Episode 533: Dr. Amy Shah: What Changes in Perimenopause and How Cortisol Drives Belly Fat After 40

All right, today you guys, we have Dr. Amy Shaw, who is not just one time certified, but

your double board certified doctor.

I'm really old.

You're really, oh my God.

Said a lot of training.

Well, you look really young, actually.

How old are you?

I'm in my, I'm 48.

You're 48?

Yes.

My God, whatever you're doing.

Same age.

Okay.

First of all, you look amazing too.

But by the way, whatever you're doing, I want to know exactly what that is because whatever

you, it's working for you.

Oh, really?

What do you do?

I mean, what do you mean?

What you're like doing?

Like all the things, like all the things that we're going to talk about.

I do.

I mean, like, wait, by the way, her new book is called Hormone Havoc, we're going to talk

all about it.

And we're starting off with what your daily routine is to look this young and fabulous.

Okay.

So sunlight every day, you know, it's like so, even if it's a cloudy day, I try to at least

in the beginning of the day try to get some, usually some kind of movement, even if it's

like 15 minutes.

I think today I did like 15 minutes because it was like, even that day when we ran into

each other, I literally had done 15 minutes because I knew that I had to get ready to go.

And so when I saw you, I, like, I was like, oh, let's, like, let's chat, but I had to

go because I literally had only planned like a 20 minute workout.

Right.

So even that, even that 20 minute or that 15 minutes makes a major difference.

Totally.

So for a walk, like, I can't hear when I'm traveling or whatever, but if I could go

for a quick walk, you can get the sunlight in and the, like, a little bit of movement

in the morning.

Yeah.

Absolutely.

I know.

You can typically, yeah, it's easier here.

Although you're in Arizona, right?

Yeah.

So it's the same thing.

Yeah.

Like, good weather.

Yeah.

Um, I feel like also getting a slight bit of bumper to the day, like in the morning.

So I'll talk to you about that because we're going to talk about cortisol, but like, I

feel like my cortisol is always out of control.

And so like in the morning, kind of doing something to calm myself, um, for the day about

like to come.

Um, so like a little bit of bumper.

So it's not like I'm just jumping into the first thing of my day.

What do you mean by a bumper?

What do you mean by a little bit of bumper?

Okay.

So I learned, do you know David Guillem Caballa?

Yeah, I do.

Okay.

So he was actually supposed to be on this podcast many times and he had to reschedule.

So David, if you're listening, honestly, like no more reschedule, literally changed my

life because he said your best ideas never come when you're overwhelmed and stressed out,

right?

Like you need to give, there needs to be space in your day because like you need to keep

like 20% of your day free.

And I'm like, that's like a lot of hours.

And he's like, no, but it's like your workout counts is a little bit of time.

And like if you're going from thing to thing without a break, you're never going to be able

to kind of get that one cortisol down so biologically, but to like process what just

happens.

Or if you're having a great conversation, you can't go a little bit longer because you're

like booked.

It's so true.

Yeah.

It's so true.

Right.

And so if we're working on our cortisol, we're working on anti-aging, like we have to put

bumpers on our day a little bit, even it's like five minutes that you have extra in

the morning to whatever, like I don't know if you want to meditate, whatever, sunlight,

gratitude.

You call it bumpers.

Yeah.

Like a bumper in your day.

So it's just like basically building in these time slots where it's not just overlap,

overlap, overlap.

Right.

Like when you're booking your day, maybe there's like at least a good amount of time where you're

not on a podcast, you're not on a call, you're not, you can all of a sudden have like an

amazing conversation.

Like we were having before this podcast and it's not like you're running late because you

already built in a little bit of time.

Right.

So you're building it into your day.

Yes.

You know, so that's interesting.

You know what I do because food so important to me is that I make sure I have lunch every

day.

So I try to make sure that I'm not just like running over that time.

Yes.

And that's like a bumper for me.

That's a bumper.

Right.

And like the biggest thing is when I came from the medical world, I in medical school,

like college, even our like lives, we've always been told that unless you're like booked

and busy at every moment of the day and weekend, like you're not really performing in life,

you know.

It's so true.

Especially our background.

Right.

Yeah.

Like, oh, yeah, the best, like ideas, the best business deals, the best thoughts, like

all of that things happen when you have that little bit of space.

So I do that now and it make it a huge difference, not just in my business or whatever, but for

my cortisol because our cortisol is like on fire because we're always late and always

rushing.

By the way, I'm still always late in rushing, but you know, but I actually totally agree

with that because then you're always kind of like you always feel on edge.

Yes.

The anxiety is a horrible feeling to live in all the time.

All the time.

And when someone's talking to you, all you're thinking is like, I got to go, I got to

go.

You know, like that whole thing.

It is so awful.

I got to go.

I got to hurry up.

I'm not listening.

I got to do people like, yes, yes, yes.

I know.

Like that whole slow morning thing, you know, like having a little bit of a slower morning

with like a few bumpers is like a game changer.

So anyways, that's that.

And then the water and like, you know, for me, I do the eye made in the morning.

And I'll do like coffee a little bit later.

And I usually have like 30 grams of protein in the first meal.

So sometimes the first meal is delayed a little bit, but I try to get that protein in

that first meal.

I don't, I used to love intermittent fasting, but I would realize it was raising my

cortisol, especially when you wait till late, late, late in the day.

I'm glad that you just brought that up.

Yeah.

Okay.

So let me just say, okay, so I'm going to introduce your book.

Okay.

I went like, I went deep-died.

I love it.

I love it.

I'm expecting you to say, I thought you're going to say 38.

So I got like a very excited.

Wow.

I'm so happy.

Yeah.

Well, it's true.

So the book is called Hormone Havoc.

And it's a science-backed protocol for pre-menopause and menopause.

And I'm going to say something to you that I actually just said to you before we started.

Was when I first saw the title of the book, I was actually not going to have you on.

Yeah.

Because I'm already like there.

I'm over it and super tired of the metapause talk, right?

But I feel like it's already been there, done that.

And there's so much noise, there's so much information, and I'm quite frankly over

it.

Yeah.

However, I really like you.

And I know that when I went through the book, there was a lot of things in it that

I'd have not seen before.

And I want to focus on those things, right?

Yeah.

I think my biggest thing is that what I didn't realize when I was in training and myself

is that all, like, there's so many things we could be doing proactively, nutrition-wise,

lifestyle-wise, that can help us as we get older.

But nobody tells us there's no handbook.

We're basically left to just like guess, look, Google, find people that we think we, that

are telling us the right thing.

And so it's really, really complicated, like the menoplasming, the hormone there, everything

I think has been talked about enough.

There's a lot of resources now, amazing resources.

Yeah.

If you want to take hormone therapy, if you don't want to take it, if you want to know

the risks, the benefits, you know, like the whole thing.

The whole thing.

Although actually, since you wrote, well, you, I want to ask you two questions.

But first, the black box thing has been taken off.

Yes.

So now there's like not that much of the, well, I still think there's still kind of like

a taboo around it.

People are still scared, but not as much because of it.

Yeah.

So we can talk about that.

Yeah.

But what I wanted to ask you is, given all the noise, why did you write a book on it?

Yeah.

This is what happened.

There is absolutely no nutrition handbook for women.

