The Missing Peace

Perimenopause, Menopause & Taking Your Power Back — Part 2 with Julie Perry

• Season 1 • Episode 6

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In Part 2 of their conversation with Julie Perry — functional medicine nurse practitioner — Brooke Benevento and Danielle Griffiths dive into perimenopause, menopause, and what women can actually do about it.

Julie breaks down the timeline of perimenopause (it can start as early as 35), why your hormones feel like a roller coaster, and what's really behind the night sweats, brain fog, weight gain, and 3 AM wake-ups. The hosts get real about frozen shoulder, pelvic floor issues, and the moment you realize your mom wasn't being dramatic after all.

They also tackle the controversial history of hormone replacement therapy — from the flawed 2001 Women's Health Initiative study to the modern push for better care — and why functional medicine is changing the game for women who've been told "you're fine" by their doctors. Plus, Brooke shares why she sees this stage of life not as a crisis, but as a powerful inner awakening.

In this episode, you'll learn:

  • When perimenopause can start and why you don't need to lose your period to be in it
  • The truth about hormone replacement therapy and the study that scared a generation of women
  • Why cortisol spikes at 3 AM and what that means for your sleep, weight, and stress
  • Frozen shoulder, gluteal tendinopathy, and the musculoskeletal side of menopause
  • What magnesium can (and can't) do — and which types actually help with sleep
  • Why strength training matters more than cardio in your 40s and 50s
  • The role of testosterone in women's health — and why there's no FDA-approved product for women
  • Julie's top 5 things every woman should do during this transition

Resources mentioned:

  • Dr. Mary Claire Haver — The New Menopause
  • Dr. Kelly Casperson — women's sexual health advocate
  • International Menopause Society (founded 1978)
  • Magnesium glycinate and L-threonate for sleep
  • Vaginal estradiol for urogenital symptoms
  • Pelvic floor therapy

Connect with us:

Have a topic you want us to cover? Want to be a guest? Reach out — we'd love to hear from you!

If you missed Part 1, go back and listen first — we covered the four phases of the menstrual cycle. Subscribe so you never miss an episode!

SPEAKER_00

Welcome back to the Missing Peace podcast. This is the second part of our very important talk about all things women, paramenopause, menopause, menstruations. So we're so glad you're joining us again. Let's jump back into it.

SPEAKER_01

Let's uh I'm thinking maybe now we move into to some perimenopause, some some midlife stuff. And yeah, let's let's move into that.

SPEAKER_00

I did some some history research. Should I share a little bit? I just have a little bit.

SPEAKER_01

There's not a whole lot. No, no, no. Share yes. Uh uh Danielle is always sharing all of her history with us, and we love that. So yes, let's start with the history of it. Some some I think this is a good segue. And then um, Julie, I won't we we have a lot of questions from our viewers actually? Uh I did a post uh, I believe last night, and I said, Hey, what kind of questions do you have? So we'll kind of go through it and then at the end um we'll add on some of these questions for our viewers if they want to hear. So it'll be great. So yeah, all right, Danielle, tell us all about history and and how it's kind of morphed. We love we love this stuff.

SPEAKER_00

Well, and I just try to keep keep it concise. I always like looking at the origin of stuff. So um I found out that the medical Latin menopauses, if I'm pronouncing that right, um, is describing the end of a female fertility. And in 1821, there was a French physician, his name was Charles Pierre Luis de Gardian. I'm gonna hope I pronounce that somewhat close. And he said that um paramount pause, it originates from the Greek word men, which means month, and posis literally means pause, pause of the monthly cycle. So that's kind of the the uh word origin of it. There wasn't a whole lot that I could find, but one thing I did find that I thought was fascinating. So in the Victorian era, which is named after when Queen Victoria, uh, the Queen Victoria of England um was in on the throne from 1831 to 1900. So that was a long stretch. The full physicians thought that women were going through perimenopause and thought they were losing their minds to the point where they called it climacteric insanity. And their solution was literally to lock women up. They they would find women that would become hysterical, probably these these uh very sharp hormone shifts, and they didn't know what to do. So they'd usually put them in in insane asylums, which I thought uh was funny, and my husband got a giggle out of that. Um, but the the other part that I found that I thought was really interesting is they really didn't know what to do about it. And a lot of the early treatments that they did find just weren't very effective. And um in 1978, the year of my birth, um, there was the International Menopause Society was founded. Granted, that's not even 50 years ago. So it just shows how much we've learned just in the last couple decades. And more importantly, you this research is helping identify and finding treatments. And I know just a few months ago, uh, again, I'm in California, uh, the actress Halle Berry came out and was kind of calling out our governor because a lot of these hormone treatments are not covered by standard insurance. So I'm sure it varies from state to state, but for me, I see all these little reels, I see advertisements for things, but I don't quite understand why it's needed. And so um, that's just the the little bit of the history that I found on on paramenopause. So just wanted to share that.

SPEAKER_04

I love it.

SPEAKER_01

Oh, that's absolutely fascinating. I didn't know any of that. Julie, did you know any of that?

SPEAKER_04

I I did not know those. Well, I knew what happened back in the 1800s and early 1900s. I knew women were like labeled hysterical, but I didn't know that um that it's that the menopause society was started in 78. But as a child of the 70s myself, that means that our moms and our grandmoms didn't really know what was happening to their bodies until they went through menopause. And my mom had a hysterectomy at like 38 or 39. So she was maybe just barely into perimenopause if she had started it. So she she didn't have any frame of reference to tell me what what was happening.

SPEAKER_00

So just that makes that makes sense. Why it's very new very much.

SPEAKER_04

It's very new information. And unfortunately, women get the short stick anyway when it comes to research. There's not a lot of dedicated women's studies, like there needs there needs to be a lot more put into perimenopause and menopause and sexual health. Uh men can walk into a clinic and get a prescription for Viagra in 15 minutes, and uh things like that are much harder for a woman. And even finding a more known provider is harder.

