Perimenopause, the transitional phase before menopause, is a natural and inevitable part of a woman's life. While it can bring about various challenges and changes, adopting a holistic approach to its management can make this transition smoother and more empowering. In this blog post, we will explore the significance of weight-bearing exercise, dietary protein, sleep, stress management, whole foods, and mindfulness as essential elements in managing perimenopause. 1.) Weight-Bearing Exercise Physical activity is a cornerstone of overall well-being, and it plays a crucial role in managing the symptoms of perimenopause. Weight-bearing exercises, such as walking, jogging, or strength training, have several benefits during this phase: a. Bone Health: As estrogen levels decline, women become more susceptible to bone loss. Weight-bearing exercises help maintain bone density and reduce the risk of osteoporosis. b. Weight Management: Perimenopause often brings about weight gain. Regular exercise can help control and even reduce weight by boosting metabolism and muscle mass. c. Mood Enhancement: Exercise triggers the release of endorphins, reducing mood swings, anxiety, and depression – common symptoms during perimenopause. 2.) Dietary Protein Dietary choices are another key aspect of perimenopause management. Protein intake is particularly important for various reasons: a. Hormone Regulation: A balanced intake of protein helps regulate hormones, including insulin and cortisol, which can affect mood and weight gain. Not eating enough protein can contribute to exacerbated symptoms of weight gain, sleep disturbance, moodiness, or fatigue. b. Muscle Preservation: Adequate protein intake supports muscle preservation, which is essential as muscle mass decreases with age. c. Satiety: Protein-rich foods keep you feeling full, reducing the likelihood of unhealthy snacking and overeating. 3.) Sleep Quality sleep is vital for overall health, especially during perimenopause when sleep disturbances are common. Here are some strategies for improving sleep: a. Consistent Sleep Schedule: Maintain a regular sleep schedule to regulate your body's internal clock. b. Create a Relaxing Bedtime Routine: Establish calming activities before bed, such as reading or deep breathing exercises, to reduce stress. c. Limit Stimulants: Avoid caffeine and electronic devices in the hours leading up to bedtime. 4.) Stress Management Chronic stress can exacerbate perimenopausal symptoms. Incorporate stress management techniques into your daily routine: a. Mindfulness Meditation: Mindfulness can reduce stress and enhance emotional well-being. Practice deep breathing and meditation. b. Dance: I'm a huge fan of dance party , mini at home dance party, dance party at the gym or with friends, dance signals to the body that you are safe and open to change and helps allow you to move through sticky emotions and experiences. c. Social Support: Lean on friends and family for emotional support and connection during this phase of life. 5.) Whole Foods Nutrition is an essential component of managing perimenopause. Emphasize whole foods in your diet: a. Fruits and Vegetables: These provide essential vitamins and minerals, as well as antioxidants that combat inflammation. The more colorful your meal the better! Avoid brown and white meals, the color in veggies and fruits indicates all the nutrients you need to feel vibrant! Check out Deanna Minich rainbow Diet. b. Whole Grains: Opt for whole grains like quinoa, oats brown rice, and Ezekiel bread combined with veggies/fiber to stabilize blood sugar levels and provide sustained energy. I know that I require extra carbs and whole grains for energy to dance and keep up with my kids. I recommend carbs prior to an activity but not necessarily before you go sit to work at a computer or watch TV. Make those carbs work! ;) c. Healthy Fats: Include sources of healthy fats, like avocados and nuts, which support brain health and hormone balance. All your hormones are made from cholesterol, avoiding fats can actually harm your hormonal pathways so make sure to include ample healthy fats with each meal. 6.) Mindfulness Lastly, practicing mindfulness can help you stay attuned to your body and emotions during perimenopause: a. Mindful Eating: Pay attention to your body's hunger cues and savor your meals to prevent overeating. As we age and if we are moving our body less and producing less hormones, the truth is that our metabolism slows down, so we really just dont need as many calories as we used to. Being mindful of how much you are eating on a daily basis and what you are eating doesn't have to be a chore but an act of self-care. b. Self-Compassion: Be kind to yourself during this transition and acknowledge that it's a normal phase of life. You are a woman experiencing and completely natural transition in your life. This doesn't have to be the worst chapter o your life, this could actually be the most important or best chapter of your life if you allow for it. I'm a huge fan of journaling "To: Love" a practice I learned from Elizabeth Gilbert on her substack. Letters to love is a daily practice where you write a letter to yourself from the voice of love, often we let the voice of judgment, irritated, or anxious be the dominant voice in our head, strengthening this inner kind voice was a life changing experience for myself and would love for you to learn more about it. Perimenopause is a natural stage in a woman's life that, when approached holistically, can be managed effectively. By incorporating weight-bearing exercise, dietary protein, sleep, stress management, whole foods, and mindfulness into your daily routine, you can navigate this phase with grace and empower yourself to embrace the changes it brings. Remember, every woman's experience is unique, so consult with a healthcare provider for personalized guidance and support during perimenopause.

