Testosterone, Peptides, and AI: Revolutionizing Menopause Health with Jennifer Gularson

In this episode, Mary sits down with Jennifer Gularson, certified physician assistant and functional medicine practitioner, to explore what women truly need during midlife—and why the current healthcare system often falls short.

Together, they unpack hormone therapy across the lifespan, including estrogen, progesterone, and the often-overlooked role of testosterone for women, as well as the growing use of peptides and GLP-1 agonists for weight management. Jennifer explains why symptom-based care misses the bigger picture and how a root-cause, functional medicine approach—grounded in nutrition, sleep, stress, relationships, and movement—can be life-changing.

The conversation also dives into the psychosocial and relational aspects of libido, intimacy, and body image in menopause, the barriers women face in accessing appropriate hormone care, and the future of personalised medicine through genetic testing and AI—without losing the essential human connection in healthcare.

Jennifer's message serves as a powerful reminder women deserve more than quick fixes. They deserve care that listens, integrates science with spirituality, and supports long-term vitality, autonomy, and self-trust.

Connect with Jennifer at yourbestlifewithjennifer.com, @jennifergularson

 00:10 Why women are demanding better menopa

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Transcript

 Women's brains are going a mile a minute. We are silently doing our, the laundry, the cooking dinner. The lists are long and extensive and we just need to shut down that brain and step into our femininity, relax, find the time. And then a lot of times he rest will come as it may, especially if physically you're well taken care of. 

Welcome back to the Menopause Disruptor Podcast. And if you are new, and if you are new here, welcome.

I'm so glad you found me, and if you're a returning listener, thank you for continuing to tune in to each and every episode. Today I sat down with the incredible Jennifer Gu She is a physician's assistant residing in the Washington dc, Maryland, Virginia area, DMV, and we had the most delightful. Conversation. It was so good. We unpacked so much about hormone therapy, peptides. as in GLP one agonists, we talked about loss of libido, loss of sense of self and purpose, weight gain.

We talked about everything that's wrong with our healthcare system and everything that could be right with our healthcare system. It was a beautiful intersection between science and spirituality. Well, mostly science and I geeked out on the science what Jennifer was able to unpack for us in terms of what's happening in the female body and remedies and modalities and even hormone therapy to help it.

She explained it in such a way that was truly understandable.the way listeners will truly grasp and I can't wait for you to hear this episode.

 science aside, the spirituality part was mostly about leaning into who we are as women and claiming our power claiming our feminine side too, which means, you know, self-care and nurturing tapping into our wisdom. I say this often, women become wise as they step through all those years of experience, all those years of doing, doing, doing, and come out on the other side.

More empathetic more in touch with their bodies and more in touch with their abilities. So we definitely tapped on that spiritual part of it, if you will. This was one of those conversations that could have gone on forever. It really did, and I think that it would be wise to bring Jennifer back.

But certainly for this episode, listeners grab a pen and paper or get your voice memos out while you are listening to this one. There's a lot in here, a lot to digest. But before we begin, here's something you need to know about Jennifer Gularson. Jennifer is a certified physician assistant and certified functional medicine practitioner. She specializes in integrative functional medicine and aesthetics using a holistic, patient specific systems oriented approach, looking at many factors such as lifestyle, genetics, and the environment.

Her goal is to address underlying imbalances and root causes that can help promote overall wellbeing and put the woman back in control rather than just giving her a bandaid solution to manage symptoms alone.

And Jennifer focuses on women's health. She's been treating women in the ages of 35 to 60 for a long time, and notice there was so much stigma attached to menopause, also known as the misery. It wasn't a glamorous subject and women felt misunderstood, uhhuh, and often treated with antidepressants.

Yep. And frustrated when they were told. It's just the way it is. Get a good night's sleep, honey, it will eventually go away. Well, the true disruptor that Jennifer is,She works with her patients so that they feel safe without judgment. Without the shame and no topic is off limit.

She gets it not only as a functional medicine practitioner, but as a woman. One thing that she specializes in is aesthetic medicine, but Her true specialty lies in treating the complexity of women's hormones, because she has experienced it firsthand, she knows what it's like to be sleepless, tired, experiencing hot flashes while raising a family and running a household, as well as having a career.

So she would personally attest that hormone therapy works wonders. And I'm a true believer that knowledge is power. when a woman understands and is well educated and intelligent on the subject and applies that knowledge, that is wisdom. So stick around. You're gonna enjoy this episode.

Please join me in welcoming Jennifer Gularson to the Menopause Disruptor Podcast.

.

Welcome, welcome Jennifer Do I call you doctor as a PA, or how do you like to go by?

Yeah, so I, I am gonna probably anger a lot of my PA for, I just go by Jennifer. if you call me Dr. Jennifer, I have to tell you that I'm not a doctor, I'm a physician assistant, but a lot of people go like, PA Gularson, that to me seems like it's more in the military, but, I'm happy with anything.

Wonderful.

How about menopause helper?

And that's exactly why you're on the show. You're going to help us unpack it all. You come from a rich background in primary care. We were just talking about that functional medicine, the Dr. Mark kind of, uh, functional medicine, aesthetics, oncology, hormones, peptides. What initially drew you toward integrative approaches, especially addressing this in hormonal health.

Yeah, so sometimes you don't get to pick your path, your path picks you, and that's, that's sort of my case. I was very blessed to, after working in family practice and then some in oncology where I did treat a lot of breast cancer patients, I got, was, pregnant with my third child and I was looking for something that was a little less stressful.

 so I joined a med spa, and I was lucky enough to witness, the doctor that I worked with go through menopause and she was a trailblazer and a disruptor herself and continues to be. We really, we, turned our practice from doing like the aesthetics, skincare, Botox, fillers, and lasers. They had a very thriving practice.

So there were a lot of women there. And we always found, one or two a day that were like, yeah, I have these dark circles 'cause I'm not sleeping well, why are you not sleeping? Because I have hot flashes and like, oh. Maybe that's something we should look at. the, I was, like I said, my, supervising physician got into hormones and was trained and then therefore it trickled down to me.