SPEAKER_01

Really? Yes, that's so interesting. Yeah, I mean, this is how I this is how I met Julie was I kept going to my regular doctor and I kept telling her for three years, I said, something's not right, something's off. And she kept saying, Oh, you're okay, you're okay, you know. It's that whole, you know, menopause thing, that perimenopause thing. And I I thought, I know, but can you do something? Can you can you can you help me in any way? And I really got brushed off, you know. And again, I and Julie and I talk about this. I I say all the time, I said, Okay, God, you're gonna have to bring me somebody, somebody that's gonna have to help me. And then here appears Julie, uh functional medicine practitioner. And I'm taught we're talking one day, and I said, Julie, what so what is it that you do? She says, Oh, I help women with their hormones. And I thought, oh my gosh, okay, well, I need to know everything because the person that I'm talking to is brushing me under the rug and acting like I'm I'm really just crazy that I just have to, you know, suffer through this. And uh yeah, Julie drew my labs and she looked at my labs. And um, you know, I'm gonna kind of speak for her a little bit here on functional medicine because I she's shared so much of it with me, and I'll tell you my experience a little bit is that functional medicine is very different than regular medicine because functional medicine looks not only at labs, but it also they look at symptoms. And what they do is they sit there and they look at the symptoms and they look at the labs and they they kind of Julie, would you agree that you you're kind of looking at the labs really in a different, sort of a different light? The numbers are a little, you're looking at different numbers and things like that.

SPEAKER_04

I look for and so optimal and not just normal.

SPEAKER_01

Right, great, optimal. She's looking for optimal level, not not just regular. And so she came back and said, Brooke, you you should you're you need this, you need this, you need this. I mean, my B12 was wiped out, hardly had any. The doctor couldn't find that. I mean, so when I when I sit here and I talk how great Julie is, she Julie really does listen. And you need to find somebody that listens to what you're saying and is actually taking what you're saying seriously because as a woman, we know when we're off. So this is why I lean more towards functional medicine now. Not that there's anything wrong with regular medicine. I have no problems with that. I just in my circumstances, it did not work for me. And so this is why I went the functional medicine route. So, and I think that this is um a a great way. I think, I think now in life we're looking for maybe more holistic and maybe different ways of approaching our health now. And Julie has been a godsend for me. She really has. Um, so if you're in the Tennessee area, you're gonna want to call Julie. But yeah, so we are um, but yeah, let's get, let's get into, let's get into peri. Let's let's get into it. And Julie, can you tell us okay, what what's happening? Let's talk about age first. Let's just kind of uh tell people what is it and when does it come about and things like that. Just kind of get the foundation for it. Sure.

SPEAKER_04

So perimenopause is the phase before menopause, before the period stops. And the uh first of all, you have to know the average age of menopause. And in the US, it's around 52, and perimenopause can last 10 years before you go through menopause. So if you go by the average age, it can back you up to 42. But then the span of typical menopause is usually 45 to 55. So if you are someone who goes through menopause a little earlier at 45, then your peri window could start back at 35. And often women are not diagnosed correctly, as it's just being perimenopause. And a lot of it is that that people think that if you still have regular periods, you're not in peri, and that's absolutely false. Um, so peri is is mainly diagnosed by a constellation of symptoms. So even if you have regular periods, if you're feeling off, like Burke said, I always tell women in front of me that they've been in their body their whole life, if they know something's off, it probably is, and they deserve being listened to, not just by me, but by anyone. So it's putting together those those symptoms and and knowing what's going on, like we were talking about earlier, awareness is as half of it, and then knowing how to deal deal with it from that point on. So um, this is a a very chaotic zone for a woman. Anything can happen, and like I said, the periods can be irregular for a long time, but you might see a lot of shifts. Like you start waking up at three o'clock in the morning because your cortisol is spiking, you have a lot of anxiety. Yeah, you have a lot of anxiety. You can start having hot flashes and night sweats in this phase. You just have no patience for anything, and then even if your periods are regular, they might be super heavy, you might pass clots, they may last longer than the typical five to seven days, they may be shorter, you might skip a period. So it's truly just chaos. And what's what's happening is especially as you get to late perimenopause before menopause to enter that last little window, there's very erratic hormones being made. So I I often will will describe it to my clients as like you're you're like an old car that sputters and stalls and and lurches, and so that's what your hormones are doing. So it could literally be something different every day, your estrogen and progesterone just going on this roller coaster ride. And so you have a roller coaster ride of symptoms, and so treatment is targeted at trying to even that out.

SPEAKER_00

And that that makes sense to me. I and I I really appreciate you encouraging people to be their own best advocate because I've definitely been maybe not in this particular realm of my health, but I had a couple shoulder surgeries years back. And after the first one, the pain got worse. And for five or six years, I was going from doctor to doctor, MRIs, everything. And they were telling me there's nothing wrong with you. Well, it ended up there was something wrong with me. It was very rare. And I went up to Stanford and got it fixed. And 48 hours after that second surgery, I was golden. But for a long time, I had people saying, huh, we're not really sure that we don't see anything. So um it made me feel like I was crazy. And when I finally found that doctor that believed in me and advocated for me and ultimately helped heal me, it would, it, it made me, it taught me the lesson to not just take a first opinion, especially if it's not changing anything or helping. So I appreciate you bringing that up because I think too many people just go, okay, well, they said there was nothing, so I must be good. And and they just live with the pain or they live with the discomfort. And it can be very uh debilitating uh mentally and physically, I think, when when you feel like people don't believe you.

SPEAKER_04

Well, that's a pet peeve of mine with my medical colleagues, is that if we don't know the answer, sometimes we would we blame the patient. And that's not the right approach. If if I don't know, I just simply say, I don't know, and I'll look into something. And I don't ever want a woman to feel like she can't tell me what's going on or she has no one to listen because we go through enough of that already, so we don't need it to to cross over into healthcare. So we absolutely need to be listening to women.

