Why You Feel “Off” in Your 30s: The Truth About Hormones & Perimenopause

Introduction to Balanced Health 0:00

Our ultimate goal is being balanced, right? Optimal health is balanced. Normal isn't optimal. Your labs could be within normal range, but that's not optimal health. Optional health when you're balanced and when your feeling the best. So we really want to have balance within our body and have that homeostasis everything working together and we have to focus on gut health. We have focuss on pathways being open because we're targeted from every direction, every single day with different toxins. So in order to be balanced, we need to look at more than just hormones, just gut, health, and just thyroid.

That we look everything as a whole, our body as whole. And we can't just treat one symptom. You have look it as an entire being. I think that's what is so great about functional and holistic medicine because that is what we do. But once you start looking at it that way, you realize how interconnected everything is. 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 Amanda, and today we're continuing a conversation that so many women tell me they need. What really happens between our mid-30s and perimetopause, And how do we move through it with confidence? Today, I am joined again by Alicia Barkholtz, our nurse practitioner. In our last episode, we named that gray zone. You're still cycling, but sleep shifts, mood and anxiety feel different. weight changes show up, and you're wondering, is this perimetopause?

So today we'll break it down simply. What peri-metopaus actually is and how you can have regular periods and still have symptoms, why progesterone often dips first, what that means for sleep and anxiety, how to time labs for real insight, think days 19 through 21, when to look at cortisol, the unglamorous but essential side of detoxing gut health from bowel regularity to magnesium and dim and why stress and sleep can amplify everything and what to do about those 2 to 4 a.m. wakeups. Most importantly, you'll hear how to personalize your support.

So you're not dismissed by normal ranges and you have a plan that fits your life. If you are in your 30s or 40s and if you've started to feel off, this one's for you. Welcome back to the Integrative Medicine Podcast. I'm your host, Amanda, and we've got Alicia back with us today. Alicia, thank you so much for being here.

What Perimenopause Is 2:45

There's this gray zone that's not really talked about. There is the fertile years and there's perimenopause, but there is another shift that happens in there. And I kind of want to hone in today and continue our conversation and really talk about what's happening in the woman's body as we go from that mid-30s pre-menopausal stage and transition into perimetropause and what that that transition feels like and what to look out for when you are starting to enter perimetopause, because that looks really different for women also, depending on their resilience, their stress, they're hormones and stuff like that.

Their lifestyle can have a big, big impact in that as well. So Alicia, let's kind of just start there. Like what is peri-metopaus in general? Perfect. Yeah. Thanks for having me again. I'm super excited to dive into this discussion. Perimenopause, by definition, is the interim between a woman's fertile years and menopaus, where hormones start to decline, and they start just to kind of have different irregularities and different symptoms. That's kind like a generalized definition of that. So, perimenopsis is really where women start those big shifts, right?

You might start see some hot flashes and night sweats that you've never had before, your sleep might and start decline. You can start to gaining weight around the midsection. You haven't changed a single thing. Those are probably some of the biggest ones that I hear. And a lot of times for women, they feel like it kind of comes out of blue. Like they haven' changed anything and all of a sudden. Well, I started to have all these symptoms, but they're still cycling regular. So they still having a period every month.

They're like, so I can't be in menopause. I'm still like cycling. Not irregular yet. That's where we get into that perimenopausal. where we're pre-menopause. So we can still be cycling normal, but we are starting to have some of these symptoms. And the reason for those symptoms is we start to just have a very slow decline in the production of our hormones from our ovaries. Again, like we kind of talked about at the last episode, we go through a life cycle. Women go though a lifecycle in their reproductive organ and you have you know, where you're producing all the hormones and slowly it will start to decline, but it's very slow.

And for some women, it can be faster than others. Perimenopause can last many years for women and it go kind of quickly for others, and I think when we talk about that gray area that you were talking about in, you, know the mid to late 30s, which you may not be considered perimenopause yet because you haven't had such a significant decline in hormones yet, but we do start to see some of that slow decline. So you might notice your sleep is not as great. You might not have as much energy as you did before.