And we started taking care of women and we got them probably, I would say like 75, 80 5% better. And then we launched into, well, let's look at their gut. Let's look at their thyroid, let's look at their adrenals. And that went down the path of becoming certified in functional medicine, which looks at that whole person, those fundamental things that we can't ignore.

 and so I'm, that's why I am here now, and I, changed practices about six years ago. I'm now in the Rockville, Maryland area. I treat people from all over and they, like I said, it kind of found me, I, there was a niche in this area and I got a name for being compassionate listening, validating, and helping them turn their lives around.

And now I have a really bustling practice and looking to, help people outside of the DMV virtually.

That's amazing and thank goodness that we have that at our disposal to be able to operate in the virtual space now and to broaden our reach far and wide. So it's interesting when you say you found your niche, the niche has changed. It's been a real call for that. We are seeing that in the media. We're seeing that from, celebrity figureheads that are really changing the narrative around how we address menopause. But it has only been in recent years, probably less than a couple of decades. Even less than that, that we've seen these pivotal moments that have profoundly redirected science to look at women and women's health, women-centric, female-focused hormone health. shifts have you seen just in the six years that you have moved into this?

It will into your new practice, but probably throughout the duration of your career as a physician's assistant?

Right. So I would say that when I started at the med spa, so that was in 2007, we started treating, I really aggressively started treating hormones, say 2009, 2010. So it's been about 15, 16 years. And back then it was like. Very, under the radar, people would come in and not say why they were coming.

 and we really, we were disruptors back then. I, my colleagues thought I was gonna lose my license and, you know, you're treated, this is dangerous. All the studies, even though we knew when we were learning about hormones in that functional space, we all knew that we just didn't see all these women on hormones.

They weren't getting breast cancer, they weren't dying, they weren't getting heart disease. So we knew the studies were there, but they just weren't. Shared amongst, traditional, just let's say traditional medicine. so we were really under the radar for a while, and then I really attribute, there were really good things that came outta COVID and really bad things.

But one of the things was, there was a study that the Women's Health Initiative, most of your listeners probably know about the Women's Health Initiative that set us back 25 years. But there was a lookback study, that came out around 20 19, so right on the cusp of COVID. I, and I feel like it got buried, but then after the smoldering, you know, the ashes were falling and, people really got into, and podcasts came about a little bit more.

So we really started saying wait a second. This study came out. We really need to look at this. It's not as bad as we thought. so during COVID was, I think women had. Time to relax. we slowed down a little bit. We took inventory, and then I think people got ticked that they were being neglected.

We were no longer saying, well, we should just push through. we're busy, but we are not pushing through anymore. We're gonna sit, sit in our feelings, sit in our symptoms and really ask and demand better. And I think this ball has just been, it's like a snowball effect that, oh yeah, and here's this study and here's this study and here's this, expert talking about it and this women's group and this celebrity.

 and it's just getting bigger and bigger because women have stopped saying, I just need to suck it up. And they're like, I just want better. And they're demanding better. And I think we're even seeing this in the millennials and the younger generation about perimenopause. Because they, because we're giving them permission to talk about this, and I, I'm a gen, I'm a Gen X, I'm 53, so I'm giving my younger generation permission to talk about all the things that we weren't, we just had to suck it up because you just had to do everything and just keep going.

yes. we thank you and your team for being those trailblazers that are really shaking up the arena and how we treat women's health, how we address hormone health. And not only that, how we look at the whole system, the whole body. So when it comes to root causes and the functional medicine, it's stopping, slowing down and starting to ask those questions.

And as you alluded to asking why they're not sleeping, why their gut health has shifted. Oh, why the hot flashes. So how do you explain that in the context because it's still kind of brand new. We are seeing a lot more of the influencers, and I'll say like Dr. Mark Hyman, who's very forthright in sharing what root cause medicine is all about. how do you explain the philosophy to a patient, to a client who has ever experienced traditional symptom focused care? And that might also include the pharmaceutical solution to their symptoms.

Right. I, I think that a lot of them come in as a last resort. I can't tell you how many my new patients have seen, 4, 5, 6, 10 different, specialists and our American system is really good if you. Are acutely ill. We are hands down the best. This is where you wanna be. We're just really not great with chronic care.

 and we're just not set up for that. So my, my initial consultations are 90 minutes, so I'm sitting down, I'm starting from the very beginning. tell me where this started. And then we go throughout their entire life and then they, we figure out how you got here. And sometimes them just talking about their journey.

 they put the things together themselves. So we talk about sleep, of course, we talk about what you're putting in your body, the, and then exercise movement, their relationships and their stress. A lot of times they're unaware of how stress, especially in the area that where we are, we're really close to our central government.

So there's a lot of high stress and anxiety, in this area. And they wear it as a badge sometimes, and we help them say that's not a thing. we need to relax. Do things for yourself. So those are my five, the five pillars, those, you know, diet, which you're putting in your mouth, sleep, stress, relationships, and exercise.

All of those are talked about in that initial consultation. And then modalities, some lifestyle modifications are usually suggested in each of those areas. In addition to some lab testing. And then once we have like a story, I tell their story back to them. They feel very heard. and then we come up with solutions.

And sometimes at the beginning it's a couple things. It's easy as, um, you know, uh, you're using blue blocking glasses, I or blue light blocking glasses. Yeah, it can be as easy as that. I just recommended that today with the patient. 'cause she says she scrolls before she goes to bed. I'm like, oh, okay. Can you at least wear these glasses?

 can you just block that blue light? Um. So it's implementing these little modalities, doing the testing. A lot of times we do fun. I call 'em a little bit funky testing. We go really in depth and then explaining what those results mean. If they can see on paper something that I'm per, that I'm suggesting or prescribing, and how this can help and get to the underlying cause of why.

Let's say, why they're depressed, why they have a little depression. Well, it could be vitamin D, it could be your thyroid. It could be your hormones. It could be your partner. It could be your boss at work. It could be the gluten that you're eating so that you could have a multitude of different things causing one symptom.

And it's not that. And Mark Hyman's famous for saying, you don't have a Prozac deficiency. we are changing a whole bunch of different things to help get a, an outcome. And looking at people is, as a whole person is very different than what they're used to. And sometimes they're uncomfortable and don't understand all the questions and why I'm asking them.

But at the end, I think they would walk away. They have been able to tell their whole story and they've been heard and they've been acknowledged and not told that they're crazy.

