The Dylan Gemelli Podcast
The Dylan Gemelli Podcast

Episode #106 Featuring Dr. Mariza Snyder! The science of menopause and hormonal decline, Stigmas of testosterone and progesterone, Embracing menopause, Estrogen facts and more!

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Episode #106 Featuring Dr. Mariza Snyder!!  Dr. Mariza's life mission is to help women overcome the stigma and false narrative of the struggles that must occur during midlife and menopause stages.  Sh...

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All right, everybody. Welcome back to the Dylan Jamelli podcast.

So, as I always say, I am super blessed that I have amazing guests that are willing to come in and

see me and talk to me in person and I am extremely thankful. And today's guest has a plethora of information. And when I saw her talking about her new book, I said, "Okay, I gotta have her. Gotta get her on here." And it wasn't just because of the book. It was because of the content and the stuff that I was seeing that she was putting out the impact that it was having. And I look for people that give out heartfelt information. Not people that are just given out

info to give it out to drive for whatever they've got going on, but people that I can see actually

care, and you can see the intricacies on what they do. And that's why I invited my guest here today,

because I want to spotlight what she does. Now, just briefly here because I can't do justice on a short bio. But we're gonna get into everything. She is a powerhouse advocate for mid-life women leveraging 17 plus years as a practitioner and author, a speaker. And she has a top rated podcast is called Energize. And also a new book, which we're going to talk about amongst the many books that I just found out that she wrote. But she has so many skillsets. Her new book is called the Perry

Menopause Revolution. So my friends, welcome Dr. Mauritius Snyder. Thank you all so happy to be here. Thank you for making the trip down to Seamy, especially during all of this busy time with your book that you've been all over the place rightfully so. Let's talk about all of these things that you're doing that I brought up because I feel like you are trailblazing for menopausal women's health, but all women's health, and really for men too. I mean, we can look at it from multitudes

of ways, but I think the impact that you're making is very prevalent. It's noteworthy. And so I kind of want to get into everything that you're doing right now. So I love it. Let's do that. Well, look, let's do this first before we get into anything. I don't do all the backstory stuff and everything, but I do want to know what your driving force and factor is into the work that you do because it is impactful and you're so passionate about it. Why the kind of menopausal

route in that realm, so to speak? Yeah, I love this question. It was my mama. My mom, you had me when she was 19 years old. So she's a young mom. And if you look at her today, you would say she's in her 40s. This woman is gorgeous. She's retiring this year and she plays competitive tennis. She is training for a marathon. The L.A. marathon right now. This woman is a force of nature.

And that's how I always had seen my mom a whole life. She was a single mom raising us

and she was superwoman. Like she was superwoman in high heels. I could hear her. She had this walk.

This is like this walk and she was always physically active when we were growing up. She was

at least like these little power suits, you know. I gave it very much that vibe. You know, like the 80s mom or the 90s, like working mom, you know, just trying to get in the room where it's happening. That was my mama and I really, I get to stand on her shoulders. Like she, she opened the door for me. She allowed me to see what was possible for me as she was trying to get in the room. And she, this invincible woman, I remember she, my sister was having some pretty big struggles.

She's in her ease. And again, moms often won't tell you what's going on. You know, they, they kind of keep it to themselves. And she was struggling in the beginning of her 40s. We weren't talking about Perry menopause then. You know, menopause was just your period stop. That was it. Maybe some hot flashes. Maybe some night sweats. And that was it. But my mom was struggling with weight. She was struggling with energy issues. She was struggling with mental energy.

She was struggling with mood, particularly the rage. And it's finally when she got into her late

Ease.

just kind of powering through the way that we tell women to power through. But in her late 40s,

I want to say it was 48 years old. I'll never forget. I got a call at 11 o'clock at night. And when your

mom was calling you at 11 o'clock at night, a twice. But it's not good. No. And she was in. She was really struggling with her mental health. She was really, she was really scared about what was going on. And she had been to Obi-guine. She had been to primary doctors and just kept being told that it wasn't menopause. Maybe some anti-depressants and just keep it moving until she got to a point where she did not know what to do. And I just watched this woman who was bulletproof

become a shell of her former self. And when I started taking care of her, I took over her care immediately. And what I realized is that not only had the medical system and health care suddenly failed her, every turn, every time she went for support, they kept gaslighting her, they kept dismissing her, and just sent her on her way. This is a woman who was silently suffering and just trying to survive this season. And as a result, like it affected her work,

it affected her relationships, it affected every aspect of her life. And when I took it, took over her care, you know, we had, I mean, over 90 days, it was like a massive turnaround and transformation. And I thought, you know, how many millions of women are suffering like this? I also thought, I'm like, is this coming for me? Is this going to happen to me when I get into very menopause? And I'll be honest with you, Perry Menopause blindsided me. It looked very similar

in the beginning to my mom's Perry Menopausal journey. But I just knew this was when I was 30 years old. I was like, I have got to be a part of the solution, not a part of the problem. And that is when I literally pivoted my practice into supporting women. I mostly had women in Perry Menopaus in Menopaus, but I was like, we, this has got to be a focal point. Because this is a biological initiation. Things are shifting profoundly in this transition and women are being ignored.

The reason why, you know, we, in a way we failed women is that we only consider those hormones reproductive hormones. We only thought of those hormones. Like, I, my physicals coming up in a month. And they're going to, they're going to ask about my mammogram. They're going to make

sure I had a pap smear. They're going to, you know, a colonoscopy is always on the list now too.

Now that I'm in my mid 40s. But when we think about preventative care for women, it is bikini medicine. Even today, it's, it's, it's ovaries, it's uterus, it's the cervix, it's the boobs, and, and done. You know, and we don't think about these hormones being whole body hormones that they're affecting every single system of the body. But most importantly, the silenced shifts. We're talking about bone loss, metabolic changes, body composition, the brain is shifting.

