Hormones in Midlife Part 2: New Insights and Experiences

Hormone Therapy Updates: GLP-1s, Progesterone Intolerance, Patch Shortages & Better Menopause Care

In this Fated to Fabulous episode, the hosts revisit hormones to address women’s confusion from too much conflicting information and share updated insights from Vicki’s practice. They discuss how hormone therapy can affect other medications, including the need to recheck thyroid labs after starting estrogen, and clarify that hormone therapy isn’t a weight-loss solution, though GLP-1s may help midlife weight gain—while potentially requiring progesterone dose adjustments to protect the uterus. They highlight overlooked care in women in their 50s and 60s, including painful sex, chronic UTIs, and the need for vaginal estrogen, and emphasize nuanced perimenopause treatment beyond “just an antidepressant.” The episode covers progesterone sensitivity vs intolerance, alternative delivery options, estradiol patch supply shortages, frustration from inconsistent clinician guidance, and the importance of realistic expectations and patient, individualized care.

00:00 Welcome Back
01:22 Hormones Revisited
02:32 Girls Trip Yums
05:18 Medication Interactions
06:38 GLP-1 Weight Reality
09:18 Menopause Care In 60s
11:45 Perimenopause Nuances
14:02 Progesterone Intolerance
18:36 Patch Shortage Options
20:10 Conflicting Clinician Advice
24:09 Realistic Expectations
27:34 Wrap Up And Next Steps

Transcript

SPEAKER_00 0:00

And then I I can you just move over even a little bit more? Yeah, this way. And then what about my microphone? Not in my face? Not in your face. Perfect. Rolling over here.

SPEAKER_01 0:17

Okay. Keegan, this is the podcast entitled High Protein, High Fiber Meal Planning for Women in Midlife. Simple, sustainable, and effective. Feel free to change that title if it's too wordy. Oh, we need to come up with a title too for her. I think we did, but we'll we can I can look in the um I can look on the schedule. Yeah. Not the schedule, but the you know our podcast.

SPEAKER_00 0:44

Yeah. I need a title for the next one too. Okay. Okay. All right. Um Hi ladies. Hi, ladies.

SPEAKER_01 0:50

Welcome to Faded to Fabulous.

SPEAKER_00 0:53

You're gonna get an um excellent um podcast today because this is something that we get asked about on repeat all the time, and it's about the difficulty of just deciding what to eat, getting all your protein, doing the things, and Ken Lovely is amazing at this part.

SPEAKER_01 1:14

Thank you. I wouldn't uh yeah, I'll I'll take the compliments. Um, I wanted to take just a quick moment to do kind of a it's kind of a yuck, but I can spin it into a yum. Okay. So it's a yuck yum story. All right, I like that. Yeah, so recently I've noticed in social and in clients that are coming to visit me, and they may have seen other forms of healthcare providers, and there's sort of this demonization of fruit. Yes, and it's making me a little nuts. So I wanted to sort of say, first of all, hear me. Hear me. The sugar naturally occurring in fruit is not a problem for the human body, it is not the same as sucrose, which is the white processed table, what we know as table sugar. So by eliminating fruit, we are eliminating one of our best sources of fiber, and we are not getting enough fiber as a culture. We are eliminating some beautiful phytonutrients that are so important for all the processes the body does, including energy, metabolism, bones, our gut health, our brain health, like everything is dependent on those phytonutrients. So by not getting any fruit, you're literally missing out. So, and also really important to know that when you eat a fruit in its whole form, the naturally occurring sugar is absorbed at a very slow rate. It's not the same spike as a Snickers bar. No, so you know, an apple still fits among the top whatever three of snacks. It is a spectacular snack. It's high in fiber, it's naturally alerting. So at the end of the day, if you're feeling groggy, if you're getting in the car to drive home, an apple is an amazing thing. In general, we eat apples more slowly. You can't just scarf an apple, there's too much skin to chew. And so, in eating that more slowly, we actually also lower the rate at which that eventual glucose. So, yeah, so if you're seeing stuff on social media about fruit being demonized, I want you to go la la la la la la la.