SPEAKER_01

Yeah, I I completely, I completely agree. Uh, can we touch base on something that Danielle speaking of shoulders, frozen shoulder? I go to the gym. I'm gonna let you explain what frozen shoulder is in a minute, but I go to the gym and there are so many women there, they're like, oh my shoulder, my shoulder. And I'm like, frozen shoulder. They're like, yeah, frozen shoulder. I'm like, it's a thing. So Julie, tell us about frozen shoulder.

SPEAKER_04

Well, first of all, literally every cell of our body needs estrogen for different reasons, and it's it's anti-inflammatory for one. And frozen shoulder is a lay term for adhesive capsulitis. So it literally means that the tissues get very stiff and it causes very limited range of motion. And like Brick said, it can manifest as pain with moving moving the shoulder. And this can be that can be a very serious and debilitating injury. And if a woman is ready to start estrogen, that can be one sign. Estrogen doesn't cure everything, of course, but that is a very common thing in perimenopause, along with with other types of uh tendinopathy, like gluteal tendinopathy is super common. It's something I hear about a lot. So pain in the buttocks, in the hips, um, can't sleep on your side anymore, you're tossed in and turning. That's a very that's very common uh sign of estrogen deficiency. So um that's actually under the umbrella of musculoskeletal syndrome of menopause. So that's a real thing. And there's there's a good orthopedic doctor out. I can't remember her name. I think her first name is Vonda, but I see a lot of her podcast replays, and she's she's a champion for hormone therapy and women because of what she sees.

SPEAKER_00

That makes so much sense. And I I I know Brooke's aware of this, and I think our audience to a certain extent, but I was trying everything I could to lose my quote unquote baby weight because my baby is now driving. Um, so I've been holding on to it for a while. And I mean, we're talking five days a week of cardio, limiting calories, like feeling like I was doing everything, and nothing worked until I started focusing on my stress level. And I'm guessing I'm learning about cortisol and you know, having too much cortisol. But once I made a concerted effort to manage my stress, I felt like other things started changing in a good way. And so I tell myself when I start feeling overwhelmed or stressed, like, okay, is this a really stressful event or is this something that is just making me feel stressed out because managing stress seems to impact every other part of my life. Do you do you find that with the cortisol levels being spinal?

SPEAKER_04

Absolutely. And when you have inconsistent female sex hormones, the adrenals are trying to help. So they're trying to they're trying to kick in where they can. And ideally, once your hormones get irregular, the adrenals can make small amounts of estrogen and progesterone. But what I find, and this was true for me myself, is that women of our generation, by the time you get to Perry, your adrenals are shot. You have you're taking care of a family, you're working full time, you're taking care of aging parents. There's so much on your plate. So you just don't have a lot of reserve when you get there. And so your body's compensating by making cortisol. And unfortunately, it spikes too early. So it's if cortisol spike at 3 a.m. means that your brain thinks it's time to get up. So you get that huge rush because there's cortisol is supposed to spike soon after we wake up in the morning. So that's that's an inappropriate time to time to spike. And because cortisol is a steroid, you start getting elevated blood sugar and insulin, and when that happens, the body loves to pack the weight around the middle. So this is a very, very common phenomenon that happens.

SPEAKER_00

Wow. And we seem to be.

SPEAKER_04

And then you're you're not keeping yourself balanced and you're not gonna you're not gonna reduce stress that way.

SPEAKER_00

I I think a lot of parents of teenagers are seeing that because they're they're looking at education, and I won't go off on a tangent, but I think this is relevant. They're they're saying 2010, that's when the one-to-one devices in the the public school system were were assigned, where students started working at all ages on screens and on computers. And I I I was in a training a couple months ago and with uh the county sheriff's office, and they were saying that they have incidences where they're interviewing teenagers and their phones like, you know, down face down on the on the table, and they can't even focus to answer questions because they are so wanting to be looking at their screen. So I understand when you get a text message, when someone likes your post, you get that little burst. Uh and and it so when you're constantly having that, and then all of a sudden you have to put your phone away, your brain is searching for that that little is it dopamine or serotonin? Stimulation. Dopamine. That's scary. And I do have grounding sheets and I love them. I and I my my family makes fun of all my little voodoo purchases, they call them, but everyone in my house now has grounding sheets. And if for some reason we have a bad night's sleep, it's amazing. It didn't get plugged back in. So there's something with the with the grounding. I I don't pretend to understand it, but it's pretty fascinating. It is.

SPEAKER_01

Yeah. Everything, everything is energy.

unknown

Yeah.

SPEAKER_04

I was gonna say Burke is the best person to answer that about vibrations and yeah.

SPEAKER_01

Yeah, everything about energy and mindset. And I and I think that's something that has personally helped me through this perimenopause uh place that I'm in is my mindset. I definitely think that I would be all over the place if I didn't have it. Um, it definitely is a is a grounding place for me and it has brought me a ton of awareness. Um, and I do want to say as we're talking about this, you know, we're gonna talk a lot about a lot of symptoms and things like that, but I do believe that this is a very beautiful time in a woman's life if she does it right, if she gets the help that she needs by a functional medicine doctor, if she has uh the ability to get a mindset coach uh and have someone that helps her through these things. I think it can, I actually I know it it is a very beautiful experience if you get the help that you need so that you still, if you're married, you keep your marriage, you know. You, you, you go through these, you know, your your children don't end up, you know, lashing out at you and things like that. And I think that we are what's happening is that we're having our own transformation. We really are in puberty. At this time, I always make a joke. I say we go through puberty around 12 and 13, and we go through puberty around 40 to 55. And our kids usually are in high school at this time too. And so they're also going through some puberty stuff. And so everybody's going through puberty. And it is a time for us that I think for the first time in a woman's life during this time, she's actually expressing herself in a way that she's never really been able to express herself before. And it really is a beautiful experience if you can't, if you do get the help. So we're here to help you and guide you in a way that, you know, if you can get that help, get it because it it's it's it will help so many avenues in your life. Um, that I I it it's it's just amazing. I think it's a beautiful experience. So we have a lot of questions from. viewers. So but before we do that, I really want to go into I want to leave perimenopause now and I want to move into menopause. And I want to give, I want Julie to give us kind of the breakdown for that. Like what what what is happening now? How do we know we're actually in menopause? And what kind of symptoms, Julie, do we still have during this time? Can you can you explain to that, explain to us a little bit about that?