What are the different types of HRT? There are many options for Hormone replacement therapy. Estrogen is one of the most prescribed hormones for managing menopausal symptoms. 1.) Oral Estrogen: Oral estradiol to manage menopausal symptoms, oral estrogen is associated with higher risks of adverse effects which is why Dr. Thorne prefers topical or transdermal delivery of estrogen. If you have low risk factors, then it is possible the pill would be beneficial for you. 2.) Oral estrogen/Progesterone (BIJUVA): This is bioidentical Estrogen and progesterone delivered in a pill form. Oral estrogens as discussed have higher risks of adverse reactions, but if you have low risk factors then you may be eligible. 3.) Transdermal Estradiol: an estradiol patch applied 1-2 times a week to lower abdomen, back, buttocks , transdermal carries the least amount of risk for adverse reactions. 4.) Oral progesterone: Oral Progesterone is required while on estrogen therapy because a.) Progesterone has been shown to protect uterus while on estrogen therapy. b.) Progesterone complements estrogen therapy and supports sleep and mood among other things. 5.) Vaginal or topical Estriol (E3 form of estrogen): can support vaginal dryness, vaginal integrity, and microbiome support. 6.) Topical Progesterone: although not FDA approved may be utilized to supplement additional progesterone in the body, however it has not been shown to protect the uterus in the same way oral progesterone has. 7.) Topical Testosterone: Testosterone has not been FDA approved for use in menopause. Testosterone is widely used for men later in life to improve muscle mass, libido and energy levels. Women make their testosterone from their ovaries and adrenal glands and levels decline in their 30's. Women may benefit from testosterone in perimenopause to treat energy, libido, and muscle mass. There are some risks associated wit testosterone therapy including clots and liver stress. So best to discus with doctor. 8.) Oral or topical DHEA: DHEA is made from the adrenal glands, and unlike the ovaries in menopause can still create estrogen, progesterone and testosterone. DHEA is kind of like cookie dough in that it has the propensity to make a lot o the necessary hormones in menopause. The issues is that DHEA levels decline with age and chronic stress. DHEA supplementation is not advised without testing first to determine safety and efficacy, since some women may have the genetics to make more toxic estrogens than others with th e"cookie dough." Menopausal women may need to take TWO different types of Estrogen: There are three types of estrogen found circulating in a woman's body. All three types behave differently, and are associated with different levels of risk. Estradiol (E2): Estradiol is the estrogen that is used for treating hot flashes, night sweats among other menopausal symptoms. This type of estrogen is typically administered as a patch or transdermal. (Other doctors may Rx oral versions.) Estriol (E3): Estriol is the estrogen that is used for vaginal dryness and vaginal microbiome and integrity. Estriol (E3) can be inserted vaginally or applied topically. Vaginally inserted estriol can reduce urinary incontinence by supporting structure or vagina, it can provide lubrication for vaginal dryness, and E3 has also been shown to improve vaginal microbiome and reduce infections. Estrone (E1): What is E1/Estrone and Why is it not prescribed? E1 is the most common type of naturally occurring estrogen in a menopausal woman whose ovaries are no longer producing hormones. E1 is derived from fat cells or adipose tissues and from the adrenal gland hormone DHEA. E1 has a higher propensity for contributing to cancers in large amounts so it’s important to monitor levels of E1 in the body with saliva testing and to not Rx any additional E1. Another reason now additional E1 is needed is that Estradiol (E2) can convert into E1 or E3 on its own. Oral estrogen vs Transdermal Estrogen in Menopause: Oral estrogen has a higher risk of causing clots and maybe some cancers than transdermal. Oral estrogens enter the digestive systems, pass through the liver and enter the blood stream. Transdermal or topical estrogens have shown to have lower risk stroke, thrombosis, clots, or cancer. Dr. Thorne prefers using transdermal hormones to mitigate any risk for herself and her patients. Here are some additional