109 | The Perimenopause Revolution: What Your Body Is Actually Telling You with Dr. Mariza Snyder

Most women step into perimenopause the same way Gabriela did — in the dark, without language, without a roadmap, and without anyone telling them what was actually happening in their bodies. The anxiety, the brain fog, the rage, the fatigue, the loss of libido — they could feel it all, but they could not make sense of it. Dr. Mariza Snyder felt the same way. Even after 17 years of clinical experience supporting women through this transition.

In this episode of Pleasure in the Pause, Gabriela sits down with Dr. Mariza Snyder for one of the most layered and honest conversations this show has ever had. This is a deeply intergenerational conversation and together they bridge that gap and pass the wisdom forward.

Are you ready to awaken your sensuality and feel more empowered in your body? Access the FREE Pleasure Upgrade Bundle at https://www.pleasureinthepause.com/gift.

Dr. Mariza Snyder is a powerhouse advocate for midlife women, leveraging 17+ years as a practitioner, author, and speaker to spark a massive movement for women in perimenopause and beyond. With her top-rated Energized with Dr. Mariza podcast, she’s a trusted guide, offering science-backed solutions for perimenopause and metabolic health. Her new book, The Perimenopause Revolution, is the ultimate resource for women ready to take charge of their health and embrace perimenopause with resilience and confidence. Check out her website, drmariza.com, for solutions to thrive. 

In this episode, we discuss: 

• The often-overlooked connection between hormones and the nervous system
• How to distinguish what's hormonal from what may be years of accumulated stress and over-functioning
• The role of rage as a messenger rather than something to suppress
• The practical tools women can use to move through this transition with greater resilience

You are not going to be the same woman on the other side of this transition. That is not a warning. That is a promise. Perimenopause is equally as destabilizing as it is transformative — and the more you understand what your body is doing and why, the more you can move through it with clarity, compassion, and a sense of what is actually possible on the other side. 

If you're seeking to reclaim your pleasure and vitality, join Gabriella at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

CONNECT WITH DR. MARIZA SNYDER:

FaceBook: https://www.facebook.com/drmarizasnyder/

Insta: https://instagram.com/drmariza/

YouTube: https://www.youtube.com/drmarizasnyder

LINKS MENTIONED: 

Episode 107 — From Survival Mode to Self-Connection https://www.pleasureinthepause.com/blog/nervous-system-reset-for-midlife-women 

Episode 106 — The Menopause Gut with Cynthia Thurlow https://www.pleasureinthepause.com/blog/midlife-sobriety-and-returning-to-yourself-with-ashley-kelsch 

CONNECT WITH GABRIELLA ESPINOSA:

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Work with Gabriella! 

Full episodes on YouTube.

The information shared on Pleasure in the Pause is for educational and informational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or Pleasure in the Pause.

Transcript

Introduction and why this conversation matters

Gabriella Espinosa 0:00

Welcome to Pleasure in the Pause, a podcast dedicated to empowering midlife women to connect with their bodies, pleasure and power in Perimenopause, Menopause, and beyond. I am your host, Gabriela Espinoza. Each week I sit down with leading medical experts, thought leaders, and trailblazers for bold, thought-provoking conversations that educate, inspire, and challenge the myths we've been taught about our bodies, aging, and sexuality. I also share solo episodes with evidence-based insights and real talk to help you feel informed, supported, and in charge of your health and pleasure in this season of life. Because your pleasure matters in and out of the bedroom. So take a deep breath, settle into your body, and let's begin. Hello, beautiful listeners. Welcome back to Pleasure in the Pause. Here on the podcast, I often find myself reflecting on my own Perimenopause journey, a transition I navigated largely in the dark without the language, knowledge, or support I wish I'd had at the time. So much of what I experienced, the anxiety, fatigue, emotional overwhelm, the loss of libido, even rage, I couldn't fully make sense of. I knew something was shifting, but I didn't have the words for it. This is why I'm so excited to bring today's guest to you. Dr. Maritza Snyder is one of the leading voices in women's midlife health and a powerful advocate for women navigating perimenopause. With more than 17 years of experience as a practitioner, author, educator, and speaker, she specializes in perimenopause, metabolic health, and helping women understand how to work with their changing biology. She is the host of the top-rated Energize with Dr. Maritza podcast, and her The Perimenopause Revolution is a science-backed roadmap for navigating this transition with greater clarity, resilience, and confidence. And honestly, as I read it, I found myself thinking, this is the book I wish I'd had when I was moving through my own perimenopause journey. What I love about this conversation is that it feels deeply intergenerational. Maritza is in her 40s, living this transition in real time, researching it, writing about it, and giving language to experiences so many women are having. How to distinguish what's hormonal from what may be years of accumulated stress and overfunctioning, the role of rage as a messenger rather than something to suppress, hormone therapy, and the practical tools women can use to move through this transition with greater resilience. Whether you're moving through perimenopause right now, in the thick of menopause, or postmenopausal and looking back, or simply wanting a better understanding of the women you love and how to support them, this conversation is for you. Let's dive in and welcome Dr. Maritza Snyder to the show. Welcome, Dr. Maritza, to Pleasure in the Pause.

SPEAKER_01 3:44

Oh my goodness, I'm so happy to be here. We are embarking on the Perimenopause Revolution. And this is a conversation for millions of women because goodness knows there's a lot of us going through it.

Gabriella Espinosa 3:57

Absolutely. I'm equally excited, and I have your book here, The Perimenopause Revolution in my hands. Your perimenopause journey is an integral part of your book, and I was moved to read your story. Before we get into the science, let's start with that, with your story. What did perimenopause feel like from the inside before you even had language for it?

