Ep. 508 Perimenopause Uncovered: From Heavy Periods to Stubborn Weight Gain – A Talk with Dr. Heather Hirsch

I’m honored to reconnect with Dr. Felice Gersh today! She is a multi-award-winning physician with dual board certification in OB-GYN and Integrative Medicine. We connected once before in Episode 221, where we spoke about PCOS and metabolic health. Today, Dr. Gersh joins me to dive into perimenopause and menopause. We discuss various issues surrounding the Women’s Health Initiative and talk about estrogen as a family of hormones, estrogen-mimicking chemicals, synthetic hormones, and oral contraceptives. We get into the importance of thyroid function, the pro-inflammatory state of a loss of estrogen in perimenopause and menopause, and the importance of nutrition and exercise for metabolism. We also speak about the lesser-known changes that occur in menopause, including changes in body odor, constipation, sarcopenia, osteoporosis, and vocal changes.  I intend to invite Dr. Gersh back again to discuss women and mitochondrial health, and then once again to talk about her latest book, Menopause: The Fifty Things You Need to Know.  Stay tuned to find out what menopause really is, and what it does to a woman’s metabolic system. IN THIS EPISODE YOU WILL LEARN: The Women’s Health Initiative study and its devastating effects Differences between synthetic and bioidentical hormones How chronic diseases of aging can be delayed when hormones are incorporated along with other lifestyle refinements What do hormones do? Why every immune cell in the body has receptors for vital hormones Menopause is not defined by a specific moment in time. Changes that occur physiologically during the perimenopause years How hormones can change the perimenopause paradigm  Why perimenopause translates into many sleep issues Phytoestrogens: nature’s gift to women Connect with Cynthia Thurlow Follow onX ⁠Instagram ⁠LinkedIn⁠ Check out Cynthia’s ⁠website⁠  Connect with Dr. Felice Gersh On her website: ⁠Integrative Medical Group of Irvine⁠ Instagram⁠ All of Dr. Gersh’s books are available on ⁠Amazon⁠ ⁠Episode 221 on PCOS with Dr. Felice Gersh⁠

I am delighted to connect with a physician friend and colleague, Dr. Heather Hirsch, today. Dr. Hirsch is an entrepreneur and a board-certified internist by the American Board of Internal Medicine. She is also the Founder and CEO of Health by Heather Hirsch, and has a telemedicine practice offering best-in-class individualized care for perimenopause and menopause. In our discussion, we explore heavy menstrual cycles and the benefits of journaling and shared decision-making. We discuss common and frustrating causes of weight loss resistance in middle age, the power of strength training and adequate protein intake, and estrogen as a metabolic regulator that is intricately linked to many physical systems, including digestion. We also examine how educating clinicians on shifts in estrogen, progesterone, and testosterone during perimenopause could prevent countless ER visits, and we tackle concerns surrounding contraception and pregnancy prevention in perimenopause, a biopsychosocial approach to low libido, and the often-overlooked silent symptoms Dr. Hirsch often sees in perimenopause and beyond. Today’s conversation with Dr. Hirsch is truly invaluable. I highly recommend her Perimenopause Survival Guide, written by an internal medicine doctor extremely well-versed in perimenopause and menopause. IN THIS EPISODE, YOU WILL LEARN: How hormonal fluctuations disrupt the body and create confusion in perimenopause The benefits of journaling  How hormonal and lifestyle shifts disrupt metabolism, weight, and insulin sensitivity during perimenopause Why body composition changes matter more than your weight How declining estrogen affects insulin resistance, metabolism, and diabetes risk The value of shared decision-making  How hormones, medications, sleep, relationships, and past trauma can cause changes in libido  How siloed healthcare often leaves perimenopause symptoms misunderstood  How irregular ovulation increases pregnancy risk and why hormone therapy is not a contraceptive Connect with Cynthia Thurlow   Follow on X Instagram LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Heather Hirsch On her website YouTube  Social media: @Heather Hirsch MD