And that's all a hormonal shift of your body just slowly working into like that perimentopausal and menoposal state. Great. I think that's important. So we start seeing this slow decline. It's really our ovaries is our, our organ in women that starts to slowly decline, it's the hormone production from the ovary is that starting to decline and that can look slow or fast depending on which person you're looking at. And it doesn't mean that you're not cycling. You can still be cycling, but you start to experience the symptoms of menopause, which menopposes when we're done cycling and so we might start experiencing weight gain or stubborn weight resistance.

sleep issues, sleep disturbances, which then if you're waking up fatigued or tired, your stress resilience is also starting to decline a little bit because when we sleep, that's when our bodies repair itself, right? And we're seeing that slow decline of the hormones. So what hormones does the ovary produce for a woman? So your ovaries are gonna produce estrogen and progesterone. Those are the main ones you get testosterone produced somewhere else. But the testosterone does play a role in, you know, when the ovaries start producing estrogen and progesterone, we do see a decline in testosterone as well.

but your ovary are mainly producing the estrogen or progeterrone. And again, We have to remember that estrogen progesterones are a yin and a yang. They have be balanced in order for us to feel optimal. So generally what we see is a decline in progerestrone first. Progesteron again is that calming hormone. So it's going to help with sleep. So that at times when women are complaining of sleep disturbances, it is because of that slow decline. If your estrogen is not declining as fast as your progesterone, then we can see estrogen dominance kind of come to the forefront where we might see heavier periods all of the sudden.

We might seem more cramping. Again, that weight gain. you know, as we get a little bit further in maybe the hot flashes and the night spots and things like that, that's from sometimes an over dominance of estrogen. And so again, it's really important to look at that and see, okay, which one is starting to decline? And again it is going to be different for every woman, but if you notice that my sleep isn't as great and now I'm starting have these other symptoms and most likely is because that estrogen is still kind of dominating and isn t declining as fast as your progesterone.

Got it. Yeah, so I know I'm personally on progesterone right now, and I probably should be on some sort of like an estrogen type of detox support just to make sure I don't have estrogen dominance, or at least I that my body's clearing it when I my proesteroin is declining.

Progesterone, Estrogen, and Symptoms 8:45

For me and my provider, we test every three months to makes sure that, my dosing on the pro testosterone, I am also on a topical testosterone. to make sure that those are still in balance with my estrogen and stuff like that. So I know that there's this importance of, if you are considering bioidentical hormones for support for perimetopause, it, you know, what you just said was estrogen in progesterone start to decline, but they need to be in balanced. And typically they're not declining in combination with each other.

It's pro testosterone first. when entering into this perimetopause state that they're going to have lower imbalanced levels of estrogen and progesterone, more specifically the pro-gestrone side of things. That's not to say everybody is going be that way, but generally speaking, that's what happens kind of first. And so if you are thinking about bioidentical hormones, or can you maybe tell me your approach when a woman who is experiencing weight gain, sleep issues, hot flashes, they're still cycling, you have this inkling that they could be in entering into like the perimetopause state.

What is that treatment plan look like for you and your patients? I know it's varied and unique depending on who the person is. But in general, what's your approach? Yeah, definitely. So I think, you know, getting a good set of labs is important. And generally, we really like to check end days 1920 or 21 of your cycle. so day one being the first day of bleeding. If we check in days, 1920, or 20, when it gives us really the best look at kind of what your hormones are doing and how they're fluctuating.

But then really it's kind of the same treatment plan that you're on is really, really generally supplementing the progesterone and then making sure that those pathways are open for estrogen. And it's, there's really quite simple. One of the biggest things is making sure that you're having bowel movements and that GI system is open. That's how we get rid of some estrogen is through bowel movement and things like that. So a lot of times if women are super constipated, they're going, you know, every three or four days, like we will have a buildup of estrogen there.

