Dhru Purohit Show - How Blood Sugar Control, Movement, Mindset, and Community Can Transform Your Experience Through Perimenopause with Dr. Mariza Snyder

Episode Date: October 15, 2025

This episode is brought to you by One Skin and Momentous. Perimenopause is something nearly every woman will experience, yet many don’t recognize what’s happening until symptoms begin to disrupt daily life. This week, I asked my sisters, Kaya and Harshal, to sit down with Dr. Mariza Snyder for an open and honest conversation about perimenopause. Together, they bring personal experience and curiosity to the discussion, unpacking what’s really happening in the body during this stage and how women can navigate it with more ease and support. Today on The Dhru Purohit Show, Kaya and Harshal sit down with Dr. Mariza Snyder to discuss the perimenopause stage of life. Dr. Mariza explains the first signs of perimenopause, which can vary widely and affect the entire body well beyond the breasts and ovaries. She breaks down what happens inside the body during this transition, how it can lead to surprising changes in daily life, and the key tests that can help women navigate this phase while protecting their brain and metabolic health. Dr. Mariza also shares why stress management, community, and movement are essential tools for empowering ourselves through this time. Dr. Mariza Snyder is a functional practitioner, women’s hormone expert, and the author of nine best-selling women’s health books. Her newest book, The Perimenopause Revolution, breaks down the real reasons women often feel “off” in their 30s, 40s, and 50s, such as stubborn weight gain, brain fog, low energy, anxiety, and poor sleep, and provides a clear, proven roadmap to help them feel like themselves again. For over 15 years, Dr. Mariza has spoken worldwide on hormone and metabolic health, nutrition, and detoxification. She also hosts the top-rated Energized Podcast,  empowering women to become the CEO of their health. In this episode, Kaya, Harshal, and Dr. Snyder dive into:  Spotting the first signs of perimenopause (1:58) Menopause as the “second puberty” (07:10) Take the Are You in Perimenopause? quiz (09:15) Why your brain changes during menopause (14:04) Tackling shifting cycles & estrogen dominance (21:17) Muscle, body composition & strength in midlife (30:56) What to do if your metabolic markers are high (33:04) Hormones, sleep & circadian rhythm reset (39:25) Alcohol’s hidden impact on women’s hormones (47:01) Stress, self-care & the power of gratitude (48:40) The overlooked benefits of NEAT (55:46) How to thrive through perimenopause (01:10:13) Inside The Perimenopause Revolution (01:13:30) Also mentioned in this episode: The Perimenopause Revolution: Reclaim Your Hormones, Metabolism & Energy For more on Dr. Snyder, follow her on Facebook, X/Twitter, Instagram, YouTube, Pinterest, Apple Podcasts, or visit her Website. This episode is brought to you by One Skin and Momentous. Right now, One Skin is offering my community 15% off; just go to oneskin.co and use the coupon code DHRU to save 15% and give your skin the scientifically proven, gentle care it deserves. Optimize your energy and mental clarity with the purest form of creatine, made by and used by the best, now available in convenient single-serve lemon flavor packets. Head to livemomentous.com and use code DHRU for 35% off your first subscription. Sign up for Dhru’s Try This Newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices

Hi everyone, Drew Prode here. Today we're doing something special for the podcast. I'm sharing a conversation between my two sisters who work with me on this podcast, my older sister Herschel and my younger sister Kea and Dr. Marisa Snyder, about something that impacts millions of women. It's called peri menopause. In fact, if you're between the ages of 35 to 50, or you know any woman in your life who you love in this age range,

listen up this podcast is absolutely for you. My sisters Kay and Herschel sat down with Dr. Maritza Snyder about what can be a wild and challenging time in many women's lives. There are so many symptoms associated with perimenopause and many women don't even know that they're going through this transition. They might just feel off or they might just start gaining weight, not sleeping, having brain fog, memory issues. Their periods become irregular. They start to develop high cortisol and metabolic syndrome. And many women during this period can feel what the heck. is going on and can anything be done about making this transition easier. So I ask my sisters,

Kea, who has a background in functional nutrition and Herschel, who shares her personal journey of perimenopause to have an honest conversation with Maritzha about this vulnerable time as a woman and how to navigate midlife with more ease using lifestyle, nutrition, movement, and other therapies that are available to them. In this episode, Dr. Maritsa shares signs that one is going through when they're experiencing this phase of life, perimenopause, and why metabolic syndrome is at the heart of so many challenges women face at this time. She also recommends test that you can talk to your doctor about and why stress management and community could be two of the most important tools to navigate this stage of life.

It's an honest conversation about navigating paramedopause with three incredible women, and I hope you enjoy it. Dr. Maritza, thank you so much for joining. us today. We are here to talk about perimenopause. And this is a stage of life where so many women say, I don't feel like myself, whether it be brain or weight related. There's so many different symptoms that we're going to talk about today. But what's interesting about this podcast is that my sister here, Herschel, and both of you are kind of in the throes of this stage. We are in it together. We sure are. So I want to talk about first maybe both of your personal experiences. We'll start maybe

Hirsch with you. Sure. What were some of the first indications that, okay, something's off here, something's going on with my body. It's not quite the same. So I think for me, it definitely started with sleep and just kind of feeling like here I am awake at 2 a.m. every single day for no reason at all, regardless of what I did the day before, or something related to, this is kind of random, but like itchy ears. So I kind of had like, you know, some itchiness. my ears. I'm like, what's going on with my ears? This is so weird. Do I have like, you know, an ear infection or something? And then, of course, you know, the weight gain that you're not, you know, used to and suddenly feel like, where did this come from? And you just feel like, okay,

something's definitely different now than it was before. Yeah. And what's interesting about the itchy ears, because we heard you complain about that is that you, nobody could tell you why you were having itchy ears. So there's a lot of very strange symptoms associated with pari. menopause that a lot of people wouldn't normally think of. But I would love to hear about your experience. What were some of the key indicators that your hormones were shifting? Yes, I was two years out from postpartum. I was still breastfeeding my son, and I had, I have Hajimoto's thyroiditis. And I had spent a year prior to getting pregnant to just get myself into remission. So that was always under the surface. And when I was pregnant and even postpartum, I watched my

antibodies climb. But I was breastfeeding my son, and I decided that. that I would much rather, I knew it was one and done. I knew that he was it. And so I wanted to give him everything I could. I mean, every ounce of everything that I could. And as I was breastfeeding him, it took me until he was almost two years old for my period to even come back online. So there was a part of me at 42 years old that thought, hmm, is it ever going to come back?

You know, because I just didn't know. I wasn't sure. I, you know, the probability of it coming back was pretty great. And my mom was cycling until she was in her late 40s. and often we can have the same patterns as our moms do as well. But still, I was observing as one does. Finally, I was finally two years postpartum. He was two years old, and I started feeling pretty darn good.

Like my brain was firing all cylinders. I had energy. I was working out more than one time a day. Like, I was taking full advantage of this new version of me. And this lasted, this runway lasted about five months. And then all of a sudden, my workout recovery started to tank. I noticed that my energy levels weren't the same. I was starting to burn out.

I was feeling more irritated. And initially, it didn't feel very cyclical. It kind of felt like it was a continuum. And so I did like most women will do. I start to think about what if I experienced in the past. What could this be? Is it my hajis that's flaring? Is it my stress response system that is overactivated?

Am I burning myself out at the workouts? I feel like we start to clamor for an answer. when it's like right in your face. It's pari metapause. Girl, you are 43 years old. How are you not putting the pieces together? It took me six months to finally connect the dots. And I ran labs more than two, I think three times,

trying to figure out what was going on because I had inflammation markers that were out of range. My antibodies were back. They were up and elevated. And so, you know, trying to figure out what this transition was like for me, it took me a minute to finally put the pieces together and to connect the dots that it was a yes and. Like I, yes, I was dealing with antibodies.

