The MiDOViA Menopause Podcast

Episode 017: Unlocking Gut Health During Menopause with Dr. Jessica Drummond

• April Haberman and Kim Hart • Season 1 • Episode 17

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Unlock the secrets to thriving during menopause with insights from Dr. Jessica Drummond, founder and CEO of the Integrative Women's Health Institute. Ever wondered how hormonal changes impact your gut health? Dr. Drummond sheds light on the estrobolome, a critical component of the gut microbiome that interacts directly with estrogen levels. Understand how these shifts can affect your digestive and immune functions, and learn strategies to maintain a healthy gut during this transformative phase.

Discover the power of prebiotics and the importance of dietary choices in supporting your gut microbiome. From seeds and nuts to a rainbow of vegetables, we delve into the foods that nourish beneficial bacteria. Uncover the benefits of intuitive eating and explore treatments for harmful microbiomes, including antimicrobial herbs and the local antibiotic rifaximin. Plus, hear anecdotal evidence on the positive impact of locally sourced fermented foods like sauerkraut.

Managing gut health during menopause comes with its own set of challenges, especially for those with conditions like endometriosis or a history of abdominal surgeries. We discuss structural changes and their effects on intestinal motility, and explore treatment options such as visceral physical therapy, antibiotics, and herbal remedies. Finally, we address the critical link between sleep and gut health, offering practical tips to improve sleep patterns and manage cortisol spikes. Join us as we aim to change the menopause narrative, empowering women with knowledge and breaking the stigma around this natural stage of life.

Dr. Jessica Drummond, DCN, CNS, PT, NBC-HWC is the founder and CEO of The Integrative Women’s Health Institute and the best selling author of Outsmart Endometriosis. Dr. Drummond has 22 years of clinical experience as a licensed physical therapist, licensed clinical nutritionist, and board certified health coach working with women with pelvic pain, including endometriosis, vulvodynia, and bladder pain syndrome. She brings a unique, conservative and integrative approach to supporting women to overcome hormonal imbalances, and chronic pain conditions. She is a sought after international speaker on topics such as integrative pelvic pain management, natural fertility options, optimal hormone health, menopause, and female athlete nutrition. Her clinical and coaching programs and educational programs reach thousands of clients and professional students in over 60 countries. Dr. Drummond has a BA in Biology from The University of Virginia, a Master's in Physical Therapy from Emory University, and a Doctorate in Clinical Nutrition from Maryland University of Integrative Health.

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Welcome to The MiDOViA Menopause Podcast! Your trusted source

Speaker 1:

Welcome to the Medovia Menopause Podcast, your trusted source for evidence-based, science-backed information related to menopause. Medovia is dedicated to changing the narrative about menopause by educating, raising awareness and supporting women in this stage of life, both at home and in the workplace. Visit medoviacom to learn more home and in the workplace. Visit Medoviacom to learn more. I'm one of your hosts, april Haberman, and I'm joined by Kim Hart. We're co-founders of Medovia, certified health coaches, registered yoga teachers and midlife mamas specializing in menopause. You're listening to another episode of our podcast, where we offer expert guidance for the most transformative stage of life, bringing you real conversations, education and resources to help you overcome challenges and reach your full potential through midlife. Join us and our special guests each episode as we bring vibrant, fun and truthful conversation and let us help you have a deeper understanding of menopause.

Speaker 1:

Today, we have the pleasure of interviewing Dr Jessica Drummond on the show. She is the founder and CEO of the Integrative Women's Health Institute and the bestselling author of Out Smart endometriosis. Dr Drummond has 22 years of clinical experience as a licensed physical therapist, licensed clinical nutritionist and board certified health coach, working with women with pelvic pain, including endometriosis, vulvodynia and bladder pain syndrome. She brings a unique, conservative and integrative approach to supporting women to overcome hormonal balances and chronic pain conditions. She's a sought-after international speaker on topics such as integrative pelvic pain management, natural fertility options, optimal hormone health, menopause and female athlete nutrition. Her clinical and coaching programs and educational programs reach thousands of clients and professional students in over 60 countries.

Speaker 1:

Dr Drummond has a BA in biology from the University of Virginia, a master's in physical therapy from Emory University and a doctorate in clinical nutrition from Maryland University of Integrative Health. Let's welcome Dr Drummond to the show. Welcome everyone. We cannot wait to have this conversation today. Many of you have been on our podcast or listening to our podcast and you're familiar with menopause. However, we have not talked about gut health, so we have invited Dr Jessica Drummond to join us today and share her expertise. Welcome to the show, jessica.

