Non-Hormone Support in Perimenopause and Menopause

Not everyone can use (or wants to use) hormone replacement therapy. Today we talk about some of the options to look at and considerations. 

We talk about

• The Women's Health Initiative, research in general, and what it means for you and your health
• The importance of not just taking something off the shelf or that you learned about from social media influences in this precarious time of health transition 
• Natural support to help manage symptoms such as hot flashes, vascular integrity, sleep
• Medication support for symptom management
• Reasons why antidepressants sometimes actually help hot flashes
• Things to consider about how medications and herbs or supplements can work that could cause issues
• The role of strength training in testosterone production in women
• The lifestyle shifts that are helpful, and necessary to feel our best
• The value of doing less but better, especially in midlife
• The importance of acceptance and embracing a new chapter, rather than trying to make everything feel like it did before
• Where to find someone that has expertise to guide you through all of this so you can live your best life, at this stage in life

Chapters

00:00 Understanding HRT and Its Alternatives
08:43 Exploring Non-HRT Options for Symptom Management
19:34 Addressing Lifestyle Changes and Their Impact
29:25 Navigating the Transition: Embracing New Chapters

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Transcript

SPEAKER_02 0:01

Real women.

SPEAKER_01 0:02

Real talk.

SPEAKER_02 0:04

Real messy.

SPEAKER_01 0:06

This is Messy Midlife. Hi, ladies. Welcome back. Good morning. So we were just wrapping up our conversation about HRT. And in the interest of people's brain space and not overwhelming everybody with all the things, we thought we would pause and come back and talk about the other part of getting support, which is the non-HRT options that you might have to help support that hormone cushion that we want to call it, hormone cushion therapy, when we're in that transitional space and we just need a little bit of extra support while our roller coaster of emotions and hormones are doing their own thing to just even it out a little bit. So there are lots of people who can't take hormone replacement therapy for one reason or another, or who are nervous about it or any of the things. So let's talk about that a little bit today. And if you don't mind, we I don't think we've actually really talked much about the women's health initiative. I think we've mentioned it once or twice here and there, like sprinkled in on the podcast, but it bears relevance to what we're talking about today, which is the study that was done that made it seem like we had a substantially increased likelihood of getting breast cancer if you use hormone replacement therapy after during perimenopause, after menopause, et cetera. And that was widely overreported, not necessarily inaccurately, but the way you talk about statistics changes what they mean, right? And so correct me if I'm wrong, but what I understand from the Women's Health Initiative is that it was reported as a 25% increased risk of getting cancer if you used hormone replacement therapy. But what they failed to say is it was a 25% increase risk over the already very low risk. So it wasn't from zero to 25, it was a 25% increase of like 2%.

SPEAKER_00 2:04

Yeah.

SPEAKER_01 2:05

So a very, very small risk increase for people in the grand scheme of things in the really big picture.

SPEAKER_03 2:14

And I think that that's the challenge with research. Like I used to joke and say, like, research is in the eye of the beholder, right? Because it is really how you read it, how you interpret it, and what you choose to say about it. I mean, it can also be how the research study was designed and if it even was research, right? When I was in residency, there was a research study that was like people that took supplements died at an earlier age. And they literally just went around and asked patients' family members, oh, did they ever take a supplement? Oh, they did? Yes. It was literally like the like most non-research, research and you know, air quotes that could have ever been done. So I think that one of the challenges that we do see in medicine, and I would say in life in general, is people take something and they run with it, right? And because medicine and medical care is in general like half evidence and half somebody's opinion, it's really how they've formed their opinion. It's that opinion that is being said to patients as opposed to the actual facts.

SPEAKER_01 3:22

And evidence is generated by and large by companies with an agenda who are designing studies in order to try and increase the likelihood of their agenda coming to fruition. And even subtle changes with how you evaluate the responsiveness, you can change things during the process of doing a study to recognize, oh, we're having this problem. What if we change this here? And what if we change that there? Not to mention that, especially if you're talking about a therapy like a medication that somebody's going to patent, they're they're allowed to do placebo washout studies so that everybody gets a placebo and ever anybody who has a strong response to the placebo gets taken out so that they don't throw off and give more strength to the placebo group. So it's just there's just so many things about evidence base that are we're just being yanked around by people who have more money and more power and the specific agenda, and then being told that we need to trust all of it. There's value for sure. There is value, especially when it comes to safety. My bigger concern is about when we talk about efficacy and what then becomes standard of care when we lean exclusively on that.

