97. Perimenopause & Mood Swings: Why It’s Not Just in Your Head with Dr. Sarah Daccarett

Feeling off balance, moody, or just not yourself? If you're struggling with brain fog, anxiety, or sleep disturbances, your hormones may be to blame—and you don’t have to just suffer through it. In this episode, I sit down with Dr. Sarah Daccarett, a hormone specialist and anti-aging expert, to dive deep into how hormone replacement therapy (HRT) can help midlife women reclaim their energy, mood, and overall well-being.

Dr. Daccarett is on a mission to break the silence around hormone health and shift the way we think about aging. Instead of waiting until symptoms become unbearable, she advocates for a preventative approach to hormone therapy—one that helps women thrive in their 30s, 40s, and beyond. She also shares her innovative approach to hormone supplementation that ensures women get the right balance for optimal mood, sleep, and vitality.

In this episode:

• The real reason so many women experience mood swings, anxiety, and brain fog in midlife
• How progesterone, estradiol, and testosterone influence brain function and emotional well-being
• Why traditional hormone replacement therapy (HRT) often falls short—and what to do instead
• The best delivery method for progesterone to maximize absorption and effectiveness
• The misinformation around hormone testing and why symptoms often tell a clearer story
• Why women have been misled about HRT and breast cancer risks—and what the latest research actually says
• How Dr. Daccarett’s Inner Balance approach personalizes hormone therapy for better sleep, sharper thinking, and stabilized moods

Resources Mentioned:

• Dr. Sarah Daccarett’s Inner Balance Program: innerbalance.com

Connect with Dr. Sarah Daccarett:

• Website: innerbalance.com
• Instagram: @innerbalance

Connect with me, Dr. Sara Poldmae:

Website: https://risingwomanproject.com

Instagram: https://www.instagram.com/drsarapoldmae

 Join me at my next wellness retreat!  https://risingwomanproject.com/retreats/2025-april/

Transcript

Sara Poldmae  0:01  
Sarah, welcome to the midlife rise and thrive podcast. I am your host. Dr Sarah pulpning, if you have been wondering how to feel your best in mind, body and spirit as you navigate through midlife, then this is the show for you. Each week. I'm sharing accessible education, heartfelt stories and exclusive interviews. We will be talking about everything from health and wellness to sex and relationships and the many challenges and opportunities that come with mid life, it's time to take charge and live fully with intention as you write your next chapter. Let's get started. Hello, everyone. Today, I welcome Dr Sarah dacaret. She is a leading hormone specialist and anti aging expert dedicated to empowering women just like you to take control of their health and well being as the founder of inner balance, Sarah has created a revolutionary solution for women seeking a convenient, effective and personalized way to manage their hormones. Her mission is to break the silence surrounding hormonal issues and provide women with the knowledge and tools that they need to thrive. Welcome to the show. Thank you for having me. Yeah, absolutely. So please tell us a little bit more about yourself and about inner balance. We would love to hear great,

Dr. Sarah Daccarett  1:27  
yeah. I mean, you nailed it, like I started inner balance a year ago. I'm a physician. I was doing anti aging in a clinic setting in Boise, Idaho, treating both men and women. And really see seeing the gap that we treat men completely differently than we treat women. When it comes to the approach, we use hormone replacement therapy as a treatment for menopause. You know, oh, you're having hot flashes, you're having vaginal dryness, when it really should be prevention, or we should prevent aging. It is foundational to aging well or increasing health span. We should be looking at it in your 30s and 40s before you're having problems, and really, when they the problems start. We do this for men. You know, as soon as men start getting erectile dysfunction, we're like, oh, you need to be treating your keeping your testosterone levels up. We don't do this for women. We make them wait. We tell them that they're normal. We gaslight them a lot. And this is the difference in the way that we even think about hormones for women, and we need to shift this thinking that women, if they realized how protective and beneficial they were, they're better than any face cream, any it's the foundation to anti aging, if women understood how powerful they were to prevent aging and keeping you in maintaining your health and not just a treatment like Don't just wait until you're miserable and you can't stand it anymore. So this is the flip and kind of the mentality change. I would say that inner balance is about, look, we're for, you know, we realize that this problem starts in your 30s. And I guess I always say that I started inner balance because I needed it. I mean, I had perimenopause symptoms in my 30s and thought that I was alone. And if I'm a doctor, and I was struggling to get help myself, what are women doing? And realizing that actually, this is the normal, but I would talk to all day long that are your 30s that really start to see and you know, the first things that come on are anxiety, depression, insomnia and kind of this mood shift. It's really just like a this is universal. This, like nobody's immune to this. It's just how maybe women have coping skills or a support group, but everybody sees this change in mental health, and it happens in the 30s, and so I just wasn't willing to put up with it. I wasn't going to be tired, I wasn't going to feel like this. I wasn't going to be irritable with my partner and co workers and family and son, and so I was like, I'm going to feel great. I'm only 37 or whatever it was, you know what I mean? Like, I'm not going to feel like this forever. And so if women knew that there's a solution that they don't actually have to put up with anything. And this is kind of where my formulation started, and the formulation is different than the other approach, like the traditional approach that you would get on the market.

