Latest / Motherhood Alliance Podcast / Perimenopause: Symptoms, Testing & Finding the Right Support w/ Dr. Alyssa McPeak
Transcript
- Andrea Renkas: Hey everybody, this is Andrea and Britt from Motherhood Alliance and we are back here with Dr. Alyssa. are ⁓ excited to have you back for this fourth episode talking about something that me and Brittany are very interested about in particular personally, because this is perimenopause and menopause. Britney Suttner: Hey everyone, we are Britt Andrea from motherhoodalliance.com and we are excited to welcome you to a four episode series with Dr. Alyssa McPeak, a doctor of chiropractic and a certified functional medicine practitioner who blends the best of both worlds as a functional medicine chiropractor. Through her practice Roots Holistic Health, she specializes in pregnancy, pediatrics, women's health, hormones, and fertility. Her passion for this work is deeply personal after struggling with her own hormone imbalances and endometriosis diagnosis. Dr. Alyssa experienced firsthand how powerful it is to dig deeper and truly understand what's going on in the body. And that journey completely transformed the way she practices today. Now she's dedicated to helping women feel heard, find real answers and reconnect with themselves while also supporting children through proactive wellness focused care. Outside the office, you'll find her soaking up time with her husband and her four kids, whether that's on the water, in the woods, or at the hockey rink. We're excited to introduce you to her now. Andrea Renkas: guess let's just start. from the beginning here, what is the definition of perimenopause and menopause and how do you help women with these stages Dr. Alyssa McPeak: Yeah, so perimenopause, peri meaning around, right? So perimenopause is the time around menopause. And I think it's more commonly referred to as the time prior to menopause. And this means that it's a time when your hormones are shifting. So this is a transition, just like puberty is a transition when your hormones are starting to be produced. Perimenopause is the time when the hormones start shifting the other direction and you start producing less of your reproductive hormones because your body is getting out of that baby-making era and into more of a slowing down. You don't need these hormones as much and so they start slowing down. And menopause would be defined as the time when you are not. ovulating anymore and not having a cycle anymore. So that perimenopause time can be very confusing. And it's not a defined amount of time. Every woman has a different timeline when it comes to perimenopause. And I really think it has to do with where your hormones are, what they're doing and how they've been supported. The average age, I would say, for when menopause happens is 52 in women. And so that perimenopause time, I have seen start as early as the 30s for women. And for example, a woman that came in to me thinking that she had thyroid issues because she was so tired all the time. doctor had mentioned thyroid, they had tested her TSH, which is not enough information to gain about your thyroid. ⁓ They had said, ⁓ yeah, you look like you're hypo thyroid and they recommended a thyroid medication. Well, she had super high anxiety taking this thyroid medication and came into me looking for other answers because she's like, this isn't working. She did not have a thyroid problem. She actually had Hashimoto's, which is an autoimmune condition that affects your thyroid. And her thyroid numbers that she was producing were in a great range, but she had antibodies. And I know I'm giving off track here a little bit, but I'm getting to a point I promise. She had antibodies. And so when she took a thyroid medication, it threw her into hyperthyroidism and hence the anxiety. So what she was dealing with was actually her hormones were starting to already decline in her thirties. And so doing the proper testing to address what your hormones are doing can really offer you more insight into the care that you need, this woman did not have a thyroid problem. She was tired because she wasn't making estrogen. so, you and she was too young to really start any of bioidentical hormone replacement therapy, ⁓ because her still had the capability of making these things. We just had to support the right systems in order for her body to produce the hormones. ⁓ And we able to get her body producing estrogen again. And And this is a woman that would have gone down this spiral of now taking anti-anxiety medications for the thyroid medication that she didn't need. And so to answer your question about what perimenopause is, it is the time around when those hormones are starting to decrease in production. yeah, you're going to feel symptoms when you're not making the hormones that you're used to making. Andrea Renkas: Yeah, what kind of symptoms are those? So if you're in your mid 40s, mid 50s, like what kind of symptoms are you looking for when it comes to perimenopause? Dr. Alyssa McPeak: The symptoms I most commonly see in women are usually in the mid to late 40s. That's when they really start hitting. But I see this in women in their 40s too. And I know myself too, I'm 41 and I've already started seeing some of these symptoms. So the top symptoms I see in women in perimenopause when it's starting are fatigue. That's number one. They feel tired. Like they're more tired. They feel like they need more sleep. And when they get more sleep, they still wake up tired. And another one is the irritability. So the short