Beyond Hormones: The Deeper Causes of Menopause Symptoms - Sonya Jensen

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2:01And today, we get to talk to a naturopathic physician, Dr. Sonja Jensen, to explore a really holistic approach to menopause. And one that looks way beyond labs and prescriptions and into the stress and the trauma that got health, nervous system regulation, and the deeper stories that your body may be telling you. And before we start the show, after a little disclaimer here that today's conversation is intended for education and awareness, not as medical advice and every woman's body and health journey are unique. So I encourage you to seek individualized care with a qualified health care provider. So now let's start the show. You are now listening to the HackMyH podcast, the show that brings you guests for the woman going through the menopause journey. I'm your host, Zora Benemoo, a gerontologist, certified sports nutrition, menopause, and breathing coach. Now, if you're a woman in perimenopause or post menopause,

3:02check out the programs and freebies on the HackMyH website or the biohackic menopause private membership and Facebook group to optimize your menopause experience because menopause is inevitable, but suffering is optional. All right, it's a real pleasure to have Sonya Jensen on the show today. Welcome. Thank you for having me. I'm really excited to get deep dive into hormones and what that means for a woman in menopause and perimenopause probably even more. And you've got a book, heal your hormones. This is such a relevant book for us right now. And you talk about healing hormones, not just replacing them which we talk a lot about with hormone therapy. So for women in perimenopause, even in post menopause, what is healing hormones actually mean in practice? Yeah, that's a great question. I think it's really understanding the hormones and the messages they're actually trying to give us because they're telling our story.

4:02And so often women at that stage will have various symptoms from fatigue, to irritability, to frustration, to anxiety, to depression, to low libido, to vaginal dryness. There's such a variety of symptoms that women will experience and we often blame the hormones, not realizing they're actually an effect, not a cause. And so healing your hormones is really understanding the dynamic between your nervous system, between your hormones, between your emotions and how that's impacting your body and then is impacting your relationship with not only yourself, but everybody around you. I heard on another episode, you were, I don't know whose where it was, but you were talking to somebody else. And I really thought it was interesting because you said the way you talked about hormones was different than what we usually say in menopause with the loss of estrogen or the fluctuations of our estrogen. And we're always blaming estrogen for a lot of things. But the message I got from you is more, it's not just losing your sex hormones.

5:02It can be your insulin, it could be a cortisol, it could be your thyroid, it could be many other things going on the body that are affecting the hormones. But in perimenopause, menopause, we're like, ah, loss of estrogen, okay, let's put it back and that's everything will be dandy again, but it's not quite that way. No, there's this huge choreography that's going on in the body when it comes to our hormones. So estrogen is impacted by many other hormones, like cortisol, like insulin and adrenaline and all the things that were navigating in everyday life. And so the estrogen gets blamed because yes, physiologically, there is a loss. There is a change. There is changes in the receptors everywhere in the body for estrogen. So estrogen is a key player in the whole scenario. But we want to take a bird's eye view and look at what's actually impacting the rate at which we're losing estrogen. That, I think, is the biggest challenge because I'll get this question from people, aren't we supposed to lose them anyways? I did a nature do this on purpose. And yes, absolutely, there's changes that happen

6:03but our body is still producing estrogen after menopause, but just from different places. And the rate at which we're losing them is because of the lifestyle and the stressors and the things that we've had to navigate before menopause, which changes our transition and just our experience of what menopause actually is. So you mentioned the rate of loss effects our menopause experience. That reminds me a little bit about some of the factors that affect the age of menopause and the average age in the Western world is somewhere around 51s and whatever. In other countries, it can be earlier or even later. But the genetics play a big role, okay, we can't control that, but there are other things that we can control. And art, is there something that's accelerating the loss of, let's say estrogen or hormones in general that can put us into an early menopause? Yeah, like you said, we're born with certain number of eggs. So that we can't really control, but then looking at actual estrogen and looking at the rate of the loss, there are things like stress that will impact it.