Sara Poldmae  4:04  
Okay, well, I can't wait to hear about that. When we first hopped on, before we started to to record, we had talked about what I could pick your brains about, because you have a wealth of knowledge and lots of juicy subjects to get into, but I thought that the audience would love to hear more about the actual connection between moods and hormones, because, like you said, it is so common for us and we we know that it's a part of it, but we don't understand why. So if you could kind of give us the breakdown of why so many women experience such profound mood changes during this time of life that would be super helpful.

Dr. Sarah Daccarett  4:42  
Yes, so it is universal, and it's one thing. Like women can you know, if they're they have acne or a little bit of weight gain or a low libido, they seem to put to kind of tolerate it. Women are very resilient. They put up with a lot more than they really should have to. But when it comes to, like, the mood, when it starts. It's to drop where they get irritable, they get almost rage, like, sometimes I hear that I'm slamming cupboards in the kitchen. I can't, like, I don't know what's going on. And yes, we shouldn't tolerate things that we shouldn't be tolerating, you know, from other people. But it's really not about that women feel a sense of like the world is coming out from underneath them, that, you know, you've ripped the rug out, that they actually feel like there's no inner peace. This is not normal, and it's because of hormones very much regulate neurotransmitters in the brain. And it's not just GABA. So progesterone and its metabolites bind to the GABA receptors. This is huge. It's like nature Xanax. Like you ever wonder why women pregnant women are most chill women on the plag planet? It's nature's way of keeping women tolerant of small children and men. And it also, you know, it really is like, keeps us in this relaxed state. And this is also plays a role in laguno. For women, we have to be in the mood for that, for example, as well. So progesterone is critical, and the uterus helps the ovaries produce these hormones. The uterus helps metabolize them, and these bind to the brain, the receptors in the brain. It's not just GABA, but other ones that probably haven't studied very well. They make us calm and centered. And another thing that really helps us with you know, it's not just this anxiety, so anxiety and sleep, irritability, rage, depression, all of it. Sometimes it feels like it's all coming at one time. Everybody gets mixed emotions, and it's not just GABA. And I think women kind of intuitively understand the GABA thing, but really, what people women are not appreciating is dopamine and how much it plays in their brain, and that's why they feel so much brain fog at the same time. So they almost feel like they don't they lose their sense of mental clarity. They can't find words that they used to be able to remember this word finding they'll be talking to their friends and be like, ah, yeah, that one thing I can't remember. So the brain fog comes with the mood changes, and we need dopamine, to sleep, to focus, to remain calm. So if you're having anxiety at the same time, you're having brain fog and you can't sleep, this is a totally lack of dopamine. And the reason why hormones play a role is because estradiol stimulates dopamine production, and estradiol and progesterone regulated. So, I mean, we're talking norepinephrine, dopamine, serotonin, GABA, all of these play a role in mood, and hormones boost and regulate all of them. This is why, when you see a drop, you see the mood to change first, because it's so critically regulated by hormones, if that makes sense, and there's nothing else like that, can do it, yeah, and exercise all you want to you can exercise all you want. You can change your diet all you want. You cannot raise your hormones with like exercise and diet. I know women are really trying. Everybody can to to get this back. You know, we're told that, Oh, you just need to sleep more. You just need to eat better. It's not your fault. There's nothing you're doing this is literally aging. Your ovaries are not keeping up with you and your really busy lifestyle that you have in your 30s and 40s and 50s and beyond, yeah,

