The Perimenopause Revolution: Exercise Snacks, Blood Sugar Hacks, and HRT with Dr. Mariza Snyder

If you are approaching or are in midlife and have found yourself struggling with mysterious symptoms, wondering what is happening to your body, or questioning if you need HRT, this episode is for you. We are joined by Dr. Mariza Snyder, who is a powerhouse advocate for midlife women, leveraging over 17 years as a practitioner, author, and speaker. 

We dive into perimenopause, hormone replacement therapy (HRT), fitness, and nutrition tips to thrive through mid-life, and the practical, actionable strategies that have actually worked for real women—including Dr. Mariza. We discuss her new book, The Perimenopause Revolution, which is a playbook based on her experience navigating perimenopause and mid-life.

Resources mentioned in this episode can be found at

https://www.fuelwitherin.com/podcast/v/episode-12-navigating-perimenopause-and-hrt-with-dr-mariza-snyder

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Website | https://fuelwitherin.com

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Disclaimer: The information provided in this podcast and its show notes is for informational and educational purposes only. It is not intended as medical advice or as a substitute for the advice of a physician or other healthcare professional. Using this information does not create a doctor-patient relationship.

Do not use this information to diagnose or treat any health problem or to prescribe any medication or treatment. Always consult with a qualified healthcare professional before making changes to your diet, exercise routine, or medications, or before starting any herbal or nutritional supplements. Statements regarding dietary supplements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. The use of any information provided is solely at your own risk. This disclaimer also applies to any of the guests on the podcast.

Transcript

SPEAKER_01 0:00

That's been the struggle for so many that they're like, I can I used to slay all of this. I had the energy to do it. I probably said yes to obligations I didn't actually want to do, but I had the energy. So I'm like, no sweat off my back. Like I'll just get it done. And then you move into peri and all of the things begin to shift. And all of a sudden, although you know that you have kap capability, you're like six months ago, one year ago, six years ago. Like you know who you were, but then your bandwidth shifts. Again, that stress bandwidth, the energy bandwidth, the mental bandwidth. And that's why Perimenopause, it's really about discernment. It's really about discovering your non-negotiables, your full body yeses and your full body no's.

SPEAKER_00 0:45

Hello and welcome to Find Your Fuel, the podcast where we bring you stories from women who've overcome different physical, mental, and emotional struggles and found the fuel to live their best lives. I'm your host, Erin Martin. And if you are approaching midlife and have found yourself struggling with mysterious symptoms, wondering what is happening to your body, or questioning if you need HRT, then today's conversation is for you. We dive into perimenopause, what is truly happening with your hormones, and the practical, actionable strategies that have actually worked for real women, including our guest. So today we sit down with Dr. Maritza Snyder, who is a powerhouse advocate for midlife women, leveraging over 17 years as a practitioner, an author, and speaker. She is a fellow podcast host and just released her new book, The Perimenopause Revolution, which is a playbook based on her experience navigating perimenopause and midlife. I have read it cover to cover, and so I'm excited to bring you the Cliff Notes as your fuel for today.

SPEAKER_01 1:58

Yeah, I love this. You know, I got a front row seat to perimenopause when I was 30 years old. I had been in practice for two years, and 95% of my patients were in perimenopause and menopause. And they were coming to me with migraine pain and all types of issues in pain and really symptoms around their brain, whether it was cognitive issues or mood swings. And I still, you know, and it wasn't as though they didn't have other things going on, but they were siloed to their cardiologists, to their endocrinologists, and all this psychiatrist. And I knew that there was more to the story than us just siloing women all over the place. Like I knew it was their hormones, but I didn't quite fully understand perimenopause until my mom started to go into perimenopause. Actually, by the time I knew she was in it, she was in late peri. We're talking crime scene periods. You know, that's that is late perimenopause for most women. Usually in early perimenopause, we're still cycling pretty regularly. Yes, we can have heavy periods. Yes, it can be a little irregular, or maybe it's less days than it used to be. But we're not skipping periods more than 60 days, not until late peri. So by that time, she was really in the eye of the storm. She was struggling with mood swings and depression, anxiety, low energy, sleep issues. I mean, there was it was a cacophony of symptoms. And what I found was that she wasn't telling me this. I just knew that she was struggling. I could see it. Like my mom had always been bulletproof. And all of a sudden, I I watched that my bulletproof mama began to falter. And I was like, what is going on? And she remember, I remember her expressing to me, she's like, I feel like a shell of my former self. And yet, doctors' visits after doctor's visits, she just kept getting dismissed. And I was so deeply grateful. I actually dedicate the book to my mom because she gave me that, she was a she allowed me to see what perimenopause really was. And um, you know, when when you see it with somebody that you love, who you know what they have always had capability for, and you watch them, you know, become a shell of themselves, you're like, we have got to do better for women when it comes to this transition. And then I I was blindsided by perimenopause too. So it, you know, I just all in the family. Yes, it's it's all in the family. Like, oh, and I guess it's really a part of the narrative. I remember growing up when I was younger, and my mom would tell me, she's like, you know, the women in our family, we suffer. That's what we do. You know, once you get into, you know, womanhood, women suffer, we suffer. And I was like, oh, okay. Like, I just didn't know any better. You know, when you're like a teenager, you're just like, all right, well, I guess that's that's what we endure. Um, and you know, I, you know, when I was finally in perimenopause, um, I was like, man, maybe she's right. I'm just kidding.

SPEAKER_00 4:45

Yes. And perimenopause, for at least my generation, I feel like I'm in the my 40s. The big things that you heard about are menopause and perimenopause wasn't really a thing in talking about symptoms and what can happen with your body. And so I think I've heard of it called the three P's before of puberty, pregnancy, and perimenopause as the big influx points during a woman's life where you've got massive hormone changes happening. And so that opened my eyes to, oh, oh my gosh, if I would have known so many things about pregnancy and having a kid beforehand, you know, afterwards, I'm like, why didn't anyone tell us this? And I feel the same about perimenopause. It's one of those things where it's gonna hit us and be like, why didn't anyone tell us this? And so here you are, Dr. Mariza, to tell us. Yes.

SPEAKER_01 5:32

I mean, that's the reason why I wrote the book, is that I found myself, even though I, like I said, clinical practice for 17 years, I had seen it. I've taken care of women. It's one thing to take care of women going through it. It's another thing when it starts to happen to you. And I just felt like there wasn't a guiding roadmap or a kind of a full blueprint on how, one, what is happening with our body? Are you are you in perimenopause? Because I think a lot of us can doubt ourselves when we start perimenopause. We're like, oh, it's this or it's that, it's our thyroid, it's all these things. And I'm like, two things can be true. It can be your thyroid and it can also be perimenopause at the same time. So I wanted women to say, I that's the number one question I get the most is am I, is this perimenopause? So the book does that. And then I also want, you know, so often we kind of we're told to dismiss, like, oh, it's, oh, it's perimenopause, you know, you're gonna go through chaos and then it's gonna be fine. I'm like, but is it? Like, what if these symptoms and signs are indicating future health outcomes? So I thought it was really important that women understood what was going on with their bodies instead of being dismissed and told, oh, well, that's that's just the way it is. Like we're so done with that, that explanation. Like we deserve better than that. And that's really what the book is designed to deliver.