Dr. Mariza's own perimenopause story — blindsided at 43

SPEAKER_01 4:22

I felt blindsided by perimenopause. And the number one reason why I was blindsided by it, although I have had 17 years of clinical experience literally taking care of women in perimenopause and menopause, I would have told you then that I really understood the architecture of the two until it happened to me. And I think what threw me off was that I was literally coming out of postpartum. My son was two, and there was a moment there, Gabriella, where I felt pretty invincible. I thought, you know what? 43 years old, watch me now. I got about a three-month runway, give or take. And then I just literally fell off the proverbial cliff. And it started with kind of deludeal symptoms, which I find a lot of my patients are experiencing. I would wake up on day 22, day 23 with this deep sense of dread. Like my whole entire world was falling apart around me. And I would have bouts of rage. My energy tanked, my brain felt foggy. It was just a multitude of things that hit at once. And I remember thinking, oh, this has got to be Hajimoto's. Because I was like, what do I know about myself that I've experienced in the past that could be flaring up? I couldn't wrap my brain around the fact that I had just had a kid and that I was entering perimenopause. So it took me several months and a lot of tracking my cycle to put the pieces together.

Gabriella Espinosa 5:41

I so resonated with your story. I had three kids in a row, and I feel now looking back, yeah, moved from postpartum straight into perimenopause with no clue. But that was 15 years ago, Dr. Maritza. And what surprised me most was like, this was five years ago for you. We haven't made that many advances in getting the word out there to women, getting the memo out there. You're changing that with the perimenopause revolution, with your book, with your education on your Instagram platform, which I think is gold. I love it. So thank you so much for the work that you're doing. We have so far to go still, Dr. Maritza. So I'm so glad we're having this conversation. I also love how you dedicated your book to your mom, Jodi. And she's part of this story too. Or entering parent menopause yourself. You were also witnessing your mother going through these debilitating menopause symptoms.

SPEAKER_01 6:40

And what was that

Watching her mother's menopause nightmare unfold

SPEAKER_01 6:41

like? My mama had me when she was really young. She was 19 years old. So we're 19 years apart. And this woman was always a freight train. This woman was the epitome of the mantra, push through at all cost. That's how I saw my mother growing up. She was a superwoman in heels. I could hear her, she had this walk, just this like she was going somewhere. You better get out of the way, walk. And so when perimenopause hit her, I was 30, she was 48. And mind you, perimenopause had been happening. It's just that, again, especially this is 2008, 2009, when she was in what is late perimenopause. At this point, crime scene periods, skipping periods, and then massive flooding, really severe depression, anxiety, rage had been happening for a long time. And it just kept getting brushed under the rug. It kept being blamed as aging. It kept being blamed as it's just gonna pass. And obviously, it got to a point where it was so severe that it was completely disrupting her entire life. It was disrupting the way that she was working out. It was disrupting her ability to work, which is her whole life felt like it was in an upheaval. And I remember watching from my own vantage point, thinking, my gosh, this for my mother, this is a nightmare unfolding. And I stepped in and intervened. There was a lot of strategies that were trying to be used on her. She was recommended SSRIs. She had been prescribed a synthetic estrogen that they just didn't dial it right for her and it spiraled her into a worse depression. And so finally I stepped in and probably one of the most healing experiences for both her and I one, to get to step in as her practitioner and for my mom to have a full 180 experience from feeling like her lowest low to bouncing back to her highest high. We're talking about in a 90 day span. And this woman on the back end of that, probably a year later, 49 years old, she decides that she's like, I am gonna do something I've never done. I'm gonna start training for marathons. And she's now ran, I don't even know, double digits in marathons, over 70 half marathons. And she also decided to become a competitive tennis player. And so my mom plays tennis twice a week. She used to play tennis maybe sometimes four times a week, but it's shifted since she was 49 now that she's 65. She's tried different things out. She hikes, but she has built her life around movement and she has built community around movement. And this woman is thriving. She's about to retire and she's grappling with it because she doesn't fit the mold of someone who retires because she has so much energy and so much bandwidth. She's like, what do I do in this? And I was like, but similar to your perimenopause, menopause transition, you get to redefine the rules. You get to decide what it looks like for you. You get to reprogram, recalibrate retirement for yourself.

Gabriella Espinosa 9:30

Absolutely. And I feel I'm heading there too. I want to be friends with your mom. And going back to your story or our story, right? I think about how many women are having children later and maybe moving through exactly what you did postpartum, straight into perimenopause without anyone naming it. We were talking about this before we hopped on, about how we can start these intergenerational conversations. What do you wish an older woman had told you? And what do you most want to say to the women coming right behind you?

SPEAKER_01 10:02

Particularly my mom's generation, we were still having children generally younger-ish. I feel like it's been my generation and a little bit before me, where we're having children in perimenopause because we are standing on the shoulders of our mothers. My mom worked so hard. She fought so hard to be at the table, to be in the room where it was happening. And she really wanted me to know that not only how hard she persevered and endured in the corporate world, but that it's going to be a different situation for me. That she was setting me up to create the level of success and that I could really be whoever I wanted. And I feel that. And so because of that, my career was thriving for a while. I held off on having children. Obviously, I was very intimately involved in my mother's peri-menopause journey. And there was a part of me that thought, oh my gosh, is that going to happen to me? Because no one told my mom she wasn't ready for what was happening to her. I think it's important to know that this transition

What perimenopause is actually asking of us

SPEAKER_01 11:00

is equally as destabilizing as it is transformative. And the more that we can pay attention to our live data, the more that we can pay attention to our cycle changes, really understand and listening to our own internal wisdom about our bodies, that really can set us up for success as we navigate what I consider to be the most profound transition of a woman's life outside of pregnancy and postpartum. You're not going to be the same on the other side.

Gabriella Espinosa 11:26

That is such great advice. I wish someone would have told me that.

SPEAKER_01 11:30

Make it positive, but also say, listen, we're talking about a six to 10 year span in what I consider to be a bit of a high-stakes game, right? We're still raising children, we're running households, our careers are potentially at their peak. We have a lot of people's needs that we're juggling, and our bodies are shifting without permission. There's a lot that we can do to future proof our health. And I think it's important that we know it's coming and that we honor our bodies through the process.