Speaker 3:

Thanks so much for having me. It's my pleasure to be here.

Speaker 1:

Is it okay to call you Jessica? Yes, yes, absolutely Wonderful. Well, I am especially excited to have you on the show because what our audience doesn't know is that I went through the Integrative Women's Health Institute Health Coaching Certification Program. That's where I received my certification, and you founded that organization. So I've been a part of IWHI for a while, and so to have you on the show is just a real pleasure. And, as I just mentioned, we're going to talk about gut health, because it is a topic that a lot of our listeners continue to ask us about. So, if it's okay with you, I'd like to just dive right in, because there's a lot of confusion. Most of our listeners are familiar with menopause, but that link between menopause and gut health is misunderstood. So can you kind of unpack that a little bit for us and just help us to understand that link between menopause and gut health?

Speaker 3:

Yeah, so most people understand that during menopause. Well, let me back up to perimenopause. So about 10 to 15 years before a woman is in official menopause, which is one year. The date of official menopause, if you remember the date of your last period, it's one year after of your last period, it's one year after. So anywhere from 10 to 15 years before that women can often start experiencing the symptoms of perimenopause. Because what happens is up until then, well, it takes a little while to establish itself.

Speaker 3:

Right, when someone hits puberty, there's a little bit of inconsistency in the menstrual cycle. Girls can maybe not have their period for a few months, then have it every two weeks for a little while and then it's a little all over the place. It can actually take up to 12 years to be fully established in the beginning part of the menstrual years, especially from a hormone and brain standpoint. One thing that's important to note is that the brain is really what drives these hormonal cycles, so it can take a little while to get established. Then you normally, if things are optimally functioning, have a couple of decades or so where you're consistently cycling through that monthly rhythm and then things can begin to shift and get wobbly. It's kind of like puberty in reverse, in the mid to late thirties to the mid to late forties, sometime in that timeline. So progesterone declines, but inconsistently, but a little more consistently than estrogen, which can be all over the place in perimenopause.

Speaker 3:

And so how that impacts gut health is that estrogen interacts with the gut microbiome. So after menopause or kind of during that menopause transition, as estrogen levels are declining the composition. So the gut microbiome is this community of organisms, lots of bacteria and viruses and fungi and parasites and things like that. They're not all bad. We want some of those to be there. In fact there are tens of millions of beneficial microbes that we do want to be there. But sometimes there's an overgrowth of the ones that are less beneficial or even more pathogenic. There can be a yeast overgrowth or an overgrowth of something like Klebsiella, which is one of the bad bacteria. In the right amounts and the right ratios, that gut microbiome, that set of organisms that lives primarily in the large intestine, is really beneficial for immune health, for digestive function.

Speaker 3:

But when estrogen declines, there's what we know in the research as the estrobilome.

Speaker 3:

So estrogen directly interacts with the composition of the gut microbiome.

Speaker 3:

And when estrogen declines the gut microbiome begins to look less healthy, less robust and to some degree more like that of a man robust and to some degree more like that of a man and, as we know, men up until menopause have a higher risk of cardiovascular disease and metabolic syndrome than women.

Speaker 3:

And then women catch up, unfortunately, you know, just after menopause, and that's primarily because of this interaction between estrogen and the gut microbiome. So what happens for women, from a symptom standpoint, is they become more insulin resistant, they have abdominal belly fat, weight gain, visceral fat weight gain, which is the more kind of dangerous kind of fat, and there can be disruptions in the functioning of the digestive system. So more constipation and, you know, bloating and symptoms like that. So it's that interaction between the change in hormone levels and the composition of the gut microbiome that starts to get us into trouble in menopause and promotes a more inflammatory environment in the body, because the gut microbiome also directly communicates with the brain and the immune system. So instead of it being more helpful for our immune system, the composition of the gut microbiome becomes potentially more problematic metabolically and from an immune resilience standpoint.

Speaker 2:

That's amazing. That makes so much sense to me that I didn't all put together. Let's drill down on some of the common issues that people are facing and understand more. How does menopause affect digestion and nutrient absorption and we think about supplements and people ask us about that all the time because their nutrients are not absorbing in the same way. What happens during menopause that affects those areas as well, and what should we think about doing about that when we're experiencing that kind of, that kind of you know disruption in our life?