SPEAKER_04

Sure. So the official definition of menopause is 12 months without a period and it's 12 consecutive period free months. So if you go six months without a period and then have one, you start over counting for the 12 months. And some providers will say you are not eligible for hormone therapy until you reach that. But there's actually some some newer studies and I can tell you just from my practice there is time to start hormone therapy a little bit earlier in in perimenopause. But the symptoms that you have in peri exacerbate in menopause. So if you had hot flashes and night sweats already they're going to get worse. If you were moody that's probably going to get worse. If your sleep was bad it's going to get worse. If you have aches and pains it's going to get worse. So all of those symptoms exacerbate I often have people come in front of me that feel absolutely miserable. A lift up brain fog that is a huge one. That is a huge complaint in carry and menopause. Women actually start to believe that they have early onset Alzheimer's it's that scary like can't remember their kids' name or miss their exit all the time. It's it's really really life-altering for women to have that much brain fog. It's it's scary. But a lot of it a lot of it can be solved hormonally. Of course not every every problem is hormones but those are the biggest symptoms that I see and then the improvements that I see once we start hormone therapy.

SPEAKER_00

The brain fog is something that I think I I I don't I I just feel like I'm a scatterbrained mom because I've got so many I tell my kids and my husband all the time you're worried about yourself. I'm worried about all y'all and my stuff and all the people I don't know and the world. I mean you you you you get that feeling of being overwhelmed but I've gotten to the point where and I used to make fun of my mom for this and I'm sorry mom that I made fun of you because I'm it's going happening to me now where I'll go into a room to get something and forget so now if if I'm going to get I don't know a pair of shoes I'll walk down the hall going shoes shoes shoo shoes so that when I get there at least I've got this keyword into my head but it's bad. I mean it makes me think I I I love history. I could rattle off dates and events and talk for hours but I don't remember what I had for lunch yesterday. So that short term versus long term memory is is pretty pretty phenomenal.

SPEAKER_04

It is it is and I think I think this part of this is like you said women are so high functioning and they manage so many things and I'm not dissing men I'm just saying we are used to managing everything for the kids the house what's for dinner blah blah blah and then when you start to see cracks in it with brain fog and inability to tolerate stress it's it's dramatic to us. And it's because we are used to being able to function at a much higher level that makes sense for sure.

SPEAKER_00

So I I have a question about the sleeping thing because I I have a lot of my friends that say they have a hard time falling asleep. I'm the opposite I can fall asleep no problem. Usually I mean we're trying we were trying to watch a movie last night I think we maybe got 10 minutes in and I was out so I have no problem falling asleep but like clockwork between 3 and 4 a.m every single morning I am up and it's not just like I kind of wake up. It's how you described I'm up almost like there's an alarm clock and sometimes I just have to get up and start doing something but a lot of times I'll sit there and just kind of stare at the ceiling. So is that's a hormone shift also when when we're waking up in the early morning like that?

SPEAKER_04

It's it's often a number of things. It it can be inappropriate cortisol spike too early and in peri that can be a manifestation of low progesterone as well. Progesterone's a calming hormone and it reduces anxiety. So it often lets us unwind and sleep and for a lot of women starting progesterone in peri is a game changer for sleep. There's there's some it's not quite as dramatic but it can be it can be super helpful to help you fall asleep. So you have to look at the different reasons why and three o'clock in the morning is in Chinese medicine is called the liver hour. So is there something else going on like is your blood sugar not balanced? Is there a reason why you're waking up and I always tell people this was passed on to me but I always tell people to quit looking at the clock when you wake up if it's dark you know it's not time to get up because you're training your brain and Brooke can tell you whatever you tell your brain it's going to happen. So when you go down and go when you lay down and go to sleep you're going to be like sure hope I don't wake up at 3 a.m well what's going to happen? You're going to wake up at 3 a.m so you have to I've even told people to cover up their their clocks before and take their watches off. I had to do this for a while and you have to retrain your brain to stop doing that. So yes hormones is a lot of it but we also train ourselves to do that.

SPEAKER_00

So one just quick follow-up on that so I keep seeing the ads especially on Instagram but everywhere for these home hormone testing kits. Is that something that you would recommend or do I do I need to seek out a a functional profession medical professional around here or do you do telehealth and I can call you like how how would someone like me approach that since this is kind of a newer concept to me?

SPEAKER_04

I do telehealth in Tennessee. So those are the only clients that I see are in the state of Tennessee. As far as those home kits to me they don't serve any purpose in perimenopause and this is where things get confusing. So we talked about the chaotic roller coaster of hormones in Perry and your estrogen and progesterone can be something different every day. So if if you spot check estrogen and progesterone tomorrow it's something it's going to be something different next week or even even the next day. So it's very inaccurate and it only causes confusion and those home kits would would do the same. So I have to remind my clients that in PERI it's really not valuable information. Certainly when you get menopausal and it looks like you've gone about 12 months without a period then those are times to start tracking tracking female hormones and then also you're you're getting therapeutic levels of hormone replacement. But for PARI no some of the some of those home kits are for menopause and what they're checking is the FSH level and if you remember go back to the stages of the cycle we talked about FSH stimulates the ovaries to get an egg ready. When you are out of eggs that's when you're in menopause. So if you're out of eggs your brain is is yelling hey ovaries did you hear us we we said get an egg ready and when there's no response they just keep yelling so FSH just keeps going up and up so that's how you diagnose menopause by labs is looking at an FSH it's usually over 50 and I imagine that's what those those home kits do is just see if you've got an FSH over 50. So could that be valuable? Yes the tried and true method for me and the way that I'm trained in hormones is to use is to use blood work. But that can that could reassure somebody that they're in menopause and then they could seek out a provider but it's going to miss a lot of people in Perry that are knocking on the door and don't feel good. So um to me I think it's better to talk to a hormone provider who can advise you so that you don't you don't get lost in the cracks.