I am thrilled to connect with Anna Runkle today. Anna is known to more than a million subscribers across many platforms as the Crappy Childhood Fairy. For the last 30 years, she has shown people how to heal the symptoms of childhood trauma to live happier, freer, and more fulfilling lives.  In her work, Anna almost always noticed a haunting sense of disconnection from others as an adult symptom of childhood trauma. Today, she shares her story, and we dive into complex PTSD and shame, exploring the adverse childhood event study, dysregulation, and how neglect affects the brain and impacts emotional regulation, memory, and learning. We discuss disconnection as a trauma response, obstacles to isolation, and finding your voice in complex PTSD and menopause. Anna also shares her daily practice and explains how writing helps to regulate the nervous system.  You will love this invaluable conversation with Anna, also known as The Crappy Childhood Fairy, who is a fantastic resource for thousands, if not millions. IN THIS EPISODE, YOU WILL LEARN: How Crappy Childhood Fairy originated The differences between Complex PTSD and PTSD What does dysregulation look like? Unseen aspects of emotional dysregulation affect daily life Ways that childhood traumas can impact the brain How early trauma often leads to a chronic sense of disconnection Ways those with CPTSD can learn to cope with the stress of dealing with others and start connecting Anna shares her daily practice technique for emotional regulation Why the transition to menopause can be particularly hard for trauma survivors The importance of addressing trauma in healthcare and the need for better education and support for trauma survivors Connect with Cynthia Thurlow   Follow on X Instagram LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Anna Runkle On YouTube Anna’s book, Re-Regulated, is available on most online bookstores  Pre-order Anna’s new book, Connectability, and insert your receipt number to gain access to exclusive free bonuses.

Today, I am thrilled to reconnect with a previous guest, Dr. Mary Claire Haver.  Dr. Haver is a board-certified OBGYN, a certified menopause provider, and the founder of Mary Claire Wellness, a private medical practice focusing on women in midlife. Her best-selling book, the Galveston Diet, and her latest New York Times best-seller, The New Menopause, are fabulous resources for middle-aged women. In our discussion today, we dive into various aspects of perimenopause, looking at the associated challenges. We discuss factors accelerating ovarian aging, the role of contraception, mental health shifts, and the often delayed diagnosis of premature ovarian insufficiency. We examine the differences between hormone replacement therapy and oral contraceptives, discussing the importance of advocacy for women's health and the benefits of vaginal estrogen. We explore the disparity in federal funding for women's health research, the impact of the Women's Health Initiative, body composition changes, the estrabolome, the 30 Plant Challenge, and the advantages of HRT. Dr. Haver also talks about her preferred supplements.  I'm sure you will find this conversation a valuable resource that you will likely revisit several times. IN THIS EPISODE YOU WILL LEARN: Why perimenopause is so fraught with chaos Some of the factors that hasten ovarian aging How perimenopause causes significant changes in neurotransmitters, leading to cognitive changes The differences between HRT and oral contraceptives How estrogen loss during menopause affects vaginal tissue The benefits of vaginal estrogen for symptoms of menopause  How women's health research funding prioritizes reproduction over menopause and perimenopause How HRT can help with fat loss and muscle mass in postmenopausal women The emergence of eating-disordered behaviors in menopausal women Some of the lesser-known symptoms of menopause and ways to overcome them How HRT could impact the longevity and cognitive health of women Bio: Dr Mary Claire Haver Dr. Mary Claire Haver is a board-certified OB-GYN who has devoted her adult life to women's health. When she began to experience the changes of menopause and mid-life weight gain, she created her online program, The Galveston Diet, which currently has over 80,000 students. The Galveston Diet is the first and only nutrition program in the world created by a female OB-GYN, designed for women in menopause. As part of her ongoing research, she became certified in Culinary Medicine in 2019, specializing in medical nutrition. In 2021, Dr. Haver opened Mary Claire Wellness; the clinic was born out of repeated requests from the Galveston Diet students and Dr. Haver's social media followers for personal guidance.  Dr. Haver lives with her husband and two daughters in Galveston, Texas. She is the author of The Galveston Diet (Rodale; January 10th, 2023). Connect with Cynthia Thurlow   Follow on ⁠Twitter⁠, ⁠Instagram⁠ & ⁠LinkedIn⁠ Check out Cynthia’s ⁠website⁠ Submit your questions to ⁠[email protected]⁠ Connect with Dr. Mary Claire Haver On the⁠ Mary Claire Wellness website⁠ ⁠Instagram⁠ ⁠TikTok⁠ ⁠Facebook⁠ ⁠YouTube⁠ Books Mentioned Dr. Haver’s books, ⁠The Galveston Diet⁠ and ⁠The New Menopause ⁠ ⁠The Menopause Brain⁠ and the⁠ XX Brain⁠ by Lisa Mosconi Previous Episode Mentioned ⁠Ep. 308 Dr. Mary Claire Haver: Weight Gain in Middle Age, Perimenopause and Inflammation