Speaker 3:

Yeah well, estrogen also, I would say the, the decline of estrogen is also at some level a physiologic stressor. So, and and also a lot of times in midlife, there just are more emotional stressors like think about what a women, women are doing at this point. Many of them haven't had a moment to unpack any trauma from anywhere in their life.

Speaker 3:

So they're just carrying it like a backpack, right, and you know, by the time you're 40 or 50 you may have children, you may have teenagers. You may have aging parents. You may be, you know, at a fairly high stressful level in your job. You may have teenagers. You may have aging parents. You may be at a fairly high stressful level in your job. You may feel isolated from friends. There are a lot of stressors Divorces are common, moving, trying to get promoted.

Speaker 3:

Whatever is going on physiologically or kind of emotionally and in your life will combine with the physiologic stress of the decline in estrogen, which brings that more insulin resistant environment. And so from a digestive standpoint, what that can do is in the small intestine. So if we think about what is the digestive tract, first starts in your mouth, right? So chewing. So again, if you're under stress, you might be eating in the car. So even if there wasn't any physiologic changes, your lifestyle can impact your digestive function.

Speaker 3:

We know from the research that each bite of food to be maximally digested needs to be chewed 40 times. I don't know about you, but that's uncommon, right? So even 10 times, right, like just sitting and chewing. I say to my clients all the time your stomach doesn't have teeth, like we have to do the mechanical digestion in the mouth, but that's generally not done. Plus, also at this point women could have problems with their dental health, with their mouth microbiome. So that's kind of a whole other topic, but it is related to the digestive function and there is a large energy requirement. So between your mouth and your stomach and then your pancreas and gallbladder and the small intestine, so food goes from the mouth to the esophagus, to the stomach, where it has to be very acidic. It's very common to have to take things like acid reducing medications, acid blockers, that can make it really difficult to digest food. That's okay as a short-term, temporary solution, but the real problem usually is that the stomach is no longer acidic enough and that the digestive enzymes that come from the pancreas and the bile salts from the gallbladder are are not robust enough to really break down the food. And you combine that with this inflammatory risk to the lining of the small intestine. So the vast majority of our nutrients are absorbed in the small intestine and that is a semi-permeable lining. But it can become too permeable to things like undigested foods and toxins. Especially if the stomach is not acidic enough, bacteria can get in there. Anything that the stomach was supposed to kill off with stomach acid, can you know, seep in so. So you end up having a challenge at the small intestine of difficulty absorbing the nutrients because the food is not broken down enough, but absorption of toxins and kind of undigested food which is seen by the immune system as an intruder.

Speaker 3:

And to build those strong digestive juices requires a lot of physiologic energy from the mitochondria. And again, what's going on at midlife, like a hundred million things. And women don't have the capacity to build enough digestive juices. So using things like betaine HCL, which is like a supportive stomach acid supplement, apple cider vinegar, can do that. That helps promote your own stomach acid. So you need enough energy, mitochondrial support supplements to support that actual energy from the ground up, and digestive enzyme supplements. So I think of these stomach acid support and digestive enzyme support as like crutches for the digestive system when you don't have that robust for the digestive system, when you don't have that robust energy to be able to adequately produce those juices. So supporting women's energy is actually a path to supporting their nutrient absorption.

Speaker 2:

Interesting and people ask us about probiotics and prebiotics all the time. You just took the words out of my mouth, kim. I'm like what about?

Speaker 1:

Because that's the question that we get Like, what prebiotic or probiotic rather should I take? And you're like there isn't just one.

Speaker 3:

No, there are gosh, probably thousands at this point, but definitely hundreds. And so here's the challenge with pre and probiotics. We do have a fair amount of research. There's a research compository called the Probiotics Advisor. It's a sort of a subscription service for professionals to look at the data about which probiotic strains have been studied for different things. So there certainly is not one recommendation for women in midlife about which pre and probiotic strains to add. Well, which probiotic strains to add?