Yes, there was a bit of inflammation and my hormones were erratically shifting and declining. Wow. And you have a health background and it took you that much amount of time. I kind of think about roughly how many women right now maybe in the country are going through this because it's not just a year, right, that people, women are going through this. Oh, you turn 42. You hit perimenopause. No, this could be happening from 35 to 50.

essentially. 55. So this is a huge population that we're talking about. 25 million women are in perimenopause in the U.S. alone. And between perimenopause and menopause, because I feel like it's a bit of a continuum, right? You kind of just go into, you know, from perimenopause into menopause, but there's close to 80 million women in the U.S. alone that are going through perimenopause and menopause. So some of us, you know, are in the throes of those erratic changes and the other part of us, the 50,000 or 50 million are at the low hormone state, right? And so often, I think what I really want to highlight here is, you know,

how often women are being dismissed and they're not getting the gold standard of care that they deserve in the second half of their lives. Absolutely. Well, in your book, you talk about this stage as second puberty. I want to talk about this reframe. Why is it important? Why is it called second puberty? I think each and every one of us can remember puberty, right?

That it wasn't just the moment that our period started, but it was this continuum. What we know about our first puberty is that it's a profound neuroendocrine transition. It was very destabilizing, right? We felt anxiety. We maybe felt depression, mood swings. You know, a lot of our family members would have told us that we were unhinged at the time, right? That things were shifting significantly. And the distinction between our first puberty and our second puberty is that our first

puberty, we are coming online to our reproductive years. So our hormones are coming online. Whereas our second puberty, we are actually coming offline. our reproductive years into menopause. But both are equally as destabilizing because the brain is going through such a profound transition. Same goes for postpartum as well. And you think about, you know, all of us here are moms. We've all been through postpartum. And think about who you were on the front end of pregnancy and postpartum. Like you are a completely different person on the other side. And that is very much the case for puberty and perimenopause. It's such an interesting

joke. And Hirsch, I'd love for you to speak about this, that so many women are going through perimenopause while their kids are going through puberty. So it's like the first and second puberty are happening at the same time. Definitely a challenge because, you know, my daughter's probably in the early stages of that and you're kind of feeling like, okay, there's a whole lot of stuff going on, a whole lot of emotions. And then I too also have a whole lot of emotions going on, you know, in this phase of perimenopause. So definitely a challenge to kind of mix all that together. But you can kind of be empathetic to what they're going through, right? Absolutely. Absolutely. Absolutely. going through similar. Absolutely. And you can kind of understand. And I think it actually helps me

give myself a little bit more grace to say, okay, that was a challenging time. And I can be empathetic to what she's going through. And so therefore I can say, well, it's also challenging for me too. And it's okay to, you know, take it a little bit easier on myself and not expect, you know, perfection as I'm having changes as well. Yeah. So you have this amazing quiz in your book that I actually loved and I actually wish I had seen something like this when I first started my paramedipause phase because as I mentioned, I saw a lot of symptoms and I had no idea that this is actually what was going on. So it's called are you in perimenopause? So tell us a little bit about this quiz and some of the symptoms that maybe, you know, women don't even know about that are on this

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For a limited time, you can try OneSkin with 15% off using the code Drew, D-H-R-U at OneSkin. That's 15% off at OneSkin.Co with the code D-HRU. After you purchase, they'll ask you where you heard about them. Please support our show and tell them we sent you. Yes, this quiz is so important because this is the number one. question that my patients come to me for and the women in my community. They want to know, are my symptoms, is what I'm going through right now, is this perimenopause? And so often it is, right? Because the symptoms can vary. When we think about these hormones, we're not talking

about bikini medicine. We're not talking about hormones that are only affecting the breast and the ovaries and the uterus. These are whole body hormones, itchy ears, dry skin, hair that's falling out, mood changes, rage, sleep issues, low libido, uti, incontinence. loss of muscle and bone and insulin resistance and creeping blood pressure. I mean, goodness. That is a range of symptoms, right? And they can really be just destabilizing. When I think about the most common symptoms or the symptoms that really throw women off,

they're often the brain-related symptoms. And for me, those are the ones that really took me out. Those are the ones that where I was like, what is going on? I remember sitting in my kitchen on my second cappuccino, not remembering like the meeting that I had that was coming up or the things that were on my list. Like I just remember feeling this deep sense of dread that everything in my life was insurmountable. And I thought, is this my new normal? Is this what life is going to be like moving forward?

And I think that's what so many women can experience when, you know, we think about all of the high achieving women that we get to work with that are sharp and stable and emotionally regulated and they've got a good stress response system. And then all of a sudden, it's like the rug gets pulled under them. And they can't remember the words that they're supposed to use. I can't remember. I can't tell you how many times I've walked into the kitchen deliberately with intention. I get in the kitchen.

I have no idea why I'm there. And it is so frustrating to be like, but I was marching in here for a reason and have no idea. I cannot tell you how many others I've walked back out of the kitchen just to walk back in so that I would hopefully remember what it was. And I think that's what can be so, like, alarming for women. But they think, I can't tell you how many times I've had women tell me, is this dementia? Is this going to be my new normal? Is, am I crazy?

Am I ever going to get my brain back? And so 80% of women in perimenopause will experience brain-related symptoms, from sleep issues to hot flashes, to migraines, to mood swings, to bouts of rage in the middle of the day that they aren't expecting. and the most common symptom of perimenopause, which I think every partner can relate to is the irritability. It's irritability. That is like all of a sudden the chewing and the breathing and the doing anything is like,

get out of the house. Like if you could just step away for the next couple of hours or the next several days, except like to help take care of the kids at the time, that would be great. Yeah. Can you, is there an explanation for this? Why do so many brain-related changes happen? into the body at this stage? I love that question. The brain is reliant on our hormones. When I think about estrogen specifically, I think about it being the CEO of the brain, the master regulator of

the brain. We're talking about energy metabolism, neurogenesis. We're talking about reducing inflammation, helping to support neurotransmitters. I mean, everything that the brain really relies on in terms of functioning, estrogen is the driver of that. And I just imagine, you know, all of us are CEOs in our own right. Imagine the CEO of your business, who's been the CEO of your business for 30 plus years and has consistently rhythmically shown up from 9 a.m. to 6 p.m. every single day, seven days a week, right? And with estrogen, we're talking 24-7, not 6 to 9. And then all of a sudden one day, she doesn't show up until 2 o'clock in the afternoon, doesn't tell you, doesn't warn you, doesn't send you a text. This is a CEO who has always texted you, who has always let you know what time it is,

and all of a sudden just doesn't show up. Leaves work at 1 a.m. doesn't come back until 12 the next day. Leaves at 2 p.m. that day doesn't show up the next day. I mean, this erratic shift in a really critical hormone and a decline of that hormone, the brain is just trying to figure out what's going on and it is doing its best to remodel and reconstruct based on losing its most vital CEO. So fascinating. And Hirsch, I would love for you to speak to this if you want to. I think that so much of what Marisa is talking about you personally experienced and would call me and say, like, I just don't know why I feel like so annoyed or so irritable on certain things. And then we looked at your blood work, right? We looked over at a year period. Can you talk about what you saw? Yeah. So, I mean, I think even before the

blood work, it was, you know, you talked about some of the irritability. I consider myself a pretty, you know, just even healed person. Don't usually get too annoyed very quickly. And I found myself just, you know, in situations where I'm suddenly like so upset about something that it almost felt like I was outside of my body and I'm watching myself be upset about this in my mind. And I'm like, wait, why is this causing me so much like rage, you know? And it was something that was just so new to me. And I almost felt like, am I a completely different person? Like, how do I feel this? And then we did do some blood work because it was around that time and I'm calling, I'm calling Drew. I'm calling K and I'm like, I don't know why I feel this way about things, you know? And we saw that my estrogen had pretty

much like plummeted. And, you know, during that time period. Now, obviously, there's so many things that could have contributed to that and all kinds of stuff. But it was just like, it pretty much represented in my mind and kind of validated a lot of stuff that I was feeling, which was like, okay, this kind of explains like all the things that I've been feeling. And I'm not crazy. This is actually happening. So it was nice to kind of see that on the blood work. Like the proof. The proof of it. It was nice to see that because for a while there, I almost was like, I don't know who I am and why I feel this way. And I think so many women feel that way. 100%. So many women feel that way. And so often the labs will not indicate that.

