Episode 63: A Whole-Body Approach to Perimenopause with Dr. Julie Sarton and Dr. Alexa Charbonneau

Dr. Mary interviews pelvic floor physical therapists Dr. Julie Sarton and Dr. Alexa Charbonneau from Sarton Pelvic Healing about common perimenopause/menopause issues they treat, including urinary leakage (stress and urge), dyspareunia (pain with sex), nocturia (peeing at night), constipation, and broader musculoskeletal problems like SI joint pain and frozen shoulder. We discuss how symptoms can reappear or become “unmasked” in midlife and emphasize that while hormones matter, one-size-fits-all HRT messaging misses crucial factors such as nervous system regulation, lymphatic and gut function, fascia changes (including estrogen receptors in fascia), old injuries, breathing mechanics, and visceral/organ mobility. The conversation highlights nuanced decision-making for cancer survivors and people with conditions like endometriosis, genetic detox differences, and mast cell activation (MCAS), stressing quality of life and individualized, team-based care. What you will learn in this episode:  - Perimenopause can start as early as 35 and last a decade - Many symptoms they've normalized (leakage, joint pain, painful sex, brain fog, peeing at night) are treatable, not inevitable - HRT is not one-size-fits-all — especially for those with endometriosis, cancer history, or genetic variants like MTHFR or APOE4 - How the pelvic floor is connected to the feet, jaw, neck, diaphragm, tailbone, and even cranial bones - How there are estrogen receptors exist in fascia which may be why old injuries resurface in perimenopause - Constipation can recirculate estrogen, making hormonal symptoms worse - The lymphatic system is deeply underaddressed and may have real implications for breast health - Nervous system regulation is foundational for lasting healing 00:00 Episode Overview 02:00 Meet the Guests 05:36 Common Menopause Symptoms 08:12 Dr. Julie’s Personal Journey 12:43 Beyond One Size Fits All 15:56 Nuanced Hormone Decisions 17:48 Detox Constipation MTHFR 19:08 Cancer Care and Quality 20:30 Mast Cell and Gut Clues 23:06 Lymph Histamine Overlap 24:01 Estrogen Swings Explained 24:37 Pelvic PT Full Body Care 25:53 How Fascia Line Connect the Head to Feet 27:48 Estrogen Receptors In Fascia 29:35 Detective Work Success Stories 30:33 Diaphragm And Visceral Work 32:25 Constipation And Tailbone Keys 34:28 Glymphatics Lymph And Drainage 37:09 Nervous System Lifestyle Reset 39:13 Menopause Recalibration Closing 42:13 Where To Find Pelvic Healing 43:25 Podcast Outro And Support You can learn more about Dr. Julie and Dr. Alexa’s practice: Sarton Pelvic Healing in Irvine and Southern California here: https://www.pelvichealing.com You can follow their instagram below: https://www.instagram.com/pelvichealing/ **Want support for perimenopause that goes beyond hormones?** Whether you (or your clients) are taking HRT but still having symptoms, not ready for it, or can’t tolerate it...there’s more we can do. I’ll be sharing practical tools from a **movement and rehab perspective**, focusing on the **nervous system, fascia, lymph, viscera, and musculoskeletal system**. If you want updates on workshops, resources, and strategies to support this phase of life more fully, would love you to join my email list. Subscribe to my email list here I’ll see you in 2 weeks! PS: If you are interested in being a guest on the show, please fill out the form here.