 90 minutes. That is absolutely unheard of in our healthcare system. This

It takes that long.

Yeah.

It takes that long to get their story. I mean, some of these people have lived 55, 60, 70 years. How do you do that in eight minutes? You can't.

that's right. And never have had the platform, the opportunity just to let it off,

Yes,

And then in the moment that you recap their story back to them, give. Logical explanation that suddenly just builds a bigger picture. stories are compelling but when we get the real information, that data that links, I mean, we are wise women stop treating us like we are.

We are not. Give us the information and then we feel empowered to make radical

decisions. Yes.

yes. I would be really curious if you wouldn't mind sharing, Jennifer, some of the outcomes or testimonies that you've had from some success stories with your clients, and then we'll get into the nitty gritty of what you're treating.

Sure, so some of the comments I hear life changing save my life. Okay, so last night I was at dinner with a, a business colleague and, we were talking and she says, you don't understand. I tell everyone that you saved my life. And I said, Anne, I didn't save your life. You just had hot flashes.

But she said, you don't. I was Googling, can you die from hot flashes and, and you saved my life and my eyes. another great, good stories, and I'm sort of conglomerate, putting a couple of patients together is wanting to be intimate with their spouse, but they have pain or anxiety or they're not, their body image isn't there, or their desire is low or 

they just don't feel like it. And giving them back that, has been a, that's a huge reward. Reclaiming that intimacy with a partner. Um, helping people lose weight. I, I, I have, part as part of hormones, all those things need to, sign kind of go together, but just changing a little bit of their habits on what they're choosing to put in their bodies can make a big difference in how they feel, how they sleep and the weight loss.

I also do aesthetics. So their having their skin look glowing because of the diet that we've fixed and their food, allergies have been fixed and then their skin looks a little bit more glowy and then we do some microneedling and they're happy about that. hair regrowth, that's always a really good thing.

 and I, I think, and I hear this all the time, you made me feel like myself again. Yeah, that's, that makes my day. 

So beautiful.

you mentioned so many things are tied together, but libido, for example, one of the leading symptoms that are reported that loss of desire, intimacy, and sometimes the root cause linked back to self image.

Yes.

Self-worth. And when they feel and see that weight gain and feel lethargic or that loss of confidence, that also is related to some hormone loss. And we'll get into that, then, of course libido is gonna fall off the radar. And it's the last thing we wanna think about is 'cause we are still in that doing, doing, doing caretaking mode and oftentimes menopause lines. So with the sandwich generation where

really not fair.

Yeah. Caregivers of our own children and taking care of ailing parents too.

And then we're right stuck in the middle, so there's no time to take care of ourselves. so when you work with women with their libido, for example, and I wanted to jump on this one first, then maybe weight loss second, what is some of the first thing common, causes, apart from what we mentioned, image in terms of their hormone deficiency or fluctuating hormones?

And what are some of the approaches that you're, that you in the clinic will take to address loss of libido?

 this is great 'cause I just, had a patient today and this is her story. She's already on hormones, she's being treated. She went into menopause early. she is. Being treated adequately on hormones, but she's tired, she has no desire and a ton of vaginal dryness, which inhibits her from having sex.

And she says, I've gone to my GYN, my, family practice, and they don't really have much in the way of helping. So we talk about, desire as a whole, whether you are, do you have. Did you ever have it? Because I don't think I can make it magically appear if you never did. But, if we do, delineate spontaneous desire, meaning, and traditionally men have more spontaneous desire, or there is one person in the couple that's a little bit more spontaneous and then there's responsive.

So making them understand that those two things, did you used to have spontaneous and you wanna get that back, or are you just saying like, I would love to be more receptive to receiving and being intimate with my partner. So that's a clear delineation. Many things. Physical and psychosocial effect.

What happens with our libido and our, passion. And they, there are many different modalities and sometimes they're overwhelmed. 'cause I was like, we can do this, we can do this, we can do this. And when you come from a place like, yeah, there's nothing to me coming and saying there's five or six different things I'd like to try.

That can be a little bit overwhelming. But I think it also is reassuring. So we talk about, communication with our partner. Like, where's your partner on is, are they on board? Are they aware? Do they understand what's going on? And why is it painful? So for this particular patient, she had multiple things.

She was, fatigued 'cause she still wasn't sleeping well. she has a younger child, but then she also had a lot of pain and some of the creams were messy and she didn't like doing that. So I'm like, well, we can. We can modify that. There's lots of different things we can try. So we're gonna, we're gonna try those things.

 and then there's also, some of the pills now that are, Addie is one of them, one of, the medications for sexual dysfunction, that now was just, in America. We got FDA approval for postmenopausal women. That was a problem before. Um, but we've been using it off label for both peri and postmenopausal women.

so that's a modality to, to help her. There are peptides that increase spontaneous desire and libido. and then also hormone replacement, adequate. And then there's testosterone. So this particular patient, she is being monitored and in my opinion, she's very well taken care of, except that, she did specifically ask about testosterone and a lot of traditional medicine, doctors, physician assistants, PAs, nps, um, they are not familiar with how to, how to prescribe it.

Plus they don't, you know, they don't, they won't test for it. that was her particular, Thing that happened to her is that they wouldn't test her, and she was a little frustrated. So testosterone is a great help. there's just recently I've been prescribing vibration, so using vibrators externally, not so much internally, but externally.

There's some, a great study out there that shows that increased blood flow, which if you think about some of the modalities, the emela out there and some of the, Mona Lisa, they're bringing blood flow to that pelvic floor into that, vaginal tissue. So blood flow to the area equals like more moisture, elasticity, and it just augments everything.

So a lot of times it's, there's not one magic bullet. It's a lot of different things, but that also takes communication with your partner to say, Hey, we're trying this. not to mention

it.

there needs to be a safe space for that to happen. So finding time, scheduling time, blocking time, and whether it's, you need a.

Nice, nice bath, some nonsexual massage. I have a babysitter, have a, you know, send the kids away, send the dog away. I have one patient like, oh, we can't be intimate because we have a dog and it's in the room all the time. okay, the dog needs to leave. and just shut down the, women's brains are going a mile a minute.

We are silently doing our, the laundry, the, cooking dinner. the lists are long and extensive and we just need to shut down that brain and step into our femininity, relax, find the time. And then a lot of times the rest will come as it may, especially if physically you're well taken care of.