You know, estrogen will be okay one day and not okay the neck. I mean, not not okay, but just it'll be normal range and then it'll plummet and it'll go up. And, you know, it's the erratic nature of these hormones declining that drive so many of the symptoms. I believe that if they would, if they would decline more of a, in a linear fashion, kind of in a slow retirement type of way, it wouldn't be so erratic. We know that these hormones are neuromodulators. They are, you know, metabolic modulators. And, you know, even they're driving, they're driving microbiome by diversity, right? So we know that it's all interconnected. These hormones are not operating in a silo. They're connecting with one another. And also, we're living in this modern.

day world where I always say that there's nothing about living in this modern day world that is conducive to optimized hormones. That's true. And then we go into perimenopause and it really feels like everything is up for review. So it's no wonder women feel like they are losing themselves. And I think in perimenopause, it's important for us to have that extra grace, but also be okay with mourning and kind of grieving who we were because this is a new level that we're stepping into. and it's we are shifting, we're changing. I will tell you that who we are at the beginning of pari menopause, we will be a different version of ourselves in menopause.

What's something that we can do to help women kind of reframe when they have these thoughts and, you know, all this is going on? How do we change like their sort of mindset on what they're feeling to kind of make them feel like, hey, you know, you're not crazy. This is actually something that's going on. Yes, the mindset is such a big part of this. I think the number one through line I want every woman who's listening to this to know is that they are not broken, that their body is going through a profound transition.

That's why I like to call it the second puberty, because that makes sense. They're like, okay, I remember first puberty. It was very destabilizing. This feels just like that. This feels very destabilizing. And just note that this transition offers a lot of opportunity for us to prioritize ourselves. Our brain, our body, they're calling for a new level of support, and they're calling in for us to prioritize us.

And I get that in the beginning. That can be so hard, especially when we are, we are the CEO of our households, our families, our careers, the obligations. Many of us are in this sandwich generation where we're not only taking care of our kids and our family, but we're also making sure that our parents are okay. My father-in-law just turned 80 today, literally. It's his birthday. And there's a lot of health challenges that they're undergoing right now that we're keeping a sharp eye on and we're very involved in. and it's very much what so many women are going through. And so my recommendation is one to know your normals.

Like know your sleep patterns, your mood patterns, your menstrual cycle patterns, your energy patterns, like understand what your normals are because we can work from there. And then next, I would say run the labs. That validation is so important, even if it's not estrogen that's shifting, maybe it's progesterone or it's testosterone, or maybe you notice that your inflammation markers are up, or your vitamin D levels are off, or potentially ferritin and iron, right? When women are going through, especially late perimenopause and they're struggling with really heavy periods and heavy bleeding, that can throw off our energy levels because it's making us a little bit more

anemic. So all this information about ourselves can really help support us in making daily lifestyle changes. I always feel like I am constantly looking at my whoop to see, I'm like, okay, what's the energy like? What was my sleep like? What's my heart rate variability to day. How much do I have in the tank to push? Or do I need to renegotiate what I was planning for the day so I have enough energy in the tank, enough mental stamina and resilience to get through my day and show up for the people that I want to show up for? I love that. So we talked about brain-related symptoms. We talked about irritability. Let's talk about some other things. You brought up cycles. Your cycle can shift pretty profoundly at this stage. And I have a lot of women who come to me and

say, I'm 42 years old, all of a sudden out of nowhere, I used to have a predictable cycle. Now I don't really know when it's coming. It comes early. It comes late. It's heavier. This feels very shocking to them. But this is pretty normal. This happens at this state.

Can you talk about that? Yes, absolutely. So we think about what this transition is all about. It's that the ovaries are deciding that they're winding down, right? We only have so many eggs after our mid to late 30s. And the ovaries know that. And so we're talking about reproductive longevity here. But as ovaries are winding down, that,

communication between the brain and the ovaries becomes, you know, garbled. It's like trying to play telephone with a bunch of four-year-olds and five-year-olds, right? By the time the message gives back to you, who knows what it was. And so that miscommunication between the brain and ovaries starts to drive the erratic behavior between estrogen and progesterone. Particularly, the hormone that we're going to start to decline first is going to be progesterone, because there's going to be cycles where we don't ovulate. And we know that ovulation is the main event. Without ovulation, we don't make progesterone on the other side. And as a result, we start to see changes in our cycle. Initially, it could just be, you're noticing that a 29-day cycle or a 28-day cycle is now

26 days or 25 days. But then you begin to notice that those lighter periods are becoming heavier or you're beginning to skip periods. And so that's why I say track your menstrual cycle every single month. It is your monthly report card. And a lot of symptoms in the beginning of perimenopause are cyclical. So you could be just fine in the follicular phase. I always joke that everybody loves day 12 us. Everybody. That's true. So true. True. Right? Right before ovulation? Like you have energy. You've got capacity. You feel... You want to hang out. Yes. You want to hang out. You feel sensual. Your libido's up. Right. It's feeling so good. And then we get into late ludial, right? Like day 22 to day 28,

give or take. And I think even we want to retire ourselves on those days. And so it's important that we look at the cyclical changes. because initially that can really validate what we're experiencing as well. And it can also allow us to advocate for ourselves during this time. I know the last three days of my cycle, I have a lot more alone time because I know that I'm going to deregulate. I know that my stress refund system. I find that my stress resilience just packs its bags and walks out the door on day 25. And it's like, I'll see you on day five.

And so I want to be prepared because I have a standard of how I want to show up as a partner and a mom. And so that means more breaks. That means more alone time. That means making sure I have all the pads and all the tampons and all the things. So I'm prepared for that season. And then, you know, a hope and a prayer that I get back to day five pretty quickly. So you said something pretty important. You said once ovulation kind of stops, progesterone goes out the door. When progesterone goes out the door, this kind of opens up the door for estrogen dominance. Is that the case in perimenopause? Do you see more cases of estrogen dominance? What can that look like for someone? Yes. So especially in early perimenopause, what I'll normally see is as progesterone is declining,

estrogen really isn't declining yet. It can be erratic, but not declining. And so I will see symptoms of unopposed estrogen, basically. And what can drive that as well is a liver that isn't metabolizing estrogen appropriately, and then the gut could also be causing some issues. So if a woman is chronically constipated or not going to the bathroom and having a bowel movement every single day, we know that she's recirculating that estrogen that can lead to more issues. So what are symptoms of estrogen dominance? One, fibrocystic, heavy breasts. My son, who kind of, you know, he kind of sees like, are your boobs hard? I'm just like, oh, yes. So notice more retention, water retention around the hips and butts and thighs. Also, migraines, headaches will

notice, and more severe PMS symptoms will definitely. And yeah, we could say, One, it's a low progesterone issue, but also it could be a metabolism issue. We're just not metabolizing estrogen properly or inconsistently. It's usually a combination of the both. And typically it happens in that late ludial phase. So we talked about the cycle. We talked about brain-related symptoms. What other systems in the body are affected by perimenopause?

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That's D-H-R-U at Live-L-I-V-E-M-E-M-O-MENTUS M-O-M-O-U-S dot com-com to save 35% off and start seeing the difference for your brain and body today. I think the big elephant in the room is though body composition changes. That is the thing that I had been hearing about for decades. I've been a clinician for almost 20 years, and that was the number one complaint of my patients

was the body composition changes that happened in midlife and also the low energy. The mood as well, but, you know, it's so funny how we can easily dismiss that is like, that's just how women are. Like, women, we're just crazy or like women just have mood swings. But the disruptive symptoms are always the sleep, the low energy, and the body composition changes. And this is the thing about hormones that are radically declining. We know that our insulin sensitivity is directly tied to how rhythmic these hormones are.

And as they decline, we become less sensitive. Also, we start to lose muscle and we start to see shifts in fat. So it goes from the butt and the hips and the thighs, which we classically think of estrogen, right when we're estrogenic, to that visceral belly fat. And that becomes pretty dangerous. Not only is it a spiral for more insulin resistance, but also in a lot of ways, it's very inflammatory and very dangerous for us. And so this is one of the biggest areas that I focus on for my women, because the more

metabolically impaired we become, the more dangerous it is for not only our cardiometabolic health but other chronic diseases down the road. And Hirsch, you've kind of talked about this. Yeah. Do you want to share about your experience? Yeah. I mean, I think, you know, I've always been pretty active throughout my life, but I will say that probably, you know, my early 40s, the workouts that I was doing were not leading to the

same results that I was used to. And it was pretty shocking. Initially, I was like, well, maybe I should just do this more. And as I'm starting to do more workouts, I was like, okay, it's still still not working. So something was obviously different. So definitely a shift in the way that my body was responding to workouts, both, you know, body composition wise as well as energy wise. And, you know, some of my tried and true methods to get back to maybe, let's say, you know, what I felt like was a good weight for me were definitely not working. So, you know, an overall shift.

