Latest / hol+ with Dr. Taz MD | The Future of Medicine is Holistic / What Is Perimenopause Really? The Symptoms No One Warned Women About | Dr. Mariza Snyder
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- Perimenopause Symptoms You Should Never Ignore... Especially the Rage | Dr. Mariza Snyder - YouTube https://www.youtube.com/watch?v=EkUpMGBcEEk Transcript: (00:00) The number one thing women tell me is that one, they don't feel like themselves anymore. And two, their ability to handle the things that they used to handle with less effort is requiring more effort from them. And the number one reason women come to me isn't the weight resistance, isn't the brain fog, isn't the hot flashes or the night sweats. It's the rage. (00:20) >> Oh, the rage. >> It's the rage. Why? Why is the rage there? What What's happening there? Why is everybody so angry? >> I think there's a lot of reasons why we are pretty angry. Where do you want to start? >> Collectively, I think pmenopause is a reason. >> Millions of women are navigating pmenopause without realizing they're in it. (00:41) They're told their fatigue, their mood swings, and weight gain are just normal signs of aging. But what if that's not the truth? >> We were told that it was all in our heads for so long. True. You know, the reason why per menopause is having a moment is that there is a collective outrage where women are like, "You're telling me this entire time for a decade, give or take, that I'm experiencing these symptoms, and you are writing it off as age or needing to exercise, >> anxiety, your depression. (01:05) " Yeah, it's misdiagnosed. Like, it's everything but these hormones, these whole body hormones fluctuating. >> My next guest is actually a friend who I'm so excited for you to meet. Dr. Marissa Snyder is a functional practitioner, women's health expert, and best-selling author [music] of the Perry Menopause Revolution. (01:23) She's the host of the Energized Podcast, and a leading voice in hormone and metabolic health for women. Drawing from over 15 years of clinical experience, she helps women navigate pmenopause with confidence, clarity, and sciencebacked [music] strategies that restore energy, balance hormones, and rebuild resilience. her newest book reframes perry menopause as a pivotal opportunity for transformation, [music] longevity, and empowerment. (01:52) Please join me in welcoming Dr. Marica to the show. Hi everyone, it's Dr. Taz. Before we get into today's episode, I just want to pause and say thank you. Your messages, your shares, your stories are the reason we make Whole Plus. Every conversation here is about connecting the science, the intuition, and everyday life together so you can feel more like yourself. (02:14) Again, if you haven't already, hit that subscribe or follow button. It helps us reach more people who need this. All right, let's begin. All right, this is exciting. We have done so much stuff together over I don't know how many years. Probably eight years. Eight years. Close to a decade. Close to a decade. (02:32) And this is the first time we're actually meeting face to face in person. So, thank you for coming up here. Dr. Marica, you and I have talked about all kinds of things. I think we've talked about essential oils, we've talked about hormones, we've talked about energy, but I think the central thing we keep coming back to no matter what we're talking about or writing about is women, right? And the state of women and the state of women's health and then what we can pull and grab to keep women healthy. (02:58) And you're on the show today because we love you and we also are so excited for you. You have a brand new book out called The Perry Menopause Revolution, right? Okay, there it is. >> There she is. >> And it's out uh today or right. >> Yes, it was out this week. This week, this is the this is the week. >> This is the launch week. All right. (03:17) So, you know, it this is a conversation. It's been interesting. I feel like it's slowly coming to the forefront, but I still feel like most of the noise kind of in the space when we're talking about women's health right now at least is focused on menopause. And we're kind of forgetting that there's this leadup, you know, and I wrote about it in the hormone shift as well, that, you know, there's this leadup to every hormonal phase of a woman's journey. (03:44) And pmenopause deserves its own airspace, just like menopause has had its airspace. So, what inspires you to write this book? And why do you think so many women hit pmenopause and just feel like, you know, the rails are coming off? >> I love this question. >> Yeah. I was blindsided by pmenopause even after 17 years of being in the clinic clinical setting and seeing women go through this transition of permenopause and menop menopause midlife let's call it the messy middle um but I had my son at 41 years old >> okay like many women today (04:19) >> like many of us yeah like millions of women today which which what a blessing that we can stand on the shoulders of our moms who have you know worked hard to get us the education and really just shift the narrative about what women have the capacity and capability to do. Definitely. (04:37) So, because of my mom, you know, I was able to really expand my career and wait until I was in my 40s to have my son, Kingston. So, two years of postpartum, give or take. I mean, my period didn't even come back online until almost two years into that journey. >> So, you're like 43. >> Yeah. 43. >> 43ish. Okay. >> And I had about a fivemon runway. Okay. (04:57) >> Where I felt amazing. like my sleep was finally good. I had good energy. My brain was finally on all cylinders and I was moving my body in a really big way that felt good to me. >> And then I felt like kind of the ground started to shift underneath me. Um I started burning out after the workouts. I began to notice brain fog and I was forgetting why I walked in a room. (05:20) I noticed that my energy and my capacity, my stress tolerance just wasn't there. The thing that I noticed the most was that things that were effortless even five months ago started to feel really challenging. Like I had to overefer to do the basic things and my executive functioning just packed it >> which is what literally we do every day is all of these big exe executive functioning tasks. (05:49) And every woman is a CEO of her household, of her work, of her family. And when that begins to falter, you begin to question your identity. And I think that's what you were asking is like, what is going on? >> When all of the brain related changes begin to happen to us, whether it's the low stress tolerance or the inability to have the hundred tabs open and handle them the way that we used to, or even the sleep issues, or the more intense rage and mood swings, we begin to wonder what is happening to ourselves? What's happening to our very identity? and we (06:20) start to feel like we don't know ourselves anymore. And this this is pmenopause for so many women. >> You know, it's so interesting cuz I had a patient just yesterday and she was like, I literally something just switched over the last six weeks. She goes, if I had come in here six weeks ago, I would have told you a different story. (06:40) And it's literally like in the last six weeks, someone has just pulled the rug out from under me and she couldn't put her finger on any of it. And you're talking about kind of the same thing. like within 5 months suddenly everything shifts and changes. >> So pmenopause is interesting because pmenopause many people don't realize >> has a big age range. (06:58) It's not as clearly defined as menopause. Right. Menopause we can kind of put like okay it's usually starting like mid to late 40s usually through your mid50s or so. >> 45 to 55. >> Exactly. And then you're postmenopausal after that. Right. So it has a little bit more >> well and we know it's that day and time where you have Yeah. (07:16) You have a period >> stops. Yeah, we we can identify that. >> Correct. It's very clear. Whereas pmenopause has a very big age range and I think that's the reason why it's like shrouded in almost more mystery than