Latest / The Dr Louise Newson Podcast / 31 - Could it be perimenopause? How hormones influence the brain

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31 - Could it be perimenopause? How hormones influence the brain · The Dr Louise Newson Podcast

0:00
As many of you know, I'm passionate about helping women
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Your body will thank you. On my podcast, I'm talking with
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Doctor Maria Schneider, who is a functional Dr. She's a hormone
0:59
specialist and an author. And we talk a lot about
1:02
perimenopause, how to diagnose it, how to listen to women and
1:06
how to think you might be perimenopausal if you are, and
1:10
how to talk to your doctor. But we also talk about migraines
1:14
and the big association between migraines and hormones.
1:18
So lots we cover. It's a great episode.
1:23
So you're in US. I'm in the UKI spend a lot of my
1:28
time frustrated, and I know you do as well.
1:30
And, you know, hormones have been around for many, many
1:34
years. We've known about them for
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decades. But what we still find is that
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so many of us as doctors are misdiagnosing women and not
1:44
joining the dots and thinking, and there is so many symptoms
1:49
associated with changing hormone levels.
1:51
And we've got all these labels that we give women.
1:54
So perimenopause, menopause, PMS, PMDD, PCOS, like and like
2:02
in my mind, we should be describing what's going on
2:05
because then we can get a better understanding.
2:08
And there are different hormones and they change at different
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rates. And we're all different, aren't
2:14
we? So I find like, it's quite hard
2:17
for women to understand and healthcare professionals to
2:20
understand how do we make a diagnosis of perimenopause and
2:24
what is perimenopause? And I'm still not convinced.
2:28
In my mind, I know what perimenopause really is.
2:31
I don't know about you. Yeah, I agree with you.
2:34
I mean, I'll never forget being and feeling blindsided by
2:38
perimenopause. You know, initially I got a
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front row seat to perimenopause when my mom went through it
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about 16 years ago. I had just entered practice and
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all of my patients were in midlife and they were struggling
2:50
with a lot of the brain related symptoms that we see in
2:52
perimenopause that they were being siloed into, you know,
2:56
psychiatrist or mental health and be in therapist and being
3:00
recommended medications for a lot of the the mental health and
3:04
mood related symptoms of perimenopause.
3:06
And I really wasn't connecting the dots back then.
3:09
This was in 2010. But when my mom started going
3:12
through it, it felt very real. It felt very visceral because I
3:15
had known my mom. I knew how strong and stable
3:18
and, you know, just how, how sharp she was, you know,
3:22
obviously having a very high level job with a lot of
3:25
executive function. And it was as if her brain
3:28
turned to mush. Her moods felt uncontrollable.
3:31
She felt untethered. She was struggling with
3:33
perimenopausal rage. And it was just a multitude of
3:36
symptoms that begged the question, you know, something
3:39
that something else is happening here that's not adding up.
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And that's when I really got to see what happened.
3:45
I'm really got to see a front row seat of what perimenopause
3:47
could be. And then it happened to me.
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And it's so interesting how you can take care of women for a
3:52
long time and help to support them and educate them, but then
3:57
it happens to you. And nothing can really prepare
4:00
you for the low stress tolerance, for the irritability,
4:05
for the, you know, the perimenopausal rage.
4:08
I remember just feeling at times just this deep sense of dread
4:12
and that life was insurmountable.
4:14
But it was fine days ago, right? And so how I really describe
4:19
perimenopause to my patients and to my community is it's a
4:23
profound silent hormone shift, you know, kind of similar to
4:28
puberty and even postpartum, where our brains are massively
4:33
reorganizing and shifting. I think of it as a
4:35
neuroendocrine transition. And I, I, and because of that,
4:39
it's never surprising to me that a majority of the symptoms that
4:43
my patients have are brain related.
4:45
The ones that I mentioned earlier, the sleep issues, the
4:47
mood swings, irritability, rage, anger, depression, anxiety, hot
4:52
flashes, night sweats, you know, lack of mental, you know,
4:56
alertness and memory. All of these are in relation to
5:01
perimenopause and this defining transition, you know, I consider
5:05
to be a window of vulnerability for us if we continue to be on a
5:10
default path. But because it's a window of
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vulnerability, I think it's also a window of opportunity about
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how we can support our future health in the second-half of our
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lives. Yeah, absolutely.