fuse, the short temper. And I think our husbands pick up on this one a little bit more because you're snapping at him or you're snapping at your kids a little bit more. And I see this as more of like, an emotional rollercoaster, I call it, where you have ups and downs, but they're exaggerated. So we have this in our cycle, but this just becomes exaggerated where you're snapping more than you usually did. And it's almost like you snap and then you apologize because you're like, ⁓ my gosh, like, I don't know where that came from. So if you're feeling that uncontrolled emotion that a lot of times can be a sign that those hormones are starting to drop off and you're not getting the normal support that you were used to having from your hormones. Another one I see in women is they will notice changes in their hair and skin. I see a lot of perimenopause hair loss. And again, this can be nutrient changes, right? We're gonna need different support with nutrients. We need a little bit more support at this point in time. And again, it's not a decline, so to say, but just a need for more nutrients, more support, a shift in the kind of care. that our body needs. Andrea Renkas: ⁓ When it comes to these symptoms, is there anything that we can do ahead of time to support? like you said, perimenopause comes about, I mean, there are things that you're doing in your ⁓ and your ⁓ that are supporting your hormones, hopefully, ⁓ you are or not, and that's affecting how you come into the perimenopause and your menopause seasons. How can you support yourself? before or even during perimenopause to help these symptoms not feel as heavy. Dr. Alyssa McPeak: I think testing is crucial to understand your baseline. I love getting a baseline of where I'm at. I test my hormones, thyroid, adrenals, and gut once a year. So it's kind of like my yearly check-in to make sure that my vitamin D isn't dropping too much in the winter or to make sure that my estrogen you know, hasn't dropped too much in the last year compared to where it was. So I do think baseline testing can be very beneficial for any woman that, you know, has or is going to go through these changes, which we all are, like you said. So I do ⁓ recommend testing to my women that kind of want to know where they're ⁓ and figure out like, What do I need to support? And, you know, I see women a lot that have no symptoms. You know, they've maybe had pregnancies and babies and things have changed with their libido, ⁓ but they don't see that as a hormone symptom, which that is a alarm system in my eyes. If a woman's libido is dropping, that's a sign that you're not making enough hormones to give you that spark. So I think too, just keying into maybe some of the symptoms that you might not realize are signaling hormone changes, which include libido changes, hair changes, skin changes, fatigue changes, stuff like that. Britney: When it comes to testing, how do you get kind of like a full cycle picture? Because isn't testing kind of like, you pick like a certain day on the cycle to do the tests? But then also like you talked about in our very first episode, we're really like four different people throughout the month. So how are you getting a full picture ⁓ what their hormones are actually doing as they ebb and flow? Dr. Alyssa McPeak: timing is important when it comes to testing. And this is a mistake that I see a lot of providers making, where I had a patient this week actually, that was so excited that her provider, her primary care provider, tested her hormones. because was in the beginning stages of being interested in functional medicine, ⁓ ⁓ had asked like, well, I have my yearly with my doctor, ⁓ tests should I ask for? ⁓ We gave her a list of tests to ask for for her primary and they tested her on the wrong day. So all of her levels were low they were recommending certain things for these low levels, but they had tested her ⁓ her period. ⁓ so all of her levels are going to be low on her period. ⁓ so I think too, you need to test at certain times during your cycle in order to get of reading uncertain hormones. For example, if you're testing for estrogen, there are two times in your cycle that you make estrogen, and that is during ovulation and during your luteal phase, which would be about a week before your period, around day 19, 20, or 21, depending how long or short your cycles are. If you're testing for progesterone, the only time you're making progesterone in your cycle is in your luteal phase. So this is between ovulation and your period. This is the only time you make progesterone, and progesterone is there to help maintain a pregnancy if you get pregnant. That's what it does. So when you're talking to your provider about testing, if they are not you what day of your cycle you're on ⁓ scheduling blood draw or scheduling that blood test on specific days of your cycle, you need to find a different provider that is more educated in a woman's cycle and hormone testing. nothing against our ⁓ but this isn't their prerogative. This isn't their specialty. And I really focusing on hormones is ⁓ an I to call it an art. It's a science and an art because you want to talk to somebody who speaks the hormone language. and testing on specific days is going to be the feedback you need in order to know what your hormones are doing. Otherwise, they're all gonna, you know, if you test on your period, they're all gonna be zero. But that's not a true indication of what they're doing. Britney: What actually happens to a woman's period as she is going from perimenopause into