Okay.

So when I looked at how are we supposed to eat as we age and we kind of talked about

this a little offline, but we'll talk about online.

We actually are changing as humans and that's a good, it's a good thing, but it is, we

have to change our habits and our food to kind of match that and why is it a secret?

Like why didn't we, you know, when you got a health class and it was like really awkward

intent, you know, when you were 10 years old and like everybody laughed, but at least

you started the conversation.

But if we had like a class that was like, Hey, this is what's happening to your body.

Like you should probably eat this, you should probably like change this or you could probably

do this.

These are some options.

Just like start the conversation, but there's nothing.

And even in the medical literature, there's nothing.

Our menopause books don't have a section on nutrition or a style.

So it's like, I felt like there was a big hole in helping women in this phase of life

in that way because I think what most of us are at home, we're not at the doctor's office.

And you want to know, like, what are we supposed to be doing from day to night to optimize

ourselves, our brain, our health or like, and it's not the same as men, and it's not

the same as when you were 20, and so that's exactly it is true, right?

Like everything does change decade by decade, and what you need today is not what I needed

when I was 25.

When you're, by the way, when you're 25, anything can kind of go anything, anything can go,

any diet can go.

Yes.

You can't basically, yeah.

And like your cortisol is like buffering whether, you know, we were saying like, can party

all night and then, you know, go to work the next day and you're fine and then do it

again that night.

And your body is like fine, but you try to do that in your 40s and you're like, like,

down for the count or you get sick.

Well, you know, what you, what you said to me outside was really interesting because I

was, I was actually telling, I was just to kind of like fill you guys in behind the scenes.

Well, you know, in front now, but, you know, I got my blood work back and I was telling

Amy that I was, I was, the people were shocked and I was shocked that my, my physical stress

test was so through the, like, so high, which is not a good thing.

Like my, my, my stress in my body is very, very high or my physical stress, but my

resilience is what saves me because I was so high on the resilience that it's basically

my personality that's pushing through it, but I'm really a burnout, right?

And then I was, you were saying to me, you asked me a question like at night, how do

you sleep?

And I said that I wake up in the middle of the night.

Yeah.

I, I follow sleep.

Okay.

Yes.

But then every night around 4 30 or 5 o'clock, like clockwork, I like wake up panic, like,

like, you know, like, like, you know, like, kind of like how a baby does when they're like

small.

And you said it's like because the cortisol, can you talk about that?

That's normal.

You're saying?

So, so everyone gets a little bump of their cortisol at night.

What I see in, and I said, high functioning girl boss women, I said, yeah, is that

they're doing all the things.

And then they wake up in the middle of the night because their cortisol bump is high

enough that it wakes them up and almost like in a panic because it's a stress hormone.

And it's thinking, like, you're like, oh, my God, am I dying?

Right.

It's like a, it's like a really, it's like a whole scary.

Yes.

So what that signals to you is that you're, you have a lot of stress in your life, which

I, you could have said that, but you have to do a better job managing that stress because

what happens is as we get older, as we move through the hormonal continuum, our ability

to offer the cortisol goes down.

And so the same things that didn't stress you out in your 20s or even early 30s start

to really stress you out.

So the same kind of, you know, those workouts where it's like high intensity training, whatever,

you could, you know, maybe in your 20s, I, I, I know I did those all the time, like every

day without any recovery.

And I was fine.

Whereas when I started in my late 30s and early 40s, they started to notice like, I was

like not getting results from that.

I was actually feeling like I was like gaining midsection fat.

Yeah.

I was like feeling tired.

And it's because they raise your cortisol so high they make you crave like a lot of

food.

Yes.

And then you're like counteracting the calories that you just burned, right?

So it's almost like this cortisol cycle that's happening.

So we really need to learn how to recover a little bit better, some more nature time,

more sunlight, more sleep, more things that bring you joy because that counteracts the stress.

Yeah.

And that's literally what perimenopause really to me is it's not the sex hormones really.

For me, it's like we're moving through our hormonal continuum that's changing our brain,

our body.

And we need to just learn to adapt to it.

It's a great time.

Like you see all the CEOs and people living the peak of their lives in their 40s, 50s and

60s, right?

Right.

So it's not that it's the end.

It's just that we have to learn to manage it.

Like if you're this successful and this happy and this like fit, you can kind of go to

that next level if you understand what's happening.

So doing more recovery, like for you, that might look like, you know, any, any version

of, don't say yoga, please don't say yoga or meditation, don't say no one or I'm going

to be showing you the door.

No, you need, you need moving things because you have that personality of like you need

to be moving meditation.

So it's like anything that I would say anything that collapses time for you.

Like is there your daughter does dance?

Yeah.

So I'm sure she's like my daughter.

My daughter goes to dance rehearsal for four or five hours and she's like, oh, it's

like it just passed by like this.

Like because you're doing something you really love.

And that buffers your course all so well.

So like what is it that you really love?

I started something called paddle.

Have you heard of paddle?

Yes.

I love it.

Okay.

It's very, very fun.

And it's, you know, it's, it's, I'm terrible at it.

So I'm not like, it's not like rigorous or anything, but I move.

Yeah.

And so I like it.

But I was going to say, and I was very interested that you said that so true that what

I've noticed in my more middle, but middle age is that these high intensity workouts actually

work against me because of that exact thing.

I end up eating 10 times the amount of food I would have otherwise ate because it makes

me so hungry.

And like I'm also like more like tired of the tea.

Yes.

Like, but like not like I just feel, I don't feel energetic.

I feel like like kind of like just sluggish.

That's exactly what happens because it riles up your cortisol and that cortisol makes

you want to eat because you need quick sugar when your cortisol is high.

Exactly.

So you feel like having the quick, quick sugary thing and then you're tired because that

cortisol being so high for so long, it's like your, your body thought you were being chased

by like a tiger for hours.

Yes.

You know, and so you're like fatigued.

And so what I realized is taking away some of that stress and really going to the edges.

So the edges being really short bursts and then lots of like low level activity, whatever

you love, like hiking, walking, you know, things that aren't like, you know, that's

that.

Strenuous.

Yeah.

Something you love to do because like because you're also the managing of the appetite

is a massive, massive one, right?

Yeah.

Because like you will gain a lot of belly fat.

I've noticed because of the fact that you are spiking that cortisol so high.

So somebody told me this and this is like very inappropriate, but I was like, this is

so true.

They're like, go to a marathon and like watch a marathon, watch the people who are winning

the marathon.

They're very like slank, like, like very lanky and thin and then watch like the very end

of the marathon when people are like come, like maybe first timers or maybe like people

who are just working on it.

And they don't always look fit.

They often are like people who do marathons for the first time tell me all the time that

like I gained weight or I feel injured, you know, by the way, I talk about this all the

time.

Like if you look at me, I mean, watch me get like completely like, let them come, let the

comments come.

If you see people who are marathon runners, they don't look fit.

Yeah.

I never, I don't want a marathon body.

I want someone who's like a sprinter body, a sprinter body or someone who's like really

toned in tights because they're not doing those 20 hours of like, of running.

Yes.

But, but, but I find that running in general just breaks down your lean muscle mass so much

and long, long endurance races is not going to get you there.

