And that is like a combined hormone replacement therapy, vaginal. Try that first and then Once you get your. I look at it as a pyramid. Right. Anti aging and longevity is a. You have to have your foundation in place. And hormone replacement therapy is that.

Yeah.

To prevent disease, to prevent problems. Problems. And then on top of that is like everything else. Right. You're never going to get away from your diet, your exercise, like your lifestyle, the other foundation. And then peptides are on top of that. Like let's say you have an extra 10 that you want to do. I want to lose a little bit of extra weight, I want a little bit of extra energy. I'm struggling with this. That's where like a peptide would kind of come in, in that maybe little top part of the pyramid and you can really optimize your health that way. But you have to have your foundation in place. So always start with that to make sure that. And plus, you know what's doing what. You start with one thing.

Yeah.

Make sure that they feel good on the hormones before you start adding.

Right. Adding everything else.

Yeah.

And are there three specific peptides that you like?

Yeah, I love. Well, I love glutathione and nad, you know, personally. So I think that those are great, great like a foundational peptides. Rapamycin is great for, you know, nobody feels it. You're not gonna feel the difference. But it's been shown to prolong life by seven years. So hey, why not try it? Yeah, absolutely. I mean you don't know like it. Maybe it'll work. But I love the story behind it. I that it's again we're, you know, using something of nature that we could potentially like manipulate mtor, which is fascinating.

Right?

Which is fascinating.

And do you prescribe fasting? Speaking of mtor?

Yes. Yeah, I, I am a big fan of protein mimicking fasting because I find that women, when you. Well, when I started fasting I would like lose muscle mass or I would binge eat afterwards, just be starving and then I would kind of not look forward to my fasts and I think that they're actually very healing. So I do protein fasting where I adjust and it may not be as effective, but I find it effective enough. You know what I mean? Like I've got to be able to do my job in life too. I can't just do a three day fast.

So protein diet's kind of like a mono diet, just protein.

Just if I do a fast for 72 hours, I'll just do like drink collagen or bone broth for 72 hours. So I'm still getting in my Say, I don't know, 100 grams a day or whatever it is of protein that you're trying to aim for 80 and then you're not consuming anything else, but you don't. I, I find that it's a lot easier to do the fast and maybe less muscle wasting.

Absolutely. Yeah, yeah, yeah, yeah.

Maybe it's a little bit more realistic.

Especially for the moms out there. Like when you have to cook lunches and dinners for everyone else and. Exactly. Yeah. I, it's funny, I've had practitioners on who obviously are very focused on the benefits of fasting. The science is there, the data is there, but I also think it really has to do with your constitution down to your nervous system regulation. From the things that you've learned as a child. Like, I think that if you put your body through prolonged fasting, if you've not resolved those things and how your body shifts into your sympathetic and parasympathetic system, you're just reliving all of that stress and trauma within your body with something as simple as fasting. So, yeah, I love that approach. Like, Dr. Will Cole talks about bone broth protocols a lot, which you're having something, you're nourishing the body still. It's not feeling like you're completely depriving yourself. And then I don't know, but I.

Add salt to my bone broth and eat it like a soup. And then I'm like, I'm eating food and then it helps me go longer on the fast.

So I've done a few days of bone broth, but I add seaweed.

That's a great idea. And so. And then I'll do green tea with it. Yeah, because. Which is also supposed to increase autophagy, however you say it. And then I know there's different ways. And then rapamycin as well. Right. So you're kind of trying to really stimulate those pathways in the body, but do it in a way that's like I can tolerate because the fast I'm not, I'm not the great. At best.

I just think that gentle, the gentle approach for women often can be a lot more rewarding long term. Okay. So we talked about focusing on the foundations of hormone optimization. Estrogen and progesterone priority there, testosterone last we talked about prioritizing the foundations of health. So your sleep, your exercise, your movement, your connection to nature, getting outside all of those key pillars, as you know, are so true. But what about like the onset of toxins, for example? We talked about that a little bit. But Are you doing labs to understand if your patients have a lot of, have a high toxic burden first before you do the hormones? Like will you ever do a detox before starting hormone therapy?

Um, I, most of my clients are over the age of 30 and I think that you can do a detox, but they're still going to need hormone. I look at it as like you.

Need both synergy, you need both.

Like most women are going to need the hormone replacement therapy. And the detoxing really makes your path, your journey optimization optimized. You get the best results, you're going to get the best longevity and health if you do the detox too.

Right.

I mean, I don't think, I don't agree. You know, you should have eliminate all of the stuff from the foods and the in the environment you're clean. Like all of that should be done.

Yeah.

I think the glutathione is a very effective way to detox. So glutathione peptide and it's also really, I don't think it should be a full time job to try to detox your environment. This is something that has to be realistic for sure for working moms and like, I mean it has to be within reason too. So just something that you can do without it overwhelming you, but then adding in these other things, you can be very healthy. I don't know if that makes sense. You're not like making it a full time job either.