SPEAKER_00

Awesome.

SPEAKER_01

I appreciate that thank you Julie yeah and I I I do want to touch on something too is that you know our mother's generation they made hormone therapy scary and I think they even put some black box labels on them which I think now have been removed. There are some things coming out about that. Julie what do you what do you kind of say about that and can you spread some light on that for people that maybe have this thinking that it hormone therapy is dangerous.

SPEAKER_04

I can so 2001 when there was a study called the Women's Health Initiative and and I graduated from nursing school in the late 90s. So this is kind of the time I was getting out into the world. They published this study and it was flawed for many reasons but it basically said all hormones are bad. We've linked them to negative things with women like heart attacks and strokes and blood clots and this study went out and all the providers at the time just pulled their patients off hormones and they didn't differentiate whether they were talking about biodenticals or synthetics, um, how old the woman was, when hormone therapy was started from her last period so there was a a a lot of flaws in it. And in retrospect now I've seen people come forward and say you know I think this is one of the biggest blunders in the history of medicine is that this false information went out and women were taken off hormones or they were denied hormones. And now women that were that were in peri and menopause during the 2000s have osteoporosis. They have Alzheimer's Alzheimer's is at an all-time high in women right now heart disease is the number one killer of women and there is no drug that does what estradiol replacement does for a woman's heart. So that generation is is not doing well physically because of the lack of hormones. So it I love that all of these providers are in in the press now they're doing interviews we're seeing Dr. Mary Claire Haberge and people are writing books like her. I love it. I love that they're getting audiences and there's lots of women paying attention I like when women come to me and say that they've read her book or read Dr. Casperson's book or they've seen them on Facebook.

SPEAKER_00

I love that they try to inform themselves because I think we we're on the the precipice of really breaking this open and getting more women not only informed but also cared for properly we actually just did a episode a couple weeks ago heredity in the family and one of the things we were really trying to remind women and pretty much everyone is to take care of yourself and not feel guilty about it. And I know I I do this every day where I think oh I really should be getting some laundry going or or doing something around the house but even 15 20 minutes in the morning do a little prayer meditation maybe plan out your day and reading a little bit I always feel so much less stressed. Even if I read for 10 minutes, it's almost like I it's like meditation and I feel so much better after I do that. And it I chide myself why don't I do that every day? Why don't I take better care of myself? So all of this that you're saying is just really reminding me the importance of that self-love of that self-care and and starting your day off like that instead of just turning on the news and getting mad at the world like a lot of a lot of friends tell me they do.

SPEAKER_01

Yeah. And I think something too is that society doesn't see functional medicine well let's I don't say society let's back up let's say insurance companies do not cover a lot of functional medicine programs. And I really hope in the future that that changes because it really is needed. And I think this is why women are so confused. They don't know what to do. Some can't afford you know functional medicine because it can be a little bit more on the pricier side. But I am going to tell you that it it is a great investment. It has definitely changed my life and so I I really hope that the women that are not getting the attention they need from general medicine that they really do explore a functional medicine practitioner doctor in their area. Like I said if you're in Tennessee you can call Julie if if not unfortunately her practice is only here but we're working on getting her going on other other states hopefully soon. So but I girls let's jump into some questions that I have because I want to uh I want our audience to get um as much as they can out of this so one of the questions was night sweats help us what do we do for night sweats Julie night sweats hot flesh and night sweats are the most commonly heard about symptoms of menopause and it's it's a a drop in estrogen affecting the brain so it's the hypothalamus that's getting affected.

SPEAKER_04

That's our temperature regulation. So that just goes to show menopause in peri is not just an ovarian disorder it affects so much else and it's affecting our our brains and the the uh biggest thing you can do is get on hormone replacement and like I said sometimes I'll put people on hormone replacement in Perry even though they haven't stopped having periods there's a lot of stuff to weigh but that's the biggest thing. For me personally I'm going to be 54 this year and I I went through menopause right at 52 and the night sweats was the worst thing I ever experienced. I mean soaked down through the sheets even if you had socks on they soak too and it's it's absolutely miserable and disgusting to wake up that way and then you have to lay a towel down on your seats and change your pajamas and all this. So I I think I'm in a position to understand that because I went through so much of it. In fact I went through a lot of symptoms of menopause but absolutely um estradiol is what saved me. Okay good so there's there's also that there's also other things to consider like are you having blood sugar fluctuations? That's a big reason why people have night sweats so it's not just a one and done simple thing. It can also be related to cortisol spikes. So you have to you have to talk to someone but in menopause night sweats usually responds well to esterol.

SPEAKER_00

Okay perfect. I remember my mom calling them like power surges and you know you're kind of flapping your your shirt and um I I used to always think and this is my ignorance I thought gosh seems a little dramatic to do that until it happened to me and it it felt like I drank 48 ounces of hot coffee. And I it's very humbling to get older and see a lot of the things that you used to kind of roll your eyes at or think people were being dramatic. And you almost want to jump in a time machine and go back there and say, I'm so sorry that I didn't take you more seriously because I most people can feel when their emotions are shifting a little bit, they don't know why. So I think this conversation is so important to like you said, break this open. Let's do more research. Let's figure out how this this heart of the family of any type of family in this this woman in her her 30s 40s 50s figure out what's going on find some help if there is some available and educate those around her so that this isn't such a oh gosh mom's PMSing or you know whatever the case is um this is this is fantastic.