Like you need to do string training.

That's right.

I always say to get that kind of body composition.

Yeah.

So I actually, okay.

So I did a framework for women.

Tell me what you think of this.

Okay.

Okay.

Four, three, two, one.

Yeah.

It's not great.

Yeah.

So it's like 30 and above, really, you know, when you're 35 and above, people, what I would

consider perimenopause, premenopause, four days of that activity that you love.

The one that like, you, the paddle that you love, the hiking, the walks, the thing that

like the time passes or you could do when you're 80 or you can do when you're 30, you

know.

Right.

So four days a week of movement.

Just whatever you love.

Three days a week of weight training because that's essential, you know, we lose, you

know, three to eight percent of muscle mass every decade.

And then for women, we go up to like one percent a year when if we're not doing anything.

Yeah.

So we got to counteract that.

So three days a week and that can be at least three days a week.

That's what this, that's what the data shows.

Like you can do two days, but that's really rare.

It's more three to build.

And then two days of hot therapy.

And that's because I feel like the data on hot versus cold, the hot therapy data is so

much better.

And for women, especially like if you're someone who wants to boost your hormones, you are

someone who wants to work on like brain health and it doesn't have to be sitting in a sauna.

It could be like moving in a sauna, you know, he did Pilates, whatever.

He did work out.

And then the one is a sprint every single week, meaning that most people after the, like

after high school have never sprinted like they've never run to their maximal capacity.

Yeah.

But if you're actually trying our muscle, our heart is a muscle.

And if you're trying to keep it strong, you need to exercise that muscle.

And if you're always working at low level and, you know, to be honest, weight training,

sometimes it can get your heart rate up, but not to the, like, not to the max.

No, it's a can't.

I mean, not for me anyway.

Maybe you sound deep.

Yeah.

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So my question to you is this with your 4-3-2-1 framework.

So of those 4 movement days, how long, for the 3 strength training, how long, give me

the duration of these.

So 30 minutes for everything, minimum, okay?

And the sprint doesn't have to be 30 minutes, you can't do a sprint workout.

Where do you go 1 minute on?

You know the Norwegian 4x4?

Oh my God, I haven't heard that for so long.

I have.

Remind me what it is.

Okay, so I do, I remember.

It's a sprint workout.

So basically there was a study where they took people who were sedentary, like literally

in midlife were sedentary.

And that means that they didn't ever go to the gym, but they did, they consider themselves

like light movement, that kind of sedentary.

And then they put them on a 2-year exercise program.

And they started with just walking, like really easy cardio, then they added weight training

and all that stuff.

And then the 1 year, 6 month mark, they added sprint training and they added the Norwegian

4x4 once a week.

And they tested their heart function at the end of it.

And they compared it to the beginning and their hearts looked 20 years younger.

Really?

By adding that 1 sprint workout, like in addition to the regular workout, just that 1 sprint.

And that was a Norwegian 4x4.

So if you wanted to like copy the study and do it exactly, but it's really hard to do

the Norwegian 4x4, maybe for you, not for you, but for most people.

So I would say most people have to start with just sprinting for the first time in their

life for 30 seconds and getting their heart rate to 85% of their max and then work up.

So Norwegian 4x4 is 4 minutes of working at 85% heart rate and then taking a break.

Wow.

So a 4 minute sprint.

Like a 4 minute high intensity, maybe it's like a biking or running or a no break for

4 minutes.

Yeah.

Do you remember Tabata?

Tabata is not like, well, that's 2010, but that's for a 4 minute or 8 minute.

I can't remember.

Yeah.

There's so many versions of that.

They just ended up picking that one, which I think is like the hardest one ever.

Oh, my God.

A 4 minute sprint.

A 4 minute very very hard.

And then you take a break and you rest and then you do it again and you do it at 4 times.

4x4.

It's like a really hard.

But you, if you think about it, 85% of your heart rate of your max heart rate is different

for everyone.

Right?

But that would also spike your cortisone.

But it's short.

4 minutes time.

4 is still 16.

It's a lot.

For them, it was like, you know, they did that once a week.

So I, I'm all for high intensity once a week or even twice or three days, as long as

you're taking lots of recovery days, like one on one day or not, that difficult.

Right.

So that doing one day, one day is probably way better than doing every, every day at moderate

to intense.

That's right.

Yeah.

So those work out like the very popular, you know, chains, like an orange theory or

an orange theory.

You're like not really getting up to 85, but you're not like, you're raising your cortisone

and to like, you're getting to like, like, 70, and so you're just always going to be like,

kind of like, kind of exhausted.

Yeah.

You're not on the edges.

Like, you want to be on the edges.

Right.

So then, and then if you do want to do a place like that, I often will go for that one

day, the sprint day, because when I'm on the treadmill or whatever, I've got a theory,

you can kind of like push yourself to that 85% as much as you can.

Like, I don't expect, I don't even think that most people can get themselves to 85%

of their heart rate for like four minutes straight for that many times.

I think it's something you work up to.

Yeah.

So I usually do like 30 second sprints, then you walk for a minute, and then you do another

30 second sprint, and then you do it eight.

Have you ever heard of crazy eighths?

Yes.

Yeah.

Yeah.

Even if it's a structure, you know, all these like different things, like I dabble, I,

um, but I think it's fair time.

Yeah.

Yeah.

Exactly.

I think that part, because I know that you're so into that, in this world, that's why

I wanted to share that with you, because I think for the woman who is going into this

next phase of their life that wants to optimize, it's not about doing more, it's really about

recovering better.

Yeah.

Say that again, because for the cheap seats that behind you, because I think that is so

true, it's hard though, right?

Because if you've, you know, like I think people get really stuck, I'm talking for a friend,

doing, you know, with things like worked for you so well for so long, it's really hard

to change that mindset and like, and do something different, right?

Even though all the numbers and all the, all the evidence is pointing to that, right?

It's so true.

Doing more is not doing you any favors.

It's not about doing more.

Yeah.

Doing recovering better.

So like that's hard for people like you and me, because we grew up, our culture, our

society, everyone around us was like, do more, do more, you know, and get smaller, you

know, like that was like the messaging that we were getting.

And like, you know, like intense, intense intensity, yes, and to get stronger and to recover

feels like so and time, yes, it seems like there's like, it seems a very, it's like it's

so opposite, yes.

And so that for you, like someone who has a lot of cortisol, like your spikes, especially

when they're, it's like your life is spiking your cortisol, your food is spiking the cortisol,

your alcohol is spiking your cortisol, your caffeine is spiking the cortisol, and then

your workouts are spiking the cortisol.

There's a lot of cortisol spiking.

So if you actually put it all together, you're like, wow, your body is like amazing that

it can even handle 100% with the difference between cortisol and your adrenal.

That's, it's all part of the same cycle.

So adrenaline comes from your adrenals.

And so when you wake up in the morning, if your cortisol is working, your adrenaline is

high.

And that's why you feel awake.

That's what makes you up actually.

How do you know if you have adrenal fatigue?

So adrenal fatigue is actually a misnomer because your adrenals are working fine.

It's not, they're not fatigued.

It's just that you're in this constant state of high cortisol.

So like, if you ask an endocrinologist, they'd be like a cringe when you say adrenal

fatigue because that's not really what happens.