7:05So depending on the story that we're carrying, so if as a child we had traumas happen or as a teen, we had struggles that we were dealing with and depending on the pattern in which our body got used to operating in. So if the body got used to operating in the state of survival, it was already telling your estrogen, progesterone and testosterone to take a back seat. So at the forefront was your cortisol just to help you navigate life. And so when we're going through these stages under that level of stress, we're already depleting these stores that we have of our estrogen and our progesterone and just allowing them to misbehave a little bit because we're changing how they're communicating within our body. And just yesterday I was talking to a patient and she's in her kind of mid-30s and I feel like I'm too early to be going through this and she's losing her period and there's longer stretches in between her cycles and her FSH is starting to go up and what I've seen over and over again,

8:06so some people would say, oh, she's got early onset of menopause, but as we start regulating their nervous system, as we start regulating their other avenues that are impacting her estrogen, like her gut, like her liver, all of a sudden the estrogen comes back up again and then she's bleeding regularly. So I think there's so many things in our environment. If we really look at how our hormones work, they're responding to the environment. So if we change the environment, we change the level at which our hormones are starting to decline. Yeah, no, it's very important. What would you say if somebody says, can you delay menopause? I think that's a nuanced question too. We said there's a certain number of eggs, so you may be that once you hit 50, those eggs have been used up and there's no more estrogen coming from your ovaries. So that part I don't think we can delay. There's things that can happen throughout our life, like pregnancy will delay it a little bit. Birth control will delay it. So these things where we weren't ovulating, those moments in our life will change.

9:08I don't think by very much, I don't think it'll change it by years, but I think it will push it. And then there's theories I'm not using HRT for really high doses of HRT, which will get women bleeding for long periods of time. It doesn't mean you're having true ovulation and you're actually producing those eggs and that estrogen and progesterone from that, but instead you're manipulating the system to make it look and feel like you're having a cycle every month. Yeah, that's very nuanced, because when you do take HRT before the 12 consecutive months without your period which defines menopause, know what your menopathy is. Because if you are doing the cycling and the bleeding, if you don't, then you don't. But if you are cycling progesterone, for example, using it from the last two weeks of your quote unquote cycle assuming, but you're making this transition with a normal cycle or wonky cycle, but you have normal bleeds with, because you haven't entered in menopause yet.

10:08And then when you enter it, you don't really know. And so one, does it even matter? If we know our mental work date and two, how else would you know? Yeah, good question. I think women will symptomatically start to feel different in their bodies. And the only way we would still have this cycle going forward after menopause in the same way is if we're really doing high doses of hormones. If you're doing actual physiological doses, I like to use with bioidentical hormones, you will stop bleeding eventually. So I think it really depends on a type of hormone therapy that you're using. And symptomatically, you would know when you're transitioning because you won't have those ups and downs throughout the month that you normally would when you have a cycle. So for example, around ovulation, your libido goes a little bit higher. And before ovulation, you have more energy. There's a cycle that your body goes through after ovulation, you're feeling a little bit more inwards,

11:09maybe a little bit more fatigued. And so we get to know this pattern that we have throughout a cycle. That pattern becomes a little bit more, every day feels a little bit more similar than it did before. So that's one way. And then the other way is actually testing and looking at your hormones, coming off of the HRT and seeing, okay, where's my FSH, where's my LH, where's estrogen, all different types of estrogen, what they're doing in my body, and looking at it from that direction. What would you say is a high dosage, a physiological level? I had one woman come to me. She lived in England and then moved to Vancouver and still wanted to continue her HRT. She was taking 100 milligrams of estrogen. But what is that in the blood look like? Because we know this. Yeah, so in the blood, hers was looking between 600 to 1000. It was going in between there, which is quite high, even for a cycling woman. And her progesterone was a lot lower than that. But she was on such a high dose. I have her on 1.25 milligrams right now.

12:12That's how low we got. And you know, she's still getting the benefits of estrogen. She's still feeling really good, but she was on such high levels. She didn't want to bleed anymore like she was. And so we got her down to this physiological level. And she's still really thriving in her menopause years. Why don't you explain that little bit? Because there's super physiological levels and then there's physiological levels and then maybe explain the different levels so people understand. Yeah, so when you look at blood work, I tend to do more urine testing when it comes to the different types of estrogen. But when you're monitoring HRT, it could be helpful just to look at blood work. And so when you're seeing less than 40, when it comes to estrogen, that the woman is getting less estrogen in her body. And so physiological dosing is just upping it a little bit. It may go up to 1.50, maybe 200. And so when you're in that physiological range, it's what the body needs to feel supported and needs to still get those benefits for her bones, for her heart and for her brain. But when you start going super physiological,

13:14you're actually creating thickness in your uterus and you're actually starting to shed parts of that uterus. So women may start spotting every month or even throughout the month is what I've noticed. And so the difference is there's different theories that if you have those super physiological dosing that you're protecting your bones and your heart more than you are with just the physiological dosing, the lower. But what I have seen over the years, same benefits. If anything, the lower amounts feel, to me, feel safer and women like them too, but the super physiological just to me doesn't make sense, to be honest. When I interviewed Dr. John Newsted and Dr. Doug Lucas about bones, these are bone experts. They told me that you only need to have in your blood of estradiol, seven picograms per ml to stop bone loss. And then to actually build bone, it was 20 picograms per ml.