5:20
And it's interesting, isn't it, because the commonest symptoms
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of those affecting our brain, and we've seen that in our
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clinic, but also with balance out, we've had hundreds of
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thousands of women reporting their brain fog, their anxiety,
5:32
their low mood, their poor sleep, their fatigue.
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And we're always taught that perimenopause is that time
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before menopause. And menopause is as many people
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know as supposedly a year after our last period.
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But people say it's when the ovaries, you know, the hormones
5:50
being produced really fluctuate. But I really think that
5:54
menopause is more of a brain condition anyway than an ovarian
5:57
condition. And I don't know, and I don't
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think anyone really knows, is it the hormones that have been
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produced in our brain that are fluctuating rather than the ones
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that are just in our ovaries? And we don't really know because
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the whole focus has always been on fertility and periods and
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ovarian function. And we know that ovaries are
6:19
important because when they're removed in young women, they
6:21
have often horrendous symptoms. But you just wonder what else is
6:26
going on because when women, for example, who have quite severe
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PMDD, premenstrual dysphoric disorder, when they have their
6:33
ovaries removed, they can still get cyclical changes.
6:37
And that's because their brain is producing these hormones.
6:40
So I think knowing how the hormones fluctuate, but also the
6:45
levels because when I was perimenopausal, sometimes I
6:50
would have like awful rage and, you know, really irritable.
6:55
But a lot of the time, every day I felt exhausted.
6:58
Every day I was just couldn't remember things.
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The brain fog was persistent. But looking back, I think I was
7:05
very testosterone deficient for probably about 10 years before I
7:08
started testosterone. And this is where I'm thinking
7:11
about the labels. You know, calling me
7:14
perimenopausal is not that helpful, but saying that I had a
7:17
testosterone deficiency and a mild progesterone and estudinal
7:22
deficiency is a lot more useful, actually.
7:25
And I think that's really important when we're thinking
7:28
about how to help women and make the proper diagnosis, isn't it?
7:34
Yeah, I think what's really helpful is when women can really
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connect the dots between their symptoms and how it's impacting
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their lives and in relation to hormones.
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And that's why I think we really need a multi faceted approach
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when it comes to taking care of our women.
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One, we are listening to their symptoms and we're seeing how it
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is impacting their lives. You know, like you said, it's,
7:55
you know, the fatigue every day, not just the rage in the later
7:59
part of the luteal phase of your cycle.
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You know, it's can be so inconsistent.
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I think initially women in perimenopause, especially with
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regular cycles, they, it can be cyclical in pattern in terms of
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their symptoms. But then as we get into later,
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it's just it's a continuum of erratic declining hormones is
8:17
really what it is. And the response, the body's
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response to those declines when we don't have hormones
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rhythmically binding to receptor sites the way that our bodies
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have been used to. And so as we move into that late
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perimenopausal state where, again, cycles are irregular and
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everything just kind of feels like it's erratic, it can be
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really hard to pinpoint if symptoms are cyclical anymore or
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not. It can just be, you know, it
8:42
just all just feels like 1 continuum of chronic fatigue or
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hot flashes and night sweats, low libido, frozen shoulder,
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lack of the ability to recover from workouts or even things
8:55
like blood glucose levels becoming destabilized and
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overall metabolic markers going out of range, Things like, you
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know, increased hypertension over time.
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And so I, I agree with you, looking at levels, looking at
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symptoms, how these symptoms are impacting our lives and also
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what are the goals of that patient?
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How is she hoping to feel in the next 60 days?
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And then how can we build a plan to really support her not only
9:19
with HRT and, and medications, also in lifestyle interventions
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and how she can really tend to herself in a way?
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I feel like this transition does really require a new level of
9:32
support. There's a lot of things that I
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feel like we just can't get away with like we used to in terms
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of, you know, really supporting our sleep levels, supporting our
9:40
blood sugar levels, moving our body and carving out time just
9:43
for us. I think that was those are
9:45
really important pillars as we navigate this transition, which
9:49
is really setting us up for the next 40 plus years.
9:52
Yeah. And I think it's really
9:53
important this word transition because I, I put post recently
9:57
on my Instagram to say that it's not a transition.
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And what I was meaning by that is it's not a transition into
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something that we have to adjust to and have to change to.
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And I think there is this narrative, isn't there, that
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with perimenopause, that's the chaos time.