And so that's just a really easy way to get, and obviously gut health is a whole nother topic, but it is just really important to make sure your gut is in check as well. And then there's two other pathways that we really focused on opening up. One of them magnesium helps to open up that pathway. And the other one is DIMM. Dimm is a supplement that has a lot of antioxidants in it. So I believe it's comparable to eating like five pounds of broccoli, which nobody's going to eat five pods of Broccoli, but you can take a tiny little capsule and it has this new type of properties in to really help open those pathways.

It's amazing. I even have some women that maybe their progesterone is still okay. And all we have to do is open up those pathways and all of a sudden they feel so much better. Because your body, you don't lose all your estrogen and that's something that I think is sometimes misconception. You know, we're just getting rid of extra. So your bodies gonna keep what it needs, but it's not gonna store extra that it doesn't need that can cause a lot of these symptoms. That's a good point is the storage part.

So we're talking about opening up pathways and hormone balance has so much to do with our detoxification. We live in this world that there's, a lot of things that we can, as well as cannot control when it comes to our lifestyle and the different toxins that were exposed to. Walk outside and breathe the air. If you live, in an area that has heavy traffic and stuff like that, you've got pollution from cars and things like that. Like it's a factor we can't control. Food for the most part we control, but we're never going to be perfect.

And so we live in this world where our detox systems are constantly challenged because we have so many things coming at us. We were not designed to have all of these extra toxins in our lifestyle. A lot of the things, like the food additives and herbicides and pesticides and things like that, those are manmade, they're created, and our body doesn't, we weren't designed have that kind of an overwhelm. Our bodies were designed detox things. probably not in the volume that we're exposed in today. And I think that's a big piece of hormone imbalances in our society in general today, because when your body produces hormones, like you said, if you have too many excess estrogen or whatever hormone that is, your buddy has to clear that and all toxins pretty much go through a similar pathway.

They have to enter into phase one of our liver detox, get manipulated into an intermediary metabolite, and then they have go into Phase 2. And that's where it gets excreted. Now, if Phase two is backed up, these intermediaries metabolites get shuttled into our fat cells. For storage. And so when our toxins get shuttled into our fat cells for storage, our fad is there to protect us. That's why our bodies created fat sells. Yep. But they also have. Because they're being stored in our cells for protection, that still means that they are having an impact on our body because they weren't cleared properly from our system.

So opening up those detox pathways and being able to allow our livers and our bodies the capacity to clear these from fat cells and toxins in storage, that allows the body to get back to its equilibrium. So I think that touching on those detox pathways, dim magnesium, and I know a lot of providers in our network will also recommend just like a, either a quarterly, or depending on how often a detox for, just to keep the body cleared, it's kind of like getting an oil change for your car,

Testing Hormones and Supporting Detox Pathways 15:00

but for you body. And then supplementing daily with things that do support regular detox of hormones and other toxins that are in storage also, because it doesn't stop with like excess hormones getting stored into our bodies. It's all of the toxins we can't process. So I thought that, I think that's an important, the detox pathways and gut health is so important for hormonal balance. And it's not just about, let's get on some bioidentical hormones. It's about making sure the body is prepared and ready and the lifestyle is there and all of that.

Right. I mean, our ultimate goal is being balanced, right? Optimal health. Is balanced and I did it. He did a seminar, I went to the seminar and it was all about hormones but one of the things that he always talks about is normal isn't optimal, right? So your labs could be within normal range but that's not optimal health. Optimal health is when you're balanced and when your feeling the best. So we really wanna have balance within our body and have that homeostasis, everything working together and we have to focus on gut health, we to have focus those pathways being open because like you said, We're targeted from every direction, every single day, with different toxins.