14:16And if anybody knows what this means, it's very low. That's really low. And I thought that was weird. How that being said, with their patients, they like them to get, I think, between 60 and 90 or 100 grams per ml, even though the research that they're crowding, that is just so low. You would think that why are we all having osteoporosis and osteoporosis and leukemia? Because most women are pretty much that low level, but unless they're post-menopausal, then it goes even, seven was really low. And that really surprised me. But again, they do say, look, there's a lot of other benefits that you get with higher dose. So this is what the research is showing today. And it could be changing tomorrow, right? Yeah, I remember absolutely. And I don't know if the blood test that you looked at, but we usually just get a general less than 40. We're not even getting numbers, it's specific. So to hear seven, that's great. But yeah, I do think a little bit higher

15:16would be nice just for those other benefits. Yeah. Which is interesting because one thing you can maybe explain to me, changed doctors and she said, why don't you try the patch? I've always been taking a cream, a compounded cream. Usually seems to be working best for me and I get around, I don't know, 150 to 200 picograms per ml in my blood and feel fine. And so I said, okay, I'm going to take the patch. So she puts me on a 50 microgram patch, micro, I guess 0.5. And that was really great. I loved, I was like, wow, this is amazing. You just put this on your belly and that's it and change it every few days. How nice. And I really liked it. However, when I tested myself, I was, I think about 44 picograms per ml, which is quite low. And I was feeling hot at night. This is probably too low for me. Then I tested, but the weird thing was, I had a bleed. I had the, I always have a sort of fake bleed just a couple days and then done. And how is it that I have? And my FSH was like 58, and I thought,

16:20how in the world, why does this happen that I have a bleed with? So maybe it's residual from before, can you explain what's going on? When you did the cream, was it just estradiol or was it biased? It was just estradiol. It was just estradiol and you were doing it pay vaginally or vaginally? No, I was doing it on my arms. On your arms, okay. So absorption through transdermal, I think is, we don't totally know how much we're getting transdermally. So I often do estrogen vaginally. So to get it in that same pelvic circulation, which was familiar from the ovaries. So from what I know, depending on the type that you're getting, estradiol is the builder. So we actually always add estradiol to stock that building so that we don't get the spotting and we don't get some of that lining getting a bit thicker. So if you are bleeding or if you are spotting, we usually get women to do an ultrasound just to see what kind of impact it's having on the uterine lining at that time. But when it comes to dosing,

17:210.5 is actually pretty small. Dose so I am surprised that it created that and may just been localized where you had the patch because going into that circulation and maybe you weren't getting that much with the cream because it was transdermal. So dependent on the carrier of the cream as well. So I think that's what I stopped the cream and changed to the patch. Yeah, that's what I mean. So you might have been getting even less with the cream than you were getting with the patch, possibly. When I tested with the creams, I was around 150 to 200. Yeah, I'm just curious about the impact, like direct impact to the uterus. So I may have been just more of what you were getting with the patch. I was just building more, whereas the other one was free. Like, it wasn't attached to receptors, it was in the blood, yeah. Yeah, we don't think about this. So I do think about this at times, but in general, we don't talk enough about it in terms of where you apply it. So you're like, oh, there's this patch really close to my uterus rather than my arms, which is farther away, would it have more of an impact or even vaginal

18:23when you think about, oh, it's vaginal. That's also much closer to the uterus than my arms. Yeah, and the vaginal can be actually really nice for the tissue in that area. So a lot of women will complain about dryness or feeling like it's sandpaper down there and then using it like a vaginal cream can really help that area up too. So the vaginal cream is somebody's using estradiol. Let's say that's it. I'm gonna use my systemic hormones, but I want to use it vaginally. They need a special vaginal formula rather than the one that I would be using on my arms. I couldn't be putting it into my vagina. Yes, you were needed compounded and I would actually add estriol to that compound so that we don't get that build up in the lining or the spotting. So I usually do an 80-20 combo. So 80% estriol and 20% estradiol. And then depending on symptoms, sometimes that can change to 50-50 or 70-30, really depending on what the woman is needing in that moment. Why does the estriol stop the bleeding? So that's its function. So estriol is really high when we're pregnant so that with this upload of extra hormones