menopause? it start to get like some more spaced out? Does it start to get lighter? Like what are some things that we can expect? And then I believe the true definition of menopause is you haven't had a period for a year. Is that right? So just help us understand how does, how do the period changes actually look? Dr. Alyssa McPeak: Yes. And again, your period is a vital sign. So keying in and listening and paying attention to what your period is doing is important to know what your hormones are doing. So in perimenopause, this is when we see cycles do weird things. This is when we see skipping a month of our period or having spotting but not actually getting a true period. And these are signs that your hormone levels are decreasing. because you're not getting the signal from your brain to shed your lining entirely. So those hormones are chemical messengers that are telling our body what to do. And so during perimenopause, we see more irregular cycles. We see, you know, going longer times between periods. So this is very common. And this is, you know, a question that I ask all of my women is, when was your last period? How many days are your cycles? How many days are you going between periods? Because this can be an indicator that those hormones aren't producing as much as they were before to that rhythm and to have that cycle. So yeah, that's very common ⁓ in to see skipped periods or light, really light periods. because you're not making as much estrogen. So estrogen, again, grows things and it grows the endometrial lining inside your uterus that you shed, the blood that you shed. when your estrogen levels are lower, we're gonna see, you know, lighter periods and not as much bleeding. And it's a sign that your estrogen levels are decreasing. Britney: Okay, so this is kind of a different kind of question. In this season of life, especially as you're getting closer to menopause, let's say you're 48, you're 50, you do not necessarily want to have any more kids. So obviously there are things like vasectomies or getting your tubes tied or things like that that are going to be a little bit more permanent, but let's talk about somebody who didn't want to do a surgery of any sort and they're used to tracking their cycles. and maybe avoiding that ovulation time frame or something like that when your periods are all over the place. But at the same time, like, are you still ovulating? Can you still get pregnant during this time? How do you navigate the season when you're like, no more kids, please. But also, yeah. So tell us about this. Dr. Alyssa McPeak: that can be exceptionally challenging, especially if you're doing natural family planning tracking cycle ⁓ and, know, avoiding those fertile times. Yes, you can still ovulate during perimenopause when you're skipping time between periods and going longer. So this could be playing Russian roulette. ⁓ And I tell ladies that are that don't want more children at this point in time, that you need to be using barrier methods, you need to be using spermicides, you need to be using things that are going to protect you from getting pregnant, especially you do not want to have surgeries or procedures done. ⁓ I encourage my ladies to talk to their partners about having the procedure done versus the women having their procedure done. nothing against guys, but it's a very, very quick, much easier, much less invasive procedure for the male counterpart to have that done than the female counterpart. And, you know, if cost is a factor too, you know, it's a lot more budget friendly for vasectomy to be done than ⁓ tubal, and they are easier to reverse as well. So again, I'm not, you know, putting my guys under the knife here. But think if nobody wants to have a procedure done, then if you don't wanna get pregnant, I would recommend using barrier methods instead of using birth control because I do think that really messes things up. ⁓ Other things that you can do though to see if you're ovulating are testing LH spikes. So you could ⁓ get LH strips and test those every day to see if you're having a luteinizing hormone spike, which could indicate ovulation. Basal body temperature can indicate ovulation. So if you're testing your hormones, or I'm sorry, your temperature, that can indicate if you have a spike in temperature if you're ovulating. ⁓ aura ring or doing any kind of like metabolic tracking, those things can also indicate ovulation testing, you know, ⁓ vasobody temp and fluctuations ⁓ ⁓ day to day, that can be another indicator. So, they're not always fun ways to protect, but if you wanna have kids, those are, ⁓ I think, lot of the options. But ⁓ I see lot of women doing the aura rings and more of the ⁓ tracking to prevent Great question. Britney: Interesting. Well, you also mentioned earlier that, you know, if you're experiencing symptoms in like your thirties, this is when it's a great time or even forties, it really doesn't matter, but this is a great time to test, right? And just see what, what, what your hormones are doing, what, maybe if there's some gut things that need to be addressed, you're just looking at like the full picture at what point or at what age do you feel like bioidentical hormone replacement is starting to become appropriate? Andrea Renkas: ⁓ Dr. Alyssa McPeak: I love bioidentical hormone replacement therapy and we do offer natural creams and lotions that you can use for bioidentical replacement. And it's getting much easier to use bioidenticals than it used to be. I know it always used to have to get a prescription to use them. And I