Latest / Motherhood Alliance Podcast / Woman’s Hormones Explained: From Puberty to Menopause w/ Alicia Barkholtz | Forum Health
Transcript
- Britney Suttner: Hi, we are Britt and Dreya from motherhoodalliance.com and we are excited to welcome you to a four episode series with Alicia Barkholtz, a board certified family nurse practitioner who specializes in integrative women's health, thyroid support, bioidentical hormones and medical weight loss. Alicia is passionate about helping women better understand their bodies and she believes healthcare should be personalized because no two women or health journeys are alike. Her journey into integrative medicine began after a close family member experienced a serious illness that traditional medicine could not fully explain. Finding answers through an integrative provider completely changed her perspective on healthcare and inspired the path she's on today. Alicia now works virtually with patients, combining functional and holistic approaches to help women feel their best from the inside out. And outside of her work, she enjoys running, spending time outdoors, baking, and making memories with her husband, daughter, and their spring or spaniel, Kip. Let's get started. Hey everyone, welcome back to the podcast. We are excited to kick off this new four episode series with Alicia. Welcome Alicia. Alicia Barkholtz: Hi, thank you for having me. Super excited to be here. Britney Suttner: Yeah, this is going to be a great series all about women's health, women's hormones, cycle syncing, just hormone imbalance, but we're also going to be talking about GLP ones as well. So I think this is going to be really informative for our audience. Before we get started though, I want to hear a little bit about you specifically that you used to drive race cars. So I'd love to hear a little bit about your background on that. Alicia Barkholtz: I did. So I grew up in a family. My dad raced a dirt truck car since he was 18. So like lived, breathed it. So he raced when I was little and then I raced go-karts with him when I was five. I actually won like the track championship. The trophy was bigger than me at the time. Andrea Renkas: you Alicia Barkholtz: So that was pretty cool. And then my parents had a few more kids. So my dad took a little bit of a step back. And then once my siblings and I were a little bit older, he got back into it and then he actually started his own business building race cars. So I worked there during high school and then into college when I was home, I would work for him. And so in that time, then I also got into racing when I was in high school. Once I got to college, then time kind of got to be an issue. So I wasn't able to do it, but also a super fun fact that brings us full circle. That's how I met my husband. He also is a race car driver and would come in to get parts and things like that for my dad's store. And then that's how we met and the rest is history. Britney Suttner: Well, that's super fun. Do you have like mechanical skills? Is that something you were learning from your dad then? Or was it more of just like, you know, helping him inventory the parts and stuff? Alicia Barkholtz: No, I definitely, so I, that was one of the deals like we had. So my brother raised as well. We had to work on our own stuff. Definitely a learning process and super funny when I was in college getting my undergrad, my RN degree, I think it was for an English class. We had to do like a how to paper, like how to do something. And I did how to take a engine out of a car and put it back in. So yeah, it's really, Andrea Renkas: awesome. Awesome. Britney Suttner: you Alicia Barkholtz: really random, but totally. been a huge part of my life and like I said my husband that's how we met and he races now too so my daughter she's two and a half now and she'll go down to a shop and like get out all of her little tools and pretend to work on stuff too so it's just a big family affair. Britney Suttner: I think that's awesome, because I think if Andrea Renkas: Yeah. Britney Suttner: there's any guys listening to this right now, they're like, like that's actually a Andrea Renkas: Okay. Britney Suttner: dreamy skill to have in a woman. How many women know this stuff? Like, zero zero one percent. Andrea Renkas: Uh-huh. Change, change your tire, do Alicia Barkholtz: You Andrea Renkas: your oil. It's awesome. Britney Suttner: You also love to hunt, which is Alicia Barkholtz: Yeah. Britney Suttner: kind of unique for being a woman, but not quite as unique as the mechanical side. So tell us about your hunting love. Alicia Barkholtz: Yeah, again, big family thing. You know, my grandpa, everyone hunted growing So I had the opportunity to go to Colorado and hunt elk and I went to Montana and hunted mule deer. And then for our honeymoon, my husband and I went on to Florida and we went to alligator and wild boar hunting. That was our, it was funny because everyone at work called it our hunting moon instead of our honeymoon. So it's just something that we have a big passion for and my husband was a big hunter too so that was another thing we had in common. So summer is taken up with racing and then fall is hunting and then we have like a little bit of an off season in the winter and then it just starts over again. Britney Suttner: fun Andrea Renkas: Wow. Britney Suttner: hobbies. And you know what? I love it because I feel like as women, there's so many women that struggle to even know what their hobbies are, especially after they have kids, they just kind of lose