19:26that we have during pregnancy, we're not bleeding anymore or we're not creating a lining in the uterus. So its job is to contain estriol and estradiol. And so by putting them together, you're still, it's a weaker estrogens so it doesn't bind to the receptors as well as the E2 would. But what it does, it still gives you similar benefits when it comes to your bone and cardiovascular and all of that, but it doesn't have the same impact on your uterus. Okay, so just for people now, E2 means estriol. Estriol. Yes. I for two, extra dial. But progesterone takes care of the uterine lining. More than yes. So the combination of the two, you always want to oppose estrogen with progesterone absolutely, but I find that estriol has more of an impact because I've had women just do estradiol and progesterone and they still start spotting without the estriol. So it's very, again, it's so nuanced when it comes to hormone therapy, no two individuals are gonna have the same therapy that's gonna work for them.

20:27And so for one woman, the estradiol is more beneficial and she's doing progesterone, whereas another one, the biased, is more beneficial for her. So yeah, really okay. So with somebody's taking progesterone statically every single day of the month, they can still have a bleed? Yeah. Oh, okay, I thought it was the cycling. No, I've got women on every day. But I still all increase it in the last half. So if I'll maybe do a lower amount because you don't really need a lot of progesterone in that first half if you're still cycling. So I'll do 50 milligrams and go up to 100, perhaps right before those two weeks. When somebody takes estrogen, just a estradiol, usually it increases the uterine lining. It's proliferative, it makes things grow and that's a good thing in some ways and not so good with the uterine lining and that's why you still have uterus then you wanna take progesterone to oppose that. I'm curious if you're not bleeding. If you just, these people, fine, you don't bleed. Is it because the estradiol is not high enough to actually create the thickness and then there's enough progesterone to oppose it?

21:29Yeah, but there's still a lining, right? Yeah, absolutely. So there's a thickness that you look at. So you want to less than five to four millimeters of thickness when it comes to your lining, when your postmenopausal. I've seen some women go up to all the way up to seven, just because their dose was so high. So then we have to bring the dose back. And yeah, again, it's just, it's so nuanced. When it comes to that hormone support. Yeah, I think there's, if you heard Dr. Louise Newson, she did studies, I think over a thousand of her patients and she said there was no correlation with high estrogen and then people have a thicker uterine lining or she didn't find the correlations that we always talk about. So she was saying, we're all bioindividual, just go and test it, go look, we don't know. I really like that approach because in the end, we say this and you're protected. I don't know, go and check and you'll know. And that's why I keep saying it's so nuanced. Every woman, it's gonna look so different for you. And it's because of those stories

22:29that we're carrying coming into that space. And that's why I like to look at the why. I like to understand what's your story before you reached menopause? What are the stresses you've been carrying? What's the life you've had? What were your pregnancies or not pregnancies look like? It's just looking at all of that is going to impact her response in menopause and her response to HRT or BHRT. So I think it's so important to unwind all of that and see what's impacting my hormones. I remember when we first started doing BHRT, this was years ago in 2012, we studied under an OBGYN and at first, I was very much in that naturopathic space. So our hormones are supposed to decline. I don't want to replace them. I just want to work on lifestyle. And then as I started using them with women and started to see the changes that and how it was impacting them, I saw the power of these hormones. And I would see the woman that was just doing the hormones because she had time for nothing else. She would hit plateaus and she would need larger and larger doses

23:31to hit that same level of calm in her body or help her sleep or help her libido. But the women that were doing the lifestyle that were working on their digestive system that's supporting her liver, that's working on her nervous system, especially, they could be on those lower doses and feel great. And so I think when it comes to hormones, it's not just the hormones that we want to be looking at, we want to be looking at everything that's influencing them. Yeah, I agree, 100%. But I want to ask you a question about the story that you bring into menopause. But before I do, today's episode is sponsored by Qualia Life. As a gerontologist and a biohacker, I believe that one of the best aging breakthroughs of the last decade are senolytics. As we age our bodies, they tend to accumulate these things called senescent cells. And these cells are also known as zombie cells because they just linger in your body long after their useful function. They waste your energy, your nutrition, and they can make us feel tired, recover slower

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25:34If somebody's getting their uterine lining checked and women don't know this, but if you're in hormone therapy, then it's good to check. But should she be just trusting her doctor that she does that or should she say, look, can you tell me how many millimeters there are and look for between four and five? She should be able to see that on her report, but I would check, I would ask for sure. Yeah. I'm gonna ask next time. Cause I always get it and they're like, you're fine. I'm like, okay, but now I'm going, no, no, I want to see. Yeah, I want to see what it actually is. Yeah. I like to always see my reports, yeah. Yeah, I'm gonna ask next time. And the other thing, just in case people are listening and going, what is this BHRT and OBGYN? What does that mean? The BHRT is bioidentical hormone therapy and the OBGYN is obstetrician gynecologist as your doctor. Just to clear some of these things up, but maybe some women are also confused about bioidentical versus what's not bioidentical. So I do want to cover that as well. We'll put pin in that, but you mentioned your,