And I feel like this is something I hear from a lot of my friends too, which is that, hey, we're still doing those workouts or trying. trying to do extra workouts and the way that our, you know, body is basically composed now is just completely different in seeing sort of that belly fat in there. Yeah. And I think that you and I have always felt that traditionally with our body composition, it was easy to lose weight. We, you know, that's kind of how we grew up as being like on the skinnier side. And then things really do start to shift and you see that.

But I also want to, I do want to give Herschel a shout out because all of the exercise that she's doing and we'll talk about why this is all important, especially as women get older, her dexas scan was like impeccable her bone density everything amazing she did what did you do calcium yeah i did a calcium uh like a clear i did a clearly yes a clearly scan and that was great too i mean i think i also had to have a shift into what sort of my goals were and i think you know when growing up sort of the workouts that i was sort of used to doing were for weight loss right and to stay to stay thin right like that's kind of what women did and that's kind of what women did and that's kind and what I grew up initially learning about.

And then I had to have a shift to be like, okay, that's not my goal anymore. You know, and I went into strength training and stuff like that. And so I was like thinking, okay, how do I keep myself strong and also resilient as I age, keeping my bones strong, avoiding like osteoporosis and all that kind of stuff. But it's definitely a mindset shift to go from understanding that like skinny was the goal to now strong as a goal because as part of that sort of string training, you know, know, there was some weight gain. Some of it is also just putting on like muscle, which I didn't, you know, traditionally have. And I've kind of learned to embrace that. But it's, it's not always easy

sort of seeing the gain in the muscle, but also sort of the weight gain that comes with perimenopause in general. I think it's sort of a mindset shift that, you know, women have to go through. Yeah. Yeah, but building muscle and being strong is going to be key at this stage. Can you talk about why that is. Yeah. I would say that muscle is our organ of longevity. It is the number one thing we want to bank on when it comes to having the freedom to travel, to hike a hill or a mountain, to get off the floor with our grandchildren to get in and out of a car. You, for example, my mom is going to be 65 in a couple of weeks. And she just ran, like literally on my birthday, she ran a 10K. And then was up with us. Well, she was at Disneyland with us. It was a Disney 10K.

so then she was running the next morning. And man, she has resilience. She can run and race with my son. I have a best friend whose mom is 63 years old. And our little boys, we play together a lot. My son is four and a half. Her son is three and a half. And her mom doesn't feel comfortable at 63 years old being with her grandson by herself

because she's afraid that she's going to have to get on the floor with him and she's not going to be able to get up. She's afraid something's going to happen and she's not going to have the energy or capacity to do what she needs to do for her grandson. And I think about the experiences of my mother and of my mom's mom and how very different they are as grandmothers for what they can do with their grandchildren, their grandboy, their babies. And I, you know, that's, I want, what my mom has. I want the strength and I want the resilience. And the number one thing that my mom did when she was in her 40s, when she was really going through perimenopause, is we got

clear that her building muscle, her maintaining her stamina and her metabolic resilience was the number one thing that she could do. And that is what we doubled down on. Because at the end of the day, our cellular energy is driving how we feel, how we think, what we do, and what we have capacity for. It is the number one area of focus, I think, for every single woman as they navigate this journey, is the quality of their metabolic health. Let's talk about that because it's a big part of your book is understanding your metabolic health. So at this stage, developing metabolic syndrome becomes a little bit more of a reality. How do people know their numbers? What are they looking out for? Talk about all of that. Yeah, I love this question because, again, we can,

most labs, most lab draws that you're going to do with your primary doctor are going to be looking at these numbers. There are a couple labs that I'm going to mention that I would love for you to request if you're not getting them from your doctor. So the big one numbers I want to look at is I want your fasting insulin. I want your fasting glucose, although your fasting insulin is going to be an indicator of early insulin resistance and potentially prediabetes well before your fasting glucose ever starts to show. Like, your body can try to maintain your fasting glucose even in a state of insulin resistance for up to a decade.

So important to have both of those numbers. I want a full lipid panel, so a cardiovascular panel includes triglycerides, HDL, obviously total cholesterol. and I want lipoprotein little A and APOB. So I want, again, these are big markers, particularly the lipoprotein little A and the APO B, for your cardiometabolic health. And then also, especially if you can't get a fasting insulin, I want to see that ratio between your triglycerides and your HDL. So you can just divide those two. I call them like the kind of the lazy person's insulin resistance score.

And ideally I want that ratio as close to one as possible. If it's creeping to two or above, we know that that is a major indicator for cardiovascular disease it's down the road. Other labs that I'm looking for to indicate metabolic health are going to be your highly sensitive CRP. Inflammation is a major player here when it comes to overall metabolic health, your vitamin D levels, an iron panel, and a thyroid panel, and a complete thyroid panel, not just a TSA and a free T4.

I want a free T3. I want antibodies. I want to look at the whole, making sure that we don't have some type of underlying thyroid issue that we're not aware of. Those are the basic labs that I'm looking for when I'm working with a patient. Obviously, there's a lot more labs that I would love, but this will give me a great sense of your cardiometabolic health. Now, when we think about metabolic health, you know, and women over the age of 45 are the most vulnerable because hormones are declining, and that puts us at greater risk. That's just a reality of navigating this profound transition. That's the

reason why we are safe and protected up until menopause, and then we become, as high of a risk for cardiometabolic disease, if not higher, once we hit menopause. So this is the window of opportunity right here, perimenopause, because it's the window of vulnerability. So what we see when we're looking at kind of the stats for metabolic dysfunction, we know that about only 7% of American adults are metabolically healthy. And we look at that through a lot of the markers that I just talked about, fasting glucose, fasting triglycerides, fasting HDL, so high-density lipoprotein cholesterol, but also, your blood pressure and your waist circumference. So if your waist circumference for women is over

35, 40 inches, we know that there's adiposity there, belly fat, that's leading to metabolic dysfunction. We also know that blood pressure of 130 over 85, that's hypertension, that's also lending towards metabolic dysfunction. And when three or more of those biomarkers are out of range, we know that that is what we call metabolic syndrome. And so, but we could just have maybe two of those markers out of range and still be metabolically compromised. So paying attention to these numbers at the start of perimenopause and throughout perimenopause into menopause every single year at least can really get us an indication of what is going on with our bodies on a cellular level.

So that's my recommendation is at least run the basic labs, at least know your metabolic markers because we can make changes from there. And so much of what you said, as you mentioned, you can get at your primary care. So it's, you know, totally free with insurance. And having all that information will give you a picture of where you are. If somebody's listening to this and they're saying, you know, my blood pressure is creeping up, my lipids are creeping up, I'm feeling like I have metabolic syndrome. What steps should they take?

The first step I would take is good to know your numbers, right? Because that gives us a lot of data and that gives us a lot of agency about what we can do. You know, I think a lot of why we are driving, we're seeing a lot of metabolic issues is going to be blood sugar deregulation, blood sugar variability. blood sugar variability. And that would be the first place I would start. Like the three biggest pillars is one, eating for your blood sugar. So eating for your blood sugar and eating to reduce inflammation.

Those would be the two things. And so my focus always is a lot of fiber in your diet, a lot of green, leafy vegetables, a lot of cruciferous veggies. I think right now we are in a big protein, like, kind of time. But I don't want you to discount fiber because you're trying to hit your protein goals. But protein is equally as important. So I always say protein, fiber, and healthy fats. Get rid of the added sugars, the liquid sugars, the refined grains, the ultra-process foods.

