Oct 12, 2026 · 36 min · 10 segments
**Dr Fatima Khan: Hormone Health is Mental Health** What if the anxiety, depression, rage, brain fog or feeling that you’ve completely lost yourself isn’t “just stress” or something you simply have…
Fatima KhanGuest
Shelly HortonHost
Then it's your foundations, which is your sleep, movement, social connection and stress.

And the third layer is the inner work, which is where we really go in and understand what is driving us to live the way we are.

But are there any unresolved underlying wounds and patterns that we need to identify? Now, in going back to your question, we always look at hormones because for women, our mental health is intricately linked with our hormones.

And there are some women who find that they experience these changes on a monthly basis.

We're going to go straight into understanding how do we know what perimenopause is.

And I think the easiest way to understand is that a woman's reproductive lifespan starts at puberty, which is when you start having a menstrual cycle to release an egg, and it ends at menopause when you have no more eggs.

And therefore, there's a critical point between 37 and 40 where the egg quality and quantity declines significantly.

I'm not bothered to produce an egg every month in order to procreate and conceive.

So every woman we know has reduced levels of fertility starting... late 30s early 40s it's a biological change that we know happens in every woman because menopause hasn't changed it's been for centuries at 51 evolutionally we still haven't evolved so the egg count is going down at 37 40 which means the transition which lasts about a decade long starts with what i call a decline of hormone hierarchy so the first hormone that declines is progesterone when we don't produce progesterone sorry i'm going to cut this out That's all right.

So every month when you ovulate to produce an egg, we know that in perimenopause, 30% or up to 30% of cycles are anovulatory, meaning you do not ovulate, means you do not produce an egg, which means no progesterone.

And we wrote a whole chapter about this in your book, about when you lose progesterone, not only do you get heavy bleeding and flooding, which obviously causes hair loss, fatigue, and exhaustion, but progesterone is your body's endogenous tranquilizer.

It supports the GABA receptors in the brain, which are inhibitory, meaning they calm the nervous system.

And things like Valium, Diazepam, glass of wine stimulate the GABA receptors in the brain.

And so every month for two weeks of the month, we produce lots of progesterone, which will prepare the lining for pregnancy, but obviously...

It's doing these other two things which are very rare, very seldom talked about in medicine, which is deep restorative sleep.

So first thing we see in perimenopause is heavy bleeding, sleep disturbance, anxious, and then feeling overwhelmed with all of this.

Then it's your foundations, which is your sleep, movement, social connection and stress.

And the third layer is the inner work, which is where we really go in and understand what is driving us to live the way we are.

But are there any unresolved underlying wounds and patterns that we need to identify? Now, in going back to your question, we always look at hormones because for women, our mental health is intricately linked with our hormones.

And there are some women who find that they experience these changes on a monthly basis.

We're going to go straight into understanding how do we know what perimenopause is.

And I think the easiest way to understand is that a woman's reproductive lifespan starts at puberty, which is when you start having a menstrual cycle to release an egg, and it ends at menopause when you have no more eggs.

And therefore, there's a critical point between 37 and 40 where the egg quality and quantity declines significantly.

I'm not bothered to produce an egg every month in order to procreate and conceive.

So every woman we know has reduced levels of fertility starting... late 30s early 40s it's a biological change that we know happens in every woman because menopause hasn't changed it's been for centuries at 51 evolutionally we still haven't evolved so the egg count is going down at 37 40 which means the transition which lasts about a decade long starts with what i call a decline of hormone hierarchy so the first hormone that declines is progesterone when we don't produce progesterone sorry i'm going to cut this out That's all right.

So every month when you ovulate to produce an egg, we know that in perimenopause, 30% or up to 30% of cycles are anovulatory, meaning you do not ovulate, means you do not produce an egg, which means no progesterone.

And we wrote a whole chapter about this in your book, about when you lose progesterone, not only do you get heavy bleeding and flooding, which obviously causes hair loss, fatigue, and exhaustion, but progesterone is your body's endogenous tranquilizer.

It supports the GABA receptors in the brain, which are inhibitory, meaning they calm the nervous system.

And things like Valium, Diazepam, glass of wine stimulate the GABA receptors in the brain.

And so every month for two weeks of the month, we produce lots of progesterone, which will prepare the lining for pregnancy, but obviously...

It's doing these other two things which are very rare, very seldom talked about in medicine, which is deep restorative sleep.

So first thing we see in perimenopause is heavy bleeding, sleep disturbance, anxious, and then feeling overwhelmed with all of this.
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