menopause. What do you see women what is like the number one thing women are complaining about over and over again that might be an early warning sign that they're in pmenopause? And how would you define if we had to put age ranges on pmenopause? I'm curious what you would say. (07:47) Yeah, I want to reverse engineer exactly what you were saying is that the average age of menopause is 51 years old at least for women here in the states and natural menopause is between 45 and 55 years old. Early menopause would be between 40 and 45 and then premature menopause is before the age of 40, right? >> And then we look at this transition, right, where hormones are wildly erratically fluctuating and ultimately declining towards menopause. (08:10) And that can be four to 10 plus years leading into menopause. And so let's say a woman goes, you know, they're going into menopause, you know, 48 years old. If we reverse engineer that about 10 years, then she could start experiencing symptoms of permenopause as early as her late 30s. Yes. >> But for some women, it can be even earlier. (08:30) But I would say that for my women, the women in my practice or even in my community, it it seems like 42 or 43 is when the symptoms really begin to show up. And you could have been in per menopause even a year or so before. For some women it's like a m it's like a big shift six weeks. And for some women it's more subtle. (08:50) And I think I spoke to it a little bit earlier even with my own symptoms. And hence why it was hard to pinpoint initially. I'm like is this just burnout? Is it my thyroid? Is it me overwork? Is it overwork out? It's a I mean I find that we even can gaslight ourselves a little bit. Totally. Yeah. Cuz I remember growing up and my mom telling me she's like >> women suffer. That is what we do. (09:10) >> It's normal. >> It's normal. And listen, you just push through anyway. >> And that has been the narrative for so many women in my generation, in my mom's generation. And so when we start to notice these subtle symptoms, we it's we're so quick to write them off. >> We're so quick to write them off as, "Oh, this is motherhood or I didn't sleep enough or oh, I just have too many demands, too many spinning plates. (09:31) " And it often is a yes. And those things are happening and hormones begin to start to decline and fluctuate. And so the number one thing women tell me is that one, they don't feel like themselves anymore. And two, their ability to handle the things that they used to handle with a lot with less effort is requiring more effort from them. (09:51) And the number one reason women come to me isn't the weight resistance, isn't the brain fog, isn't the hot flashes or the night sweats. It's the rage. >> Oh, the rage. >> Why Why is the rage there in your opinion? What What's happening there? Why is everybody so angry? >> I think there's a lot of reasons why we are pretty angry. (10:09) >> Where do you want to start? >> Collectively, I think Perry menopause is a reason, >> you know, in the sense that we were we were told that it was all in our heads for so long. True. You know, the reason why per menopause is having a moment is that there is a collective outrage where women are like, "You're telling me this entire time for a decade, give or take, that I'm experiencing these symptoms and you are writing it off as age or needing to exercise more, your anxiety, your Yeah, it's misdiagnosed. Like it's (10:37) everything but these hormones, these whole body hormones fluctuating." I think the real reason why we're experiencing rage is we get to this point where we have capability, right? Women are so capable, but then we start to max on capacity. >> And there is this disconnect between what we're capable of and what we don't have, what we have bandwidth for. (10:58) And as that begins to shift and we have less bandwidth, I feel like we can get frustrated. We can feel really irritable. But also, there is this time in our lives during our reproductive years where we are often people pleasing. We're accommodating. We are saying yes to everyone. We're taking on those obligations. (11:17) And when we get into pmenopause and we don't have bandwidth for all of the things that we had said yes to or the beliefs that we're holding on to, as that begins to shift, I think we start to realize like, you know, we start to feel that frustration. We start to feel that rage and also hormones are declining, right? We know that progesterone is declining in the in the ludal phase of our cycle. (11:38) And that's I mean that's when I was feeling rage was like day 23 like clockwork. >> Yeah. Day 21, >> you know? Exactly. my progesterone was declined or she just didn't show up to the party >> and um I would just kind of hit my edge. >> Yeah. It's interesting as you were talking I'm like I wonder and I'm sure there's no scientific basis to this whatsoever but I wonder if we are like biologically programmed to be yes people while we are in that reproductive time frame so that we aren't making too many enemies. You know what I mean? like (12:08) we're sort of like creating community and c you know kind of buffering ourselves because we are about to have children or in the throws of raising children young children and then as we get further away from that it's like wait a minute why am I putting up with that exactly why why did I say yes to that I wonder if there's a a biological reason for some of that you know >> we're looking into that you know there's there's some scientists are that are saying that estrogen is that accommodation hormone and again we don't (12:35) have a lot of research on the brain and on our hormon hormones 100% yet and I think that's going to shift in the next couple of decades but when estrogen you know being the master CEO of the brain being that accommodation hormone that is throughout the entire cycle you know she's there the entire time except for those few days during our menration which mind you is when we're the least accommodating is in our cycle is during that time but as estrogen begins to decline you know and progesterone as well yeah I think we become less (13:04) accommodating we be we come we are set our boundaries we become more discerning. Um, and we start to realize that, you know, especially with the symptoms that we're dealing with, that if we don't begin to prioritize ourselves, um, despite what the world has told us to do, which is to prioritize everyone and everything else, that our health trajectory is probably not going to be great. (13:26) >> That's so true. Well, one of the things I know you've said and many have said is that uh, pmenopause is almost like a second puberty. Why do we call it a second puberty? I love this question as well. So, we think about those hormone shifts. I mean, I feel like everyone needs to go and grab your book. >> We should put them together. (13:44) How's that package deal? So, >> we know that we go through three major hormone shifts. And I'd even argue, gosh, every cycle I feel like is a major hormone shift. But puberty, um, if you know, pregnancy and postpartum, and then our second puberty, which is pmenopause. And each of these big hormone shifts are neuroindocrine transitions. (14:03) And as a result, you know, our brain and our body are massively reorganizing to accommodate to that next level, right? And so, in a lot of ways, pmenopause is an upgrade. It doesn't feel like an upgrade yet, but I promise that when we get to the other side and our brain is upgrading in so many ways that we're going to be so grateful. (14:23) However, in that time of pmenopause, it is a window of vulnerability, but also a window of opportunity, particularly a window of metabolic opportunity. As the brain is is reconstructing and remodeling and think of it as this way, you know, we have the master CEO estrogen, right? She's coming online in puberty. So are other hormones. Now, we are the reverse. (14:44) She's coming offline into pmenopause and menopause. And this master CEO has been showing up to work from 9:00 am to 6 pm every day for 30ome years, give or take. And then all of a sudden in perry menopause, she doesn't show up until 12:00 p.m. Doesn't