There's got to be more women that were doing

everything right and I ate really well.

I was exercising.

I was doing all the right stuff.

And yet I was still gaining weight and still having all these health problems.

And so I then decided I'm going to become a nutritionist.

And I ended up getting pregnant with my second baby.

So first, what are the most common types of hormone replacement therapy that somebody who might be a little bit skeptic or hasn't done yet any hormone replacement, a listener, what should they know?

birth control pills,

antidepressants, sleeping pills.

Which is not always from hormonal loss, but if all of a sudden you're getting these symptoms...

in perimenopause, then there's a good chance it's because of the hormonal loss.

And we know that over 80% of women now are going to have symptoms of menopause and perimenopause, and 25% are going to have severe symptoms.

And when I say severe, I'm not just hot flashes.

No.

And so I

Mm-hmm

... that you need to be looking out for.

And typically we're seeing perimenopause starting kinda earlier and earlier right now, but at usually late 30s, early 40s is when the first symptoms start to show up.

But we are seeing it start even sometimes mid-30s for some women.

I think I for sure started perimenopause in my mid-30s, 100%.

I had kids late, but I was g- I had n- very little progesterone.

I did get tested, and so I think I was going through early peri- like, uh, perimenopause.

What kind of testing should these women be looking for? What does that look like?

When a woman asks, "But is it safe for me?" what parts of her health history need to be considered?

So I will say that majority of women can safely use HRT.

And here's what you have to remember.

You were producing boatloads of these hormones through the majority of your life, right? From the time you were 13 till the time you were in perimenopause, you produced boatloads of estrogen, and it's estrogen that everybody fears, right? Where everybody's like, "Oh, I don't think I can take HRT," and, you know, "I have a histo- family history of breast cancer." And we also know from the research that women that do replace their estrogen in perimenopause and menopause have a reduction in breast cancer cases.

So we know that it's, there's actually a breast protective component to estrogen.

But if you have a history of breast cancer, then you are gonna want to talk to you- your oncologist as well as somebody that really understands hormone replacement therapy to decide whether or not it's gonna be safe for you to take.

There is a lot of new research coming out around that topic.

Hmm.

So can you explain what is the midlife transition that women go through?

Absolutely.

Yeah.

A lot of women don't realize that perimenopause actually starts quite early in life.

And we don't notice it because the symptoms creep up really slowly for most women.

But we're starting to see perimenopause symptoms starting even in our mid-30s.

It's getting earlier and earlier.

We have pellets.

like...

What just happened? Like never in a million years did I think that could happen to me.

And so I came out of the experience going, we are not being told anything.

Like if me, the person that's been in this world, practicing nutrition as working with hormones, gone.

didn't think that I was going to go through that, then how many other women out there in the world don't realize what's coming down the pipeline? And they think us healthy women think we're going to have it easy because we're healthy.

And what I realized from that experience was you could be the healthiest person in the world doing everything right.

and you could still get slammed with the worst symptoms of hormonal loss.

Or my peptide.

So what is the critical window for starting, whether it's a patch, a pill, or a vaginal estrogen? And what would that window look like?

So we like to see women start looking and exploring HRT when they start going through perimenopause.

So that's typically around early forties.

We lose our progesterone first.

So that's Usually the one that gets replaced first is the progesterone.

And then from 45 to 50, you really watch your estradiol numbers and your FSH, follicular stimulating hormone.

And a lot of doctors will say, well, we're not going to give you, we can't give you estrogen because you still have a period.

So

[laughs]

I love that stuff.

I love it.

I've been thinking a lot about sex, and I was gonna actually have a couple of my girlfriends come on a podcast to, to just chat about what their sex life is like now that they've hit midlife.

And I'm like, I wanna hear from the regular woman, because I've had the sexperts on.

I've had a lot of them come on my podcast.

I've had Susan Bratton.

[swoosh]

Why start one now? Sorry, Karen,

it's to you.

Yeah.

So I did see a recent post actually from a practitioner that was saying, don't ever test your hormones in perimenopause.

There's no point.

And you hear this a lot.

And their theory behind that is in perimenopause, your hormones are jumping all over the place, especially in late perimenopause.

At a time.

Yeah,

because that's something that I think you need to address, Zora, because something that we're seeing right now, kind of a growing movement or awareness around the fact that we have to quit giving these micro doses or just even... regular doses for some women of hormone replacement therapy, that it may take higher levels of hormones to get protection.

And I don't think this is a blanket statement for everybody.

I think some people can be on low doses and get that kind of protection.

But I think we need to start looking at this because I think it's going to start going towards the fact that we're giving higher doses of estrogen, of testosterone, not testosterone.

I don't think we need higher doses of testosterone for women necessarily, but estrogen because estrogen has been feared for so long.

But if it's a green light, please get back to me and let me know what you think.

But estrogen, because estrogen has been feared for so long and it's always, don't give very much, mix it with estriol, make more estriol than the estradiol, which is not going to give you that bone protection like estradiol is going to.

Why is it so freaking hard in perimenopause and menopause to lose the weight?

Yeah.

There are so many mechanisms of action that start to come into play.

I call it the midlife metabolic storm, because that's literally what's happening on the inside.

And in the beginning stages, so I'm gonna kinda walk you guys through from perimenopause to menopause, what starts to come into play.

And in perimenopause, which typically starts around your late 30s, early 40s, the first hormone that we know that starts going is progesterone.

Now, progesterone actually doesn't have a massive effect on our weight.

Yep.

Yeah.

And I got into this because I went into a very early menopause.

At 42, I started to go into menopause, but at that time I had been a practicing nutritionist.

I, my, my focus was on hormonal weight loss resistance in women, because I had experienced hormonal weight loss resistance.

And so I was bringing it out to the world of women, and I thought I had everything dialed in and had it all figured out because I had figured it out for myself and I had lost the weight and I had come out the other side.

So now I'm counseling other women on how to do it, and had somebody said to me back then, "You know, what's, what do you think your menopause is gonna be like?" Let alone me- perimenopause.

I didn't even think about perimenopause, but I would've just thought, "Oh, I'm gonna have a couple months of some hot flashes and night sweats," because that's what I equated menopause to.

What prompted you to create products to address that?