I think we can all agree no matter what camp you land on when it comes to nutrition, that reducing the fake foods is going to be so important. But also be considering getting rid of alcohol. Alcohol can also be a driver of inflammation, and it can also drive insulin resistance, particularly when we're drinking at night. So those are the things that I want women to be thinking about. Next, probably the biggest needle mover that we can make when it comes to getting our labs back into metabolic, like optimal metabolic range is going to be moving. Moving as much as possible throughout the day.

And so I know that gone to the days where we're training to be skinny, it's about training to be metabolically fit. And one of the best ways that we can do that is moving after meals. You know, I'm about to put a continuous go-coast monitor on. I debated putting it on before I got here today. and one of the things I'm looking at is not just my fasting glucose in the morning, but what is my glucose variability throughout the days, particularly after meals, two hours after meals? And ideally, I don't really want it to be above 110 milligrams per deciliter.

And what I have learned is that if I move meaningfully after meals, I will keep that blood glucose level under 105 milligrams per deciliter. That movement allows for our body, our muscles, to soak in all that glucose. without having to leverage insulin as that signal molecule, which is so mission critical when we are navigating this profound journey. The other big thing, and I know, you know, it's about consistency, but the other thing that will make or break so many women's metabolic health because they just don't have the energy to get through the day is going to be sleep. You know, and this is all tied together. You know, if you eat those late night snacks before bed or you drink that glass of wine before bed,

it's going to mess with your sleep, it's going to mess with your blood glucose levels. And as a result, you're going to wake up with the high night. higher fasting glucose in the morning and your sleep is just not going to be quality. And so it's going to be really important that, one, I always tell women, if you can, move dinner a little bit earlier. You know, I always say anything after 7 p.m. is late night snacking. Because you want that three hours between that meal and sleep for you to digest all that food.

And then be consistent with your bedtime routine and your bedtime and your wake time. So for me, even last night as I was prepping for this interview, lights were off at 10. lights are off with 10. I was up at 6.15 this morning. My sleep consistency, which I track on my loop, was 90, I think it was 90 percent because, again, my body's like, this is what we do. We go to bed at 10. We get up at 6. And the more consistent I am with that, the more quality sleep I get, and the more I wake up feeling like I can tackle the day. And my fasting glucose is often really, really good, usually 77 or 79 milligrams per decilator. Yeah, so you're talking about sleep. I actually, you know, why, what happens during this period in perimenopause that

it becomes so disruptive? What's actually going on with our body with, with those disruptions? Absolutely with the sleep disruptions. Yeah. So one of them is going to be the glucose deregulation. I think a lot when we're exhausted and we've hit a wall at the end of the day and we're in perimenopause and like we're just like, are the kids asleep? It's like our time. And so I think that's the time where we will drink wine to wind down, which is driving deregulation, right? It's driving, it's messing with our thermo regulation as well. Ask a woman in her 40s if she's having a hot flash or a night sweat in the middle of the night because she had a glass of wine earlier that evening.

Same thing with even just eating chocolate. You know, I was talking to my mom about 10 years ago, and this was her little routine. She was having chocolate before bed because, you know, she had a really hard day and she was still kind of at the very, very, very end of herring menopause into menopause. And she was waking up with these night sweats. And she's like, Marisa, what is going on? I'm like, what are you doing before bed?

Like break down the sleep routine. And she's like, well, I've been having this little huge chocolate. And I was like, that's blood sugar deregulating that's messing with your thermal regulation. You know, a lot of women will see hot flashes and night sweats at night because they had sugar before going to bed. But the other thing is that as hormones are declining, whether it's progesterone or it's estrogen. These are, again, in control of our sleep regulation cycles. This is messing with our circadian rhythm. It's messing with our calming, you know, calming hormones, our gabableness.

a neurotransmitters. And so when all these hormones are inconsistently binding to receptor sites in the brain, we get this crazy, like, mismash of waking up in the middle of the night, not being able to go to bed before going before, like, not being able to calm the brain before going to bed. It's really these hormones that are not binding to receptor sites the way that we are typically used to them binding. But also add in lifestyle strategies, you know, gone are the days. Well, we can just run into bed and go to sleep.

And I think, those are good times. And a lot of us are having children later, too, which means we are, you know, they're getting us up. They're waking us up. And so I think it's a multitude of things, but the biggest shift here is going to be the hormones. The hormones are messing with the regulatory systems that typically control our sleep patterns and that typically optimize our circadian rhythm.

If you look at, when you look at hormones on a graph, you'll see that progesterone is declining a little bit more linearly than estrogen. but also along with progesterone is melatonin. Melatonin is declining at the same rate as progesterone is, and no one ever talks about that. And if we don't have melatonin showing up the way that we need her to before going to bed, we're going to be waking up in the middle of the night multiple times. And then add on lifestyle where, let's say, you are chronically stressed heading into bed,

or you are eating late at night, or you had a really stressful day, or you were indoors at blue light all day long. Like melatonin never even rose to the occasion. And she's already declining. So you've got this twofold situation where lifestyle is impeding melatonin production, but also melatonin production is being impeded in general during perimenopause. So I would say that it's a multitude of things that are happening when it comes to sleep issues. And that's why 67% of women in perimenopause will struggle with sleep issues.

What do you recommend for our melatonin production if that's the case? The first thing I would say is to really optimize your search. circadian rhythm. And that starts in the morning. If there was one thing that you do, it's you consistently wake up at the same time every single morning. And then ideally, within an hour upon waking, and I did this this morning, I went outside. I had my bare feet on my grass. I was looking at all the beautiful flowers and all the beautiful, like just nature. And I was getting sunlight first thing out the gate. That's helping to reset our circadian rhythm. And then throughout the day, I do my best to get outside in nature as many times as possible. Because

As great as this light is to create a really beautiful podcast, it's messing with our circadian rhythm, right? It's messing with cortisol. It's messing with melatonin. So the more that we can be outside in nature as much as possible during the day, not only is it regulating our nervous system, it's balancing our blood sugar, but it's supporting our circadian rhythm. And then ideally, and again, I rarely pull this off, but if we can be outside when the sun is setting, even better still. And we really got my son excited about sunset so that we could all get to be outside. But someday he wants to build Legos, you know, and that's what we're doing instead of going outside to see the sunset.

So ideally, the sunsets, we dim all the lights in our house, we keep consistent routines. You know, all of us as moms, our children have sleep routines, right? I mean, from bath time until lights are off, we need to go back to that for ourselves. We need to have our consistent sleep routine that our brain and our body. body knows so well, and that by the time we are ready to turn the lights off, the brain is like, let's go, let's get to sleep, and then we get up at the same time the next day. And when we are consistent, even seven to ten days of that level of consistency, you will change the quality of your sleep and you will be waking up more well-rested.

That sunset tip also works for kids so well. My kids sleep so much better when they're outside at night. It makes a huge difference. Yeah, and I also love Epson Salt Baths for my son with a little bit. bit of lavender oil. I feel like I'm kind of like drugging him a little bit in his little lavender bath so that he's ready to go to bed at 8 o'clock. I love that. Let's go back to the alcohol because you noticed this big time. You kind of felt there was a shift where you were like, I don't even want to have one drink anymore because it's impacting my sleep. So I would say probably right around 40.

I was never really a big drinker, but I could have a margarita if I went out with some friends or somebody. And it was, you know, I didn't notice the impact on my sleep as much. I was. I was, you know, I didn't notice the impact on my sleep as much. Now looking back, I think that there was probably some signs that I'm now aware of, but probably around like 41, 42, I would have a drink and that was it. My whole night was disrupted, which of course then led to the next day being disrupted. I just feel miserable. It almost felt like I had had like five drinks, right? Even though I'd only had one that was probably even watered down with some ice. And then it got to the point where I was like, this is just not worth it anymore. It's not even fun.

because I feel miserable the next day, and it's just having such an impact on my body. And I think a lot of my friends kind of went through that same situation. So what happens in that time period where you can suddenly, you know, enjoy that one drink, and then it's just not worth it anymore to have any? Multiple things are happening. But the number one thing that's happening is that we're not metabolizing alcohol the way that we used to. Our liver just isn't doing the job that it used to do. Our hormones are changing, but also our sleep is just more erratic, right?