All of this is happening. Mental health concerns, cognitive issues. Like, and again, not every woman, it's, it's going to be very unique to every single woman. But this is, it's a reckony. It is a full body recalibration. And the fact that we are minimizing it, too, this is a reproductive transition. And oh, your periods are over. Is doing no one any favors. hormonally, because I know a lot of women still, even though it's more acceptable and understood.

Now, they still have a fear of testosterone. And nobody really talks about progesterone, like they should. And the balance of testosterone progesterone estrogen, which I'm sure we're going to get into thoroughly there. But then when you talked about bone loss and muscle loss, can be fatal. And people don't realize that. Like, they think that when, when you say something

like that, that your fear mongering, no, that can kill you. Well, and that is, I think that's the

other issue that I see playing out is there's a lot of narrative around this being a fear mongering conversation. Because I think, again, if all you ever thought, well, that menopause is natural and just grit through it, you know, push through it. Yeah. And it is just a loss of a period or hot flashes, night sweats, maybe some sleep issues, maybe some, you know, general urinary symptoms. And that's it. It's not doing us any favors when we know that women, you know,

in terms of quality of life, it's significantly more diminished than men in the second half

of our lives. And I mean, the stats are there. We know that more women than men are going to get Alzheimer's and dementia. We know more women than men are going to die of a mostly preventable heart attack. We know more women than men are going to have migraines and are going to have, you know, even osteopenia, they're going to fracture a bone. Like, these, these are real stats. And what I call kind of the, the window of opportunity, because it's a window of vulnerability,

is perimenopause. And even into early menopause, but I think it's not fear mungering that's just

letting women know, you know how you're not feeling good right now. Things are massively shifting. These are signals. The body is telling you, hey, I need a new level of support. And we have got to be mindful at looking at these silent shifts. No one feels blood pressure creep up. No one

feels fasting insulin, go into prediabetes. We don't feel these things. But ultimately, they are

Devastating down the road, especially in our 60s and beyond.

of so important. I have always been Mr. Plan ahead, because I coach steroid users and body

builders, and I've dealt with supplements, and I've always, always, always stressed doing blood work early. Yes. Do it often. Yes. And don't think because you're too young, that you don't need to check

certain things. You may not need to check it as often, but you should still in your early 30s,

in my view, start testing heart signs, cardiovascular signs. See if there's anything there, you know, that you were passed down. You never know. Yeah. I know I had a best friend 38 years old. Not in Perry, Metapazietch. I would call her in late reproductive. You know, so hormones are shifting, the other answer like, you know, I'm thinking about not doing this job anymore. And she's worn down to the mom of two. I could tell, you know, weight gain. And I made her run an advanced

cardiovascular panel. And sure enough, her lipoprotein little A was was extremely high. And right this is a genetic, you know. And so but she didn't know. And we're talking about we were catching this in her 30s. Yeah. Thankfully, and I wish we would have caught it even sooner because she was literally she was prediabetic. Her, she was a severe insulin resistance. I mean, every she had metabolic dysfunction. But more important that the thing that I was most worried about was that

lipoprotein little A. Yeah. And if we hadn't, I mean, luckily we're making all of these lifestyle modifications. We are on top of it now. But I think about all the years that we, you know, if we had known even sooner, how many interventions would have been a lot easier to implement? Anybody listening that LP little A is a genetic condition. You're not going to control it with diet. You're not going to control it with any of the other things. Stattens will increase your LP little A.

All of these things need to be known. And that is something that you can, you can spot it early.

Yeah. It'll take cardiac acute tests. You need to be checking APOB, LP little A particle

sizes, all of that. And that's one of the things that I would stress to people. You could find that in your 20s. Absolutely. I had a 330 LP little A and was able to get it down in the 90s. Yeah. She was a 220. Yeah. And that's extremely high. And that's a great way to get like

silent plaque build up that you never know is coming. I walked in and got a calcium score and was

blown away because I don't know how the hell it could have been so high. And there was the culprits. So it's good that you did that and found it early enough because if you don't, then one day you wake up and you have a 70% blockage and you wonder what the hell happened. Exactly. And even earlier than you think. Yeah. Yeah. Even earlier than you think. Let's go down the stages. Yeah. Let's go down the stage. Okay. So first, maybe let's give

some telltale signs. Sure. And I understand that there is no magic answer in one of the charts. Right. No, there is no magic. It doesn't announce itself one day. There is not lab like a passing insulin or an avovage or kind of let you know what's going on. It is a clinical diagnosis based on symptoms based on your age and and menstrual cycle changes. Is there anything that could put you into it early and or what is the average when it would start? That's a great question.

So the average, let's reverse engineer menopause really quickly. Yeah. I feel like everyone knows menopause. Right. That's a fine moment when you have it. And even that definition needs to be redefined. But the divine moment where you haven't had a period for 12 consecutive months. The average age is 51.6 for women here in mostly globally, but you're in the U.S., anywhere natural menopause can fall anywhere between 45 and 55 years old. And so if we reverse engineer that,

you know, and I have a lot of colleagues who go into menopause in their late 40s, not there, not the early 50s or mid 50s. And so if Perry menopause is the four to 10 plus your transition leading into menopause, then we're talking about as early as your mid eights for some women.

And the only way we really know on besides starting to pay attention to those that clinical

diagnosis of symptoms and the things that I mentioned is asking your mom. Now, unfortunately, a lot of moms didn't know when they were in Perry menopause. Some of them remember when they went into menopause, some of them don't. And many, I can't tell you how many times I've had a patient, tell me, my mom doesn't know because she had any strength to me in her 40s or in her 30s. And so just note that that would be one of the ways that you would know is ask your mom and that's kind

of a proxy of when you'll go into menopause and when you'll be in Perry menopause. So you asked what would potentially kind of bring you into a Perry menopause in menopause earlier to really big ones are going to be smoking and in alcohol, so excessive alcohol drinking or pretty consistent, alcohol drinking. We don't know if stress is a major player here, but when I think about, you know, kind of reproductive longevity and ovarian longevity, I think of mitochondrial, longevity,

ultimately there they go in hand in hand. You cannot 3D print human beings without mitochondria,

really important. And so excessive stress is a big one not having children could potentially put you in because again, if you, when you have a baby or when you're pregnant in postpartum, you don't have a cycle for quite some time. Depending on when you start your period, that could