26:36the story that you bring into menopause. And I think this is really important because very often I get calls and messages from women saying, I'm feeling like this. It's, I'm feeling bad. Is this my hormones? And I said, what's going on in your life? And they would say, I just got divorced or I'm moving or my children are now fling the coop. And I said, hormones are no hormones. This is life and that's stressful. And you're gonna feel bad. But what I'm seeing is that they're less resilient. I used to be able to handle these stressors in life, but I'm not as resilient. So I always think it's two things actually. Yeah, with the loss of the hormones, probably not helping anything, but you can't discount the stress that's happening in the life, the things that are going on. And I think I heard you also mentioned in this other podcast is that if you come into perimenopause already with insulin resistance or overweight or struggling without immune disease or other issues, they tend to be exacerbated. So it's not, let's just blame it all on menopause.

27:38Yeah, absolutely. That piece is so important because that is when women start to feel everything is just amplified. Their emotions are amplified. Their symptoms are amplified. And that can create some chaos within because she feels like she's losing herself and not knowing how to respond to her changing body. And so yes, we have this loss. So then the coding that our nervous system got or the protection that our nervous system received from our hormones is no longer there. Or it's slightly there, but it has this window of vulnerability to help us heal those stories that we're carrying in. So if we've been playing out the role, for example, of the people pleaser or the silent struggling that was doing everything for everybody else, not for herself, and maybe that was our protection because of an experience we had in our past. Or the woman that is dealing with that autoimmune disease that couldn't ask for help, couldn't slow down, and now she's in a state of burnout at this stage because we don't have that protection anymore, because our window of tolerance is so much smaller

28:39and that emotional resilience just isn't there. And it's there on purpose, I feel, so that we can look back, we can reflect and see what are the missing pieces here, and what identities do I need to let go of? What roles have not been serving me? And how do I want to step into this next phase of life with clarity and with command of what it is that I need for myself? But that transition between those two can be really rocky. So when your brain is in getting the estrogen that it needs to boost up that serotonin to feel joy or that dopamine to feel that pleasure or when your progesterone's not showing up to give you that calm through GABA, then those triggers in our present day are going to feel bigger and amplify because we haven't healed what was already there. And so it may be there's something going on in your relationship or something in traffic or just overwhelmed by the deadline or your kids talking over one another. The sounds are just too much. And it's yes, it's about the present moment,

29:41but it's often about the fact that we've been living out this pattern that just hasn't served our nervous system which then hasn't served our hormones. Hmm, chewing gets amplified too. Oh my gosh, I think the worst for me. I'm allowed to breathe in front of me. You know, the chewing granola especially, I don't know what it is about that crunch. What is it? No, it's the mouth is open chewing. Yeah, it's amplified. It didn't bother me before and now it's okay. But the whole tolerance thing that's going down, I always think it's a bit of a superpower. I think it's telling us for this anymore, I'm just not gonna take it. I think we're truth now. Yeah, yeah, I do think it's a superpower. I think it's more daunting when I had a mom come in one day and she's, I'm overreacting to my kids and it's changing my relationship with them. And I don't want, and I can't even control it. I can't even control myself in that moment. That's where that discernment needs to come in.

30:41I'm okay, maybe physically physiologically, you're just not getting enough of what your body needs. You're not getting enough nourishment, you're not getting enough hormones. So when we have that foundation, then we can pause, then we can breathe, then we can ask ourselves, why are we so triggered? Is it about this moment? Does this actually belong to me? Then there's space and time to actually ask those questions and heal and understand. But when our body isn't giving us what it needs because it's not receiving what it needs, it's so difficult to feel balanced, so difficult to respond instead of react. So if somebody comes to see you in the middle of Paryment Apause and says that, I just, the thing's one of my mouth, I can't control. I know this must be my hormones. I am starting to have joint pain or hot flashes, whatever it is that she has. There's 103 symptoms of menopause, so she names a few. Yeah. How do you get started with her? Where do you look first? Yeah, so I created this thing called a hierarchy of hormonal healing and I always start in the physical.