SPEAKER_00 6:49

Yes. And for people who are listening and can't see the book that I'm holding up right now, this is literally the playbook that Dr. Miraza's talking about, the perimenopause revolution. I have read it front to back. And I love all of the tips that you have in it, which I'm gonna pick your brain on. But I think to start, just identifying, like you said, of when you are in perimenopause can be so hard because I think you said there's about 40 different symptoms, and it all collides with the time in your life when you're busy with kids' activities, you're busy at work, there's just so much going on that you can easily miss many symptoms and brush them off as, oh, I'm just busy, or oh, I'm just tired because I'm doing a lot and all of that. So I'm curious for you, what symptoms did you see that triggered you to say, I'm in perimenopause?

SPEAKER_01 7:38

It was really one. It was two symptoms. Um, the first symptom was around day 22. So the start of my late luteal phase, that second week, the week before your period, as I call that late luteal, um, I would wake up with this insurmountable amount of dread. Like I like life was just too much. And I was like, it was fine, literally yesterday. Like nothing about my life changed. My brain changed, but nothing about my life had changed. And then also I was feeling this deep sense of rage. Like I would have these moments of rage. Now, mind you, luckily that rage didn't land on my family. But I I remember thinking, I'm like, I don't, I don't, one, I don't feel like myself. And number two, this isn't who I am. I remember really grappling and when I'm I'm always a proponent of women tracking their mental cycle along with their symptoms because perimenopause is elusive. It is a moving target to the point where women could, you know, be sleeping well in the follicular phase and then it kind of tanks in the luteal phase. But then that could happen for three months and then sleep gets better. And then, you know, month six, it's worse again. And so it can really be up in the air. And so perimenopause is a clinical diagnosis of symptoms. The three criteria is one, your menstrual cycle, symptoms along your menstrual cycle, and then your age. Usually those three things will help us identify if you're in perimenopause or not. But for 80 plus percent of the women who have come to me in my practice, it's always the cognitive changes and the mental health changes. So the rage, the irritability, the mood swings, the depression, anxiety, um, even kind of PTSD type symptoms, panic attacks, but then low mental energy, a lack of focus and alertness, um, not being able to handle the hundred tabs that you use to effortlessly handle, your executive functioning feeling like it's going offline. These are the things that women would come in with me because they ultimately it lended to them not being able to show up for their family or do the job that they were meant to do or be as productive as they expect them to be themselves to be. I feel like we are the with the worst critics. Like we have this high bar of productivity and expectations. I mean, have you seen an average woman's to-do list? It's impossible. It's an impossible list. But then you hit perimenopause, and it's it's it's so frustrating to not even get through half of that list when you used to get through three-fourths of that list. And so that's when women come to me and tell me, like, something isn't right. Like I can't function the way that I used to.

SPEAKER_00 10:06

Yeah. And so what was going on in your body then to reflect, you know, the symptoms you were feeling, what's actually changing in your body at that point when you started to feel those symptoms?

SPEAKER_01 10:17

Yeah, when we take a look at the physiological level, when we talked about the three P's, right? Puberty, pregnancy, and perimenopause, we know that we are entering a neuroendocrine transition. So the brain, like if you've ever had, if you've ever been in a house remodel, you know, you probably have to move out. You got to pay a lot of attention, like everything is just everywhere. And if you're not really intentional or paying a lot of attention to what's going on in that remodel, it just can be like chaos unfolding. And so you can imagine your brain is very similar to a big house remodel in the sense that it's losing erratic hormones. Like one day, progesterone can be at a decent level. The next day it's tanking. So hormones are erratically declining. And as a result, our thermoregulation center is impacted. Our neurotransmitters are impacted. Um, for many of us, sleep is impacted, our stress response system, we have low stress tolerance. Um, and our word recall or the re, you know, knowing why we walked in a room, all of a sudden, all of that. And so it really is the fact that it's not just that hormones are declining, they're declining erratically. So it's not a linear progression. I think it would be a much smoother ride if hormones were just kind of steadily moving down over the the course of four to ten years, but that's just not how it is. And that that I would say kind of haphazard binding to receptor sites leads to a decrease in energy metabolism, leads to a decline in neurogenesis, the way that we we build neurons and make neurons, and also inflammation in the brain as well. That tends to go up. And so as a result, these symptoms ensue.

SPEAKER_00 11:57

Yeah, and one thing that you said in the book, which I love too, was you do not need a lab test because every woman will go through perimenopause. So it's not a matter of if, it's when. When.

SPEAKER_01 12:10

Unless, yeah, unless you go into premature menopause. Due to um Then you'd skip it. Yeah, you would, so yeah. So I have I I was actually interviewing a friend yesterday who went into menopause at 38 years old. And do how we define early menopause is between 40 and 45, and then premature is before the age of 40. So that could be because you had cancer treatment, chemotherapy, and radiation, or you had an ophrectomy where your ovaries were removed, or a complete hysterectomy, or primary ovarian insufficiency where the ovaries are just not cranking eggs anymore. So you there that's really the only way you bypass perimenopause is that you go into menopause much earlier than perimenopause.

SPEAKER_00 12:50

Makes sense. So then talking about what we can do about it and aid ourselves through the process, where did you start?

SPEAKER_01 12:58

Yes, I would say I started with one understanding what was going on. Like once I feel like once I identified it with peri, I was like, okay, I got this.

SPEAKER_00 13:08

I'm not crazy. I'm not crazy.

SPEAKER_01 13:11

Um, then it was more so building in one, tracking my cycle, so kind of understanding what was going on. I had been doing that, but that became so important in my journey. So that I was like, okay, around this time things kind of went to the wayside. Like I felt like everything got a little chaotic for me. Um, it was building a lot of self-care, regulating my nervous system with breath and gratitude practice, a lot of, I'll be honest with you, solo time. So I had my son at 41. So I'm I have a preschooler. He's in TK. That's where I'm at. And I'll never forget I was we did a little camping trip with his school with a bunch of other preschool parents and moms. And I remember sitting at the fireside with them, and I was like, they were all talking about walks and what we can do to help our blood sugar. I was kind of talking about this. But then I brought up solo walks. I was like, who is solo walking over here? Because mama needs a break. And they actually, they none of them were. I think that they were just like, we you don't do that. You just spend all the time with your kids when you're when you're with your kids. And I'm a solo walker.

