How Menopause & Hormones are Impacting Your Health

Your body didn’t “fall apart” overnight, it changed priorities. That midlife swirl of weight gain, sleep disruption, mood swings, and weird new symptoms has a name and a mechanism: perimenopause and menopause. I’m breaking down what’s actually happening inside your physiology so you can stop blaming yourself and start using strategies that fit this season of life.

We talk through the hormone reality behind the chaos: progesterone dropping fast, estrogen swinging unpredictably, cortisol hitting harder, and blood sugar getting less stable. I explain why the old playbook of eating less, doing more cardio, and pushing harder can lead to fatigue, burnout, and stubborn body composition changes. Then we get practical with the new non-negotiables: protein targets you can actually calculate, strength training that preserves your metabolic engine, and sleep and blood sugar habits that protect your nervous system.

We also go deeper on labs and hormone optimization, including why “normal” blood work can still leave you feeling awful, how functional and integrative clinicians interpret patterns differently, and what to know about hormone replacement therapy, delivery methods, and real risk factors. I share a very real and very under-discussed part of menopause: vaginal dryness, fissures, and urinary changes, plus why topical estrogen may be a game changer. And yes, we cover men too, testosterone decline is real, symptoms matter, and treatment should be monitored thoughtfully.

If you found this helpful, follow the show, leave a review, and share it with someone who’s quietly struggling. What symptom do you want me to unpack next?