SPEAKER_03 4:36

Well, and I think it's also, you know, physicians picking and choosing or healthcare providers picking and choosing what research they're going to cite and quote, right? I remember I was at an oncology conference, I mean, gosh, now probably six years ago at this point. And there was a doctor there who did a lot of research in breast cancer and hormones. And one of his main takeaways was that because estrogen has so many other functions and so many positive functions, bone density, cardioprotection, his big thing was actually more in the cardiovascular space that women who had had breast cancer themselves, I'll have to look up the study to tell you exact amounts, but basically the gist of it was women who have had breast cancer, them taking estradiol, not biased, not estradiol, estriol combination, just straight estradiol, had a lower risk of mortality from all of those cardiovascular causes. And that that basically decreased the risk of that more than it increased the risk of them having a recurrence. And so what came out in the wash was it was actually more supportive of their overall health and not just quality of life, but length of life and risk of any type of cardiovascular event was better for them to take some estradiol than to not and to avoid it, which is typically what you know, women are told at diagnosis is they can never take it again. And look, I recognize, like as somebody who does this with patients who does BHRT and who also sees a lot of patients with cancer, I still would have a difficult time saying, yes, you had a hormone-positive breast cancer, take these hormones, right? But there are certain instances where you might not be doing all of the hormones, but you could be doing some. Like I will absolutely use estriol vaginally for things like that. But in some cases, progesterone can be helpful too. So I think that's where you have to and we have to understand, and patients have to understand that it's not, nobody gets like a set, you're taking this bias and this progesterone and this testosterone. It's not this set, well, it shouldn't be size fits all away. But it shouldn't be that everyone gets the same prescription because we're all so different with what we need.

SPEAKER_02 6:59

That's what I love about the naturopathic training and our perspective on health is that you know, somebody comes in with a very strong family history of cardiovascular disease and a history of breast cancer, you're dealing with a very different case than somebody who doesn't have that family history. And it influences the way that we would make our recommendations. And similarly with research, we are very biochemically focused. So we think about what form of a supplement is actually functioning in the body versus something that's just getting flushed out. And in conventional medicine research, they don't make that differentiation. And so they're getting really low quality supplements in their studies that are showing kidney stones with calcium or because they're not balanced products. They're not balanced and they're a low quality. And so there are so many factors to consider. And the I may be a little biased, but the naturopathic approach tends to just be more comprehensively informed.

SPEAKER_01 8:11

Okay. Um, so we spent the a while talking about HRT when we were not supposed to be talking about HRT, but I still think this is important because there might be people who came right here thinking HRT is not available to me for X, Y, or Z, and that might not be the case. So if that is you and you're thinking that, it might be worth going back and listening to the HRT episode if you skipped it for one reason or another. So that being said, there's lots, there's people for many, many, many reasons that HRT is not accessible to them, not available to them. They don't respond well to it. So, what sorts of things can people use to help with this cushion that they need while we're having this chaos happen with our hormones?

SPEAKER_03 8:53

So a lot of it is, you know, symptom management, right? So we look at the things like pretty typical, which are hot flashes and night sweats. And there are different herbs that can be used for that.

SPEAKER_01 9:06

Before we go any further, I want to make sure we say very, very, very clearly, this is not any medical advice or specific for anybody here who's listening, right? Um, and I want to say this before you mention any of the things that you might be seeing. Just because you can get an herb over the counter, it does not mean it is safe for you to take. There are lots of herbs that have lots of downsides and can cause some issues for people. And so what we're gonna talk about today is to make sure that we talk about some of the options or some of the things that might be available that you can talk to a provider who is skilled and educated in this about to make sure that you are getting the right things for you. And I say this just because I'll be perfectly honest, guys. We talked before we started recording. Do we talk about specifics? And I said it would be a disservice for us to not talk about some of the specifics that you guys are hearing about from wellness influencers who don't have any medical training and who are saying, take this, take this, like it's perfectly safe. Meanwhile, it's leading to all sorts of bigger problems. And no one suspects the thing because, oh, it's just so benign, but it's natural. I bought it at Whole Foods, you know? So just because it's over the counter does not mean that it is safe. There's a whole separate way that dietary supplements are regulated that is both good and bad because it does not have the same consistency or oversight that medications do. So just keep all of this in mind. We'll talk about some specifics here. And don't take it unless you talk to somebody, because this is a really big time of transition where if something's gonna start to go on in your body, if you've got a susceptibility and you got a little bit of kindling, this is the time when things start to show up, right? We've got a lot more autoimmunity show up in perimenopause. We get a lot more insulin resistance, diabetes onset. This is the time when our bodies are gonna start to change and those kindlings that are like not even noticing can turn into fires with the wrong things. So now that I've said that piece, Elisa, sorry I interrupted you, but go on back to the symptom management. For example, hot flashes, there are some herbs.