considerations: Estradiol pill: oral administration of hormones is common, however more associated with increased risks. If you have low risk factors, then it is possible the pill would be beneficial for you. Estradiol patch: estradiol is administered as a patch on the lower abdomen, buttocks, or belly Estrogen/Progesterone combo pill (BIJUVA) is a bioidentical progesterone and estrogen combined pill designed to treat hot flashes and menopausal symptoms. Resources: 1.) Bioidentical Progesterone safe in menopause, safer than “gestagens” (aka synthetic progesterone) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245250/ 2.) Oral vs Transdermal Estrogen safety: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147786/#:~:text=Transdermal%20HRT%20is%20differently%20metabolized,to%20premenopausal%20levels%20%5B10%5D.

There are many things to consider when determining your eligibility for HRT. Hormone Replacement Therapy can be beneficial and life changing for many women, however some women it may not be suitable. The research terrain for eligibility is rapidly changing! More research on women's health is emerging, and re-analyzed in the book "Estrogen Matters" that no longer aligns with the standard risk model. However, below is the more conservative list, but you may still be eligible even if you fall outside some of the below ranges. There are lifestyle changes and monitoring mechanisms to mitigate those risks, and that'w why working with a functional medicine doctor is optimal in a holistic approach to menopause and HRT. Below you will find 10 things to consider for eligibility of hormone therapy. Enjoy!

Holistic explanation and approach to Perimenopause. Perimenopasue symptoms, lab testing, and holistic treatments. Seattle, WA

Holistic Menopause and Perimenopause Check-list. Seattle, WA

For the vibrant women of Seattle, embracing life's changes often includes navigating the transformative journey of menopause. This natural phase in a woman's life can bring with it a spectrum of symptoms that impact physical and emotional well-being. While some women opt for Hormone Replacement Therapy (HRT), others seek holistic solutions to manage menopause symptoms, including weight gain. In this blog, we'll explore how Seattle women can empower themselves through holistic approaches to menopause, weight management, HRT, and symptom relief. Understanding Menopause and Its Impact Menopause typically occurs in women between their late 40s and early 50s. This significant life transition is characterized by the cessation of the menstrual cycle and a decline in hormone production, particularly estrogen and progesterone. These hormonal changes can lead to a variety of symptoms, including hot flashes, mood swings, insomnia, and weight gain. Hormone Replacement Therapy (HRT) in Seattle Hormone Replacement Therapy (HRT) is a conventional medical approach to manage menopausal symptoms. It involves replacing the hormones (usually estrogen and sometimes progesterone) that decrease during menopause. While HRT can be effective in alleviating many menopausal symptoms, it's not without potential risks, and it may not be suitable for all women. Consulting with a healthcare provider is crucial when considering HRT. Holistic Approaches for Seattle Women Seattle is known for its holistic and health-conscious culture, making it an ideal place for women to explore alternative approaches to menopause. Here are holistic strategies that can complement or even replace traditional HRT: Nutrition and Diet: Seattle's abundance of fresh, organic produce makes it easy for women to maintain a balanced diet rich in whole foods, fruits, vegetables, and lean proteins. Incorporating soy, flaxseeds, and foods high in calcium and vitamin D can be particularly helpful during menopause. Active Lifestyle: Seattle's natural beauty encourages an active lifestyle. Regular physical activity, such as hiking, biking, or even mindful walks in local parks, can help manage weight and improve overall well-being. Mindfulness Practices: Seattle women can embrace mindfulness practices like yoga, meditation, and tai chi to reduce stress, enhance mood, and find inner peace during the ups and downs of menopause. Natural Supplements: Herbal supplements like black cohosh, evening primrose oil, and red clover are popular among Seattle women seeking relief from menopausal symptoms. Always