Ep. 560 “These Are the Hormones I Don’t Skip” — How I Structure HRT for Brain, Bone & Heart Health

Welcome to this week’s Midlife Minute. Many women have been asking why they wake up at 2, 3, or 4 am every night. So today, I'm breaking down 10 common reasons this happens. I’ve also included some research links in the show notes for those who want to learn more. Stay tuned as I unpack the key factors that disrupt women’s sleep in midlife. IN THIS EPISODE, YOU WILL LEARN: Cortisol spikes and sleep disruptions Why caloric restriction and repeated fasting could stress the body and lead to an overactive sympathetic nervous system The link between declining progesterone and nighttime awakenings How chronic under-eating or over-exercising can disrupt sleep, recovery, and metabolic health Why estradiol fluctuations make it harder to stay asleep  Alcohol and late-night sugar fragment sleep Hormonal changes during perimenopause/menopause and increased sleep apnea risk How inflammation, leaky gut, and disrupted neurotransmitter production contribute to early awakenings Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow  Cynthia’s Menopause Gut Book is on presale now! Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Research Links Progesterone for treatment of symptomatic menopausal women Sympathetic activity and hypothalamo-pituitary-adrenal axis activity during sleep in post-traumatic stress disorder: a study assessing polysomnography with simultaneous blood sampling Progesterone prevents sleep disturbances and modulates GH, TSH, and melatonin secretion in postmenopausal women [EMPLOYMENT OF THE ELDERLY PEOPLE IN THE EUROPEAN UNION AND UKRAINE: REALITIES, PROBLEMS AND PROSPECTS] Obesity and its implications on oncological urological surgery Metastatic phenotype is regulated by estrogen in thyroid cells Soy protein isolate increases urinary estrogens and the ratio of 2:16alpha-hydroxyestrone in men at high risk of prostate cancer NMR at pressures up to 90 GPa

Today, I am thrilled to connect with Dr. Zelana Montminy, who holds a doctorate in clinical psychology. Dr. Montminy developed her career speaking for and advising Fortune 500 companies and academic institutions. She regularly appears on Good Morning America, The Today Show, and Access Hollywood.  In our conversation, we unpack the concept of novelty bias, exploring how it shapes our neuroanatomy and compromises our conscientiousness. We debunk the myths of multitasking and task switching, and dive into generational shifts and our disconnection from ourselves and the world around us. We also highlight the vital role of the gut-brain connection, share practical social tools such as the Pomodoro Technique, and examine the transformative power of curiosity and awe.  This discussion with Dr. Zelana Montminy is an exciting and forward-thinking exploration of how our brains and bodies are programmed for distraction. Her book, Finding Focus, also offers a compelling narrative to help us get back on track. IN THIS EPISODE, YOU WILL LEARN: What is novelty bias?  How technology impacts our mental health and ability to empathize in the long term  Why are we seeing a loss of conscientiousness in the younger generations, and why do older generations tend to feel and process things more intensely? How constant exposure to technology affects the ability of the brain to process information  Generational differences in information processing The detrimental effects of multitasking on productivity and focusing ability, and the benefits of single-tasking and staying in the present moment How being in a constant state of fight or flight dysregulates the nervous system  The importance of nutrition, sleep, and hydration for mental health Tools and strategies to boost your ability to focus  The value of curiosity for problem-solving, resilience, and health Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow  Cynthia’s Menopause Gut Book is on presale now! Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Zelana Montminy On her website Instagram Finding Focus: Own Your Attention in the Age of Distraction is available on her Website and on Amazon.

I am delighted to reconnect with Dr. Scott Sherr today. In our conversation, we explore the sympathetic spiral of doom that middle-aged women often experience during a pivotal time of life marked by constant shifts in mitochondrial health, hormones, and neurotransmitters. We explore what it is and how to reframe it, and offer advice on navigating that stage of life and setting the tone for the decades to follow. Join us for an empowering discussion where we share practical strategies to interrupt the spiral, reset your nervous system, avoid burnout, and shape the trajectory of your future. Troscriptions  - ⁠https://troscriptions.com/discount/CYNTHIA10⁠ IN THIS EPISODE, YOU WILL LEARN: Why the intense practices promoted by wellness trends are not advisable for stressed-out individuals The importance of having a flexible nervous system that can rise under stress and return to parasympathetic calm How calming the nervous system improves your mental clarity, focus, and decision-making ability Many stress reactions may be more about how we respond than the actual event that occurred The value of doing micro-resets to regulate your emotions quickly How sighing, prolonged exhales, humming, and gargling stimulate the vagus nerve and strengthen the parasympathetic system Sleep is essential for supporting mitochondrial function, mood, and the ability to handle stress Fight-or-flight mode  may damage your cellular energy systems Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow  Cynthia’s Menopause Gut Book is on presale now! Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Scott Sherr On his⁠ website⁠ Troscriptions  - ⁠https://troscriptions.com/discount/CYNTHIA10⁠ ⁠Health Optimization Medicine ⁠⁠One Base Health⁠⁠⁠⁠⁠ ⁠ Previous Episodes with Cynthia Thurlow and Dr. Scott Sherr Calm, Clear, & Balanced: How GABA & Progesterone Unlock Stress Relief & Hormone Harmony | S. Sherr The Future of Healing: HBOT, Methylene Blue & Cellular Regeneration | Dr. Scott Sherr