So in order to be balanced, we have to look at more than just hormones, just gut health, and just thyroid. We have look everything as a whole, like our body as whole. And we can't just treat one symptom. Like we as an entire being. And I think that's what is so great about functional and holistic medicine, because that is what we do. But once you start looking at it that way, you realize how interconnected everything is. So like you said, working on the toxins, that it's so huge in hormones, and we don't think about that, right?

Like you think, OK, I'm going to start hormone therapy. I am going be good. Yeah. If we're not releasing everything, we are not really going, to be optimal. Absolutely. Just talking about this too, You can prepare and even thrive through this transition if you're starting to notice those things. Supporting hormone metabolism, which is your gut and your liver and gut health and, even, adrenal recovery and protecting your sleep. sets you up for an easier transition. And so starting to do some of these detoxes and things to support your liver and your gut, I think is also just a proactive approach.

If you're in your mid-30s doing a quarterly or even an annually, any step makes a difference, Yeah. And there's even easy, like one of the detracts is that I do when I talk to patients about even like foot soaks, you use a little Epsom salt and baking soda and it opens up those pathways and you can pull stuff out through your feet. How easy is it to sit and do that and read a book or watch an episode of whatever you're doing? You know, I know sometimes like shakes and supplements like scare people, but there are other ways to just do minor detoxes to help open things up.

And you know a big one is making sure you have a bowel movements. Like our bodies were designed to poop, like you need to go. So just really focusing on that is huge too. Yeah, absolutely. We talked a little bit about the progesterone and the estrogen, gut detoxing. Let's talk about role of stress and lifestyle and environment and how stress, and sleep deprivation and even environmental toxins, how that can accelerate hormonal decline. Mm-hmm. Yeah, so one of the things that I always tell patients is I look at, when we're looking at the body holistically and I'll look hormones, I think of a triangle.

So we have hormones. We have adrenals and we thyroid, right? So you got all three and they all interconnect. And if one is off, the odds of them altering the other ones are very, very very high. When we think stress, we can think the adrenal glands. The adrenal gland are what produces uses cortisol, it helps to produce DHEA, which are going to be our hormones in response to stress. And a lot of times I think we only think of stress as being like mental stress, right? You know, we're super stressed with our job.

We're stressed, with their kids were stressed. With this, but any stress on our body. So any illness, inflammation. Anything chronic going on will also cause a stress response. So it's not just the mental stress that we always feel. And it so much easier said than done, right? Like, okay, do some meditation and you'll be better. Like that's so easier to said then done. But it really is so important. to really reduce stress where you can. Taking 10 minutes away from something that is a stress-less situation for you, let your body reset.

And like you said, sleep is another really, really important one. Like our bodies were designed to rest. Our bodies are not designed go 24-7. I know that there's demanding jobs and there is demanding kids and life just gets so, so busy. But getting optimal sleep was so important. When we think of hormone-wise, a lot of times just adding in progesterone for women. They're like, oh my goodness, I sleep so much better and I feel so better because you've given your body that time to rest. A lot times I hear people who wake up between 2 and 4 a.m.

and they can't fall back to sleep and there's a few things we can tweak and all of a sudden they sleep through that and just feel better, because they've just given their body time, to just rest and relax. I understand that life is crazy and life was busy and some days you're going to have more stress than others, but just being, I think, mindful of that and understanding how that plays such a big role in things is super important. And just when you are feeling overstressed, like I feel like anybody who's super stressed can feel it on their health, right?

You just don't feel as good. You don't sleep as well, you don' feel as good. So being mindful of that and really giving breaks where breaks are needed is super, super important. Yeah. I think one thing that I noticed when I started to notice about a year ago, my sleep and also just my stress and anxiety just kind of hitting a new level. And I know we kind talked about that, this gray area, right? This period between fertile and between perimetopause, you might not be experiencing all those symptoms, but there's certainly a decline that's starting to happen because you're not in your fertile window anymore.