SPEAKER_01

Yeah what uh I I think I think Danielle had this question too and actually someone else had it. Um magnesium. I wanted to talk a little bit about that. I I use magnesium to help me sleep. There were some questions about magnesium soaks too. So Julie do you know can you tell us a little bit about that and your experience with it? Sure.

SPEAKER_04

I love magnesium and it's one of the most common things that I prescribe as a supplement. But you have to understand there's several different types of magnesium. So you have to choose the the right one for your circumstances. I personally take I think three different kinds because I have different needs for them. So if you're if you're wanting magnesium to help you sleep those are typically magnesium glycinate and L3N8 help with sleep and restlessness so you take it at bedtime. L3 is also supposed to be good for our brains so it can be a double whammy for us. As far as magnesium soaks go yes they can be very helpful to help you relax. You do have to stay in the bathtub like 20 minutes to get the full effect of it. So you can't just soak for five minutes. It's a slower way of getting getting into your body to use it because it's soaking in through the skin so you do have to give it give it time to be beneficial for you.

SPEAKER_00

Can we do both? Like can we take the supplement and do the magnesium soak or is it a one or the other type of situation?

SPEAKER_04

You you absolutely can do both. A bath is good for see what see what works. A bath is good for so many other reasons besides getting magnesium in it's it's relaxing and is a little bit of me time so it goes back to that self-care so there's lots of good reasons to do it. It's particularly helpful in the in the evening for sleep so but women burn through a lot of magnesium and we have higher needs even if you had a magnesium blood draw that was okay that really doesn't mean anything except that it's not critical but we we need magnesium for so many processes in the body for for things to happen. So absolutely that that is something I use quite a bit with myself and my clients yeah I do magnesium soaks.

SPEAKER_01

Oh no I do them too Danielle and I I can send you what I use and then you could try it I I love it. It really does relax you but you you do got to be in there for a little while but it it it does really relax you. I I feel very relaxed after I after I soak in magnesium because I I don't know never really thought about it but now that I'm thinking about it I'm like oh yeah it's the magnesium that's just soaking in my body. But yeah I just one day I was like oh I'm gonna try this because my muscles were so sore. Yeah and I feel like magnesium soaks help for that too. But uh Julie yeah and I want to real quick because this is kind of a segue I guess to it is uh you know Danielle was even talking about earlier about uh cardio cardio cardio cardio you know we're trying to lose this weight but really what I've heard and I don't know if you would agree with this is strength training is really good for women in this in this time of our lives. Would you can you explain some of that and what's going on there?

SPEAKER_04

I absolutely agree. I have a bachelor's degree in exercise physiology and from the early 90s and back then everything was about cardio and we've had to shift all our thinking about exercise over the years that I've been leg warmers in practice. Yes everything was aerobics and running and stairmaster elliptical machine everything was about cardio so we have to shift our thinking so we need to be strong when we get to be older women and you gotta you gotta start now you start losing muscle in your 30s and it it gets more so exponentially through through every decade and loss of muscle it's called sarcopenia that's what contributes to old age the most we lose our balance we fall you get a fracture those things accelerate aging and have a high morbidity mortality so yes strength training is important I do want to stress that you shouldn't look at strength training as your way to lose weight because that's you're not going to be successful with the results. You have to approach strength training as this is what my body needs this is my nursing home prevention program. I want to be strong I want to be able to get out of a chair or up off the floor so you have to look at it with that lens. Yes it can have some benefits on your metabolism like more muscle tissue takes more calories to maintain it but it is not your your big weight loss plan. Your nutrition is and you also have to think of yourself in your 40s and 50s you're not the same person you were in your 20s and 30s. You've got different hormonal needs different shifts so you have to shake things up a bit we may have to adopt a different diet like more anti inflammatory Inflammatory, we may have to give up alcohol for a period of time, or altogether we don't tolerate it like we used to. So you have to think of yourself that way. You can't keep trying to stuff yourself into a 20-year-old's body because you're not that anymore. So you have to adapt with it and see what your body needs. Yeah.

SPEAKER_01

Yeah, I love that. You can't stuff yourself into a 20-year-old body. Y'all. Yeah. We're in our 40s. Love it. Yes, I love it. 40s or 50s. Yes, I love it. Okay. Next question. How soon can you use vaginal estrogen?

SPEAKER_04

To my knowledge, there's not a set time. I started in clients who have urogenital symptoms. Again, that's another syndrome that we can have of menopause is urogenital syndrome of or genito-urinary syndrome or menopause, let me put it that way. There is a tiny, tiny, tiny amount of women where vaginal estrogen would not be appropriate for. And so that means that almost everybody could take it. I do start women in Perry on it who are having symptoms of vaginal dryness, or they have a lot of urinary frequency, or getting a lot of urinary tract infections, because those can be symptoms of vaginal atrophy starting. And when vaginal atrophy starts, the skin starts getting thin, and you get those symptoms of like frequent urination and pain with sex and and so forth. So vaginal vaginal estrogen just works locally, and because of the dose, it does not get your blood levels up, so it won't throw your hormone balance off by using it vaginally. But um, I'm not I'm not afraid at all to give it to a woman and a woman in her 40s who's symptomatic and could benefit from it.

SPEAKER_01

Okay, so another question kind of going into that was them not being able to hold their pee. And then the kind of the other question they asked about that, like they have heard something about maybe our organs are shifting at this time too. So is that something that you can you can kind of talk about? Because I I don't know about this. So is this is this sort of a symptom?

SPEAKER_04

That that does happen with a lot of women, the organ shifts. After you've after you've had children, things don't stay up in the pelvis like they used to, the the bladder falls. Women I've seen women get incontinence associated only with their period, and that's because if they have a very heavy period and they have a lot of pelvic congestion that pushes on the bladder, they may leak urine. So that can be common in peri. Um incontinence itself is just a common uh common thing in perimenopause where you lose control of urine for for no apparent reason, it's hormental shifts. And I like I said, I really believe in in using vaginal estradiol for that because the alternative is if you go to the doctor and say that they're probably gonna give you a pill, like a urinary frequency pill, and those those kind of things dry everything up and you got a dry mouth, and it may help some, but it doesn't treat the root cause, which may be some vaginal atrophy. So going at it from from that approach is usually quite helpful.