Elongate you into menopause.

it makes sense of smoking and drinking. These are things that could set you back and have you

start Perry menopause and menopause earlier. Also, epigenetic driven stress and trauma. So we know

that, you know, women of Latin descent, African-American women, we do see them going into Perry menopause earlier and we do see them having more exacerbated symptoms even earlier and that they're in Perry menopause longer. Would you say that people that tend to go in there early have like higher levels of inflammation lower mitochondrial health? Yes. Things like that. Yeah. And so a lot of women again, we can we are quick even as patients as women to gaslight ourselves to second

guess or something because it's always at motherhood. Is it burnout? Is it stress? You know,

is this this can't be Perry menopause? Like what is this? Can I will tell you that as I am running labs, especially if I have a timeline of labs like you just alluded to, a starting as early as your early thirties or at least your myth is, I can tell when your highly sensitive CRP goes up, when your lipids begin to go up, when you're fasting insulin begins to go up. So I can identify Perry menopause sometimes just based on labs alone. Again, it's a composite of many things

that I'm looking at in alignment with symptoms. And so yeah, I will see that as you move into

Perry menopause hormones are beginning to erratically shift. And again, life is lightening,

right? Stress is still happening. You were you're carrying a lot that I will begin to see

labs move out of range. And I have diagnosed Perry menopause through labs, but not the labs that you

think of. Not I wasn't through hormone labs. It's looking at metabolic labs and inflammation labs. Okay. Is there any sort of diet that you could be doing for many years? Example like low fat or high carbohydrate or something that could trick throw you into it early or anything like that? We don't have any evidence on that for a moment. So I won't speak to that. What I will say is that we know that a majority of adults are already struggling with

insulin resistance and metabolic dysfunction before Perry menopause. You know, by a time a woman is 45 years old, she's more likely to be obese or overweight than men. We know that often we're about 90% of women by a time they're 45 years old are going to have one or more labs

metabolic labs out of range. And so, you know, a lot of women are coming in with polycystic

ovarian syndrome, which I feel is a metabolic driven, you know, infertility, potentially infertility

issue or reproductive issue. And so, if you've got these issues coming in, you know, again, a fasting insulin that's headed into pre-diabetes or your lipids are going out of range or you have liver enzymes that are out of range. Like all these types of things that are going on, I will see an exacerbation of symptoms of my patients in Perry menopause. So, yeah, if you're coming in metabolically, you know, busted, it was called it, you know, it's you're going to see

bigger body composition changes. Yeah. You're going to see more mood and brain changes. You're going to see more belly fat. And so, you're starting to see these exacerbation of the most common symptoms of Perry menopause mainly because we're coming into this season, already struggling with some issues. So, when you start to get into this Perry menopause state, what are some early, just tell-tale signs that could warn you like, okay, it's coming. Yeah, absolutely. So,

if we were looking at early Perry menopause and I would say on average from my patients, it's usually 41, 42, 43. And they come in and they're like, I don't really like myself anymore. I can't, I can't protect like this is something else at this point. And they may notice some cycle changes usually in the luteal cycle. So, after ovulation, we know that we need to ovulate in order to make progesterone. Progesterone is the progestation hormone. And in that cycle, if she

shows up to the party, or it's at least, you know, robust, we feel pretty good. You know, you know, maybe some PMS symptoms, you know, those last couple of days before your cycle, for your menstruation hits. But for the most part, we feel pretty good. It's when we're not ovulating, we're having those ant ovulatory cycles, or ovulation just isn't the way it used to be. If on his robust, it's not, again, with the mitochondria aren't doing in their due diligence,

they didn't show up to the party either. And so we'll notice maybe you feel great in the follicular phase, but the luteal phase is feeling even harder than it used to. So you'll notice more mood changes. You'll notice more PMS symptoms. But instead of two days, we're talking five, six days, more rage, more irritability, a more bloating and water retention and inflammation in that last week, or maybe even the whole luteal phase. So that's some of the symptoms that

we'll experience. Also, instead of 29 days of their cycle, or 28 days of 27, maybe now it's 25. Or it swings all the way to like 37. So we're starting to see some swings in the cycle. That's an indicator. But more so what I hear more than anything is that I, I don't feel like myself in relation to things feeling harder. Things that used to be effortless are now requiring more mental effort. Now, they don't have the same stress tolerance that they used to have.

Things are hitting them harder than they used to be.

going to say in a presentation, or, you know, they're not feeling as motivated or as confident. So it's almost it feels a bit like an identity crisis in a way that you're like, this is the

woman I've always been. These are the things that I'm fully capable of. But now I don't have the

thing bandwidth to do what I know I know how to do. And it's that grappling with yourself about why can't I do this anymore? Why is everything requiring so much more of me? This is usually what early perimenopause can feel like for women. So and some people don't understand that that mind-body connection. So if you get off really bad hormonally, you lose your sharpness. You start to get brainfall. You can't focus. You're probably way more irritable. And just sometimes I wonder

do women kind of go through this, they react to certain way and don't even realize you're doing it.

Absolutely. Yeah. Yeah. I mean, I think again, when you will lose that stress tolerance,

could not just estrogen testosterone and progesterone that are shifting, cortisol is often deregulating melatonin. It's beginning to decline as well along with progesterone. Again, because of that bidirectional relationship with insulin and estrogen, you know, our energy capacity, again, even on a physical level, is shifting as well. We're seeing our bodies change without permission. You know, the workout recovery is not the same.