Today, I am thrilled to connect with Dr. Elizabeth Yurth. Dr. Yurth is double board-certified, as a physician in physical medicine and rehabilitation in addition to anti-aging and regenerative medicine. With over 30 years of clinical experience, Dr. Yurth continues to lead the way in orthopedics, cellular and regenerative medicine, and the future of aging. In our conversation, we explore immunosenescence and its implications for longevity. We discuss the off-label utilization of medications, including low-dose naltrexone, rapamycin, and GLP-1s, and examine other types of peptides, growth hormone secretagogues, and thymic peptides. We speak about hormones and anabolics, highlighting the benefits of anabolics for the bone health of those with osteopenia and osteoporosis. Dr. Yurth also shares her favorite supplements and outlines the key elements for optimal brain health. This episode is the first of a series of conversations with Dr. Yurth. She will join us again to dive into cardiovascular disease and explore powerful ways to support healthy aging at the cellular level. IN THIS EPISODE, YOU WILL LEARN: Why the thymus gland shrinks with age and what that means for immunity How thymic peptides support immune health, healing, and recovery The role thymosin alpha-1 plays in modulating the immune system Why thymosin beta-4 must be cycled for safe healing support How IGF (Insulin-like Growth Factor) decline impacts muscles, joints, and the brain with aging How growth hormone secretagogues can safely raise IGF How BPC-157 (a gastric peptide) aids gut repair, musculoskeletal healing, and brain protection Why mitochondrial peptides matter for energy, recovery, and repair How anabolics support bone strength and recovery How creatine and choline support the brain and muscles Bio: Elizabeth Yurth, MD, ABPMR, ABAARM, FAARM, FAARFM, FSSRP, is Co-Founder and Chief Medical Officer of Boulder Longevity Institute, where she has been providing Tomorrow’s Medicine Today to her clients since 2006.  Dr. Yurth obtained her Medical Degree from the University of Southern California Keck School of Medicine, completed her residency at the University of California – Irvine, and her Fellowship in Sports and Spine Medicine from Stanford-affiliated Sports Orthopedics and Rehabilitation (SOAR) in Palo Alto, CA., along with her 30 years as a practicing orthopedist specializing in sports and spine medicine.  Dr. Yurth has made it her mission to learn and share the latest scientific research on how to truly heal the body at the cellular level. She is Fellowship trained in Anti-Aging, Regenerative, and Cellular Medicine. She has completed +500 hours of CME training focused on Longevity, Nutrition, Epigenetics, Bioidentical Hormone Replacement Therapy, Regenerative Peptide Treatments, and Regenerative Orthopedic Procedures.  Dr. Yurth continues to serve as a thought leader in Cellular Medicine, speaking at longevity events across the world and teaching others through her position as a founding faculty member for Seeds Scientific Research and Performance Institute (SSRP), which leads the way in connecting the latest research to clinical practice. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Elizabeth Yurth On her website Dr. Yurth on Facebook The Boulder Longevity Institute on Facebook Dr. Yurth on Instagram The Boulder Longevity Institute on Instagram

I am delighted to reconnect with Dr. Stephen Hussey today. He is a Chiropractor and Functional Medicine practitioner who guides his clients back to health using the latest research and health-attaining strategies.  In our conversation, we explore the challenge of chronic pain, discussing how it is assessed, experienced, and managed. We unpack the concepts of coherence and heart rate variability, highlighting the value of optimizing circadian rhythm for managing hormonal changes and pain in perimenopause. Dr. Hussey also shares his perspective on chiropractic care, the nervous system, fascia, and the role of trauma, metabolic health, and environmental factors in healing. Join us as we explore how to navigate chronic pain, support natural healing, and restore balance from the inside out. IN THIS EPISODE, YOU WILL LEARN: Why is pain so difficult to treat? How the Flexner Report influenced medical education and contributed to pharmaceutical-based care The breadth and scope of the opioid crisis, and why people become addicted How our bodies perceive pain  Why the fascia is so important, and its role in our physiological processes What is structured water? The link between cellular hydration, metabolic health, and the pain response How obesity and diabetes are directly associated with artificial light exposure How trauma rewires the brain and contributes to chronic pain Dr. Hussey explains the concept of coherence and its importance How pain changes during perimenopause and menopause  Bio: Stephen Hussey Dr. Stephen Hussey, MS, DC, is a Chiropractor and Functional Medicine practitioner. His story of personally healing heart disease using light and environmental health strategies has become an inspiration to many and a calling for change in healthcare. In addition to Chiropractic clinical practice, Dr. Hussey is a health consultant, speaker, and the author of three books on health: The Health Evolution, Understanding the Heart, and Pain Sense. Dr. Hussey guides clients from around the world back to health by using the latest research and health-attaining strategies. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Stephen Hussey On his website Social media:@drstephenhussey