SPEAKER_03 11:15

Yeah, I mean, there are some that look, we just see that work more often in patients, right? So things to talk to your doctor about could possibly be black kohosh and could be rhubar root extract. Like those are two of the things I would say with most women that struggle, they have some relief. I can't say it's a hundred percent, but they have some relief. And look, realistically, if you're having hot flashes all the time and they're reduced by 80%, like you're pretty happy. I am, right? I think that there can be other things to look at in terms of the integrity of our blood vessels, right? Because that warm-bloodedness, right, can cause the flushes too. And so things like vitamin E or Hesperidin can really help with stabilizing those blood vessels.

SPEAKER_02 12:01

And on that same hot nature or imbalance, Chinese medicine, traditional Chinese medicine is wonderful. They have a lot of herbs, acupuncture, and of course, homeopathy. How can we not mention I've seen that alone be really fantastic at managing a lot of these symptoms?

SPEAKER_01 12:19

I guess I should say I have seen more than once homeopathy alone help somebody manage through the transition without ever having to use any hormone cushion therapy. Um, and I've also seen it be not enough for people. So it's always going to be dependent on what the individual needs.

SPEAKER_03 12:38

Well, and being able to have those combinations, right? So sometimes it's a little bit of estrogen and a little bit of something else, right? I also want to say, because it's not just, okay, these supplements work. There actually is a really great medication that you can talk to your doctor about. If you are somebody who can't or does not want to take hormones, and if supplements aren't necessarily working or that's not your first choice, there is a prescription medication that is super, super helpful. I'm not affiliated with them. I just see it, I see it work in a lot of my patients. It's called VIOSA. And it actually, I've I haven't had a patient say I've taken it and it didn't work. So I think it's nice to know that there are also other options and that you never have to suffer through something. There's always a next step. And I think that's really important to as a patient. I I mean, I need to know this as a patient myself, there's always a next step.

SPEAKER_02 13:33

Yeah.

SPEAKER_03 13:34

Because otherwise I think we can end up feeling really stuck.

SPEAKER_02 13:37

Yes. Yes. I love that you mentioned this. There are, there are many non-hormonal prescription options that can improve quality of life. Not my go-to, but they I've seen them work. Gabapentin works well for hot flashes for some people where they can't do hormones or herbs in some cases. And that's what helps to relieve the symptoms. Sometimes antidepressants can because of the interplay between hormones and brain chemistry. I just want to highlight that because it's not, it's all in your head, or you know, just take an antidepressant, everything will be better. There's actual physiological processes that are supported with antidepressants. So there are there are many, many options that are not hormones that are prescription still, because sometimes people just don't tolerate herbs well.

SPEAKER_01 14:28

So that's a an important consideration. Yeah. And I want to just point out a couple of things that you mentioned too. And then we can maybe tackle some of the other symptoms and and some things that people might regularly see and things they should consider with the different options. So you mentioned black clo black kohosh, and that's one that people will see pretty frequently. It does actually impact hormones too, right? So it can it can drive hormone production to a degree. So is that something that people should consider, right? You're talking about like an estrogenic.

SPEAKER_03 15:00

So that's what was obviously was that black cohosh was very estrogenic, but it's actually not. People used to think of it as like herbal or supplemental estrogen, but it actually does not affect our estrogen levels. The mechanism of action with black kohosh is actually helping to act as we call them a CERM, selective estrogen receptor modulator, and actually acting more on a serotogenic basis to what you were saying, Karen, with our brain chemistry and those serotonin receptors. So it's actually not impacting estrogen, but that was a belief for a very long time. So it that but that's kind of been disproven.

unknown 15:42

Okay.

