I do have people come in who are like, you know, I've been tired my whole life. I don't remember ever feeling rested. In those cases, you'll see like maybe something that they were more resilient with as they were younger.

I always say kids are amazing as far as their ability to heal and push through and stuff. But as you get older, especially for women, when we hit kind of that perimenopause phase, You know, those sex hormones that are pretty protective for a lot of things start going down in general because of age, and you're less resilient then to the changes in the effects that stress are going to have on.

Plus, I say the longer we live, the more we're exposed to things, illnesses, you know, infections, toxic exposure in our environment, and that all puts additional stress on.

Your health is shaped by more than symptoms. Through real stories and expert insights, we explore how your genetics, environment, and daily choices affect your wellbeing.

We uncover root causes and share practical tools to help you find the healing you need. Welcome to the Forum Health Integrative Medicine Podcast. Welcome back to the Integrative Medicine Podcast.

I'm your host, Amanda, and today we're talking about something that affects nearly every woman, stress and hormones. Joining me today is my good friend, Emily Rodriguez, nurse practitioner at our Forum Health Madison Clinic.

Emily has a background in nurse midwifery and now focuses on functional medicine with deep expertise in women's hormones, thyroid health, and stress resilience across the lifespan.

In this episode, we break down how chronic stress disrupts cortisol, thyroid function, estrogen, and progesterone and what women can start doing today to protect their energy, metabolism, and mood.

Let's dive in. Welcome back to another episode of the Integrative Medicine podcast. I'm your host, Amanda, and I'm joined today by Emily Rodriguez, a nurse practitioner in our Madison location.

Hi, Emily. Thanks for joining us today. Thanks for having me. No problem. I'm so excited to have you here today. I love our Madison location so much. I love all of our locations.

Madison is near and dear to my heart. You guys are like 15 minutes away from my home and you guys are my home clinic. And so I'm so excited to have you guys on the podcast.

And Emily, tell us a little bit about yourself and how you got into functional medicine. How'd you find this? Yeah, absolutely. So I have been in the medicine office just over two years now.

So another NP in the office and I, Tracy, we went to nursing school together, but my journey into functional medicine is pretty long. Like many of us, I was a patient many, many years ago as a teenager and functional medicine was life-changing for me and a lot of people in my family.

Fast forward, I went to school for nursing and actually got my degree in nurse midwifery. So I was a full scope nurse midwife for seven years, delivering babies and seeing women in clinic.

And midwifery and functional medicine kind of go together well because it's a very holistic type of care. And so when I was looking to make a transition out into working in this space, I was able to join our Madison clinic.

And it was a nice, good transition, especially with the focus in our clinic on women's health and hormones. Absolutely. I love that so much. And you know, one thing that women you know, and men, everybody, we all deal with this stress.

Stress affects everyone. But for women, it's uniquely tied to our hormones, right? So from like our monthly cycles to fertility, perimenopause, menopause, stress interacts with hormones in powerful ways.

Today, We're going to unpack how stress impacts women's health at every stage and what you can do to protect your resilience. So Emily, how does stress affect women's hormones across the lifespan and what can women do to protect resilience during these changes?

Yeah, absolutely. I think you made an interesting point about we tend to associate stress with women's health. And I think it's getting a lot of attention lately, which is good.

I see mostly women, but we do have quite a few growing population of men seeking out our care now, too. It's about time, men. Come and see us. We want you guys to come in.

But I ask all my patients about their stress, and it's very rare that someone tells me that they don't feel stressed. Yeah, I would love to meet the person who says, I'm good.

No stress here. Once in a while I get one in and I'm like, okay, good, cool. But when we talk about, and we'll get into this more, but when I see those people who are like, no, I feel pretty good.

You know, yeah, I've got a lot going on, but I feel good. It's a lot of it has to do with the things they've set up around as far as coping and making their lifestyle to protect their peace, I would say, and to make sure that they still have enough time for themselves.

to help cope with the stress of life. I always tell patients, you know, we can't get through life without stress. It's part of life. And there's a lot of different types of stress.