SPEAKER_00 14:11

Oh my gosh.

SPEAKER_01 14:12

I was like, can I sell this vision for all of you? Because this is where it's out. We're all burned out. We're all at capacity, you know, and um life isn't, life isn't stopping. And so I was like, like, even five minutes of a solo walk, 10 minutes, gosh, luxuriate on a 20-minute walk, um, listening to a good book or listening to a great podcast like this one, like regulating the nervous system, I think is one of the greatest gifts that we can give ourselves. And and we do that by sending safety signals to our brain. And it can be through a lot of different things, sending voice memos to a bestie, walking with a good book that you're listening to. I'm a big romantic fantasy um reader and listener. And right now, I can't wait for brimstone to come out next Tuesday. And so I'm so excited for that. So, like, what are the things that bring you joy that you are doing for you? Maybe it's going and getting your favorite tea and matcha down the street by yourself. Or maybe it's listening to something when you're dropping your kids off that that you really love and you drink your sexy matcha or your coffee or whatever that may be. So punctuating your day with as much, you know, safety signals to the brain and self-care, I think can make a huge difference for women in periomenopause.

SPEAKER_00 15:25

Yeah, and it's really hard to try to prioritize. I think we all know we need to prioritize self-care, but it can be really hard to do that and carve that time out. But I think the key thing that you're hitting on is that stress resilience and how it goes down through this period where we need to invest in having that healthy mental state, that space for ourselves and providing to, like you said, tell our bodies that we are in a safe place so that we can handle everything and not freak out on our families, you know, have anxiety attacks ourselves. Like all these things just can't, you can't handle it as well, is what it sounds like. And I know for me, just even going in, I'm probably, you know, very ripe for perimenopause right now in midlife. I feel like my stress resilience is going down. What I could handle a hundred million tabs being open at once and slaying work, slaying kids, slaying dinner, all the things after that, like not a problem at all. And now it is a problem. It's not as easy to handle anymore.

SPEAKER_01 16:24

No, and and that's I think that's the struggle. That's been the struggle for so many of my patients is that they're like, just like you said, I can I used to slay all of this. I had the energy to do it. I probably signed up for things that I probably shouldn't have said yes to. I probably said yes to obligations I didn't actually want to do, but I had the energy. So I'm like, you know what? Well, no sweat off my back. Like, I'll just get it done because I can, because I get it done. And then you move into Perry and all of the things begin to shift. And all of a sudden, although you know that you have capability, like you're like, I used to do this like six months ago, one year ago, six years ago. Like you know who you were, but then your bandwidth shifts. You again, that stress bandwidth, the energy bandwidth, the mental bandwidth. And that's why perimenopause, it's really about discernment. It's really about discovering your non-negotiables, your full body yeses and your full body no's, your boundaries. And I think this is a beautiful opportunity and initiation and a portal to discover what you love. And one of the ways that I tell women to do this is when something comes to you. It's, you know, and I get that some things can't move. You, you know, you gotta go, you gotta pick up your kids, you gotta do, you know, you gotta do all these things. Like there's some things that you can't move, but there's probably things that you're taking on that you always used to take on because it's just who you were and it's what you were told to do. It's what your beliefs believe, you know, it's how you were brought up. But now you're getting to this point where you're like, actually, I hate doing that. I don't want, I don't want to carry this for that other person anymore. Like you get to be discerning. And and so what I recommend, let's say a a request comes in of you from a friend or a family member or a work thing that you don't necessarily have to say yes, even if it's an opportunity, like it's it's like, you know, it's presented to you in a really awesome way. If you feel any level of contraction, like something you're like, ugh, ugh, like you just you're like, I don't, uh, that is that is your body, that is your intuition telling you that that is a full body no. Like, and if it's expansion, like you're like excited and you're like, yes, I want to do that. Like that's in alignment with my values and and what I will what I want to be doing for myself, then then say yes. But I think again, that discernment, and I if we've never discovered that for ourselves in our 20s and our 30s, man, we are often forced to discover that for ourselves in our 40s. And I don't think that that's a bad thing.

SPEAKER_00 18:46

Yes. I've heard that also be called kind of the midlife reckoning where we're finally comfortable in our own skin. I like what you said about the full body no. I also, I personally call it the unfiltered Aaron, where I just say, unfiltered Aaron says, hell no. I love that. That's my answer on that one. And then you just don't care as much and you're gonna live into it. So it's almost this gift for us to be able to get out of the rat race, reset because we're forced to, the life we want to live and what is filled within it, which hopefully is still friends and connections, but balance with personal time and family and everything that you love. And so I know for me personally, there is that balance of I crave alone time, like you're talking about, and I also need to invest in relationships because there's such a healthy piece of keeping me sane as well. And so there is that balance where I've seen myself over-index on I'm the I'm the friend that goes to bed early all the time. But it is a balance, and it is a balance, yes, and I've also seen this. Is probably why all the smart women in their 50s are not drinking. There's like this big wave of not drinking happening for everybody, but I think I've seen more ladies in their 50s just completely give it up. And it's probably because they're finally like, no, I don't want to feel inflamed, intoxicated, or foggy and bogged down. I don't want to live that way. And I'm just gonna completely eliminate it. And who cares about the social pressures or norms of drinking? Exactly.

SPEAKER_01 20:25

And I will say that, you know, a lot of women who got away with drinking, no problem, in their 20s, 30s, they get into their 40s and 50s, and it just isn't, it isn't doing, it doesn't have the same benefits without like some big cost on the back end. And so you get to, again, whether it's habits or it's relationships or it's obligations, everything gets to be up for review. And if alcohol is one of those things where you're just like, I don't know, like it doesn't feel like it's serving me the next day. Like I just, I'm not fully hung over, but I'm just not at my peak, you know, like the way that I want to be functioning. And I we get to decide. And here's the thing, I've, you know, and as an example, I I stopped drinking years ago. And I still, although I will say most of my friends don't drink either. So there's that. And that's really nice. Um I'm not the only one not drinking, but I can I can make a sparkling mocktail or I can I can order a sparkling water with lime in a really sexy glass at the restaurant and it all just kind of looked the same, you know. So I mean, there's a lot of ways to make it work, and especially, you know, if people are giving you a hard time about drinking and you're thinking to yourself, like, I just need, I need a break. Yeah, I think you can really, you know, you can get people to understand what you're going through and just say, hey, alcohol has been making me feel awful. It's driving migraines and headaches. Like, I just feel like crap on the back end. Like, I'm just gonna give it a break. And it's rare that you're gonna have a friend or a family member who's gonna give you a hard time because you're giving up something due to a health issue or due to symptoms. So I think there's, you know, we it's and and if friends and family are not meeting you with compassion, again, this is a time of discernment.