Sara Poldmae  8:10  
yeah. And I do think that lifestyle can play a part in speeding up that process and making the process more uncomfortable. But I like to remind my patients that if we're lucky enough, we get to menopause, right? Like not everybody's that lucky. Some people leave this earth before that time. So we need to make the most of it, and we do not need to suffer. Like you said, Men. If this was a problem for men, it would have been solved a long time ago. We know that, but we're finally having these conversations, and women are finally getting educated, and that's such a beautiful thing. So tell me a little bit more about you. Said that your protocol is a little bit different. So tell us a little bit about your protocol and how you approach hormone supplementation.

Dr. Sarah Daccarett  8:51  
The beautiful thing about my approach is that it really addresses this mood and sleep and anxiety and irritability in women some of the other formulations that are traditional, like orals and creams that are topical, and so I said pills and patches. These are meant as a treatment. They're, you know, if you're over the age of 60 and you have severe symptoms, this is what these products were invented for. They're not made to make a 40 year old not have anxiety and sleep well and feel like really vibrant. Okay, so if a 4050, year old, even a lot of these women, will still use the traditional patch and pill and low dose vaginal creams and topical creams, they will still have mood problems. And then we tell women, now it's your you need to do your diet and supplements and all the things, and no, we're just not treating giving her the right hormone replacement therapy. Okay, so if you're, if anybody's listening, and you're still having irritability, kind of rage, like symptoms, or your can't sleep, or you're having depression on your current HRT, it's because of the formulation and the dosing are not appropriate for you. HRT. Has the ability to make you feel calm and centered. If it's done right, you should feel balanced. And I think that women can understand that, yes, you can add alternative things too. You can diet, and you should diet and exercise and do all the you absolutely need to do all the other stuff too. I'm not saying that anybody can get away from that, but if you need the foundation first, so if you have the appropriate hormones in place, then all the other things that you do, the good things you know, the the herbs that you know, all the supplements and dietary changes, will work for you. So your circadian rhythm changes, going to bed at the right time, shutting off the lights, like all the things that we're promoting cold, like saddles, everything, they'll work better if you have the hormones in place. And so the beautiful thing about progesterone is that it will help you, but it's hard to get into the body. So it's a really big molecule. So if you swallow it, the liver just metabolizes 80% of it. If you try to put it on the skin, it doesn't go through the skin. Skin is like a barrier that blocks progesterone is too big to really fit in through the skin pores. So where do we do we have we can inject it, and then we'd have to do an injection every day. So I developed a formulation that's vaginal because the vaginal wall or mucosa is very absorbent. So I'm not the first to think of this. We do a lot of delivery of drugs through the vaginal route. And there's a lot of literature to support this. In fact, there's hundreds of studies on vaginal delivery of hormones and other drugs. And so I've just packaged it in a really good cream that has high absorption, no, paraben free plant based, like really chemical free, so that it is non irritating and microbiome friendly. And this allows the progesterone to absorb really well systemically. And within 10 to 14 days, women tell me that, well, I feel more centered and balanced. I feel like this anxiety is going away, starting to sleep better, and they really notice a difference on their brain and their mood. And that's the way you want to see within 14 days. And then it just continues to get better as these receptors and pathways heal,

Sara Poldmae  12:03  
amazing. So I like that. I know that I have read about topical progesterone without it being a mucosal tissue is basically worthless. You know, a lot of women that I know are on oral progesterone. What about your methods for estrogen and testosterone? So let's