Speaker 3:

I would start with just optimizing the digestive function, as we talked about Mindful eating, sitting for meals, chewing more thoroughly, eating more slowly, eating in a more regular timing, because the brain and the digestive system and the bowel really like routine, and so one of the most common challenges in midlife actually is constipation, which is a huge problem, because then we get like backup of detox. You know the daily, regular detox that we need just to live in this environment. I mean, at the end of the day there are no sparkling clean places left on earth and you know our water is polluted, our air is polluted, we wear microplastics, we eat microplastics, like there's only so we need to be kind of daily pooping just to kind of keep our head above water of the tox environment that we live in and that's really hard when things aren't moving in a rhythm. So instead of thinking pre and probiotics which I'll talk about prebiotics in a second before I would recommend any particular probiotic, there would be two reasons I would do that. One is if we've had a stool test and we see which bacteria are lacking and could use more support, sometimes more personalized, supportive, specific strains can be valuable. Other times we'll do it based on symptoms. For example, there are certain strains that are beneficial for all different kinds of kind of quote unquote diagnoses Like. One example is certain spore-based probiotics help kill COVID in the gut, like there's one called Tundrax. So if people are struggling with long COVID which is one of the things that I see obviously a lot now, that could be beneficial at least for a little while to kind of rebuild the robustness of the gut microbiome Because, as I mentioned, that helps increase the robustness in general of the immune system. So spore-based probiotics can be helpful for immune function. But I wouldn't recommend anyone just take those, because people who have histamine issues or allergy problems, those are also histamine producers so you could actually develop something like an anaphylactic shock from it. So probiotics, I actually don't recommend that people take without consultation with a skilled nutritionist or functional medicine doctor or GI doctor or something like that. Prebiotics is a little bit of a different story. And doctor or GI doctor or something like that, prebiotics is a little bit of a different story. So prebiotics is the beneficial foods that feed the good composition of a gut microbiome.

Speaker 3:

So if we think about, there's tons and tons of microbes living in our large intestine primarily. Sometimes they get into the small intestine in different ways and that's what's known as SIBO or bloat. You'll have bloating as the main symptom, but it could be an overgrowth of bacteria or fungi or anything else, and so sometimes we need to quote unquote kill off the bad bacteria, and we usually do that with herbs. But everyone can benefit from eating a diet that does less to feed the more pathogenic or quote unquote bad bacteria and other microbes and more to feed the more supportive microbes. The problematic microbes love sugar, love processed grains, you know all the things that our brain sometimes loves for serotonin. But if we can reduce those things, we actually at some level starve out and help the beneficial microbes get a stronger, more resilient. Because what we want is that whole community of organization, sort of self-balancing, rather than just adding certain strains, at least in the long-term or unless you know which one you need, depending on your situation. So not eating sugar, much less processed grains In some cases no grains at all, but I only like to do that temporarily because there's benefit to the beneficial bacteria of prebiotic fibers, and a lot of those are in some of the gluten-free grains, like quinoa is really a seed.

Speaker 3:

Seeds are great, like all the different seeds are great, sometimes nuts, a wide variety of vegetables. So if you can look at your weekly meal plan, how many different colors, different vegetables, different seeds, different nuts, different herbs and spices, different herbal teas that variety of beneficial prebiotics, which is essentially fiber and phytonutrients, which is what we get colorful fruits, vegetables, herbs, spices, things like that from, is what feeds the beneficial bacteria. So that's where we would start before adding prebiotic fibers that we would purchase or probiotic supplements that we would purchase, and you can also eat probiotic foods. That's really what people used to do and that's another great place to start. Things like fermented food sauerkraut, fermented beets are some of my favorite and it's really interesting.

Speaker 3:

In my practice I've often seen women who were in this midlife transition. They might go on a trip or they might go to a place where they might want to live and they get a sauerkraut from that farmer's market and that one makes them feel much better than where they are, than the one they get from where they are now, and that is sort of a really fascinating and there's no research on that. But I think it's one of those intuitive things where you know, I had one client years and years ago. She lived in Brooklyn and she would visit this kind of like Airbnb or something in upstate New York and both places had a farmer's market and she just thrived with the sauerkraut from the upstate New York and she just started bringing it back to her other place. So if you're on vacation somewhere, it would be fascinating to explore if your body likes the gut bacteria, the bacteria that's around in the place where you feel good.

Speaker 1:

So interesting. It's so interesting. I've heard the same thing from people, not specifically about sauerkraut, other things. I'm curious if we can go back to a comment that you made about treating the bad microbiomes with herbs. What herbs would you recommend?