That's incredible. I, I really gravitated to what you said. the bio psychosocial aspect of our health.

yes.

throw in a fourth one, bio-psychosocial and even spiritual,

Yes.

said it, you tapped in it to reclaim our feminine divinity, like our feminism.

 that part of us that needs the self-care and nurturing. Do you work in that aspect? Maybe not name it spiritual, but encapsulate some modalities and practice that help the woman say, you know, what you are a feminine being and as such you need that nurturing, which is very much a feminine quality as well.

 I think, by virtue of where I'm practicing, I am surrounded by very strong women pioneers in their industry, their CEOs, their leaders. They're, even you can be the CEO of your family. so in this area, I feel like there is a very. elevated woman, sort of boss babe, if you will. That's a little term.

 but they are commanders most of the ti day making decisions. all the way from, what's the kids gonna wear, what am I gonna wear, you know, that you're making hundreds and thousands of decisions a day. I really do speak to stepping out of that role and with your partner, 

So talking about letting your male partner be the male and let you be the feminine so that you can finally relax. And a lot of them like that. Permission to not be in charge to relax, to let someone else take over for a second, to relinquish all of those responsibility and all those balls that they're juggling.

And, I would say that I had to do that for myself. I had, you know, you make a lot of decisions, you're, I run my own business. So giving permission to step into that, I think we've lost a little bit of that. and then as soon as you're done, you can go right back to bossing everybody around. But you do need to take care.

If that is what will make you relax, then that is what needs to happen. So yeah, I address that. And some people look and realize oh, I guess I don't allow myself to step back and let someone else take over for a second because I've been so in charge all day. So it's something that we do discuss. Yes.

Yes. So we've addressed libido, and you addressed testosterone as one of those modalities. To address the problem. But I do like the way you say it's a multi-pronged approach and that you need to almost be experimental, try one and is it getting results? Maybe it needs to be layered with another modality or another therapy. but talking about testosterone specifically, and here in Canada, health Canada doesn't prescribe unless you have hypo sexual drive disorder, HSDD.

Mm-hmm.

 that is the truth as well in the United States is that it's just not recognizes like estrogen therapy and progesterone therapy in the whole, hormone, or menopause hormone therapy, MHTI like to say. But testosterone is earning its place in terms of getting real results. Do you see that there will be a shift in due time that prescribing. dose testosterone for women will finally come online. Slowly as we start to see that the evidence is moving the yardstick forward, we're getting more research empirical data to state that this is actually something that the woman's body needs just as much as to estrogen and progesterone

I think that we're demanding it, which is nice. So I, the way I explain it to patients is, um, that if I show them that it, the lady today, her, she had le, she had no testosterone available, like it was low, that was not, could not find any less than three, so that there was no testosterone found in her body.

 I tell them there is no, FDA approved testosterone. I cannot write a prescription. And you go to our, your CVS or whatever and pick up a pre prescription. You can get a mail dose and you're gonna pay for it because your insurance won't pay for it because there's no FDA approved form for women. But that doesn't mean that we don't have a ton of data, that it helps us.

And in fact, we have a lot of safety data on trans, men born female transitioning to men at 10 times the dose. That we would give you my patient, and they don't get breast cancer, they don't get heart, have heart attacks and have heart disease, they are fine. And we have a tremendous amount of data with those higher doses.

So then therefore, why would a five milligram dose of testosterone cream for women be dangerous? I know that it did help that the black box warning on testosterone for men came off a little bit before we got our estrogen black box taken.

yeah.

but I think it sort of opens the conversation.

Do you know there's controversy over whether we will ever have a dose that's FDA approved. But, more and more people are educating themselves. There's a ton of data out there we use. I particularly like to use compounding pharmacies because they, can give me the right dose rather than someone breaking up in a packet, splitting it in a 10 different pieces and trying to figure out dosing from that.

 there's good and bad with changes of administration and stuff. everybody has their own platform. I don't know, I would love to have them. Also, I know that during, the Biden administration, they were trying to declassify it into something that's not a controlled substance. 'cause it does, it's creates a barrier to entry for some people.

 and then also that's why some of the, healthcare providers in my area just choose not to prescribe it. I think it's a tremendous help for many, many women, I'd say about 75% of them feel something better. and then the rest of the 25% are like, I don't know. But I know that it's good for my bones. I know that it's good for my brain.

I know that it's good for my motivation. I know it's great for my libido. It has that oomph that get up and go make decisions, that kind of stuff. And they were missing it. Also, aches and pains. A lot of my patients find that they, the joint stiffness in addition to the estrogen, 'cause that helps with joint stiffness too.

 the testosterone helps also and it just strengthens the ligament, the muscles and the ligaments, helps with bone density. we all had estrogen, progesterone, and testosterone. We were our twenties and thirties and forties. We should be replacing it for most people.

The Menopause Society has a statement, came out in with a statement in 2019, followed by the similar statement, I believe it was 2022. or Statement on Menopause Hormone Therapy or HRT. just basically disputing all the findings 2002 Women's Health Initiative and debunking some of the misunderstandings, although it's taking a long time.

And the ghost of those headlines that came out back in the early two thousands still linger in her healthcare. testosterone is one that they have not. Come out and updated the statement, because almost like science marches on, but it takes some time for maybe the advisory board or the review boards to finally say, okay, this is officially the statement on it. But you said, and rightly so. The demand is there, and right now we're still limited to compound pharmacy. But with testosterone, if, do you envision that it, once the menopause society finally makes the official statement on it brings it back more to what we're finding with the empirical data that's coming out now that we might finally see prescription based testosterone?

So here in the States, we have to have a company that's willing to go through the red tape of, going through the FDA and for what formulation. And, but I think there's a precedence and maybe there is, It would be nice if the people who are making some of the, already, some of the formularies, they just decrease the dose a little bit because they're already at like 12.5 packets.

can't we go down to a six, six milligram or a five milligram packet? I don't think that that's, and I think Australia does have that. It's a five milligram, packet and I believe there's someone in the uk. I can't, I'm not exactly sure There's somebody in the UK that, um, and it might even be the Great Britain, they, they allowed the five milligram packets.