SPEAKER_00 21:59

Yes. Yeah, I love that. And so what other tactics in your toolkit did you pull out? We talked a little bit about the mental side. What else did you do on the fitness? And I know you have a lot of nutrition tips as well. What else did you dive into?

SPEAKER_01 22:14

The other big thing that I doubled down on was more movement. You know, the research is so clear when it comes to mitigating some of the brain-related symptoms that we talked about already, that movement is one of the best ways to lift depression and anxiety, to reduce that low stress tolerance, to have a brain that's firing on all cylinders, and to even get deeper restful sleep. For me, regulating my nervous system and many of my patients have just felt like they are at capacity, they are overstressed, and adding a walk in throughout their day, whether it's after lunch or after dinner, not only is it helping with blood sugar, but it's helping to just calm their mind. And some of I recommend at least once a week to do it without your phone or without listening to something. Just be in nature, just walk down the street. Um, and it can just start with one, you know, one walk a day. That I find that movement is a game changer. And then you can move from there, you know, whether, and if you can't get outside because it's snowing or whatever, walk up and down your stairs or, you know, you can get a walking pad. There's a lot of ways that we can build in movement in our days to help us feel a lot just more, more energized and to feel more like ourselves again. The next thing that I did was I really did double down on community. I wanted women that I knew were going through this with me. You know, I can't tell you how many times a friend, I'm on a voice memo and they're just like, my brain, my brain's done. And I was just like, girl, I every time, I mean, like I like I had four friends the other day who literally they were all memoing me at night and they're just like, I'm fried. I'm so sorry. Because there's, you know, the word recall isn't happening. I can tell that they're done. And it's just so sweet that we're we're helping each other out, we're supporting each other, we're responding to each other's memos, and yet our brain isn't even like at the party anymore. Like it took off, you know, packed its bags and walked out the door. But I'm just like, I get it. Like I totally understand what it feels like when your brain just left the party. And so it's nice to have people that are going through it with you and that can hold space for what you're going through because each and every one of our journeys are going to be unique based on where our kids are in their life, based on what's going on with our parents, our family, siblings, friends, you know, and and it's always nice when people know what you're going through and they understand you and they can be a safe place to land. So that was another thing that was really big for me. And then the other thing that was really, really big for me, now just be straight up about it, is hormone replacement therapy. Like HRT was a game changer for me, particularly the brain-related symptoms. Like I didn't take HRT for physical symptoms, I took HRT for my brain.

SPEAKER_00 24:50

Interesting. So you're gonna have to break all of that down too, because that's something I've been researching a ton on. When to introduce it, when's the right time, which it sounds like before menopause for sure. So perimenopause is probably the right time. And then how do you indicate or how did you find out what specifically that you needed for your brain, for your body? How'd you go about it?

SPEAKER_01 25:11

Yeah, that's a great question. You know, initially I started with oral micronized progesterone because again, it was the rage, it was the low stress tolerance, you know, and I knew, you know, I ran labs, you know, the third time around, finally it looked like my progesterone levels had been dropping. And and again, that's, you know, the one thing, you know, women are like is they're a lab test. And we talked about this that there isn't, unfortunately. But I think it's always a good idea to be looking at hormones anyway. I think it's you know, having a baseline of your labs and your hormones can really tell you a lot, especially as you move through perimenopause and menopause. But I knew I knew the symptoms were indicating a little bit of progesterone support. I mean, I use progesterone to get pregnant, and I probably just never fully recovered from postpartum either. You know, I just kind of got drop kicked from postpartum and breastfeeding into perimenopause. I don't know if my hormones ever really fully recovered. Um, and most women who are having children in their 40s kind of feel the same way. So progesterone was the first hormone, and and I I cycle it every 14 days. So I cycle it after ovulation. I'm not always ovulating, but you know, I know when that that window is, and then I take it for the 14 days between ovulation and when my cycle starts, when you start your period. And that was was a game changer. Like I, my the rage under control. I'm not promising that all of your irritability is gonna be under control, but you know, some of the big swings, those you can the progesterone can support for the majority of women. You know, some women have progesterone sensitivity or they're struggling with um PMDD, premenstrual dysphoric disorder. And so, you know, there's other tools in the toolbox for that. But majority of my patients who are on progesterone, they see some really great benefits in reducing anxiety, low stress tolerance, ill irritability, and also sleep and just that wired and tired feeling before bed. So I love it. I usually recommend it about an hour before bed. But then it wasn't addressing everything, you know, and that was the re I mean, I was on it for I think six months only progesterone, but my brain was still struggling. And I was really struggling with the cognitive changes as well, you know, and there was other extenuating circumstances that were driving some of that inflammation in my brain. But then I just like, you know what? It's time for I, you know, you get to that point where you're like, I'm not willing to suffer needlessly. Like I'm suffering, and as a result, like it's impacting my life. I think that's really important to point out when you're talking to your doctor and you're advocating for yourself, is to not only point out the big symptoms, like the ones that are really rocking your world, but to also connect them to how it's impacting your life. It's impacting my ability to perform at work, to do the presentations. It's impacting my ability to be a compassionate mom to my kids. Like show them, and they have to listen at that point when you really connect the dots between how it's impacting your quality of life. So I knew that estrogen was probably or a decline in estrogen or erratic estrogen was having an impact in my ability to show up, not only in work, but also in my family life and just executive functioning. So I brought on um an estrogen patch, and that has significantly allowed me to have these conversations, to write books and do all that. And so, um, so I'm both on progesterone and estrogen at this point.

SPEAKER_00 28:24

And then estrogen, so is the patch continuous and then the progesterone you just cycle with what your body would naturally be producing during that your normal cycle?

SPEAKER_01 28:34

Yes, exactly. So I just changed my patch this morning. I change it twice a week, but it's continuous. And that's because estrogen is continuous.

SPEAKER_00 28:42

Yes, does that mean that makes sense? And so for you, did you know just being a doctor and seeing the symptoms that estrogen could support regardless of where your labs landed with estrogen? Or was there a specific specific level of estrogen that you saw and you're like, oh, that that squares with why I'm feeling this way then? Let's introduce estrogen. Like, how do you interpret and figure out to add that piece in?