Oh, really?

Cortisol dysregulation.

Like what we're saying is like you're keeping, you're never in the parasympathetic mode.

You're always having your nervous system and your hormones in the mode that they have

to focus only on survival.

And you need the mode of your safe.

And I'm ready to digest.

I'm ready to critically think that's not going to happen if you're always in that sympathetic

mode.

So you have to learn.

So sympathetic is talking about your nervous system being activated.

So when your cortisol is high, it activates your nervous system.

And so you know, you feel like on edge when your results are like irritable and like on edge

because that's riling up your nervous system to be like ready to go as if there's danger

around.

And so one of the reasons you wake up in the middle of the night is like to look for danger.

And that's why you're thinking about like, Oh, shit, I forgot to do that thing.

I like all the danger things that your body feels as dangerous.

They all come to you at that time.

Did I lock the door?

Did I unplug that thing?

Did I send that email?

Did I?

You know, that's what you're thinking about because your cortisol was like, Hey, hey,

we're in danger.

Remember all the dangerous things like that.

Like they're not life threatening literally, but like our mind thinks that they're life

threatening.

Yeah.

And you think about all of them.

And then 100%.

I totally agree.

It makes perfect sense.

So what are like some things like where are some habits that people do that are actually

aging them that they don't even they're not even aware of?

Okay.

So you said the first one that you don't do is alcohol alcohol.

Yeah.

I don't know.

I used to have a whoop.

I don't wear anything in them.

I wear this.

I used to wear the whoop and the oral ring and all the things now and I'm wearing them.

Yeah.

So I think it was really nice for me though because I would say, Oh my God, my HRV is

like so low today.

I don't know what I did.

And it was like, it was just like in passing, I would have a drink at dinner.

Like, you know, just like nothing like that.

And then it was like, every time I noticed my HRV.

So that's like a measure of your nervous system, you know, how tightly wound your nervous

system.

Yeah.

Exactly.

So my HRV would drop every time I would drink.

So it's like a unknown, even like you're having one or two every night.

Yeah.

So now we know that that's even one or two every night is not good for our, it ages us

basically in every single way.

So the first, the one thing people, the first thing that people are doing that's aging

them is alcohol.

Yes.

Number one thing that they should cut.

Number one thing that you as aging use alcohol.

I agree.

By the way, that's why I look, I hate to say look at JLo, right?

Yeah.

She doesn't drink at all.

Yeah.

So she's like 12.

No, you know, 100% and she says that's why she doesn't drink that because she doesn't

want to eat 100%.

Yeah.

I'm like, is that why you stopped?

No, no, I'm lucky because the one thing I never, ever, ever liked was alcohol.

I never liked the taste of alcohol.

I never drink in high school, college, whatever.

I hate the taste of it.

So I got lucky on that one.

That's amazing.

Yeah.

Yeah.

So okay.

Number two.

Yeah.

Number two is ultra processed foods, like especially high sugar foods, because what they

do, the other thing that happens as we age is that our ability to process sugar, like

so our insulin resistance goes up.

So our, before you could eat something very sugary and your body quickly absorbs it into

itself.

And so that's why it's good to walk around after a meal because you want to quickly

absorb all that sugar.

But when you ask you about that after, remind me.

Yeah.

So when we start to lose estrogen, we also lose a little bit of our ability to absorb

that sugar.

So it kind of sticks around a little bit longer.

And so that-

Oh, really?

So wait.

So that again.

Yeah.

So as we lose estrogen, that's when sugar kind of sticks on our body longer.

Yeah.

Okay.

So our, our cell's ability, like, so our cell becomes a little more resistant to sugar,

to sugar, right?

So taking it in.

Um, because-

As our estrogen drops.

Yes.

So you'll see a lot of people, including myself, they're hemoglobin A1C, like a marker

of your blood sugar.

We'll start to rise during that time.

That's like a marker of perimenopause is like people, people have a diabetes history,

like my family, everybody has diabetes.

You'll see, like, now you're starting to see even people who look healthy, your sugars

are climbing up.

And so the same, it's aging you because when that sugar kind of sticks around in your

bloodstream, it is a very, like, your body's doing everything.

It can't to bring that in.

That sugar that's there is aging you by the minute, you know?

So every-

Really?

And so that's why things like eating fruit instead of having a sugary thing is much better

because it's slowing, like, when you have fiber with your sugar, it's slowly absorbed,

right?

But it's a dried fruit.

Dry fruit is not as great because you're, you're getting the sugar in concentrated form.

Yeah.

And so you're getting that spike that you don't want.

And for, you know, for people who are really, really healthy, people are like, why would

you care about blood sugar spikes?

And you don't necessarily, but when you're getting to, when you're, like, over the age

of 40, your ability to, like, process sugar changes.

And so especially if you have a family history of anything, heart disease, diabetes, you

really want to be kind of minimizing those spikes.

And so that's why it's really important to eat fiber because, like, kind of want the

sugar response, but all processed foods, like, devoid of fiber, right?

So if you're eating ultra-process food, you're automatically eating a super low fiber,

high sugar, or high, you know, process, whatever diet, that's the number two.

Sugar, okay.

And liquid sugar is the worst.

So liquid sugar.

So alcohol, liquid sugar, obviously, that's bad, but like, frappuccino, like, never drink

your calories.

Yes.

That's why, by the way, I'm not a big smoothie person, because, like, the amount of calories

that people are, like, piling on stuff and they're thinking they're doing themselves

of service.

And it's not as satisfying.

As I'm starving, after I have, like, for example, it takes you three seconds to drink it.

I'm a volume eater.

I like to have food volume, because I feel like it's a whole, like, a whole thing.

Yes.

Like, what do you call it?

Like, it's like a whole event when you eat.

And when you chew something, you get the signals to your brain that you're eating and

that you're, you have food in your system.

Exactly.

And when you have a smoothie, in four seconds, it's like a finish, and I'm like, okay,

now where's my meal?

And then I just had a thousand calories.

Yes.

Every, these ultra-processed sugary foods is, like, the number two thing you can do.

And I don't mean, like, take it all out.

Like, if you're, like, eating a piece of fruit, I mean, okay, so for dried fruit, fruits

out of everything, dates are the best.

Yeah.

I don't know.

I see.

Mangels are amazing.

I don't mean.

I never, ever, ever vilify fruit.

Like, these people who are, like, don't eat fruit, like, it's insane.

Like, what do you mean don't eat fruit?

Like, they have all these spido, they have all these nutritional values.

All you beyond just the sugar content.

Exactly.

And the fiber of when it's fresh fruit, so you're saying that I can't eat my mango?

You can eat your mango, but, you know, obviously, the dried mango, not the dried mango, and

not the mango flavored, like, like, drink.

No, no, I wouldn't have that.

No, no, no.

But the minimizing sugar spikes also, you can have, there's tricks to do that.

So, like, if you're eating a dessert, like, if you eat something with fiber with it,

it'll slow it down.

So, like, don't, you know, eat your dessert after you've already had your meal.

So, you're not, like, spiking your blood.

It's much worse if you're eating it, like, on the go, when you haven't.

Does that mean that you shouldn't, like, if you eat fruit by itself, there's a lot of

people who, like, eat fruit first thing in the morning, and nothing else.

