Habits and Hustle - Episode 533: Dr. Amy Shah: What Changes in Perimenopause and How Cortisol Drives Belly Fat After 40

Episode Date: March 3, 2026

Midlife is not subtle. You’re disciplined, productive, training harder than ever, and still waking up at 4AM wired, gaining belly fat, and realizing the formula that used to work no longer does. In this Habits & Hustle episode, I’m joined by Dr. Amy Shah to break down why cortisol is the real driver behind stubborn weight gain and 3AM wakeups and how too much intensity can backfire after 40.  We also unpack her 30-30-3 Method and 4-3-2-1 Movement Framework so women can start a practical reset in just three days. Dr. Amy Shah is a Double Board-Certified MD, Nutritionist, and New York Times Best Selling Author. She trained in internal medicine and immunology and studied nutrition at Cornell University. Amy is the author of I’m So Effing Hungry and I’m So Effing Tired, with Hormone Havoc forthcoming. What’s Discussed (02:26) Morning sunlight and short movement to stabilize cortisol (04:07) Leaving 20% unscheduled to reduce stress load (11:57) 3-5AM wake-ups and cortisol spikes (13:02) Why intense workouts increase belly fat after 40 (18:10) The 4-3-2-1 workout framework for midlife women (28:28) Alcohol, sugar, sitting, and stress as aging drivers (44:48) Sleep as the most underrated anti-aging tool (49:52) Gut health as a foundation for hormone balance Thank you to our sponsors: Rho Nutrition: Try Rho Nutrition today and experience the difference of Liposomal Technology. Use code JEN20 for 20% OFF everything at https://rhonutrition.com/discount/jen20. Prolon: Prolon is offering listeners 30% off sitewide plus a $40 bonus gift when you subscribe to their 5-Day Program! Just visit https://prolonlife.com/JENNIFERCOHEN and use the code JENNIFERCOHEN to claim your discount and your bonus gift. Therasage: Visit Therasage.com and use code JEN to get 15% off your order. Your skin deserves this level of care. Air Doctor: Head to AirDoctorPro.com and use promo code HUSTLE to get UP TO $300 off today! AirDoctor comes with a 30-day money back guarantee, plus a 3-year warranty — an $84 value, free! Magic Mind: Head over to www.magicmind.com/jen and use code Jen at checkout. Momentous: Ready to try supplements that actually do what they claim? Head to livemomentous.com and use code JEN for 35% off your first subscription.  Manna Vitality: Try it now by using the code Jennifer20 at mannavitality.com.   Amp fit If you’re ready to make consistency a habit without sacrificing your sanity, check out joinamp.com/jen.  Find more from Jen:  Website: https://jennifercohen.com Instagram: @therealjencohen Books: https://jennifercohen.com/books Speaking: https://jennifercohen.com/speaking-engagement Find more from Dr. Amy Shah: Website: https://amymdwellness.com Instagram: @dramyshah Facebook: @drconfidential Youtube: @dramyshah Tiktok: @dramyshah “Hormone Havoc” out February 24th: https://amymdwellness.com/pages/books

Hi guys, it's Tony Robbins. You're listening to Habits and Hustle. Cresh it. All right. Today, you guys, we have Dr. Amy Shaw, who is not just one-time certified, but you're a double-board certified, doctor. I'm really old. You're really? Oh, my God. I did a lot of training. Well, you look really young, actually. How old are you? Thank you. I'm in my, I'm 48. You're 48? Yes.

My God, whatever you're doing in same age. Okay. Well, you look amazing too. No, but by the way, whatever you're doing, I want to know exactly what that is because whatever is is working for you. you. Oh, thank you. What do you do? I mean, what do you mean? Like all the things, like, all the things that we're going to talk about. I do. I mean, like, I'm, by the way, her new book is called hormone havoc. We're going to talk all about it. And we're starting off with what your daily routine is to look this young and fabulous. Okay, so sunlight every day, you know, it's like so, even if it's a cloudy day, I try to, at least in the beginning of the day, try to get some, usually some kind of movement, even if it's like 15

minutes. I think today I did like 15 minutes. Really? Because it was like even that day when we ran into each other. Yeah, yeah, yeah. I literally had done 15 minutes because I knew that I had to get ready to go. And so when I saw you, I, like, I was like, oh, like, let's chat, but I had to go because I literally had only planned like a 20 minute workout. Right. So even that even that 20 minute or that 50 minutes makes a major difference. Totally. If I can go for a walk, like I can't hear when I'm traveling or whatever. But if I could go for a quick walk, you can get the sunlight in and the like a little of movement in the morning. Yeah.

Absolutely. In LA, you can typically, yeah, it's easier here. Although you're in Arizona, right? Yeah, so it's the same thing. Yeah. Like, good weather. Yeah. I feel like also getting a slight bit of bumper to the day, like in the morning.