SPEAKER_02 15:43

Also generally safe then. Black Kohash would generally be safe with a history of breast cancer. Absolutely. Yeah. That's actually really helpful. That's an update for me. And I do this all the time. But it's not just me. That's like, wait a minute, what?

SPEAKER_03 15:58

No, I think it's a very it's like a really common belief. And I think, look, when we were in medical school how 18 years ago, I don't even know how long ago.

SPEAKER_01 16:06

We don't need to lose a life time ago.

SPEAKER_03 16:08

But when we were in school, like that was something that was being talked about. And so if that's not something that, you know, is is in your realm of practice, it's, you know, not updated.

SPEAKER_01 16:21

So then the the other caution then would be if it's actually acting more on the serotonin receptors, is that people who have a susceptibility to bipolar disorder or have that family history of that, that might be something to be a little bit more alert to. Or if you're taking other things that drive serotonin production. So whether it's an or or serotonin retention. So whether it's something that you are like an antidepressant that's also affecting the serotonin receptors, migraine medications, tryptans impact serotonin receptors. People don't always think about that. There's lots of different things that can impact serotonin, and you don't want to drive too much serotonin and end up with serotonin syndrome or accidentally trigger a manic episode.

SPEAKER_03 16:59

Which is exactly why it's like drives home the point of you have to talk to your doctor that knows you and knows your medical history and knows all of your medications and knows all of your supplements before adding things in. So this all should should be with a doctor who understands the completeness of everything you're taking and symptoms.

SPEAKER_01 17:20

You also mentioned some of the herbs that could be have impacts on the blood vessels. And so we also need to think about the cardiovascular state that you're in and risk factors, anything else that could contribute to it, because that might not be so great to take if perhaps you have high blood pressure or climbing blood pressure, that kind of thing.

SPEAKER_03 17:36

Well, and and they can be, right? Because it's it's stabilizing those vessels, it's giving those vessels more integrity. So that typically is helpful, right, with hypertension, things like that. But again, we can't say that. We don't know that for every person. So you have to have a doctor who is willing to talk through that, but from a place of true knowledge about it.

SPEAKER_00 17:55

Yeah.

SPEAKER_02 17:56

And don't ever hesitate to bring information to your doctor because just because they haven't brought it up doesn't mean that it isn't relevant for you and that they're not knowledgeable. It's just that sometimes we're holding a lot as providers, we're holding a lot of information about your specific health. And, you know, that's why the collaborative process is so important. And if you have a good relationship with your provider and they are the right provider for you, they will be grateful that you brought this information to them.

SPEAKER_01 18:25

Right. And it doesn't necessarily mean like even if they're not knowledgeable about that specific thing. Like if you were somebody who had listened to Aliza talk and then went to work with Karen and she hadn't heard Aliza say that thing yet about Black Kohosh, then as long as Karen is like, that's fantastic, let me confirm. Let me look this up and see. Yep, this looks solid. Thank you for bringing this to me. I'll make sure I take this into consideration both for you and people moving forward. If you're willing to give this a try, I'm willing to give it a try now where I wasn't before. So it's the receptivity to new information and the willingness to work with you and grow themselves. Because no matter who you are seeing, they are not going to have every single piece of research and updated information and understanding on mechanisms of action or anything like that. So we have to be a little bit of grace, I think, for our medical providers because there's just they can't possibly know everything.

SPEAKER_03 19:22

You can't know everything. I mean, I used to joke when I taught oncology at the medical school, like the more I learn about cancer, the more I realize I don't know.

SPEAKER_01 19:29

Yes.

SPEAKER_03 19:30

Right. And I think that's true across the board. It's like the more that we as doctors learn, it's like the more that we realize there's so much out there that we just don't have it exposed to and don't know.

SPEAKER_01 19:41

So and the complexities of everything. All right. So what about some of the other symptoms that people see come up? Changes in sex drive, changes in skin, changes in mood, that kind of thing. Vaginal dryness.

SPEAKER_02 19:52

There's man, this could be multiple episodes.