'cause I do sometimes have patients who travel outside of this country come back with packets and show me and say, this is what I want you to prescribe. And I'm like, we don't have that here, but I could get it for you. And it just in a different modality.

It just seems ludicrous that we can create Artificial general intelligence. that can do just about any task and job that a human could do. . But we can't whittle down a prescription testosterone into a smaller package. It, and again, you said exactly why it's the red tape, uh, the bureaucracy that we're up against. but we'll still keep advocating and with, goodness, compound pharmacies 

I just would like manufacturers to make more patches 'cause they're always out. So, and I look at it that as a good thing because maybe more women are on it, so they're, you know, the demand is higher. But now we need the manufacturers to get that because I don't want any delays in, in my patient's care.

Absolutely. You know, that's a nice segue. Jennifer into another area that you work with in your clinic and yourself, and that is weight loss. And that's another one of those leading symptoms, on that scoreboard that tends to disrupt us in menopause and gets the most complaints. let's address that.

And in terms of peptides as well, um, I've done an episode, but there's still so much more to unpack. GLP one agonists is coming on board full stream. We need to really start breaking down the stigma attached to it and explaining exactly how it works, why it works, and the advantages and disadvantages.

So I would like to address it just from a very broader perspective, weight gain and some of the root causes that we see happening in women's bodies as they go through menopause.

So when a woman has no more hormones, their ovaries stop, stop working. Um, they lose obviously estrogen. And estrogen is really a key to unlocking fat, and letting, and when you have low estrogen, you have dis. Functional fat. So you start gaining in different ways. You start having inflammation, you have that cellulite 'cause you get the striations because of the inflammation that's around the fat.

So you really do need estrogen in order to lose weight. So replacing that first is one of the things, or, um, maybe optimizing is, is important. testosterone also, I feel, helps women with the joint stiffness. So if they're not working out because they have joint stiffness, it's almost like what comes first, the chicken or the egg.

But, doing, making sure that they can perform, uh, weightlifting and walking. so losing the hormones changes the way your body stores fat. And the other thing I think that happens is we are, especially in our twenties and thirties, told that we need to exercise, exercise, cardio, cardio, cardio, cardio.

And I'm really, it's really great to see the younger women in the gym actually lifting heavy things, doing weight, like doing good technique, learning this, because they're gonna be so thankful in their thirties, forties, and fifties. That, and even beyond that, they're doing this. Um, so I think getting off of the rat race and, and killing ourselves with a lot of cardio, which spikes your cortisol, which then makes it so that you can't, you become insulin resistant, you gain weight, and then you are, you're fighting a whole nother battle.

So. Adding stress, cortisol on already stressful woman is just stress on stress, and then your cortisol increases and then you're not sleeping, and then you're gaining weight. So making sure, again, starting at the beginning, looking at their gut, looking at all their habits, sleep, stress, uh, what they're putting in their mouth.

And then the movement is really if they're not doing those things correctly, then I can't guarantee that what we do, even if we use a peptide or whatever, that's gonna help. So starting with, starting with some interventions like. Diet. I work with nutritionists, I work with dieticians. I give recommendations, but I am not the accountability person.

But I give them recommendations and then have them work with, uh, people that what is a plate with? 20 to 35 grams of protein look like and 40 grams of fiber, like what does that look like? that's, that's your job is to figure that out. And then, um, then make sure that you're fueling, I think pe women often because, well, at least my generation, we grew up with diet, this, diet that less calories, starving ourselves, yo-yo dieting and things like that.

And then there's the whole pasta snack, wells, high carb, low fat, all that. We are just, there's just a mess right now with what we're supposed to eat. But I think the message is pretty clear. Lots of protein, lots of fiber, lots of fruits and vegetables, and then all the carbs can be extra and don't be afraid of fat.

Um. So doing all of the, what you're fueling your body is the first thing. Getting your exercise dialed in is the second thing. Getting your hormones, your thyroid, all your supplements, nutrition, your gut, are you absorbing everything? All? That's great. Okay. Now we can talk about peptides and whether it's, um, I start them out on some berberine, which is a nice blood sugar, blood glucose regulator.

 and they sort of get a little bit of benefit from that. And then I'll, then I can go into to the peptides. I tend to enjoy going low dose first. I like to microdose. I think that a lot of the side effects and the scariness of some of the peptides or the reluctance is because of some of the, um, side effects that people have seen.

Hair loss, diarrhea, constipation, nausea. those things happen usually when you escalate too fast, and you're not following the rules, you're not, you're just not doing what you're supposed to be doing. I often tell patients, if you're not eating, you're taking too much.

So I think we went and took a medication that was aggressive in lowering hemoglobin A1C for diabetics. And we took that exact paradigm on how to treat weight loss and I think it probably was too much.

mm-hmm.

I just get a lot of success with patients who are doing everything right. I mean, no one's perfect, but doing as much as they can, starting at a low dose, maybe a quarter of a starting dose, and then escalating only if they're having, trouble and they're not losing.

If my patients are losing a pound a week, I am happy and okay, if it takes them six months to lose 15 pounds, 20 pounds, I think they are. And they're developing the skills to. Make a good plate that they're lifting heavy weights, they're getting their hormones done, they're sleeping, they're doing all the other stuff.

If it takes them that long, they are more apt to have lifestyle changes that are gonna change their life long term so that they can keep that off. It's these, and their skin isn't saggy, so then they're not having to do interventions for that. that's my philosophy is go slow, start with the basics and go slow and escalate up as needed.

 and then probably back off a little bit and maintain, I think, I used to think that maybe we should stop them, but there are so many health benefits to remaining on these medications, probably at a much lower dose than what we got the patient to lose the weight at.

When I hear all of this, I think in terms of interventions and a lot, well, women just don't want to do the lifestyle changes or even integrate behavioral changes they're feeling low energy, not feeling themselves, feeling low libido, not intimate with their partner, which is an additional stress. Workload, their careers, like all these things, like you said, these stresses add on. And so, they're not remotely interested in investing in some of these interventions when they just don't have the fortitude to do it. And yet we are understanding now that interventions such as hormone rela hormone therapy, I hate to say replace or replenishing, so MHT, including testosterone is bringing back that sense of self a little bit more.