Yeah. You know, and I think that why not start the hormone therapy anyways? Because it's a slow, gradual rebalancing that's probably going to help you feel better in the meantime.

Yes.

And at the same time, I'm just such a big believer in incorporating something that's going to help your body detoxify. So glutathione is for sure one of those things, things. Infrared sauna, lymphatic drainage, I find for women is so helpful.

Infrared sauna, do it like twice a week if you can, you know, and then lymphatic drainage. But movement will also drain the lymphatic system. But like I think that for example, there are environmental insults all around you. You can't get around it, you know, and you could be exposed to mold, for example. But the more healthy you are, like for example, if your hormones are optimized, estrogen and progesterone, especially progesterone modulates the immune system. Right. It boosts and protects the immune system. And so if you have a really strong immune system, when you do get exposed to that insult which you can't control. Like, you didn't control your mold exposure. Like, you never would have been like, hey, I'm gonna just be in front of mold right now. Like, you didn't choose that. So it was an insult to you. And so you can't control that sometimes. But if you maybe had your, you know, if you have your hormone levels optimized, then maybe that mold exposure wouldn't have impacted you as much.

You nailed it. There was zero visible mold whatsoever. It was actually water particles in a vent next to me. And, yeah, I don't think I would have been susceptible had I not have been so depleted.

You were depleted. And so I think that maintaining optimal health as best you can, and then when the insult happens that you can't control, you're able to really go through it. You're able to, like, heal from it and not. It not bother you. It's much.

Can we debunk the two parts? Perimenopause, men, menopause and cellulite. Perimenopause, menopause and weight gain.

Yes.

I know. Things that women are going to want to hear. Yeah.

So the. What's the myth that we need? So, because the weight gain is definitely, like, a thing.

Yeah.

So estrogen raises GLP1. It maintains GLB1, which we're finding is really important for weight maintenance. Maintenance, like with the injectables that are out. So we were learning a lot about this pathway and how important it is. And so there's no doubt. But it's difficult to lose. The best thing to do is to prevent it. Like, if you can kind of get on top of it and prevent. That's why I always want women to, like, hey, if you think you're low on hormone replacement therapy, you need to start it because you want to prevent the weight gain. It's actually harder to lose the weight once you've gained it. Once you've gained it, it's. Hormone therapy supports your efforts in losing it. Is that the brilliant.

That's kind of.

Yeah.

Yeah. And I think you just. You nailed it. It's not waiting until you have exasperated symptoms before you start. It's really finding a practitioner who's your partner in prevention before you even get there. Yes.

Treatment's a lot harder than preventing.

I love it. And Sarah, like, what I love about your content also is you talk a lot about. Around the fame or. Sorry, you talk a lot. Why am I losing my words? You speak a lot to the shame that is around female sexuality. And I've heard A few women say, and I'm even coming into my own. Like, my sexuality, I feel, is finally being awakened. I feel like there's this shift that's happening. Women are now just recognizing that there's no stigma around being sexual beings anymore. But how would you feel? Like, do you see an awakening of how this is deeply, deeply rooted in our culture and how there's a shift towards uprising? The femininity and the divide sexuality aspect.

Of it is definitely like an awakening. I love it. I love to see it. Women, we, as a culture, like society, we have, we prioritize men's sexual pleasure over women's. And so I think we're starting to shift that women are, you know, they're just. They're dismissed. Like, their concerns about sexual wellness are often dismissed.

Right.

They go to the doctor. So if a man goes to a doctor and he's like, I have low sex drive and rectal dysfunction, they're going to be given Viagra and testosterone to treat that. It's treated. This is a health concern. This is a health problem. You're actually at risk for diabetes and obesity and heart disease. We need to get your testosterone up. When a woman goes to a doctor and says, I have vaginal dry dryness, which is just a big of a problem for women, as erectile dysfunction is for men. Right. But if they go to the doctor and say that this is a problem, I have low libido, the doctor's like, you just need to read a spicy novel and date your husband. This is a. It turns into a relationship concern instead of a health concern. Doctors should be thinking you're low in hormones. And we need to actually, this will help prevent diabetes, heart disease, osteoporosis, infection. You know what I mean? Like, this was. We need to, like, get on this because is the sign that you have a low libido is a sign that your hormones are low, that something's wrong, that we need to like, hey, let's. We can actually fix this. So. But women, they. They kind of culturally, they've also dismissed this. I'm not supposed to have a, you know, it's not supposed to be a thing for us or. And I think it's how we talk to our daughters. We need to start talking to our daughters the way we're talking to our sons about it.

Absolutely.

That this is a normal thing.

Pleasure or 50. 50 works both ways. Yes.