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And then menopause, things will be calmer and, you know, they
10:17
transition into something else. But then in menopause, hormone
10:21
levels are low and there's even more risks to your future health
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as well. And symptoms might change or
10:27
they might reduce, but you've still got this cardiometabolic
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problem. You've still got the risk of
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inflammatory disorders. And so I think there's a lot of
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talk out there, when I say out there often on social media,
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talking about how you can sort of supplement your way through
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the perimenopause or you can exercise your way through.
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And I think we have to be thinking about those hormones
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and what important roles they have in our bodies and tissues
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and organs. Yeah, I agree.
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We have to be thinking about long term health.
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I think one of the biggest myths that I hope to dispel is that we
11:03
get on the other side into menopause and that everything's
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going to be OK. What about the muscle loss?
11:11
What about the bone loss? What about the changes in
11:14
inflammation in the brain? What about the blood sugar
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levels and the lipid levels in the inflammation markers?
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A lot of this is silent and this is developing during due to
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erratic, not just declining hormones, erratically declining
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hormones which can drive inflammation.
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We know that these are these are immune system modulators.
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And when it's erratic, you know, often we'll see inflammation
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particularly in the brain. As you mentioned earlier.
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I do believe that this transition is more of a, a
11:45
neurological transition than any, than anything else because
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I see my women even on, you know, kind of figuring out
11:51
dosage for HRT and still, you know, certain times of the month
11:56
having more brain related symptoms and other times like it
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can be so inconsistent. And that's why I think it's
12:02
important that we're looking at the entire body and we're
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looking at the the areas that are silently shifting,
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particularly the cardio metabolic health.
12:11
We know that a majority of women in developing countries are
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going to die of a mostly preventable, you know, heart
12:17
attack or stroke. Why aren't we looking at that
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through line earlier as we start to see the erratic decline of
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estrogen, progesterone and testosterone in women in their
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in their 40s in early midlife? Yeah.
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And one of the problems of we all know is that the medical
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system is failing women actually, because we haven't
12:35
been taught properly. No one told us what hormones did
12:39
to our body. And I know for many years as a
12:41
doctor, people would come in with their low mood, their brain
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fog, their anxiety. I didn't even think about
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hormones because no one had taught me and I didn't join the
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dots. But actually what has changed
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over the last 10 years or so is that women have become more
12:58
empowered and they've become more knowledgeable.
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And I think that's the most important thing when we think
13:06
about changing the scene, changing and improving things
13:10
for future generations. Because now women are going to
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their doctors and saying I have brain fog, I have anxiety, I
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have low mood. And you know what, I think it's
13:19
related to my perimenopause. And that's happening in the US
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as well as in the UK, isn't it? Yes, it is.
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The reason why people, you know, ask me a lot is why is
13:29
perimenopause having a moment? It's because women are demanding
13:33
to be heard. Women are advocating for
13:36
themselves and they're asking direct questions.
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Could these symptoms at 43 years old or 45 or 40 years old, you
13:44
know, wherever they land in that continuum.
13:47
Could this be perimenopause? Could this be declining
13:49
hormones? And can you support me in this
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journey? Do you take care of women in
13:54
perimenopause? Are, are you trained in
13:56
menopause and perimenopause care or do I need to find someone
14:00
else who can really support me? I think that's the reason why
14:02
we're having a moment is that women are, they're tired of
14:05
being ignored. I, I mean, think about how many
14:07
generations of women were just given, you know, antidepressants
14:10
or they were told it was just aging or that this is how it is.
14:14
This is how it is for women that we just kind of suffer silently
14:18
and we need to be stoic. And women are done with that.
14:22
I think one we don't, we're feeling, I don't know if we're
14:24
feeling worse, but we're beginning to really connect the
14:27
dots between how we feel and our that are we just don't we don't
14:32
feel like ourselves anymore. And it's got to be connected to
14:34
something bigger than us just aging over time.
14:36
And I think, you know, as doctors, we have to listen to
14:38
our patients and we have to explore it because not everybody
14:42
with low mood is going to be perimenopausal, but a
14:45
significant amount are. And we can't keep ignoring them
14:49
and gaslighting them. But you know, I saw someone in
14:52
my clinic on Monday who's 54 years old.
14:56
When she was 47, she started to develop anxiety and worsening
15:01
headaches and migraines, which she'd never had before.
15:05
She's feeling a bit clammy at night time and she's getting
15:08
some joint pains as well. So she's been back and forth to
15:12
a migraine specialist who's tried to optimize her migraines
15:15
with all sorts of medication, including off license medication
15:20
of course, and it hasn't helped and cause side effects.