Today, I’m delighted to reconnect with Dr. Elizabeth Yurth. Dr. Yurth is a double-board-certified physician in physical medicine and rehabilitation and anti-aging regenerative medicine. With over 30 years of clinical experience, she is at the forefront of orthopedics, cellular and regenerative medicine, and the future of aging. In our discussion today, we explore mitochondrial health as the driver of energy changes in middle age and beyond. We discuss the value of hormone replacement, examine the effects of chronic pain and mitochondrial dysfunction, and discuss specific fuels that benefit the mitochondria. We clarify the importance of starting with energy production and repairing mitochondria, and explain the intricate connection between muscle and mitochondrial health. Dr. Yurth also shares the two specific labs that indicate poor mitochondrial health, and we dive into how peptides support immunity and seasonal cycling. I know you will gain from today’s conversation with Dr. Elizabeth Yurth, which is truly one of my favorite recent conversations. IN THIS EPISODE, YOU WILL LEARN: How immunosenescence accelerates aging- particularly in women How thymic peptides can support and repair immune functioning   Why mitochondria are foundational to our overall health How mitochondrial decline can increase insomnia and anxiety The value of seasonal cycling for aligning with natural seasonal changes, optimizing adaptation, and reducing unnecessary stress The benefits of longitudinal tracking  How orthorexia and excessive focus on longevity routines can increase anxiety and undermine any health benefits How aging naturally decreases hormones, mitochondrial function, and cellular repair mechanisms Using peptides as a “cheat” to maintain immune and mitochondrial function when daily routines or travel make ideal practices impossible Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected]. Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Cynthia’s Menopause Gut Book is on presale now! Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Elizabeth Yurth Boulder Longevity Institute Human Optimization Academy Instagram YouTube

Welcome to today’s Midlife Minute episode. I've received a wave of questions about the best ways to fuel workouts and how to recognize signs that you're not eating enough to support your exercise routine. This topic is particularly relevant because many women in my community have practiced fasting, intermittent fasting, or other forms of time-restricted eating for years, which can sometimes lead to chronic under-fueling. Stay tuned to learn how to spot the signs of under-fueling and ensure your body gets the energy it truly needs. IN THIS EPISODE, YOU WILL LEARN: How practicing intermittent fasting or time-restricted feeding for years can lead to energy deficits and poor workout recovery What happens to you when you’re middle-aged and your protein intake is too low? Why women have a higher risk of chronic under-fueling consequences as their progesterone, estradiol, and testosterone decrease with age  How chronically elevated cortisol negatively impacts women’s muscles, metabolism, and insulin sensitivity The importance of maintaining your muscles as you age Signs that indicate you may be under-fueling Strategies to support your health and performance in middle age Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow  Cynthia’s Menopause Gut Book is on presale now! Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Discount Offer Kion Aminos - Use promo code CYNTHIA to get 20% off! (Cynthia’s favorites are the capsules) Research Links  Impact of Protein Intake during Weight Loss on Preservation of Fat-Free Mass, Resting Energy Expenditure, and Physical Function in Overweight Postmenopausal Women: A Randomized Controlled Trial Resistance Training Preserves Fat-free Mass Without Impacting Changes in Protein Metabolism After Weight Loss in Older Women