You're like, I used to be the woman you could do this big workout and now I feel like I can't function for the rest of the day. So all of this is up for review. But it's a lot of that. I would say

the mental shift. I always call that neurochemical transition. That really can destabilize women

along with the physical changes that are happening as well. So those are often the early signs that I see that again, in the beginning, we can easily brush off as, well, I'm just not going to bed early enough. I'm not honoring my, you know, circadian rhythm. I'm not optimizing my sleep consistently. I just, I have too much work going on. It's really easy to ride those things off. And again, a lot of women that I meet patients, including myself, you know, I didn't come into parry menopause

with the cleanest bill of health. I have a, I have hygiene models, dietitis. And the, you know, I've had burnout before. I've had deregulation of my stress response system. And so initially, when I started going through parry menopause, I thought it was, it was the first thing I pointed to, I was like, oh, it must be my thyroid. But it must be, oh, it must be, it must be burnout. It must, you know, it's all these other things. And it's kind of like when you finally kind of cross those

off, because it can be a yes and you're like, okay, you know, semi-assign, making impossible for me to miss. And for me, it was the rage. And I knew it because I knew my mom's rage. I see, okay,

what about sleep cycles? Like circadian rhythm thrown off anything like that? Is that an issue?

Yeah. Oh, absolutely, 66% of women in parry menopause are in mid-life, even more, like from 40 to 60, are going to have sleepish. And that just exacerbates the problem even further,

because the sleep lack of sleep just makes everything worse. I always say sleep or make or break you.

Yeah. Oh, yeah. Actually, in this, in this student, you know, it's, we're talking about a second puberty, except that women are meant to, we're just supposed to smile through running households, taking care of kids, running careers, being leaders, you know, and just all the things. And it's this, it's this major upheaval. And so yeah, in your sleep goes, they're that motivation to get up at six o'clock in the morning to go work out in the gym. Like, that's gone. You know, it's not one thing

people always ask me what's going on with the belly fat and the body composition changes. And it's not just estrogen. Yeah. You know, you kind of repositioning fat or messing with insulin sensitivity,

it's the fact that your deregulated at night. And you can't get to bed. And that line down,

just wreck your sleep. You know, and you wake up, just feeling like hot garbage. You don't have, we have the capacity to do the non-negotiables to survive, to get your kids off to school, to do the work. But you don't have room for anything else. So a lot of the lifestyles begin to slip. You're noticing that you can't lift the way they use to in your 30s. You can't train the way that you use to in your 30s. And so you pivot. Maybe you're spending more time on the cardio machines now.

You know, maybe you're now, no, maybe you're doing a zoom but class or you're doing more Pilates, you know, and so you're actually losing more muscle in the process. So it's not one thing. I find that there's a lot of things that spiral out of control a bit. So what is, is the actual reason or cause of when you start to not have your cycle anymore? Why do these hormonal changes occur? What is it about the cycle itself stopping? It causes all of this to go

haywire. I love this question. It's eggs. Okay. How many eggs do you got? You know, it's eggs apply. And so we don't have an ability to keep these ovaries going. They have an expiration date. We're born with a, about a million eggs give or take. By the time we get to puberty, we're down to half a million to 300,000. And then we start cycling every single month,

Rhythmically.

years to really come online. Again, that, although, you know, your period's one day in time,

I think we really have to have extra grace for our girls who are navigating, you know, the

teenage years because their brain is massively remodeling. Everything is massively remodeling in puberty.

Finally, you know, by the time we're in our 20s, we're running, this is running pretty,

pretty hopefully in lockstep. And, you know, estrogen is showing up consistently throughout the entire cycle. Let's be honest, for gesturing is showing up in after ovulation is showing up in a alludial phase of cycle. Stasturing is in the first phase of the cycle and the follicular phase of the cycle. And the body, all of the receptor sites that are receiving these chemical messengers, they are expecting them rhythmically every single month. So we know when that extra dial

peaks going to happen on day 11, day 12, right? So many things are going to happen. One, ovulation is going to be initiated to begin with, right? And that moves, you know, our species forward, but we're suppressing like we have tumor suppressor genes that activate. We are optimizing brain capacity and function like there's so many things that are happening because these hormones

are doing their job every single month. But every month, we are priming eggs that one egg

is chosen. And we release it in hope that we are going to propagate the buspices of the human race. And we start moving through them. By the time we're about 35 years old, give or take, we have about 10,000 eggs left. The ovaries know it, the brain knows it. Although they pretend like they don't aren't communicating really well. And so we're talking in our mid to late 30s, if it isn't premenopause for many of us, we're in our late reproductive years. Right. And so

we will start to have an ovulatory cycle. So we will, as I mentioned, we will start to notice that progesterone is declining. And for in today's world, it seems to be happening sooner and sooner earlier and earlier. I'm due to stress. And in the toxic world that we live in, there's nothing about this modern-day world that lends to optimize hormones. Let's be honest. They're already fighting to keep rhythmically recycling every month. And yeah. Now we're running out of eggs. The

ovaries know it. And so then there becomes this miscommunication. It's like trying to play telephone with a five-year-old or four-year-old. You're just going to get a garbled message that HPO access, the hyposlimic pituitary ovarian access, that relationship begins to get a little wonky. Oh, by the time we're in our, let's say, early 40s, we're early premenopause for most of us was really showing up. Our even, we're down even more eggs. We're down to like maybe five to seven

thousand a-a-wow point. And so that's really what's come happening. And as a result, that miscommunication between the pituitary hormones, follicular stimulant hormone, food-nazine hormone, spotting the ovaries to keep moving eggs, you know, and the ovaries are like maybe maybe one month.

And then it pops to the next month. That's why we have more twins in our 40s and late 30s than any

other time. But then as a result, that miscommunication happens with estradiol and progesterone. Right. And then that becomes erratic. Initially, it's progesterone. It's erratic. It's declining erratically. But a bit more of a study declined than estrogen. Estrogen can be more, we can be more estrogenic in the beginning, some more estrogen dominant types symptoms. And but then ultimately, towards late premenopause, where we're skipping at least a period

every 60 days give or take, we now are in estrogen decline. And so that's where we really start to see what I call the eye of the storm. This is where the hot flashes in the night sweat and the vaginal dryness in the low libido with the depression, the anxiety. This is where we start to see the greatest amount of bone loss. This is where we start to see pretty big. We will see muscle loss. This is where we really begin to see the major changes,

because this is when estrogen is beginning to significantly decline. And by the time we're in menopause, we have less than 1,000 eggs give or take. And we're done at that point. We're not.