their hobbies and their identity. And they're like, I don't know what I like to do. Maybe shop on Amazon. So it's like, it's kind Alicia Barkholtz: Yeah. Britney Suttner: of nice to hear, you know, somebody that you've had hobbies in the past and they've been able to stick with you as you've become a mom and continued and you can, Alicia Barkholtz: Mm-hmm. Yeah. Britney Suttner: it's a whole family thing. Well, let's also hear a little bit about your story. You're now into like integrative medicine. I'm guessing you didn't completely start there, but maybe you did. So I'd love to hear a bit about your journey into what you're doing now. Alicia Barkholtz: Yeah, so I did not originally start there. So when I was in college getting my RN degree, I had a really close family member who got really, really sick and traditional medicine just could not figure it out. They were being worked up for MS, Parkinson's, like all of these different things, just really weird neurological symptoms to the point where this family member couldn't walk without assistance, so was using crutches and things like that and young. mean, I'm definitely not to the point where they should be having issues walking and things like that. And finally, my dad and I just like went online and we were just like trying to find something like someone who could possibly help us and give us another opinion. And we found a clinic out of Fond du Lac at the time it was called the Fox Valley Wellness Center. Dr. Merez was the provider there and we got my family member in there and found out they had chronic Lyme disease. And it was overtaking the nervous system, the heart, everything like that. And so we started treatment kind of from a holistic standpoint, more of an integrative approach. And I can 100 % say with confidence that without that, I know my loved one would not be here anymore because we were not going to get that type of treatment in traditional healthcare. So I finished my RN degree. I did work in the hospital for about a year and then they actually had an RN position open up at Fox Valley Wellness Center so I applied. I worked there for two and a half years. I moved to Fond du Lac because it was over an hour drive from where I lived so I moved to Fond du Lac. Worked there, learned so much but when I decided to go back to NP school was hard because what I was learning and had to learn did not correlate with what I was doing. you even like the blood pressure meds, just cholesterol meds, just things that you had to know. was like, I just am not integrated into that right now. So I did end up moving back to the Appleton area. I got a job back in the hospital, worked really well to kind of correlate what I was learning. And then as soon as I graduated, Dr. Mraz actually reached back out to me and said that they had an NP spot. He loved to start getting women's health into his clinic. And I was like, wow. I think I could do that. So I started there as a new grad and just dove deep into hormones and women's health and everything from a holistic standpoint, like all of, know, I just attended so many lectures and just so many things and I've been there ever since. I'm going on four years this summer of being, it's now Form Health. We had a little bit of a change with the company, but still integrative, holistic, and I just, I love it. And I love how I've got to this point and just being able to to treat the body as a whole is really what it all comes down to and what I just love being able to do in women's health is definitely my passion. So I just got obviously out of hand in this whole journey because it really just you know went full fold and now here I am. Britney Suttner: And how is your family member doing now? Alicia Barkholtz: good, much better and thriving and, know, still doing some treatments, but so, so much better. So it Britney Suttner: Mm. Alicia Barkholtz: was truly, truly a miracle that we found Dr. Merez when we did. And we're just so thankful for that. Britney Suttner: You have to wonder how many other people are suffering still, you know, Alicia Barkholtz: Mm-hmm. Britney Suttner: they haven't found this approach. So while you do specialize Alicia Barkholtz: Yeah. Britney Suttner: in women's hormones and women's health. And so we're going to be spending this episode talking about women's hormones in general, how they kind of change over time as we age and we go through different seasons like pregnancy and postpartum and perimenopause and menopause. like the women's women's body is complicated. So I guess just to kind of lay the foundation, can you just tell us like, are the main hormones we'll be talking about and in general, what are their roles? Alicia Barkholtz: Sure. So I would say the three major hormones that we talk about are estrogen, progesterone, and testosterone. And I like to think of them as like three friends. So they're like three friends in high school. So you have estrogen, which is going to be more of kind of your ringleader. She is the more dominant hormone. So she is the one that really kind of controls everything. So she's going to be the one that's going to be controlling ovulation and the sort of the menstrual cycle and things like that. So very dominant personality. and one that we have to keep in check because if we don't, she gets a little crazy and can wreak a little bit of havoc. So then you have her best friend, which is progesterone, and that's the calming friend. That's the one who is super chill. She always is able to pull estrogen down a little bit and bring