Transcript

Why Perimenopause Feels So Confusing

What Hormones Are Doing To You

What Works Now For Fat Loss

Labs, Thyroid, And The “Normal” Trap

HRT Done Right And Real Risks

Vaginal Changes Nobody Warns About

Men’s Hormones And TRT Basics

Anxiety, Leg Cramps, And Wrap Up

How To Support The Show

Krista 0:11

Welcome to Serenity and Fire, the podcast where wellness meets grit. I'm your host, Krista Wageni, founder of Panacea Luxury Spa Boutique. Join me as we dive into the intriguing world of biohacking, clean living, cutting-edge spot trends, and the hustle, grind, and grit of entrepreneurship. From my personal battles with weight management and infertility, through a 30-year struggle to create and launch my dream business, to building a sanctuary for those who have been touched by cancer. I'm here to share real talk, inspire big dreams, and spark a passion for holistic living inside each and every one of you. So let's dive in. Welcome back to Serenity and Fire. Today I'm going to talk about a topic that I feel like is super frustrating for most women, but also maybe one of the most misunderstood topics in women's health, and that's menopause. More specifically, I want to talk about perimenopause, you know, the phase where everything starts to feel off, and yet no one really ever explains why. And this whole topic came up when I was on a trip to Savannah with my sister and one of our best friends, Nikki. And we were kind of all sharing different things that we've been experiencing. And Nikki and I both had been experiencing something that we felt was very odd and wondering if this is something that other women were experiencing. So that led me to reach out to my other best friend, Trisha, over text. And I told her, I'm like, I really need to know something about symptoms that you might be experiencing because I've been experiencing this and I'm wondering if you're experiencing it too. It's something that feels very isolating for me. Um, it's kind of embarrassing. And like I said, it's TMI. And I'm gonna share that specific conversation with you a little later in the episode. But basically, when I shared with her what I was going through, her response was this What in the world do you do to make that better? I've never heard of it, thank God. And then she went on to also say, I can tell you my estradiol patches are tearing my skin up. Itchy, red, irritated, inflamed. I change it twice a week, and it's hard to even keep it on the three and a half days without ripping it off. Also, I had been about 150 plus days without a period, and now I've had two in the last three weeks, not to mention snapping at Mike for no reason and then sobbing because I feel terrible. And I feel like I could cry right now just thinking about it. I woke up one morning and my entire body was covered with cellulite, places I've never had it before. It makes me so sad. And I remember thinking after reading her text, this is what no one prepares you for. And what's even more interesting is that I'm now watching so many of my friends, many of them who are, you know, five, 10, 15 years younger than me, go through what I went through years ago. The weight gain, the inflammation, the confusion about what's happening in my body, and feeling like so self-conscious about how I look and feeling like I was completely alone throughout that whole process. And if you've ever snapped at someone, cried about it, apologized, and then cried again, you're not broken, trust me. You're just hormonally dynamic. And men, please don't tune this out because we're also going to talk about what happens to you during this phase of life. Yes, manopause, as I like to call it, is definitely a real thing. That might not be the technical term for it, but you're going through a life change too. You're not just getting grumpy and tired all of a sudden for no reason at all. And we're gonna get into that here further in the show. So definitely stay tuned. But before we get into what to do about all of this, we have to really understand why this is happening to our bodies because it's not random, it's biology and it's your physiology changing over time. For women, your body's shifting from a state of reproductive priority to a state of preservation and longevity. That means your ovaries are producing fewer follicles, ovulation becomes less consistent, progesterone starts to decline fast, and progesterone is your calming hormone. So when that drops, you feel it. Then estrogen starts to fluctuate, not just drop, but like spike, crash, and become super unpredictable. And at the same time, your body becomes more sensitive to stress because you no longer have the same hormonal buffering that you once did. So cortisol hits harder, blood sugar becomes less stable, and recovery takes a lot longer. This is not your body failing, this is your body changing priorities. And for men, they don't really experience all of this as abruptly as we do, but they absolutely experience it too. Testosterone peaks in a man's 20s. And after about age 30, it begins to decline by roughly about 1% per year. And why this happens is because testicular output declines. Something called SHBG increases. This stands for sex hormone binding globulin. And what it does is it binds to testosterone in your bloodstream, making it less available for use. So even if a man's labs say their testosterone is normal, that doesn't mean that it's usable. And then there's another factor when it comes to men, and that's that testosterone can convert into estrogen through a process called aromatization. This increases as body fat increases. So as men gain more abdominal fat with age, they can actually shift toward hormonal imbalance. This doesn't mean that men become more feminine, it just means that they become hormonally imbalanced, which can show up as lower energy, more fat storage, lower muscle mass, mood changes, and lower libido. So the key takeaway here is that women experience a hormonal shift while men experience a hormonal slow fade. But both matter and both are real. These changes affect our confidence, our relationships, our sex lives, and just about everything in between. And this is where many of us get frustrated because what used to work stopped working. Eating