Yeah.

Doesn't that just spike your blood sugar, then?

Well, fruit, depending on the fruit, it has a ton of fiber.

Yeah.

So, like, raspberries have eight grams of fiber, which is insane.

It's like a huge chunk of your fiber for the day.

You just get from the raspberries.

A raspberry.

Yeah.

It's amazing.

It's not very high in sugar.

So, berries are incredible, because they actually give you all of the polyphenols and

the fiber without actually giving you that blood sugar spike and taste really good.

Yeah.

I'm talking about, like, the straight-up, you know, candy bar from your local, it's,

like, devoid of fiber, and it, you're, like, sugar sugar, like, sugar sugar.

Like, we were, we were, like, saying, like, oh, hungry first knickers, what it was,

the saying, like, you know, like, yeah, I know what you're talking about, yeah.

Because you would eat it because you're really hungry at, like, three o'clock, but that's

like the worst thing you can do because it's, like, spiking your blood sugar.

It's ultra-processed, and, you know, as, as we get, if we're talking about aging, that's,

like, literally aging you.

So, that's-

Can I ask you a question?

What about this?

Because this is what I do sometimes, and I, like, so, because I get super, I want that sugar

creeping, I'll have, like, an iced coffee with, like, a little bit of, like, sugar-free vanilla

in there around three o'clock.

I love that.

Yeah.

I do that, too.

You do?

Yeah.

Yeah.

It just, like, kind of takes the edge off.

Exactly.

And other thing you can do that I have caffeine.

But it's caffeine.

Well, I mean, if you're not sensitive, people-

I'm not kidding.

I'm not kidding.

I can have, like, I can have a vat of caffeine.

Yeah, you're so lucky.

That's a genetic thing.

Oh, really?

Okay.

Most, like, some of us don't have that, so we can- we can't have caffeine with a big, although

I did.

One of the tricks I have, there's two tricks I have.

So, one is, when you're having something, so say you have a yogurt perfe, and you want

to have something sweet, like crumble, cookie, or something on top of it.

So you're having, like, your protein, your Greek yogurt, the protein, and then maybe

some berries in it.

You get your fiber, and then you're getting your treat.

You're like, it's there.

It's just paired with a bunch of things that can, like, escort it into your body in the

right way.

Right.

With the protein and the everything.

Fiber, fiber, blood sugar.

Fiber, blood sugar, sugar.

I like that, okay?

Yeah.

So if that's a trick, and then the other trick, which is something I've used for years, is

if you really want your process, nap, or like, there's something you really want, put

it in a really small bowl, and then walk away from the kitchen, like, go to your patio,

go to the farthest place that you would go, and like, bring a glass of water, and like,

just have, because if you're standing in front of an open bag or box, that's like the

worst thing you could ever do.

And but if you give your, it's not about deprivation, like, if you're like, I really just want, like,

one cookie and like, you know, whatever, a couple of chips, you put it in a little bowl,

you walk away, bring your water with you, and then you're not, it's like, really,

it's much less likely that you'll just, it takes a lot less willpower to just be like,

okay, I'm done for right now, you know.

So wait, so you're saying put it into the bowl, and then, and then leave, leave the kitchen,

close the thing, close the thing, and eat it there, take it with you, and that's your

treat.

That's right.

So you're saying you're not likely to come back to the kitchen.

So you're less, yeah, you're less like the times, and that's your dopamine power.

So like, put it back in the freezer, put it back in the, you know, put back the things

that, yeah, like close it up, yeah, and then go out, go somewhere where you feel really

less stressed or, well, have you ever known her, like, the big joke of the, of the world

or the times is like, you know, when you have like a big cake and people, like, oh, just

have a sliver, and then they put the rest in the fridge, but the person just keeps

like going back to this, I think, go back to the whole cake is old, because it's finished.

Did you see that one where they, like, threw the cake in the garbage, and then they ate

the garbage?

Yeah, yeah.

I hate to say it, but like, so I don't, I don't know if that last trick would work for

me, because I would, I start to obsess about something, I'm like, well, I might as well

just go and have enough.

I've really had it.

So I might as well just have more now, and like, you get into that crazy loop of like eating

it, because you already, like, did the damage, you're going to continue doing the damage.

So the same, they actually want, so I mean, I don't want to say like, oh, the whole

evil conspiracy theory about processed, ultra processed foods, but the companies are

looking to, like, create foods that make you do that, that make you want to come back,

and like, you can't stop thinking about it.

100%.

So if there are foods like that, that's like a sign you need to cut it out.

It's like drugs.

Yeah.

Don't even bring it into the house.

Yes.

It's triggering your dopamine pathway.

Our dopamine pathway is so strong that you will get up out of bed into your car and

go across town for something that stimulates that dopamine.

100%.

That's what's so dangerous about these things.

Yes.

And so I feel like, okay, so ultra processed foods.

I would put sugar.

Let's put sugar and fried like all in one category process food.

Yeah.

Okay.

And then number three, sedentary, we are meant to be moving like our bodies.

We are genetically and evolutionarily programmed to be moving like humans, moving things.

And I think that we're not programmed to be sitting for eight hours a day.

And when we do that, our body doesn't function as well.

And that really, really accelerates aging over time.

So it doesn't show up when you're young, but over time it actually does age you about.

Yeah.

I agree.

And four.

And number four is stress, which we kind of talked about.

I mean, stress should be number one, probably as there are ways that people like to maybe

are stressed and they don't even know their stress or like does everyone just know when

they're stressed?

Well, did you know that you were stressed?

Yeah.

But I didn't know.

But I didn't know I was that stressed and the other tests that they showed that you

can do is that how your body manages stress.

Yes.

Did you know about this test?

Which, what's it like?

I don't know what it's called, but they've basically said again, like I have a lot of stress,

but my body's good at like, of like deflecting the stress.

It's a very good thing to be able to be resilient to stress.

But I honestly believe that a lot of us are holding stress like, okay, I'll give you

an example, neck pain.

People who have like a lot of like shoulder neck stiffness or pain, sleep issues, like

you said, waking up in the middle of the night, palpitations or feeling like nervous

about things like shouldn't be like, you know, anxiety provoking is like another sign

that your, you know, cortisol system is really activated, cravings, sugar cravings because

if you think about it, if your body's preparing for to run away from like an animal, it needs

quick energy.

So you're going to be craving sugar.

And so a lot of people, as soon as they bring down that stress, like the sugar cravings

really subside, which is a huge thing that helps their life, you know?

So I feel like stress is one of those things that ages you without you even really knowing

that it's aging you.

And it's, I mean, if you really want to know, we know evidence of this.

It's like you, look at people who've been through wars or really like stressful time,

famines and wars.

And you see how fast they age.

Yeah.

Look at the president's like, not this one, but you remember like most other presidents.

Yes.

When they start, when they start, firstly, when they finish, they look like they're a 30

years older.

Yeah.

Yeah.

Yeah.

It's really unbelievable.

So if you think about it, this is the only president who looks younger now than he

did before.

It's totally, you know, which is a whole lot of story.

That's all there is.

Yeah.

I, that's exactly right.

So if we're talking about like aging, per se, that stress will age you more than anything.

Totally.