her back to life. Very nurturing, very calm, helps you just feel more relaxed. And then you have testosterone, which I like to think of as like the more sporty friend. So that's the one that's peppy and energy and likes to do sports and weight lift and all sorts of things like that. So that one's going to be more towards like muscle, being able to maintain muscle and energy and libido and things like that. I'm a very visual person and you're going to figure that out through through this podcast. But that's how I like to explain it, because I think it's very easy to kind of understand where they lie and kind of what, when you think of it that way, it kind of helps to understand which one we have to keep our eye on more and make sure is in check. And really it comes to balance because for all of them to be cohesive and all get along, they all have to play their part and be balanced in order to make us feel optimal. Britney Suttner: Well, let's start at the beginning of when these hormones really start to show their faces. So sometime in puberty, right? Is there anything that kind of kickstarts the first menstrual cycle for young girls? And the reason I ask is because I have a daughter who's eight. I have a niece who's 11. You know, I'm surrounded by a lot of friends that have girls that are kind of starting to hit that age where they're like, boy, the first period comes anywhere between like 11 and 13. And I've heard little rumors like, well, when a girl is hitting around 100 pounds, that's typically when it starts. Or I just want to kind of debunk that or help us understand what kind of kick starts that first menstrual cycle for a girl. Alicia Barkholtz: Yeah, there's a lot of factors that play into it. I think that is a really good kind of rule of thumb. Like once you kind of hit a certain weight, it definitely does help to show because at that point you're starting to kind of develop the breast buds, right? You're starting to put weight on in different places. That is indicative of puberty and things starting. The other thing is it family history does play a role. So if you know you're someone who started later, the odds of your child starting later towards 13 and 14 are probably pretty high. The other thing that in this day and age, especially that we really, really need to keep in mind is like what we're putting into our bodies and what these girls are eating and what they're doing and things like that. So it's super important, you know, if they're eating a lot of processed foods and having a lot of additives and things like that, like it can cause our body and our hormones to start earlier, it kind of kicks them into drive, which isn't necessarily the best thing. And activity level too is a big one. So a lot of times children who might be a little bit more obese and things like that tend to start their cycle earlier. kind of the reason for that is fat cells hold estrogen. So when we have more fat, then we can have more estrogen and things like that, which can cause us to cycle a little bit sooner. So there's a lot of different factors. And if you have a child who starts earlier, I mean, it's nothing to be of concern, but definitely something to watch how it progresses and make sure that everything stays in check because it is known that children who start younger can sometimes have more issues throughout with like PCMS and things like that. So it is just important to really kind of watch how the cycles work and the symptoms that develop and things like that to just kind of keep that all in check. Britney Suttner: Do you feel like the things that we're eating are the primary reason why girls are starting to get their periods a little bit earlier? Because I feel like when we were growing up, the average age was probably closer to 12. I've heard of 10-year-olds getting it now. So Alicia Barkholtz: Yeah. Britney Suttner: is it like our environment and the things that our body is taking in? Is that their cause? Alicia Barkholtz: I do. I do. Yes. And I think there's a lot of research to support that. And that's why, like I said, it's just so important to know what we're putting into our bodies. And obviously, you're not going to deprive your kids of, you know, going out to eat and going out with their friends. But just, a big one that I think has come to the surface is like food dyes, right? Like different dyes and things like that. And now there's a lot of dye free options. So it's really just trying to Find healthier options to really support the body especially through puberty because so much is happening and the body really needs to be supported with the different nutrients and Minerals and things like that so but I do I think that there that is a big part of it because when you think of back to when We were growing up and it was a little bit older like There wasn't as there were still obviously processed foods and things like that. But I think it's gotten a lot worse. And it's just like the convenience of grab and go things. And kids are a lot busier now, I feel like. And even just when we factor in like exercise, OK, now there's social media and there's tablets and there's TV like I didn't have a tablet growing up. But like you went outside, like you were bored. You went outside and you ran around and you rode your bike and stuff like that. And that's it's a different. era now of really, you know, making sure that kids are getting exercise and stuff like that. So definitely environmental and food, I think plays a huge factor in when children can get their first