SPEAKER_03 19:56

So I know, right? So we can look at sleep, right? There are a lot of different supplements that can be really helpful with sleep, also depending on where the issue lies, right? So we're looking at, you know, difficulty falling asleep. You know, I think again, a lot of people talk about melatonin. It's like melatonin gummies, melatonin this, there's all melatonin on its own doesn't work for a lot of people. And melatonin, when you're doing, you know, higher doses of it, like three, five or more milligrams, can make some people really drowsy in the morning. So I think it's always better when you have a combination of different things. And you can have like a little bit of melatonin, right? Quarter of a milligram, half a milligram, three-quarters of a milligram. But I think smaller amounts of melatonin combined with other botanicals and amino acids can be really helpful. So things like L-theanine, which is an amino acid, again, we're naturally making it, which is why I like it. Melatonin, we're naturally making, right? In our pineal gland, in a dark room with no light. But L-theanine can be really calming too and help with sleep onset because L-theanine can help act as a GABA agonist. And GABA is like our natural, like happy, sleepy, relaxed brain chemical. So a lot of times L-theanine, in combination with other things too, can be helpful. So like different calming herbs like passion flower and lemon balm and valerian and lavender and poppy and hops, those are all things that are pretty calming to our nervous system and can help when people fall asleep. What I see a lot though in my patients and my friends, like across the world, is not so much difficulty falling asleep, but 2 a.m., 3 a.m., 4 a.m. wakeups. And I would say that's the kind of the common thing I see across the board is like the 3 a.m. wake up in women in paramenopause. I feel like sometimes we could like if all the women who were up at 3 a.m. could just get together, we would solve the world's problems.

SPEAKER_02 21:54

Maybe that's the maybe that's the evolutionary reason for it.

SPEAKER_03 22:00

And that is actually what when we talk about evolution, a lot of where that comes from, I think, is like that was a natural rhythm, right? We would wake up early and that's when we would be doing a lot of the things we had to do. And so I think in a way we kind of go back to that. But I do think a lot of that has to do with cortisol, right? So actually, not what we would consider a sex hormone, right? But it can be that cortisol, where cortisol is supposed to rise within two hours after we wake. I see it in a lot of women rising way too early and waking them up out of sleep. So in that case, we can do things that help to sensitize those cortisol receptors and work on more of that level. Yeah, there's just so many different ways to think about it. And like your sleep pattern and your sleep and wake pattern is a really important piece of that.

SPEAKER_02 22:52

And that brings up the important topic of adrenal health during perimenopause as a general concept because cortisol is produced by the adrenals. And we we see that the different hormone-producing organ systems will start to shift and compensate for the decrease in ovarian function. And so they you'll see extra strain on the thyroid system and the adrenals and digestive hormone-producing organs as well. And all of this can in have an interplay, which some of the herbs that Elisa was mentioning are like ashwagandha. Actually, I don't know if you mentioned that one. That's a an adaptogen that supports the adrenal glands and can help to modulate that adrenal spike of cortisol at 2 a.m. and do lots of other things. So I don't want to pause, I don't want to interrupt your train of thought. I just thought it was helpful to make a plug for the adrenals.

SPEAKER_03 23:49

It's never interrupting. And I think it's it's actually super important, especially when we talk about, you know, Jen, one of the things you says, like testosterone. Well, a big part of being able to make testosterone is having healthy cortisol levels, right? And those cortisol levels levels are all out of whack. It can be harder for our body to say, oh, what a great time to make this hormone, right? When your body's like, oh, am I going to run from a lion or try to fight it? It's not like, oh, what a lovely time to make hormones, right? It's just in a stressed state. Like it's not like, oh, what a lovely time to have a bowel movement, right? It's like, no, please don't poop now. So or if you are going to get it out fast. Yeah. Right. So I think that that can be really important, that the whole idea of supporting those adrenal glands and right having the appropriate cortisol levels at the appropriate time, right? Highest two hours after we wake up and then slowly sliping down for the rest of the day is really important. Not having spikes in the evening or early morning. Obviously, you know, there's a lot of talk about weight training and peramenopause. And yes, it is super, super important to have, I mean, longevity has a lot to do with our muscle tone and our muscle capability, right? But that's also a piece of it where the weight training, and I'm not saying you have to be like in the gym every day, but doing body weight exercises and even more gentle Pilates, walking, right? But doing more of those strengthening exercises. We don't have to be like, I think we used to think like, oh, we've got to get our heart rate up so high and we were doing all this cardio, but it really is more about having those strong muscles, and that can help increase testosterone production.