less, doing more cardio, pushing harder now leads to fatigue, weight resistance, and burnout because your body is now more sensitive to stress. So when you undereat, it perceives that as stress. When you overtrain, it also perceives that as stress. And when you fast aggressively or too aggressively, it perceives that as stress too. More effort is not necessarily the answer, but better strategy is. So if the old strategies stop working, the next question becomes what actually works for this phase of my life? Because this is where everything shifts. This is where we move from doing more, eating less, and pushing harder to being more strategic about fueling your body properly, preserving muscle, and stabilizing our nervous system. And this is where protein, strength training, and sleep stop being nice to have and become non-negotiables. So let's get specific about this. When we look at protein, a good protein target is gonna be 0.7 to 1 grams of protein per pound of your ideal body weight. So for example, if your ideal body weight is 150 pounds, you're looking at roughly 105 to 150 grams of protein per day. So what that actually looks like in the foods that we eat every day is like this. Three eggs is gonna be about 18 grams of protein. Four ounces of chicken, which is a great source of protein, is gonna be about 30 to 35 grams. Four ounces of salmon is around 25 grams, Greek yogurt is about 15 to 20 grams, protein shakes, 30 to 40 grams, and cottage cheese around 12 to 14 grams. So if you're eating eggs for breakfast, a salad for lunch, and then a light dinner, you're probably nowhere near the levels of protein that you need to be. Your ideal structure is gonna be about 30 to 40 grams per meal, three to four times a day. And again, that's for the person who's gonna be really targeting like 150 pounds as their ideal weight. Most women are dramatically under-eating protein for this phase of life. And this is something that I struggle with too. I really try to get a lot of protein in, but 120 to 150 grams of protein is a lot. So you really have to think about that and where you're getting your sources from. So now let's talk about why this matters so much. Well, here's the thing: as your estrogen declines, your body becomes more catabolic, meaning it breaks down tissue, especially muscle, more easily. And muscle is not just about how you look, as we know, it's about your metabolic engine, your blood sugar regulation, and your hormonal support. So if you're not eating enough protein, you're losing muscle faster than your body can rebuild it. And when that happens, your metabolism slows, your insulin sensitivity worsens, and your fat storage increases. Protein isn't just about building muscle in this phase, it's about preventing your body from losing it, which leads us to strength training. This is unfortunately also a non-negotiable. You need to be doing this three to four times a week for 30 to 45 minutes. And a lot of the sources I hear and listen to typically say 30 minutes is sufficient. But this means resistance training, not just movement. You want eight to 12 reps where the last few reps feel hard. So if your workout feels easy, it's not doing what you need it to do. Strength training matters more than cardio in this phase because cardio burns calories, but strength training builds and preserves muscle. And muscle is what determines your metabolic rate, your insulin sensitivity, and your long-term body composition. And here's what happens when we rely just on cardio. If you do excessive cardio without resistance training, you can actually lose muscle. And when you lose muscle, your metabolism slows, your body becomes more efficient at storing fat. Cardio burns calories in the moment, but muscle determines how your body burns energy all day long. The bottom line is that muscle is your metabolic engine. And now more than ever, you must protect it. So when you're lifting those weights, if it doesn't feel hard and you're kind of struggling to get those last couple reps up, then you're not lifting enough weight. And typically what I do see is that you want that weight increasing as you continue to get stronger and stronger. So for instance, for me, when I first started doing heavyweight training, my dumbbells that I was lifting were eight pounds. Now I'm up to 25. Um, and when I do eight to 10 reps, I'm really struggling to get that last one or two reps up. But once I start noticing that I can get to like 12 to 15 reps with no problem, then I need to up my weight a little bit. So that's how you know if you're doing enough when it comes to strength training. And also when you're doing things like resistance training, it might look like you're doing elevated push-ups or modified push-ups, and then eventually you're doing full push-ups, and then eventually you do weighted push-ups. Or if you're doing squats, you're doing them with no weight, and then eventually with weight, and then you're doing split squats. So those are ways that you can progressively increase your strength training over time. And that's what you want to be working towards. And when we look at sleep, we also need to look at blood sugar too, because that does affect and impact how well we sleep. We need about seven to nine hours of sleep, but more importantly, it has to be quality sleep. If you're getting eight hours of sleep, but you're waking up 24-7, that's not good sleep. And sleep gets worse as we approach this phase of life because our progesterone declines, our estrogen fluctuates, and our cortisol levels rise. And when we look at this picture, blood sugar matters because if you go to bed too hungry, your blood sugar drops and then your cortisol rises. And when that happens, it makes you wake up. If you go to bed too full, your digestion interferes with sleep. If you're doing long fast windows, like we talked about in some of the fasting episodes, this may no longer work for your body because you may no longer be metabolically stable enough to support these types of fasting regimens. And I know, like for instance, if you're doing 18-hour intermittent fasting and you're eating in a six-hour eating window, but you don't start that six-hour eating window till three, four, or five o'clock. And then your last