We don't have that protection. we have more inflammation in the brain due to declining hormones that's lending. That just is just adding fuel to the fire when we're drinking alcohol. And then also we should, you know, that skinny margarita, you know, probably with a skinny margarita, right? Even that is deregulating our blood sugar. And when we have estrogen declining and we are less insulin sensitive, we're more insulin resistant, that's causing more of that fogginess, that brain fog.

We have blood sugar issues throughout the night that's waking us up. And the data is clear. Like, you know, I've been able to work with Dr. Kristen Holmes, who's the, you know, kind of the scientific advisor for Woop. And they have so, they have millions and millions of data points, particularly of women in midlife. And across the board, sleep is massively disrupted. Your heart rate variability is disrupted.

Your resting heart rate is disrupted. Even though it may put you to sleep, the quality of your sleep is not the same by any means. So those are the major players that are happening when it comes to alcohol. and midlife. I also want to talk about stress because you mentioned that you are going to be wearing a continuous glucose monitor. When I had mine on, I didn't see a spike with anything as much as I did when I felt stressed out. It is a huge driver of increased blood sugar for so many people. I hear this over and over again. How do we combat stress at this stage? What are like real practical tips that people, because we talk about stress management. It's like, yeah, yeah, I know, I get it. But, you know,

what really works? I love this question because this is an area that I have been combating since I was in my 20s. Like I used to think that stress was my slight edge. That's how I leveraged it. And when you're in your 20s, you can actually do that for a time. You know, and then eventually it catches up to you. I would say that this is, if there was ever a transition that we were dealing with stress, it's going to be in perimenopause.

Because, again, our stress tolerance declines. It decreases. And we can feel that. We can feel that with how we're snapping at our family members, at our partners and the you know i don't know if you've noticed the extra sign that you're doing oh yes i literally talked about this yesterday this actually was brought up during a work call just yesterday for me where are you sighing so much is everything okay i know and i'm in peri menopause that's exactly my answer i said you know it's that's actually just one of the things i do now is i sigh

It's like a self-regulation calming, and I don't even notice that I'm doing it, but I, that was exactly my answer. I'm in paramedipause. That's what I do. The number one thing I would tell women is to carve out, gosh, 10 minutes for yourself and do something that regulates you, that brings you joy, whether that is, maybe it's breathwork, maybe it's reading a good book that you really love, maybe not personal development, maybe it's fiction.

Yes. The three of us can relate that. That's our stress management technique is reading romance or fantasy or. or whatever it is. It's my favorite thing to do. Yes. And then for me, the thing that has moved the needle for me in the most meaningful way is walking. There's something about walking that, I mean, the benefits are endless really,

but just moving kind of that bipedal movement just calms my nervous system and regulates me. Also, I'm not walking with my family. I'm not walking with my partner. I'm not, you know, no one's telling me all the things that they need from me or that need to be handled. It is my time. So I would say carving out alone time is really critical in this time. And getting clear on what brings you joy. I think in this transition, we are so bombarded with the obligations of what needs to get done

and all the things that we have signed ourselves up for, that we lose ourselves in the process. And we forget how to attune ourselves back to what feels good in our bodies. One of my favorite mantras that I say a lot is it feels good to feel good. And the other one I love to say too is nothing is wrong. I'm always trying to find something to solve, like a problem to solve. And I'm like, nothing is wrong. Like you're outside, you're listening to an amazing book. There's no problem to solve right now.

It is okay. It is all good. If you can, I would say also grounding in nature. If you're by the beach, get in the ocean. Like be in nature as much as possible. That's going to help you regulate. I know a lot of people will speak into meditation and breath work. And I know sometimes that just doesn't feel.

like it's moving the needle or that you don't have time. But you do have time for five minutes to just step outside. You do have time for five minutes to go and reset your system, to re-regulate. And you have time for a little dance party. Maybe it's a couple squats. I find that movement and anything that shifts your state can really help to regulate your nervous system. And so I think everyone's got to find the thing that works for them. For me, it's walking.

For me, it's walking solo. And also bookinging my day. So once my son is asleep, my partner, my husband knows not to bother me. That is my own time where I have my own sleep routine. I'm reading my book. I'm doing my thing. And also in the morning, I get up before everybody else so that I can just take care of me. And those bookends, those moments in my day that are just mine, it changes everything,

especially when I'm able to be intentional about my morning so that I set the tone for how the rest of my day is going to go. I love that you said that it doesn't have to look one particular way because I think that so often people think, oh, I have to be doing the yoga, the breathwork, which are all amazing things. And if you love them, like, please go for it. But it's mostly about finding what brings you joy and doing that thing because so many people, especially at the stage, if you're busy, you don't make time for the things that bring you joy. So even 10 minutes of that can make a huge difference. I also feel like it has to be something that really resonates with you. And I, you know,

I love the idea of breathwork and yoga, but that's just not who I am. And so for me to kind of get out of head and out of my own way, I have to like, for me, that's lifting heavy, right? Getting in the gym and just being in such a position where I sort of turn off my brain from all the, I have to do this next or I need to support this person or be there for this drop off or that drop off. It's like just something to completely get out of your head and self-care, right? Yes, absolutely. Lifting heavy is phenomenal, right? And you think about all, I'm a big fan of double dipping. I love to get multiple benefits from one thing. I also love to love. to do the things that are going to help me feel alive today and are setting me up to win 20, 30,

40 years down the road. And so I'm a big, I'm a big fan of being in the gym and lifting. My son isn't with me when I'm a lifting weight. And when you're focusing on a, you know, you're focusing on a big press or you're focusing on an RDL, like that's all you can focus on. Same thing with yoga, I will say. Like, I always say I love to hate yoga. I hate to love yoga. Yeah. It requires, you can't think about anything else when you're trying to maintain that pose. You have to be in the moment in the present. And the last thing I wanted to just mention in terms of a reframe and what we can do to support ourselves and regulate our nervous system is just to be in gratitude as much as possible.

Have a gratitude practice that is sustainable. And that could be three things that you're grateful for when you're in the shower or when you're brushing your teeth. For me, it's with my son every night when the lights are off and he's cuddled right at my shoulder. He's always sleeping right on my left shoulder. I just ask him, you know, what were the two things? that you loved most about your day, that you appreciate most about your day. And so we have this

little gratitude practice that we do together. For me, I always love to start my day with a number of things, whether it's the sunset or it's celebrations or it's a podcast or it's pure water, whatever it is. And then at night, I have a little rose quartz crystal that I hold. And I just kind of remind myself of all the things that went right for me that day. So I kind of book in my day with gratitude practice. And I do find that when we're in a state of gratitude more often, joy happens spontaneously more often as well. And I don't know about you, but like for me, I want as much joy, spontaneous joy as possible throughout my day. Like over the weekend, my son was sick. I was talking to you guys about that.

And it was my birthday weekend. We had to cancel all my plans. But I was like, okay, what can we do that would feel joyful? I got all the Halloween decorations out and all the fall decorations out. And we decorated the entire house. And I get that this is early September. But I was like, why not? Like, this is so fun.

And so it's just, how can we experience that as much as possible? Yes, absolutely. Life is always so serious. We don't need to add more seriousness to it. We need to add more joy to it. So I love those little tips. One thing I see you do often that I admire is this idea of meat. So non-exercise activity thermogenesis.

Is that right? Yes, that's correct. Can you talk about this? Why is it so important? And how do we incorporate it in our days? Yes, I would say this is where the juice is worth the squirrel. wees. I do believe that us being physically active is where it's at. When I look at the Blue Zone Research, they are not actually in the gym lifting heavy weights. They're not doing hit classes.