15:23
So then she went to see a hormone specialist because he
15:26
said I don't know anything about hormones but go and see this
15:29
woman. And she went to see him and she
15:32
showed me the letter and it said bloody blah blah, you know,
15:36
having migraines, whatever. She has no symptoms of estrogen
15:40
deficiency, therefore she doesn't need HRT now.
15:45
This lady's 54 and she hasn't had a period for two years.
15:49
Unsurprisingly, she's menopausal, right?
15:52
She's she's in a state of of estrogen division.
15:54
Seriously. So I was there reading the
15:56
Lesser thinking, right? Do you have to have awful, awful
16:00
symptoms before you can diagnose estrogen deficiency?
16:04
I don't think you do. But also, how does this doctor
16:08
know that her headaches and migraines, her anxiety, her
16:13
other symptoms, you know, being clammy at night?
16:16
Like, why are those not related to estrogen deficiency?
16:19
It feels really weird. I think it's very clear that
16:23
there is still a big knowledge gap in our clinical research in
16:27
kind of the bedside manner and the information that we have in
16:29
a healthcare system. And you mentioned earlier that
16:32
we are still continuing to fail women.
16:34
We are not connecting the dots. I was interviewing a dear friend
16:37
and a fellow practitioner here in the States and we were
16:40
talking about her symptoms of perimenopause.
16:42
I'm doing this, this really kind of this exclusive podcast series
16:46
called the perimenopause Expert Tell All because I find that a
16:50
lot of doctors like ourselves, we are always, you know, being
16:54
the experts. But I, I want to know, you know,
16:56
what has been the raw experience?
16:59
What happened behind closed doors when you went through this
17:02
profound transition? How did it uproot your life,
17:05
your career, your family, your your just your relationships?
17:09
Because it is, it is rewriting your midlife story.
17:12
And she was telling me she was in her late 40s, about 4849
17:16
years old, and her sleep was severe.
17:20
She was struggling with headaches.
17:22
She was dealing with mood, most importantly her brain.
17:26
It felt like mush. And I think about women that are
17:29
very high level and she's written many books and she's
17:32
supposed to be writing this new book.
17:34
And she wondered, she's like, I don't maybe I can't write this
17:36
book anymore. Maybe I'm never, my brains never
17:39
going to recover. You, you really do feel like
17:41
you're experiencing early signs of dementia.
17:44
And so she went to her Doctor Who happened to be on leave, on
17:48
sabbatical. And she got another doctor,
17:49
another woman who was 65 years old told her hormones are not
17:54
indicated at this point in time. They're not indicated for your
17:57
symptoms. And, you know, as far as your
18:00
sleep is concerned, like just grit through it.
18:03
I do, I think that's very much that that the kind of the
18:07
underlying narrative is that women should have to suffer
18:11
through this and then maybe come up with some, you know, Band-Aid
18:15
solutions to just manage it all the way through.
18:19
And I, you know, I asked her, I'm like, how did it feel to be
18:22
like so many of your patients who've come to you after they've
18:25
been dismissed and they've been gaslit about their symptoms?
18:28
They're told there's something that they can do about it.
18:30
You know, not really. And she, it was really eye
18:33
opening. And so I, I can't tell you how
18:35
many times I've met hormone doctors, you know, OBGYN's who
18:39
have gotten the same treatment as the millions of other women
18:42
that I know out there trying to advocate for hormone replacement
18:46
therapy and are told that it's, it's not indicated for these
18:50
symptoms. Yeah, and it's such a shame.
18:53
And you know, there's lots of reasons why women choose to take
18:55
hormones. Sometimes it's for their
18:57
symptoms, sometimes it's for their future health, and often
19:00
it's for both. But one of the reasons this
19:03
woman came to see me was because she had heard me talk about
19:06
having migraines and she just wanted to get my opinion.
19:09
And I know that you're a migraine sufferer yourself, and
19:13
migraine is a chronic long term condition and it's often a
19:17
genetic condition. But it definitely can get worse
19:22
for many of us when my hormone levels are changing in our
19:25
brains and it can be triggered by a change in estradiol,
19:28
progesterone, but also testosterone levels as well.
19:32
And for many years, I think people have misunderstood the
19:36
importance of hormones with migraines.