Yeah. Yeah. So there's more complexity here. So for men, there's always a test-osterone

estrogen balance. And when a man's estrogen gets too low, there's a lot of problems. And I've seen that time and time again, because just the concern is always for the elevated estrogen. So kind of comastia, holding water, high blood pressure, loss of libido. And then it it'll cause depression. But low estrogen has a lot of similar symptoms. And there's a balance issue there. So with women, it's like a trifecta, right? So testosterone, progesterone estrogen.

Can you explain the roles of each, especially progesterone? Because I think that's the one that

more people don't know enough about. But also the importance of testosterone levels for women as well, especially the ones that have this, and I get it that there's almost a stigma on, you know? We're trying to tackle that. Yeah. And I'm trying to help too, because I went through it on the man's side with the estrogen thing. And there's a greater understanding there are most bodybuilders and people that deal with it, but not mainstream people. And with women,

one of the things I see that bothers me that I wish I had a bigger voice in was explaining the role the importance, even though it's not a lot. It's still that little bit makes a big difference.

Yeah, let's talk about, I mean, absolutely.

think about, you know, women in men are very different. You guys are running on 24. Very simple,

very easy, you know? And we're running on this monthly cycle, you know, that a lot of things can throw that off as well. And so, you know, progesterone and estrogen. I mean, these are their initiators for one another. You know, in order for estrogen to really show up, we need progesterone on the back end. Right. And they are, they are really helping to support one another.

You know, when I think about progesterone, I mean, the number one job and this is kind of where we,

we kind of put progesterone in its little, like we kind of put in this little box. If that progesterone, as I mentioned earlier, is that progestation hormone. And so, this is the hormone that shows up. It's got receptor sites all over the body. For some reason, we think it's only on the uterus. And you know, it's the reason why progesterone is prescribed for women with uterus. But if you don't have a uterus, you don't need progesterone. And I'm like, what about the brain? You know,

immune system, and the gut microbiome, and the ligaments and tendons and muscle, and even metabolism, progesterone is involved. I don't know why to be think that it's just the uterus. It's mind blowing to me. So, but we do know that it's a major player in maintaining that pregnancy if we get pregnant. For every single month, the body is like, do we do we do we get pregnant? And if we don't, then everything begins to decline and we have menstruation. So, progesterone is that that beautiful

hormone that helps us to maintain pregnancy. But also, we know that it is, it's a neurotransmitter, known as our pregnant alone. I'm sure you guys have talked about this on the show. And it activates GABA receptors to help kind of calm the system. But it's doing even so much more. I mean, we know that it's helping with neurogenesis. We know that's helping to reduce inflammation of the brain. If anything, progesterone is helping to modulate inflammation across the entire body. And so,

those are the things I think about when I think about progesterone. But it helps for sleep,

helps for calming. And it's no wonder when we start to see it decline in the luteal phase in early perimenopause that women are experiencing a lot of these more neuro-neurological-based symptoms. So, it's going to be progesterone that's not showing up again the way that it used to. With estrogen, estrogen is throughout the entire cycle. But in the follicular phase, it's playing

the big role of basically prepping the uterus for implantation of that egg. But also initiating

ovulation. That's the really big role. But it's doing so much more than that. And estrogen is driving energy metabolism. Again, there's this direct relationship between mitochondrial capacity and energy and ovarian capacity and function. And so, estrogen is a very big part of that relationship. It is the CEO regulator of the brain. And not just in terms of energy metabolism, but helping to initiate and regulate neurotransmitters like dopamine and serotonin. It's helping to ensure that

we are brain is actually getting clear of inflammation. It's helping to manage insulin sensitivity in the brain. It is helping to keep, I mean, I think about collagen and our, you know, the health of our joints, the health of our muscle, and tissue. Everything you think about when it comes to a woman's body, estrogen is pretty much involved. All the way down to our gut microbiome. I know you've talked to Cynthia about this. Great, great, great length. You know, estrogen begins to decline.

We see diversity drop. That's the thing. And when we talk about dominant hormones for each sex that they need to understand how big of a vital role they play. And testosterone. Yes, and I want you to touch on that, please. Yes. And it's your build you up hormone. I mean, it is a confidence,

but a spaceship. You know, I always joke that everybody loves day 11, day 12 us. I even, even me,

I felt, you know, when I didn't understand what was going on with a cycle, I was like, why can't I feel like this day? This week, I can make a follicular phase all the time. You know, I would hit day 26, day 27. I would try to, you know, do a PR, you know, a personal, no, there was no, that was not happening. Now, it would be so angry. I'm like, why can't I push the way that I was pushing two weeks ago? So, and that's testosterone is showing up at the party right then as well.

And so, that's when you feel the most vibrant, the most confident, the most self assured you want to go out. You want to create more intimacy and connection. Like, this is where we feel the most alive. And that's because testosterone into the party as well. And when we start to lose testosterone,

you know, the only thing that we can even, well, we can't even off label prescribed to

testosterone to women, right? It's not FDA approved. And we think about it the only only way that we can even get approval for it is that, you know, it's a, it's a libido issue. It's not that, you know, we're not looking at confidence, we're not looking at motivation, we're not looking at drive, we're not looking at working out recovery. These are things that we are considering for testosterone therapy. But these are the things that make some of the biggest difference in women when they start

testosterone. Yeah. I mean, like, I've been doing this for two decades. I'm the biggest TRT advocate on the planet if you need it. And I have found over the years because I was like,

Really male dominant in my coaching for too long.