But I noticed that my stress resilience and my anxiety kind of started to like take a front seat and really was having an impact on my quality of life also. And that I think has to do with the progesterone, but do you notice a lot of people having more of that anxiety and anxiousness or even depression and other like possible like things that they were able to manage? I was always able manage it naturally. But do notice maybe some like mental health or like anxiety, whatever happened? Yeah, absolutely, and it's so frustrating for women because they could handle it before, right?

And it almost like a defeat, because it like, what did I do differently? We have to understand that the hormones that were helping us work through that and helping control that are declining. And again, it is nothing that you or I are doing. That is the natural pathway of our reproductive organ. So, recognizing that, I'm being like okay, this is what's happening, how can we navigate this? and how can we get back to being optimal and things like that. But absolutely, when we think of progesterone, especially being the calming hormone, it's not just for sleep.

Stress, Cortisol, and Sleep 23:00

It definitely helps with anxiety and just feeling a lot better. I have a lad of women who just say they don't feel necessarily depressed, but they just don' find as much joy and things. They're like, I'm not depressed. Don't wanna sleep all the time, this just isn't giving me what it used to. Again, it's like that decline in hormones and making sure that we're looking at everything too, not just hormones. Looking at the thyroid, looking the adrenals, because they all play such a big role and they affect each other as things start to decline.

So we have to again, you know, look at that body as a whole, but absolutely. Speaking of other hormones, so we touched briefly on this in the beginning. I mentioned since I am on bioidentical hormones and I'm in this period where I AM starting to see that decline in my hormones. I get tested about every three, three-ish, sometimes six months to make sure that my, my scripts are in alignment with what my body needs. So typically what I look at on a three month cadence is basic hormones, but then every like six month or so I add in thyroid cortisol and stuff like that, just to makes sure those are on balance also.

What is your preference when you are getting labs done? What do you look at foundationally for women when they come to you and they're exploring if hormone replacement therapy or if they want to know where they are hormonally in their body? So definitely, you know, the basic platform that I use for hormones is estrogen, potassium, testosterone, ATA. I look at an FSH and LH. You know? Look at all of those. And generally I start with that because I don't want to overwhelm people too much, right? So we start that.

We talk about the things that are wrong and then I do recommend, we really should look at the thyroid and I explained to them what other symptoms might be stemming from thyroid dysfunction or you know if things might off with that because it is going to be a little bit different than what you're noticing from a hormonal standpoint as far as estrogen and progesterone. 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. One of the things I really, really like that we offer, too, is we are different kits that people can use. So we can obviously check hormones through a blood test, but we also can check hormone saliva testing or a Blood Spot Test, which is where you just prick the tip of your finger.

and you put blood on a piece of paper and send it in. But when we look at saliva, then we can really look a four-point cortisol level. So then, we see what your cortisol is doing from the moment you wake up, midday, min-afternoon, and at night. And that's super important, too, because we want it to be kind of, you know, a steady state throughout the whole day that your body is able to manage stress and manage what's being thrown at you. If we're seeing these spikes and dips and things like that in cortisol, that is definitely something that we need to address.

So you know, looking at testing from that way as well. But I think my approach to medicine, and it might be different for everyone, is we just kind of take one step at a time. If you're looking for hormones, you feel like this is the problem, let's check those first. But then let us also think about what other things could be contributing to it. The thyroid and the adrenals, really. So we start with hormones. Get a picture of where we are first, then next step of partnership, if the patients are ready for that, a discussion and looking at either thyroid or the adrenals or a combination of the both.

So you had said something about cortisol, like the spikes and all that stuff. How does that influence hormone? Like the estrogen, the progesterone, why is it so important that we keep the cortisol in this balanced place? How did that play into the other hormones? So again, when we think of cortisol, it's our stress response hormone, right? So we, think about cortisol does the, if you're getting chased by a bear, you are going to be running for your life. You're all listening and get all this energy and you know, other things that are gonna slow down, your digestive system is going slow it down because we have to, our heart has to pumping, blood has go to our hearts and our lungs to get us away from this bear.