Gabriella Espinosa 11:59

I love that message, and that message is weaved through your book so much. Let's get into the science. You refer to perimenopause as a neuroendocrine transition. And I appreciate how clearly you break that down in the book. Can you walk us through what that actually means and what's happening to our hormones?

Perimenopause as a neuroendocrine transition

SPEAKER_01 12:18

This is one of the biggest misconceptions about perimenopause and menopause, that it's simply a reproductive transition, that this is simply a hormone situation. What we're really experiencing is a neuroendocrine transition and honestly a vascular transition. It's deeply connected in with our neuroendocrine, our brain, and how our brain is functioning. So where the brain is having to recalibrate its relationship with fluctuating estrogen and progesterone after decades of predictable rhythmic communication. So I think of estrogen as the CEO of the brain. It is not just a reproductive hormone, right? It is a neuroregulator. It affects our neurotransmitters like serotonin, dopamine, and GABA. It influences cortisol regulation and most importantly, brain energy metabolism. And that's why so many women tell me that they don't feel like themselves anymore. I know that's like the classic symptom of perimenopause. It's specifically early perimenopause. When a woman comes to me and she's like, something's shifting. I know that I'm capable, but my bandwidth isn't the same. What is going on? And we often can't handle stress the way that we used to. Our ability to multitask shifts, our sleep architecture is changing, and we start to feel like we're losing our resilience. The brain is ground zero for the perimetopause transition. What many women interpret as anxiety, overwhelm, brain fog, or emotional instability is really the brain adapting to a completely new hormonal environment. And one of the most empowering things that we can do is stop blaming ourselves or thinking that it's a personal failure and really understanding that our brain is recalibrating us for the next chapter of our life.

Gabriella Espinosa 13:59

Yeah, that is so much more empowering than I'm broken or something is wrong with me. Something I keep coming back to is this idea that, and you mentioned it earlier, you thought it was something else, Hashimoto's. This idea that not everything a woman feels in her late 30s, 40s is perimenopause. Obviously, there is this brain transition happening, right? Some of it is, but some of it is what she's been carrying for years, finally showing up in her body. So, how does a woman start to distinguish between what's hormonal and what's her nervous system responding to the life she's been living?

SPEAKER_01 14:39

Any woman listening to this right now can really feel this deeply that it's often a yes and that perimenopause exposes overfunctioning or exposes a deregulated nervous system. And I see this over and over again. I saw it in my mama, I saw it in me. I talk about it in the book very vulnerably. I see it in a lot of my patients who

How declining hormones expose years of accumulated stress

SPEAKER_01 15:00

are high functioning women who have been operating at a level of high function, and I would say a level of high hypervigilance. And again, it looks really good on paper. It looks like a lot of promotions, it looks like higher education, it looks like a really beautiful career and juggling all the balls in the air and doing it relatively effortlessly. And then we get into the season where these hormones, I think of them as scaffolding, this armor that has been protecting us, been allowing us to operate like this for so long. And when those hormones begin to shift and falter, that armor begins to be a bit more vulnerable and the cracks, it's like we're unmasking a lot of what's been going on under the surface. And so women have spent decades, right? We're being caretakers, problem solvers, people pleasers, and just folding everything together until our system begins to really show the signs of deregulation. And one of those hormones that I think really gets to be highlighted here is also cortisol. That hormone is doing the best it can with what it's got in the moment that it's in. But if you're racing from a phone call, it doesn't know the difference between racing from a phone call or multiple hard emails versus running from a tiger. Your physiology doesn't know the difference. And so suddenly, as perimenopause arrives, our body just says, hey, we can't manage this anymore. We can't operate at this level anymore. This is where our hormones do not allow us to compensate for a life that has been draining us for a long time. So I really think that it's a beautiful opportunity because I think of it also as a vulnerability, that when we see that vulnerability, that we get to reassess. It becomes an invitation to reassess boundaries, reassess relationships, commitments, expectations, and decide what do we want to spend our energy on. Energy is our ultimate currency, and often we are leaking it in areas that probably don't even feel good to us. And so this is really that opportunity to get clear about what is a non-negotiable for us and what we get to let go of.

Gabriella Espinosa 17:07

I love that idea of an invitation. And something that you talk about in the book, I've also talked about this with Cynthia Thurlow, who you are familiar with, the author of the Metaphose Gut. And I recently shared an episode where I shared a little bit of my story, how some of these patterns they started decades earlier. I mean, we were children. I talk about identifying my own adverse childhood experience and not realizing that I was using my parents' divorce as a mode of coping. The patterns that I adopted was being the good girl, making everything good for everyone else, getting good grades in school, being perfect. That perfectionism carried me through my professional life, through motherhood until I hit a wall. And I think that decline in estrogen uncovers all of that. All of those things we haven't dealt with that we've been suppressing. How much of this do you see with the women in your community?

SPEAKER_01 18:12

Almost with everybody, including myself. I have an ACES, four of a six, and I grew up in a lot of trauma and abuse, and I felt like I was in survival mode most of my life. And really, what's interesting when you have parents who, whether it's an abandonment wound or it's a people-pleasing wound, or it's a, hey, shut up and be quiet wound, or it's just not feeling worthy of love, right? It's that worthiness wound that plays out. And I think about as children, it's not like any of us had a degree in psychology or trauma-based therapy. We're just pulling tools out of our booties at four, five, six years old, maybe 10 years old, and we're rolling with it. And we keep rolling with those until, again, probably for most of us in midlife, oh my gosh, these tools that I've been utilizing to patch up this trauma, it really comes up for review. And I am often prescribing trauma-based work, somatic work, internal family systems, maybe cognitive behavioral therapy to really, really dig into the beliefs, particularly the limiting beliefs that we're still living by, that still need to be a certain way or we still need to act a certain way. We don't realize that it's our six-year-old driving the bus the whole time.