Speaker 3:

Well. So the traditional way to do it is to use a fairly local antibiotic called rifaximin, and that does work. It's very expensive and it's short lasting, but sometimes it can be a cure. It just kind of depends on why someone has this overgrowth of bad microbes, bacteria, particularly in the small intestine. It's a local antibiotic, so it's a little different than other antibiotics that can actually mess up the gut microbiome. This one is helpful.

Speaker 3:

But the challenge I see is many of my clients have endometriosis or they might've had some other abdominal surgery or chest surgery or, you know, even a C-section and the structural changes that can happen from or even like a back injury, like if you think about where your intestines are. Think about where your intestines are, endometriosis in particular can grow or there can be areas of inflammation on or around the bowel. There can also be areas of like adhesions and stickiness where the bowel might be stuck to something and again, that might also happen with a surgery or the need for surgery, with a surgery or the need for surgery. And so when there are these little pockets that don't move normally with the normal intestinal peristalsis, think about that. That's a warm, moist area where there's a lot of food. Visceral physical therapy can be helpful to kind of keep those areas moving, but it's usually a structural challenge that we have to manage rather than cure. So if you're someone who's been doing all these like SIBO diets and SIBO antibiotics and SIBO herbs and it keeps coming back, take a step back and consider that it's probably either like the whole process of how you're eating Is it stressful, is it too fast, is it too slow, how's the motility? And or there just could be some stickiness from anything from gosh scoliosis or inflammation. So that antibiotic is one option and there is another one too, depending on what kind of bacteria there are, for sort of cleaning up the bad bacteria and setting more of a clean slate.

Speaker 3:

There was a study I believe it was back in 2015 at Johns Hopkins. One of the researchers was Gerard Mullen, who was a really skilled functional medicine gastroenterologist, and they did a study where they compared rifaximin with two kind of commercially available herbal supplement combinations. One was a company called Metagenics they have candy-backed and AR and BR, which are antimicrobial herbal combinations, and that one or there was another company, fc, cidal and Dysbiocide were the names of those supplements, and so either set of two of those used together was equally as effective as using the antibiotic, which is valuable because that antibiotic is particularly expensive. And the benefit to herbs is that using them kind of you know, especially for my clients with endo or some other reason that they do have that structural change we might do the antimicrobial herbs for three months, then take a month or a few months off and just kind of periodically pulse it in for a week here and there.

Speaker 3:

Those are primarily the supplements that I use for that, because they've been well tested. But at the full dose they often increase symptoms before the symptoms decline. So I usually either start with a smaller dose, because many of my clients are also really sensitive to a lot of different things due to their immune system, their gut, whatever, and so we'll either start with a lower dose and then work up to the full research dose or we'll use another. There are some other products on the market that are just gentler. There are similar combinations of herbs but they're much lower dosing or they're just gentler combinations of herbs. So I always know I always like to keep it as evidence-based as possible, but sometimes, you know, people can't do the full research thing.

Speaker 2:

I'm hearing maybe we shouldn't try to do the herbs on our own for gut issues.

Speaker 1:

Yeah, yeah, I'm gathering that as well. You can't just go and buy herbs and do that on your own.

Speaker 3:

No, because, well, what might happen? I mean, it's more or less it can be a low risk thing, but I don't encourage it because what can happen is you actually exacerbate your symptoms more short term, which could. There's one reason that that could be very problematic. Sometimes we overdo it so much that the immune system way overreacts and there can actually be like an anaphylactic reaction. That's probably the worst case scenario, but more commonly you could experience what's known as a Herxamer reaction, where essentially these bacteria are being killed off and the immune system doesn't know what to do with that.

Speaker 3:

They've been hiding in little crevices and little biofilms and some people make biofilms more than others. That's a genetic variability. In the same way that some people scar more than others, there's a fibrinolytic genetic snip that can make some people harbor more of these bacteria, viruses, other pathogens, even molds, yeast, things like that. So if you throw an herb in there at a high dose that breaks up the biofilms and all of a sudden you've like flooded the system with all these bad microbes, the immune system doesn't feel good, like you blow it up.

Speaker 3:

And especially if you're also constipated and or you've got really high progesterone relative to low estrogen, progesterone slows gut motility and remember, as I mentioned, in perimenopause, sometimes your progesterone and estrogen are just way off. So you end up like bloating way up, feeling terrible. You can have joint pain everywhere. It can kind of expand beyond the gut. You're more constipated. You can't, you know, get rid of all these bugs that you killed off and are now like causing generalized inflammation. So a really gentle, slow, skillful approach is key when it comes to using either probiotics or antimicrobial herbs.