Vitality also aiding in, like you said, the brain, the muscle, but yet it seems like our healthcare system is too readily available or willing to jump on the GLP one's agonist prescription before we could push the yardstick and get testosterone. There's still so much more gray area and taboo around hormone therapy. It just seems like there's a real disconnect. what is happening in the healthcare system? Why are they so eager to prescribe for weight loss but not manage hormones for women?

They were never taught how to manage hormones because hormone replacement was bad. So there's no education and that's not their fault. Uh, it just, that's, that is, and I do some teaching and PA programs currently, and there still is no hormone taught, uh, replacement or, um, therapy taught, certainly not testosterone stuff.

 and then time, time, they don't have the time. So to sit and talk about. Why, uh, eating cues or what's driving, or do you have, repetitive thoughts? Like there's just a a lot of, food noise. Talking about food noise. Where does that come from? How are we gonna stop that? what is your sleep hygiene that, none of that.

I never learned any of that. I learned that all in the functional medicine course and that's like a two or three year course where you are learning, learning all the stuff that we should probably be learning as healthcare practitioners. But the thing is, you can partner with, you can have people in your office that do that stuff, or group visits where you learn all of that.

But it's the education. We just don't know. And it's easy to write. an FDA approved if your insurance pays for it, okay, here you go. I inherit a lot of patients that just don't understand what it's supposed to be doing. I have one patient inherited and she's like, I'm on this medication and all I eat is three Skittles a day.

I am like, no wonder your hair is falling out. No wonder you're like, you can't, you don't have any energy. So it's, I think it's, it's a. The CRUT crutch is not a way it, it is an augmentation. It is a helper, but you gotta, yes, do all the other stuff. And I do, I will start women on a really low dose to sort of give them a little bit of a nudge and a little bit of hope, because if I, if they leave with nothing, they feel defeated.

If they have a little bit of a tool, whether it's a prescription for testosterone or an estrogen patch, or a lab slip that's going to see, or a low dose GLP one, that and a prescription to go see the, a nutritionist, it gives them the power back. At least they have something. I think that's giving them hope and listening and saying, I promise I'm here to help you.

This is a relationship. We're gonna get through this together. But listening, validating their feelings and giving them a little bit of hope is, is really, really important. Traditional medicine doesn't have the time. I feel so bad for my colleagues who are seeing, if I see 12 patients a day, that's a lot for me.

'cause it's either a half hour or 90 minutes. 12 patients is a lot. 12 to 15, my colleagues are seeing 30, 40, 50. And it's, you know, in and out, in and out, in and out. if you are really sick in America, it's a great place to be if you have a chronic disease, not so great.

We're just not prepared. We just have to change the paradigm. And then we also have to reimburse for health. We reimburse for sickness.

you read

So sometimes, I'm struggling if, especially if I have a really dialed in patient and, and they're just looking for optimization. So I have a lot of patients that come in like, I wanna optimize, I wanna outsmart my genes.

I want, my mom has dementia. I don't want it. What do I do? And they are doing everything right. What do I put on there as a diagnosis? Like they, they have no complaints. They're optimized, but they're just, they're looking for a genetic test that looks at all her snips or his snips to say oh, I should be taking this type of B12 so that I can outsmart things.

 how do you bill for that? It's, it's hard.

And it just seems The first test it has to pass is the judgment. You have to be able to explain your positioning. I'm in great health. I wanna do better.

Yes,

and yet here are healthy patients still having to explain themselves away. Yeah, I, I was gonna ask about that reimbursement here in Canada, of course, we have a healthcare plan and a lot of our healing modalities, including going to see your doctor, telehealth, even, uh, nutritionist, naturopath, osteopath,

all those modalities, by and large insurance companies will cover to a significant not all of it. So that makes it more readily available.

Yes.

then there's other avenues where if there's no reimbursement, there's no reinve, there's no investment, and this is where the. the things that can really help them, and I'm speaking in terms of memberships, a personal trainer, even working with someone like me as a doula, helps unpack like you do, getting to the root cause, building the story and then farming out, referrals to the specialists who can, apply the therapies, if you will, of the prescriptions. But it just seems that if I'm not gonna be reimbursed, what's the incentive? like you said, unless you're very clear in your mind and you can connect the dots. Ah, if my gut microbiome is doesn't have good diversity, I'm setting myself up. Or if I have high insulin, I'm setting myself up for, or increasing my chances for dementia and Alzheimer's. But that language is not in our medical practice at the moment. We haven't connected those dots

No, not yet.

 we're on the precipice of change. I see that, but it just, it's unfortunately, and that's what my point was, it just seems here in Canada, we're at the mercy of what the insurance company decides, what will get reimbursed.

And yet there's so many different other like somatic therapy and yoga, like these are yoga. Like this is stuff that gets really to the root cause that trauma stored in the body. And Mark Hyman speaks about this too, that can be really aiding in someone's health journey, not sickness journey, but their health journey.

Yeah. They wanna know what your diagnosis is and what's the prescription we're gonna fill it with.

What else can we see happening maybe in the future where we're really starting to see more shifts in proper health care as opposed to sickness care?

 one of the exciting things that I see are more peptides. Of course, there, there's gonna be more and more and more, not just for weight loss, but also, some of the ones for ligaments, for tissue recovery, for, human growth hormone secretion, for decreasing inflammation, other places, mitochondrial health.

 so all of those things that, that all signal decrease inflammation, which equals longevity at the end.

Mm-hmm.

I also see, more attention to the gut microbiome, which is if you go way, way, way back, all disease starts in the gut. so that is exciting. And then also personalized medicine to the point where you're looking at your genetic makeup, and some of the snips or the oopses that have happened in your particular genome.

And then devising, supplements, diets, lifestyle interventions that, that circumvent those genetic. I call 'em genetic oopses. 'cause not everybody knows what a snip is, but those like genetic things that are, creating long-term problems. But it, wouldn't it be nice if you had a, six or 7-year-old and you did a genetic test on them and it gave you all the answers that you should, they're predisposed to A DHD.

So then you start them on magnesium at a young age, or you start feeding them certain types of foods or you know that they have a gluten sensitivity. So you just start, stop that right at the beginning. Or that they have the M-T-H-F-R, where they can't methylate as well, so then you're feeding them more cruciferous vegetables or you're giving them a certain type of VB vitamin or, and the magnesium and you know, it just, I, that's where.