SPEAKER_00 3:31

Like anything that requires you to eliminate an entire food group is problematic, which we know.

SPEAKER_01 3:37

Yeah.

SPEAKER_00 3:38

So, anyways, that is my so that's the yum.

SPEAKER_01 3:40

And turn it. And the yum is an apple, and the yum is like, you know, a clamshell of raspberries is 10 grams of fiber, people. Like, so please, please don't give up on the beautiful fruit. Fruit. I love it. So that's it, yeah. Um, our topic is, and yes, I get asked this a lot, and so I thought we had approach it from sort of the practical perspective of why it's helpful to meal plan. What are the things that typically get in the way or make it arduous or whatever? And what are some simple strategies that you can apply to make food planning? Not just another chore.

SPEAKER_00 4:18

Right.

SPEAKER_01 4:18

Right.

SPEAKER_00 4:19

So all right. Um talk about why it's so important, and you are the person to talk about why it's so important.

SPEAKER_01 4:29

Um, my history is that I have planned meals since I've been 19 years old-ish. When I was living in my first apartment, um, I started planning meals. And I think it was really more of a management of what I now know as ADHD at the time. I just thought it was my crazy brain, right? So it was a way for me to manage my own brain. I did not do well with decisions about food in the evening hours. And, you know, that as I became older and a parent, and that sort of became even more evident for me. I didn't deal with small children, end of the work day, figuring out what everybody's gonna eat. I didn't do well with that. So it's sort of this natural path into meal planning. Um, so and a menu. And a menu, yes. I have created a menu since that time. Um, why it's so important for women in this area of life, there's a lot of boxes to tick with regards to our nutrition, right? And we know that you know, getting our protein and getting enough fiber and paying attention to healthy fats and you know, not partaking in too much processed foods, trying to eat more whole foods, likewise our brain sort of being a little fatigued when it comes to decision making. So meal planning allows you to take care of all those important things in a 10-15 minute period of time, as opposed to trying to make all of those decisions on the fly, every day, at the end of the day when you're tired, right? So that's why it is more important, and also from a cost perspective, sure, right? If you don't absolutely plan your meals, you're much more likely to waste food, which doesn't feel good for anybody.

SPEAKER_00 6:24

So, yeah. How so a lot of times when we're sharing women in in our in our practices, it's the decision fatigue. You already said that, and so they're like in decision fatigue. Um, they may not have gotten aligned with their hormones yet, they're a little bit more tired, they maybe don't have kids at home. All of those pieces going on. How without having them shut down completely, how do you keep it simple? Like, how do you tell them to keep it simple? Um, I start with the lowest hanging fruit. Okay.

SPEAKER_01 6:58

Right? So, kind of what is your goal? Are is your breakfast going pretty well? Great. You're doing, you know, one or two different breakfasts every day, going well. Lunch, maybe lunch is a disaster. Maybe you're getting lunch at work cafe, a cafeteria, or you're ordering out, or you're not eating lunch or whatever. So I may start with the thing that might be most bothersome and just one thing. And so we might just start with lunches, okay? And then I ask the question what would a perfect lunch for you look like? And we remember we've already already had this thing at this age. I don't want a grappy lunch.

SPEAKER_00 7:31

Like what Kim and I don't let each other eat gross lunches. So if we brought a lunch that we're have we have the ick from it, like we've maybe eaten it too many times in that week, or we're just not feeling like it, it's like, nope, full permission, you may go get something else for lunch. Yeah, yeah.