31:42And so you wanna see where she's at because my first job is to build that trust with her so that I can really get to her root story. But in order to get there, if she's not even aware, that's what the cause is, it's important to look at what she's presenting and what, so I'll start with testing. And we'll do some hormone testing, we'll do some, we'll test her thyroid, we'll test her insulin, we'll test all of her hormones. And then I start to tell her story to her through the test. And then she's, oh, it's not just in my head. My body is changing, there's something actually going on. And so then I'll plant some seeds around different things that she can do in her day. So there's movement, there's nutrition, there's herbs, things that we can bring in to boost her up so that she can finally feel better, she can feel a little bit more energy. And then we start to do the mental emotional work of those roots, of where is this actually coming from and how can we support ourselves now so that we're not reacting or overreacting?

32:42I like that approach. It's interesting because we know that we can't out hormone a bad diet in lifestyle. So it's just one tool in the toolbox. But when we tell women to do the foundation, get some good sleep and manage your stress and go to get good food and do your exercise when she's feeling like garbage and she's got half lashes and nights was and just can't, how can you ask a woman to do that? And she needs a bit of support. And what I'm here and you say is that will you test, you figure out what things maybe she has some deficiencies and you can support it with herbs and all these other things and other modalities and maybe HRT is part of the component. But then helping her with the emotional and the mental is then she feels I can see it's a multi-pronged approach to help her do what she should be doing, but just can't get it together. Yeah, and the most heartbreaking thing for me that I've ever heard is a woman say to me that I'm not worth your help. So sometimes even saying, okay, let's eat this.

33:42Let's take this supplement. Let's move our bodies like this. Even that feels like a struggle. So really understanding where she's at with that too because one patient right now who is suicidal and we just celebrated the fact that she's still here is 2026, I didn't know I was gonna make it past 2025 and she's still here and it was those little things that we brought in every single day to just plant that one seed. Just getting her out of her bedroom was a victory. And so sometimes we think we have to do these grand changes in our lives, but we really need to celebrate those things I got out of bed today when I really didn't want to or I picked up the phone and called her friend today when I really wanted to isolate myself. Sometimes it's those things in combination with that all of a sudden your body's getting that nourishment, then there's hope. Then we can feed off of that hope and then bring in those bigger elements after. So how many women in the Perry Menopause and Post Menopause age are you seeing

34:44who want to have hormones and which ones don't want to have hormones? They come in new to you and say, I want to be all natural, whatever that means. But or something else. It's pretty 50, 50 with me. I think because of how much information there is out there now. So some will come and be like, I just want to go on hormones. I know it's going to help me. But then through our conversations, she'll start to understand that okay, it's not just about the hormones. Get her feeling better with a little bit and then okay, let's talk about your digestion now and then see what we can do for that. Let's talk about your immune system. Why have you been getting sick so often? And we'll start to do that other work alongside. And then I have, yes, I have ones that are like, I don't want to do hormones. I just want to do everything naturally. And then we find the herbs that are going to support her. We find the lifestyle factors. She knows she's already ready to work hard to get there because it just doesn't happen overnight. And then she learns more about herself through that process too. You mentioned testing is one of the first things that you do.

35:44What testing do you do? Yeah, so I do a combination of blood work and also urine testing for hormones. So I will do the Dutch test. And then with that, I will test their fasting insulin. I'll do a full thyroid panel through blood. I'll test their homocysteine. I'm looking at their CRP. I'm looking at their lipids. I want to see their APOB, their LPA. Because I want to get the full picture of a cardiovascular system as well. So those are, I would say, the big markers that I'm doing with everyone, their regular CBC in Faritan as well, to check out her immune system. Those are all in my list of labs. Oh, good. That's excellent. And in case anybody knows what the Dutch is, it's the dried urine test of comprehensive hormones. It's a GP and a little cup, and you put these little strips in, you wait for them to dry. There's a way to test urine metabolites. And there's other ways, that's just one of the brands that are out there. But it's the way to see how your hormones are behaving, right, through your urine. Yeah, absolutely.