text you. Doesn't slack you. (15:06) Doesn't send you a tech, an email or a voice memo. Just doesn't show up, right? >> Goes home at 11 o'clock that night. Doesn't show up again until 2 in the afternoon the next day. that inconsistent of these hormones as this profound hormone binding to receptor sites all over the brain can just feel so destabilizing. (15:24) But as the brain is reorganizing, it can be equally a very transformative experience, especially with the right tools and the right support. And that's what I love about this book, The Perry Menopause Revolution, is giving you the the road map through and a pathway forward so that you were stepping into the the most powerful chapter of your life. (15:43) So do you think in these hormone transitions that the brain is really the starting point? Like we need to be thinking about the brain before we're even thinking about so many other determinants because it's the mood component, the cognitive component that women are are catching first. Is that been your experience? >> That has been my experience. (16:01) 80% of women I think it's way more than that. I think it's all of us that going through this inevitability are going to have brain related symptoms from sleep issues to hot flashes and night sweats to lack of word recall, cognitive changes, mental energy, the mood swings like you talked about anxiety, depression, rage, irritability, low stress tolerance. (16:22) I mean this rocks us at our core if we are not listening and paying attention and then also bringing in that proper support advocating for ourselves and also bringing in the the habit stacks are going to help move the needle for us. So I mean women will tell you you know I'm dealing with frozen shoulder or weight resistance or you know even obviously menstrual cycle changes are happening um joint pain inflammation but the thing that women come to me the most is always going to be the brain related changes because it affects everything. (16:52) It affects their family it affects their community and ultimately it's affecting their work and the world. When we don't feel like ourselves anymore it has a profound impact all over the world. And women are so talented and have so much to give. And what we don't want, and I'm speaking for you, but you know, I was talking to a woman about this yesterday who really wants to create programming in the workplace around understanding what your hormones are doing and how you plan for it and support it so that you (17:21) don't just opt out. you know, like the minute you know, things hit the fan when it comes to how you're feeling that you turn, you know, sort of outwardly and be like, "Okay, I'm quitting or I'm taking a different job or I'm doing something different or I'm downshifting, right? Because I'm not the same person I used to be. (17:41) " I think, you know, for me at least, I'm like, well, let's try to optimize you. Let's try to get you back, you know, if you are having these brain related changes, you know, and let's see what we can do. I think you said something else very interesting and I hope everybody caught this is that you differentiated the memory, the word recall, the rage and the irritability from just this general concept of mental energy. (18:08) Because many people will notice that their mental energy is going down, but maybe their memor is still just fine. Or their mood is still pretty stable, but their overall cognitive or mental energy, which is a really important marker of health that's changing. So now they're crashing in the evening versus still having energy for their families or they're you know uh having to take frequent breaks or you know the other thing that I see a lot and probably personally experienced honestly is now to like support that mental energy that is declining and you (18:39) don't have without the obvious like red flags or big symptoms. you're drinking more coffee or tea or sugar or, you know, crunchy chips or whatever it is cuz you're trying to like get that energy, get it from somewhere, you know. >> So, you know, what would you tell women like how if they, you know, are trying to figure out what to do? How can they sort of check in with themselves, you know, so that they know it's time to start thinking about pmenopause, to start maybe having a conversation around it, you know, what are some things that (19:10) you would tell them to do just starting at home in your bathroom mirror and in your bedroom by yourself? What what kind of conversation should we be having? >> Yeah, I love this question as well, Dr. Taz, because this is what sets us up to win. This is how we become the CEO of our health. (19:26) Even if you have an amazing doctor, right, that is really listening to you, that is a team member. Yeah. They're not with you 247. They're not the the big changes like how we future proof our health is what we do every day in our home. How we support ourselves and understanding our bodies. Knowing your number, knowing your normals is so important. (19:46) >> Totally. I And I would >> This is why you and I are in such alignment because I've said that all the time, too. Like you got to check things. You got to track them because we have to know what's good to know what's bad, you know, >> and you have to know your good, your and I would say even so much just your normals like what is your energy level, how what is your sleep, what is your your mood, like knowing those things, but most importantly tracking your menstrual cycle, right? >> This is going to be one of the best (20:09) indicators of knowing if you are stepping into pmenopause and more importantly not only tracking your menstrual cycle every month as that monthly report card, but tracking your symptoms along your menstrual cycle. This is how I knew I was in Perry menopause. You know, months prior to finally knowing I was in Perry, I had two backto-back concussions. (20:29) And I remember, you know, going through a massive 90-day concussion protocol to get on the other side. And then a couple months later, I started experiencing rage on day 22. >> And the first time I thought, maybe this is still my concussion. Like maybe I because I know people can have rage symptoms due to getting head in the head. (20:46) >> True to a concussion. Y >> uh month two day 22 rage month three day 22 rage and I was like perry menopause >> and that's how I knew and the thing about perry and I hear this from women all the time I had a patient Angela just coming to me and she said you know I noticed the mood swings around you know late felicular sorry late ludial phase I would say day 22 day 23 um for three months and then it kind of just kind of phased out a little bit and then it came back and so it can be a moving target. (21:17) But I will say those cyclical changes, particularly in the beginning, can really help pinpoint if this is early per menopause or not because so often our menstrual cycle is still pretty normal. >> Yeah, your menstrual cycle, I think, is a vital sign and something that needs to be tracked. (21:32) You know, just like your heart rate, pulse, blood pressure, all these other numbers and you know, when that menstrual cycle starts to shift and change, that can be the earliest indicator to women that something is different. >> Something's different. Yeah. You know, would you say that the primary conversation around pmenopause is around ludial phase shifting with and by that guys we mean like progesterone levels going down. (21:56) Is that the primary hormone that we are dealing with in the ludial phase in your experience >> for most women? Absolutely. you know, we we step into th those late reproductive years and some of those cycles are going to be an ovulatory cycles, meaning we're not ovulating on the back end or that ovulation just isn't as robust as it used to be. (22:13) And as a result, that corpus ludium that's supposed to crank out that progesterone on the back end in the ludal phase just isn't as robust as it used to be. And so, we don't have that big um progesterone boost that we would expect in that that first part of the cycle around, you know, day 19, day 20, give or take. (22:30) Um, and I