Today, I had the honor of connecting with Ashley Koff. She is a leading voice in personalized nutrition and the founder of the Better Nutrition Program. With over 25 years of experience and the groundbreaking GLP-1 Optimization System to her name, she’s helped redefine how we approach sustainable weight health. In our conversation, we dive into how her book reframes the concept of healthy weight. We explore integrative perspectives on digestive health and GLP-1s, why many women blame themselves when they struggle to lose weight, and how Ashley’s framework helps them remove that self-blame. We also discuss issues surrounding info-besity and the “less is more” approach, natural ways to support appetite regulation and satiety signaling, key areas of digestive health, and the importance of detoxification. Ashley also shares the red flags she sees in women who are undernourishing themselves or over-fasting, things to consider when you want to stop taking GLP-1s, and her opinions on new drug therapies. Join us for today’s thought-provoking and insightful conversation around metabolic health and weight-loss resistance for women in middle age, perimenopause, and menopause. IN THIS EPISODE, YOU WILL LEARN: The interconnection that exists between digestion, hormones, and metabolic signaling How the hormonal fluctuation that occurs in perimenopause disrupts women's digestion What drives satiety?  How GLP-1 medications simply amplify, extend, or mimic an existing communication loop within the body rather than creating new pathways Why do women blame themselves when they cannot lose weight? How info-besity blocks the body from doing what it is naturally designed to do  Why detoxification is essential for supporting natural digestive and metabolic processes The red flags that indicate undernourishment or over-fasting in women What you need to think about before stopping GLP-1s Bio: Ashley Koff, RD, is the USA Today bestselling author of⁠ Your Best Shot⁠ (HarperOne) and founder of⁠ The Better Nutrition Program⁠ (BNP). An acclaimed weight-health expert and practitioner for more than 25 years, Koff is leading a transformative movement in personalized nutrition, turning “better, not perfect” choices into practical, sustainable strategies that deliver real outcomes. Your Best Shot introduces weight-health hormones (GLP-1, GIP, CCK, PYY) as the regulators of weight health, offering the first-ever assessment of their function and a personalized optimization system—shot or not. A trusted expert featured across major media and a sought-after educator for health professionals, Ashley has been recognized as one of CNN’s Top 100 Health Makers and featured in InStyle as “Hollywood’s Leading Dietitian.” Connect with Cynthia Thurlow   Follow on ⁠X⁠, ⁠Instagram⁠ & ⁠LinkedIn⁠ Check out Cynthia’s ⁠website⁠ Submit your questions to ⁠[email protected]⁠ Join other like-minded women in a supportive, nurturing community:⁠ The Midlife Pause/Cynthia Thurlow⁠  Cynthia’s⁠ Menopause Gut Book⁠ is on presale now! Cynthia’s⁠ Intermittent Fasting Transformation⁠ Book ⁠The Midlife Pause Supplement Line⁠ Connect with Ashley Koff ⁠The Better Nutrition Program⁠  On ⁠Instagram⁠ and⁠ Substack⁠ On other social media: @Ashley Koff

Today, I am honored to connect with a friend and fellow nurse practitioner, Marcelle Pick! Marcelle is passionate about transforming how women experience healthcare through an integrative approach. She has successfully treated thousands of women through her unique approach to wellness. Marcelle is currently a faculty member of The Institute of Functional Medicine and has served as a Medical Advisor to Healthy Living Magazine. She has written countless articles and multiple books, including Is It Me or My Hormones? I always think of Marcelle as a pioneer in the women’s health/nurse practitioner space. In this episode, we dive into her background and the impact of the Women’s Health Initiative. We discuss the limitations of the traditional allopathic model regarding hormones, common misconceptions about adrenal health, perimenopause, and menopause, adverse childhood events and adrenal health, how lifestyle affects our sex hormones, fibroids, endometriosis, PMS, PMDD, and contraception for perimenopause. We speak about endocrine disruptors, mold, and micro toxins. We also get into ways to think about hormone replacement therapy and ways to address intimacy and low libido. I love connecting with other nurses and nurse practitioners! I hope you will love today’s conversation with Marcelle as much as I did! IN THIS EPISODE YOU WILL LEARN: Marcelle was part of the first all-women practice in the country. How the Women’s Health Initiative has impacted health care for women. The limitations of the traditional allopathic model are particularly in terms of perimenopause, menopause, and hormones. The less-common labs Marcelle likes to look at for her patients Marcelle shares her approach to unraveling the symptoms of perimenopause. Some unique ways in which Marcelle deals with problems like fibroids and endometriosis. How childhood trauma could lead to adrenal and autoimmune issues, weight-loss resistance, and various other health problems. Many of the things Marcelle recommended for treating PMS and PMDD back in the day (1985) have now become the standard of care. Contraceptive options for women in perimenopause. The impact of stress on adrenal function during perimenopause and menopause. Marcelle dives into liver health and detoxification, chemicals and other factors that could impact our health, and changes we can make to avoid problems and feel better. What Marcelle does to help women with low libido. Connect with Cynthia Thurlow Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Join other like-minded women in a supportive, nurturing community (The Midlife Pause/Cynthia Thurlow)  Cynthia’s Menopause Gut Book is on presale now! Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause supplement line Connect with Marcelle Pick On her ⁠website⁠    ⁠Facebook ⁠Instagram⁠ All of Marcelle’s books are available on ⁠Amazon