36:45And I love that it gives you this picture of your liver, too, and how you're methylating, and whether, you know, if you're on hormone therapy, and if your body's not responding to the estrogen, the way we wanted to, it may be a challenge with your liver. Because a lot of women show up in this stage with estrogen dominance. If she's had fibroids before or challenges, or she's had PCOS, so it kind of gives you clues as to, okay, if I give her testosterone, is she actually going to break that down properly in her body? There's another new test, too, called the hormone zoomer, that does all of the metabolites, but also looks at environmental factors. So it looks at valleys, it looks at BPA, it looks at all the things that can raise your exogenous estrogens in your body, which I think is great, because that's a conversation I think that's needed, too, which impacts so much of how we feel, physically and even emotionally, too. Yeah, you wouldn't think of it when I tell my husband, careful the plastics, he's like, whatever, I don't believe it. Yeah, because it affects men, too,

37:45it affects their estrogen levels. Yes, it does. But we won't believe it. We have evidence for that. And I guess maybe some people are more sensitive than others, or they're able to detoxify better than others. That's what it is. If your detox pathways are open, if your liver is more efficient, with its phase one, phase two, so that you might have a easier time, detoxing, what's coming into the environment. So that's what we do is our environments, full of stressors, chemical stressors, physical stressors, emotional. So if we can bring up your vitality, your ability to handle what's coming in from the environment, from the emotional resilience, all the way to your detox pathways, then we can handle what's coming in. But when we're constipated, we're not detoxing well, maybe we have water attention and our lymphatic system isn't working well, then everything's feeling stuck, not only energetically, but also physically. So getting movement in your body is so important for us to be able to handle our environments.

38:47I think we need to talk a little bit about the detox, a little bit more in our liver. And because this is where I see a lot of women get tripped up when they take HRT, and they're excited to get on, they have all the great benefits, and then it backfires. They feel worse or something's not right. And very often, not always, but it is their body's not detoxing it well. And then on top of that, maybe drinking alcohol, not realizing that needs to be detoxified as well. And so why don't you talk a little bit about the detoxification of our hormones, whether it's you're taking hormones or if it's your own hormones, how that works and what a woman needs to know about. Yeah, so there's this enzyme called beta glucoronides in the gut that is working with our liver to detoxify estrogens in our body. And so when the gut's not working well when our microbiome isn't balanced, we may not have enough of that esterbolum, which is a group of microbiome bacteria that actually helps to detoxify those estrogens. And our liver with its phase one and phase two,

39:48so phase one will take, for example, exogenous estrogen and make it a bit more toxic. Phase two will either methylated or put a sulfur on there to make it less toxic to get rid of it out of our body. And estrogen will only leave through our bowels. And if it doesn't, so if you're constipated, that estrogen is recirculating into the system. And if we think about our monthly bleed, it's a portal of detoxification. We're detoxing the month from before emotionally and also physically. So women that have the heavier bleeds or the clots that they're seeing in their bleed is often due to those excess estrogens that are recirculating in their system. So by supporting your liver, whether it's through glutathione or things like dem, B vitamins, tumeric, just habits around milk, thistle, dandelion greens, eating bitter foods, all these things will support your liver and then supporting your digestive system through prebiotics and eating variety of food, eating fiber, all of that will help to detoxify

40:51those excess estrogens. And on an emotional level, one of the biggest emotions that women will talk to me about around perimenopause and menopause is rage and anger. And in Chinese medicine, they say that we hold that emotion in our liver. And so there's this stagnation that happens and anger actually increases pro-inflammatory cytokines in our body, so it makes us more inflamed. So when you start to see how connected or emotional body or physical body or hormonal system is, you start to see that it's like, you do that one thing to support all of it. And then you do multiple things to support the one. Everything's working together in that symphony. So we can compartmentalize hormones away from these systems. Okay. You said estrogen can only get rid of, oh, we can only detoxify our estrogen through our bowels. Through our bowels. Yes, we can't sweat it out or pee it out. It only comes out of our bowels. From what I understand, am I training?

41:52It was predominantly, it's going to leave through the bowels. Yes, we're gonna sweat some out. It's going through our urine too as we see through the metabolites. But those Xenoestrogens, the exogenous estrogens, go through the bowels. Okay, so Xenoestrogens are the things that come from plastics or certain plants, but no, not plants, certain pesticides. Yes, and we don't realize, yeah, we're living a modern world and these happen. And even though if you don't feel it has to come out and think it's filled up over time. So what happens then if a woman is not focusing on the detox, what's going on in the body, what will she feel? Fatigue is a big one inflammation. So a water retention, her digestive system is going to be off most often there's constipation. So bloating is a big one. Headaches, brain fog is also present. So it's anything that you can associate with just feeling stuck in your body