Or even just if they learn more about themselves. So, for example, we know what causes an erection. It's blood flow for men. But it's actually the same thing that causes vaginal dryness or, like, lubrication for women. It's blood flow. So if women knew that the more blood flow they had to the pelvis, this is just blood flow seeping out of the vaginal wall. And it's like filtered water and proteins, and that's what causes the. That. And that can happen multiple times a day. And that's healthy. Just like men can have multiple erections a day because it's blood flow. Right. It keeps those tissues healthy. Women need to understand that this is what's keeping vaginal health. And wetness is very important for their vaginal health and their overall health. So if they were in tune to that and prioritize that, it would help their overall health.

The clients that I've worked with, the women specifically, they attribute it to aging and psycho, you know, know, lose my sex drive. It's supposed to happen. This is just the way that it's going to be moving forward. Or they see it as something that they need to do more work for them. Oh, I need to go buy sexy lingerie. I need to set up date night. I need to figure out something that's going to turn them on. I need to.

It's a relationship problem.

It's a relationship problem. And, like, there's no deeper understanding of, like, oh, your body's simply communicating with you, honey.

Find a doctor.

That's really going to just help you understand that.

Because.

Because your sex drive can come back. Like, you haven't ever experienced it before.

Sex should be better over the age of 40. You're more mature, like, you know what you want. You're more like. We definitely need to make sure that women are having better sex over the age of 40.

Yeah. It. Honestly, for me, it feels like this unlearning, like, oh, hey, like, of course I am supposed to feel this way. Or I get to call the shots, or I get to be a little bit more controlling, or I want this to be the same.

I love it.

Right. I think that that's so powerful. And like, when we shift from this aspect of pain to pleasure, when we think about woman, women's sexual pleasure and satisfaction. Do you coach on this? Do you talk about this at your.

I just try to make them feel like this is normal. I mean, like, we know that sex and orgasms raise dopamine.

Right.

So this is something that they should prioritize.

Yeah. And the reason why I asked this question is when I think about hormone optimization. Gosh, when I talk about my pregnancy, it There was so much pleasure and satisfaction and joy and. And for me now, engaging in conversations like this, like, oh, I can have that again, even though I'm not going to be pregnant again. It's just a completely different lens that we're looking at through hormones and aging and women and what's to come.

I think an. Yes, absolutely. And I think if you look at, like, I mean, it's easy. So, like, estrogen binds to a serotonin receptor.5htat, I think is what it's called. But it's the same receptor that. That MDMA binds to.

No way.

Yes.

I didn't know that.

So when we know that MDMA is effective at raising libido, it lowers inhibition, it raises oxytocin. Like for sex, for women, is all about lowering inhibition and receptivity in a way. So being receptive to it, you know, you don't even necessarily have to be the one with the drive, but being receptive to that. And so we know that estrogen does the same thing. It lowers inhibition, it raises receptivity, it raises oxytocin, improves arousal and sensitivity. You know, it. It definitely, like, puts. And then progesterone binds to the GABA receptor. It's like our nature, Xanax. It makes us feel calm and in the moment that we're able to, like, be in that moment. And so they all work together. Testosterone plays a role again, but it's like the women need all three hormones in order to have a sex drive and to have that sexual experience. And, like, they'll lose the ability to orgasm. Women will come into my office, be like, that's the thing they're complaining about in perimenopause. They're like, everything was working before, and now it's not. Now I can't have an orgasm. And I'm like, that's the only thing you've noticed? Like, you know what I mean? But like, the. All. All the other stuff that hasn't been as much. But that's great. I think that's great that that was her.

Yeah.

And that will come back with hormone replacement therapy, too. So definitely should be prioritizing pleasure.

So this, to me then sounds like it directly ties into the change in physiology that happens in your brain. Yes. As we move through menopause, we have.

A very complex neuron. We are literally different species then men. So, like, I think that this is. We cannot ignore the hormonal influence on all of these, like on mood, emotions, drive, and everything. For women, it's very important.

Walking, talking, miracles this has just been. My cheeks hurt. I've been smiling so much in this conversation. Thank you. All right, I can't wait to have you back on. To wrap things up, I want to just send over some rapid fire questions that we ask all of our guests. What are the most common mistakes or misconceptions that you're seeing women make with their health?

Oh, this is hard. Well, I think the most common misconception is that hormones are dangerous or that they're going to hurt them or that I need to lower my hormones or that they need to be low and I'm gaining weight because they're high. I just, I don't. And I think it's because we had birth control. So we all had a bad experience with birth control. Yeah, right. But birth control does the opposite. It takes away hormone hormones, and we're not doing that, we're replacing them. So we get this bad impression about hormones. Like we think that it's going to be like a birth control experience.

I have to tag on another question to this. Okay, so as hormonal knowledge and well being is taking its rise right now, do we have to be concerned of the sourcing of those hormones, where they come from, additives and ingredients and what's going into our body?