19:39
And I think it's worth just unpicking that a little bit more
19:44
because there is still some confusion.
19:46
People think that we can't have hormones or if we give hormones,
19:50
it might make migraines worse. But many cases, including for me
19:54
hormones have been transformational for for my
19:57
migraines severity and frequency.
19:59
Yeah, I've, as you mentioned, I've struggled with migraines
20:02
since I was a little girl. I started getting them when I
20:04
was 7 years old and I got them under control.
20:07
For a while I got pregnant when I was 40I and during that
20:11
pregnancy they came back with a vengeance.
20:14
I averaged probably two or three a week during that pregnancy and
20:19
they have continued since. I, I didn't remember or recall
20:23
having a lot of very early pre menopausal symptoms leading into
20:27
the pregnancy, but about two years postpartum is when it
20:31
really started to hit me. What I think exacerbated a lot
20:34
of my migraine symptoms and that drove more brain inflammation
20:38
because I do believe migraines are are tethered to inflammation
20:41
in the brain was 2 back-to-back concussions that I had in 2023
20:45
about two years ago. And ever since then they've been
20:48
more pronounced. However, you know, I have
20:51
implemented a lot of strategies to manage them.
20:55
One, balancing blood glucose, a lifestyle, you know, I'm always
20:57
mindful like what drives brain inflammation in general.
21:02
You know, I know that blood glucose can like, you know,
21:04
insulin resistance in the brain can do that.
21:06
Poor sleep can do that. You know, oxidative stress from
21:12
overdoing over pushing. But most importantly, mine have
21:15
always been tied to menstrual migraines.
21:18
So I, you know, a decline in both probably progesterone and
21:21
estrogen. Now, I've been playing with a
21:23
lot of dosage. We were talking about this last
21:25
time I was on your show or you were on my show where I have
21:29
been noticing when when I'm on hormone replacement and actually
21:34
a higher dosage of estradiol. So I'll even increase my dosage
21:38
about three to four days prior to my period.
21:41
I can mitigate them or they're not as severe.
21:44
Yeah. Now I, I just ran labs with a
21:48
company here is a huge multi lab panel and they wanted to run
21:53
labs two different times, 1 during my period and then two
21:57
during like about 10 days later. And so and it was recommended to
22:02
not be on hormones at that time. And I was curious to see what
22:05
was going to happen. So I took off the estradiol
22:08
patch that I normally wear leading into my cycle for these
22:12
labs. And as a result, and again, I'm
22:14
just an end of one experiment and I'm always experimenting on
22:18
myself. I ended up with a three day
22:20
migraine, a migraine that didn't end until yesterday when I was
22:25
flying here to Washington, DC and it was unbelievably
22:32
disruptive. It's the kind of mic and I
22:34
don't, there's no, I don't know, there's quality and different
22:36
types of migraines, but but this three day migraine where I just
22:39
feels like there's no reprieve, like it feels like no medication
22:42
can touch it. There are no words for the level
22:45
of disruption. Like I it's just it's more of a
22:48
prayer that I wake up the next day without one.
22:51
It, I've, I mean, I've noticed that with, with actually
22:55
Esterdale and testosterone especially, so if I use a lower
22:58
dose of oestrogen, then it triggers migraine.
23:01
And I've done it before where I've forgotten to change my
23:05
patches or a few weeks ago. I, I just, I wear more than one
23:09
patch and I'd, I'd put them on my back.
23:11
So I hadn't realized until I'd taken them off that two had
23:14
overlapped. So they weren't actually getting
23:17
through. So I was using a lower dose and
23:19
that week my migraines were just awful.
23:23
And then a month or so ago, I was just trying changing from
23:28
the testosterone cream to the testosterone gel, just just to
23:32
say about the absorption. And over the weekend I was
23:36
really tired, like really brain foggy.
23:39
And my husband said, are you all right?
23:40
Have you changing your hormones because you act like you used
23:43
to? And I said, Oh, well, funny
23:44
that. And then the migraine came out
23:46
of nowhere and it lasted for a few days.
23:49
And sometimes if migraines are short acting, it's sort of fine.
23:52
I go to bed, I take some medication and I think I'll wake
23:56
up and I'll be fine. But when it hangs on and hangs
23:58
on, it's, you can't think properly.
24:01
That's really hard and it's just so awful.
24:06
So now back on the testosterone I've been on for many years.
24:09
I, I, I'm OK again. But I see this in patients.