SPEAKER_01 7:46

So I sort of like, what would be, you know, and most women will say something like an enjoyable, um, not too much effort, stress, food prep, whatever. So I kind of figure out like what is it that would make sense for them? And when then we literally just plan it. So it might be, you know, someone might say, I can't stand having the same thing every day for lunch. Like, I just I can't deal with that. Right. I'm like, okay, so let's pick three different proteins, let's pick some kind of carbohydrate, and let's pick a vegetable. And that's just boom, boom, boom. So that might mean that you buy precooked chicken. Absolutely. Right? And that could go in a wrap or a bowl or on its own, like charcuterie style lunch, right? Um, do you like eggs? Could we do some boiled eggs where one lunch you have some boiled eggs? Do you like tuna? You know, if you don't want to do the canned tuna thing, those little packets can be really good. So I look at, okay, so we're gonna look at the protein first. Let's figure out the protein. We need something that has a little bit of carbohydrate in it and preferably a high fiber carbohydrate. What might that be? Well, I don't really feel like having grains or whatever. Great, let's get a wrap. Let's do a one mighty mil wrap. Here's where you get it. Here's your fruit. Easy peasy, right? And let's, you know, let's add a fruit. Easy. And so it's sort of more of this like pick this, pick this, pick this, be done with it. And I've learned through you actually, one of the things that I've stolen is that I'm quite a tzatziki fan. So I like a glue with my lunch. Yes. So I will tell people, do you like a glue, right? Yeah. Yes, I want a glue. Okay, you're gonna buy a container of hummus and a container of tzatziki, and you're gonna put one, the other, or both with your lunch. And that can make a huge difference. When it comes to dinners, I think that sometimes we are we almost shoot off our foot before we've even made the decision. In our brain, it's like, oh, this is so hard. I don't like this, I'm tired of it. Well, if you have that sentence, it's gonna make you feel awful, and then you'll show up awful. Change the sentence to, I need to figure out three different meals, period. I need three different dinners for the week. Done. Like, find a very neutral sentence that doesn't have any emotional crapola attached to it, right? And then, all right, I need three different meals. I'm gonna throw together a chili that will give me two dinners, a couple of lunches. I'm gonna throw together one sheet pan meal, vegetables, a sausage, that'll get me a meal.

SPEAKER_00 10:13

That is my that is my absolute life. I can do it. I can get like the um turkey kielbasa or sausage. Yeah, I do all the veggies on the pan. Yep, I do cauliflower rice or whatever, and it is so good. And I don't get sick of it, and then I have multiple meals. And you have to figure out who you are. You said that earlier. I can eat that all the way along. Yeah, not everybody can do that. So if you know that about yourself, then you're gonna have to be a little bit more um, but you know, if you know that you don't want to eat it on repeat, what if you make that big one sheet pan meal and you freeze some servings and do that so once a week, you're creating this big sheet pan meal of different things that you like and putting little, you know, sample servings aside. Yeah.

SPEAKER_01 11:01

Um, the other thing too is you can flip-flop the leftovers. So I knew my week was gonna be kind of busy. So I made a big pot of your buffalo chicken chili, which I love. Oh god.

SPEAKER_00 11:10

So we need to post that somewhere. Yeah, for example.

SPEAKER_01 11:11

That is we'll make that one and do it. Um, it's great. So I made a big pot of that on Sunday for Monday. And then I also made it's a um orzo, chicken pieces, tomatoes, peppers, really easy. It goes into the oven and it cooks itself basically after you brown the chicken. Um, so rather than having them all together, right, or one right after the other, we had the chili on Monday night, the chicken on Tuesday night. And tonight you can choose. You can have chili or chicken. So it kind of like breaks up the sort of monotony of what you're doing. If you're if you're somebody who needs that variety, you're not going to be bored, which is great. By the way, the sheet pan idea, it's also great to clean out your vegetable crisp. Like whatever's left. What do I have? Yep, and everything works. So with sheet pan meals, if you've never made them, they are the best. They are the bomb. If you're doing root vegetables, they all cook at the same time. So carrots, squash, sweet potatoes, beets, not um summer squash, but like winter squashes, they all take a little bit longer. So you can start those. Yeah. And then you can toss on peppers, mushrooms, summer squash, zucchinis, some tomatoes, and it's all still on one pan. They just have two slightly different cook times. And then you can put any protein that you like. If you're gonna put chicken, you can put the chicken on when you put the roast, the um root vegetables, and it'll cook in time. If you're doing the turkey sausages, which are cooked already, they can go on. Yeah, they can go on at the end. Um, salmon. So I'll buy the pre-frozen pieces of salmon, I'll throw those on, and I put them on with the second batch of vegetables because the salmon will cook really quickly. You can make it vegetarian. You could do tempeh, uh yeah, cut the tempeh into chunks, throw that on, and again with the second batch of vegetables, right? So she pan meals are amazing.