I am delighted to reconnect with Dr. Jason Fung today. He is a trained nephrologist and world-leading expert on intermittent fasting and metabolic health. He has authored multiple books, including the New York Times best-seller, The Obesity Code, The Diabetes Code, and, more recently, The Hunger Code.   In our conversation today, we unpack the obsessive focus on the calories-in, calories-out model, which is neither practical nor effective. We explore the root causes behind the narrow-minded thinking that calories alone drive obesity, differences between types of hunger and conditioned responses, how hormones affect other hormones, and lessons about GLP-1s. We examine the critical importance of fiber and protein, and offer clarity around carbohydrates. We also cover the impact of meal timing, sleep, and circadian biology, the fat thermostat and sympathetic tone, nutrition, stress, and mindful eating, and dive into the issue of ultra-processed foods. Join us for an insightful conversation that challenges conventional wisdom and offers a nuanced and sustainable approach to understanding hunger, metabolism, and long-term health. IN THIS EPISODE, YOU WILL LEARN: “Calories in, calories out” framework is technically correct, but practically useless How the homeostatic, hedonic, and conditioned hunger types differ Dr. Fung shares his take on GLP-1 medications How fiber stimulates natural GLP-1 production Processed and natural carbohydrates produce vastly different glucose and insulin responses. Avoid eating late-night meals! Complex relationship between hunger, hormonal regulation, and sleep quality Hormones that drive body fat regulation  How bitter foods suppress appetite and enhance satiety Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow  Cynthia’s Menopause Gut Book is on presale now! Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Jason Fung On his website Instagram and YouTube Dr. Fung’s latest book, The Hunger Code, will come out in March. Pre-order on Amazon!

Most of the questions I’ve been asked lately have been about my current hormone replacement regimen. So I have dedicated this episode to unpacking what I use transdermally, orally, and topically for hormone replacement therapy. As you might expect, my approach includes the basics, along with a few additional strategies. I also share a topical option for facial skin that Dr. Felice Gersh recently recommended. Stay tuned to find out what I do for hormone replacement therapy. IN THIS EPISODE, YOU WILL LEARN: What you need to optimize first, before even considering adding any additional items Why I might need to increase the dosage of my Dotti transdermal estrogen patch Why I consider estradiol the most potent estrogen our bodies make before menopause Factors that influenced my decision to prioritize estradiol therapy The role of testosterone, beyond libido Why I use progesterone The value of intra-vaginal products Why I use a compounded intra-vaginal product  What copper peptides, estriol, DMAE, and hyaluronic acid may do for aging skin Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow  Cynthia’s Menopause Gut Book is on presale now! Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Research Links Efficacy of Transdermal Estradiol and Micronized Progesterone in the Prevention of Depressive Symptoms in the Menopause Transition: A Randomized Clinical Trial Hormone Replacement Therapy Effects of Ultra–Low-Dose Transdermal Estradiol on Cognition and Health-Related Quality of Life   Regenerative and Protective Actions of the GHK-Cu Peptide in the Light of the New Gene Data Treatment of skin aging with topical estrogens SCF-induced airway hyperreactivity is dependent on leukotriene production The role of dimethylaminoethanol in cosmetic dermatology The Missing lnc(RNA) between the pancreatic β-cell and diabetes

Today, I am thrilled to connect with Dr. Sonya Jensen, a naturopathic physician on a mission to transform how women understand themselves and their bodies. She believes women are central to their families and communities, and by supporting women, we create a ripple effect that supports the whole. In our conversation, we explore the sense of selfishness many women feel when advocating for their needs, and why choosing ourselves, especially in midlife, is essential. We discuss science-versus-soul transformations, gestational silence and trauma, and the physiological effects shaping this generation and those to come. We also unpack how stress impacts the immune system and autoimmunity, why stress reduction techniques are the key to vagus nerve activation, the link between mental health and hormones, womb-wisdom and generational influences, how grief and sadness can influence us profoundly, and the value of trusting our intuition and embracing the gifts of aging. I know you will enjoy this discussion with Sonya Jensen. She shares a gentle, loving, and kind message for women- one that is well worth reflecting upon. Be sure to keep an eye out for her upcoming book, Heal Your Hormones, Reclaim Yourself, scheduled for release in early 2026, where she connects hormonal chaos, emotional overload, and relationship pain through her integrative method. After the recording, Dr. Jensen noted a clarification: there were 50 famines in total during British rule in India, not 50 famines in a single year. IN THIS EPISODE, YOU WILL LEARN: How awareness practices can help you become more physically regulated when things feel overwhelming Why friable emotions are not due to personal failure or a faulty mindset How to reconnect with your body The benefit of body-based practices for supporting nervous system regulation    What is womb wisdom? How womb wisdom influences the way we show up in the world Some of the biggest obstacles to women’s healing Why so many women struggle to trust themselves Why loneliness can surface as women age, and ways to counter it   Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow  Cynthia’s Menopause Gut Book is on presale now! Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause supplement line Connect with Dr. Sonya Jensen On her book website: Heal Your Hormones, Reclaim Yourself Instagram