would even say as we move through Perry that I always joke that everyone loves day 11 us or day 12 us where we are flushed with estrogen. Yeah. She's like really really at its height and we feel sensual. We feel alive. This is when we want to do the big go out and hang out with friends and everyone's loving us right in that energy. (22:53) And then as we move through Perry that that peak isn't peaking as as well as she used to. So you may even notice as you move through per menopause that even the follicular phase begins to not feel so shiny. You start to notice you're like, "Huh, where's that early estradiol boost on like day five?" Like she's kind of not showing up the way that she used to. (23:13) And so it's that's why I think it's so important to be looking at the entire cycle. Initially, it'll be the ludial phase. PMS symptoms instead of two to three days, now they're four to five to six days. It starts to elongate, right? All of a sudden you're like, is this whole entire phase PMS? >> Right? you know, and all of a sudden sleep issues are happening in the ludal phase, but you're okay in the follicular phase. (23:33) And that's why I think it's so important to track those symptoms along your cycle because you'll notice, you know, one part of your cycle still doing amazing, second part of the cycle, not feeling so hot. And so, I think that that gives us a lot of information. Also, I'm a big fan of bioservability, particularly for us. >> Bioservability. (23:51) No, I'm just I'm teasing. Oh jeez. Bioservability. All right. Got it. looking, we're observing our biology, right? And so whether it's on a Whoop strap or it's an Aura ring. Yeah. Or a continuous glucose monitor where you're looking at your blood sugar. Um this type of information in real time can give us so much data on ourselves. (24:12) And when I wake up and my HRV, my heart rate variability tanked from the day before, right? >> I'm going to be like, "Okay, today is not the day where I'm going to go do a HIT workout. You know, I'm going to choose walking or I'm going to choose yoga. like I'm going to really, you know, connect. (24:27) And I think it's important that we do a body scan. You know, I was I was brought up told again, we suffer, don't really pay attention to your body, just plow through. And so, I kind of felt like a bit of a cake pop where like everything was here and I just ignored the rest of it. And I think a lot of us are that way where even if we have symptoms, we're kind of like, well, but have you seen my to-do list today? Have you seen all the spinning plates? And so, it's so easy to ignore. (24:53) But my recommendation is if you are more attuned to yourself to do a body scan every morning and just check in with you know how does my body feel and if you feel like you know this that is something that's not intuitive for you having this type of data like a like a Whoop or a Fitbit or a Garmin or whatever whatever technology you want to use that can that could tell you what's going on as well. (25:17) I will tell you that my Whoop rarely gaslights me. It's pretty spot on. [laughter] Pretty accurate. >> What does it tell you? What have you learned from your wound? >> Um, I haven't looked. I didn't look this morning. I was I'm pretty sure, you know, there's some days where you wake, you got like five hours of sleep and you're like, I don't actually I don't need to look. (25:32) I don't want to look today. >> Yeah. >> But there will be days where I have really amazing HRV and because of that, I'll push and maybe I'll accidentally over push. So, the next morning I'll wake up and I'm like, "Oh, well, it looks like I pushed a little too hard." And so, it's looking at HRV, resting heart rate. (25:49) I will see both of those go up during times of stress and um just pushing too hard. Yeah. Um it'll give me a body score. Um and also it um what I love about Whoop in particular um is that it looks at your stress in real time. >> It also looks at your sleep. So it'll just be really honest about what's going on. (26:05) So that's a great accountability system and that's honestly a way of like talking to yourself through a data standpoint. And people get really academic about these tools, but I always remind them these are trends and patterns. You're just trying to look for the changes. Whichever device you pick, you're just trying to look for the changes dayto day. (26:21) It's not going to be like down to the number >> and it validates what you're feeling. Totally. And that's what I think can be helpful. And then the other piece is just is looking at your biomarkers, you know, and if your doctor isn't willing to run those or um you're having a hard time getting a lab draw from from your primary doctor, there's a lot of different places where we can go direct to consumer. Totally. Yeah. (26:41) And get those labs. The a lot of the silent shifts that happen in pmenopause are the scariest shifts. We're talking about creeping blood pressure or creeping lipids, fasting insulin, moving into insulin resistance, fatty liver. So, you know, looking at those liver enzymes, and if we can catch that early, if we can start to see those numbers creep. (27:00) And so, I tell women if we can start a timeline of your biomarkers in your 30s, h even better still, so that I can look your fasting insulin was a three. It was a three, three, three, and now it's a six. Okay. So, what happened at 44 years old where it it b you bumped up and you're telling me, Dr. (27:19) Cider, I haven't done anything in terms of what I'm eating and what I'm doing in terms of exercise, but labs are beginning to move out of range. And so, that would be a potential indicator for pmenopause as well. >> Absolutely. I want to go back to HRV because I think that's a really interesting number to track and watch. HRV again guys is heart rate variability is sort of monitoring your stress adaptation ability, your stress response. (27:43) It's tied to cortisol is often what I've said >> and I don't know where your HRV hangs out. Mine >> you want me to I mean >> ideally the higher the better. Um there's somebody in this room whose HRV is super low but I don't know where yours is. >> I have no problem. It I have I have full disclosure. I always love to be honest about where I stand. (28:02) So the highest I have ever seen my heart rate variability in the last three years is 52. >> 52. So the highest I've ever seen is probably about 56 >> is about as high. And I've noticed, so this goes back to habits and maybe just constitutional energy, some of these ideas from Eastern Systems of Medicine, but I've noticed that even in my most stressful moments, I rarely go below about 35 or so. (28:26) I don't know if you've dropped below that. I have. You have. I have. I've seen. >> And what has triggered that? How low have you gone and what has triggered it? >> I've seen it as low as like 29, 27. Yes. >> So, the reason I'm bringing this up is because HRV in my observation with myself and just in talking to others is very tied to progesterone. (28:46) >> And what I'm noticing over and over again is while it's a hallmark of cortisol and what cortisol is doing in our bodies, there's that whole idea of cortisol steel where the more your cortisol is off, it crashes your progesterone more rapidly. So that's why this whole conversation around pmenopause while we talk about it as like 38 to you know 48 or whatever age range we want I think with the stress that even our like children and teenagers and young women are going through today I feel like they're pushing that age range downward you know (29:17) like where it's actually women in their early to mid30s having this issue with progesterone and cortisol and you know if people can walk away with one thing like check your HRV, see what's happening because if it's starting to drop, you know, significantly and you're a younger person or younger woman, then you might need to be thinking about this conversation earlier rather than being like, "Oh, this doesn't relate to me. (29:41) " You know, I'm I'm not 38 yet, you know, that type of thing. So, >> and same as looking at resting heart rate, right? When my HRV heart rate