or girls can get their first period. Britney Suttner: Staying on this age group for one more question is you just mentioned like it's important to support their bodies. What would be like your top two things that you would recommend for a mom that has a kiddo that just started her menstrual cycle? Alicia Barkholtz: Yeah, hydration would be a big one. Making sure that they're staying hydrated and whether that's through water or some really good like electrolytes. They make like good electrolytes for kids too that aren't so heavy in salt and things like that. then I'm going to do three. One is going to be protein because protein is going to be super important for helping them to build the adequate muscle and things like that. And the other thing I know this is going to be a trickier one, but truly the vegetables because of the antioxidants. So antioxidants, and this is something we'll probably touch on a little bit later, but that's what helps us metabolize estrogen appropriately. When we talk about women further on, when they get older and are in their 20s, 30s, we talk about there's a supplement called DIM, and what it does is it really helps to metabolize estrogen well. It's equivalent to five pounds of broccoli. Nobody can eat five pounds of broccoli. But the antioxidants in the broccoli is so important to help us metabolize things appropriately and get extra out of our body. So really focusing on, like I said, the hydration, protein, antioxidants, then, okay, fourth thing, making sure they're having adequate bowel movements. that is gonna set them up. Gut health is going to set them up positively way later on in life. We need to make sure that the gut is in check. making sure that they're having adequate bowel movements. And if they're not, what is going on? Is it a lack of fiber? Is it an issue with bacteria in the gut and things like that? those are my four points. I'm not doing anymore. Andrea Renkas: One thing I was thinking too, I mean, obviously, Alicia Barkholtz: Thanks. Andrea Renkas: a lot of girls, not a lot, but I know there's a lot of people who, especially when they start young with their periods, they can have like painful periods or like irregular periods. All the things that you just talked about, I feel like would help with having regular periods. what kind of what kind of advice would you get a mom of a young girl who has a period and they're concerned about regular cycles or irregular cycles. Alicia Barkholtz: I think the first thing, it's super important to develop that trust and that this isn't like a voodoo topic or a gross topic to talk about. it's, it's the, the woman's body is so amazing and we were designed so incredible when you really think about how it works every month, we're going through all of these changes in order to prepare your body for ovulation and fertilization if that were to occur. So I think it's super important to set that framework right away that you can come to me with any questions, right? and explain what it's supposed to look like. Like, you know, you're supposed to have a period for around five days and you might have a little bit of cramping and things like that. So really explaining to them how the process ideally is meant to work and then having that open communication that if it's not that way, like what is going on? Are we having terrible cramping? Are we having excessive bleeding? Making sure that they're comfortable using different devices, right? So like a pad, obviously in the beginning, they're not going to use a tampon, but being very open about all of this is so, so important. And I think developing that groundwork is important to just to have that open communication. But I think with that comes when you have that, then they're going to be more open to say, yeah, this is happening. I can't even get out of bed because my cramps are so bad, or I am bleeding so much like I bled through at school and it was terrible and super embarrassing. And then at that point, you know, looking at nutrition, right? Like, okay, so what are we eating? And we're going to cover in a couple episodes like cycle syncing, which I think also is very important to develop at a very young age. And just a quick, quick overview of that is just looking at what the hormones are doing at each stage of the cycle and how we can best support them through nutrition, through exercise. that's super important because your body is going to need different nutrients at different points of your cycle in order to best get it to flow appropriately. And just like I said, being comfortable with the fact that a period is normal and it doesn't have to be something that's like, my gosh, I hate this time of the month. Like trying to be like, okay, I know that it might be uncomfortable for a week, but like this truly is amazing. Like what is happening Andrea Renkas: Yeah, Alicia Barkholtz: is amazing. Andrea Renkas: absolutely. Britney Suttner: Yeah, and I'm excited for that cycle syncing episode. think that's going to be really eye-opening. Staying high level in this one though, can you just walk us through with those three hormones you mentioned in the beginning, what is actually happening during a normal menstrual cycle hormonally? Alicia Barkholtz: So day one of your menstrual cycle is the first day of bleeding. on day one, all of our hormones are kind of at baseline. They're just kind of chilling. uterus lining is sloughing. You're having bleeding usually lasts about five days, roughly. And I'm kind of going to gauge this on a regular 28-day cycle. And