think too mentioning bioidenticals is also important because you want to make sure that you are using something that is bioidentical versus just hormone replacement therapy that your body's not going to recognize. And there are more risks with using hormone replacement therapy that's synthetic versus a bioidentical that your body recognizes and can utilize easily. Timing of this, I think, and this is just my opinion, is when you are not going to make the hormones anymore. And I think this does depend on age as well. So when I am testing hormones and thyroid and adrenals and looking at the big picture of what a woman is dealing with, if she has gone a year without a cycle, the technical definition of menopause, when I think bioidenticals can be. ⁓ a really great resource to use. Imperium menopause, I don't use them as often. I don't recommend them as often unless somebody is at more of the tail end. And again, this really depends on where their hormone levels are at how progesterone, how much estrogen, how much estrone they're producing. And really looking at all the puzzle pieces and putting them together versus just throwing a bioidentical at somebody who, you know, whose periods are a little off, I think it's still a little early at that point. And some providers might disagree with me on this and that's okay, right? I think it really, you know, depends on what the patient is gonna benefit from the most. So if I have a woman that is in perimenopause, she's still getting some cycles, but her fatigue is draining her and she can't function and... She's not making a lot of estrogen. Maybe she could use a little bit more support. I really think it depends on the person. And that's where I think it is important to work with a provider that is experienced in working with bioidenticals ⁓ instead just taking them willy-nilly. Britney: Sure. ⁓ that's a great response. And I do love hearing the different perspectives that different people have because like you had said earlier, if your hormones are low, there are things that you can do to, your body is not done making them, but there are things you can do to help support your body or maybe remove barriers that's going to allow the body to actually produce them naturally still, right? And so if you can try those things first, that's always a great step. Another thing, just, to help optimize our hormones during this pre-menopause time when it is really a roller coaster. Should our workouts or nutrition be changing at all during this season when people are especially getting symptoms? Dr. Alyssa McPeak: Yes, the answer is yes because in this phase of your life you're gonna have a harder time building muscle and so I think and ⁓ my gosh I feel like this is another trend that women are hearing about is protein protein protein. protein waters and protein shakes and protein bars and you know I think ⁓ women in our ⁓ we are inundated with protein and That's not a bad thing. I do think we do need to be aware of how much protein we are eating and getting, but also the sources of protein that we are taking in and making sure that we can digest them. You know, lot of my A blood type ladies have a hard time digesting animal protein. So taking a digestive enzyme with betaine HCl, which helps you break down protein is crucial to breaking down the proteins into amino acids that they can actually use. So I think to each woman is going to be different in how they digest and metabolize protein. But that is something that I really talk to women about is to prioritize protein in perimenopause and menopause because we need more protein to build and maintain muscle tone. And as we get older, muscles are one of those things that deteriorate faster and maintaining muscle is I think is so crucial to maintaining balance and preventing injuries as we get into later stages of life. And the best time to do that is now, is to maintain that muscle now because it's gonna get harder to build that muscle tone as we get older. I also think for exercise, that weight bearing exercises, and again, here's another trend, all the weighted vests that you see out there. I think those are great, ⁓ as women, in those shifting hormones and changes, putting on weight while we're walking. I mean, not weight on our bodies, but actually like wearing a vest and wearing weight to push our bodies a little bit ⁓ muscle or muscle production. ⁓ And muscle a little bit more is ⁓ challenging our And that's a good thing. ⁓ Andrea Renkas: Thank Dr. Alyssa McPeak: So I do think weight-bearing exercises are important during menopause and perimenopause. ⁓ lot of women shift to swimming, you because it's easier on their joints if they have joint pain. And that's not a bad thing, but you have to ⁓ weight-bearing exercises as well if you are swimming, because according to Wolf's Law, bones are going to get stronger when you put more stress on them. So when you take stress off of your bones, that can weaken bone structure in time. So I do think we need to put weight on our bodies when we're working out, whether that's weight-bearing exercises like push-ups or squats, stuff like that. You don't have to add necessary dumbbells to all those exercises and workouts, but doing weight-bearing exercises and just walking are, I think, really, really important for women in perimenopause and menopause. to be putting stress, healthy stress on our bodies. But when I'm working with women that have adrenal stress issues and cortisol issues and maybe adrenal dysfunction, heavy workouts in the morning can add ⁓ unhealthy to