SPEAKER_00 13:06

Yeah, and and you know, you don't have to. I think we complicate things because we feel like it has to be complicated to be good. And I will tell you that some of the most complicated recipes that I have found online, I'm like, yeah, it actually doesn't even come out that good. Whereas like my sheep ham, like it took me two seconds, yeah, is delicious. So it's it's just getting a few of those under your belt. Um, it doesn't need to be yeah, challenging.

SPEAKER_01 13:32

So I'll walk you through how I plan my meals for the week. I I've done it the same way for years, it just works for me. On Saturday, when which is my paperwork kind of morning, I sit down with a cup of coffee, I take a just a plain old white pad, I have my calendar on my phone, I have a pen, my glasses, my coffee. I look at the the week coming up. What's happening? Where am I? When am I late? What are the days that I really need leftovers that I just don't want to think about? I don't want any dishes, none of that stuff. And I sort of plug those in. What's the weather look like? Is it a crappy day? If it's summertime, is it beautiful? Is it a grill day? Is it a rainy day? So I kind of look at the weather and then I and then I might use some inspiration. So I'm always taking recipes that I see and I toss them to myself as a text. Interest or yeah. So sometimes I need an inspiration. Sometimes I pull out my own binder, which is all my favorites, and I'll be like, oh, I haven't made that in a long time. Sometimes I might ask a question, like of my spouse, like, hey, is there anything that you feel like having? Most of the time, I don't usually get an answer because I think he's sick of being asked, right? I think it's been 30 years of being asked, so I think he's tired of being asked. Um, so that's kind of how I do it, do it, and I only pick three things for the entire week. That's it. Um, I don't think that we need to make a fresh meal every single night. I think it's too overwhelming. It's not realistic. You know, maybe if you're fresh married and whatever and you're not burned out yet, but once you're at our age, oh my gosh, I like that.

SPEAKER_00 15:05

That's where girl dinner comes in, correct? Like from social media. Girl dinner is a real thing. It is a real thing. And I think it's nice, like I was just telling you earlier, I I went away um to my friend's house who lives in Naples, and so it's three of us, three of my friends, and just women, no men there. And guess what? It was like uh, I'm gonna eat some cottage cheese now. Okay, I'm gonna just grab the hummus and the veggies. It was just very we weren't caring what we were eating, it wasn't, you know, the the central focus. Um, but I do find I do that a lot more with no kids at home. Yes. Whereas before I think we felt obligated in a way, it was like a expectation that you as a woman are gonna prepare a meal every single night. Now I'm like, all right, I have a protein, I've got a veg, like I'm good. I wonder what that looks like.

SPEAKER_01 15:55

Yep. When I was traveling last week too with Jennifer, we found ourselves doing like liner or lump less. I really like that. I like having a nice bigger meal, sort of like as a late lunch or early dinner. I love that. I love that. That's what we did the whole day. I can see myself when I'm in retirement mode in 100 years going to more of that old farmer style, right? Where you have a main meal in the middle of the day. Exactly. You know what? You're not gonna you're not gonna have to wait for a seat. No, no, and and you don't have to digest your food all night long either, which is kind of nice. Um so I think that you know, taking sort of the drama out of it, yeah, approaching it like something that's helpful to you as opposed to another chore, um, and make it really simple. Maybe thinking of three meals to make for the week or three dinners is too much. Maybe just thinking of one meal to make that might get you leftovers for another night, maybe that's enough. Maybe that's where you start. Um, if you are, you know, sort of in this place of like, I'm really tired of making the decisions, give yourself a break. You know, try a meal delivery service for a couple weeks or something, right? There's tons of them out there, and we've tried a few of them. And and they, you know, some of them are not less work as far as hands-on, but they're a lot less work as far as thinking. Thinking about it.