then after that, we start to get a little bit of an upclimb in estrogen. So what that's doing is that is going to start telling the body like, hey, we're gonna be ready for ovulation in a couple days. And then we're slowly gonna have an increase in testosterone. Then when you get to about day 14, estrogen and testosterone are gonna be at their peak. And that's where you probably feel the best. You have the most energy. For women later on, they're gonna have the highest libido at that point, because our testosterone is the highest. You're feeling really, really good. You feel like you can conquer the world when you're kind of at ovulation. And then once ablation occurs, roughly now we're talking about, you know, it day 15, 16, maybe testosterone and estrogen start to decline. And then we get an uptake in progesterone. And if you remember from the beginning of that episode, progesterone is our calming hormone. So when we think of why it's spiking at that point, your body is anticipating that ablation and fertilization occurs. So now we're going to have a huge increase in progesterone because that's our nurturing hormone. So that's the one that's going to welcome you in, give you a blanket and a cup of tea and be nice and cozy. When it realizes that there isn't any egg fertilized, we have a huge drop and it drops quick. And when it drops quick, that's where we see some of like the PMS symptoms of super tired, sore breasts, maybe some of the, you know, mood swings and things like that. And then once that declines, now we're at days like 21 through 28, and then it just starts over again. Britney Suttner: A woman is having her Alicia Barkholtz: Thank Britney Suttner: cycles and in our next episode we're gonna be talking about hormone imbalance. Maybe when you're not having the perfect period. I think in this one we just want to understand how is this changing over time. Let's say that fertilization does happen, a woman gets pregnant, What happens to her hormones then? Do they just kind of like sit at a steady state and they are not fluctuating the same way as you just explained? Tell us about that season. Alicia Barkholtz: Yeah, so once pregnancy is detected in the body, HCG is produced. So that's the growth hormone. That's what gives you a positive pregnancy test. But then progesterone spikes and it gets super high. And that's generally what's going to cause the breasts to become fuller. And that's what, you know, kind of stimulates the body like, hey, we're growing a baby and you need to think about producing milk and things like that. So the progesterone spikes intensely and that's going to be the highest one. Estrogen will spike as well. but not as much. Progesterone really takes over. This is her time to shine, And then like I said, that first trimester is when you're really having the most hormonal fluctuations and that what causes a lot of the different symptoms that women might experience like constipation, the morning sickness, because now not only is your progesterone super high, estrogen is starting to rise, but now you've got this HCG hormone floating around too that's, you your body is just going, okay. We're doing this, but it might not be the easiest. And then eventually they will start to kind of level out into the second and third trimesters. And then after the baby's born, when women talk about the hormonal shifts, we have another huge drop in progesterone. And now we're having a much larger drop in progesterone because in the menstrual cycle, it peaks, but it doesn't peak as high as it does in pregnancy. It triples, quadruples. mean, it's a huge amount in pregnancy. So then once... baby's born and that adrenaline wears off, then it's a huge decline. And that's where we can see of the increased anxiety. Because when we think about what progesterone does, that's our calming hormones. When we lose that and we have such a quick drop in that, that's where a lot of times we can see more of the postpartum depression, anxiety, and things like that, just from how quickly that falls. But that's kind of a quick overview of kind of what those hormones are doing over pregnancy. Britney Suttner: Does testosterone just kinda stay steady yetty? Alicia Barkholtz: That will, it'll increase a little bit. Women might notice kind of in the second and third trimester, they have more of like a sex drive and they're feeling a lot better, more energy and things like that. That's a little bit of an increase in the testosterone. They will like estrogen and testosterone will gradually rise. It's just not, progesterone goes so much quicker and it's kind of the one that Britney Suttner: through the roof. Alicia Barkholtz: dominates and takes over. But the other two will also slowly increase as well. Britney Suttner: So obviously that's going to be a season of life. How long does it take for the postpartum timeframe, typically for things to re-stabilize? I it's Alicia Barkholtz: This is what you. Britney Suttner: going to be different for every woman because some women get their periods back six weeks after having their babies and some get it back when they're done breastfeeding. So is it really, that's kind of your indicator that your hormones have re-stabilized, is when your cycle starts again? Or tell us about that. Alicia Barkholtz: I don't know if I'd say 100 % it's stabilized. My rule of thumb is always like three months. So you give your body three months. So once you start your cycle again, give it three months to see what it's doing. Is it now regular? Are you having extensive