But I do see it with women. I feel like especially since COVID, there's a big shift. And part of that was women tended to burden a lot of the extra stuff that came along with COVID.

They were working from home, their kids were home, they were trying to oversee the schooling that was being done at home. There was a whole bunch of extra layers added to that.

And I saw a lot of women come in after that and kind of towards the end saying, you know, I was feeling really good until that happened. Stress, yeah, stress affects a lot.

So we think of cortisol. You hear a lot about cortisol and absolutely it's a big player. When we are stressed, cortisol goes up. It's the, I'm going to run from a bear.

So cortisol goes up and it suppresses what we call our non-essential functions. So if you're thinking I'm going to run for my life, what do I want my body to do?

My blood is going to go to my skeletal muscles to run away. And our body doesn't know if it's a bear or if it is, my job is really stressful right now or my kids are sick or whatever it is, not getting good sleep.

It reacts the same way. And when we think of those non-essential parts of the body, which I, that's just, that's what it gets called. They are still very important.

But we see a suppression in our digestion and we see a suppression in reproduction. And what comes into the role of that is when cortisol goes up, especially if it's elevated for a long time, there's a suppression of our production of our sex hormones, especially estradiol, progesterone, and testosterone too.

And that controls a lot in our body. And the other part of that is our thyroid function. So when stress goes up in cortisol is high, our TSH, which is the pituitary hormone that stimulates our thyroid to make hormone, that is suppressed.

And then we have a lower production of our thyroid hormone. It also affects the ability of our thyroid to convert T4 to T3, which is our active thyroid hormone, which controls our metabolism.

And a common lab pattern I see in patients is, you know, sometimes their other thyroid markers look pretty good. Like their TSH will look kind of nice in a lower level where we like it, but stress can suppress that.

Their T4 might look okay, but their T3 often is what we would call suboptimal or low. And T3 is a big controller for a lot in our body. So things like…

our metabolism, our body temperature regulation, even our mood and our depression can be affected by T3. But the common things I see people come in for are, I'm gaining weight, I have terrible brain fog, I can't sleep.

And those are all symptoms that go with these hormonal changes that we see. That's just so stress, right? Like it's such a simple like, oh, cortisol goes up.

Yeah. It's not simple though. Like the whole body impact of just that And it's, it's almost out of our control. Like it's, somebody cut me off in traffic.

Stress. Kids screaming in the middle of the grocery store. Stress. I'm running, I'm running behind on my podcast schedule. Stress, right? And so it just, it happens and it's always there.

And then there's also the unseen stress too. Like if you get a poor night's sleep, that is, that stresses the body. So like there's the perceived stress that we all have all day because, you know, I work on mindfulness all the time.

Like, you know, oh, I'm running behind in my, my schedule today. It's okay, you know, like I'm practicing a lot of mindful mindfulness for that. But I do think that there's the unseen stress that a lot of people are not aware of how like sleep cycle disturbances impact your cortisol and your your body stress or even You know, we live in Wisconsin and ticks are real in Wisconsin and, you know, get bit by a tick and maybe you have, maybe you've got Lyme disease or, you know, something like that.

Even those low grade infections in the body, they signal the stress response in the body. Even though we, as a, you know, a conscious human, we're not, this isn't stressing me out right now.

This stresses me out right now. it's still creating that low stress response in the body. So, absolutely. And I think I hear, you know, sometimes I have people who are coming in, they say, you know, I was feeling really good up until a year ago.

And then, you know, my mom died and this happened and they kind of will list off some things and we'll have like a clear turning point of what the health changed.

But I do have people come in who are like, you know, I've been tired my whole life. I don't remember ever feeling rested. In those cases, you'll see like maybe something that they were more resilient with as they were younger, because I always say kids are amazing as far as their ability to heal and push through and stuff.