Dr. Sarah Daccarett  12:19  
talk about that. Because so oral progesterone, for example, some women with PMDD or severe mood problems, like for example, they really feel unstable. They get worse on oral progesterone, and so then they say that they can't tolerate it. And I want women to know that it's not the progesterone that you can't tolerate. This is your own natural hormone. It's the oral formulation that you can't tolerate because the liver makes so many metabolites, and then your these metabolites can cause irritability. So if you're getting irritable or you feel a little bit anxious or kind of ragey on your oral progesterone is not the progesterone doing that is because you're making too much of something else, because you can't control like these liver metabolites can turn into anything in the body, not anything, but they do turn into certain things that may not be helping you. And so, yeah, the approach on we we need both estrogen. We need estrogen too, right? And estrogen. So you can take estrogen vaginally as well, estradiol and testosterone. Women have been told that we need that. It's like our primary hormone. I even hear women tell me that it's I need testosterone, it's low. I'm like, well actually your two other hormones, your progesterone and estrogen, are also low. And those are your your woman, those are your primary hormones, and testosterone is important for cognition and mood and drive and some sex drive and things like that. But when we get too much testosterone, women feel very irritable as well. So when you get too much, so women will get peloton, they'll do injections, they'll take too much testosterone cream, and they will get mood instability with too much testosterone. We're not tiny men, like I am not a tiny man if you give me too much. So I don't want to inject testosterone. I even think I would never. I mean, this is like, will make women very irritable, and so yes, we need a little bit, but our body can actually make it from progesterone. So if you take progesterone vaginally with us, like with our formula, with my formulation, your body will make the right amount of testosterone. So you don't even need to supplement extra testosterone. Your body will make what you need based on your genetics and your activity level and whatever your body's normally doing, so you don't get too high. And that's the problem with a lot of other formulations, is that women just get a little bit too much testosterone, and they get acne, hair loss. It's not just mood so, but they do notice this irritability with like a pellet, for example.

Sara Poldmae  14:34  
And so do you do testing before replacement? Because I know some physicians don't test. Some do test. Tell us more about that.

Dr. Sarah Daccarett  14:46  
The thing about testing is that hormones do fluctuate that much throughout the day. So I know that women feel gaslighted when you tell them that, but it was true, and there's a lot of variability in lab testing. The federal laws don't actually require them to be that accurate. So so. If, I mean, you could take it in the morning and be completely different at night depends on when you put your HRT on or, you know, so real women really need to trust themselves. Like, if you are having issues and you were the age of 30, you're in perimenopause, like this is better. It's more of a clinical diagnosis than it is a laboratory diagnosis. But that being said, there is one marker that's helpful that nobody orders and nobody pays attention to and it's called FSH. And when the brain and the ovaries are struggling to make hormones as we get older, the brain will tell the ovary, it'll stimulate it to try to make more and it releases a substance called FSH. Okay, so FSH will stimulate the ovary to make more hormone. And this is where we get confused in perimenopause. So if you I have, like, the just the other day, I had a 40 year old woman. She was like, Dr Dara, my labs came back. My estrogen was 1000 okay? My progesterone was absent, and somebody told me I had estrogen dominance. Like, what do I do? I'm miserable. I actually have all the symptoms that are like on your website, but yet everybody's telling me, I don't need anything, right? Because I'm making plenty of estrogen. FSH is elevated, like through the roof above it was like 20 and so this what's happening in a lot in her and a lot of women. And I think if I explain this woman she was, this is what's happening. The ovaries start to fail. I'm sorry. This happens. As we get older, they become like fatigued, they don't work as much anymore. I'm fine with that. It's okay, like you said, it's actually privileged that we are living this long, right? So when there's a solution, we know, if we know and understand that our ovaries are just failing, all we have to do is support them. We have control over this, this whole process, right? So do you understand your ovaries are no longer working, and that's also why we can't get pregnant as much in our 30s and 40s, right? So it's because our ovaries aren't working. The brain will send signals, FSH, and then every now and then, the ovaries, like, I can do it, I can do it with so much stimulation, they'll put out like a bunch of estrogen. So then your estrogen will go to 1000 right? But it's making zero progesterone. Okay, so clearly, the ovary is not functioning because it's not making its primary hormone, which is progesterone. And so it's not you don't have estrogen dominance. You just have ovarian failure. Your ovaries are not working. Okay? So you get this level, this random level, you happen to get a high estrogen of 1000 because your ovaries happen to work. The day before that, you took your lab test, and now there's all this misinformation and confusion, and she's told not to take any hormones. This is really damaging, because actually, she's in ovarian failure. She should be taking it both estrogen and progesterone, and when you take estrogen, so if women understood that, let's say your estrogen is 1000 and you take estradiol. I'm not going to add to that. I'm not going to make you 1500 or 1800 or 2000 what happens is the brain will see that there's estrogen present and stop stimulating the ovary, right? So it's not going to make as much anymore. It's just going to like, relax, the ovary won't have to work as hard, and then she'll feel like, evened out that she's getting her primary hormones. So yes, women in like, their 40s should consider like, if you getting because I know that, I say not to get lab tests, but women all over getting these fancy lab tests, and they're getting told the wrong answers.