SPEAKER_00 17:23

Yeah, but yeah, no, some of them are like at 40 steps to get these turkey burgers. I'm like, no, ma'am. Yeah, you know, but some of them are easy and they're already put together. So that is definitely, even if you have some of those staples in your freezer for the one you know you don't have it in your cup to give that week, you've got a little bit more of a challenging week.

SPEAKER_01 17:43

You know, and that's another thing to take advantage of, too, right? So one of the things I do do as well is I will buy the five-person family meal at Whole Foods.

SPEAKER_00 17:52

Uh, you I that is a fantastic idea. Yeah. Also cost effective. Extremely cost effective. Yeah.

SPEAKER_01 17:58

They're usually around $25 for the tinfoil thing, and there are five very generous servings. In fact, one serving is actually almost too much for me. And they'll always be two-ish chickens. There'll be something like a meatloaf or a stew type thing, there'll be a fish. Um that's great. Yeah, and then so on. It just takes all the brain power out of it for you. On grocery night, you know, if you're if you're like me and you grocery shop late on Saturday afternoon, you come home, you put all the groceries away, and you're like, I don't want to make dinner now. That is great. And if they're depending on how many you're eating, I can actually turn that into some lunches for myself too for Monday and Tuesday. So, and then you know, there are particular restaurants that might have good things. Sadly, our little Italian market in Bedford has closed, which is very sad. But they made fantastic meatballs, right? So taking advantage of some well-crafted, beautiful foods that you can then bring into your own. Add a salad, yeah.

SPEAKER_00 18:57

Yeah. Um what would you say? So pick one thing. Pick one thing for somebody to tackle this week or to try to make a change or to help them.

SPEAKER_01 19:14

Um I think that the one thing to tackle would be what is your thoughts around meal planning? And if they're not helpful, clean them up. Take it to a more neutral place. This is just a meal. I'm just I'm just thinking through how we're gonna eat this week. Like try to take the emotions out of it. I think we get stuck in this.

SPEAKER_00 19:38

All or but also all or nothing. Yes, and all or nothing. Getting all or nothing and guilt-driven um decision making out of it. Yeah, so just being aware of your thoughts, even is what you're saying. Being aware of your thoughts. I think is the first step to making any kind of change is realizing where is my behavior coming from?

SPEAKER_01 19:55

And it's like I said, with my little the way I do it, you know, I have my coffee, I have some paper. I've done it the same way all the time. It's just part of routine. There's no part of me that goes, Oh, this really sucks. I'm like, no, this is just what you do. Like this is this is what you do. This is make makes life so much easier for me for the week. I don't have any meal planning to do during the week. I have no decisions to make. They're done. That's it. I make my decisions in 10 minutes on Saturday morning and I'm done. I think that's easier than standing in front of the fridge at 5:30 p.m. and going, what's for dinner?

SPEAKER_00 20:27

Yeah. Always. Because then you you know that decision making is not gonna go well. You're probably not gonna have a balanced meal in that case. You're probably gonna spend more money because you're gonna go, I hate every door. Um cereal. Can I ask you? Yeah, where do you see technology being helpful in this arena? And tell me how you've been utilizing that and what you recommend.

SPEAKER_01 20:53

I definitely use Chat GPT. Um, especially if I have a particular agenda and I can't think myself creatively. Um, for example, we participate in a CSA. Okay. So sometimes we'll get all these funky vegetables, and I literally put them on the counter, right? Yep. And I take a picture and I say, plan me three dinners using those vegetables. And it literally will plan a week or meals with those particular vegetables. That saves me so much time. And every time it's knocked the ball out of the park.