consult with a healthcare provider before adding supplements to your routine. Acupuncture: Seattle offers a thriving acupuncture community. Many women find this traditional Chinese medicine practice to be effective in reducing hot flashes, improving sleep, and restoring balance during menopause. Stress Management: Seattle's focus on well-being includes various stress-management resources, such as mindfulness workshops, therapy, and support groups. Reducing stress is essential for managing menopause symptoms. Managing Weight During Menopause in Seattle Seattle's love for outdoor activities and farm-to-table cuisine can make weight management during menopause a positive experience. Here are some tips for maintaining a healthy weight: Local, Fresh Foods: Embrace the bountiful local produce and seafood to create nutritious and delicious meals that support weight management. Community Fitness: Participate in group fitness classes, join hiking groups, or take up water sports like kayaking or paddleboarding to stay active while connecting with like-minded women. Farmers' Markets: Explore the numerous farmers' markets in Seattle to find fresh, organic, and locally sourced ingredients for your meals. Mindful Eating: Savor every bite and eat with intention. Seattle's focus on conscious living can extend to mindful eating practices. Seattle women approaching or experiencing menopause have a wealth of holistic resources at their disposal. While HRT is a viable option, embracing the city's health-conscious culture allows women to explore alternative approaches to managing menopause symptoms, maintaining a healthy weight, and finding balance during this transformative phase. Remember to consult with a healthcare provider to tailor a holistic approach that aligns with your individual needs and preferences. In Seattle, the journey through menopause can be an empowering and transformative experience.

Menopause is a natural phase in a woman's life that marks the end of her reproductive years. While it is a significant milestone, it often comes with a range of symptoms that can affect a woman's physical and emotional well-being. Many women turn to Hormone Replacement Therapy (HRT) for relief, but there are also holistic approaches to managing menopause that can be effective, especially when it comes to weight management and alleviating symptoms. Understanding Menopause Menopause typically occurs in a woman's late 40s or early 50s when her ovaries stop producing eggs, leading to a decrease in estrogen and progesterone levels. This hormonal shift triggers a wide range of symptoms, including hot flashes, mood swings, insomnia, and weight gain. The Role of Hormone Replacement Therapy (HRT) Hormone Replacement Therapy (HRT) is a medical treatment that involves replacing the hormones (estrogen, progesterone and sometime testosterone) that decline during menopause. HRT can be effective in reducing or even eliminating many menopausal symptoms. However, it's important to note that HRT is not without risks, and it's not suitable for everyone. It's crucial to discuss the pros and cons with your healthcare provider. Holistic Approaches to Menopause Many women seek alternative and holistic approaches to manage their menopausal symptoms and maintain their overall health. Here are some holistic strategies that can complement or even replace traditional HRT: Diet and Nutrition: Eating a balanced diet rich in whole foods, fruits, vegetables, and lean proteins can help regulate weight during menopause. Foods like soy, flaxseeds, and foods high in calcium and vitamin D can also be beneficial. Exercise: Regular physical activity can help manage weight and reduce the risk of bone loss and muscle atrophy associated with menopause. Aim for a combination of aerobic exercise, strength training, and flexibility exercises. Mind-Body Practices: Practices like yoga, tai chi, and meditation can help reduce stress and improve mood, which can be especially helpful during menopause when mood swings are common. Herbal Supplements: Some women find relief from menopausal symptoms with herbal supplements like black cohosh, evening primrose oil, and red clover. However, it's essential to consult with a healthcare provider before using herbal remedies. Acupuncture: Acupuncture is an ancient practice that involves inserting thin needles into specific points on the body. Some women