Sara Poldmae  18:11  
I see patients every day that are disappointed that, you know, we don't recommend testing hormones. I'm like, we can tell you what's going on with your hormones based on how you're feeling, and that's what it is. But I think we're so test heavy as a society, and we want immediate, very clear, black and white answers, and that's just our inclination. And I think by the time women come to our clinic, they're also feeling a sense of desperation. So I can understand that they want to see something on paper. It's, it's understandable, but maybe not clinically relevant. Yeah, I

Dr. Sarah Daccarett  18:45  
get it too, because they're like, well, if I'm going to start this forever, like, I want to make sure that I really do need it. So I hear and I get that and, like, but if you're miserable, like, you need it, you should. Don't wait so long, you know? Like, why would you wait to feel better? Yeah,

Sara Poldmae  18:58  
absolutely. So then do you prescribe estrogen for women that are still menstruating regularly? Or no, yeah,

Dr. Sarah Daccarett  19:05  
because women the period, we put too much importance on the period. It is something visible, right? That we've like we it's the mark of the onset of it and the ending of it. And we think that if we're menstruating, that we're making hormones, and that's garbage. There's no evidence for that. In fact, you see women all day long that are having a period, and you're shaking your head yes, because you're like, I see it like women are having a period and they're making zero hormone. They're miserable. The period means nothing. In fact, you can ovulate and not have a period. You can not ovulate and have a period. And there's something cyclical about the period there that we haven't studied. I feel like we don't understand it. I'll have, like, a 70 year old woman tell me that she feels like she's cycling. And I think there's something in the brain that might do that, you know, we don't know. We haven't researched it. We need to understand that something is as basic as her period. We actually don't have the medical understanding that they she would think. She thinks that we do. And so no period is nothing. Um. It's absolutely, you should not wait until there's a change. And people will be like, Oh, my period's normal. I don't need anything. Like, no, doesn't mean anything. That's fine if you feel great, it's fine if you feel great, absolutely. So, I mean, like, but the period you should not be waiting for. That's the very last thing to happen. It is, like, a symptom. It's like, if you're waiting for your period, stop, you've, like, waited too long, yeah, okay, not too long. You can still get started, right, right?

Sara Poldmae  20:24  
Any other advice that you have for women when they're considering hormone replacement therapy, besides just do it?

Dr. Sarah Daccarett  20:31  
Well, sometimes, like, you got to try it. Like, I think there's this, am I going to mess something up if I just try it? You know? And then you can actually try hormone replacement therapy. If you don't love it, you just stop it and you just go back to what you were before you started. You're not gonna met and you're already messed up. Like, you know what I mean? If you're having all these symptoms, your hormones are already messed up. You're not gonna mess it up further. If that helps. Like women feel better that sometimes you do have to dive in and just try it. You're trying everything else. Like women will try a $30 supplement online, an herb that you actually don't know what's doing. You don't know what that's doing, like when you get and it's not even regulated, like these herbs are not regulated. We don't know what's in them. They sometimes bind to stuff in the brain and then increase serotonin neurotransmitters, but we don't know anything really about them. You're willing to try that over simply replacing your natural hormones that your body normally makes. Why is that trying some random supplement online better than actually a prescription from a doctor that kind of knows what they're hopefully most you know, some of us know we're doing this is actually kind of a safer thing for you than a supplement online. I don't know why people seem to think the supplements are safer, like or natural. This is kind of right. Bonkers. Yeah,