SPEAKER_00 21:28

And you know what's cool about that too? And this is like you were the one who sort of opened my eyes in this. Um, you can then say, okay, so I have these vegetables, I have these things in the house. Also, I hate chicken, and I'm allergic to avocado. Yes, like that. And I'm trying to get 30 grams of protein with each meal, and also get 25 grams of pro fiber during the day in this kind of calorie range.

SPEAKER_01 21:56

So it can be really, really specific. I'll tell you if. Funny thing I did. I did it at a friend's house. We were talking about using Chat GTP to make menus. And I said, You can literally take a picture of the inside of your fridge and it'll give you menus like meal suggestions. And she was like, No way. And I'm like, and I opened up her fridge, took a picture, and did it. It was wild, right?

SPEAKER_00 22:17

So it's kind of scare me. It is. I think things like that. It can be really helpful.

SPEAKER_01 22:25

It can be really helpful. Um, when I've done that, then I've also said, give me the prep plan.

unknown 22:31

Yeah.

SPEAKER_01 22:31

Right.

SPEAKER_00 22:32

And the and the menu, and and what I need to get at the groceries.

SPEAKER_01 22:35

Exactly. The grocery list. Yeah. Um, which of these things could I turn into a lunch for myself so you could really take advantage of that. I did. You can. Yeah, it's fun. I'm I'm, you know, for for good or bad, I do use chat GPU. I am I am I laugh. She gets me out of trouble, man.

SPEAKER_00 22:55

She Kim just calls her chat. I just call her chair on a first thing. And she's a she. For sure. She's too smart to be a I think about a she. Um, so thank you for because I this is like I've I turf to you all the time on this because it really is an area that I think women get stuck. Um, and it is really important. And the the whole really take-home here, too. This doesn't need to be an area of your life where there's stress. It just isn't, and and doesn't have to be. So yeah.

SPEAKER_01 23:25

No, honestly, the 10 minutes with my cup of coffee, like that's not stressful. It's just something, you know, it's it's a time commitment, but it's not long. But if you want to take half an hour, go for it. But I limit myself, I say you gotta get this done in 10 minutes, that's all you have. And I do that because it forces me to not make not to be like, well, I could do this, but I could do that.

SPEAKER_00 23:45

Yeah, because then you're gonna spend an hour doing it and and my you know, um, I also think that we need more of some of what we've done in the past. Yes, if you work with other people and they also are like, I'm so sick of figuring out food, and you you know they don't have like cats that are like licking like their kitchen utensils, that may be somebody that you say, Hey, I'm making this buffalo chili on Tuesday, I will bring us lunch on Wednesday, and then you're making the sheet pan. Can you, you know, bring us each a serving on it? We need to get back to that. Yeah, we were better about that. Yeah, and I I really enjoy that because I loved your food.

SPEAKER_01 24:24

I love your food. Yeah, yeah. So, yeah, take advantage of friends and share. Share the love. Yeah, we need to help each other out as well. Yeah, okay. Um, we are going to try something new. We are going to uh attach a link to finding a tool, it will lead you to a tool that will help with meal planning, very um simple meal planning tool. And anybody is welcome to it. If you feel that's an opportunity for you to give back to this community, um use it as an opportunity to donate to Beta to Fabulous's production cost. Um, we have said before that Vicky and I are self-funded and we receive no monetary help for any of this, but we would like to sort of recognize that and give people an opportunity to sort of say, you know what, this is worth $5 for me for them to keep keep doing this.

SPEAKER_00 25:18

So we have no sponsors, although I'm we're working on culture is gonna reach out to us. And one mighty function of their cottage cheese.

SPEAKER_01 25:28

If anybody has any links at One Mighty Mill, please share them because I recommend that product all the time, and I've reached out and I haven't gotten anywhere. Um, so yes, uh, we would love to be able to continue to provide our content. We don't want to get into the ads and commercials and stuff, it's just not us. Um, but we would love to be able to give people an opportunity to donate should they feel that that's something that's worthy for them. All right. Thank you. Thank you, ladies. See you soon. Bye.