I am delighted to have Jessie Inchauspé, the Glucose Goddess, joining me on the podcast today! Metabolic health is my passion! It is a huge area of focus in my work, and Jessie is truly a gift in the space! She is a rising star author and biochemist with a clear and accessible way of explaining the science behind glucose metabolism.  Jessie joins me today to discuss the impact of glucose metabolism and spikes. We dive into her background and how an accident created her pain-to-purpose story. We discuss the role of continuous glucose monitors and how glucose spikes impact our mitochondria, inflammation, and oxidative stress. We get into glycation and aging, how weight gain is a protective aspect of glucose spikes- or hyperglycemia, and the role of vinegar, movement, and fiber. We also talk about Jessie’s new book, her opinions on fasting, and so much more.  I loved interviewing Jessie! Her enthusiasm is contagious, and it is easy to understand why she is such a beloved author in the health and wellness space! IN THIS EPISODE YOU WILL LEARN: Jessie shares how an accident led her to where she is today. Wearing a continuous glucose monitor (CGM) changed everything for Jessie How Jessie developed her simple principles to stabilize glucose levels What is the purpose of glucose in the body? Glucose spikes and our mitochondria Vinegar hack for reducing side effects and symptoms of glucose spikes Being metabolically unhealthy impacts the aging process Benefits of having savory breakfasts and eating vegetables first with every meal Jessie’s book, The Glucose Goddess Method How gaining weight protects our bodies from the impact of glucose spikes Walking or moving after meals to balance blood sugar levels Why blood sugar so important Connect with Cynthia Thurlow Follow on X Instagram LinkedIn Check out Cynthia’s website Connect with Jessie Inchauspé On her website   Instagram Link for Jessie’s new book: Buy a copy of Jessie’s book, The Glucose Goddess Method.

Today, I am thrilled to be joined by Dr. Sarah Hill, an award-winning researcher, professor, and leading voice in the field of women’s hormones and brain health. She wrote This Is Your Brain on Birth Control and has also authored The Period Brain, which is due to be released this fall. In our conversation, Dr. Hill dispels the myths surrounding bioidentical hormones and shares her view on how women are not biologically disordered, but just ignored by science. We dive into research on how oral contraceptives affect the brain and how the pill creates a dysregulated stress response, particularly in women with histories of adverse childhood experiences. We also explore progesterone through the lens of an evolutionary biologist and neuro-endocrinologist, highlighting its role in supporting GABAergic tone, the key differences between synthetic progestins and natural progesterone, and research on PMS and PMDD, including practical ways to manage those issues. This helpful discussion with Dr. Sarah Hill is a must-listen for women at every stage of life. IN THIS EPISODE, YOU WILL LEARN: Why has science ignored women? How oral contraceptives affect the way women perceive the world How early-life trauma impacts the ability to manage stress in adulthood Often-overlooked benefits of progesterone The different ways estrogen and progesterone impact women’s ability to build muscle mass from resistance training The positive effects of the GABAergic system in the brain The problem with combined hormone therapy How progesterone gets ignored and villainized, even though it can help women experience better lives How the protective and anti-inflammatory properties of progesterone support brain health and enhance neuroplasticity What the research suggests for women experiencing severe PMS or PMDD Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dr. Sarah Hill On her website Instagram Pre-order a copy of Dr. Hill’s new book, The Period Brain: The New Science of Why We PMS and How to Fix It, which will be on sale at the end of September.