It was so perfect.

And like people that have gone through like really difficult, like, you know, come from

war, torn country, like they often are, um, have like a lot of signs of physical aging.

That doesn't mean that you can't do anything about it.

It just means that the stress that you experienced is aging.

You wore, you know, all these things or kids, by the way, kids, yes, but not even kids.

If you look at a woman who's 40 years old with kids versus a woman who's 40 without kids,

yes.

It's out the woman who's 40 with kids looks older because of the stress of like taking

care of other humans and like the time restraint you have on your life and like your whole

life is different, right?

Yes.

Like it's super stressful.

Yes.

You know, like the women who are 40 without kids, like they don't really have a care in

the world, right?

They can just have to take care of themselves.

It's much easier.

Well, I mean, I agree with you because kids are very stressful.

Kids are super stressful.

I'm super stressed out all the time.

Like my friends who are my age, they look like they're 32, you know, who don't have kids,

you know, the ones who are have kids.

And they often have like other life stressors, but it's just different.

What's different?

Yeah.

Like what I'm saying is like I'm joking.

Yeah, yeah.

No, I know.

But like they have, there's so many other life stressors that don't age you like having

kids ages.

Right.

And that's what I'm saying.

Like it's true though.

Like when you have like to like just, and it's also not necessarily like bad stressors,

but it's like having to deal with other people's calendars and schedules and driving and feeding

them and move.

If you don't have as much time, you don't have enough downtime.

Yeah.

So you don't have any downtime.

Yeah.

And you don't have that ability.

You're worried about them more than you were about yourself.

Well, that's right.

So like that stresses you.

Yes.

And actually that ages you, I'd say.

That does.

Right.

It does age you.

I'm just being real.

Yeah.

You know, that's another one.

Like the most...

Kids.

Yeah.

Well, it's true.

Yeah.

Good and bad.

Yeah.

Number five is maybe definitely should be number one in terms of like, you know, like the

ability to age you.

This one is like the most important.

Can you guess?

Smoking?

Well, smoking I would put in that drinking category, but yeah, that's right.

Okay.

Why the drinking category?

I guess because it talks and you're bringing it each.

Okay.

Number five.

Um.

Hmm.

I know you know it, but.

I probably do.

We talked about sugar.

We talked about alcohol.

We talked about junk food, processed food, stress, hormones.

Not sleeping enough.

Oh, my God.

Of course.

Yes.

Like, that's a number one.

Oh, my gosh.

Of course.

So I should have been looking at your friend.

She was probably, she was like, pictionary, like she's doing like that.

Damn.

Okay.

No, I literally think that it was like, of course, sleep.

Yeah.

If there's one thing that you could do to anti-age yourself is like start getting

more sleep.

Yes.

Like more than you think.

I think women tend to feel like they are lazy.

If they're sleeping like eight hours or whatever, whatever requires you feel refreshed.

Yes.

It feels indulgent.

It feels like.

Totally.

And it feels like, um, that's one thing that's actually different between the genders.

Men tend to need less sleep than women.

And I don't know, most people like don't allow themselves as much sleep, but really you

should sleep without an alarm and see how much sleep you actually need.

And that's when you're not sleep deprived.

And then that's kind of your baseline of sleep that you need for recovery.

And like them, when we're talking about working on stress and working on, like part of, like

you said, it's really hard for you to meditate.

Just like sleep a little bit longer.

That's like the perfect way to bring down your stress.

I know.

True, but I'm not a great, like also your body has like an algorithm, right?

Like I'm so used to sleeping like five and a half, six hours now.

That's my baseline, even though I'm tired all the time.

Yeah.

Like I think that like my internal anxiety won't allow me to even stay asleep.

Yeah.

No.

So that's what you have to work on.

So one of the things I did, I was the same way as you.

I used to be like, I would like, I felt tired, but I would just have an alarm all the

time.

Yeah.

Yeah.

Yeah.

So one of the things I started doing is like really getting a lot more sunlight first thing

in the morning, like within an hour of waking up, that is going to reset your circadian

rhythm so that your body knows now, okay.

And about, you know, 12 hours from now, I'm going to start really releasing malatonic,

like it rewires your brain.

So if you're someone who like goes to a different time zone, like you're traveling, you're trying

to rewire your sleep schedule, yeah.

Getting a lot of concentrated light, natural light into your eyes or not behind sunglasses,

not behind a window, but actually direct, it goes straight from your retina to your brain,

to your super kiasmic nucleus and like rewires everything.

It's like one of the best ways to get better sleep and more sleep.

And then the second thing I would say is the data shows that sleeping at the same time

and waking up at the same time every single day, even as much as you can, even on weekends

within 30 minutes, can really improve the quality of your sleep that you're getting.

So even if you're getting less, the quality, the restoration that you get from it is

better.

Yeah.

I try to do that anyway.

Like also, like you said, I feel like I'm a creature of habit.

Yes.

So like going to bed around the same time.

But now because of this waking up in the middle of the night, that's the problem.

I can't fall back asleep.

Yes.

And then now you're awake at five o'clock in the morning and I'm like, oh my god.

And then it takes you a couple hours to actually like get yourself into a place where you

can like function.

Yeah.

That's exactly right.

So you want to, for you, I would say work on all the things.

You need a cortisol reset.

There's a cortisol reset in there.

I know.

They're work on all the things to decrease cortisol.

That's like, I would say, like that's like the number one thing that I see women struggling

with as we're moving through like the hormonal continuum is having trouble figuring out how

to like recover, not giving, we don't give enough permission and enough time to actually

have recovery.

So recovery doesn't always just mean like cold pungent sauna.

It means also like sleep and also means nature and also means like turning down the volume

on the training if it's like draining you, you know, that kind of stuff.

So right.

So recovery is not just about like these modalities of like the sauna and the cold plane.

The red light and the, you know, it's also about like eating to support your gut bacteria

because your gut bacteria actually is your own mixture, own ibuprofen.

So like our own stress-reducing anti-inflammatory compounds that we create in our body is created

by gut bacteria.

And so like we can do things by eating food to support that that will stimulate.

So it's like they create these things called short-chain fatty acids and they work like

natural ibuprofen, calm down the cortisol, calm down the inflammation, go all over our

body.

You also don't want their own like bottle of ibuprofen inside, right?

Well, that's what you have to build it.

But how do you do that?

Like, I think right now everyone talks about gut health, right?

But like everyone says, oh, I have leaky gut, I have this, I have that.

But it is like the gut really is like the brain of your body, right?

It is.

It's not the brain.

It's the gut.

Yeah.

But if so many people have gut issues, like isn't that kind of like what are the, where

are the some key factors that people can even know?

And is that, is that also interfering with maybe the symptoms of perimenopause and

manopause?

I actually think that if you fix your gut, you'll fix your hormones.

Really?

How?

Tell me how?

Because our gut is constantly talking to our brain, our hormones, our immune system.

And when you need more estrogen, there's like actually gut bacteria, we call it estriplone,

like a bunch of bacteria that like put the estrogen back in your system.

They take out estrogen from your system.

They're like modulating your hormones.

And the gut bacteria are like literally like the captains in charge, like they're the

walkie-talking, your brain, they're walkie-talking, the rest of your body to do what they send

more hormone this way, to send more hormone.