Speaker 1:

That makes sense. You know there's so much. We've talked about nutrition, we've talked about gut. There's so much that we could talk about in this podcast sleep and how that affects gut, and exercise, and what type of exercise do I need to do? And just for sake of time, because you worked with so many clients with gut, health and menopause, is there one other area that we could talk about here that you feel as though our audience could benefit from?

Speaker 3:

Well, I think there's two things. I think you really can't underestimate the power of at least one a day, up to three a day, but no less ideally good bowel movements, because you've got to have that motility, and so for me, the thing that helps with that the most in midlife is walking, is exercise, because most of us have fairly sedentary jobs so I have like a little treadmill that sometimes I'll walk on. I don't usually do that when I'm podcasting.

Speaker 1:

It would have been okay.

Speaker 3:

Yeah, but also like more like what we call rotational movement. So my career began as a physical therapist. So if you're struggling with digestive and gut health issues and bowel function issues, don't hesitate to see a pelvic physical therapist, or even an orthopedic physical therapist that has training in what's known as visceral mobilization, or any manual therapy practitioner who works a lot with fascia and like organ mobilization, because we need this level of movement in our rib cage, in our pelvis, in our abdomen. So many of us are just kind of sitting all day and that's not great for your digestion Just taking a 10-minute walk after each meal, especially in perimenopause and menopause, because we have this decline in metabolic function.

Speaker 3:

Now, obviously, supplemental estrogen, maca there are lots of things we can do to actually help hormonally. From a perimenopause menopause standpoint. That will then impact the gut. But even if you're doing that, it's not exactly the same thing as being premenopausal and often you are taking a relatively high dose of progesterone to protect the uterus if a woman still has her uterus. So I really can't overstate for women in perimenopause and menopause the value of if you're at 5,000 steps, you're at 5,000 steps, start there. If you're at 1,000 steps, then do 6,000 steps, then do 7,000 steps. The more walking the better. And then working with a practitioner. Pelvic physical therapists are great because often they have a lot of these different tools but Pilates kinds of movement, yoga kind of movement we have to really like expand and rotate the rib cage and the abdomen and the pelvis to support the function of the digestive system.

Speaker 1:

Makes perfect sense. It really does. We're big yoga fans and we're both yoga instructors, and I love that you just mentioned that as well.

Speaker 2:

It's funny in our in both of us are health coaches, where we often the first, one of the first questions is let's talk about your gut motility, and people are like, well, we're going to start, you know, yeah, we're going to start, you know, yeah. One last question that I'm curious about before we get into our rapid fire, is sleep patterns and gut health during menopause. We talk to a lot of women who are having parties in the middle of the night right trying to manage their sleep. Sleep Is there a relationship with how well we take care of our gut and sleep, and what can we do to help both of those things as we're managing everything else with menopause?

Speaker 3:

Well, I think the most important thing is the metabolic relationship with, kind of like, what we're eating and when it comes to sleep, because normally that wakening in the middle of the night between 2 am and 4, sometimes a little later, is an early cortisol spike. So when blood sugar drops overnight, cortisol can spike and wake a woman up in the middle of the night. Or it can just be behavioral and habitual. I mean, gosh from breastfeeding, right. Sometimes we stop. We were up all night breastfeeding for five, 10 years and then you know there's a behavioral re-education of the bladder that needs to happen. So again, that's another key area of a public physical therapy role. But when it comes to your last meal of the evening and in fact remember I said how the brain and the bowel like this routine, so getting up in the morning, having some kind of get your circadian rhythm reset with daylight, and then having a strong, high fiber, high protein breakfast, eating another four to six hours later and eating another four to six hours later, and eating another four to six hours later.

Speaker 3:

For women, intermittent fasting can be okay, but it's not where I would begin if someone's waking up in the middle of the night because that means they're under some adrenal stress.

Speaker 3:

So at least an eight hour window of eating, if not a little bit more, but ideally, even if you are going to do some kind of gentle intermittent fasting, what I would recommend is eating less at night, like skip dinner, not breakfast.