Gabriella Espinosa 19:24

Yeah, and having some compassion for that six-year-old girl. I love internal family systems. I've been seeing a practitioner for years, and it's a beautiful modality, such a beautiful way of holding those parts of ourselves that want to be seen, want to be expressed, and bringing her to the table with you and saying, sit down next to me. You're gonna be okay. Because she's there. That six-year-old self is always there, right?

SPEAKER_01 19:51

And then you've got your protector who knows how to step in. And I think of my protector as my hype man, my hype woman. I'll be maybe not always feeling the feels because my hype person will come in and be like, you know what, girl, you've got this. This is how we're gonna rework this problem. We're gonna solve this. And then, you know what? Get yourself back up, dust yourself off, get back out there. Action is a strategy. That has always been my little protector. She solved my problem, she gets me back in the game, and then I just distract myself into a solution. And I think that's a lot of us, especially when we're problem solvers for so many people, and probably we're problem solvers for our parents and siblings and people in our life earlier, especially if you're the older daughter, you'll see that playing out. And I think this is again another invitation to go a little bit deeper. I find that there are deeper wounds that are ready to be healed. Because I do believe that many of us in this particular generation, we're here to be cycle breakers. Perimenopause. If we haven't been cycle breaking before, especially if you're a perimenopausal mama, maybe to a young child, and you know that you're a cycle breaker. Oh, well, then you've got a lot of deep work ahead of you to get to unpack and to get to heal from.

Gabriella Espinosa 21:04

Yeah, the sooner we start, the earlier we can start breaking those cycles, not only for ourselves, for our children who are mirroring us, as well as for the generation who follow us. So important. I came across a Substack post. I am on there a lot, which I love that I wanted to talk to you about. What people are calling these grandma hobbies, millennial moms turning to gardening, knitting, sourdough book clubs, and they're being self-deprecating and joking about it. But I don't think it's a joke. When I look at what those activities share, slowing down, repetition, being present, real life connection with other people. It reads to me not so much like something trendy, but more like a sign. Do you think women's bodies are asking for something that modern life just simply can't provide for us anymore?

SPEAKER_01 22:00

Oh, 100%. I think about the act of gardening, the active walking. Two of my besties run this beautiful group called Fully Expressed here in San Diego. And yesterday we had a fully expressed beach walk at 6:30 and just felt so good. Most of the women are in midlife as well. Walking and talking, like what a beautiful way. I think one of the things that women are the best at. It's one of our superpowers is tending and refriending. It's one of the fastest ways out of survival mode, or just even a simple act of walking of just all of these habits are just helping to regulate our nervous system. And our nervous system is meant to be in a state of regulation. And yes, we have that ability to fluctuate between sympathetic and parasympathetic, but it's really meant to be a fluctuation. And the majority of us, whether we know it or not, are often living in sympathetic survival mode.

Gabriella Espinosa 22:51

And what does that look like in a woman's body? And why do so many women miss it until something just totally breaks down or they hit a wall?

SPEAKER_01 22:58

It looks like rushing from one thing to the next. It looks like always being on time. It looks like being extremely efficient. It looks like handling everybody's needs. It looks like having that checklist and checking those things off, even as you move into the evening time and it's messing with your sleep routine. It looks like always being not only resourceful, but you're indispensable to the people around you. You are always following up. You're the friend who, when a text message comes in, they know that you're going to respond in the next three to five hours. That is what it means to be in survival mode. And it's playing out so many different ways throughout the day. And so I would say the majority of us are living in a state of survival to some degree, probably mostly throughout our day. It's trying to fit in as much as you can in between the meetings and to make it work. It's being the person who can pee the fastest in the line.

Gabriella Espinosa 23:58

Oh my gosh. Yes.

SPEAKER_01 23:59

Again, you're just fast. You're efficient. You're getting it done. It's your superpower. It's who you are.

Gabriella Espinosa 24:05

So many women I know see it as a superpower. I certainly did revel in that that I could get so much shit done.

SPEAKER_01 24:11

And all the kids in the car in 10 minutes. Do you know what it takes to rally three children in a car? You know what I'm saying? Like, think of just morning and evening routine every night.

Gabriella Espinosa 24:23

I saw the rewards for it in real time. So I'm like, yeah, I'm doing pretty good. Yeah, you're like, got this. So, but what is the actual hormonal cost of years of running that way? And what happens when Perimenopause starts drawing down the reserves that were helping a woman cope?

SPEAKER_01 24:40

There was a really great way of describing it. I may butcher a little bit, but I remember reading an article from the Journal of Hormones back in 2000. I read it probably in 2020, but it was 2009, and it talked about the danger of chronic stress, chronic deregulated cortisol. And what we know is when cortisol is dysregulated, whether it's too high or we're just pumping it. And it's really, again, cortisol is a byproduct of a system that is constantly in survival mode. We co-elevate insulin. So insulin is probably the biggest root factor of cardiometabolic disease. So we become more insulin resistant. We deregulate like glucose, which has a profound impact on our vascular system as well. We co-elevate eating. So overeating, a lot of women experience more cravings, more overly processed foods. And what that ultimately lends to is more inflammation, oxidative stress, and it's wear and tear on the body. So it is low-grade inflammation that becomes more high-grade inflammation that messes with our gut microbiome, our blood sugar regulation. We become more insulin sensitive. It rewires the brain for trauma and survival, and it's driving oxidative stress and inflammation. So it's literally aging you. The fastest way to accelerate aging is to be in this state.

Gabriella Espinosa 25:53

And it definitely comes back to bite you when you're moving through that menopause transition later, I feel.