SPEAKER_01 29:07

Such a great question. I love this because it's that nuance, right? Yes. Your typical primary doctor, if they're even prescribing hormone replacement therapy or your OB guyne um is not gonna run labs most of the time. They're gonna base medication on symptoms. And so it for me, it was symptoms. Every time I ran my estrogen panel or my hormone panel, it looked okay. Looked, you know, it was definitely within range. And um, but yet, and I think that was the reason why I kept telling myself I didn't need it. Because I was like, oh, but it's in range. Oh, but it's in range. I'm like, yeah, but you feel like crap. So at some point, I think you just get to a place where you're like, I'm I have felt like crap long enough. I'm over it. And I can start HRT. And if it isn't doing what I need it to do, I can always come off of HRT. I mean, you want to be working, obviously, you're working with a clinician, you're working with a provider very intimately with your hormone replacement journey. But I always tell women, I'm like, especially in perimenopause, you know, if if symptoms are stacking up and you're debating whether to try HRT or not, you work with your provider. And I always tell women, when you know is when symptoms are messing with your quality of life. It's worth giving them a try and seeing what happens. And note that probably the first time you start hormone replacement therapy, especially estrogen therapy, you're gonna have to play with your dosage. You know, it's it's not, it's it's not a one size fits all for any of us. And so, and usually with pri for usually with providers, they're gonna start with the lowest dose and move up from there. And they'll usually have you kind of feel it out for 90 days. But if you are 60 days in and you're just like, this is not cutting it, like it's not enough, it's it's microdosing estrogen, like I just need a little bit of a bump, they're most likely willing to go up again. So usually we start at like 0.025 um, and that's like the lowest dose we can go. Um, but you know, for some women, it's just not, it's not gonna do enough. Um so you can ask, you know, 60 days in, if it's not feeling like it's a light bulb moment for you, um, then I would consider, you know, asking to tailor that dosage.

SPEAKER_00 31:12

I've heard about that with testosterone as well. That often, you know, you'll start at a low dosage, and then the wild thing about testosterone is the the normal ranges are not optimal ranges. So then trying to, you know, self-advocate for an optimal range versus what someone would read and be like, oh, you're you're fine, you know, your labs are within range. It's like, well, that's based off of a sick population, not an optimal range or what my body needs.

SPEAKER_01 31:38

So Yeah, I mean, it's I it's really unfair how much we have to advocate for ourselves. I I want to share a quick study that just came out by the Mayo Clinic. We're looking at 5,000 women in perimenopause and menopause. I don't think that they were really specific. It was between like 46 and early 50s. Um, and let me just really quickly, I I have it right here. Um gosh, it was right here. It's as well as basically the the research showed that most women um were suffering from 87 women were between the ages of 46 and like 52 years old, um, suffered was suffering with a lot of symptoms, sleep issues, vaginal dryness, low libido, um, it was affecting their work, their their mental energy was affected. So a lot of different symptoms were happening. Of those, the 80, the eight of those women, those 5,000 women, 87% of women did not seek out care. And there were three major reasons for that. One, they felt like they were just too busy with all the obligations and the things that they needed to do for their families. They just, they didn't have time. Number two, they didn't know that those symptoms, a lot of the symptoms that they were dealing with, were menopausal or perimenopausal symptoms. So they didn't think they could seek out care for them. So there was a big knowledge gap and doctors weren't asking because there was a knowledge gap there too. And then number three, and probably the one that kind of hits the hardest, was that women feel judged in their doctor's office. They're meant to, they're meant, they're blamed for their symptoms and they're ashamed of what they're experiencing and they don't want to bring it up to their doctor. And so as a result, although, you know, we have solutions available, women aren't seeking them out for those reasons.

SPEAKER_00 33:24

Oh, yes. And especially the anxiety, the rage, you know, all of those type of emotions you would feel a little more ashamed about, but shouldn't when really it's just this symptom of what your body's going through. But those specifically are hard to describe to someone. And I don't wish anxiety or rage or any of those on anyone. I've had some anxiety attacks in my life, and they are not fun in the least. And so to go through that in a consistent state, I literally can't even imagine. It would for sure affect the ability to live your life in any way, just completely debilitating. So that self-advocacy piece, it takes bravery, a little bit of knowledge. You know, there's a lot that goes into it to be able to stand up for yourself. And then once, you know, a provider that you trust says, Oh, but your labs look normal, you just have to keep pushing, unfortunately, and just say, No, like I'm not okay. Exactly.

SPEAKER_01 34:23

Yeah, know that you know you're not okay and and trust your intuition. And you know, I shared with you, even with all everything that I know and all the patients I've taken care of. Like I it I waited almost eight months before I decided to get on estrogen. And it was, I just got to a point where I was like, I just can't suffer anymore. Like I I have and it's I'm willing to give this a try. And if it doesn't work, it doesn't work. Like I will, I'll I have other tools in the toolbox. Um, but again, if you are suffering needlessly, you don't deserve that. No woman deserves that. And I think it's really important for women to know that they are not broken, that they are going through a profound hormone shift. These whole body hormones are impacting every organ system of the body, most importantly, their brain and their mental health. You know, it breaks my heart how often, you know, perimenopause and menopause are misdiagnosed for more just a mental health issue when it's really their hormones that are declining. And that I get that at times it's so destabilizing, but also because you are in this profound transition, your body is calling for a new, like a massive level of support and you deserve it. I believe that women deserve the best of everything, not the least of things. And I think about those stats: 87% of these women were not seeking care because they were taking on the least of things, because they were giving everyone else the best of things. And we deserve all of it. And and if we need to come from the standpoint of if you are optimized, if you are thriving, everybody around you benefits from that. So if we got to come from that standpoint of like, hey, you gotta take care of you so that you take care of everybody else, then let's do that. Um, but I want you to be taking care of you because you deserve to be taken care of.

SPEAKER_00 36:07

Yes, uh, 100%. And so fast forward, I'm curious if we make it through perimenopause, we get some support we need, what happens with the aftermenopause period? Like what happens with our bodies? Are we just, you know, supported by HRT? Does our body normalize? Are we living with these symptoms and just trying to manage it? What does that future look like?

SPEAKER_01 36:30

And this is a really great question. And it's gonna be different for every single woman. I'm gonna give an answer, but I just want to make it clear. I'm gonna do my best. Um, one of the myths that I'm I'm really trying to dispel in these conversations is that we talk about perimenopause as being the zone of chaos. This time of like all these nuisance symptoms, and they're just gonna flesh themselves out. They're gonna, they're gonna level out in menopause. And and some of that is actually is very true. But the some of the silent shifts I think should really be on our radar. The muscle loss, the bone loss, especially the accelerated bone loss in late perimenopause leading into menopause, the again, the neuroinflammation, the cardiometabolic changes. I see lipid levels go up in an unfavorable direction, I see blood sugar go up in an unfavorable direction. I see creeping blood blood pressure that happens in um perimenopause into menopause. And so, although some of these symptoms can like level out, the biggest, what I call the silent shifts that drive the biggest level of chronic conditions, they will still continue to move through menopause, right? They become more pervasive and they become more presented. They present more like in our 50s and 60s and beyond. And so I want us to be thinking about perimenopause and menopause more from the the term, more from the standpoint of longevity. How are we protecting your health span? How are we protecting your future health outcomes? That's how we need to be thinking about perimenopause and menopause. And that window of opportunity really is during the time when our hormones are erratically declining. We're now seeing that when we start HRT within a window of 10 years of menopause, especially on the sooner side, the earlier side, not the later side, that we are actually we're reducing the risk of cardiometabolic disease. We're reducing osteoporosis and neuro neurodegeneration. And so I it's important that we're looking at all the tools in the toolbox, but we're looking at everything from the standpoint of like how do we ensure that we are future-proofing your health, not just mitigating symptoms? That's how we look at perimenopause and menopause and beyond.