bleeding? Is it comparable to what it was before? Are you getting terrible PMS symptoms or is it not too bad? Really, three months gives you a really good idea of what your body is doing. Because that first period, Now it's tricky, right? Like it comes out of nowhere and sometimes it's super light. Sometimes it's heavy. But I would say after three months of cycling, you get an idea of where you're at. And at that point, then you can kind of decide, OK, is this regular or are we way off the charts? Like, it coming every 50 days instead of every 28 days? Am I bleeding a ton? Because that's something a lot of women notice after having a baby is they bleed more, which is to be expected. mean, your uterus had so much more blood flow to it for, you know, nine months and everything like that. Things have changed. Your body never goes back to the way it was prior to having a baby. So really gauging after three months. And then if it's really irregular, that's the time I think to get your hormones checked and to talk with the provider and be like, okay, am I estrogen dominant now, which is something we'll talk about in a little bit. But that is really a good gauge then to see A lot of women, their hormones will naturally eventually regulate, but for a lot of women, it might take some help in order to kind of get you back into a natural rhythm. Britney Suttner: Well then we hit the next phase. So now you're done having kids, you're just kind of going through your cycle again and then stuff starts to get wonky. And this is when you're starting to hit perimenopause. And so what's happening to our hormones? I just envision like everybody's hair is on fire, like all three of the friends their hair is Alicia Barkholtz: Peace. Britney Suttner: on fire, they're all running around, they don't even know what they're doing anymore. And that's why we're getting like all these weird symptoms. But walk me visually through what's happening during perimenopause. Alicia Barkholtz: Yes. So, in perimenopause, first hormone, and unfortunately, the first hormone that we see kind of walk away and decline is progesterone, which is unfortunate because that's our calming hormone and that's what kind of keeps us steady. So, that one kind of, you know, says bye to the friend group is like, I'm done here, I've done my duty and she kind of walks away. Well, now we don't have anyone holding an estrogen and testosterone is kind of just hanging out like, okay. I mean, I don't really know what I'm supposed to do. So when we have a decline in progesterone, a lot of times I'll say the first symptom most women experience is their sleep gets really crummy. I used to sleep great. I've never had issues with sleep. Now I can't sleep. I'm up all the time. I'm more anxious. I'm more crabby. That's because progesterone is the first hormone to start to decline. obviously sleep is super important. So that's going to play into kind of how your body responds. Now we have estrogen that's kind of roaming on its own, right? So now are we all the sudden, we could start having irregular cycles, we could start having excessive bleeding, because progesterone is what helps kind of keep our periods in check as far as bleeding goes. So a lot of women might experience bleeding for days, like way longer than what they had before, because they're missing that progesterone. And then... hot flashes and ice bits can start because now estrogen is just super dominant. Eventually estrogen will follow and it starts to decline but it can take a while and women can be in period menopause for like 10 years which I know is not what most women want to hear but it's true. It can take a very long time for the hormones to completely decline. Testosterone that one is a little bit slow. That one's tricky because some women that will drop very quickly and for some women I have women in menopause who still are producing testosterone. So that one is just kind of on a patient by patient basis. But in general, progesterone goes first, estrogen eventually follows. And to be in menopause, it's one year without any period. That's what's considered like the definition of being in menopause. But okay, now we have no hormones. So why am I still having symptoms in menopause if I don't have progesterone and I don't have estrogen? Well, we have receptors throughout our entire body, right? In our brain, in our heart, everywhere where hormones have to go. Hormones are so important for more than just the menstrual cycle. They're important for brain health, heart health, joint health. Those receptors get mad because now they've had hormones for years and now they don't. And so now they're running around with their head on fire because they're just super mad that they don't have anything. So they'll still cause symptoms to happen, right? So the hot flashes might continue the trouble of sleeping and stuff like that. So that's why. introducing some hormones back into the body can be super beneficial and help women transition through perimenopause and then well into menopause. Britney Suttner: And that's, that's bioidentical Andrea Renkas: Love it. Britney Suttner: hormone replacement, right? Alicia Barkholtz: Yes. Yep. Britney Suttner: Yeah. And we'll talk a little bit about that in the next episode. Yeah. This is really helpful to just understand. Andrea Renkas: Yeah. Britney Suttner: You know, I think one of the things that is a big struggle for women though, is during perimenopause when things are just kind of all over the board and now you're getting your period, but