meal is at nine or 10 o'clock, you might be too full when you go to bed. So just, you know, you need to think about those things and plan those out strategically. And you want to make sure that that last meal that you have is like a high protein, high fat, low carb type meal. What worked five years ago may now be working against you. And that's really the key takeaway here. So now let's talk about lab work and blood work. You all know that I'm a huge advocate for regular blood work, but also understanding what that blood work actually means. The problem is that there are general accepted guidelines when it comes to lab data, which is what most traditional medical practitioners follow. Typically, your general practitioners, your family practice medicines, some OBGYNs, even some traditional specialists like your endocrinologists. And then there are practical physiologically based guidelines that look at your entire body as a system, how it functions, how things work together and against you, and how to fix underlying issues rather than just putting a band-aid over the symptoms. Conventional medicine looks more at the disease and how to fix the symptoms. Functional medicine or integrative medicine looks at the root cause and getting your body to function optimally. The point I'm trying to make here is that you can have normal labs and still feel completely off. And if you're not with the right physician who can analyze and detect and figure all of this out, then you're gonna get nowhere. So, for example, for me, my thyroid is the perfect example. The guidelines say that your TSH or your thyroid stimulating hormone should be at a 0.5 to 3.0 level. And for years, when I would go to my endocrinologist and my family physicians, my levels would come back at like two, two and a half, two point eight, three. And they kept telling me that that was normal. But I kept packing the pounds on visit after visit. And what I later found out after one listening to my own body and then finally finding a functional physician who would listen to me, I found out that what was actually optimal for me was going to be more around that 0.5 to 0.8 or less range. And whenever my levels get above that, I literally start packing on the pounds almost instantly. I'm not saying that that's the range that you should be in, but what I'm saying is that for me, that's where I feel best and that's where my body responds the best. And one of the biggest frustrations I hear, and also one of the biggest frustrations that I've had over the years, is that people will say my labs are normal, but I still feel terrible. The bottom line is that normal ranges are based on population averages from people with underlying health issues. They're not based on optimal health and peak vitality. For instance, if we look at progesterone labs, conventional physicians are gonna look at a number. When we're looking at the luteophase of your cycle, it's typically gonna be five to 20 nanograms per milliliter. But when it comes to functional medicine, those physicians are often looking for balance relative to estrogen levels, not just that number. Another example is gonna be estradiol. Targets are typically cycle specific, so there's a very wide range of levels, but the functional approach is gonna look at stability and symptom alignment. For example, my most recent lab showed that my estradiol levels were fine based on general levels, but based on my symptoms and other lab work, my specialist increased my progesterone and then told me to monitor my symptoms to see if I was getting more hot flashes and more night sweats, which would indicate that my estrogen levels needed to be increased. And that is actually what's happening for me. But what I can tell you is that increasing my progesterone levels changed everything for me. She had asked me before we increased them how my sleep was. And I was like, I'm pretty sure it's good. I think it's fine. I literally did not know that I was not getting good sleep until we increased my progesterone. And wow, what a big difference that has made in my life. So increasing the progesterone changed everything for me. I feel so much better. I feel more alert, more focused. I feel more rested when I wake up. And that said, I am having more night sweats and more hot flashes. So we're gonna be increasing my estradiol levels. And the thing about going to a functional medicine physician is that they're gonna be more prone to putting you on supplements and medications that are gonna be more bioactive and more bioavailable and less made from synthetics. So we'll be increasing the estradiol, and that should help improve those night sweats and hot flashes for me. And then when we look at testosterone levels, conventional metrics say that these should often be between 15 to 70 nanograms per deciliter. But a lot of the functional and specialty clinics are targeting 90 to 200 plus. That's a big difference. And many women are on that low end of the spectrum and are very symptomatic. So a lot of women need testosterone replacement therapy and aren't getting it. For men, the normal ranges are typically between 240 to over 950. So a lot of men, especially as they're starting to get into their middle ages, are definitely low on testosterone as well. Testosterone in women, like I mentioned, is especially overlooked. And it's crazy because it affects energy, motivation, muscle, libido. So it's not just whether your hormones fall into a range, it's whether they're optimal for how you want to feel and how you want to function. Normal does not necessarily mean optimal, and that's true for men as much as it is for women. So let's talk about hormone replacement therapy because if you're gonna go down this road, it needs to be done correctly. So, what do I mean by correctly? First, it needs to be individualized to your personal needs. I just gave plenty of examples of why that's the case. Also, the delivery mechanisms need to be correct. Do you do topical, oral, or do you do injectable therapies? And then all of your hormones need to be balanced. And I'm talking about the whole story, not just one hormone specifically. And this needs to be monitored on an ongoing basis. You also need to fully understand the risks of hormone