So many women. And they don't even know. No. Don't test it. And then if you bring it up to them,

it's like, oh, no, I don't want to do that. Well, we want to. We won't test it. You know, we, we, we were not really prescribing it. Women have to, I find so many people, some of the women. I know are fighting. Yeah. Try to get it. And the dosage is messy. They know some of the problem altogether lack of education and understanding on how to actually take care of the women because they haven't done it enough. Yeah. I know that there's a big fight. I mean, there's a big

push right now for the FDA. It's going to be a minute. But I think, you know, with the advocacy

that's happening right now for women to get testosterone therapy. I'm hoping within the next five years, we'll have a solution. I hope so. I just switch to Kaiser Drexel, which is the oral form of it. And so I'm hoping that that has the same. But, you know, because of Drexel's nice, because it doesn't crush your luteenizing hormone or your follicle stimulating hormone. It's not supposed to have the effects on estrogen. So it's really nice that yeah, as we

curious how that works. Yeah, but I mean, I have so many friends and colleagues and even patients in mind that are on testosterone therapy and feel amazing. It's like, like, this light comes on. But more so, again, not that estrogen can't do this as well, but with testosterone particularly, especially with high level women where they're so used to the confidence and the motivation.

Like, again, it's that identity shift. You're like, I was always motivated. I was always

ready to do the thing and all of a sudden, it's all flat. Yeah. And then you look at the levels and they're pretty much ground zero. Perry menopause. We've got this like 12 month buildup of not having a cycle. And so that's the Perry menopause phase in a year, right? No, 10. Oh, it's 10 years. 10 years. We're talking about a freaking career. I mean, who you are at the beginning of Perry and who you are at the end? Like, you're talking about a completely different

person. Okay. You got a decade in. We're talking about a decade. So yeah, like I said, those late reproductive years are usually late 30s, mid to late 30s, progesterone is already declining. You're trying to notice some symptoms. Like, again, maybe the your ability to push in the gym in the recovery isn't there. A little bit more irritability, a little bit more PMS symptoms.

And this is the time where we're often just saying, oh, no, it's this. It's this. Now, and then

41 42, it's full early Perry cycles are changing at this point. You are like, I don't recognize myself anymore. Something isn't right. And it's none of these other things. That is early Perry. Again, you're still cycling regularly. And if you, if you look at the CDC, they will say that

Perry menopause is technically late Perry menopause. Because the only way that we really

recognize Perry menopause until this last decade or so was that you were skipping periods more than 60 days. That's not until late. So there's this whole, you're, you're still cycling regularly. This is where women are told. It's not Perry menopause. You're too young. It's just data. Go relax. Eat less exercise more. And they're already doing all of that. You know, something isn't right or here's some, here's an antidepressant, maybe some birth control and like send you off on your

in your, in your, in your, in your life. That's early usually. And this is where we really miss the boat. Then there's, you know, there's a little middle. I'm in middle Perry. I'm kind of not an early anymore. I'm 46. I'm heading into late Perry. I'll probably be there by 47 48. Because I'm still not skipping periods. I'm still regular cycling. How we define late Perry menopause is your skipping periods more than two months. You are having, you know, often crime scene periods at this

point, too. Like one month, it's not there. The next month, you're bleeding through everything. And this is where the hot flashes the night sweats. And this can go on for three to four years. Now, this is where this is the more severe depression, anxiety. This is where we see higher rates of divorce. And this is where women really start to feel a seismic shift. So I was a real dick all the time. With that, I was told, you just don't understand. You just don't

get it. I said, I don't like that excuse. So I was a real jerk. This is, yeah, this is, this is the

really hard time. Again, you know, hopefully, and that's why I love these conversations. Because

what if we could have caught her at 42 43 when we just kept saying, oh, no, just keep pushing through. Like, what if we could have caught my mom of then? You know, I caught my, we got I caught my mom. When we all caught my mom, which was 48, crime scene periods, you know, how fashes night sweats, severe depression, anxiety, like, was like untethered. Did not who know who she was anymore. And didn't think she was going at that point for so many women. They don't, they're like,

it's everything that I implode. Like, am I going to get through this without losing my job or losing my marriage? For so many women, it can feel that intense. If we're talking another, you know, three years in that transition. And then you're in the perpetual waiting room where you maybe don't have a period for six months and then it comes back. And then maybe don't have a period for three months and then it comes back. It's like you're just kind of waiting for a metabolic pause. But at that

point, the, the, the, the, the, the, the, all of the hormones at this point are low for the most part. And you have testosterone can be relatively stable for some women, you know, 50% of women,

Give her take.

And I think a lot of women think, this is, this is the, where we've really miseducated as a lot of

women think that now that the hormones are stable or that they're gone at, you know, everything's going to level out. But because we've lost these hormones, you know, we are seeing it and exact, we see the bone loss, the muscle loss. We start to see the cardiovascular risk though. We start to see more brain inflammation. Again, it's the silent shifts due to the fact that we've lost these hormones or that they were erratically going away for years that puts us at greater risk for the silent

shifts, the big diseases. So yeah, no, maybe you're not as irritable as you used to be. Maybe the hot flashes of kind of dissipated, maybe some of the, your period is now gone. So you're not having the crime scene periods. But what about the bone loss? What about the limits that are now at a range? What about the climbing blood pressure? These are the things that I want women on on the radar.

What about the, you know, the potential sarcopenia that's starting to develop? This is why I think

we have to be having this conversation. And it's not fear mongering. It's just a deep understanding that there are major shifts that are happening during this transition that if we know and we take intervention in this time, we can future prove our health. But if we keep, you know, following the dialogue of, oh, this is only natural. This is what's meant to happen. Well, we're going to see a lot of the statistics that we see playing out right now today. Yeah. One of the things I talk about

especially lately is implementing creatine use, not just for the muscle, which that's the obvious, but then the right appear. And I think that a lot of people are now catching on to the creatine benefits for the mental side. But then a couple other things that I have been working on or talking about. One is higher protein intake to to build the muscle. And that's really for anybody anyway, but especially during this time period of importance. And then I think that other things that we

were kind of talking about, you got your mitochondrial decline. So I'm looking for ways to improve mitochondrial health. Any D levels are dropping. These are dropping naturally for men and women anyway. Yeah, that's happening. Yeah. And then it's accelerating. Absolutely. All of these things are naturally going to decline. So you've got to catch onto it early, be preventative, diet-wise. Are there better diet structures as you enter those stage, like higher protein,

higher fat lower carb, higher carb, like whatever or is it kind of variant among individuals. And then

what are the most important vitamins somebody needs to be making sure they may be beginning extra.