But as you get older, especially for women, when we hit kind of that perimenopause phase, you know, those sex hormones that are pretty protective for a lot of things start going down in general because of age.

Right. And you're less resilient than to the changes in the effects that stress are going to have on them. Plus, I say the longer we live, the more we're exposed to things, illnesses, you know, infections, toxic exposure in our environment.

And that all puts additional stress on the body. And I do think culturally, I mean, how many people hear about, like, talking about the joys of the European month-long vacation?

They're so good at taking breaks. We are not. Like, our culture is kind of a hustle. And, you know, I have a lot of people come in and they're like, yeah, I'm stressed, but that's just life.

Like, that's just what I'm doing. And then I sit down and talk, okay, well, what's your schedule looking like? What's your days looking like? What's your weekends looking like?

And they're so overextended. A common thing I see patients come in and it's like, they're skipping meals, they're skipping breakfast. They're hardly feeding themselves.

If they eat something during the day, it's on the go. They're running out the door. They're having stuff in their mouth. And everybody's done this. Like it's, you know, I would say sometimes periods of life are really busy.

But what the problem is, is when you go long term in a lifestyle like that, your body's not going to keep up with you. Eventually, it kind of peters out.

And you'll get what we'll call kind of like dysfunctional patterns of cortisol. And we can test this. We can do saliva testing, urine testing are good ways to test this, where you'll actually see a disruption in what the normal pattern of their cortisol curve would look like.

And that those people will come in sometimes and they'll be like, you know, I'm tired all the time, but I can't sleep at night. I'm waking up a bunch of times.

I feel terrible. Or it's like I'm exhausted in the morning after sleeping all night. And then in the evening, I'm so wired. And that's all a dysfunction in our cortisol curve, so.

And you know, a lot of this sounds like, you know, I've had periods of times in my life where I've been under a lot of stress and, you know, exhausted and all that stuff.

And it sounds, you know, this sounds like, oh my gosh, I have so much to do. You know, it's a big but. One of the beautiful things that I love about partnering with a functional and integrative medicine provider is getting the tools and the guidance and knowing what to do.

You know, being able to test our hormones and understand where we are and getting on some of the hormones and corrective measures that we can take. Because that is going to start giving the body back the signals that it's missing and lacking today.

to give them the energy to start making those changes. Absolutely. I think, too, sometimes people come in and they feel so lost, like, I've been doing this, I don't know what to do.

You know, I would say two of the biggest kind of red flag symptoms I see with prolonged stress for women are consistent weight gain, or inability to lose weight.

And that's very distressing for people, especially because they're… It causes more stress, right? It causes more stress. Yeah, absolutely. And they'll come in and they'll say, you know, I'm exercising five days a week, I'm running, I'm lifting weights, you know, doing all these things, and I can't do it.

And sometimes that is almost stressful too, right? Like, I'm doing all of the things, there's the stress, right? Like, I'm not seeing the results. But then also, pushing yourself to the point of like, okay, I'm busy, but I At Forum Health, we uncover the why behind your symptoms.

With advanced lab testing, hormone optimization, and cutting-edge therapies, we help you heal and perform your best. And now, through shopforumhealth.com, you can access physician-grade supplements trusted by our providers, supporting everything from adrenal health to focus and longevity.

Learn more at forumhealth.com and explore supplements at shopforumhealth.com. But I have to do this. And it also turns into the but. It's not the and conversation.

People aren't having and in their head, right? It's I have to do this, but I'm really, really tired. Instead of having the mindset or of I get to do this and it's good for me.

I know actually that made me think of a patient I saw a couple years ago. She had come in and was with severe fatigue. Fatigue was like her biggest symptom and we checked her.

Her hormones were lower than what they should have been. Her thyroid T3 was low and she was going, she was exercising a lot, like over exercising. And it had been a part of her life, but she was so fatigued.