42:53is going to happen if we're not detoxifying well. You also mentioned the estrogelome. And I think we talk a little bit more about that. And you said there's this bacteria in there that can help detoxify the estrogen. So how do we support the estrogelome so we get the microbes we need? That's anything that's going to support health of your gut. So that's prebiotics. So those are your different veggies and you can get prebiotic powders too if you feel like you're not getting the right amount of veggies in your daily practice. Fiber is the other piece which I think is really important for women to have adequate amounts of fiber. And then the other piece is stress. So when we're under stress, we're actually shunting that blood away from our digestive system and we're not supporting our microbiome and it's actually changing our microbiome. So decreasing stress, supporting ourselves with nutrition that supports our body in our season,

43:54that's going to support that estrogelome. When we think of stress, we're often think about just overwhelm and feeling stress. But does that also mean the stress that comes from exercise or fasting or things that causes stress, even maybe a good for you, quote unquote, and certain dosage? Yeah, in that moment, it would because you're raising your cortisol, you're accessing the hermetic stress in your body, which is actually a good thing because you're coming down from it. It's the chronic stress that we live with. It's that hum in the back of our minds. That's always there. It's the weight that's always on our shoulders. That is what we have difficulty digesting. So how we digest our food is a reflection of how we're digesting life. These hermetic stresses of working out cold therapy for some running a marathon, doing these things, these are great to bring resilience into the body. But when we're chronically stressed and we're chronically burnt out, that's where this challenge, that's where we're not producing enough serotonin and we're not producing enough healthy bacteria

44:56in our body as well. I see some women in our community who are overtraining and under-eating, and I say it's a stress on the body. And when we remove the intense exercises and start feeding them again, their gut issues improve. And so I'm wondering, is this because they're feeding the astrobiolum, they maybe the astrobiolum was off because they were overdoing these stress, then they became cold. Yeah, absolutely. It's when you're not body's not feeling nourished, it's not feeling safe. And your brain will literally go into that fight of light mode to help you feel safe. It can't tell a difference. This is where that discernment is so important of what season you're in and where you are in your cycle for those that are still cycling when it comes to exercise and nutrition and just knowing your body and what it needs and how much it needs is so important to understand how we're going to feed that microbiome. Yeah, okay, it's all tight. I just interviewed Cynthia Thurlow, who wrote the book. And in the book, it's everything's the loss of our hormones affects so many things in the gut

45:58and gut specifically. It blew my mind. So I thought that was pretty crazy. So I have to switch for a wrap it up here. I can't believe how fast the time I know that went back really quick. Oh my goodness. So my last question. Okay, if you could reframe menopause for women who are listening right now. What's the biggest mindset shift that would reduce fear and then help them feel empowered instead of broken? Yeah, menopause is such an opportunity to finally live the life you were meant to. It's such a blessing to be able to look back at life, to be able to age, to be able to reflect on what didn't work for you and how your hormones are giving you this opportunity to heal those stories so we don't have to pass them forward. Like stepping into your wise women years is such a gift because you're coming in with all this wisdom of what worked and what didn't and now you get to make that daily choice for you. And from that space, you're able to give to your world

47:02to your community from such a different place instead of from a place to burn out or people pleasing but just authentically from yourself. So I think menopause is a gift. I like that. Menopause is a gift. Where can we get your book and learn more about it? So you can go to the website, healyourhormonesbook.com. You can also follow me on Instagram at Dr. Sonya Jensen. Excellent. I'll have a link to that in the show notes as well as your website. Are you taking clients a few? I am. With you? Yeah, I'm still taking clients. Oh, great. Okay. That's wonderful. I love my 101's. And your local, you're in the US, is that correct? No, I'm in Canada. I'm in Canada. Okay, so can you work with both people in Canada and US? Yeah. Absolutely. I have patients all over the world. Yeah. Okay. So global. I love it. Wonderful. Thank you so much, Sonya. Are you really clear to some confusion and answered my own personal questions too, which I loved? And I hope to have you one again.

48:02I'm excited to continue this conversation. And I want to thank everyone who's listened to the very end, who's obviously very curious about hormones. I hope you learned something new. Stay tuned. We'll always have more. And I hope you have a good day. Good night. Good morning, whoever you're at. And thank you, Sonya, for your time. Hey, did you enjoy the podcast? Don't forget to subscribe to be notified of all the new episodes. And leave a review to help build the tribe. It's a small act of kindness that brings me big benefits and helps others find this amazing content. The best thing you can do is share. Sharing is caring. Statements made on this podcast have not been evaluated by the US Food and Drug Administration Anything we say or products we mention are not intended to diagnose, treat, cure, or prevent any disease. Information provided by this podcast is not a substitute for personal medical advice and not intended to replace a one-on-one relationship with the qualified healthcare professional. It is intended as a sharing of knowledge and information from the personal research and experience of me and my guests.