They're not doing power yoga classes at core power. They are just moving their body all the time throughout the day, whether it's going to the grocery store to get milk and eggs, or it is going to the post office and dropping off mail or taking a bike ride or fidgeting in the garden, you know, deweeting or whatever they're doing. Like, it's just about physical activity. And there's so many ways that we can build that in. Like if your family is not okay with taking a walk after dinner, you can sweep the kitchen, you can go up and down your stairs three or five times. You can do jump squats a couple of times while you're building Legos. I can't tell you how many times I'm in the middle of building a Lego set and then I knock out 10 squats. And then I get back to the

Legos and knock out another 10 squats. I mean, there's so many ways that we can punctuate our day with movement, especially at work or at home. And it's, and I always say track it. Like if you, if you're not measuring it, it's so hard to know if you are making progress moving forward. But over 60% of adults in America are sedentary, we are clocking less than 4,000 steps a day, which is crazy to me. And it's so easy to add another 500 or 1,000 by simply standing up and folding laundry or by, you know, sweeping the floor every night before bed. I mean, I don't know if I want to be doing that, but I'm just suggesting things or just taking

a quick little walk around the block. For example, I was just sharing this with Dr. Isabella once today. you know, I have my favorite coffee shop, very similar to parakeet, it's lofty coffee, and we get together at Blue Bottle a lot. And I will order my coffee, and so often, what do people do after they order coffee? They get on their phones, right? They get on TikTok, they get on Insta, they check their email, they get into the to-dos of everyday life. And I do not.

I go and I walk around the block. And if my coffee isn't ready, I will walk another round around the block. And I will clock somewhere between a thousand to 1,500 steps in the 5 to 6. 10 minutes it took for me to get my coffee. And so it's just these little micro shifts that we can make. Instead of looking at our phone, take a quick walk. Or instead of looking at our phone, do some drum squats. Like, that's as easy as it can be.

And if we punctuate our day throughout the day with these little micro movements, these little neat movements or exercise snacks, man, it will make a huge difference in our blood glucose variability, in our energy levels, even in the quality of our sleep. Like, watch your sleep become more quality because you are moving your body throughout the day. It's so interesting. I was just reading, it was a research or a tweet or something where essentially the researcher was saying, instead of trying to do 10,000 steps where you go on like a long five mile walk or something in the middle of the day, go on an hour walk, try to break it up because I think so often people think, oh, I have to get 10,000 steps. I'm only at like 4,000.

What do I do? And it's like instead think about it this way. How about every hour you get up and you do five minutes of something? And I thought that's such a, that's basically me, right? is that kind of... Or exercise snacks. And it doesn't even have to be five minutes. It can be two minutes. It can be one minute. Like you could just do 10 pushups very quickly or you could do 15 squats really quickly or go up and down your stairs a couple of times and then get back. There's these moments where we can build in micro movement that, yeah, I mean, one, it can feel so arduous to say, oh my gosh, I have to go walk for 45 minutes or I have to go walk for 60 minutes. And how easy is it for us to just not do it? Because we didn't have time. Like some other obligation came up. We had to pick up.

up a kid early from school or whatever came up, right? Something always comes up. And so if we just embed our life with these micro movements, I like to call them exercise snacks, mainly because you're just snacking on movement. But the power of an exercise snack is that it is a short burst of movement that actually revs your heart rate. It revs your metabolism. And it helps you to burn calories. And so instead of it just being a walk, like do, can you do 20 jump squats? Can you do 30 mountain climbers. Can you do 10 pushups or can you do jumping jacks or jack squats? I'll tell you what, the juice is worth the squeeze. Like you will burn calories, you will lose weight, you will have more mental clarity and energy, and you will sleep better throughout the night. Like the benefits are

endless and we're talking about two to three minutes max. Yeah. And that's just so much more attainable, especially for people who are busy or if you're older or if you're not used to going to the gym. I think so often people think that movement needs to look a particular way. I have to go to the gym for one hour and it has to be full out. Otherwise, I'm just not going to do anything. And these exercise snacks are really nice. Essentially, everybody can do them. Everyone can do them. Yeah. And I mean, I used to believe that myth. I used to believe that if I didn't do the big 50-minute workout, what was I doing? Like, I wasn't, it wasn't, it didn't count. And I remember thinking, I remember seeing people walking, just walking around the lake. I used to live by this big lake.

And I would think, well, there's no, like, there's no benefit as much as there would be running. I need to run the lake. I need to sprint the lake. And now that I'm older, gosh, the benefits of just walking or movement, any kind of movement, even for five minutes, it adds up over time, but particularly around balancing blood sugar and overall metabolic health, that's where we move the needle. You know, if you just do that one 50-minute workout and then you sit all day for five to six hours, you're basically negating that workout. It's better off that you just do two-minute breaks in between those meetings throughout the day

than even getting that workout in. Now, if you love a 45-minute walk, get it. If you love that heavy-lift workout at the gym, get it. I just want you to work and move your body consistently throughout the day. It's a yes-hand. I want you to do the workout, and I also want you to move your body throughout the day. Like, you're not done once you leave the gym. You need to keep moving your body.

Let's talk about community and connection, because you are just so good at this. I've learned so much from you on this topic. Why is community medicine? You know, I was thinking about you, Kay. how I was courting you for about a year. You're so sweet, and you've become such a good friend. And I'm so grateful. I have no idea how grateful I am.

To one, just to be having this conversation with both of you and to get to be in community. You know, when we're going through this transition, and we've got the obligations of all the things that I've talked about today, family and work and just the myriad of to do lists. And the symptoms begin to pop up, right? The rage starts to happen, the irritability, the early signs, what feels like dementia. You're like, is this, is this dementia? And then you call your girlfriend who had her own perimenopausal moment.

I always call it pari menopause in the wild. Or like, I'll be with a friend who's like, you know, that thing, that thing. I'm like, you're water bottle? You know, like. And there. You know, it's, and it's just to have someone who is safe or a group of amazing women that feel safe, that understand what you're going through, that you can confide in, that you can be in the fire. together, there is nothing more healing than that. And so I would say that if there was one thing that I

recommend in terms of medicine, it is to walk with your friends as much as possible. I always say that is like the underrated longevity hack of the century is to grab a matcha or a coffee and to go on a really incredible walk in nature with your bestie. You and your best friend are going through this together and you guys are on the phone. You want to talk about this? Yeah. So I have a best friend. and she actually lives on the East Coast and she's, you know, same age, we're sort of going through all this together. And we, it's exactly what you said, which is that if we did not have our calls as we're walking around talking about our Perry Minimau's moment of the day, we would think that we're going crazy because there have been times, I mean, most recently someone, you know, I'm an,

I'm an avid reader and someone asked me, you know, what was my favorite book from last year? I couldn't think of the name of a single book that I have read in the last year, not one. And I, I read multiple books a month. And I was like, oh, wait, what, what? How do I not remember a single book? And I called her and I told her and she said, yeah, remember we read that one book together. We couldn't think of the name. We couldn't even think of how it ended. And, you know, for a while there, if you don't have someone to share that experience with, it can very much feel like, oh my God, something is actually wrong with me. And we've had that question several times. Like, is it dementia? She's even said, you know, are we in early Alzheimer's? Like, what's happening to us? But it's just nice to kind of

talk out those symptoms with someone in your community and have them feel like, you know, me too, me too, I'm going through those things too. We're not crazy. Or if we are, we're crazy together, you know, at least. Even better still. Yes. Even better still. It can be so lonely and so isolating when we're experiencing symptoms, you know,

when we live in a society that not only blames us for what we're going through, but also makes us feel ashamed of what we're going through. And so it's no surprise that women feel like they go inward. Like we feel inward. We feel like we need to step back from being in the limelight or being out and about and showing up. And, you know, it's unfortunately not doing us any favors because when we're in that isolation and we're feeling alone, we know that that lends to premature aging. We know that that lends to more mental health issues and even cardiometabolic issues as well. And so it doesn't put us in a good state. And if anything, it can drive symptoms to be even worse. And so I always tell women, that this is the time to not go inward. I mean, if you have those days where you need a little moment to yourself, that alone time, please have your alone time moment, but also have your girls on speed dial, even if it's just sending a voice memo, but also schedule dates together in real time, in real life, where you can connect and you can have a moment. I know that you're

in it right now. I have a best friend of mine who just had a miscarriage a couple days ago, and she's 40 years old. And, you know, that process is long and inconsumely. And I, you know, every day I've been checking in just to see how she's doing. What's going on with her? How's it going? And just I know that even though I haven't heard from her every day, that I know that my just leaving that little message is just anchoring her in the knowing that someone is thinking about her every single day.