Is it vitamin D, vitamin K? Like what are essentials that we need to really wrap our head around? Like this is going to help. This is going to mitigate a lot of this shit that I'm going through. Absolutely. I love this question. Again, we talked about mitochondrial function. And I think everything cellular energy is the epicenter all of it. You want your brain to work. You want to be

old of pay attention and focus. You want to have capacity to pick up your grandkids. Like that's what

we're talking about here. And so I always think about what is a proxy for cellular energy. It's going to be blood sugar. So how do we make sure that we're balancing blood sugar? And a majority of us coming into this time in our lives. Blood sugar is probably not ideal or optimal. And many of us don't know. We don't know that it's variable is jumping all over the place. We don't know that our fasting blood glucose is maybe 95 milligrams per desolator,

which is just that things we know. So I would say, you know, I and I always want to keep it simple.

I want to keep it accessible. But we have to be thinking about balancing and optimizing blood sugar throughout the day from the beginning of the morning to the end of the day. So protein is always first. And especially in the morning. I want to make sure that you won protein so that you are not angry at 11 AM and making some decisions that maybe you're going to regret. That we yeah, we start with protein. But also we start with fiber. I want to make sure mitochondria

really thrive when your microbiome is thriving. So I don't want to forget about the fiber piece as well. And then some good healthy fats. And I think that can be depending on how you tolerate fats, look at your lipids, kind of pay attention to that. Some people do better with saturated fats. Some people do better with more plant-based fats. Like kind of figure out, look at your numbers. Yeah. This is where it can be more bio-individual. But protein forward. Again,

you have to gird of the ultra-process foods. Yeah. You have to get rid of the added sugar.

And it's so sneaky. I know. You know. So it's really paying attention to those things as well and being very honest with yourself about where is it in your creamer for your coffee. Are you having a little probiotic drink? And it's got a grams of sugar in that little. You think you're doing a good thing. But you're messing with your blood sugar. Read labels. Read labels and ingredients. Yeah. So those are the things that I

so I talk about this in the book. It's how you build metabolically healthy meals. Focusing on how do we build muscle? Oh, it's balancing blood sugar. How are we protecting our gut microbiome? And in how are we ensuring that you are that you feel energized? Yeah. That's going to be important. And in reducing inflammation. Those are going to be kind of

I always talk about just protein, healthy fats, and fiber.

rest. But even alcohol is up for review. Like you got to re-negotiate that relationship. Because that's going to be messing with you. Yeah. Also, I'm a big proponent of early time restricted eating. Okay. So meaning I've I look at blood sugar numbers all the time on continuous glucose. I would say CTMs all day. Yeah. I mean it's even for two weeks just to know. Yeah. Like how how you're living, how you're how you're operating, you know, is that

is it the meetings that are stretching out that are driving blood sugar? Is it the, you know, that little late night snack right before it? But is that messing with your fasting in the blood

sugar in the morning? I this kind of data so important. Even just two weeks to kind of take a look.

But in all the research, I've looked at all the data points. You know, we can keep it pretty nice in the morning and it starts to creep by the end of the day. Yeah. And so it makes a big

difference what time you we dinner. In I always say, you know, and I've looked at this on so many

patients over the years, you know, patients can have salmon, I'm talking salmon, salad, and, you know, maybe, you know, some roasted broccoli. Like they could have that dinner at six o'clock or five thirty. And blood sugar looks great. Yeah. How that same dinner at eight p.m. blood sugar is going to start to shift. And so the earlier we can eat and then kitchens closed like it is closed. It was closed when I was a kid. Like they were going back in the kitchen. And then you don't

need until the morning. And he started with a what I call kind of a metabolic boosting breakfast. I'm just having a good metabolic boosting morning routine that sets the tone for the rest of the day. If you start your day with a latte and a croissant, you're not getting off that blood sugar roller coaster. I don't care if you eat only salmon and broccoli for the rest of the day, you're not recovering from that blood sugar by literally not. That's going to be important. So

and if if indeed like you are so hungry after eight o'clock at night, that you don't know what to do and then it's going to be a very protein-focused little snack so that you're not stressing your system out. I don't want to stress out because you're so starving, you can't get to sleep.

So, you know, there's always little swaps and things that you can do. And so that is where I land

on basically on in terms of meals. And then for people listening when you got a plate, you can protein first, eat your fat second, eat your carbs last and that will help to blunt the glucose spike to if you eat an order. And always do not eat naked carbs. Yes, she's gone of the days if we could just eat grapes. You know by themselves, like if I my son, my five-year-old, he can do them. I got a pair of that with sub-baby bears. So

I've just been really mindful about how we're pairing it. And in fine ways, it's, you know, I eat about a tablespoon of seeds, either flax seeds or chia seeds every single day. Yeah. In the book, I'm so practical about how do we go from only five or 10 grams of fiber a day? How do we get to closer to 25, 30 grams? Okay, you know, how do you move up? Or how do you go

from only 65 grams of protein to let's get you to about 90 to 100 to maybe 110? Like I always

say, we're aiming for 100 grams, but I get, like we got to, we got to work our way up there. And so I have, all this whole book is all about practical ways to do that. I love that because sometimes the numbers can look crazy. Then if you see this is what I have to do to myself a lot is looking the mirror and and say stuff out loud, so I realize, okay, all right, okay. I love being my own

height man. You have to be your height man. Yeah, I have to. That's how you stay accountable too

as you look in the mirror and you can't, I mean, if you can sit and lie to yourself and I don't know, I can't. That's when I'm the most honest is when I look directly at myself and go, all right, dude, you know, and that's what I'm saying with a lot of these foods, especially when you look at numbers on protein, it can look daunting until you sit there and like for me, I go, okay, well, I just had 12 ounces of salmon, 78 grams of protein like that, right? And you can digest