SPEAKER_01 26:01

The inflammation, the accelerated aging of perimenopause and menopause. And we always hear that menopause in its own right can accelerate aging, but that's not the whole picture at all. Chronic stress that we've been operating in, that if we continue to pursue that as hormones are declining, we do see an uptick in accelerated aging.

Gabriella Espinosa 26:22

I want to talk about one more thing around this theme of emotions and emotional resilience because I appreciate how you talk about rage in your book and that you don't frame it as something just to manage,

What rage is really communicating in this transition

Gabriella Espinosa 26:34

right? What is rage actually communicating in this transition? And how do women start working with it rather than against it?

SPEAKER_01 26:43

Rage is communicating an unmet need. Rage is communicating a life of tolerating and accommodating. Rage is communicating that your needs are not being met and that they've been silenced, that your labor has been silenced. And that is all up for review. I think we just get to a point where we just can't tolerate what we've been enduring for so long. But I think that there's a collective rage, particularly in perimenopause, around the lack of health care that we receive, having someone hears and listens to us, and also recognizing that the demands from our life and our families, like it just doesn't let up. And I think that the body finally is just like, I can't keep managing this. I can't keep operating at this level and feel good in my body. And so I feel like when rage is coming up, it's a great time to listen and to evaluate what is serving you in the well-being of your life and what is really not helping you to thrive.

Gabriella Espinosa 27:48

I'm still apologizing to my 20-something-year-old kids for my rage, the rage that I inflicted on them when they were younger. They now joke about my paramenopause rage that they witnessed. They can joke about it now. But I wish I knew then what I know now and what you're talking about now, and what you outline in this beautiful book. This is the guidebook that I wish I had then. You talk about the practice of sending the brain safety signals.

How to send the brain safety signals throughout the day

Gabriella Espinosa 28:17

What does that look like in a woman's day? What's the entry point for someone who genuinely cannot slow down right now, who feels so overwhelmed by her life?

SPEAKER_01 28:28

I know that there are so many women listening right now and saying, there's no way. I thought it was gonna be an easy drop-off. We have a week and a half left of school. He's been doing school for a whole year. He did not want me to leave. He was crying. He got to a point where he was hyperventilating, like he was so upset that I was going to leave. And when my husband drops him off, no problems. Bye, dad. And that's it. But recently, when I've been dropping him off, it's been this whole thing. And so I thought I was gonna get to leave very quickly. Ended up being a 30-minute me needing to stay. And there's a deep part of me that really wanted to stay and help him regulate and help him feel safe and figure out what was coming up. And then there was the other part of me that was like, I gotta get to a podcast interview, I gotta go. And not willing to feel that urgency. This is so you never know what the messy part of your day is gonna be. But the one thing that you can control, at least I believe we can, is we can bookend our day with self-care. So once everyone's asleep, you can take care of yourself, you can send yourself safety signals. So really just reading a book, meditating, taking a bath, having a beauty routine, four, seven, eight breathing, whatever you love, that kind of just lets your brain know that you are safe. That is the ticket. And the same thing in the morning, getting outside and getting sunshine, making yourself a really wonderful cup of tea, telling your body and your brain that you are worthy of healing. These are the ways that we can send safety signals to our brain. And then throughout the day, if you can punctuate during the day, is taking a five-minute walk outside, letting your brain know it's safe, sitting down and maybe reading a book for a couple of minutes, or having a mini dance party, telling your body that you are safe. Two of my favorite mantras that I use a lot is nothing is wrong. Because I feel like I will create a problem to solve a problem. There's always problems to solve, but easily like nothing is wrong. And it feels good to feel good. And so the more that we can punctuate our day with these little micro moments of breath, of movement, connection, maybe it's a voice memo to your bestie, reading a little book, having a little mini dance party, hugging a partner or a puppy or a dog or your kids, these are safety signals because we know that a body cannot heal when it doesn't feel safe. So the more that we can tell the brain through these beautiful little habits that don't take a long time, that you are safe. You're safe to heal, you're safe to be regulated, that is how we start to move towards a place of regulation. The other thing that I learned recently, I was interviewing someone, was about the moment that you know you have a feeling coming through, just give yourself 30 seconds to 60 seconds to feel it. And then let your hype person step in. And then the other thing I wanted to share is when you feel yourself running and racing and rushing, which I get that's a lot of us all of the time. See if you can intentionally slow yourself down. Say, ooh, I'm going quickly. Let's slow down and slow down your walking, slow down your stepping, slow down whatever you're doing. And just that act of slowing down tells the brain that you are safe, that you're not racing from something.

Gabriella Espinosa 31:57

Those are so good. I've been much more intentional with those practices in the last year, and it's made such a difference. I would notice that I was going to bed with all the things that I'm carrying that day. And then when I took just that five minutes just sitting on my sofa for a breath, just letting my body decompress, I realized I wasn't bringing that into the bedroom. It improves intimacy, it improves your sleep. I'm not waking up in the middle of the night anxious about those things. So we don't realize how much you're we're bringing that stuff into the bedroom.

SPEAKER_01 32:34

I always say we really need a runway for sleep. And I will say that sleep is the force multiplier. Like when you get disrupted sleep or fragmented sleep, it makes everything harder on the back end. And so even if it's just your evening routine, and I think about again, gone are the days where we can just run into bed and expect to just fall asleep or be intimate with our partners or to have intimate moments, your brain is going to be running through all the things that you didn't finish, all the things that you need to do tomorrow. That list never ends. And so I just think you should be thinking about like I have an hour, kind of a wind-down hour, and to break it up in three segments. That first segment is whatever you need to get done, whether it's getting the backpacks out for your kids or prepping your clothes for your future self the next day, just kind of handling your business. You got 20 minutes to kind of get everything kind of wrapped up. The next 20 is hygiene, just the beauty routine, brushing your teeth, taking your supplements, doing all the things that you do to kind of get ready for bed. And then that final 20 is really the wind down, whether it's meditation. And I get that the four, seven, eight breath can be a bit challenging for us. The idea of holding our breath for seven minutes and who can exhale for eight. You know, most perimenopausal women cannot. And so I tell my women to start with a four, five, six breath. And you want to do at least 10 rounds of that breath because the best way that we can get sleep or we can calm down that deregulated nervous system is by slowing down our heart rate, right? Our resting heart rate. And about 10 rounds of that four, five, six breath, and you can get it all the way up to the four, seven, eight, really calms the system. Have a good book or have a beautiful conversation with your partner. Just have something that you really enjoy in that final 20 to 30 minutes after you've anchored yourself out of the anxiety, out of the overwhelm, out of the overdoing until you're headed to sleep, honoring that hour that makes a big difference.