And one of the things I told, like we talked about in conjunction with the protocol we put together for it was, I want you to slow down on the exercise.

I'm like, we cut out cardio for a while. We switched just to kind of some slow, gentle weights, walking. And even just doing that, she saw a significant improvement in her fatigue because we were reducing some of that stress on the body.

And I told her, I'm like, this doesn't mean forever. We're going to get you to a point where you're going to be able to run again. I know you love it, but right now your body needs a little extra love.

And I think functional medicine does that. We can help in a couple ways for this. I always tell patients, I can't fix your home stress. You know, you can't get rid of your kids.

Most of us need to work. We need a job. But what we can do is, you know, do some testing. See, where are their deficiencies? Is there anything we can support right now?

We have really wonderful health coaches. So getting people on a good meal plan. You know, I have so many women who come in where the first thing I tell them to do is, I want you to start eating breakfast.

I want you to start eating breakfast. prolonged fasting and skipping meals is another stress on the body. Yes, absolutely. And there's a time and place.

Yes, that's what I like to say because two, one, there's so many diets out there. Yes. There's low carb. There is, you know, there's the… fasting, 24 hours, there's five days, all the things, right?

There's certainly a time and a place. And I think it's even more important for women to understand when that time and place is with our cycles, monthly cycles, and then how our body transitions from decade to decade.

All of that, I think, needs to be taken into account because when I was coaching women in this space also, some of the things were, but I was told low carb.

Well, your thyroid needs carbs. Yes, low carb can be good, but like it has to be the right kind, right? Like let's get sweet potato, let's still hit our 30 to 50, like if that's what we're choosing to move forward with.

Or if you're doing a fast, there are certain times in your cycle where that's going to be optimal and not optimal, right? Absolutely. So I think getting that, and the other big thing that I heard from people too, when I was coaching was, but I have a family.

I have two things to say on that is why wouldn't you want to do that for your family first? What you're setting the example and also just providing that nutritious substance to the family as well.

And so, and that's why our health coaches are great, being able to help identify, find recipes that pleases the whole family, as well as takes off the burden of meal prepping and cooking and stuff like that.

We've got the resources and tools for that. And then the other side of the coin tooth is how long can you afford not to do this for yourself? Because the longer you wait to take a small step for yourself is more progression in the direction you don't want to be going right now.

Yeah, absolutely. I think, I mean, there's so much research on investing in women's health as far as what that does for the family and the spillover in terms of like partners, children, and societal benefits.

Yeah, I do hear that a lot of people. Well, I have kids. I'm like, well, I do too. And it's, you have to… Nothing worth doing is easy. And if you feed yourself well and nourish your body, it does amazing things.

And it's the small steps too. I think people sometimes sit down and think, I have to do everything right now and I have to do it the right way. Where life, it does not work like that.

No, absolutely. No. It is, what is the small thing that I can do consistently today and make it a habit? And then when that becomes a habit, what's the next small thing that I can add into my day that becomes a habit over time?

It's not trying to jump in and do it all at once. That's why we have tools and steps for people to follow. Yeah, absolutely. And I think in specific situations, especially like I think of patients who come in with fertility concerns, guidance of working with somebody and getting actual testing, getting a dietitian working with you and looking at the specifics of your daily life.

I always say our health coaches are implementation experts. They're going to look at your specific situation. What's your day-to-day look like? What's your lifestyle?

And how can we tailor things to fit in to make those small changes? And I learned so much from the health coaches. I learned so much from my patients.

And again, I'm like, how do you remember to do this? How do you work things into your routines? And that's where you see a lot of changes. Yeah, and I think, yes, stress is a big one to tackle.

Like I said, some of these external factors, we don't have a lot of control over. And part of that is where, I mean, there's some great tools out there, Vegas Perf supports, you know, different counseling programs, cognitive behavioral therapy, EFT therapy.

There's some really wonderful things. to help people learn how to adapt and respond to that so that our body doesn't look at, oh my gosh, there's bears all around me.