It's a great question. I think that the compounding pharmacies are very regulated. And now I think that's not as big of a concern. I think that there's pharmaceutical companies that will make you believe that compounding pharmacies are not. But these, they, they source them. They're pure ingredients. And I think as long as you're getting it from a licensed compounding pharmacy or like a, then it's going to be sourced without. It's going to be fine.

Beautiful. Thanks for clarifying. What is one way that women are making healing and health too complicated?

Yeah, I don't know. Like, that's a good question. But again, I think it's, it's, it is simple. And they're making it so complicated because we've been told that women are complicated. I think we're just like, hey, we're going to exclude you from studies because the women's cycles make you too complicated or you're too complicated. We're not going to figure it out. So women internalize that and they also think that, I can't figure it, I'm too complicated.

That is such a good answer. No one's ever said that. We have been told that we're too complicated.

And so we, we just tend to believe that, and that's not, it's. This is not rocket science. Right. And this is like if we take on these basic principles, even the ones that you practice and preach like this is. People can do this and then else to unlearn. Yeah. Something else to unlearn.

That is beautiful. Thank you. What is your favorite ancient healing remedy? We talked about your berberine. We talked about your green tea. Yeah.

What else? No, I still think fasting is probably one of the biggest things that we can do that, that from our ancestors that.

Do you have a consistent fasting schedule? Like every day?

I just feel like when I need to reset, like I will do a fast and so it actually is probably more frequent. I find that I feel. So I actually fast every day. So I'll do a pro. So I mean personally I do a fast protein fast until dinner. So I'll eat nothing but protein until dinner.

Beautiful.

And then I tend to not worry so much. I just eat dinner, whatever. You know, we tend to eat healthy dinners. So. So that's my practice. And then if I need more than that on top of that, like a 72 hour fast there, those are just when I feel like I need to really reset things.

Reset things. Do you drink caffeine outside of green tea?

I do. I love caffeine.

Okay, good. I always have to check. I love coffee.

I can't Like, I actually tried to stop multiple times. Yeah. And you know what? It's okay. Like, I like the dopamine. Exactly. I like espresso raises dopamine. I'm like, every time I drink it, I'm like, I'm raising dopamine. It's fine.

If that's our vice sister.

I think we're good. Yeah, exactly.

Okay. If you had to pick something about modern medicine that's really exciting you right now, what is it?

I think what's really exciting about modern medicine could be peptide therapy. And this is still more alternative. But things like. My interest is autoimmunity and healing the immune system, which is very difficult. But I think that things like low dose naltrexone and ways. And we know that progesterone, for example, heals it. But I think what's very exciting is that autoimmunity is really common and we, we could potentially have a solution for that. And I find that to be like very cool.

Something else that women don't need to be suffering from.

Exactly.

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

Hormone replacement therapy. I really think like, it's like, it is like one of the just basic, easiest things that you can do, you know. And then on top of the second and third would be to start listening to your body. So as we talked about in the beginning, it really is like the core, or if you're listening to your body, you're going to give it what it needs and that foundational, like, support. So two other things. I mean, it is, it does go back to the basics and it's. You're never going to get away from.

Yeah, okay, I get it. If you leave our listeners with just one takeaway that you're most passionate about right now, what would it be?

I want women to really, like, take control of this hormonal. Like, we're gonna be the ones to solve it. Like, we're not gonna. Nobody's like, we need to just take, do it and there's nothing. The hormones are healing, they're safe. Nobody should be afraid of them. They need to ask for it. They need to advocate for themselves. They need to recognize that it's a problem and just keep going. Like, we're on it, we're doing it, we're swinging the pendulum. So just, just keep doing it. Keep the momentum.

Painted such a beautiful, liberating picture of the future of hormonal health and the fact that it can be a lot more simple than what media and doctors have just been. Been portraying it to be for way too long. Decades.

Decades.

Literally decades. So I just thank you for that and thank you. I'm so happy that you came on the show. How can people find you? I know you're gonna get lots of questions from this.

You know, we're doing actually free consultations right now too. So if they wanna reach out and like, get some answers, yeah, they're welcome to do that. But it is just, we're online, like a hundred percent online again. I really wanna make it easy for women.

Yeah. What's your website site name?

Inner balance. So it's innerbalance.com. and then we're in 28 states now, soon to be all 50. So they can check us out, get more information and then really, can we answer all of your questions online too?

Great.

So you don't have to sign up to get your questions answered. You can even just reach out to us.

We'll link everything out below for everyone. I just wanted to thank you from the bottom of my heart. What an honor to sit with you today. Thank you for the conversation and the motivation. H. It's like, it feels so good.

Thank you I feel like I'm very grateful. Like I'm very lucky to be on with you. Thanks.

Until next time.