variability drops, resting heart rate is often going up higher. Yes. So, you'll see that correlation as well. And I agree with you. I see women every day in their mid30s that have lower or sub-optimal progesterone levels and are dealing with a bombardment of chronic stress. (30:06) >> And the thing about chronic stress is that it's so insidious in the sense that it feels like normal living. >> I feel like that's kind of where we're operating today. We're running from one thing to the next. I I always say like you're you're rushing to wait. You know, you don't even know why you're running somewhere anymore. (30:24) You're just doing it by default. You know, I was interviewing Dr. Sarah Rearen the other day and we were talking about how we push P, right? >> Because gosh forbid we not be efficient. I know I always tell I remember you said even up to about a year ago before I learned this I I if I was in a bathroom line like at a restaurant and I would tell the woman behind me I'm like it's your lucky day because I'm gonna be in and out of here faster than any guy you've seen. (30:48) Like >> I used to be proud of it. I was like oh I'm a camel. I can like hold my urine forever cuz I we used to work in the ER until my husband was like, you know, >> you're not a camel. You're not drinking enough water. [laughter] I'm like, oh yeah, maybe that's it. That's it. Yeah, hydrate. >> So, anyhow, >> um yeah, we're just plants with big emotions, right? We need to hydrate. (31:09) So I think we we don't even realize how stressful life has become whether it's the chemical stressors >> push and and this is where kind of it all I feel like this is where we feel like that rug is pulled we just don't have the same level of stress tolerance and you know on that on that ludal side of our cycle we feel it again it's that I don't feel like myself anymore something isn't right and that something is progesterone stop showing up to the party because the level of chronic stress that we're dealing with is having (31:42) a profound impact on your entire body. Your reproductive system is just one of the systems that's being impacted by that >> very much. I saw this tongue-in-cheek Tik Tok recently where it's a guy, you guys might have seen it before, but he's like women should not work. Here's the women reason why women should not work at all at any point in their lives. (32:01) They're not wired to work. They have something called adrenal fatigue. They come into the world with adrenal fatigue and all that work does is make their adrenal fatigue worse. And I'm like, >> come into the world, >> wow, wow, what a way to gaslight us and kind of be empathetic to us, but also gaslight us at the same time. (32:20) But what can women do once they understand, you know, and they have that aha moment that, okay, it is progesterone. My HRV is low. I'm having issues cognitively. I'm having the rage that you've described so well. You know, it must be progesterone. Something's changing in my ludial phase. What's their next step? >> Great question. (32:41) I mean, I'm not going to pretend like I don't love oral micronized progesterone. I do. Yeah. >> And that's necess not necessarily going to solve the chronic stress issue, right? Like yes, that could help with the progesterone and some of those mood changes, even sleep, but that's not changing how you're operating in the world, right? You know, um and I would say like we got we've got to shift the operating system and how we see things. (33:02) I think this is a really great opportunity for us to become more discerning, >> you know, what have we said yes to that we are actually a no to. So I think permenopause is the perfect opportunity to say if this isn't a full body yes, it's a full body no. M >> get clarity on your boundaries and you know be the ultimate delegator. (33:21) Are there things that really do not need to be on your plate anymore or are there boundaries that you that that are compromising your values or are you out of integrity with with your values getting clarity about that? And then another thing that I love is like getting real like practical right is sending the brain safety signals. (33:40) >> You know I was talking to Dr. many pels yesterday and we were talking about if you can bookend your day with a morning routine that is only yours. It's not your families like they it's they are not on the agenda and an evening routine that again is only yours not your families you can get through anything during the day. So give us examples. (33:59) Give us some like very tactical examples that somebody listening because again like I say the same things, right? >> But I also live this life and I know how difficult it is to put into motion. And one of the things selfishly that I love about travel is that I'm like forced to be alone for blocks of time. (34:17) Whereas the rest of the time in my life, I'm actually not alone. And so I can actually put these things into motion. I actually did this morning some energy work and some journaling and all those tools that we talk about, you know, and feel amazing. But do I do it every morning when I'm back into the rhythm of the family and, you know, uh, everything going on at home base? I try, but I only really get there >> maybe three times a week. (34:44) So, what is it that's blocking us? And how how do we put this kind of into motion? I this is this is such a throughine for me because I have a four-year-old. I mean he believe me the second I walk out my door or if he's awake it is mama and I think kids there was a like I read a research article recently that that was looking at how many times a child especially a younger child asks their parents for something and it's 400 times a day. (35:10) >> Oh my gosh. >> It's it's insane. And so I, you know, I I've just decided I think it's really the decision of like, how do I want to show up for my family? How do I want to show up for me? And also, how do I want to feel? I think that's the question I love to ask a lot of my patients. How would you love to feel? >> Yeah. (35:26) >> And then that means that I've got to reverse engineer from there. So I've made a decision that I want to feel energized. I made a decision that I want to show up with good emotional and mental resilience. And so that means I wake up before my family >> and my son and my my husband wake up in at around 7:15 7:30. So I'm up at 6:15. (35:48) 6:30. >> So you have that time. >> So I have at least 45 minutes. And let me tell you, as a woman in parmenopause that operates with good executive function, I can get a lot done in 45 minutes. It's like the world is my oyster, you know? And so I wake up. Um I usually do a gratitude practice that takes literally a couple of minutes. (36:07) I just name off three things that I'm grateful for for the day. I have my emotional support water. I take my >> Wait, what's emotional support water? >> It's my just my electrolyte water. I have it everywhere. Support. >> I just have to have it all the time. >> I was like, "Wait, where is it?" I would um So, I have my emotional support water. (36:25) I take my thyroid medication out the gate and I do my body scan. >> Okay. >> I also check my biometrics. I'm like, "Okay, what's going on with me today?" Yeah. >> Um I head downstairs and I we have a little not not a big backyard cuz I'm right at the beach so we don't have a lot of backyard at the beach and I put my feet in the grass and outside we have big birds of paradise trees every day. (36:46) I do this every day and it literally we're talking >> this is 45 minutes. >> This is 45 minutes. I'm talking two minutes. Okay. >> And one of the things I learned from a dear friend of mine Dr. um Dr. Melissa, she talks about how easily we can get into our phone and that's other people's priorities and agendas and things that they need from you. (37:05) We get into Tik Tok or Instagram. You get into those DMs. Again, it's other people's stuff. You've lost you've lost your day. >> Yeah. >> Now you're on somebody else's timeline. You are fulfilling somebody else's demands. And if you're a woman who is a problem solver and you are accommodating to everybody, you know how easily you