24:13
They really respond often to testosterone and there's limited
24:16
data, but it does make sense because we know that the
24:20
hormones reduce inflammation. They help the this even the size
24:23
of the blood vessels. And it's really often the
24:28
missing peace for so many women. And with migraine, it's not just
24:33
about hormone, obviously. It's about taking the right
24:36
exercise, eating the right thing, having the right routine,
24:40
thinking about any supplements which may or may not be helpful,
24:44
but but you can do all that. But if your hormones are out of
24:49
because especially in the perimenopause when they're
24:50
really fluctuating, it can be really detrimental concept.
24:55
I agree with you, there's so much that we can do to help
24:58
maybe mitigate them or lessen them.
25:01
However, I mean anti-inflammatory diet, moving
25:04
your body, getting good deep restful sleep.
25:07
So being consistent with your sleep time and your wake time.
25:10
Yes, taking supplements like magnesium and vitamin C and
25:13
activated B vitamins, maybe even melatonin at night to reduce
25:17
that brain inflammation. However, I will tell you that I
25:20
have there's no one more committed through not having
25:23
migraines then probably us and me.
25:27
And I will say that even I can check all the boxes and if I
25:32
have an erratic drop, which is what's happening in
25:36
perimenopause again a more frequent migraines than ever
25:39
before then I can ever remember in my life.
25:43
If I am not dialed on my hormones, I, I will, I will have
25:47
more severe migraines that will last longer.
25:50
I will say that walking out of this experiment of not wearing
25:54
an estradiol patch, a higher dose estradiol patch at the
25:57
onset of my period just to run these labs was simply not worth
26:01
it. It was not worth the three days
26:03
of pain and suffering. And so it was just a beautiful
26:05
reminder to me of like what I am willing to say yes to and no to.
26:11
I'm not willing to run labs without an estrogen patch on
26:14
anymore if it means I have to run them, you know, during my
26:16
period. It's just not like I, it's
26:20
interesting how sometimes we'll, we think we're like, oh, you
26:22
know, let me make this little, you know, shift and change and
26:26
I'll, I'll, I'll forego this for a moment for this thing.
26:29
And what perimenopause has taught me, particularly with the
26:34
onset of more migraines, is that I'm not willing to compromise my
26:38
health. I'm not willing to compromise my
26:40
quality of life. And you know, I'm, I'm, it's my,
26:44
my health and, and my ability to have a functioning brain is, is
26:49
the most important thing in my life.
26:51
And it's, it's so important. And, you know, I sort of think
26:54
migraines are a blessing and a curse in some ways because I
26:58
can't cheat on my diet. I can't stop doing a certain
27:01
exercise or I can't go to bed really late because I know the
27:05
next day I'll, it will trigger a migraine.
27:07
So it, it helps you to be healthy, you know, I can't, I
27:10
can't just go and buy some junk food and think it will be OK.
27:15
And if I do, I know I'll get a migraine and it's just not worth
27:17
it because they're so awful. But I do think if anyone's
27:20
listening who he's getting worse in migraine and it's of any age
27:24
really, but especially if it's triggering before periods, we've
27:28
got to be joining the dots. We've got to be thinking about
27:32
hormonal changes. And this is very different to
27:35
contraception. So a lot of people find that
27:38
when they're on contraception, migraines might get worse or in
27:42
their pill free week, they might be triggering migraines.
27:45
So but having the natural hormones, especially like you
27:48
say, the estrogen as a patch or a gel doesn't have a clot or
27:51
stroke risk. So it can be not only safe but
27:55
very transformational for people with migraines.
27:58
I absolutely agree. Yeah, I know that there is some,
28:01
you know, concern around contraindication with women with
28:03
migraines and aura, but I believe that the transdermal
28:06
patch in gel really helped to mitigate that.
28:08
Or cream, whatever. But as long as it is transdermal
28:10
and it can make a world of difference.
28:12
But I absolutely agree with you as well with migraines and, and
28:15
anytime we're dealing with chronic issues, you know, it is
28:17
a blessing and well, it really a hidden blessing in a lot of ways
28:21
because it does force you to be more intentional about your
28:24
health. Another part, another aspect
28:27
where I, I get to be really mindful.
28:29
I don't know if this is true for you, but it's just really,
28:32
really mitigating stress because I find stress can be a major
28:36
trigger point for migraines as well or just, you know, again,
28:40
other inflammatory driven conditions and diseases.