Today, I am thrilled to reconnect with my friend and colleague, Dave Asprey, for our third podcast together.  Dave is the founder of Bulletproof Coffee, the Bulletproof Diet, and the biohacking movement. He is a four-time New York Times best-selling author, and his latest book, Heavily Meditated, is a USA Today best-seller. As a leader in the longevity movement, Dave collaborates with medical professionals, researchers, and innovators to develop groundbreaking techniques and products that enhance mental and physical performance. In our discussion today, we explore what it means to be triggered, covering the five Fs, the role of ego and altered states, and the impact of social media, credentialism, and health bullying. We also discuss the importance of intuition, especially for women in perimenopause and menopause, highlighting that the ovaries contain the greatest concentration of mitochondria in the female body, the value of forgiveness, and the importance of finding peace in our lives. Dave also shares his breathwork “buckets bicep” practice and explains its effects on the dopamine receptors. I thoroughly enjoyed this inspiring conversation with Dave, and every woman navigating midlife transitions will benefit from the insights he shares in this episode. IN THIS EPISODE, YOU WILL LEARN: What it means to be triggered Dave explains the biological and neurological aspects of triggers The difference between managing triggers and turning them off at the source How fear, food, and reproduction drive automatic behavior The benefits of meditation  How criticism often triggers a deep-seated fear response  How credentialism and health bullying prevent people from trusting their intuition and personal experiences  The power of forgiveness to free energy and reduce emotional triggers. The value of intentional discomfort practices during perimenopause for recalibrating dopamine receptors The potential link between mitochondrial activity and the intuitive ability of women Bio:  Dave Asprey is the founder of Bulletproof Coffee, The Bulletproof Diet, and the biohacking movement. He is a four-time NYT bestselling author, the author of the recent USA Today Best-Seller, Heavily Meditated: The Fast Path to Remove Your Triggers, Dissolve Stress, and Activate Inner Peace, the CEO of Upgrade Labs, and hosts "The Human Upgrade" podcast. Dave pioneered online sales in the 1990s, co-founded an early data center company, and later transformed his own health by losing over 100 pounds and improving his cognitive function. This journey led him to create The Bulletproof Diet and coin "biohacking." Dave runs the 40 Years of Zen neurofeedback program, the Biohacking Conference, and a regenerative agriculture farm while investing in biohacking startups. As a leader in the longevity movement, Dave collaborates with medical professionals, researchers, and innovators to develop groundbreaking techniques and products that enhance mental and physical performance. Using science-backed methods, his mission is to help people upgrade their minds to a happier, more conscious state and optimize their bodies one cell at a time. Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia’s website Submit your questions to [email protected] Connect with Dave Asprey On his website Danger Coffee The Human Upgrade podcast Heavily Meditated: The Fast Path to Remove Your Triggers, Dissolve Stress, and Activate Inner Peace is available on Amazon.

Today, I am delighted to reconnect with two previous guests, Dr. Darren Candow. Dr. Candow is a distinguished professor and an internationally renowned researcher on creatine monohydrate, nutrition, and physical activity, whom I had the pleasure of speaking with on Episode 301, where we discussed creatine.  We are doing an AMA session today, delving into various themes surrounding creatine, from debunking outdated RDA recommendations to exploring the synergies between strength training and creatine efficacy. We examine the cognitive benefits of creatine, investigating its interactions with caffeine and its implications for bone health, hydration, anabolic resistance, and metabolic health.  You will find today's AMA session as enlightening and enriching as I did while recording it. IN THIS EPISODE YOU WILL LEARN: The safety and efficacy of creatine as a supplement How creatine increases muscle mass and reduces protein catabolism The benefits of combining creatine with protein  Is it better to take creatine before or after a workout? How creatine supplementation may improve brain performance and mental clarity Why exercise is essential for those who want to experience the benefits of creatine for maintaining their bone health The benefits of resistance-band workouts for post-menopausal women Are there any age-related limits for creatine supplementation? Bio: Dr. Darren Candow Dr. Darren Candow, PhD, CSEP-CEP, is Professor and Director of the Aging Muscle and Bone Health Laboratory in the Faculty of Kinesiology and Health Studies at the University of Regina, Canada. The overall objectives of Dr. Candow’s research program are to develop effective lifestyle interventions that incorporate nutrition (primarily creatine monohydrate) and physical activity (resistance training), with practical and clinical relevance for improving musculoskeletal aging and reducing the risk of falls and fractures. Dr. Candow has published over 120 peer-refereed journal manuscripts, supervised over 20 MSc and PhD students, and received research funding from the Canadian Institutes of Health Research, Canada Foundation for Innovation, the Saskatchewan Health Research Foundation, the National Institute of Health, and the Nutricia Research Foundation. In addition, Dr. Candow serves on the editorial review boards for the Journal of the International Society of Sports Nutrition, Nutrients, and Frontiers. Connect with Cynthia Thurlow Follow on X ⁠Instagram⁠ ⁠LinkedIn⁠ Check out Cynthia’s ⁠website⁠ Submit your questions to ⁠[email protected]⁠ Connect with Dr. Darren Candow On⁠ Instagram⁠ and X  Previous Episode Mentioned: ⁠Ep. 301 Creatine: The Best Supplement for Better Bones & Brain Health with Darren Candow, PhD, CSEP-CEP⁠