get sucked into that. (37:22) So, I do not look at any of that yet. This is still my time. Yeah, >> I'm still protecting my time. So, I put my feet in the ground and I look out 5 to 10 feet. And the reason why I do this is that so often when we're in our screens or we're looking at our Yeah. You're just you're you're not able to even kind of have an intention or daydream or visualize or just be in the space of of just your thoughts. (37:46) And so when I look out there's there's like there's spiders and there's hummingbirds and there's there's butterflies and there's >> there's a lot going on out there in there's a lot. It's so beautiful. The sun is is rising depending on the time of the year it is and it's just so pretty. (38:01) Like my backyard is like this tropical oasis. So thank thank you to my mother-in-law and my husband for being landscapers and Yeah. And so I just get to be in that and I just sit in that for a moment. >> Um let this I don't I'm not usually like I don't stay out there long enough probably to get enough sunlight on my eyes to be honest. (38:18) And then I go into the kitchen. I make my coffee with cinnamon. I have my I'm sucking down my emotional support water. Um and then I sit with um usually I'm listening to a book or um journaling just kind of and then I do some movement, a little bit of movement and in that 45 minutes I just center in on what are my biggest rocks for the day and what is the intention that I want and this happens most most [clears throat] weekends, most weekdays where I just I at least at least have 40 minutes to 30 minutes just to myself. (38:49) >> Do you think all of us should be getting it? I mean, I know I I get up I like to get up early and try to find that time for myself, too. But do you think >> should we just tell women just get up before your family? >> Get up before your family. >> Just get up before your family. >> It's going to protect your peace. (39:02) It's going to protect your emotional and mental resilience. Um it's going to allow you to It's buffer. >> Yeah, >> we're talking about we need buffer. If you're about to hit the ground running once the family's awake, like making lunches, I don't know where everyone is at in their mom journey, but like everyone's got demands, right? You know, there's and the house is screaming at you. (39:24) I mean, let's be honest, it it just is. And you and then you get into work and then you just go from work straight into mom mode or household mode again. It doesn't stop. And so, I don't know how we function without these moments, without these bookends. So, the same thing with my nighttime routine. So, my son is asleep like by 8:00 at the latest and I have 45 minutes max to just do stuff before I go into the nighttime routine. (39:51) And I always say you have to protect your sleep like it is a sacred act. >> Or if you're like a businesswoman like us, um like it's a million- dollar meeting. >> Like what is Netflix a million dollar meeting? Is looking over that email copy a million dollar meeting? >> Million dollar meeting has to be worth that much. >> Has to be worth that much money. (40:07) Is someone running something by you, responding to a test text message or an email? Are those things million-dollar meetings? They're not. >> Okay. What about your teenager that wants you to look at college applications at 10:30 at night? >> Yeah, that might be a million. That's kind of a million. (40:22) Depends on how often that's happening. No, exactly. I mean, Kingston is a million. If my son is sick or he wakes up in the middle of the night, I am I'm going to go and check in on him. But otherwise, I am downstairs. I'm taking my supplements. I have my little supplement stack. I've got my my sleepy tea. (40:37) It's like a holy basil tea that's got yummy adaptogens in it that just tastes so good. And it's that ritual in the kitchen, I get my emotional support water that that is coming with me everywhere. Everywhere you go. >> Um and then once I go up the stairs into my room, um I'm sleep divorced. I I'll just be honest. Okay. >> Um once that door shuts, you do not get to come. (40:56) >> Wait, why did you do a sleep divorce? >> We um one with my head concussions back in 2023. Um, we were still co-sleeping with my son and my husband volunteered to keep doing it. >> So, my husband co-sleeps with Kingston in Kingston's room and I get our room to myself. >> And you have a deep night sleep. >> Yes. (41:16) And so, I have a, you know, I do the beauty routine. I brush my teeth. I've already taken my supplements. I have my tea and I'm usually reading a good fiction book. >> Wow. >> I'm really blessed that I'm not having sleep issues >> yet. I I'm holding the vision. I'm just not going to have them. So, we'll see. Um, I've got my progesterone just in case and I just I read. (41:35) So, I go to bed at the same time every night. I wake up pretty much at the same time every morning unless I'm traveling. That gets a little messed up, but I I'm I Lights are off by 10:00. >> Do you like for women to go, you know, other than like having these great habits in place and and trying to manage some of the cortisol that way? Should they just be line straight to progesterone or is it worth in your opinion trying so many of the herbal formulas, so many of the like micronutrient formulas that are out there? >> You know, by the time many women come to (42:04) me, they are they're in need of oral micronized progesterone. >> And you like the oral, not the topical. >> I do like the oral. I, you know, I I really want both. Yeah. Well, and I love both, too. I think oral for especially and usually it's for sleep, it's for rage, it's it's to kind of calm that nervous system and and to really help support sleep at night for a lot of my ladies. (42:25) Um, but for the anxiety or the mood swings or the low stress tolerance, I think a topical cream or serum can be really helpful as well. So, I think it can be a yes. And >> I say women deserve all the tools in the tool box. >> That's so true. It's what and I find patients that do this and I'm sure you do too. It's like they'll overthink a decision or over question a decision, >> but at the end of the day, you're not meant to suffer. (42:46) >> No. >> Through pmenopause, through any of it, right? So, if something is not working, move on to the next option. The toolbox is pretty big. >> As you've mentioned, from these lifestyle habits to, you know, even how you care for yourself to visions to body scanning to then hormones. You know, the toolbox is big and you deserve >> to do something and just keep moving through it rather than getting stuck and being like, "Oh, I'm not going to do that. (43:13) " Or, "Oh, I'm not going to do this." Just find what works. >> Exactly. I think women, we've settled for the least of things or the leftovers, and we deserve the best of everything, right? >> I am a full body yes to the best of all of it. I want you to have a buffet of options that you get to choose from that work for you. (43:31) And I think again the lifestyle medicine is always going to be the foundation particularly around cellular energy and really good mental energy. But then I all the adaptogenic herbs whatever is working like for me holy basil is a fan favorite. I I love um rodeiola as well to kind of boost me. I love scissandra. (43:49) So I think a lot of these adaptogens can be really helpful you know but by the time you know some of the herbal remedies like let's for example whether it's chase berry you know in in the ludal phase and that can be really helpful especially in our late reproductive a time or even during the you know during the reproductive years but by the time a woman's like 44 45 and her sleep is bad she's coming to me with rage mood swings I mean do I need to test not guess to know that she probably needs a little bit of progesterone support I think it can be very (44:18) worthwhile to be looking at labs at all times, but I'm never going to tell a woman, you know what, we need to look at your labs first before I give you some support. >> Right. Yeah. >> Right. That's so true. So, I think again, and one of the things that I've observed is that