our bodies. So this is where I'm telling women to walk. You need to walk every day. And walking, think, is a lost art when it comes to exercise. ⁓ And I walking is one of the best ways to increase flow, you get a little bit of cardio, you're moving your body, you're working your muscles, add a weighted vest, add some dumbbells when you're walking to add some healthy stress to our bodies. But you know, if you're in adrenal dysfunction and adrenal fatigue and dealing with cortisol issues, you know, your workouts need to be lower and slower to allow your body to recover. Britney: So finishing out this episode, what would be your final piece of advice for a woman going through premenopause? Because oftentimes it can feel like you're in a body that's not your own. You're irritated, you're like snapping at people, maybe you're gaining weight, like just your body is just all over the place. So what would be one last piece of advice on this topic? Dr. Alyssa McPeak: Test your levels, test your hormones, go to see a provider that is offering testing for the phase of life that you are in. ⁓ different providers specialize in different phases of life. really, ⁓ going back to choosing your provider, that's going to be crucial to getting the information that you need ⁓ support that phase of your life. ⁓ in perimenopause, getting that baseline, really knowing where you're at is key to supporting where you're going. Because if you don't know where you're at or where you are starting from, those changes not be as evident and not gonna know where those levels were if they declining now. I also think in on nutrients. Like looking at your iron levels, looking at your vitamin D levels. These are things that you have to test. I saw a woman last week that was taking vitamin D because her primary care provider told her that vitamin D is great for depression and she was feeling really low and wanted to avoid medication. And she just started taking vitamin D and she had been taking it for months. And when she came in, her level was at 120, which is... high. You want vitamin D to be around 60 to 80 nanograms per milliliter. And so she was overdosing on vitamin D and her provider never tested her. So she didn't even know where she was at and she just started taking it. And then she was experiencing more joint pain, which she thought was aging, but it was actually overdosing on vitamin D because when you take too much vitamin D, it can cause hypercalcemia, which can store calcium, which can cause muscle cramps, pain and joint pain. So I do think take the takeaway ⁓ is Get those levels tested, know where you're at so that you know where you need to go. Britney: I think the idea of also testing before you start having any symptoms. Like I just had testing done last year and it's like, I'm 37. And so I just wanted to know what my baseline would be like before any of this stuff starts to hit the fan. So I think that that's great advice coming from you as well. For those listening, I do want to mention that Dr. Alyssa is offering 20 % off an initial chiropractic exam or functional medicine consult. All you have do is contact her and mention that you heard about her through the motherhood Alliance podcast. Thank you for offering that. And to finish out our four part series, always love to ask, what does the future of your business hold? What's the future of Roots Holistic Health? Dr. Alyssa McPeak: I am growing my team currently. So we are looking for another chiropractor or two to join our team. And I do want to focus more on the functional medicine side of my practice, which I love chiropractic and I want to continue to offer chiropractic. But in order to see more people, I need more hands on deck. we are hiring and we're looking for a chiropractor or two to join our team right now. I only handle much and ⁓ really trying to protect my and my time with my kids. ⁓ So I need more help ⁓ and. ⁓ Again, growing the chiropractic side of our business is going to allow us to see and help more moms and kids. And I know we focused on women in this podcast, but we also specialize in ⁓ care and we see, you know, newborns to teens when it comes to kids ⁓ really helping them thrive and grow and develop the way that they can. So. ⁓ Yeah, that's where we're at. And with functional medicine too, again, I would love to continue to grow that. And it's just finding the right providers to join our team that have the specific niche focus that we do, because it's very unique. I feel like it's very unique, yeah. So I want to help more people, help more women, educate more women. So again, with Find Your Fertility, that's more of the educational piece and really spreading the word that one size does not fit all anymore. And if you are being treated that way, you need to find a provider that's going to offer you more education and options. I just, want to encourage ladies out there that you ⁓ do not fit in a box. ⁓ And if are being put in a box, need to look for a provider that ⁓ aligns more with what you need and what you want. Britney: Great advice. And I'm super excited to see you just bring on more providers and be able to flourish in what you're loving. Yeah, super exciting. Well, thank you so much for joining us as a guest on this podcast. We loved all four episodes and I know our listeners will as well. Dr. Alyssa McPeak: Thank you and you guys keep rocking it. I love what you bring to the community and we need more of this with information and connecting providers, connecting people ⁓ giving women options. That's key. Thank you, ladies.