Speaker 3:

So ideally, though, no matter what, you're stopping eating by 6 pm or so Daylight is a good rule of thumb for you know it'll vary seasonally, but roughly two to three hours before you're going to be going to sleep. I love like for people to stop eating by six 7 PM at the latest, but again, it depends on your work schedule, like we can be flexible with this, but the earlier the better. And at night it's even more important to not have a heavy carbohydrate meal, because that stimulates those shifts in blood sugar that can wake women up. And then the other thing I would say about sleep for midlife women is how you breathe is very important when it comes to sleeping. One of the biggest risk factors for sleep apnea is menopause. So there are therapists known as myofunctional therapists, who help optimize your breathing, your tongue, positioning your airway, opening the strength of your mouth and tongue, and breathing through your nose versus breathing through the mouth at night, and so working with that kind of therapist and then considering a sleep study is really important in midlife as well.

Speaker 1:

Yeah, we always say prepare for bed the minute you get up. It's the best. Yeah, yeah About your day Right, think about it in the morning, not just at 10 o'clock at night.

Speaker 2:

I always call that preparing for tomorrow. Kim Like, how can I make? Sure that I for tomorrow, kim, like, how can I make sure that I'm okay tomorrow when I wake up today? So yeah, yeah, for sure, great information.

Speaker 1:

Jessica, before we jump into our rapid fire, which is the fun part of the podcast, is there anything else that you would like to share with our audience that we haven't talked about?

Speaker 3:

No, I think that's plenty for them to start doing. I think the only thing I would say is be patient with yourself, learning these tools and integrating new ways of taking care of yourself and eating differently and sleeping differently. These are decades old habits that we have to revise, so this can be a multi-year process, and it's still good if you're just moving in the right direction. Thank, you?

Speaker 1:

I know we're going to have tons of questions. I know we are, so where can people find you?

Speaker 3:

Our website is integrativewomenshealthinstitutecom. That's all of our professional training programs. You can email my team if you want to work with me as a client. We'll have a page up for that later this week. And the other best place to follow us is on Instagram at integrativewomenshealth, or at integrativewomenshealthpod Podcast, which is on Apple, Spotify and all the other podcast spots.

Speaker 1:

Fantastic. Yeah, there's great information out there on the podcast, so thank you for that. Okay, fun time. Are you ready? I think so.

Speaker 2:

No these are fun and easy. Do you like the summer or the winter Olympics?

Speaker 3:

These are fun and easy. Do you like the summer or the winter Olympics? Oh summer. Well, honestly, I love all of it, but summer. I was a gymnast my entire childhood.

Speaker 1:

Oh, you know that about you. Okay, how about a best date? Would you rather go out or would you like to stay in? Go out, Cause I'm always you're right where you are right now Right.

Speaker 2:

Yeah, Flip-flops or tennis shoes tennis shoes.

Speaker 3:

I think, yeah, I don't know why.

Speaker 1:

Oh that's okay. I was going to say why yeah?

Speaker 2:

Okay.

Speaker 1:

All right and last but not least, we ask everyone what is the best piece of advice that you've ever received?

Speaker 3:

It's. It's so important to take care of your own health over everything else and really hard to do. I am always challenged by wanting to, you know, make sure I'm still working and taking care of everyone else, but periodically my parents honestly remind me of that, even though you know they they sometimes do the same thing. I think it really is important to prioritize your own health because it keeps everything else in life humming along much more easily.

Speaker 2:

Great advice.

Speaker 1:

I love that you said that. Yeah, we're all about radical self-care and I feel like we preach that all the time, Kim Self-care, self-care, self-care. Feel hard and we have to remind one another. So thank you for that reminder. We're going to do a little self-care for ourselves today and with that we thank you so much for being on the show today. It's been a pleasure. Jessica and audience, until we meet again, go out and find joy in the journey. Thank you for listening to the Medovia menopause podcast. If you enjoyed today's show, please give it a thumbs up, subscribe for future episodes, leave a review and share this episode with a friend. There are more than 50 million women in the US who are navigating the menopause transition. The situation is compounded by the presence of stigma, shame and secrecy surrounding menopause, posing significant challenges and disruptions in women's personal and professional spheres. Medovia is out to change the narrative. Learn more at medoviacom. That's M-I-D-O-V-I-A dot com. Thank you.

People on this episode

Head Shot

April Haberman

Co-host
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Kim Hart

Co-host