And we get conditioned for that. We get used to responding that way and it's hard to turn that off. We've been doing it for our whole life. We've been doing it.

And it's not going to, we're not going to flip a switch tomorrow and be a different version of who we are when we've been trained over the decades. Yeah, absolutely.

To be and perform a certain way. So it takes a lot of, it takes a lot of It takes a village. And that's what we want to provide people is the village.

Yep, for sure. So I would say as far as like specific things that I tell patients that are kind of the, not easy, but the free things that we can do. One is protecting our sleep.

Gosh, everybody I see has sleep problems. Well, then I ask them, okay, well, what's your nighttime routine? Well, I get in bed at 11. I lay in my bed and scroll through my phone.

Yeah, I mean, that is constant. It's constant, they say. And I'm like, all right. Well, so you need to get into bed earlier. We need to have a better routine.

You know, I'm sure people have heard, keep your mornings bright, your nights dim. That circadian rhythm set is what, our circadian rhythm is determined by our sunlight exposure, by our artificial light exposure, and by our melatonin curve at night.

So they're all interconnected. There's actually a study that was done by the NIH, I think it came out in 2021, and they were studying night shift nurses who had high rates of breast cancer, and they were trying to figure out why.

And during that study, they essentially determined that artificial light was a carcinogen because of the disruption to our cortisol and our melatonin from being up overnight in artificial light.

And there's a lot of things that we can do to protect it. I know for my family, especially in these fall days as it gets dark early, we like candles. Like we eat dinner by candlelight a lot of times.

My kids calm down, they go to sleep better, and we all feel better. Yeah, okay. Take away, everybody. Eat by candlelight at dinner. What a mood. Yeah, it's a good vibe.

I think it's special and it's really good for your body because that artificial light keeps your cortisol high, which prevents your melatonin from going up.

Well, this just means that I have to go out and get some more candles. Yeah. If people are looking for a candle, what kind of candle should they be looking for?

Because I've also like inky candle and stuff like that. You light one of those candles and it's like a candle like that burning for like an hour is equivalent to I can't remember how much secondhand smoke.

Yeah, so I tend to buy from small vendors to produce like off of Etsy. Yeah, there's a local shop near me that I get from. With essential oils, not the perfumes, not the scents.

Like if you're looking at a candle and it says like perfumes or… Artificial fragrance. Artificial fragrance is another one. You know, that industry can, in that one word, I think there's up to like 60 ingredients in that one word.

Yeah, and I personally, if I'm around artificial fragrances, don't tolerate an unscented candle. An unscented candle. We buy some just plain beeswax that are not scented.

That's what I would say most of the candles in our house are. It gives a really nice light. That's great. Yeah, I love that. The other one too is step up, if you can like wake up from bed, which I will say this is so hard for me to do, but if you can get up and like within the first like five to 10 minutes of waking up, if you can go stand outside and get some sunlight on your face for like two minutes, or even like standing outside if the weather is nice and like having your feet in the grass, if that's is something that you're able to do.

Yeah, I try to walk in the morning most mornings if I can, which is a good time to go. But if I can't, I do go outside. Actually, now my older kids do too.

They'll go out and stretch. They'll go out on the deck in the morning and stretch and go lay on the deck and stuff. Because we've talked about it, the importance of sunlight in the morning to help with setting that curve for your body.

I love that. Yeah, sleep is a big one. Awesome. The next thing is feeding your body good. So, nourishing foods, not skipping meals, good whole foods. Omega-3s are really important for inflammation, just helping support your body through stress.

B vitamins, you know, looking at B vitamins. And actually, something that I do love technology for, if I have a patient come in who it's like, all right, here's my food sensitivities.

you know, here's what I avoid. I don't, yeah, eggs, whatever. They give me kind of their specifics. I will go into basically AI and say, give me five high-protein breakfast ideas that are egg-free.