SPEAKER_00 38:41

Mm-hmm. That makes sense. And so, for you, for example, being on HRT, will you continue that and continue that dosage now that it's dialed in? Or do you, does it increase over time? What does that look like?

SPEAKER_01 38:55

I love that question too. I think it's so good. So, yeah, in perimenopause, I think that one of the reasons why we were hesitant to give women hormone replacement therapy in peri is that it is a moving target. Like it's so complicated. She's so complicated, which is not a good, that's not a good enough reason. Um, and how, but it is true that your perimenopause experience and symptoms at 41 are gonna be different at 44, at 48, you know, at 51, they're gonna constantly change. And so, particularly in PERI, your hormone protocols, your HRT protocols will shift over time. And yes, most likely they will, they will, you know, progesterone, are we are we gonna see a major increase in progesterone? Probably not. You know, standard dosage for oral micronized progesterone, um, aka prometrium is usually 100 to 200 milligrams. You know, some functional doctors will go up to three and four hundred milligrams, but your standard doctor is gonna keep it around one or two. And for most women, that works really, really well. And that's probably gonna stay the same for decades, you know, depending on the person. Estrogen, there's gonna be a lot of finesse. There's gonna be some finesse with estrogen, and most likely it's gonna, it's gonna continue up. And at the end of the day, what it's really about is not only mitigating your symptoms, but also protecting your bone, your brain, and your heart. So we need to be thinking from that lens of longevity and health span, not just getting rid of hot flashes and night sweats. HRT does so much more than mitigate hot sweat night sweats and hot flashes. Um, and then with testosterone, again, it depends on the woman. It's always important to be testing these hormones, especially once you're on, ideally. Um, but more importantly, testosterone. And doctors really can't prescribe testosterone without testing. So you're gonna see, you're gonna have testing for testosterone. But for some women, testosterone levels are okay in their 50s. For some women, testosterone is subpar in their 30s. So you really do have to test, not guess, when it comes to testosterone therapy.

SPEAKER_00 40:50

Yeah. For testosterone specifically, what range do you like to be within for yourself? Because I've heard so many different ranges of what's optimal and a good range for women. I've heard like 10 to 100. And then sometimes I've heard 150. I'm like, what is it? I don't know. It's everywhere.

SPEAKER_01 41:08

I mean, I would say yes, I would normal range is like 15 to 50, give 55, give or take. And so ideally, I like optimal range between like 25 and 50. That's an optimal range for me. And every woman's a little bit different, and so some women, you know, thrive a little bit better, a little bit over 50. Um, but what I'm seeing a lot of that I find can be very dangerous is that we are overdosing women with testosterone and we're saying that it's okay, and it's not necessarily okay. And so um, you know, we're we are not small men, we really have to dial this in for women, and and especially with testosterone, it's very much a Goldilocks approach.

SPEAKER_00 41:47

Yeah. And is that because FDA has only approved testosterone for men, which is usually a higher dose, and we're trying to dose down something that's made for men and missing some of the dosage correctly.

SPEAKER_01 42:00

Yeah, it is it is so messy. Uh it is so messy. It that you know how we're, you know, we're like we're at it, we're at a point right now with testosterone where we're giving, you know, we get those little tubes of testosterone gel and that men are supposed to use in one day, and we're like, now take a tenth of this per day. So they're like, it's like, how do you figure this out? It's so ridiculous. And I don't know how long it's gonna be until we finally have an FDA-approved testosterone on the market. It's gonna be a while, I have a feeling. Although with the FDA rolling back the black box warning on vaginal estrogen and changing guidelines for other hormone therapy, particularly estrogen therapy, I, you know, I'm I'm much more hopeful. Um, but yeah, right now it can be very complicated. And with testosterone, we've got pellets, we've got injections, we've got trochies, we've got creams and gels. And, you know, if I had to choose a method of delivery, I would, I would lend towards the cream and gels because you can finesse it more. You know, it I find again, there is we're in this place where we're overdoing it, where clinicians are getting like a weekend course and then they're just starting to inject women with pellets. And I, you know, that I find that the especially if you're starting that journey of testosterone therapy, that can be very dangerous because once those pellets are in, we can't do anything about it, especially if we overdose a woman.

SPEAKER_00 43:15

Yeah, yeah. Oh, so much good stuff. I've been wanting to pick your brain on HRT specifically since I read the book. And I know a lot of other things that you give really good tips on is the movement piece, which I love because I think especially when we think of exercise and movement, we think it has to be going hard in the gym five days a week when really it's about movement, like you said, a walk, stretching, being active with your kids, getting outside. It doesn't have to be these five times a week orange theory classes necessarily. So we need to redefine what movement and exercise means in our life, which I've tried to pick up some more heavy weights, but even then, I think I do, you know, a half an hour, two. To three times a week, which is totally doable, or pair a 15-minute walk with 15 minutes of arms. There's ways to go about it where it's not overwhelming and you can get into it and just start moving your body.

SPEAKER_01 44:13

You make such a great point. That is such a great point. And yes, two to three times a week, 30 minutes a session, that's amazing. I just want to celebrate you. Like, and then punctuating movement throughout your day, like that's that's where it's at. Like, I I'm a big fan of women. We deserve wins. Women deserve wins. And if a win is just walking after a meal or squats after a meal, or just building in, you know, one strength training session every week, like that is a big win. And then from there we can build up. Like I do recommend two to three times a week in the gym, or you it can be in how a house gym, or it could just be weights in your living room. Like it doesn't have to be anything fancy. I have weights everywhere. Like I just because I have to be, you know, I don't need the house to be pretty. I I need to be functional, you know, in terms of my my lifting. So I lift in the living room, I lift in the bedroom, I I have weights in the office in here. We have another, another setup in the garage. And so, yeah, just weights are all over the place in my house. And that's that is totally okay for me. Um, and again, it doesn't have to be a long time, it just needs to be quality. Um, but the more physically active that we can be, that is probably if I could bottle up exercise and and you know, and give it to every single person in terms of mitigating symptoms, but also building to a stronger future, that that would be the thing that I would hand over because it would be that and in HRT.