Gabriella Espinosa 34:33

I love that. I know these beautiful practices you just offered are part of the sleep component of your five-step plan. And I want to hear more about it. But before we go there, I just wanted to talk about one other thing because we've talked about hormone therapy here on the show before. And what I appreciate about your book is that you speak directly to perimenopausal women. And I want to bring that here for the women who are listening who maybe feel this conversation isn't for them. But how do you decide with a perimenopausal woman whether hormone therapy is right for her? And what are the needle movers that she needs now to support her now, not later?

When to start the hormone therapy conversation

SPEAKER_01 35:13

This is what we need to scream and shout from the rooftops is that I believe that every one of us deserves to take up space in our health care, that we are not difficult when we are asking for menopause care. And that the moment that you're noticing shifts and changes, whether it is your sleep architecture or your mental resilience, your emotional resilience, or you're simply just thinking to yourself, what is happening with my body or what's going on? What's wrong? Why don't I not feel like myself? That is the time to have the hormone conversation, have the hormone replacement conversation. Because when it comes to perimenopause, there's no one test that identifies you're in perimenopause. There's no one lab. It doesn't announce itself one day in time. It's I'm here. It is a clinical diagnosis based on your age, your cycle changes, and your symptoms. And it's over 50 plus different symptoms, emotional, cognitive, and physical. And so the moment that something doesn't feel right to you, it is worthwhile to be like, hey, can we talk about HRT and whether I'm a candidate for it? And are you willing to look? I would love to give around a full lab panel. Just looking at everything across the board from lipids and cardiovascular markers to hormone markers. And again, in perimenopause, it often feels like a moving target. And you will hear doctors say it's not worth running your labs in perimetopause, especially hormone panels. I disagree. I think that it can provide some valuable insight, especially validate what potentially you are experiencing and get you the solutions and get you the therapy that you really need in that season. And so I believe that we've done women a massive disservice telling them to wait until symptoms get worse, wait until their labs are in pathology, or wait until they're completely in menopause. This is the transition where we are losing bone, we are losing muscle, we have more vascular risk, our brains are shifting profoundly. The more support that we can get during this transition, the better we're gonna move through menopause and postmenopause with a lot more strength, resilience, and joy.

Gabriella Espinosa 37:21

Absolutely. And yes, just start now.

SPEAKER_01 37:24

If you're noticing the rage, if you're noticing that stress resilience has really packed its bags and walked out the door, you're noticing that you are more irritated than ever before. Your luteal phase is like a whole nother beast, but almost feels like PMDD. That is time to be having the conversation at the very least with progesterone and bringing that on. I have patients who are on progesterone in their early 30s. You know, we see drops in progesterone levels due to PCOS, due to an ovulatory cycles for all kinds of reasons. We need to ovulate in order to make progesterone. We shouldn't be thinking about this just as menopause therapy. If a woman in her 30s is really struggling in her luteal phase, it is a worthy conversation then too.

Gabriella Espinosa 38:08

I agree. And I wish I had that knowledge when I was going through perimenopause. I was a wellness girly in my 40s, wanting to do everything the natural way and resisted. I had heard about HRT, it was in the Zeitgeist then, but I resisted the thought of hormon therapy because the soup I was swimming in was like everything should be natural. Sure enough, when I was closer to menopause, I was diagnosed with early on-stage osteoporosis. And I thought I could have looked at this sooner. I could have had the labs done maybe, but just had the conversation about knowing what my family history was, which included osteoporosis. But yeah, I waited until then to really consider life and death. I need to use hormones, but you don't want to get to that point.

SPEAKER_01 39:04

So to a point where you're literally a puddle on the floor, that is so deeply unfair. Take up space in your health care, take up space in that appointment. And how you take up space is one tractor cycle. If you are headed into perimenopause or you're in perimenopause, I have been in perimenopause as we have four years. My cycle is still pretty regular. I know that I am in perimenopause. I don't need an irregular cycle to determine that. That's often late perimenopause. Women are in perimenopause for up to five plus years before cycle changes begin to happen, where we're skipping cycles. So track your cycle, track your symptoms associated with your cycle. So how are you feeling in the follicular phase? How are you feeling in that luteal phase? This is how I knew I was in perimenopause, like day 21, day 22, and all the wheels just fell off. And I was like, okay, this is definitely perimenopause. Track your lib data. How's your sleep? How's your energy? How's your mood? How's your cravings? Have that data as well. And then when you make that appointment, have the three to four non-negotiable symptoms or concerns that you want to bring up. Have it on paper because you're gonna get questioned as well about what you're experiencing, and it may derail what your non-negotiables are. And then have the labs. I have a really incredible perimenopause lab guide with optimal lab labels because so many of my patients, their iron, their ferritin is off, their vitamin D is in the tank, they're heading into metabolic dysfunction. See this all the time. They have low-grade inflammation. And even though the hormones look normal, there's a lot of other things that are happening that are being brought up to the surface because of perimenopause. And so when we're able to look at that data in a meaningful way, this is where we can step into precision medicine. This is where we can really help you with HRT or lifestyle medicine or cognitive behavioral therapy or internal family systems. Often we do need all the tools in the toolbox, and you really deserve that.