SPEAKER_02 25:33

That's actually been a huge change for me is going from, you know, almost every day of the week, orange theory, 60-minute, super hardcore running, heavyweights, to for sleep specifically, because that's, I mean, there's so many benefits to that, obviously, but sleep and mood. And now understanding that that is not okay. That's not okay for me. It's not the right fit for me. And I don't have to do as much of it as I used to, which is really wonderful, to get the sleep benefits. So infrared sauna, 20 minutes of that will improve my sleep or a 30-minute walk. I try to sweat almost every day or have some significant movement of my lymph to support my sleep. And I find that if I get to the end of the day and I haven't done something like that, jumping in the sauna, jumping in a really hot Epsom salt bath can also be really helpful because magnesium helps to break down cortisol and it's just lovely, right? And then the hot bath itself will promote sweating as well. So piecing it together is very different than it used to be. And even though it is very necessary for me to do something every day to support my sleep, it doesn't have to be as elaborate as it used to be or intense.

SPEAKER_01 26:51

Intense. Yeah. I'm so glad you guys got here. I just was writing down we have to talk about lifestyle and all the ways that sometimes what we need is not necessarily another thing to do or another thing to take, but something to remove and to do less of and looking at less but better in all things in our life, right? So it's not necessarily how many more pills can I take, how many more reps can I do, that especially in this place of transition, our body's gonna respond differently to all sorts of things, including exercise. We've talked about this on a previous episode where our bodies just feel different in response to exercise than they used to. The muscle aches are different, the ways, the ways that it used to help with sleep, but now actually disrupts sleep. And part of that is because exercise to a degree is a posit is a use stress, but it does have a point where it crosses the threshold and it becomes a distress to the body and it can have a negative impact on those adrenal hormones, which then pull that spider web and make everything go wonky, right? And it and it shifts all of our hormones because you're tugging on one, it tugs on everything. And so sometimes when we try to keep going at it like we're 25, when we're 45, we're doing more harm than good. And our natural reaction is, oh, I'm not doing enough. I need to do more. When really sometimes you need to do less.

SPEAKER_03 28:19

I think there's also the mindset oftentimes of, well, I used to be able to do this. I used to really should play.

SPEAKER_00 28:27

Yeah.

SPEAKER_03 28:27

Why can't I right now? And I think that it's interesting. I think if we can think back and really actually have an awareness of what it was like family used to wake up and go to like a 4:30 or a 445 spin class, like, oh, I could never do that now. But when I think back to it and remember going to work after that, like at nine o'clock in the morning, I was exhausted. Right. So though in in, I guess superficially in our brains, we can think, oh, I used to be able to do that no problem. I think if we really think about it, it's like really true. Yeah, I don't think, I don't think, I think it's more of a story.

SPEAKER_01 29:03

So um, I think just recognizing how things shift and change is so we just had more reserves to to deal with the ways that we were abusing ourselves and fewer responsibilities that you know, and like little humans or employees or whatever that we had to deal with. And we had the the ability to lean on our hormones when they were reliable and they're no longer reliable. So we just have to lean into sometimes we just have to change some things with our lifestyle a little bit more. Then we have to add something into our life, and that it might mean that we take up some old lady habits, you know, do some knitting, read, read fiction, because I feel like there's so much more therapy you can get from fiction than from reading self-help books and all that sort of thing. So just some of those shifts are important.

SPEAKER_02 29:56

I love what you said, Elisa, about what we, you know, that that mindset of, well, I used to be able to do that. And even this ties into the hormone replacement, right? That replacement versus cushion. It's that we're expecting to continue our lives as they always have been when they're not. This is so us. This is this conversation is very much a messy midlife conversation because what we're really highlighting is we are stepping into a new self. It is not trying to preserve how do we preserve our previous life moving forward? It is chapter closed, new chapter opens. And that perspective has been so liberating for me, especially with the exercise. That's one where it's like so black and white, so, so different. And I'm in a place of tremendous peace. And I hope that we can help to spread that message of peace when you open a new chapter. What is and with with beginner's mind, right? Like growth mindset. What is this? What are the opportunities here? What am I having to do? Because I feel like I don't have a choice, but it's it's new. It's not how do I get back to the old? It is opening a new chapter.

SPEAKER_00 31:12

Yeah.

SPEAKER_03 31:14

And seeing what works for us now.