And then, you know, once we're done, our body then resets and our blood flow goes to everywhere else and we can calm down. If we have elevated cortisol for a length of time, we are always in that fight or flight response. So our stress hormones are so high. But our stressed hormones can contribute to having more of an inflammatory response in the body. And it's just going to put stress on everything, including your ovaries. and including your brain and things like that. So if we see this high state of constant fight or flight, our ovaries are going to take a hit.

And it's possible that they will start to decline faster. is that your body is focused on the stress response and not on biological. So when we see these big ups and downs with stress throughout the day, those big-ups, and if they're constant, basically turn everything off in the body because your bodies only focused stress. And so if we aren't able to shut that down, then The body's other processes are constantly off or flickering off because you're in this up and down state. So you are not really repairing, you aren't really producing and it's really just kind of giving the signal to the ovaries and honestly the rest of the body.

We don't have time to focus on this right now. Right, exactly. I think another big thing is like, and I see this with, I used to see with coaching clients, with my own family, where they're like I'm not stressed. Well, yeah, you might not mentally be stressed, but what I also think a lot of people need to understand too is that you may not have perceived stress. Maybe you're very secure and you've got a good life. That doesn't mean your body isn't still under stress because the things that affect your stress, yes, there's the mental and emotional that is going to have an impact on your response.

connecting with when we talk about stress is what is your perceived stress. However, sleep cycle disturbances that also initiates the stress response and you might not even know it and blood sugar dysregulation. If you're having a super, you know, I'll admit this, today, all I had was a coffee for breakfast. That did not start my blood sugar off well today. So, I mean, we're all human, but there's so many other ways that our bodies see stress. If you have an underlying infection that you're not even aware of, you could have been bitten by a tick five years ago, 10 years, ago.

And you can have a low-grade, like, Lyme sort of pathogen in your body. I get cold sores and so like, I know I've got that underlying in my, those things that are there that you don't see and you might not feel are also causing your stress response to go. So getting that, that cortisol test, understanding where you are from a stress resilience standpoint. can be really eye-opening because then you're like, oh, well, I don't have perceived stress. So where could this stress be coming from in my body?

And there are certainly ways that we can improve our body's stress resilience with like adaptogens, rhodiola, things like that. Those certainly can help our bodies. capacity to tolerate stress is a way to supplement it. But really, I think the most powerful thing is, is understanding where that stress coming from. Is it from sleep? Is from an infection? is it mental and emotional? Where is blood sugar? where is the stress stemming from in the body? Because that's playing a huge role in overall hormone balance as well.

Yeah, I mean, finding the root cause is so important. I think you hit on some really good points there. One is, you know, our bodies are designed, it's kind of like a hierarchy symptom, right? Like our heart and our brain, those are like the two big things. And our lungs, like everything else will take a backseat. If that is what, if that's the only capacity the body has is to focus on those because it is being so overwhelmed with everything. That's what it going to do. and your thyroid and you're hormones and things and Your ovaries are going to take a backseat because your body can only focus on so much at one time and I think you did a really good job of explaining that and also I Think a Really important point to make too is You know, I see a lot of patients and they're like, well, this is just like this Is my new normal, right?

This is how I felt for years. Like I don't feel great, but I can still function and Things like that. Well, why like why is this your new Normal? You know, like you said, is it an underlying infection? How has your sleep been? Why is your asleep so bad? What can we do to help that? You don't have to have a new normal. You're new, normal doesn't to be feeling crummy, but you're still able to function. So really focusing on that and finding the underlying cause and things like that is just so important because again, body's a whole,

Labs, Adrenals, and Root-Cause Care 33:00

we have look at it from an entire systemic point, not just one specific symptom. Yeah, I think that as we talk about perimetopause and what it's like to transition into that, a few big things that we touched on today is your gut and your detoxification system play a huge role in that. And there's small things we can do to be proactive, which is you know, detoxing and supporting our detox pathways is a really big one. I think that testing and knowing where your hormones are today can be very impactful.