So if you really want to like get your hormones in check and balance, like you need more of

that gut bacteria because the modern world, the way we live, it strips down our gut bacteria

to like 50% of what we actually need or we're supposed to have.

And so we're working with like less than we started with.

And then as we move through perimenopause, our estrogen levels go down, our gut bacteria

die, some of them are dependent on hormones like estrogen.

And so we need to do stuff to work extra hard to keep these gut bacteria alive and healthy

so they can signal to all the places in our body.

So like your hormones, a lot of people will tell me, as soon as I change my diet, all

the sudden those symptoms that I thought I had because I was getting older went away.

Really?

So how would you do that though?

Give me an example.

Okay.

So that 30-33 that I kind of developed so that the second, so it's 30 grams of protein

in the morning, 30 grams of fiber throughout the day and three servings of probiotic

foods.

So three fermented foods a day.

If you start with the fermented foods, which every culture you eat fermented foods,

now nobody eats fermented foods, it's like, you know, less than, I mean, 95% of the

population don't even eat enough fiber and they're definitely not eating enough fermented

food.

Fermented food is the one thing we know that can add bacteria.

So like increase the bacteria in our gut and also lowers the inflammation.

So it's the one thing that we know and diet through all the studies.

If you want to lower inflammation and your levels in your body through food, you want

to be eating more fermented foods.

Yeah.

Fermented foods are very, very popular now, I feel, it's getting more popular.

It's, it's, like, is that like sour crow?

Yes.

It's sour crow, kimchi, but it's also like yogurt and probiotic cottage cheese and, oh,

I can have you, oh yeah, yogurt.

Yeah.

And, you know, I should be eating way more of that stuff.

Yes.

So that can help kind of calm down the inflammation in your body and in your brain.

So like, that's a great way to manage that gut brain connection and get that stress

down and also help your hormones.

And then the fiber is food for the gut bacteria.

So imagine, like, you're supposed to have an Amazon jungle in there because it's little

like that trillions, trillions with the tea bacteria that live there.

We have just like the same amount of bacteria in our body that we have our own cells.

So like, there's a trillion of them.

They are starving because all they can eat is certain foods like fibers, one of their

main sources of food.

And when you're eating an ultra processed diet, which most of us are, you're not feeding

your bacteria, anything.

They're starving.

They're dying.

Wow.

Yeah.

So then what do you think of having?

Okay.

So if it's fermented foods and everything that you just said, you're going to say probably

not.

But if we eat better and then we are taking care of our gut, would that make us not have

to take hormone stuff?

Yeah.

Therapy.

So that's, so I will say this, when you're in parimenopause and starting to get the symptoms,

this will probably often be enough because you can just say, like, hey, I don't feel

myself.

My gut's not, you know, my brain fog is a little high.

Like I'm not.

That's a bandaid.

It's a, no, it's a foundation, I mean, that you can't stop doing it even as you get

old.

That's true.

Okay.

Fine.

You're building a foundation.

Yeah.

You're building a foundation.

A lot of us never had that foundation.

Like I was in medical school and trained, like I studied nutrition and we did not learn

this.

That's why I think it's so important to have the book like this for me because I'm

like, we didn't even learn this.

How are people supposed to know this?

Well, that's the thing.

I always found that very interesting, that doctors never get trained in nutrition at

all.

No.

And the thing is the shocking, shocking thing is that not only do we not get trained

on nutrition, we really don't get trained on women at all.

Like women were excluded from it.

Right.

Because they're training.

It's all usually based on men.

Correct.

Yes.

All the research, all the medical studies, everything was based on men.

So not only do we not have enough nutrition knowledge, we really don't have any nutrition

knowledge for women.

And so all the stuff that I'm saying, for a lot of people, they're hearing it for the

first time.

I know.

It's not crazy.

It's not.

It's so crazy.

So I looked at the textbooks for menopause, for parimenopause, like where is the information

about like, hey, we need more protein because we want to build the muscle, we're losing

muscle.

We need fiber, we need the studies are there, but we don't have any instruction around

it.

So that's that's really why I felt like I needed to talk about it.

To talk about it.

What about it?

So let's talk about HRT because we're here anyway.

Yeah.

Like, so what's your take on it?

Okay.

My take on HRT is that we're in a very unique situation in our world right now where we live

well past menopause and we want to thrive, well past menopause.

So imagine there's every animal in the animal kingdom.

If an organ dies in your body, you die.

Like you can't live with like something that's not functional in there, right?

It's like, it's very critical.

And so for us to be living 30, 40 years past an organ kind of in ballooning and not functioning

properly is incredible, right?

So we're in a very unique situation in history, like we are living longer, we want to do things

longer.

And so I think that hormone therapy has a role, especially if you're someone who has

osteoporosis, if you're someone who has major hot flashes or night sweats, because we know

both of those things can be solved, like literally solved by hormones.

There are conditions that cannot yet be solved by hormone therapy.

So osteoporosis can be hot flashes, night sweats can be, and then vaginal symptoms like

dryness and discomfort can be.

Those things you can actually reverse completely, hormone therapy, don't slam dunk.

What we don't have data yet on clear clarity, weight loss, brain fog, gut issues.

So all of this foundational stuff is still what we need to do for that.

Wow.

I didn't realize that.

Yeah.

It's not a magic pill for everything.

There's not a magic pill for weight loss or for brain fog or for heart health, even

or for heart health.

So that's, I mean, that's very interesting because I think that what the, I guess what

people are just, are just, they just assume, really, the assumption is that it's kind

of the panacea.

Yes.

For every symptom.

Well, in their defense, like, I think there's a lot of confusion, right?

So if you're like, yes, it's good for this, but we're not sure about this.

I think it's like more like, hey, you should talk about this with your doctor.

It's a good option.

Mm-hmm.

But like the nuance, I think, is really important.

Well, life is about nuance.

Yeah.

Nothing is black and white.

Yeah.

If you're taking it for weight loss, like that is not the right reason to be on hormone.

They're being same thing with like dementia and hurt.

There's a lot of like new studies like that are like, we have estrogen receptors in our

brain.

That's amazing.

But the data is not strong enough.

There's not good data to say like you can reverse brain issues or you can prevent dementia

or you can prevent heart disease.

So what we're saying is like, yes, there's estrogen receptors everywhere in our body and

there's some potential there, but we're not there yet.

Interesting.

So it's not like a panacea, it's not like a cure all.

It's not.

And I think that I'm super excited.

Like I'm really happy for people that are like embracing it more, but I think we need

to talk about that other side.

It's not like you're just going to take it in your life automatically.

It's like shiny rainbows and butterflies and you just don't have to do anything else

anymore.

Well, that's the thing.

And also they say if you take it too late, then you don't get any of the effect.

Is that true?

So it's kind of like this fear based, like, oh, shit, if you miss the boat, yeah, if I

miss that boat.

So do I have to start taking it now?

If I, if I don't want to like basically shrivel up and die a 10 years, you know, I think

if that's exactly right, the thing about taking it late, though, is more about the breast

cancer risk.

So when you looked back at that study where they saw a link with breast cancer, it was,

there's a couple of reasons that came out is one was people taking it very late, like

10 years postmenopause in their 60s, if you're taking it, because you already got you

still kind of like not having the hormones and then you're adding hormones.