Medicine is going to be at some point. and there are some practitioners that are like, are there, and we, and a small part of my practice is that. so I think that's really exciting. And that's when you're gonna get the longevity. And you don't just want longevity. You wanna be able to, to move around.

You want your brain to work. You don't wanna live to a hundred and not be able to use it.

So that's where I, I see that happening. and with ai, you can.

ask

 put in that genome and it will say, these are the things and, and research you need to, um, research needs to catch up to the entire genome sequence.

But putting it into AI and then saying, create a two week diet for me based on this gen, my genomic makeup and how I'm predisposed to, gain weight in certain areas or like, I can't tolerate this amount of carbs. all the information is in there. it's just being willing to go from a. Uh, diagnosis type of society or we wait until there is a problem in order to address the problem.

We're, I think, in women's hormones, we are now looking at, uh, prevention. Versus misery before three or five years ago. the modality was, well, okay, now you're still having hot flashes. Okay, now you can qualify for some of these supports. you're really not that miserable. I'm not gonna risk it.

That's gone. Now. We're doing more preventive. We wanna save your bones, your brain, your muscles, your everything. But we're not that there yet with everybody else. So when we go to that prevention mindset, which is what our, what we were back in the, you know, fifties, sixties, seventies. You had your primary care doctor and they knew everything about you.

And now we just have so many specialties, which is great, but then we never, the infrastructure's not there to take care of people as a whole. Yes, we need our specialists, we need high, we need ev a person that, that does very, very specific work, but we also need the people to cultivate. at the root level of your, of your health and keep you healthy that way.

So prevention versus like, uh, we're already, the house is already on fire and we, we could have prevented it by putting the fire screen up

That's right. Right now things are still very siloed. It's to, to treat what's

and no one communicates with the anybody. your neurologist doesn't really send it to your lung doctor, to the cardiologist. They never talk. And then they were very, very siloed in uh, I don't know about hormones. I'm not gonna say yes. Or, you know, they're, they put, this is where I am and I don't have any opinions about anything else.

Go ask, that person, which I understand, but we have nobody to, keep these people whole.

The AI

Yeah.

talk at great length. I'm a science communicator at heart and I could really geek out on the science. But I could see an AI information war evolving in terms of if we have this capability and it maps our genome and gives us the lifestyle choices to support so we can prevent or improve that circumvents medicine in terms of pharmaceuticals, I can really see, A real war on this happening AI could be used to our advantage, in this case, to our advantage, it would cut out a couple of things, maybe even pharmaceuticals or reduce, significantly reduce. And it would certainly put a real wrench in manufacturers who are constantly producing sugar laden foods keeping the consumers buying because they're on this sugar rush and cravings.

And 

yeah.

real disruptor too, as we finally put a stop to that because we're now realizing, but, and so much faith is being put into the results that we get from our AI 

I have patients now come in and we finish our, we finish, like we go over everything. I come up with a plan, we have our discussion, and they're like, okay, cool. And they pull out their piece of paper. They're like, you said exactly the same thing as my, I I was like, I'm glad you didn't tell me you did this beforehand.

You scared me. But yeah, they're like, oh yeah, that you, we agreed on this and this and my AI said this. And I'm like, okay. Yes. No, I, I don't think that's a good option for you because of this. And so, I may become obsolete. I'm sure a lot of my patients think that too.

 I still think that accountability partner, that coach in the corner,

Yeah.

cheering you on, is still, a human experience that I

Oh, yes. And I don't know that AI can talk about the intimacy, the communication, Yeah, I thinkIf AI takes over after I retire, that'll be fine.

 I knew this conversation was gonna be both interesting and disruptive. We've

Yes,

 talking about our intimacy and libido right on to ai. And you know what, in this day and age, that's exactly what a lot of conversations are all about.

absolutely.

You said something, this is my science brain geeking out now.

 M-T-H-F-R When it comes to, some of the diagnostic that, we could read, and if we have that information, we could, we can, introduce those modalities. So just define that for the listeners.

there's a couple things. So, how you break things down, especially hormones is really important. So we have things like the Dutch test that looks at your metabolites. but genetic wise, there are some people who can't, methylate or can't break, detoxify our hormones a good in the proper way, or they do it very slowly.

So there's things that help to speed up that process. and then there's other one, like COMT, that's another one if you, have, that is for estrogen metabolism and estrogen detoxification. So everything we put in our body we need to break down, whether it's air, uh, food, medications, and there are genes that turn things on and turn things off.

So when we're specifically looking at hormones and creating. Um, hormone replacement and putting in sometimes synthetic, then there are going to be some repercussions and your body's gonna have to work hard to, to digest, if you will, or detoxify things. So knowing where your, vulnerability is, whether you don't, you have A-C-O-M-T SNP where you prefer a different pathway to detoxify your estrogen and therefore you have to take some things like dim or.

 methylated, B vitamins, methylation, enhancers or Sam e that's another one that sort of gets things going through to help you detoxify things or you may need less of something. You might not. And not everybody's the same. That's why some people at a low dose of estrogen can feel breast tenderness.

And people that are take 10 times as much, they don't feel any breast tenderness because of their, the way they break things down. So that's where, it's a little bit more nuanced when you're looking at your specific genetic makeup, but it can give you some ideas on how to be safely on hormones and how to break them down and detoxify them, as well as other medications that you may take.

Very great explanation. Really honestly, it's the first time I've really heard it explained in such a simplistic, understandable detail. right now, the tests that are available for us to know, our ability to break it down To be able to absorb these, the hormones or whatever we might be on, what tests are being used right now to be able to determine if we can do that effectively.

So there's a couple, there's two things. Number one is the genetic test. So you can get your genome mapped out and you can get some of this done. We have, we work with a couple different genetic companies, and then you can also do different panels. there's a neuropsych panel, like if you're having trouble finding out which medications would work best for you.

 then there's also detoxification panels, so there's different panels genetically. Then, as far as hormone testing goes, the Dutch test is really great. I don't use it for dosing, but I usually, I have once a year or. Once in their lifetime, look at how do you process hormones and are you putting yourself at risk?