Sara Poldmae  21:39  
yeah. I just did an episode on that last week on the podcast. And my point was, if someone you know comes into our clinic and we hand them 15 supplements, then run the other way, you know, like, I think there are supplements that are, you know, third party tested, and there are supplements that are valuable, but to just randomly grab them off the shelf because some sexy influencer that's 20 years old told you that your 55 year old body is going to love this. I mean, we have to be careful where we're getting our information from, for sure, and I think that there's just so much fear from the studies that have been since debunked about hormone replacement therapy that have just caused an uneasiness that is unfortunate and such a disservice to women that we just need to, you know, really find the practitioners we can trust and then follow their advice. Yeah,

Dr. Sarah Daccarett  22:30  
and I agree with you, like, if there's supplements that we use targeted, like, if you need a specific supplement, but you work with somebody that makes sense to take a supplement, supplements do actually work, some of them, and herbs do work in, like, a specific but just randomly taking a bunch of, like, herbs and supplements, you're not going to get the results that you think you're going to get. You can't just, like, throw money at it, right, or whatever, and, like, women spend like, 1000s of dollars a year trying to feel better. And you're right. These influencers like and an herb that might stimulate ovulation a younger woman. You know, there's a lot of Chinese herbs that do that actually work very well for like, fertility, they're not going to work. I'm sorry. You know, like, at 35 and above, like, if you're, if you're 48 and you're trying to use an herb, it's not, I'm sorry. It's not gonna work for you. It's just gonna, they don't work. And so we don't, our bodies don't naturally make dong quai. Our bodies don't make Berry. They don't make, like, turmeric. Like, I don't make turmeric. So why is a plant, like plants or medicine, I get that like, they actually do, like, it feel like they have a place, but like, in order for replacing hormones, we don't naturally make turmeric, yeah, um, our bodies naturally make estradiol and progesterone and so you're simply just replacing, like, it's like a supplement. I brush my teeth, I've washed my face, and I take care of my body. When you do hormone replacement therapy, I'm just giving that the foundation, and then that's like, the foundation. And then on top of that, you can do all the other functional medicine. You can help your gut, you can get a diet. You can do, you know, there's all that other really, really good things that we're doing on top of it, yeah, 100% agree. No, the study, you're right, like, this is really devastating. I feel like all this 50% of women, there were some poll that 50% of women still believe that it causes breast cancer. And it's like we've known for eight years that it prevents breast cancer, potentially, right? It could potentially protect against it. And this, nobody's talking about that. We're all talking, you know, we still have this. We use the word breast cancer and estrogen in the same sentence. We use the word stroke and estrogen, the same tense sentence is really strange. People associate them, even though there's no science behind either of those. I feel like, I mean, you probably see it like, it feels like suppression of women, like, if we just keep women sick and away from their own hormones and keep thinking that their own hormones are dangerous, then we can suppress them. And if women could see that that it's another form of suppression, they would be empowered. I do not do that to men. I do not tell men that testosterone is dangerous for them. Your testosterone is too high. You're making too much testosterone. We need to lower it. Let's give you a supplemental lower like That's insanity. Everybody would look at me like I'm bonkers if I said that to a man. But we tell women all day long that that her estrogen is bad for her. Like, is this, how is that not sexist?