report reduced hot flashes and improved sleep after acupuncture treatments. Stress Management: High stress levels can exacerbate menopausal symptoms. Engage in stress-reduction techniques such as deep breathing exercises, progressive muscle relaxation, or seeking the support of a therapist or counselor. Managing Weight During Menopause Weight gain is a common concern during menopause due to hormonal changes and a slowing metabolism. Here are some tips for managing weight holistically: Portion Control: Be mindful of portion sizes to prevent overeating. Eating slowly and savoring your meals can help you recognize when you're full. Stay Hydrated: Drinking enough water can help control hunger and prevent mindless snacking. Strength Training: Incorporate strength training exercises into your fitness routine to build muscle, which can boost your metabolism. Sleep: Prioritize quality sleep, as poor sleep patterns can lead to weight gain. Establish a regular sleep schedule and create a relaxing bedtime routine. Mindful Eating: Pay attention to what you eat, and how it makes you feel. Emotional eating can be a common response to menopausal stress. Menopause is a transformative phase in a woman's life, and there are various ways to navigate it holistically. While HRT is an option, it's essential to explore other approaches like diet, exercise, stress management, and alternative therapies to manage symptoms and maintain a healthy weight. Remember that every woman's experience with menopause is unique, so consult with your healthcare provider to determine the best approach for your individual needs and preferences.

#1: Adapt to your new bodies metabolism "The ones most adaptable to change will survive and thrive." In menopause your metabolism changes because your entire hormonal system changes. The hormones estrogen and progesterone aren't just involved with having a period and pregnancy, but also your immune system (whether you are allergic to foods or medications), they impact sleep and insomnia, energy levels and mood, and your metabolism. As estrogen and muscle mass decrease with age, this contributes to insulin resistance and abdominal weight gain. (See other blog for more details.) Adapting to your new body and metabolism means that what was working for you before (diet, lifestyle, stress, exercise) may not get you the same results in menopause. I encourage my patients to be open to a new way of eating, exercising, and managing stress, and prioritizing sleep. Menopause is a time to listen deeply to your body, to shed the past and embrace the new. Its also an opportunity to embrace a new way of living and experiencing your life! #2 Change the way you eat: What you ate before menopause may no longer work for you. Take-out food, refined sugars and carbohydrates get lodged much more easily in the fat tissue unfortunately. I like to prescribe my patienst a Libre glucose monitor in menopause so that they can see live time how they're body is responding to different foods. this can help customize their diet. There are 3 things to focus on with meals: 1.) Timing of meals: larger meals should be eaten earlier in the day when metabolism is strongest and smaller meals later in the day. Avoid eating meals close to bedtime. I even recommend early dinners between 5-6. 2.) Portion sizes: with a slower metabolism your portions dont need to be what they once were. You can still enjoy your favorite meals but to support healthy weight make sure your portion sizes fit your new bodies needs. 3.) Avoiding snacks between meals: snacking between meals and snacking after dinner before bed also contribute to weight gain and poor sleep. #3 Change the way you sleep- you eat more calories when sleep deprived! Sleep should really be #1 in all of this because poor sleep can contribute to a perceived 500-600 calorie deficit. Meaning that you want to eat those extra calories to make up for how exhausted your body feels. When we run on low sleep our impulse control is lower and our cravings are more focused on easy energy foods rather than complex healthier foods. You may be used to burning the candle at both ends with a career, kids, taking care of parents but in menopause everything changes and sleep becomes a major priority. Poor sleep also contributes to cortisol imbalance, cortisol by default signals the body to release glucose from the liver and to store