It can very enlightening and empowering, especially if there is, if you find out like, hey, progesterone, and not to say it's an easy win, just, you bioidentical progesterone and get great sleep and then a lot of other things start falling into place. Awesome. And I do think that the other one that we talked a little bit about today is stress and cortisol and how that plays a big role. I think another proactive measure is just starting to understand where stress is in your life. Be proactive with it, with your mental health.

And also knowing where your cortisol is, there's different stages of adrenal dysfunction and knowing I can say pretty confidently that a lot of us are in some sort of adrenal dysfunction. We are combated by toxins and toxins just in general initiate the stress response in the bodies. Knowing where you are and supporting your adrenals is a really great proactive step that you can take as well. Yes, 100%. And I think it's, you know, we kind of talked about it in the last episode too. It's really just finding, like finding yourself, right?

Becoming one with yourself and understanding yourself. And okay, what is, What is a stressor for me? You know? This doesn't work for, even though it might work, for someone else. Like finding what works for you and how to best navigate everything is super important. Yeah. And I think it's too, perimenopause is not a single moment. It's a phase, right? It is a multi-year transition for most people leading into menopausal and it is marked by a decline in estrogen and progesterone and a fluctuation in our overall hormones.

There are a lot of things we can do to be proactive about it. When we're looking for ways to support ourselves and be better and thrive during this time, I think reflecting. A lot of times we're moving through life so quickly. Like I didn't sit and stop and think until it really affected me. And it was really having a big, big impact on my life and my productivity, my brain fog. And I think if we stopped and slowed down more often, we would notice those, those signs a little bit more. I there's a lot of great technology out there.

that tells us our sleep quality and things like that. And taking, it's one thing to have this information at your fingertips, that's another thing, to use it. It doesn't mean that you have to fancy technology or apps either to be able to take stock of where you are and how you're feeling. If we take five minutes, even once a month, and be like, how did I sleep this month? How did feel this And if we were able to do that more proactively with ourselves, I think that we would get ahead of this a lot sooner.

And that's why I love this conversation is I hope any of the women and or men listeners out there just start checking in with themselves and saying, how do I feel this today? How is that different from? Last month, last year, the last six months, are there things that you're noticing, patterns that your noticing that can catch ahead of time? Are you feeling a little bit more tired? are you not keeping up with the kids as much as you want? Just taking stock in, how's your energy? How's is your life?

how is it your joy and your passion in life. And it gets so easy for us to keep moving, moving moving so quickly that we lose checking in with ourselves, especially women, because we're always so go, go go. Yeah, absolutely. So with this gray area, getting into perimetopause, a lot of times, this is like one of those gray areas that I don't know if we have a ton of support as women in the traditional system when we are starting to go through this. What do you think conventional or traditional medicine, if somebody is going to their OB or their PCP, Why do you think that, I'm not going to say they get dismissed, because I don't think either, but what do think the big miss is from a conventional or traditional standpoint when people kind of go in or a woman goes in and says, ''I'm really just not feeling good, and they, your hormones look okay.'' I think the miss is that we are that this is what your body does, right?

We know that and we know, that that can't be changed. And so I, think, the misconception is, there's nothing we can do. This is normal. For you to start losing sleep because you're starting, your hormones are declining. That's normal, That what's supposed to happen. Once you get past those fertile years, you know you, get into that transitional stage, perimenopause and menopausal. I Think we get so fixated on this as normal and this is what's supposed to happen that we miss the thought of there's things that can do to help that transition.

And I think that that's the biggest miss is that this normal, this what supposed happen, everything else looks fine, like you're good to go, just work through those symptoms on your own. Where when we look at it from this way, it's okay, yeah, that is how it supposed happened. We can't do anything to change that, but there is so much we can to support you along the way. and help you transition and still feel optimal. I think one thing you said was symptoms. Like, I that in the more conventional setting, labs are what rule the, they just rule, right?