Yeah. And it's so fast. They're simple. And then I can literally give patients these lists and say, all right, here's some new ideas for breakfast. Like, let's start eating breakfast.

I love that. So I use ChatGPT for recipes right now. And we just made, me and ChatGPT, we friends, and we just made a great pumpkin Turkey chili. Okay, and it was good season for that.

Yes. Yes. Yes. Yes. So Emily For women who are listening and who might feel a little overwhelmed right now because this is a big topic. Yeah, you know What is the first step that they can take today to better manage stress and protect their hormones?

I Yeah. Well, I think we kind of talked a little bit about like the sleep and feeding. I always say, and this is something I did with my patients who would come in with post-harm depression.

I'm like, okay, let's go back to the basics. Let's protect our sleep as much as you can with kids. I had some tips. If you wake up in the night or kids are up, don't turn on a bunch of lights.

Don't look at your phone. Don't look at the clock. It doesn't matter. Take care of what you need. The alarm will go off and it needs to go back. Get back in bed.

And I know for myself too, if I'm up with a baby in the night and I look at my phone every hour we're up, it stresses me out. So I'm like, get the clocks and phones out of your room and protect your sleep.

to, you know, food, making sure you're eating and making sure you're sitting down to eat. I know we have some podcasts coming up about gut health and stuff.

I talk about gut health with all of our patients. Eat with intention. Eat with intention. Take some time to sit. It doesn't digest. It doesn't do anything for you.

Yes, we don't digest. If you eat under stress. Yeah, and we don't absorb our nutrients. Yeah, absolutely. You're in flight or flight, so your blood flow doesn't go to your digestive system.

It's going to your legs. Like you said, maybe not your brain, but it wants you to go. So if you're eating when you're stressed out and you're angry or whatever, it's really just kind of, have you ever just, excuse me, have you ever just had a meal and it's just like sitting at the bottom of your gut?

Common, I would say a common symptom I hear from patients when they come in with like higher stress and stuff is reflux. They're having reflux and they're having GI symptoms.

They all go, this all goes. That's a whole, I guess, yeah. We'll go into it. But I tell, I talk about that with patients about good meals and protecting that meal time and sitting and enjoying meals.

And part of that looks at like, what's our family obligations? What am I committing to? People are so overtaxed. You know, if they're running around, they're eating on the go, they never sit down for a meal.

I mean, we're missing so much of that. Right. All the Blue Zones, all the Blue Zones where people live really long. One of the things they all have in common is community connection and they all sit down for these nice long meals where they're taking their time to eat.

Good book out there, the Blue Zones. Yes. Yeah. Highly suggest. But I tell people, you know, bring back your family dinners. Sit down and eat with people you love and, you know, make a community.

I think that's something post-COVID that people really missed is, you know, connecting and joy and just leisure. Leisure is so important. It's, we're missing it.

So we're prescribing relaxation. Relax. Relaxation. I don't mean like go pay for a massage and stuff like that. It's another to-do thing. Yeah. Protecting your space and, you know, whether it's family, friends, you know.

Take a break. Take a break. Take a break. I love that. Well, thank you so much for today. I so appreciate. Our one-minute takeaway is going to be for today.

For women, stress and hormones are deeply connected. High stress can throw off cycles, worsen PMS, amplify hot flashes and menopause. And as hormones naturally decline with age, resilience to stress goes down.

The good news, with small steps, better sleep, mindful stress care, nourishing foods, and hormone support, when needed, you can restore balance and feel more like yourself again.

I hope you guys have a great rest of your day. See us next week for our next episode. Thank you for joining us on the Forum Health Integrative Medicine podcast.

Each episode, we help you understand your health from every angle and inspire your lifelong wellness journey. Follow the show, share it with someone who needs hope, leave a review, and take the next step toward feeling your best at forumhealth.com.

Emily Rodriguez, CNM, APNP

Stress & Hormones: What Every Woman Needs to Know