SPEAKER_01 31:16

Yes. Love this as a place to wrap with one thing that I just feel very compelled to say because I feel like somebody must need to hear it. When I feel this compelled to say something, some of the things, if you do go and try things on your own, which you should not do, don't go and try those things on your own. Even something as simple as melatonin, which is a pretty innocuous thing, but even something as simple as melatonin, people can actually do worse on it. I have realized that for a while I did okay with melatonin. And now I'm finding it if I, the days that I take melatonin because I think I need help sleeping, those are the days that I'm gonna wake up at 3 a.m. But if I don't take it, I'm actually gonna sleep through the night. So there are a lot of things that that people can have unexpected responses to. Some of them herbs that were mentioned, there people can actually have a paradoxical response to. So rather than it being very calming, it can actually be very stimulating. So again, this is why it's important to work with somebody because even if you know that it can be stimulating, if you're using anything, especially like a combination of herbs together or herbs and nutrients, it's really important that you're working with somebody who understands these things so that they can help you sort through what's working and what's not, and what is most likely to be causing any symptoms that you might be having. So it's just really, really vital that you work with somebody who understands these things really effectively. And we've had some people through social media and through reaching out for the podcast who've asked us where you can find people who might know these things. Ladies, do you have any recommendations for where you would say to look for somebody who's skilled in these things?

SPEAKER_03 32:43

So my first thing is always ask your friends because I feel like that's where we get like the best referrals are from people that we connect with. And so oftentimes, if that's how I that's how a lot of patients come to me is through friends, right? If your friends are seeing somebody that they really connect with and they really like and you're good friends with them, it's highly likely that you will as well. So I think that's number one. I think any other, whether it's functional medicine or naturopathic medicine, right? Everybody has their different strengths and weaknesses. So I think you can look at the different state naturopathic doctor associations and see who's in your area and then call and ask, right? What are the areas that Dr. So-and-so specializes in? I think those are the big things is you can look things up, but you have to actually have that conversation.

SPEAKER_01 33:33

And the last thing I feel compelled to say is that naturopathic doctor, like that title, a naturopathic is not protected in all states. So it is important that if you want to know that you're working with somebody who actually has medical training, has a medical license, or has some sort of oversight someplace, that you make sure that they are actually licensed or licensable as a naturopathic doctor and not just somebody who is calling themselves naturopathic because there's not any regulation in that particular state. And then bring this up just because your friend might be seeing somebody and saying, I'm seeing this great naturopath. And it might be somebody who can't actually do any lab diagnosis and doesn't have the same level of training they might have done something like a six-week online course or something like that.

SPEAKER_02 34:15

So that may not work for your level of complexity, right? It might work for them and just understanding that if you do see them, there are limitations to them being able to conceptualize your needs that a naturopathic doctor licensed would be able to do. Right.

SPEAKER_01 34:32

Uh, and the main thing here is really, really under being able to order and understand and interpret labs and then take action on those labs too, so that you can really understand what it is that's happening in your body and what your body might be doing in response to any of these treatments that you're using, hormone replacement therapy or otherwise, because these things can have impacts on your labs as well. All right, ladies, any other things that we should think about other than all the stuff that we've talked about, with a special reiteration of sometimes it's okay to just lean in to the changes and the new that we have for our life and just finding comfort and cushion to give enough comfort to allow this transition. None of the things we talked about are the goal is to make you back to where you were when you were 25. It's to lean into your 45 or 50 or 37 or wherever you're at, where perimenopause is starting for you. It's to lean into that stage in your life with as much ease and comfort as possible, not to not to avoid it altogether. Yeah. And to know you're not alone in it. Yeah. All right. Well, thanks so much, ladies. Thanks so much. Love you so much. And I'm grateful that we got this medical stuff tackled so that when we have conversations about our own stuff, especially my upcoming things that I'm sure we'll talk about uh in more detail, that we can have a foundation for people to understand what it is that we're talking about.

SPEAKER_02 35:54

So and if there's anything we didn't cover that you want to know more about, send us a message and we'll include it in one of our future episodes. Absolutely. All right. Take care, everybody. Love you guys. If our messy is your kind of messy, we'd love for you to rate, review, and follow or subscribe wherever you get your podcasts.

SPEAKER_03 36:16

We'd also love to know what's on your mind. If you were to join us, what would we be talking about? Email us at messy midlifepodcast at gmail.com or message us on Instagram or TikTok.