Sara Poldmae  25:02  
Well, I mean, the fact that we're offered about 70,000 different forms of birth control, and men really aren't is another sign. But that could be a really long different type of podcast episode that might cross political barriers and do all sorts of things that would shake people up. But I agree. I mean, you know the fact that we have women taking birth control, which does have some evidence of causing cancer, and women take it for, you know, 15 to 20 years, and a lot of my patients have been put on it recently in perimenopause to deal with their moods, which is a shocking disgrace, is a huge disservice and perhaps a suppression of women that is always so disappointing to hear that we can do so much better for ourselves and for our daughters, and

Dr. Sarah Daccarett  25:52  
it is depressing to think that we are being suppressed. And women need to understand that once you're past the reproductive age, like you are not like you are, you're not worthy, yeah, and you're not important to the medical community, like one. So you need to advocate for yourself. You are absolutely important. There's practitioners that absolutely do care so but you need to, women need to recognize that they're being like, suppressed, like this. It is, it is beneficial to the to a lot of people, a lot of pharmaceutical companies. I don't want to, like, maybe it's a bit very but a lot of people make money and profit off of women being sick. They're the bulk of anti anxiety antidepressant medications, right? We're talking about mood like they're offered an antidepressant and anti anxiety med before, or birth control, which is a pharmaceutical offered that before any kind of natural approach they're offered, like, sleep aids. They have more autoimmunity, like they're sick, and so it's like, but keeping them in a state is like a form of suppression, because if they're healthy and vibrant and feeling well, then they're not going to spend money on all their all your stuff, you're trying to sell them for menopause, like everything is marketed to menopause, right? Your solution, all the solutions out there. And so I agree, like birth control, if women understood too, that is not a hormone it is a hormone suppressant, right? And so like to offer a 50 year old or, you know, I see 50 year olds on birth control too. I agree with you that this is really weird, like the FDA even says that this contraindicated over the age of 35 that we should not because of the increased risk of stroke and breast cancer. So why are OB gyns and primary care physicians offering this to menopausal women and perimenopausal women is really shocking to me. It doesn't give you hormone if women understood that, it doesn't give you hormones, it suppresses hormones further. So any estrogen that your ovary was able to squeeze out, you know, we talked about in the beginning, the ovary was kind of like trying to do its best. You've now stopped that with the birth control, and that's why you feel maybe a little bit more mood stable. It's possible, because you're, you know, women really need to have all these hormones imbalance. So at first it might feel like you are gaining stability, but you're not gaining any benefit or no health benefit from the birth control, because now you've have zero estrogen, you know. So, yeah,

Sara Poldmae  27:56  
yeah, it's, I, I'm always shocked by that. And, you know, there's a real kind of pushback with the Western medicine community. We have local doctors that aren't super happy with us questioning as functional medicine practitioners and integrative medicine practitioners aren't super happy with us questioning their choices. So I had a patient the other day come in and say that she went to her OB GYN and was was expressing that she wasn't feeling like herself anymore, and that she was, you know, not super happy with her hormones. And the OB GYN said, well, let's just put you on birth control. And the patient said, I don't think I really want that. Are there any other options? And the OB GYN kind of threw up her hands at it, because she didn't have any other options for her, and said that because she was still cycling. Now, mind you, she was actually only having about three or four periods a year, but because she was still cycling, that hormone replacement therapy was not on the table for her. So she came to our clinic and began bioidenticals and was back for her regular checkup, which we do not do, and women do need to see their doctors for their regular checkups, and I don't think that that doctor is going to be referring us anymore patients. And that's really sad, because, you know, she was not offering an alternative solution to just birth control, and we were, and this woman feels fantastic now. So it's just sad that the that we're butting heads now. It's,

Dr. Sarah Daccarett  29:25  
it's, um, it is. It's sad because, like, I don't pretend to know OBGYN. You don't pretend to know OBGYN. We don't do pap smears. I don't. I'm not a surgeon. I don't deliver babies, right? Like, I don't, I don't go in and pretend to know their field. So I don't know why they feel like they all are experts on hormones or functional medicine. Like the functional medicine field and hormone replacement therapy and anti aging longevity is an entirely different specialist field that we have like that dove into trying to learn. We learn about it outside of school. And it's a wellness, prevention, health, you know, their stuff that they do. Is very acute, which we still need. You gotta deliver a baby when you need it. But if women understood that obkines are not a lifelong health doctor, they're just deliver your baby and that's it. And they keep going back for pap smears, which we don't even need to do pap smears every five years now, and we can even get a molecular test online. So I don't know why they go back every year to their OBGYN, but they do because the OB gyns have not told anybody. Wait, hold up. Many, many years ago, you can