But your estrogen and your progesterone look like they're in a good spot. They can be within that normal range if we're entering into perimetopause and yes, that's what the body does, but it doesn't mean we have to get through those symptoms on our own. And I think that where we differ a little bit more or a lot more than your conventional or traditional is that, yep, you're going through peri-metapause or metapausal or whatever. We still listen to the symptoms and it's not a, well, your labs are within conventional range.

So there's nothing we can do, which is, from our perspective, there is so much we could do to alleviate those symptoms and create a more vibrant and thriving life. I don't think that women, we don' have to live with fatigue and night sluts and poor sleep. There's a lot we can do. A really good example of that is just when we look at her gesture and I think the reference ranges like two to like 20 or something like that. And generally we've like I found through research and reading and things like, that women feel really get around that 10 mark, right?

But you could be out of three. And you're going to be normal and it's not based on your labs is not going show that you need supplementation, but your sleep is terrible. Your anxiety is worse. And all of a sudden we bump you back up to 10, which is still in that normal range. Like we're not, we are not throwing you off the other way. You know, that's when you come. and do this type of therapy and things like that, we're not throwing you overboard and getting you much higher than normal. We're just keeping you in that reference range, just maybe a little bit better and a bit more optimal.

But it's crazy what even a bump from three to a 10 can do for women, but still within that preference range.

Normal Ranges vs Optimal Health 42:00

Right? Yeah. I love that. Well, I am so glad that we got to jump on and continue our conversation. I know that this is such a big, powerful area. I'm learning a lot too, because it's my phase of life that I am kind of in. And I just so grateful that, I get to speak with providers like you and pick your brain about all these things. Alicia, what do you wish every woman knew about this stage? Oh boy, that's a good question. I think that the number one thing is you're not alone, right? Again, this is normal, so you are not losing this battle.

This is what's supposed to happen, you aren't alone. Everyone goes through it in one way or another. No, it's not going to be the same. Every woman is going And every woman is going to have symptoms a little bit differently, but this is normal. So don't beat yourself up about, oh my gosh, I can't sleep now. My anxiety is worse. What am I doing wrong? You're not doing anything wrong. We have to recognize that this normal, that there are things that we can do. So just looking within and being like, okay, what changed?

When did this change? My outside world didn't change. My diet didn' t change, I didn t changed anything. So what internally could have changed. And I think that that's super important to focus on. Absolutely. The transition from your mid is to perimetopause doesn't have to feel confusing or chaotic. It's your body evolving and when you understand what's happening, you can work with it and not against it. Supporting your hormones, your sleep, nutrition, gut and stress all lays the foundation for vibrant energy, balanced mood and strong health for decades to come.

So there's a lot we can do, and I'm so grateful that we had this because I think it gives a really good takeaways on what people can. Alicia, thank you for helping us demystify this stage of life so more women can experience this with vibrancy and more awareness and understand what they can do to proactively enter this stage of life. So to everybody listening, if you're in your thirties or your forties and you've started to notice changes in you mood, your energy or cycles, just know this, you are not alone.

And it's not all in your head. There are answers and there's also support out there for you as well. You can connect with Alicia and other form health providers for personalized hormone and integrative care, both in person and virtually. So if you found this episode helpful, please share it with a friend or a loved one because every woman deserves to feel informed and empowered through her hormonal journey, which never ends, does not end for us ever. All right, Alicia, any final thoughts for our listeners today?

You know, one of the things that I always tell my patients, every single one, of them is, you know your body best. And sometimes we really have to advocate for yourself. So, even if your labs are showing one thing and you're still feeling this way, like keep pushing because you. Know your best and I tell women, I'm going to base my treatment off of how you feel, not necessarily what's on paper. So really just, just keep that in mind, like keep fighting if you have to, because you, you know, your body invest and you will know where you want to feel.

Yes. Thank you so much, Alicia. I will catch you next time. Thanks everybody for listening. 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.