replacement therapy, which are way less concerning now than what the media and academia made them out to be in years past. For example, clotting has always been a primary concern associated with oral estrogen, because oral estrogen passes through the liver and can increase clotting factors. But this risk is not the same for everyone. You're at a higher risk if you have a personal or family history of blood clots, smoking history, obesity, sedentary lifestyle, and certain genetic clotting disorders. But your risk is lower if you use transdermal estrogen, if you have a healthy metabolic profile, or if you have an active lifestyle. The clotting risk is real, but it's specific. And when you understand who it applies to, it becomes much more manageable and is not a concern for everyone. So if you're someone who cannot tolerate transdermal patches or you do not see results with those topical forms of the hormones, that doesn't necessarily mean that you can't use other forms of the medication. It's just something that you need to talk to your physician about. I also wanted to share some information with you about the Women's Health Initiative study that was published in 2002. This study dramatically changed how hormone replacement therapy was viewed. It showed increased risk of breast cancer, heart disease, blood clots. And as a result, millions of women stopped using HRT right away, and doctors really stopped prescribing it. But here's what was missed in that study. Participants were older, typically average age of 63. Many of them were 10 to 15 years post-menopause, and they used synthetic hormones in that study. They were not bioidentical hormones. That WHI study wasn't wrong, but it was misapplied. And what we now know is that risk depends on timing, type, delivery, and individual health. And what I mean by that is first, let's look at delivery methods. When we look at how you take your hormone therapy, transdermal methods are often preferred, but not everyone can absorb them well. Some women need oral estrogen for stronger systemic effects, and that's definitely the case for me. Testosterone often requires injections because creams can underdeliver. And again, that was the same thing for me. We tried the topical testosterone. Not only did I get weird hair growth in places that I didn't want, but it also didn't absorb well enough. So now that I'm on injectables, my levels are where we need them to be, and I definitely feel way better. So the best method is going to be the one that your body responds to. And as long as you're monitoring symptoms with your care provider, side effects can be very minimal. Now let's talk about cancer, because this is where a lot of fear around hormone replacement therapy comes from. So can you take hormones if you've ever had cancer? And the answer is it depends. If someone has had hormone-sensitive cancers, like certain types of breast cancer, systemic estrogen is often approached very cautiously, especially early after treatment. But here's where nuance matters. Some women may still be candidates for localized vaginal estrogen because it has minimal systemic absorption, but it targets tissues differently. And this matters because avoiding all hormones can lead to severe vaginal atrophy, pain, recurrent infections, and a poor quality of life. So for many women, this becomes a conversation about quality of life and not just about risk avoidance. So if you're someone who has had a cancer diagnosis or you're prone to having a cancer diagnosis, you definitely want to have your oncologist. And your menopause specialist in alignment. Get them talking, make sure that everyone's on the same page and that you're proceeding in the right and proper way based on your personal health. Now let's talk about an organization called the Menopause Society. This organization is solely dedicated entirely to this phase of life. They train clinicians specifically in menopause care. They provide evidence-based guidelines and they certify specialists because menopause is not just general medicine. It is a specialty. And if your provider isn't trained in this, they may not be equipped to guide you. So who should you work with when it comes to dealing with this phase of life? Well, let's be honest. Most general practitioners and family practice physicians are not trained in the depth required to manage hormones at this level. And even many OBGYNs are trained primarily in reproduction, not hormone optimization. And when I share my story with you a little bit later about that TMI conversation that I had with my friend Trisha, what's interesting about that is that I took that to my OBGYN probably about eight years ago. And I would consider her definitely a leader in her field. And yet she mentioned nothing to me about this being a hormonal driven issue. And what I later found out is that that's definitely what it is. And we'll get into that here in just a few minutes. But going back to the type of physician that you should be working with, who should you look for? Well, I recommend that you look for a functional medicine physician, an integrative medicine provider, a hormone specialist, and or providers that are certified by the Menopause Society. If your provider isn't having a nuanced conversation with you about hormones, it may not be the right provider for this phase of your life. So just keep that in mind. Okay, now let's revisit that very uncomfortable TMI conversation that I had with my friends, Trisha and Nikki and my sister Steph. I can't believe I'm about to share this with you in this podcast, but honestly, I feel it's important if we're going to be real about what's happening to us through perimenopause and menopause. And so here it goes. So for me, I started getting these almost like paper cut-like slits in the skin of my vagina in between my inner and outer labia. I know I told you too much information, but this is real because it wasn't only happening to me, it was happening to my friends too. And once we started talking about this, because I had thought for a long time that this had to be something hormonally related. But as I mentioned, I brought it up to my OBGYN like eight years ago, and she never said one word about it to me being potentially related