Sara Poldmae  30:22  
get your Pap smear online

Dr. Sarah Daccarett  30:24  
Well, so what it is, is it's a vaginal swab that you want to test. So we've known for like a decade that HPV, if you test for this with a molecular platform, that it's more sensitive than a pap smear. That means that it's a better screening test. So when you get the test online, Everly, well, sells it. Let's get checked. Sells it all. Shout out to all like, those really big companies, I think even for hers is doing it now. I mean, we're talking about, like, these online companies, they'll send you a kid at your house, do a vaginal swab, send it in, and if it's positive, if you're HPV positive, then yes, you should go see your OB, GYN, and get a passenger follow up to make sure that you're don't like, have any dysplasia. But other than that, you know, it was women get older. We're not, you know, they they tell patients come back every year because they can, if patient, they can bill for that. Doctors need to make money too. OBGYN is how they're making their income. So they do not need to see you every year. This is something that they have not told anybody, right? But you don't like. So it just always bothered me that OB gyns, like they step in thinking, and then it's okay if you do know, like, if the OB GYN actually does know something about functional medicine or diet or hormones or how to, you know, get that the root cause of something, but they just pretend to know, and then they end up giving a lot of misinformation that scares women, like that hormones are dangerous, or that you can't start hormone prison therapy until your period stops. This is just misinformation, and it just does a lot of damage. So women need to understand that the OB gyns and primary care physicians are not trained in this. You have to go to specialists, like in a sort of functional medicine doctor or hormone replacement therapy doctor, somebody that's like, really only

Speaker 1  31:52  
doing this, yeah, yeah. I love that. That's why

Dr. Sarah Daccarett  31:55  
you don't. I mean, you and I don't do pap smears. Like, yeah, no,

Sara Poldmae  31:58  
no. And there's a reason why I don't All right, well, tell us again how we can get in touch with you, the name of your company and anything else that you want our audience to know about, how you can be of service to them going through their mid years. We're

Dr. Sarah Daccarett  32:16  
available like for questions, too. If you're doing your research and you just want to reach out on our website, we can help you with answers like getting the right information, either about our formulation, or even just what's out there, traditional or and we're at online in 40 states right now, seem to be 50, and it's just inner balance.com so it's kind of a way a lot of women don't have somebody like you that they go to. Lot of women don't know that they don't have or they're in small towns, for example, they also don't have this resource. And so we're here online. We ship it to your house. We follow up with you in a telemedic, you know, like, over text and audio and visual, like, I can jump on a call with patients all day long. And so you get the support that you need, like, after you start therapy as well. So a lot of companies will just sell you the HRT online and then leave you hanging, you know, like, here's some patches and pills be on your way, which is okay, too, if you know what you want. But if you don't know what you want and you need some help, like adjusting in those first three to six months and getting on, like, a more personalized, custom dose, then we would be here for you to help you get on, like a more customized approach. So we change the dose as you go based on how you feel. So as we mentioned, we don't do labs. We see your progress, and then we might adjust the dose based on that. So this is the online approach that we have wonderful

Sara Poldmae  33:32  
Well, thank you so much for your time today. It was great learning from you. I always love to have hormone specialists on the show, because I just think it can make such a world of difference for so many women out there. And you know, like you said, there's a suppression aspect. They don't want us to feel good, because, you know, as we age, we get more opinionated, so we might stir up trouble if we're feeling good.

Dr. Sarah Daccarett  34:02  
Um, that's probably true, that's happening.

Sara Poldmae  34:08  
Well, thank you. It's been a pleasure, and looking forward to tuning in next week. Thank you.

Thank you so much for listening to this episode of the midlife rise and thrive podcast. If you are enjoying what you hear each week, be sure to follow the show and leave a rating and review, letting me know what you think I would love to hear from you see you later.

Transcribed by https://otter.ai