SPEAKER_00 45:38

Yeah. I I am, yeah, in want to enroll in both. And one thing that you share in your book, which I love too, especially because I work remotely. So I'm at home, I'll pop out for walks when I can. But other than that, I am in front of a screen in back-to-back meetings, and one thing that you talk about is exercise snacks, which I'm sure some of our audience have heard about, but I'd love to hear what you do in terms of exercise snacks throughout the day.

SPEAKER_01 46:03

Yeah, so it's not snacks after exercise. In case you were wondering, basically you're snacking on exercise. So it's it's mini bursts of movement, but it's mini bursts of hit movement because I'm like, if I'm gonna move, I'm very much like where the juice needs to be worth the squeeze. So it's one to five minutes where you are raising your heart rate. And so some examples of exercise snacks are um jump squats, um, jumping jacks, mountain climbers, push-ups, going up and down your stairs with weights, like even it's a five five-pound weights or 10-pound weights, maybe three to five times. It's burpees. If you really want to do burpees, it's jumping rope, it's rebounding on a rebounder, it's whatever is gonna rev that heart rate, bur burn that metabolism, but also help you to burn fat. One of the things I've seen in my patients is when they implement even two exercise snacks a day for two minutes. So two minutes twice a day, four minutes total. Usually they're doing, you know, mountain climbers or jack squats or something like that. Um, they are sleeping better, they have more physical energy, more mental energy, and they just feel like they have more bandwidth. Also, they lose weight and their blood sugar stabilizes, becomes more optimal. So it's just, again, even two two-minute exercise snacks a day between meetings or after dinner can change the game in your metabolic health, but also your mental health and cognitive health.

SPEAKER_00 47:28

Everybody has five minutes. And one thing that I've started to do, which makes it fun, is do it with my kids or at least in front of them. And so then, you know, I'm not worried about, oh, I need to like go off and be by myself to do, you know, my minute of burpees in the garage without the family around. No, I'll try to get my kids to do it with me, who can do the most burpees in a minute and get them involved. And then they're also just seeing me move my body and seeing what that means and trying to see how many push-ups they can do and are proud when they can do a pull-up. And it's just a really good thing, I think, to bottle for kids as well. So I always try to think about what I can do with kids around, where before I was always, oh my gosh, I have to escape for my kids so I can exercise and which I love that too. I love a moment alone to have a good yoga session, go on a run that's kid-free. But those little exercise snacks are perfect times to be able to incorporate stuff with kids.

SPEAKER_01 48:26

Yeah, I 100%. My son and I love to do mountain climbers and his jumping jacks are so hilarious. You know, at a four-year-olds, they're kind of like it's all over the place. It's like an octopus. Um, but jump squats, we do a lot of jump squats together. And then the other thing we've been doing, especially if you're listening and you're a mom to young kids, after dinner, we do freeze dance. We so we, yeah, we'll put on music and we will dance. And usually my my my husband will will freeze it. And I'll tell you what, like it, you're burning calories, you're having fun with your kids, you're listening to fun music, and it's just it's giggly and it's fun. And usually we just freeze we freeze dance for maybe five minutes. Five minutes. And I'll tell you what, it sure beats having to do like 60 squats. Yeah. So let's say you can't leave the house. Like as much as a walk with my family is just lovely, it's just not always happening. My son wants to build Legos in the living room, like, and he wants me to be there with him, which I get it. And so instead, we do a dance party. And but freeze dance, we make it a game, and it is I it is so much fun. Like, I know I didn't I haven't done freeze dance since I was like since I was probably his age. And so that's that's a really fun way to involve your family.

SPEAKER_00 49:36

Yes. And I always try to encourage myself or tell myself to also just get on the ground with your kids. Yes, get on the ground. Not only for your body, practice getting up and down from the ground. I think um, I think that Netflix documentary that talks about the blue populations that the blue zones, yeah. Yes, the blue zones, and one of them is, you know, they don't have furniture. They just sit on their floor and get up and down all day. And that's why it's contributes to their longevity. And so that's another piece that I try to do is okay, I can get down and stretch with them. I can play Legos on the ground. Let's just get on the ground.

SPEAKER_01 50:13

I'm always on, and I also like to be at the his level, yeah, my son's level. That there's something to be said about being at their level. So I'm on the floor all of the time with my son, building things, playing. We have like forts and all that stuff, and it's just kind of and I love it, you know, there's a part, you know, there's had there been challenges having a child later in life? Uh-huh. Yes, there have. But also it's been great because I'm probably I wouldn't be doing these things if I didn't have a really young child in my house. Um, and so actually a lot of the movement that I talk about in the perimenopause revolution was inspired by the Blue Zone research. Um and the thing that I I found the most intriguing was that a lot of Blue Zone communities don't have core power yoga or F-45 HIIT classes, or they don't have, you know, they don't have gyms where you're doing these crazy workouts. They're just moving their body. They're just extremely physically active. They go to the store, they walk to the store, they walk to the mailbox, you know, they they garden, they're playing with their kids, they're walking after meals. It's really just about building their life around movement. And I think that's the one thing where we have lost that. And so when I think about exercise snacks, it's really my kind of cheater way to build my life around movement, especially if I'm at a computer all day long. Like that isn't necessarily gonna change, at least not right now, but I can at least knock out, you know, 60 or 20 jump squats in between meetings before I head into the next one.

SPEAKER_00 51:36

Yeah, so good. Every time I schedule Instacart, I will think I need to do my exercise snacks now because I skip the grocery store run.

SPEAKER_01 51:43

Yeah, and and think about it like I run I run baths every night. So when I'm running the bath, I do jump squats. When I order my coffee, like I have a really sexy coffee. Um, I instead of getting on my phone once I place the order, I walk around the block and then usually by the time I'm back, the coffee's ready. So that's a good one. It's all of like how can I begin thinking about that mindset shift of where can I build in movement? Can I do it when I'm in doing my beauty routine in the morning or my makeup routine in the morning? Can I do it when I'm getting my kids ready for bathtime routine? Can I do it when I'm waiting for my coffee or I'm, you know, or after a lunch break? You know, like that's when you start thinking about how can I build movement into my day, you'll find all these mini moments to build in movement. And let me tell you, you want to mitigate symptoms super fast. It's it's through movement all day long. That's what's gonna move the needle the most profoundly for your metabolic health, your brain health, your bone health, everything across the board benefits.

SPEAKER_00 52:39

Yes. I admittedly have done jump squats on playgrounds, pull-ups. I mean, my kids are probably so embarrassed by all the stuff I do at playgrounds because I'm like, you guys are playing, and I'm not just gonna sit on a bench. This is my opportunity to walk and move my body, and I don't care if you're embarrassed. And one thing I would definitely want to touch base on before we end our time is the nutritional piece because you also have so many good tips on the nutrition front. So break down what you do for nutrition right now as well.