SPEAKER_00

Yeah, no one no one tells you to be scared of trampolines after you've in birth, and then you're like, what is going on?

SPEAKER_01

Well, uh I we uh there's a common joke. I I go to burn boot camp. I I think some people know that. And you know, it's a lot of it's a lot of heavy lifting some days and things like that and um strength training. And I absolutely love it. But the joke around there is is have you peed your pants yet? Uh because a lot of women that are like, you know, but I'm serious, like 35 to probably 60s, and you know, they're like, oh yeah, I've peed my pants during a workout. Oh, I've peed my pants during a workout. It's just something that we're like, oh yeah, well, that's what we do. So um I would say that it's somewhat, I guess, kind of normal, but um pelvic floor, that's a whole nother episode. But pelvic floor um is yeah, it's really important to strengthen that. Yeah. And ladies, it's not just Keggles. Uh I also have a pelvic floor practitioner that I have gone to. We should probably have her on someday and have her talk.

SPEAKER_04

Because we absolutely need to normalize women getting pelvic floor therapy, whether they had vaginal bursts or cesarean. It's just it needs to be normalized that that that happens.

SPEAKER_01

Yeah, and it yeah, and keggles are not are not everything. They're not that's not the whole the whole story. Yeah, definitely. Okay, last question. Can you tell us the five most important things that we can do to help ourselves during this time?

SPEAKER_04

I think sleep is super important. If um someone comes to me and they're not sleeping, that's the first thing I want to work on because that's gonna affect your cortisol and how you feel all day long. So sleep, whether it's adding progesterone, magnesium, other things, that's super important. It's also time to tighten up your nutrition. Like I said, choose more of an anti-inflammatory type diet. Doesn't mean that you do everything perfect, it doesn't mean that you have to be 100% gluten and dairy free, but just adopt a different way of life where you're choosing lean proteins and you're eating protein at every meal, 30 grams at least every meal, and then you're you're eating a vegetable and fruit rich diet. So sleep, nutrition. Um you need to make sure you are creating regular exercise patterns during this time. It will help you reduce your stress and it will help you build muscle and has it has an effect on your metabolism. So that needs to be part of your your routine. You need to do things with your kids that are active. So um that needs to be a normal part of what you do. And then I would say what Danielle was referring to earlier is the stress reduction, actually learning how to reduce stress, finding out what you need. For some people it's therapy, some people it's life coaching and learning how to approach life in a positive way. For other people, it's doing vagus nerve exercises and so forth. So that is that's certainly super important. And then five, I would just I would just say keep yourself aware, just know what's happening to your body so that you know how to advocate for yourself, you know how to talk to your partner, your kids, your job, if if something's going on with you, just information is is very valuable, and there's there's so much more access to information now with the internet and these um these pioneers and menopause lately that have been coming out. So, so absolutely spend some time with that and advocate if if your doctor does not have hormone training, and it's okay for you to ask, have you been to a hormone course? Because I'll tell you, they don't teach this stuff in medical school and they don't teach it in NP school. There's there's not much time spent on this. So it's okay for you to ask, have you had extra hormone training? And if not, it's true right to find somebody who does because you want someone that's well versed in in using the hormones and knows how to tailor them to you and not just a one-size-fits-all script for everyone. So it's it's okay to ask those questions.

SPEAKER_00

Yeah, Julie, I really think that the five things you just mentioned are really resonating with me because I have I keep hearing repeatedly that it is very important for everyone, not just women, to try to sweat every day. And it doesn't have to be this big long two-hour workout, but taking the dog for a walk, going to a sauna, you know, going for a little jog, because our system does have a way of getting rid of those, those, those toxicities, if you will, but getting that sweat on seems like it's it's really important. Would you agree with that?

SPEAKER_04

Absolutely. That's one of the ways we detox is by sweating. And if we don't, if we don't move, we don't sweat unless you're having a hot flash and that doesn't count. So um gotta do something to help your body detox. Absolutely. And getting rid of toxins is is something that we could spend a whole podcast episode on about endocrine disruptors and how to get rid of them. Um, that's super important to learn about the products you use and and so forth. But I won't I won't get off into a big tangent on that.

SPEAKER_00

But the the sleep is huge though, because I do not get enough sleep. And I just I think I've kind of resigned resigned myself to the fact that I'm a busy working mama and I'm not gonna get very much sleep. But now that I'm stopping and thinking about it, sleep is solid night sleep.

SPEAKER_04

Yeah, sleep is also about a time to detox as well, because you have to give your body appropriate rest so the liver can do its primary job. So you have to think of it that way. It's our reparative, it's when tissues are repaired. Uh, we we need that period of time. So it's not just it's not just something to make us feel good. It's absolutely essential to your body to sleep well and long enough. Women need like seven to nine hours. Yes. Seven to nine hours is what you need.

SPEAKER_00

Well, and it it goes back to the awareness thing. I I I know I've told Brooke before as an entrepreneur, I thought if you're gonna be wealthy and successful, you need to be stressed, you need to be overworked, it needs to be a struggle. And I I just don't believe that anymore. I think we've been sold this lie that that's what equals success. And now I think it's quite the opposite. I think taking care of ourselves, taking care of our bodies, finding time to improve our minds, improve our bodies, spend time with loved ones is more important than just the the the grind, so to speak.

SPEAKER_04

I agree.