Gabriella Espinosa 41:01

Okay, let's move into

How to track your live data and prepare for your doctor

Gabriella Espinosa 41:03

the practical. I love that your five-week reset starts with mindsets. At the core of it is something really honest. You start with, okay, let's start with letting go, the grief, acknowledging what's there, the grief of no longer being who we used to be. We got to start there. You invite women to what's possible once she names it and accepts it. And so from that acceptance, you invite women into something beautiful, a vision of who she's becoming. So I love the questions that you ask of women. Why don't you share them with us?

SPEAKER_01 41:37

I think that this is the perfect opportunity for all of us as women to really envision our future epic health and our future epic life. I start with two questions that really set your health intention or even your life's intention. And that first question that I think always just really lands for my patients and for women that I've worked with over the years is how do you want to feel? And it could start as easy as how do you want to feel in the next 30 days, or how do you want to feel in the next year? And just taking some time, whether it's with a matcha, maybe you're at a cafe that you love, and just free-flowing. And in that question, not only how do you want to feel in the next 30 days, but what would you love? What would you love in that? And when it comes to health in particular, because it's often as a clinician, that's what I'm working with, is what do you want to experience more of in your health as you step into menopause or as you move through perimenopause? And again, these open-ended questions really invite that daydreaming vision of who you are and why it's so powerful, at least for me, is that once you get clarity on what you would really love and how you really want to feel, whether that's a year down the line or five years or 10 years down the line, you really get to construct who that future version of you is. I also love there's questions around what are you letting go of as you're stepping into her? Who did you work with to become her? What did you invest in? What did you de-invest in? What are the habits that your future self is embodying every day that you really get this tangible experience? What does your morning routine look like when you're 60 or you're 70 years old? And as you start to build out kind of the details, and the more detailed, the better, I find, because then you really do have the archaeotype of who you're becoming. And then once you have that crystal clarity, you know that she's already there. That future version of you, she's just waiting for you to take those steps to get to her. And so I think of that version of you as your North Star. And it's just a matter of stepping into the habits, the ways in which you are curating a healthy and joyful body. I feel like when we have that roadmap, it is just so much easier to execute.

The five-week reset: mindset, vision, and envisioning your future self

Gabriella Espinosa 43:58

What makes me think uh Of when I hear you speak like this, is just giving us permission to do that. I don't think I felt I had the permission to do that in my 40s when I was in the thick of child rearing. So I'm so grateful that you're giving women now that permission to, yeah, envision their future selves and take time to really put those pieces in place. Once a woman has done that inner work, what does the reset actually ask of her? What are the core pieces that make the real difference? You talked about sleep and we've talked about mindset. Anything else that you want to add?

SPEAKER_01 44:34

I think cellular energy is the foundation of all of it, right? I think of lifestyle medicine being mitochondrial medicine. And one of the first ways that we can really support that is with stable blood sugar. And it's an easy lift in the sense that it's not super crazy complicated. We're not talking about a lot of biohacking strategies here. We're really majoring in the majors. I talk about building a metabolically healthy plate that has got fiber and protein and healthy omega fats and pre and probiotic rich foods. And I have tons of recipes and tons of how-to to make that happen. But simply even moving after a meal. It's easy as that. It's probably the longevity hack that is not given enough stature in terms of what it can do for us. Just taking a walk or doing jump squats or sweeping your kitchen after a meal will help to stabilize that blood sugar. Next is building lean muscle. I do love some resistance training. I did my 20-minute workout today, but I, like my mama, I think it's about building your life around movement. And that movement can include gardening. It can include a walk with your friends. It can include jump squats and exercise snacks. It's really about moving throughout the day as much as possible. I used to believe that as long as I did the 50-minute workout in the early morning, that I could just basically sit on my booty all day. And we know that is not it. In order for our bodies to thrive, we really need to be in movement. And it can be micro movements, one to three minutes multiple times a day. That adds up to better metabolic flexibility and better blood sugar regulation and better bone health, better muscle health, burning fat, better sleep. So I'm a big fan of helping to preserve and protect muscle and building your life around movement. Obviously, sleep, we talked about the sleep routine earlier, but sleep consistency is really big because I am convinced that everything is a lot harder, including stress, when you don't get good restful sleep. It just feels like everything is

Blood sugar, movement, sleep, and community

SPEAKER_01 46:34

more reactive. You're more on your edge when you don't get good sleep. So really prioritizing that, like it is a million-dollar meeting, building in the safety signals to the brain. And then the other thing I think is really deeply important is really building your life around community, having your soul sisters. We know that loneliness is a crazy epidemic right now. It's lending to a lot of mental health issues. And we're feeling lonelier and lonelier since the pandemic. We feel more isolated since the pandemic, and perimenopause and menopause can be one of the most isolating phases of our lives, right? Our kids are often grown up. Maybe they're off, not mine. I was doing, like I said, I was doing kinder drop-off this morning. But for many of us, we are heading into empty nesters and it the friendships that we had, either from working or from drop-offs or from sports, maybe they're just not there or they've changed and developed. But I think if we were to really focus on the richness of life, that building those connections and building those soul-sister relationships is probably one of the most important things that we can do. And so if you really want to supercharge that, I always say have friendships, but move with your friends. Instead of doing cocktails on a Friday, you're doing a hike on Saturday. Instead of gossiping over a lunch date, like you are playing tennis together, you're playing pickleball together, you're doing yoga together, you're taking a walk on the beach together, whatever it is, spend time with your friends in movement.