more fat because it believes that there is danger with low sleep. If you are having trouble sleeping it could be due to low progesterone, so talk to you doctor about progesterone at bedtime. Circadian Rhythm sleep cycle: our bodies are aligned by our curcadian rhythms, the circadian rhythm determines cortisol, melatonins and hormone levels in the body, and whether we feel energized or sleep. The circadian rhythm is synced with the type of light and darkness we are exposed to. In menopause going to bed early (at least 80% of the time) is essential for healthy hormones and metabolism. Before 10pm, this is non-negotiable and doenst matter if you sleep in. We are light sensitive mammals and our hormones and bodies respond to the rising and setting sun and available light. #4 Change the way you move your body Building and maintaining muscle tone is a must for healthy metabolism in menopause. Muscles are the ticket for becoming more resilient to those "treats or carbs snacks" that you have on occasion. Muscles can soak up sugar without the assistance of insulin. When muscles are weak or reduced then those extra treats are often deposited in the mid-section. Your body will thank you for it because weight lifting and strength training reduces the risk for osteoporosis because exercise imporves bone remodeling, whereas being sedentary or not exercising contributes to bone atrophy/break down. So make weight lifting a part of your menopause journey, Get strong! #5 Changing from Stress Response to Stress Resilience Stress is just part of the human condition, meaning we all have stress during various parts of our lives. Our response to stress is largely a result of our upbringing in childhood to be honest. But with menopause comes the wisdom of experience. You've probably experienced a lot of stress and learned a lot about what matters and what ends up turning out ok. If you haven't then this is something to work on. Your adrenal glands make your stress hormones and in menopause they take over for making your sex hormones. DHEA accompanies cortisol in the body for managing stress, DHEA is the cookie dough that makes estrogen and progesterone iim menopause. So having healthy adrenals and healthy stress responses is essential in menopause. I recommend my patienst all get a 4-point salivary cortisol and DHEA test to assess where they are on the stress spectrum. Form managing stress I recommend letting go of people, situations, environments that are no longer serving you., I recommend working with a therapist on letting go of thoughts and core beliefs that have been haunting you for too long. Menopause is a time for rebuilding the new you, and this requires addressing that which is no longer working for you in your life. How do you want spend the next 50 years?

Weight gain can be seen commonly in peri-menopause and menopause. I hear from a lot of patients that, "what was once working for me no longer works for weight loss." This article intends to to discuss why weight gain happens in menopause and natural solutions to address it. Weigh gain in menopause happens as the estrogen levels become lower and less stable in the body. One of estrogens major responsibilities in the body is to deliver insulin to cells, improving improves "insulin sensitivity." Insulin sensitivity is important because it optimizes fuel ingestion and metabolism. Insulin sensitivity is linked with a healthy and strong metabolism. The opposite of insulin sensitive is "insulin resistant," which you may or may not already be familiar with. Low or no estrogen levels contribute to insulin resistance. Insulin resistance is when the cells are no longer responding the insulin, the insulin-glucose duo is delivered instead to peripheral fat cells in the belly. When insulin resistance occurs the blood sugar averages raise overall promoting more inflammation and more weight gain. As we age we tend to loose muscle mass, and fat typically increases. Losing muscle mass actually slows down your metabolism, because muscles are the bodies secret weapon for quickly metabolizing loose sugars from carbohydrates. When these loose sugars are no longer being metabolized by the muscles they are converted to fat. So maintain strength and muscle tone is extremely important in menopause. This is why if you continue to eat prior to menopause without increasing exercise you will likely gain weight.