SPEAKER_01

Yeah, sleep is so very, very much needed. And yeah, get your nine hours. Get your nine hours. Uh there was something that someone else said in the comment section was that she understands now when her mom said the change of life. And I wanted to kind of touch a little bit on that. Being a mindset coach, I would, I feel like it'd be a disservice to not talk about this during, you know, when we're going through this, this sort of time in our lives. And I really want to encourage women, again, we talked about this a little bit earlier, but to really encourage women to not look at this as a midlife crisis, to really look at this as an inner awakening and to really look at yourself and start getting to know yourself maybe in a different way. Start shedding old roles that you've played or your identity might be changing. You might be finding that you're tired of the same patterns in your life or the same experiences over and over again. And a lot of us women right now are asking, you know, who am I now? And what do I actually want with my life? And this is the truth that is really emerging from you. And like I said, this is a beautiful, beautiful time in your life to really experience yourself in a way that you've never experienced yourself. So, like I always say, you know, what you think about and the words that you use are really important. And so I think if we we move from this midlife crisis, we keep telling ourselves that over and over again, and we move more into this inner awakening or this great awakening that we're having, it will definitely change the mental capacity that you have to hold what you're going through. And a lot of this, and I think Julie will also agree with this, that this is not only a body transformation that we're having, but it's also a mental transformation that we are having. And we need to explore both together. I Julie and I talk all the time. I have clients that come to me and I tell Julie, I said, Julie, you you have to see this client. Um, and she and Julie sends clients to me too and says, Listen, you you have to see this client because something Julie and I have really come to terms with in both of our professions is that this mind and body connection is so huge. And with one without the other, it just doesn't work. And so Julie and I have really partnered with a lot of our clients to help them because we have found that there has been a gap there. And we need to start closing the gap. And the gap is, you know, you need to get your physical self right and you need to get your mind right. And once you do that, it's it's it's it's a very beautiful process. And Julie, I know you've seen it time and time again with your clients. Uh, when they really sort of put this work in, this, this, this, you know, the things that you ask them to do and the things that I ask them to do, we definitely see more of them having more of this sort of more of a beautiful experience. Would you agree with that? I completely agree.

SPEAKER_04

And from personal experience, I would say that too. I started a business during the throes of perimenopause and didn't fully understand what I was going through. But to your point, it can be a very beautiful time because it stirs us to make changes. But you have to you have to connect the dots with your brain and your body and what you're what you're able to accomplish. You can't separate the two. And I don't think I could have started a business without proper mindset training for sure. It yeah, it just lays the framework for everything else that happens.

SPEAKER_01

Yeah, it really does. And and I I couldn't have laid, I couldn't have kept going with my business without you making sure that I am I am physically and mentally in there. I am okay with my hormones. So um something that I want to touch base on real quick before we end this episode, because we like to keep these kind of short and sweet for you all so that you, you know, don't spend hours and hours of listening to us talk. But one thing that we didn't talk about that I just want to touch base real, real quick, is testosterone. And I think it's a really important hormone to discuss real quickly before we get off here. So, Julie, can you explain to us a little bit about testosterone and not from the man's perspective, but from the woman's perspective?

SPEAKER_04

I'm glad I'm glad you're making time for testosterone because I happen to love testosterone and it's something that I fully incorporate into my practice. But testosterone gets gets a reputation of being responsible only for libido, and that that is that's not so not true. We need it just like we need estrogen and progesterone, and with those hormones, testosterone also declines in perimenopause and menopause. So this is a an opportunity to replace that hormone as well. Testosterone and estrogen and progesterone all play off each other. So if you don't have one that's optimized, it's gonna kind of mess up the other chain. So there has to be a balance between them all. But testosterone does help us with libido and it can help with vaginal and and urinary symptoms, but it's also gonna help us with making our muscle mass, it can reduce our cardiovascular risk. And I'm talking about biodental testosterone. For women, they have an improvement in their well-being and their energy, usually. And testosterone also helps modulate the immune system. So, you know, most people that have autoimmune disease are women, so it's a particularly important hormone to optimize if you've got somebody on that continuum of having autoimmune disease. And replacement for testosterone is controversial because there is not an FDA approved product for women on the market. For men, there's probably 15, and I don't even know. I don't even know how many are on the market. There's a lot, there's a lot of men's products on the market. We don't use the same dose as Amanda's, it's much, much less. So that's a caveat that needs to be understood, and it's a controlled substance. Um, at least it is in Tennessee, where where I practice, it's a Schedule III drug, and so that's prohibitive if some providers are not willing to prescribe it. But it's a super important part of balancing the hormones and can certainly improve quality of life, and it's not that expensive.

SPEAKER_00

And even to come that women uh would take testosterone. That just shows I had no idea. That's interesting.

SPEAKER_03

Yes, we need it just like we need the other ones. And it's cheap.

SPEAKER_01

It's cheap, y'all. It's great. It is. Yeah, yeah. Um, yeah, okay, great. Well, I think we've covered a lot today, and I am I'm so excited for this episode to launch and and for everyone to hear this. Uh Julie, will you promise us that you will come back again and talk more about all the things that we didn't get to talk about today?

SPEAKER_04

Absolutely. I feel like I feel like the time just flew by. So I enjoyed it. I'm so passionate about how we letting women know what's going on with their body. So absolutely.

SPEAKER_00

And that was one of the the main goals of this podcast is Brooke and I felt like we were having these conversations where with all these awakenings and all these just breakthroughs, I guess would be a way to describe it. We wanted to share that so that not everybody has the time to go dig into doing research or talk to experts. And so if we can help even one woman per episode, obviously I hope it's more than that. But that it just it makes brings me so much joy to to think that someone's listening to this and thinking, oh, that makes sense, or a husband's listening to this and going, oh, now I know that they're you know different types of the cycle. I thought that was fascinating. I'm really excited to to put into practice some of the suggestions you gave us. So thank you. Thank you.

SPEAKER_04

My pleasure.

SPEAKER_01

All right. Well, thank you for listening. And of course, if you have any questions, you can email us. The uh all the information will be down below, and you can just click on it. And we will see you all next time. Bye.

SPEAKER_03

Bye.

SPEAKER_01

Bye.