that I know there's been this, I won't even get into it. But anyway, you can do it and you can try certain hacks throughout the day to do it properly, eating real food. I don't like to depend on protein powders or anything. They're there for a purpose. You need a little bit of extra sweet. But like you said, naked carbs, I love fruit, but I pair it with full fat yogurt when I eat it. It's always together and I, I'm in control and I like data. I think that what you said is

perfect, we need data. You can't just play guesswork the whole time. Well, especially in this season, we're talking about that midlife season of that pregnant apostle season, data is going to really help us. We can't change. We can't optimize where we're not measuring. If you don't know what your sleep is looking like, you don't know what your steps look like, you don't know what your stress is looking like. I love a woof, I mean, or even what your

blood sugar is looking like throughout the day, how are you going to make changes that's so easy to tell ourselves that we're, we're eating healthy. We're doing all these right things,

but yet we're not seeing the results. You want to see. And this is why it's, I think, it's so

imperative, particularly in this time of our lives, is that your body is going to change without permission. Yeah. And so in if you're not looking at that, you're not looking at your lab numbers, at least annually, if not maybe twice a year or quarterly, if you're not looking at real-time

Data every day, you just aren't going to be able to optimize.

particularly for women is that we have been told, women have been told to not trust themselves. Yeah. They're not, they're not trust their intuition to not trust what's going on with their bodies. So we don't listen to our bodies very well. And so sometimes data can really help validate

what we're experiencing. That's right. But you have to do your own data. Yeah. You have to do your

own data. You have to know your patterns. You have to know your energy patterns, your mood patterns, your sleep patterns. And I know again, just like the protein numbers, it can feel a little bit

daunting at first. But you start to look at your info. You start to track your data. And it's

a quick look. That's it. And then you just, you just keep going from there. And so I am a big proponent of tracking data. For me, it's accountability. You know, it's just like, okay, I'm on track. Okay. That's it. And some days are different than others. Right. Okay. We blitz through our times. So I want to talk about your book because I just looked up and I'm like, shit, and how you can get through half of what I want to talk about. So you've written several books

like we talked about what makes this one different or so special. Because I know this one is doing extremely well. Yes. Well, it makes it so special. I mean, it's deeply personal. Yeah. As I mentioned, I pray menopause blindsided me. I thought I knew after watching my mama in so many patients. I mean, this has been the group of women that I've been blessed to care for 17 years. And I will tell you, it's one thing to support women through a transition like this.

It's another thing to go through it. I'm like, whoa. Okay. So I just understanding through the research how important this biological inflection point is and knowing that there's so much that we can do to future proof our health, to be resilient, to feel resilient. And if women just had that information that they could begin to implement, it would change everything. It would change

the trajectory of the second half of their life. That is why this book is so important. If anything,

this book is more leaning towards longevity, but also helping women to know that they feel seen they feel heard in their journey. And so that's really what this book is bringing to the table. So part one is, am I in Perry Menopause? I'm going to help you dissect that really quickly.

Part two is, okay, these are all the symptoms. What does it mean for my future health outcomes?

How do I track this? How do I know what's going on with my body? How do I advocate and then the pillars from community, to mental health, to blood sugar balance, metabolic health emails, movement, building muscle, building resilience. That is all of what that the pillars are. And then it's a five week plan that puts it all together so that you don't have to second guess what you're doing. You can just implement. You're giving people hope here and understanding that

this doesn't have to be miserable and of the lifetime. No, I am. I am not settling up for survival through this period. I want to thrive. I do, and I have no desire to survive, Perry Menopause. So before we stop here, I want to talk a little bit about like when I brought up the creatine. Are there any other essentialists? No, no, no, no. It's okay. We end on to the diet, right? So we guess creatine is definitely one of them. Yeah, but what else would you say? Because, okay,

so when I brought up like you're a Lithanat, we're a Lithanat. Very important. And then, you know, I and a man and a man that the world under percent precursor vitamin D. Yeah. Usually at least 4,000

I use. I cannot I 90 a percent of women will have subpar vitamin D levels 3k to always. Yeah.

Yeah, always. Omega's big one. I love a good probiotic. I think it's important. I think our

gut microbiome can use all the help we can get. I'm a big fan of activated methylated B vitamins. Those women are deficient there. Some type of magnesium, whether it's 3 and 8, 3 and 8, malate glycinate. I'm a big glycinate girl that's for sleep. And we all need that little sleepy, sleepy mocktail before going to bed. I just take my supplements. And then I'm a big fan of antioxidant support and liver support. So a good turmeric, supplement, or curcumin,

polyphenols are going to be a big one. I know I'm forgetting, you know, my list of supplements. I try to keep a tight pack for the liver. And then so yeah, the milk this will are good liver supplement. That's kind of hitting all because you can just get a good liver support supplement. It's got a lot of the polyphenols and the milk this all in there. And other mitochondrial precursors you can, you know, some of the big precursors that I love. Again, you're a Lithin A does such a great

job of delivering what we need for mitochondria. I see those will be my big heavy hitters. And then I love HRT. I love hormone replacement therapy. Absolutely. If needed, that can be a life saver. I'm on it. Yeah, I'm on it for my brain loves it. Me too. I've been on it for, I don't know, 10 years now. So I get it. I totally do. So thank you so much for what you do for the help that you're providing for sacrifices that you've made to do what you do because I know it's not easy

having a kid and traveling all over and being everywhere and discussing everything, writing books and everything else. So we need more people like you and your work is greatly appreciated. And I know you're making a massive impact. And hopefully we've gotten you out and out of more people. Thank you so much for having me. Yes. Thank you for coming to see me. I appreciate it. So tell everybody where to get the book, where to find you and we'll put everything in the description.

Yes.

best of things and not the least of things. So go and get the book. And then you can find me on the

energized podcast as well. Awesome. We'll make sure to follow, check, check out her book,

please, and every other piece of content to chat online because it is phenomenal. I've seen plenty.

So, all right, everybody, that wraps up another one. Stay tuned for plenty more to come,

Dylan Jamelli and Dr. Mauritius Snyder. Sign it off.

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