then you don't get another one for 35 days. And then your next one seems to come early and you just don't know what to expect. You also don't know when you're ovulating. And so if you're like at the point where you're like, I'm in my mid to upper forties, I do not want to get pregnant again. A lot of these women that are listening to this podcast are more naturally minded and so they're not on things like birth control or sometimes have a sex to me as an option. But do have any other thoughts on avoiding pregnancy during this timeframe? Alicia Barkholtz: Yeah, that's a tricky one. I don't love birth control. So obviously using condoms or things like that is a big one, but also just kind of really gauging and listening to your body. I think a lot of times even with ovulation, things change, Discharge can change your body temperature can change and things like that. So just really being mindful of that is big but also just keeping it in the back of your mind that yes, you Technically can ovulate up until menopause right up until you're not having periods anymore And the other thing that's tricky is sometimes you drop an egg and sometimes you don't so you can still ovulate and the egg might not drop it just kind of fizzles out and it doesn't actually drop into the fallopian tubes and things like that and then sometimes it does so just really trying to like hone into the body and understanding like, okay, am I having a little bit of different changes and things like that? And then maybe we're going to back off for a day or two big one. That's a tricky question because there's no Britney Suttner: Ha! Andrea Renkas: Mm-hmm. Alicia Barkholtz: foolproof plan to help prevent pregnancy in that stage. Britney Suttner: But if somebody has been doing natural family planning where they're kind of checking their discharge, they're actually taking their Alicia Barkholtz: Yeah. Britney Suttner: temperature, stuff like that, that would still apply during this time to understand when you're ovulating. It's just that it might not be as predictable. Okay. Alicia Barkholtz: Correct. Yep. Britney Suttner: Okay. So to finish out this episode, I would love to just hear, no matter what season a woman is in, do you have any, even maybe like your non-negotiables as you're going through your life, but like, what are some lifestyle changes that women... can really focus on to make sure that they're supporting their home ones. Alicia Barkholtz: So biggest one I think is cycle syncing. So which is something we'll talk about really just giving your body what it needs at the point of the month that it needs it is super important. But non-negotiables are definitely hydration. And I know that sounds so silly because we always talk about hydrating, but it's so important to help keep detox pathways open, to help keep digestion going. So that's a super big one. Protein, I know I talked about this before, but that's another really big one, especially as we move through those different changes in life and the hormones start to fluctuate and we might lose a little bit of testosterone and things like that. It's really important to keep our protein intake up. Again, it helps to metabolize the hormones appropriately. It helps to open up those detox pathways. And then making sure that your gut health is in check. Women fall into such a pit, I guess, of, you know, well, I've always done this way. I just, go, I have a bowel movement every three days. Like I've always been this way. That's not good. We hold on to so much when we're not having adequate bowel movements and not having adequate gut health. So that is something that I think is non-negotiable. Like you need to be regular, take a probiotic, really kind of support the gut. The doctor, Merez, when I worked with him, always talked to, always said the gut, the gut, the gut. Like that is where everything stems from. And when you think about where it is in the body, it's true, right? It's our central point. So we need to make sure that our gut health is in check. And then honestly, everything else kind of will follow in balance. Britney Suttner: Well, I know that you offer a free consult for anyone who would Alicia Barkholtz: Mm-hmm. Britney Suttner: like to connect with you and maybe just ask some more questions. What would be the best way for them to book a free consult? Alicia Barkholtz: Yeah, so you can either find it online. So you can just search my name, Solisha Barkholtz, form health, and then you'll be able to schedule directly online. Or you can call our number, which is 833-510-1463. The 15 minute discovery poll is great. I love it. It's just a conversation between me and you just to get to know what you get to know what you have going on and making sure that I can help you. if it's something that I feel like is out of my scope, then I will refer you to somebody else. So you're not wasting your time or your money on an appointment that, you know, isn't going to go anywhere. Cause that is always the worst when that happens. Britney Suttner: Perfect. And we'll put that link directly in the show notes as well. Well, this, we're going to be hitting pause really on this conversation because next up we're going to be kind of flipping into what a lot of people are going to be interested in hearing about is when that cycle is not being perfect the way that you just explained it. So when there's hormone imbalance or just symptoms that are going on, like what are the steps and what's Alicia's recommendations for that? So we'll be back soon with the next episode.