28:43
So another thing to be mindful of, you know, there was a lot of
28:45
years where I could really get away with stressing my system
28:49
and borrowing from, you know, my norepinephrine and epinephrine
28:53
and those corticosteroids. But now I'm in a time in my life
28:56
where especially when I'm more sensitive to hormone
28:59
fluctuations, my brain is much more sensitive.
29:02
I can feel that in the brain related symptoms that, you know,
29:06
prioritizing myself, getting alone time, spending time with
29:09
friends, being out in nature, you know, prioritizing my
29:13
morning and evening routine. All of these are strategies and
29:17
habits that have helped me have less inflammation.
29:20
You know, I just got my highly sensitive CRP and it's below .5
29:24
milligrams per deciliter here. And I was so happy because I've
29:27
been working so hard to mitigate inflammation in my body.
29:30
And so it was good to see that. Hey, even still, it's
29:33
interesting to see labs and to see labs in optimal range and
29:36
then to still be suffering with migraines.
29:38
So it's important to be connecting the dots between your
29:42
your migraine symptoms or your chronic pain symptoms and
29:45
hormones. I will say that because although
29:48
if you look at my lab reports, they look like a chef's kiss.
29:51
A lot of people would love my labs.
29:53
And yet I'm still suffering from migraines when I don't have my
29:57
hormones dialed appropriately. Yeah, so it's so important and
30:00
really great advice. Thank you.
30:02
So before we end, 3 tips. So three things that would help
30:08
people who are suffering with migraines and it could be
30:12
related with their hormones as well.
30:13
What three things would you say to these women?
30:16
Number one is track your migraines, track when they're
30:19
happening. Get as much data as possible so
30:22
that you can really communicate with your doctor what is going
30:24
on so they get the right type of care #2 talk about HRT, open the
30:30
door for that conversation. Ask your doctor if they're
30:33
willing to prescribe hormone replacement therapy for
30:35
migraines that look like they're very much related to hormone
30:40
fluctuations and most importantly, declining hormones
30:43
and the number three lifestyle. Again, treat your sleep, treat
30:47
your meals. I always think about what I'm
30:49
putting on my plate and what I'm eating.
30:51
Is this nourishing my future brain More and more than
30:55
anything I want to know, is what I'm eating nourishing my future
30:58
brain? Is it going to give my brain the
31:00
appropriate substrates that I'm not driving Brain inflammation,
31:04
sleep, your, I would say also movement and not just the one
31:08
workout, the one with resistance training workout or the
31:11
cardiovascular workout. Do your best moving your body
31:15
throughout the day, whether that's a couple squats after a
31:17
meeting or that's walking after meals.
31:20
We know that that working out is going to support your mental
31:23
clarity. It's going to help you get
31:24
better, deeper, restful sleep, and it's going to help freak
31:27
your proof your health down the road.
31:28
And that's a lot about what my book The Perimenopause
31:31
Revolution is all about is 1. Connecting the dots between our
31:34
symptoms and declining hormones, advocating for your health
31:38
because you have this information and data about
31:40
yourself that can help you steer the conversation to getting the
31:43
support and the HRT and the the solution that you deserve.
31:48
And then stacking lifestyle strategies that are going to not
31:53
only mitigate symptoms right now because it's important that you
31:56
feel alive now. This isn't about surviving
31:58
through the second-half of your life.
32:00
It's about thriving with more confidence, more energy, more
32:03
mental clarity and more joy. So having those habits that
32:07
don't feel overwhelming, that just augment and help to make
32:11
you feel more alive in your body.
32:13
Brilliant advice, thank you. And just hold up your book so we
32:16
can just see the title. Here it is, the perimenopause
32:21
revolution. Reclaim your hormones,
32:23
metabolism and energy. I am so excited to get this book
32:27
out into the world. It has a five week road map and
32:30
again, is, is, is menopause and perimenopause A5 week plan?
32:33
No, it is a full lifestyle strategy that you get to
32:37
implement. But the way that I built that
32:39
five week program is you know, when you get to the the end of
32:42
this five weeks, my intention is that you feel different.
32:46
You feel more confident, you have more wins, you feel more
32:50
motivated to continue that lifestyle for many, many years
32:53
to come. Perfect.
32:54
So I look forward to reading it, but thank you so much for your
32:56
time today. It's been great.
32:58
Thank you for having me.