Gabriella Espinosa 48:01

I love that idea. I am going to try to do that more and more. I do want to add that movement after a meal, that was such a game changer for me. I spent a month monitoring my blood glucose levels with a GM. Oh my gosh. And then just seeing what happened after I would go for a walk, just after the meal. Like I was seeing it in real time go down. And so that was one habit I picked up. And I totally get it. It's so easy to say, I'll do it later, or oh, it doesn't matter. Sometimes I catch myself doing that, especially if I've booked podcast recordings back to back. But right after this, I'm gonna get up and move, and I'm gonna probably take my dog with me and make sure that I can get my booty up and move. Thank you so much for this conversation. I think this conversation that we're having right now, our mothers didn't have it. Most of us didn't have it with ourselves until we were already deep in it. So thank you so much. When you think about the younger women in your life, Dr. Maritza, stepping into motherhood, full careers, their 40s not yet in sight. I have some of those women in my family. What do you most want them to know? Maybe not so much about Perry Menopause specifically, but about the patterns that get women there already depleted.

SPEAKER_01 49:18

Yeah, I would say that the thing I would love younger women to know in their 20s and even in their 30s, that they deserve to feel good, that they deserve to prioritize themselves always. And the sooner that they really understand their live data, they're attuning to their own internal wisdom, that they're listening to their bodies, the more that they can collect that data on themselves, it really sets them up for stepping into motherhood, stepping into perimenopause, stepping into some of these bigger hormonal transitions because they have that deep knowing that they get to take care of themselves, that they get to honor their bodies, and that their bodies have just such deep wisdom that they can trust and rely on. They don't have to outsource that to someone else.

Gabriella Espinosa 50:07

I love that. Yeah, I think more younger women need to hear that. It's not something that we earn later on in life, although we do, but you can start that process now in your 20s and 30s for sure. And then for those of us on the other side, what's the most valuable thing we can offer the women coming behind us? Maybe not so much advice necessarily, more like a witnessing or an honoring. What can we do more for our younger counterparts?

SPEAKER_01 50:36

I think to be having one more conversation, initiating the conversation and having extra grace, that we come in with that sage wisdom, but with grace, that we are kinder and we are more loving to our daughters and our granddaughters, that we really see them and that the advice isn't like, oh, well, that's how it was for me, or oh, that's just the way it is. None of that's helpful. I found myself getting that advice even at this age where someone will say to me, Oh, it's just the way it is. And I'm like, is it though? Or I had a woman recently say, you just have to keep pushing through at all costs. And I was like, You're telling me that there's not a cost, because I'm pretty sure not only do I witness that cost all the time in patience, but I have felt that cost. There is a cost. It's being extra grace, it's coming in with an open heart and an open mind and initiating that conversation so that we kind of know what to be looking out for, how to be future casting, and how to really start to think about our future selves.

Gabriella Espinosa 51:37

So beautiful. Thank you so much, Dr. Maritza. This has been such a rich educational and informative conversation. These are the kinds of conversations we need to be having more in our living rooms, in our book clubs, at our tables. And please share with our listeners where they can find you and your incredible educational resources and your community.

SPEAKER_01 51:59

I believe that women deserve the best of things, not the least of things. I'm so over us getting the least of things. And so this book, not only does the book itself, I map it all out, I leave no stone unturned, but the bonuses of this book are insane. I stacked on stacked on stacked. My team was like, how many bonuses are we doing? I'm like, all of them, everything. I don't want women to feel like they got shortchanged at all. So drmarisa.com forward slash book. Now, if you want to check out the community, it is drisa.com forward slash fire for midlife on fire. And that is it's such like a low entry into my world where I get to spend time with you multiple times a month, but that we really are in community. And to me, I just can't imagine any other place I want to be besides my son's cuddles than being with women in community. Kingston Cuddles and women in community. That is where I want to be.

Gabriella Espinosa 52:54

Oh, I love that so much. Thank you so much, Dr. Marisa. I'll put all the links in the show notes. And please also follow you on Instagram at Dr.

SPEAKER_01 53:04

Marisa. I love to bring levity to Perimenopause, but I also like to bring a lot of clinical insight as well. So you know how to have that communication with your doctor. You know the labs to order, you know the strategies to implement. I want you to feel like it's a one-stop shop on social.

Gabriella Espinosa 53:19

Thank you for everything that you do for women, Dr. Maritza. It's been a pleasure talking to you.

SPEAKER_01 53:24

Thank you, thank you.

Gabriella Espinosa 53:26

I hope you enjoyed this conversation with Dr. Maritza Snyder as much as I did. As I sit with everything we discussed, I find myself looking back on my own perimenopause journey with fresh eyes. Perhaps for the first time, I can see more clearly what was happening beneath the surface, the hormonal shifts, the nervous system changes, the ways my body was trying to communicate with me long before I understood its language. And honestly, I've been feeling a deep sense of compassion for the woman I was back then. A woman doing her best, caring so much and trying to make sense of anxiety, brain fog, fatigue, overwhelm without the knowledge, support, or guidance to understand what was happening. I'm so grateful for voices like Dr. Maritza's that are helping shine a light on this transition and empowering women to understand their bodies with greater clarity and confidence. And yet there's still so much work to be done. Because this knowledge doesn't belong only in books and podcasts. It belongs in conversations with our daughters, sisters, friends, colleagues, and the women gathered around our kitchen tables and in our living rooms. So if this episode resonated with you, please share with someone you know. Let's normalize these conversations and let's pass this wisdom forward. Let's make this journey a little less confusing and a little less lonely for the women who follow us. Thank you so much for being here. And until next time, remember, your pleasure matters. Thank you for joining me for this episode of Pleasure in the Pause. Want to help me spread more pleasure in the world? Please hit subscribe to the podcast and share this episode with a friend, a sister, or any woman you care about. Because when we share these conversations, we remind each other we are not alone. Together, we create ripples of empowerment and support that reach far beyond ourselves. Your support means the world to me. Thank you. Remember, your pleasure matters. The information shared on this podcast is for educational and informational purposes only, and it's not intended as medical advice. Always consult your healthcare provider before making any decisions about your health or treatment. The views expressed by guests are their own and do not necessarily reflect the views of the host or pleasure in the pause.