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

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Can you really balance your hormones?

Or do we need to do something a little deeper?

And what have menopause isn't the breakdown of your body,

but just a wake up call to heal patterns

that you've been carrying around for decades?

Maybe it isn't just menopause.

And 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,

check 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.

And 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.

It 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

but 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.

So 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,

so 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.

I 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.

And 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,

maybe 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.

That'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,

you'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.

And 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

would 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,

how 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,

0.5 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

when 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

that 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.

And 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?

Yeah, 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

that 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

to 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.

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If 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,

the 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.

Yeah, 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

and 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,

but 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.

I'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.

And 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?

I 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.

Let'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

who 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.

What 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.

And 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,

it 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.

I 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,

so 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

those 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?

It 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

is 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,

that'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

in 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

and 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

to 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.

I'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.

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