It kind of like seems to be linked with higher rates of cancer.

And then, you know, that's kind of the reason that even now, if you've kind of gone 10

years postmenopause, that's a conversation that you have to have with your doctor because

a lot of times that's like an increased risk.

Why?

We don't know.

We think that maybe your body got used to functioning without hormones then.

Oh, so then you kind of like introduce hormones again, and you're kind of puts into overdrive.

Exactly.

And then the old hormone therapy also use like synthetic progesterone, but if you're not

using synthetic, and you're using bio, yeah, the micronized progesterone, that still

can have the same effect you're saying.

So that, if you start it really late, yeah, like I'm saying like we say 10 years late because

your body's not accustomed to them at all.

And the thing is like the studies are still evolving and still we're still trying to figure

out like, okay, what is a right combo?

What?

How many years?

So it's not something that's like a slam dunk.

I said, for those three conditions that I said to you, osteoporosis for vaginal symptoms

and for hot flashes and night sweats, it's actually there's good data to be like, yeah, the

risk outweigh the benefits in most cases.

Yeah.

The most people are doing it.

Benefits outweigh the risk in most cases.

Most people I would say are doing it for the other reasons.

Yes.

So it's become really invoked to be like, oh, I'm like, you're like, it's almost like

how people take peptides and test off.

That was my next question.

Yeah.

Well, testosterone is one of the things that they put you on estrogen and testosterone.

Yes.

They're people out there again, like all they're doing, they're showing you their estrogen

patch and their testosterone, I'm like, maybe put it away.

I don't need to see anymore.

That's what's happening is become like a badge of honor, you know, like I just don't,

like, so it's not something that you feel is necessarily like, uh, it's not a sand

dunk.

It's not a sand dunk.

I think the reason why people are kind of going, going overboard on the other directions

started out in a good, it with good intentions.

Like, yes, everything to pat the pat, uh, what the road to good intentions or the, whatever

that in the path.

That's right.

The path to good intention.

That study was so flawed, the, you know, the WIMS health initiative was so flawed, everyone

was so scared.

So trying to like, turn the tide on that, right?

So we're kind of like, the pendulum is swung so far the other way now.

That's right.

That everyone thinks that they need to start at 40 and like, exactly, like, just be on

it, just in case, because they're exactly, just in case, exactly.

And I actually say in the book, I really say, like, I actually looked into it.

Like, I was like, okay, what are the pros and cons for me right now?

Are you doing them?

No.

Okay.

So you're a doctor and you're a real doctor, a double certified doctor.

What kind of doctor by the way?

And so I did internal medicine, so that's like general medicine and I did immunology.

So you're like legit doctor, doctor, and you're not on them.

Yeah, because I think it's a conversation that you have to think about the pros and cons.

Like, I think if I, once I have hot flashes, if I do, great, I'll do it.

Once I have osteoporosis, I hope like knock on what, like, I would, you know, like, vaginal

symptoms that are like very out of the, like, I'm feeling discomfort or dryness and

like, a vaginal estrogen is perfect for that.

So I would totally do that.

Like, I'm not against it, but I, when I was talking about it with my friend who was,

we were just saying, okay, so the indications, I don't have any of the indications.

Can I really uplift like my habits, my diet, my lifestyle, my, and really get myself to

a place where I feel good?

Yeah, I've done it and I think I'm getting to that place.

Like if someone just asks you, like, do you need hormones and like, the answer is not

always yes.

Yeah.

I mean, I'm not taking anything.

Yeah.

And it's great.

I mean, and the thing is, if you need it, you should take it.

Well, that's the thing.

I'm not, I would take it.

Like, that's why I'm asking you these questions.

I'm like, listen, I'm more than, okay, I'm happy to take it if I actually need it.

Yes.

But like, I've always had this, like, this idea in my head that I don't need it yet.

Yeah.

So why would I do it?

Just because just because everybody else is like, I'm not a believer in that.

If you're cycling, if you have periods, yeah, I do, then you're, you know, you're obviously

your ovulation that you're having a very much information for everybody.

Yeah.

It's like a medical consultation here.

Yeah.

But like, and also the progesterone is a lot of people, though I would say the one caveat

I will say is like a lot of people, maybe you too, including myself, the early signs

of parimenopause is sleep disturbances.

And so one of the things that is kind of aggravating your sleep issues is your lack of hormones,

including progesterone.

So having progesterone here and there, especially around certain times of your cycle, could help.

So I would do that, consider that if you want.

So for example, right before our period, our hormone levels dropped like to like, you

know, really, really low levels.

And so that's why you feel a lot of like that low energy and a lot of people have sleep

issues, issues right before their period.

And so that is a sign that your progesterone is really low.

Progesterone is like our sleepy, anti-anxiety hormone.

And so that can be used kind of spirit, like as needed for people and you can even cycle

on and off of it.

And that can help with just like the symptoms that are starting, but you don't have to be

on the patch and you don't have to be in a combo, you don't have to be on the testosterone.

Like that's kind of like maybe like a first step for people that they want to try it.

And then the estrogen really, you know, you're in menopause when your periods are really

irregular and you're skipping periods or you're going a full, when you go a full year without

having periods, that's what's going to happen.

That's who you know.

Yeah.

Well, all right, lady.

I think I have enough information here.

I mean, is everything else I need to add here before I go watch my daughter do her dance

recital?

I know.

You need to go watch your daughter do her dance recital.

I do.

I think you need to, um, just like every woman probably listening to this or most

women listening to this, um, you need to give yourself permission to recover and get that

cortisol down.

Maybe go, do you know like when you go on vacation and how you sleep so well and you don't

sleep well on vacation?

Um hmm.

Vacation?

Oh, stress.

Yeah.

I'm, I'm teasing.

Yeah.

Yes.

I know.

I know I'm supposed to be sleeping well on vacation.

Yeah.

All these things.

So like give your body a little vacation from everything you're doing and even though like

and a vacation doesn't mean you're lying on the couch.

It just means that hey, I'm not going to like overcaffeinate.

You don't drink.

So like you're someone who's drinking like you might want to cut, cut down the alcohol.

Maybe you really concentrate on getting more protein and fiber and fermented foods to

like calm yourself.

Maybe you allow yourself, you know, get, figure out how to take that little nap or add

20 minutes to your sleep schedule, however you can fit it in in the week.

You can't really sleep more than 20 minutes at a time, um, extra.

So like if you wanted to try to sleep a little extra, it would be like 15 to 20 minutes

more than what you do.

And that's how you kind of like retrain your body.

What you should give yourself permission is like to recover.

So give yourself a cortisol reset for three to five days and really get that cortisol

under control.

That's going to change your life.

My God.

Okay.

I'm going to try that.

Okay.

Dr. Shaw.

Where else do people fall?

Okay.

First of all, the book again is called Hormone Havoc where people can find you on Instagram.

You're like very, very popular.

Totally.

Very active on social.

So it's at Dr. Amy Shaw on Instagram and TikTok.

And then it's amdwellness.com.

I love it.

Well, thank you for being here.

Thanks for having me.

That was fun.

I was so fun.

Thank you.

Thank you.

Bye.