So when they look at estrogen, detoxification, if you choose one specific pathway because that's the way your body is made up, there are, some supplements that I can put you on to push you to a better pathway. So there's three diff, three different ways to detoxify estrogen. There's the good prep pathway, the bad pathway, and the it's okay pathway, but we don't love it.

So we can take medications like dim to push it down, that good pathway. And then we also need to make sure once you have that first pass metabolism, those are all the, Free radicals that are out there, so we know what free radicals are. Then you have to take those free radicals and use things to get them out.

Second pass metabolism, and we use oxidation. We use glutathione. We use our B vitamins and so. Knowing how you do that, the Dutch test is really great for you, specifically how you process things. And if you're in danger, if everything looks great and you're on hormones and all your metabolites are within normal limits, that's great.

If they're a little bit off kilter, then we can, um, outsmart it and put things through to help you detoxify a little bit. The same thing goes with, with, testosterone breakdown. we're always looking for DHT, so if you prefer to break down testosterone in an alpha pathway, we can give things like saw palmetto or Finasteride and those are, will inhibit the DHT and push it down the other pathway so that you don't get the acne, the hair growth, and then the hair loss.

Interesting. 

pretty cool.

Absolutely. And I,

I.

sure that there's some listeners right now thinking, wow, I want to be able to have somebody lead me down this pathway so that I can get the right tests and I can optimize my therapy, optimize, just my nutrients or my supplements. and this is wonderful.

Again, like I said earlier, we live in a day,and age now where we can work virtually. And that's exactly what your clinic can do.

Yes.

Jennifer, please tell the listeners where they can find you so that if they're far away in the United States, of course only, they can still take advantage of what you have to offer 

Sure. Yeah. So if you're in the DMV area, which is, Maryland, DC, Virginia, that we see patients in person. and if you're outside of that area, my website is your best life with jennifer.com. And I do, I probably would not be able to prescribe for you, but what I do offer patients is advocacy.

 I can go over all your labs, I can tell you what to order, and then I can work with you to find a practitioner in your area that would be able to prescribe what, what we come up with. So, going through your labs, figuring all that stuff out. Is great. but then you need somebody to sort of take over your care and help.

I'm always here as an advocate for people to find the right practitioner in their area. They're out there, we just need to find them, or we just work with them and we educate them as we go, which would be great.

Perfect. And that is of course for United States. You're not working abroad outside United States at the moment. one day we will come to a point where it'll be more universal care, 

 yes. That would be so great.

Yes.there's some cutting edge, medical care, if you will, or healthcare in, places all over the world. You mentioned a few, Europe, Australia would be wonderful to have the same advantage, but until such time, this is for our United States listeners, but you still gave us a wealth of knowledge that is universal. So

Absolutely.

take away a lot. We will get all of those links in the episode description. Thank you so much, Jennifer, for joining me, sharing your expertise, unpacking a lot of the confusion our midlife journey, and really empowering women with the knowledge so that they can make wise choices.

Uh, thank you so much for all you do, Mary. You're a blessing.

 Lots of aha moments in this conversation. As always, that's why I bring the guest experts onto my show from this conversation with Jennifer Gularson, These are my key takeaways. The importance of holistic root cause approach to menopause and women's health, integrating functional medicine in today's medical system.

So important because it gets right to the heart of the matter. Asking curious questions, building a story and looking at what might be causing some of the symptoms as opposed to just masking them. deal with it. And this also involves a practical approach to lifestyle changes and hormone optimization.

Again, it's just not about symptom management, it's about optimizing our health. Jennifer also highlighted the cultural shift that's underway because women are demanding better care and more information, which is driving advances in research and care options, 

Jennifer also outlined her five Pillars for health. They mirror a lot of the work I do as a menopause coach. what you put in your body, how you rest your body, sleep. Stress management, relationships and of course how we move the body. And Jennifer also stressed the importance of understanding each woman's backstory, so you can tailor.

Her menopause journey for success

hormone therapy. Yes. Traditional estrogen, progesterone, but understanding the role that testosterone plays in a woman's body and how we can advocate for testosterone replenishment, very important.

But right now in Canada, the United States. Not all places worldwide, but certainly here in North America we are limited. Unless you have hypo sexual drive disorder, HSDD, then it's very hard to get a prescription based medication for testosterone 

But very important that you do your homework, you do your research, present your case to your doctor and advocate. Testosterone just might be one of the sex hormones your body is lacking for brain health. Recovery from exercise, sexual desire, and just that feeling of being yourself again, being whole.

We deserve this. But, There is still slow progress in mainstream acceptance of therapies like testosterone for women, and so more advocacy and demand are driving the change.

at the regulatory and educational level as well where we continue to see some of the barriers.

The role of peptides in GLP one agonists. featured recently with my conversation with Dr. Terrick. it's a conversation worth having again and again because weight management and weight gain are two areas of prominent concern in the menopause journey, and there's many reasons for that. If you're considering going on GLP ones or you're already on GLP ones, understand that they are there to compliment, not replace core lifestyle changes. Working with a team such as nutritionist. And incorporating other lifestyle changes, including my favorite exercise, strength training, resistance training. So vital, whether you're on GLP ones or not, your body has the ability to improve health markers if you just move it and fuel it effectively.

And that's why working 

With the right people in your care team can help you with that slow, steady, sustainable progress. 

What I found a really crucial point in this conversation was the importance of understanding how women detoxify and metabolize medications and hormones differently.

And some genetic differences can influence how hormones are processed, affecting both safety and efficacy of these therapies. And then we looked at the big paradigm shift, shifting the mindset from sickness care to healthcare, with the main focus on prevention and personalized medical treatments and holistic

modalities that are unique. Individualized for each person. And that's when we had that little discussion about the future where genome mapping and AI will enable even more personalized and precise healthcare, helping practitioners tailor diets, supplements, and interventions to each person's unique genetic makeup.

And more so empowering women with information and support that they deserve, being the true disruptor that Jennifer is. She discussed how advocating for women to reclaim their health and embrace their Femininity is vital, as well as seeking practitioners who will listen, validate, and partner with them on their journey to optimal healthcare.

You can find Jennifer on her clinic's website, osteopathic Center for healing, ofchealing.com, and you can also find her on yourbestlifewithjennifer com. She's also on Instagram at Jennifer Gularson. All those links would be the episode description below.