to my hormones. And so what I want to share with you is that this is unfortunately one of the most under-discussed parts of this whole entire menopause conversation. And that is the conversation of how everything changes down there. We get more dryness, more burning, more itching, more pain, these micro tears or fissures in your labia and even urinary symptoms. So why the heck is this happening? Well, when we go through this phase of life, our tissue becomes thinner, our collagen decreases, our blood flow decreases, and lubrication decreases as well. The tissue becomes much more fragile and it's missed in conversations because a lot of women don't talk about it and providers don't ask. But here's what helps. And I found this out because I was talking to my other good friend about this exact situation which she was also experiencing. And for her, she started using topical estrogen and it immediately resolved the issue. And the reason is because the estrogen restores tissue, improves elasticity, and it improves blood flow. So the good news is that while I lived with this for eight years, this is not something that you have to live with forever. So if you're experiencing this, definitely talk to your physician about it. It's probably an estrogen-driven issue. Now let's talk about men and menopause. Men experience testosterone decline over time, as I mentioned earlier. And here's what you should be looking for if you're concerned about whether or not this is an issue for you as a man: fat gain, muscle loss, low energy, brain fog, mood changes, and low libido. And TRT can help energy, muscle, mood, and libido. And I know that there were concerns about testosterone replacement therapy being linked to increased risks for prostate cancer, but those concerns have been now largely debunked in healthy men. But if there is a history of cancer in your family or in yourself, this is definitely something that must be carefully monitored and managed. The key takeaway is that hormones matter for men too. So now let's talk about two things that often feel random, but really aren't when it comes to this change of life. The first one is anxiety. You have to understand that hormones affect your brain chemistry too. Estrogen impacts serotonin, progesterone impacts GABA. GABA is that neurotransmitter that helps calm the brain. It's what allows you to relax, feel grounded, and to sleep. So when progesterone declines, GABA activity decreases. And that's why you may feel more anxious, more wired, and less able to relax. This isn't just emotional, it's neurochemical. And it is normal. So when these fluctuate or decline, you can experience anxiety, panic, irritability, emotional sensitivity, even if you've never had anxiety before. And then there are leg cramps. Yep, you guessed it. This is also common during this stage of our lives. And it's largely driven by dropping estrogen levels, which can affect circulation, impairing blood flow to the legs. Lower estrogen levels can also reduce muscle mass, muscle strength, and affect collagen in our connective tissues, leading to aches and joint health. This transition can also cause magnesium deficiency, dehydration, and muscle tension, leading to cramps and spasms, which can lead to burning, tingling, or that heavy leg feeling. Unfortunately, these symptoms are all part of the systemic shift. So there you have it. This is the 411 on everything perimenopause and menopause. The good news is that your body didn't break. It just updated the operating system and didn't ask your permission to do it. You're not broken though, I promise. You're just evolving. And there are solutions to all of the things that you're feeling. You don't have to just live with what's happening. So as we wrap up for today, I hope this episode gives you clarity and helps you understand why things are happening and what may help you minimize or resolve what is going on. At a very minimum, I hope this episode helps you understand that you're not crazy. These changes in your body are real, whether you're a man or a woman, and they are not isolated only to you. That said, please remember that everything shared on Serenity and Fire is meant for general information and inspiration purposes only. The topics we discuss are not intended to diagnose, treat, or replace personalized medical care. So please always consult with your healthcare provider before trying anything we talk about on the show. Your health is unique and your care should be too. In closing, I just want to share that at Panacea Luxury Spa Boutique and here on Serenity and Fire, we're all about helping you feel your best. So if you have more questions, please message into the show and I'll do my best to get you the answers you're looking for. And if I miss something that you might be experiencing as it relates to the change, please share so I can share it with others because I can guarantee that whatever it is, someone else is experiencing it too. And I don't want anyone who's listening to this show to ever feel alone in what they're going through. Thank you so much for listening to Serenity and Fire. If today's episode inspired you, the best way to support the show is to follow, leave a review, or share it with someone who might need to hear this message. And as always, you can connect with me on Instagram, visit us at Panacea Luxury Spa Boutique, or explore more episodes where you listen to your podcasts. Until next time, keep balancing Serenity with Fire. I'm Krista Gwageni and I'll talk with you more in our next episode. At Panacea Luxury Spa Boutique, we don't just offer traditional spa treatments. We create rituals that relax your mind, restore your health, and rejuvenate your spirit. From biohacking technologies to advanced oncology trained care, everything we do is designed to help you heal on the deepest level with clean, holistic therapies, products, and amenities that are second to none. And right now, you can experience two of my favorites our whole body LED light bud or hyperbaric oxygen therapies. And as a thank you for listening, you'll get 10% off your first session when you use the code Serenity10 at Booking. What is your panacea? Let us help you find it because true wellness isn't a quick fix, it's a ritual.