So even if you don't hear from a bestie or you don't hear from a friend, just know, I just want you to know that that message that you sent, it is doing something in such a beautiful and a positive way that you may not even know. And I'd love for you to give tips to anybody who's out there. One really amazing tip that I heard about community is go where people grow. So go where people are learning more. They want to better themselves. Like that's going to be where you might find people who are more like-minded.

What are some of the things that have worked for you? If anyone's listening, they want to grow their community. They're feeling isolated. What would you recommend? I would say number one. I think this is a big mindset shift is decide. Decide that friendships are worthwhile. decide that they're worth cultivating.

Because you and I all know, gone of the days, we're in college and in, you know, even in, you know, in high school where friends were just there. You know, you just made friends. Like, we have to go and actually physically cultivate them. And I love that. Like, go where people are growing, right? Where people are learning and especially things that you love. But decide that friendship is worth it and see who you can level up into friendship mode. Maybe it's kids, moms from school, or maybe it is, you know, for me, for me, for me,

me again, I got drop-off moms that I'm connecting with. Or maybe it's a co-worker that you've been co-worker friends for a while and it's time to elevate them up. Maybe it's a friend that you haven't talked to in a while. I know that the pandemic for so many of us, we lost contact with some of our people that I bet if we were to reach out and say, hey, you know, you've been on my heart. I've been thinking about you. I'd love to just get an update on what's going on and see if that opens the door to reigniting that friendship. I have a feeling that it will. Another thing that I recommend as well, is, you know, if you love reading or you love yoga or you love hiking, like find groups that are doing that and connecting there. So just, and being open to initiate, keep reaching out,

keep following up. Like the fortune is in the follow up. That person may be going through a lot right now where their lives are really full. And you just continuing to be like, hey, you want to grab coffee. Hey, you want to get together. And then also, I also love little gifts. Like make them feel like warm and invited and make them feel like you really cherish their time, your time together with them. Like, like, again, like you would court somebody, court your friends, especially in midlife. If it's someone that you feel is quality and worthwhile, put in that extra effort. I promise you it's going to pay off. Oh my gosh, that's so true. There are actually two apps that are really amazing. There's peanut, which if you're a new mom, you can find other new moms in your local area and

make friends that way. And I've done that. It's been amazing. And then there's also Bumble BFF. So Bumble, which is like a dating app, they have Bumble BFF where you can go and find just other women that you want to be friends with and like-minded people. So I love both of those things. And like you said, you can be the one to initiate. So often people don't do that. But then you will find probably the other person is really surprised and delighted to get that message and that could cultivate something really beautiful. The worst case that happens is you don't hear back from them or they're too busy or whatever. I mean, that is the worst case.

but at least you tried. And I will tell you that I have pursued so many friends and I've been so grateful that I did it because it turned into these beautiful, rich, meaningful connections that I'm just so grateful for. So it's always worthwhile to pursue. I absolutely agree. I mean, I think part of that is also

you're going to be able to create the community that you want and you have the powers when you do something like that to build something that you're looking forward to as well. You talked about courtship and that's kind of, it brought up an interesting point for me, which is like around this time of perimenopause, a lot of people think of it as sort of like a decline, you know, and society kind of is like there's a decline and you're aging and all that kind of stuff. And it's almost like the value of women gets put into question and stuff like that.

And I kind of wanted to hear your thoughts. Like, you know, this is something I think that many of my friends even feel, which is that, you know, they're sort of out of maybe one stage and it's sort of heading to decline. How do we change like society's mindset or like the, the cultural, like, perception around, you know, perimenopause where it's not a decline and it's, you know, something more positive. How do we empower women through this stage? I think it's important. Knowledge is power, right? It's these conversations that we're having today that really shift the way that we think about it. As I mentioned before, your body is shifting. And that is okay. We get to step and we get to rewrite what midlife gets to look like for us.

I think about all of the hard one lessons that we have learned over the years as mothers, as career women as CEOs, as women that have taken on a lot and have navigated it all. And that now we get to stand on those hard won lessons and those successes and those moments in time where we have stepped into our power. And so that's what I say. Like this is a defining moment where you get to set up your boundaries. You get to set up your priorities. You get to rewrite your story and you get to decide. Like again, that word decide. You get to decide what the second half of your life is. You get to decide what the second half of your life looks like, how you want to step into it. I think about the women who are the most influential in this world are often in midlife and beyond, that they're the ones who are, again,

leveraging their education, their knowledge, their wisdom, and they are moving forward in rewriting on their terms, deciding what they want to do, stepping into their power. So I would say that this is not a decline. It is an ascension into the woman that you're about to become. It is a ascension into your freedom and your power. And you get to decide that. It's, it's you. No one gets to take that from you. Yeah. I think there's so much power in the idea of like almost like a rebirth. Yes. Right. And also the phrase of you get to. You get to. And I jokingly say that to, you know, my husband sometimes. I'm like, I get to, you know, at this point, be that. But that's, that's so empowering. Yeah. It's a beautiful time. It really is when we really take ownership. I think there's a big difference between our blaming ourselves and taking ownership, deciding who we want to become,

deciding what we love, deciding what brings us joy. This is a time where we are stepping into this transition that's asking for a different version of us, but a more, I would say, not so much a more optimized version, but a more truthful version of us, a more aligned version of us. This is a time where everything is up for review. Relationships are up for review. Careers are. up for review, how we've been living our life up into this point is up for review. The beliefs that we came into paring menopause with, maybe it's time to get rid of some of those old beliefs, right? That we get to step into a new level of belief about who we are and what we're here to do in this lifetime. And I think that that is so powerful and so empowering if we choose to take on that

assignment. And I don't know about you, but I am understanding the assignment and I am stepping in to this next version of me and to this next part of my life, just feeling more empowered. And I'm powered and more clear on who I want to be versus how I've been living for other people. Absolutely. Absolutely. Oh, my gosh. Amen. And I'm so thankful for women like you who are setting a new standard for perimenopause because

as I transition to that phase in my life, I'm going to have that reframe. I'm going to get to learn from you guys. And so I have your book here, which is coming out very soon next month. Yes, next month. Yes. What's the official date, October? October 21st, 2025. Amazing.

So this is the guide to perimenopause. The perimenopause revolution, everything that we kind of talked about today, but really fleshed out. And there's a five-week plan. You talked about it. But essentially, like, what is something that you want people to take away from this book? This book is the roadmap to midlife. This book is going to give you the action about tools that are going to move the needle

so that you feel alive. Again, not only today, pari menopause isn't about survival. It's about thriving. And that book is the roadmap to do so. It's going to help you identify if you're in Perry. It's going to connect the dots between your symptoms and your future health outcomes, but it's going to give you actionable strategies that you can begin to implement right now. Because I'm in it, I know it.

I know what it means to be consistent, what it means to have the habits that move me forward, what it means to feel alive and have the energy and the capacity to show it for the people that matter most to me. That book is that roadmap. It's got recipes. It's got workout plans. It's got self-care. It's got optimizing. circadian rhythm, friendship, connection, how to optimize your mental health and feel amazing.

And it's all wrapped up in things that you can take action for today. It's one thing to, like, explain what it is. It's another thing to give women a pathway through. And that's how I wrote this book is I wanted you to have a pathway through. And I wanted you to know that we were in this together. That was so important to me. So that you knew that you had a army of women, that you had a collective of women who who were in this with you.

And together, we are stronger. That's what I believe to be true. Oh, I love that. I already have five people that I'm going to give this one too. So thank you so much for joining us for this conversation. I'm really excited for your new book. Thank you so much. This is the book that I wish I had had.

So I really appreciate this being out there. Thank you so much. Hi, everyone. Drew here. Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already, subscribe, just hit the subscribe button on your favorite podcast app. And by the way, if you love this episode, it would mean the world to me. And it's the

number one thing that you can do to support this podcast is share it with a friend. Share with a friend who would benefit from listening. Number two, before I go, I just had to tell you about something that I've been working on that I'm super excited about. It's my weekly newsletter. And it's called Try This. Every Friday, yes, every Friday, 52 weeks a year, I send out an easy to digest protocol of simple steps that you or anyone you love can follow to optimize your own health. We cover everything from nutrition to mindset to metabolic health, sleep, community, longevity, and so much more. If you want to get on this email list, which is, by the way, free and get my weekly

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