we can boost progesterone through some of these other ways and even some of the other herbs. (44:36) Diet is a big one like getting the right fats and all that other stuff in. >> It's just slow. Yes. So, if you are if you are in the throws of it, be open to taking a little bit of progesterone while you work through some of these holistic plans to get your hormone levels back on track because it does all work together. (44:56) But many people are either like camping out like all pharmaceutical or all holistic and not understanding that there's a way to kind of do both. I want to turn to another issue that women in pmenopause often often deal with and some of these issues are interconnected. that I know but there is a shift in metabolism. Can you talk about that for a second? >> Yes. (45:17) This is one of the biggest reasons why women come to me as well, right? It's the weight resistance. >> The weight resistance, right? And I'm so over the the kind of the bro science or the bro narrative that women are just lazy or that they're it's like we are supposed to be blaming ourselves during this time when it's very clear and the research is beginning to back this up that pmenopause is a metabolic inflection point. (45:41) >> It's a metabolic storm for so many women. By the time women are 45 years old, a majority are going to be more obese or overweight than men. This is yeah this is the reality that we are facing. And it this isn't because all of a sudden at 45 you stopped working out and eating the way that you did in your 30s. (46:01) This has to do with hormones >> as estrogen begins to decline. And again it's not doing so in a linear fashion, you know, in a very kind of chill way. Yeah. It's not subtle. It is erratic. >> And it's that erratic nature that's really driving a lot of this. And so we're losing muscle. We're losing bone. We are we're seeing body composition changes, but we're laying down fat. (46:22) Except that we're not laying down fat on the hips, butts, and thigh, per se. We're laying down fat in the belly area in the in the we're laying down visceral belly fat, which becomes inflammatory in its own right, which is a driver of insulin resistance. We also know that insulin is very sensitive to estrogen. (46:39) And as estrogen [clears throat] is declining, we're becoming more insulin resistant. And many of us heading into pmenopause probably have some subtle levels of insulin resistance beginning to develop. But then as we lose these hormones, we lose that protective armor. So whatever was kind of keeping everything together in terms of our metabolic health and our body composition changes begins to just falter and we start to see that significant rise in body fat percentage and loss in lean muscle. (47:08) Um we also start to see those body composition changes and then nothing is happening linearly. We're also struggling with sleep, right? We're also struggling with motivation and and just having that get up and go cravings and energy. So, a lot of it's a loop. >> It is it's a cacophony of many different hormones that are shifting and changing without permission. (47:28) As a result, we start to see this kind of this metabolic storm begin to develop. And this is why by the time women are in early menopause, we do see lipids out of range. We see more insulin resistance. Yes. Higher blood pressure. When we see this, we see a development of metabolic syndrome become more pronounced in women as they move through pmenopause and menopause. (47:47) >> So, it's not about willpower and working out harder and starving and things like that. They need to understand maybe the starting point is your hormones. >> Is the Are you an advocate for women in pmenopause starting on some estrogen? >> I am. >> You are. Tell me how you like to how you like that because we have to be careful with estrogen, right? and progesterone is kind of a little bit of a no of a no-brainer, but how do you like women in pmenopause that are still cycling? What is the best way for them to be on (48:16) estrogen without creating a situation of estrogen dominance or estrogen overload? >> Yeah, I love this question because again, usually in early Perry, we do see estrogen still still being on the higher level. Yeah. Yeah. And I think you know that's why progesterone again both both FDA approved for efficacy and safety. (48:35) Progesterone being pretty darn safe across the board a great place to start especially with the brain related symptoms. But what I find is that you know as we creep through pmenopause and >> a bit slow because it is about 10 years give or take. I always say that this isn't a transition. This is a career. Yeah. (48:52) >> Like this is a huge change that happens over time. None of this is happening overnight. Right. And if your symptoms are still not being mitigated well with progesterone and some of that lifestyle medicine, it may be worthwhile bringing in estrogen. However, with estrogen, we need to use it and lose it, right? So, we need to make sure that estrogen, yeah, we need to metabolize estrogen. (49:14) You can't just slap estrogen on the body and expect it to just be metabolized and do what it's supposed to do. And so I always want to make sure that my ladies have good estrogen detoxification pathways that are open. So they're getting good liver support, they're getting good gut support, they're not chronically constipated, um, and that they are supporting their overall metabolic health. (49:36) We need to be good hosts for hormones for the hormones. Yeah. So in order for them to be optimizers in our body, that's the way that I think about it. But there is research, you know, a preliminary research that had just that's coming out um looking at women who start estrogen and pmenopause are able to mitigate cardioabolic risk factors and other other chronic diseases. (49:57) And so it's going to be interesting to see, you know, as more research is coming out for HRT and pmenopause versus just looking at menopause and postmenopause. Yeah, I think the biggest challenge most women have with with pmenopause and estrogen is again are you going to metabolize it effectively because you still have a lot coming from those ovaries. (50:16) So, you know, just very gentle gentle micro do >> and I would say that most doctors really do start with low dose. You know, I don't see a lot of, you know, and and and pay attention to the symptoms. Are you all of a sudden you have Yeah. swelling, your boobs hurt, and your heavier periods, you're bloating, you just like you're like something isn't right. (50:35) Like I feel like women will notice when estrogen is being unopposed and is not being metabolized appropriately. >> Correctly. Yeah. Uh you talk a little bit about the seven pillars of pmenopause, right? We've touched on a few of them today as we've been discussing this. What are those for our audience? Like what are the seven things I like this that they should be thinking about when it comes to perry menopause? And is it in the book? >> In the book. Literally in the book. (51:00) This is all of part two of the book is breaking down those seven pillars. The first one is going to be balancing blood sugar. Okay. >> I think this is one of the best barometers for your overall cellular energy. We don't have a way of measuring insulin in real time, right? We just don't. (51:14) We just it's a snapshot, right? In a blood test. But glucose, we can look at with a continuous glucose monitor. We can look at your fasting blood sugar every day. We can look at blood sugar variability. We can look at postprandial blood sugar. So, how do we look at that variability? That's number one. Number two is making metabolically healthy meals. (51:32) This is taking into account hormones. This is taking into account your gut microbiome. This is taking into account your blood sugar and your overall cellular energy. So that is micronutrient-rich foods, antioxidant rich foods, omega-3 fatty acids, probiotic rich foods. Lot I'm not going to lie, a lot of it's plants, you know, to support that gut microbiome. Yeah. (51:52) And variety as well. So, lots of variety. Um, I talk about averaging at least 20 different types of plants every single every single every single week. >> Wow. Moving up to >> that would be a good challenge. 