SPEAKER_01 53:09

Yeah, and I want to keep it super simple. So I always think about building my plate around balancing and optimizing blood sugar. Um, because once we get into midlife, blood sugar becomes it just it becomes a beast, right? We tend to become more insulin resistant over time, and blood sugar is the best proxy for becoming more insulin sensitive versus resistant. And one of the things I do with my patients all the time is I put a continuous glucose monitor on them for at least two weeks so that they can learn about, you know, how their sleep, their movement, their food is impacting their blood sugar. Like to me, that's the ultimate biomarker for your cellular longevity and cellular energy. Now, when it's come to building a plate, I always think about, you know, the kind of the five principles, which is micronutrient and antioxidant-rich foods. And that's gonna be molecular information, it's gonna drive the reactions in your cells. Because at the end of the day, your metabolism is the sum of what that that those trillions of cells are doing in order to function and live and survive in your body. And so I want to be thinking about it from that standpoint. So, what's gonna drive those the cofactors that they need so that they can they can do their job? So micronutrient-rich foods, antioxidant-rich foods, basically plant foods. You know, how are we how are we sprinkling as many plant foods as we can throughout the week? And diversity is key here, not only for the gut, but also for your cells. Um, making sure that we're getting enough protein so that we actually are able to build muscle. Um, muscle is our metabolic and glucose sink. So the more muscle we have, the more metabolically healthy we are. And ultimately, that is the end, that is the name of the game. It's not about being thin, it's about being metabolically resilient, strong, and capable. Like that's what we want to aim for. Omegas for reducing inflammation, a big one here, whether it's flax or walnuts or or or fish, there's a lot of different ways to get it. Um, and then, you know, thinking about prebiotic and probiotic rich foods as well. So fermented foods, things like kombucha, there's lots of lots of ways that we can get those things in. Again, that's supporting your gut microbiome as well. It's helping to support blood sugar regulation. And then, you know, I love, I love trying to crowd out the bad stuff with the good stuff. But when we're thinking about the bad stuff, I think we can all agree that ultra-processed foods are not helping us out on this journey. So think about, you know, where is their added sugar that you can curtail in your everyday life, whether it's like a vanilla latte or it is, you know, a bunch of crackers or, you know, whatever that may be. So be looking at a lot of the liquid sugars that you're consuming and see if you can walk those back and see how you can be swapping out ultra-processed foods for real whole foods. But again, with that through line of balancing your blood sugar, and the number one thing that we can do to balance blood sugar besides what's going on on our plate is moving after those meals on the back end.

SPEAKER_00 55:57

Yeah, so good. And even with the sugar piece of processed foods, one thing that I've found I have had to rethink is eating out or packaged healthy foods at different uh places like Starbucks, for example. I think I finally looked at one of their labels for their salad because I was debating whether to have the protein box or salad. Oh my gosh, there was like 30 grams of sugar. I like how does 30 grams of sugar end up in a packaged salad? In a salad.

SPEAKER_01 56:29

Yes, I know. And I mean, I think that's the insidious nature of packaged food is that you like you just common sense tells you that that's not even possible, and yet, and yet it it is, right? So I think it's important to read that ingredient list, like become very ingredient list savvy, not so much nutrition label as as much as is like what's in the package.

SPEAKER_00 56:50

Yeah. And that's where eating out, sometimes I have a hard time with it because I don't want to stick to crazy food rules and say that any foods are bad, but at the same time, I feel so salt logged when I go out and have a burger somewhere. And I know exactly why I feel inflamed and salt logged. It's because of that burger, which it looked pretty good and tasted good and healthy. And same with salads. Again, there's just so much extra on them where you think I'm ordering a salad, it's healthy, but it comes with all this unknown. And so, really, if you can stick to the 80-20 of having whole foods at home, it seems like the best route.

SPEAKER_01 57:25

Yeah, agreed. Yeah, as I mean, ideally, we're eating, we're we're cooking as much at home as possible. I know that that's not always easy, but it's it's the one way that we can control. And I try to make it so simple with the meal plans and the practical recommendations for building these metabolically healthy meals. You know, the question I always ask myself is what I'm about to eat going to fuel my future brain or going to create my future brain because we are what we eat. And I think through that through line, it really shifts the way that we think about how much we're spending on processed foods or takeout and how we can start focusing more on cooking at home so we know what we're actually eating.

SPEAKER_00 58:04

Yes. Well, I know we've come to our time, and so I'm curious if there's anything else that we didn't touch on within the book, which there is so much there. So I do recommend that everyone you can check it out on Audible or get yourself a copy because I loved it. There's a million things that we didn't talk about here in it. But is there anything else that you wanted to surface that we didn't touch on that you think women need to hear?

SPEAKER_01 58:25

I would say the last thing is really the mindset chapter because we are stepping into the unknown, we're stepping into the most powerful chapter of our lives. And one of the things I go into a little bit in detail is becoming clear on who you're becoming, your future healthy self. Because when we know who she is and what she's doing and what she's saying yes to and no to, we have her as a North Star to anchor to. And then we can start building habits from there. So I walk you through that full exercise. Um, and it's been so powerful for so many of my patients. And I have a feeling that readers are really loving this because a lot of women aren't asked, like, who, you know, who do you want to become? How do you want to operate? Like, what are you what are the things that you love? What what would you love? Like, that's what that chapter is all about.

SPEAKER_00 59:10

I love it. You also stop dreaming almost in midlife thinking, I am grown up. You don't think about who am I gonna be when I'm grown up because I am grown up, but you should. You should always be thinking about your future self. I love it. Well, Dr. Marisa, thank you so much for coming on. Where can people find you? Find the book, all that.

SPEAKER_01 59:29

Yes, the book is drmarisa.com forward slash book. All the bonuses are there. Go get your bonuses when you get the book. Energize with drmarisa is the podcast, and Instagram is at D-R-M-A-R-I-Z-A at Dr. Marisa. And again, where books are sold, that's where you'll find the book.

SPEAKER_00 59:46

Love it. Well, thank you again. Thank you. Thanks for listening to another episode of Find Your Fuel. If you enjoyed the show and want to support us, please leave a comment or review. And before we go, I have to give you the obligatory medical and legal disclaimer. This podcast is for informational and educational purposes only. The advice and recommendations we discuss are not intended as medical advice and do not replace the treatment or care of a physician or any other primary health care provider. Using the information shared today does not create a doctor-patient relationship and it should not be used to diagnose or treat any health problem. Always consult with a qualified healthcare professional before making changes to your diet, exercise routine, or medications. The use of any information provided is solely at your own risk. So, in a nutshell, let's be smart and remember these stories and conversations are for educational purposes only. Help other women find the fuel to live their best lives. We'll see you in the next episode.