20 different plants a week. Yes. And technically I talk about 30, but I I I tell you to like, hey, look at it every day. Um oop, sorry. (52:12) I know I was Thank you. Look at it every day and um and and kind of count how many plants you're eating and see if you're at five a week or 10 a week. See if you can go up to 15 and then guys, this is this is types. >> This is variety. >> That means not broccoli every day for dinner or spinach every day or kale every day, but like switching it up. (52:30) >> Yeah. Like right now pimmens are in season and pomegranates are in season and different squashes are in season and chard Swiss chard is really big right now and so yeah go you know peruse the farmers market peruse some of these places where you can see that variety happen where you can see the seasons changing your produce right it's really really incredible yeah so that is a big part of the the the metabolically healthy meals but also obviously protein healthy fats but omega fats are going to be really important here because I want (52:59) to reduce inflammation I think about food as being molecular information and I always want women to be thinking >> food is molecular information. I love that. >> You got a lot of these sayings today. What was it like emotional support water bio what was the word? Bio bioservability. >> Bioservability. >> We talk about it in the book. (53:18) >> And then what was this last one? What did you say? Plant >> molecular molecular information. Food is molecular information. Well, we think about these brain related symptoms and some of it can be a decrease in energy metabolism or inflammation in the brain. You know, some do some research would argue >> some researchers would argue that pmenopause is a default state of neuroinflammation. (53:41) And so, I want you to be thinking about Yeah. >> I want you to think when you're making that meal for you and your family or you're thinking about that snack, think is this going to fuel my future brain? Because that's what's feeding your future brain cells. And if cellular energy and brain energy in particular is the name of the game for you right now, that's that's the through line I think we should run everything through. (54:01) >> I love thinking about ourselves that way. It's literally like think about yourself as a plant, giving it the >> most nourishing fuel for it to continue to grow, you know, because it has a higher demand. I think there's a higher demand when you get to pmenopause and through any hormone shift that women have, they have a higher demand for quality food, quality nutrients, and all these other determinants. (54:22) I want to touch on one last thing. I know we're we're running into time here, but I want to touch on one last thing because I do think it's pretty important. So, >> what is the role of sisterhood and community as we move into pmenopause because in some ways women actually have become more isolated as they move into that phase, right? Because when the >> kids are young and you have young children, there's community, right? Absolutely. (54:47) But as they get a little bit more independent and older, I feel like for a lot of women, their community, unless they're very conscious and deliberate about it, starts to fall apart. So tell us a little bit about that. >> Yeah, this is one of the pillars. >> Okay, sisterhood is a pillar. >> It is a big pillar when we look about the we look at the number one predictor of a healthy life of like and I'm not looking to live a long time, right? I just want the time that I'm here to be so quality, right? And I want it I want (55:14) to be doing the things that I love with the people that I love. Like that is my that is my full intention is that I want to connect with the women that support me that feel safe that feel amazing. And we know that community is going to guarantee that. It's going to be the best predictor for your longevity. (55:32) And in perry menopause in particular when you can feel like you're experiencing early dementia and you could feel like your mood swings are all over the place and you're like what is happening to me right now? There is nothing more reassuring than your best friend going through the same thing. And yeah, exactly. (55:50) Her not remembering what that thing is. I can't tell you how many times my four-year-old completes my sentences because I forget the word, right? And so I have so many friends where that's the same case where they're just like, "Can you hand me the the that I'm like your phone, your glasses, you know, or why we walked into their room and then we don't remember, you know, why we were even here. (56:08) " And so having community, having women that can hold space for you, what an oxytocin boost. What what a way to know that we are in this together. And so that's the thing I tell women to double down on. And if you've lost that community, if you've lost that, think about colleagues or women in your life that you can upgrade into friends. (56:24) >> I like that. >> Reach out. You know, I am I court people all the time. I'm a big quarter. I >> You are [laughter] I give gifts. I I make the plans. I set up the coffee date. I I am. Yeah. I'm the one hosting friends giving. I always are. I'm usually hosting like a Halloween party and a Friendsgiving party and a little like a gift exchange during the holidays. (56:46) I have friends coming to me going to the pumpkin patch this weekend, you know. And so I I'm always trying to cultivate that community because that's where I don't know about you, Taz, that's where I feel the most alive. That's where I feel like my nervous system >> make the effort. I think we get tired and we don't make the effort, but I got to make the effort, but I think it hurts us in the long run. (57:05) >> Well, the book the book is available everywhere books are sold, right? The Perry Menopause Revolution. How can everyone connect with you and find you? >> Yes. So, and so you've been on my podcast multiple times. Yes. Energized with Dr. Maresa because who doesn't need and want more energy? And it's really about helping women navigate into the second chapter of their lives so that it's more vibrant, more energized, and just feeling like it's happening on your terms. (57:34) Um, the book is Everywhere Books are sold. I I read the Audible book or audio book. So, it's on Audible. Yeah, it's in my voice. Um, it's ebook, hard cover. I mean, get in where you fit in, whatever you love. I have bonuses at dra.com/book. I'm talking workout videos, more recipes, meal plans, uh, symptom tracker, menstrual cycle tracker, complete lab guide with functional lab levels so that you can be the CEO of your health when it comes to understanding your labs. (58:02) I mean, again, I wanted women to have a full solution. No more half solutions here. Women deserve everything. They deserve the best of it all. And the bonuses and the book bring everything that I could possibly imagine for women so that they can start making these changes literally today. >> Incredible. (58:21) So, everyone grab a copy and help us educate women about pmenopause. It's not just about menopause. There are hormone shifts happening sometimes much earlier than we all realize. >> And finally, what makes you whole? >> My my girls. >> Your girls. community, sisterhood. I love it. >> We all need to find that community as we go through these different changes and challenges throughout life. (58:44) So, thank you so much because you're a part of my community. >> So, thank you so much for being here today and sharing this book and your knowledge with us. I know we're going to connect again in the future. I don't doubt it for one second. And for everyone else watching and listening to this episode of Whole Plus, thank you for joining us. (59:00) And don't forget, we post new episodes every week. Before you go, remember healing doesn't happen all at once. It happens in moments. If today's episode gave you one of those moments, subscribe and keep learning with me. 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