So I'll talk to you about that because we're going to talk about cortisol. But like I feel like my cortisol is always out of control. And so like in the morning kind of doing something to calm myself for the day about like to come. So like a little bit of bumper. So it's not like I'm just jumping into the first thing of my. day. What do you mean by a bumper? What do you mean by a little bit of bumper? I learned, do you know David Guilla? Yeah, I do. He was actually supposed to be on this podcast many times

and he had to reschedule. So David, if you're listening, honestly, like no more rescheduling. It literally changed my life because he said your best ideas never come when you're overwhelmed and stressed out, right? Like you need to give, there needs to be space in your day. He's like, you need to keep like 20% of your day free. And I'm like, that's like a lot. lot of hours. And he's like, no, but it's like your workout counts is a little bit of time. And like, if you're going from thing to thing without a break, you're never going to be able to kind of get that, one, cortisol down so biologically, but two, like process what just happened. Yeah. Or if you're having a great conversation, you can't go a little bit longer because you're

like booked like back to back. It's so true. Yeah. Right. And so if we're working on our cortisol, we're working on anti-aging, like we have to put bumpers on our day a little bit. Even as like five minutes that you have extra in the morning to whatever. Like, I don't know, if you want to meditate, whatever, sunlight, gratitude. You call it bumpers. Yeah, like a bumper in your day. So it's just like basically building in these time slots where it's not just overlap, overlap, overlap. Right. Like when you're booking your day, maybe there's like at least a good amount of time where you're not on a podcast, you're not on a call. You're not, you can all of a sudden have like an amazing conversation like we were having before this podcast. And it's not like you're running late because you already built in a

little bit extra time. Right. So you're building it into your day. Yes. You know, so that's interesting. You know what I do because food's so important to me? Yeah. Is that I make sure I have lunch every day. Like I try to make sure that I'm not just like running over that time. Yes. And that's like a bumper for me. That's a bumper. Right. And like the biggest thing is when I came from the medical world, I in medical school, like college, even our like lives, we've always been told that, Unless you're, like, booked and busy at every moment of the day and weekend, like, you're not really performing in life. Yeah. You know. So true. Especially our background. Yeah.

Yeah. And so when he said that and he's like, oh, yeah, the best, like, ideas, the best business deals, the best thoughts. Like, all of that things happen when you have that little bit of space. So I do that now and it made a huge difference, not just in my business or whatever, but for my cortisol. Because our cortisol is, like, on fire because we're always late and always rushing. By the way, I'm still always late in rushing. But, no, but I actually totally agree with that because then you're always kind of like, you always feel on edge.

Yes. And it's like a horrible, the anxiety is a horrible feeling to live in all the time. And when someone's talking to you, all you're thinking is like, I got to go, I got to go, you know, like that whole thing. It is so awful. I got to go, I got to hurry up, hurry up. I'm not listening. I got to just be polite.

Yes, yes, yes. I know. Like that whole slow morning thing, you know, like having a little bit of a slower morning with little like few bumpers is like a game changer. So anyways, that's that. And then the water and like, you know, for me, I do the IMAid in the morning. And then I'll do like coffee a little bit later. And I usually have like 30 grams of protein in the first meal. So sometimes the first meal is delayed a little bit. But I try to get that protein in that first meal. I don't, I used to love intermittent fasting. But what I realized it was raising my cortisol, especially when you wait till late, late, late, late in the day.

I'm glad that you just brought that up. Yeah. So let me just say, okay, so, let me just say, okay, so I'm going to introduce your book. Okay. I went like, I went deep dive into the second we go over here. I wasn't expecting you to say, I thought you were going to say 38. So I got like very excited. Oh, I'm so happy. Yeah, well, it's true.

So the book is called hormone havoc. And it's a science-back protocol for premenopause and menopause. And I'm going to say something to you that I actually just said to you before we started. Was when I first saw the title of the book, I was actually not going to have you on. Yeah. Because I'm already like very, I'm over. and super tired of the metapause talk. Yes.

Right? Because I feel like it's already been there, done that. Yes. And there's so much noise. There's so much information. And I'm quite frankly over it. Yeah. However, I really like you.

And I know that when I went through the book, there was a lot of things in it that I have not seen before. And I want to focus on those things. Yeah. Right? I think my biggest thing is that I, what I didn't realize when I was in training and myself is that all, like, there's so many things we, could be doing proactively, nutrition-wise, lifestyle-wise, that can help us as we get older. But

nobody tells us, there's no handbook. We're basically left to just like guess, look, Google, find people that we think we, that are telling us the right thing. And so it's really, really complicated. Like the menopause thing, the hormone therapy thing, I think has been talked about enough. There's a lot of resources now, amazing resources. If you want to take hormone therapy, if you don't want to take it, if you want to know the risks, the benefits, you know, like the whole thing. whole thing. Well, now though, actually since you, well, you, I want to ask you two questions. Yeah. But first, the black box thing has been taken off. So now there's like not that much of the, well, I still think there's still kind of like a taboo around it. People are still scared. Yeah. But not as much because of it. Yeah. So we can talk about that. But what I wanted to ask you is given all the noise, why did you write a book? Yeah. Because this is what happened. There is absolutely no nutrition handbook for women. Okay. So when I, I looked at how are we supposed to eat as we age.

And we kind of talked about this a little offline, but we'll talk about online. We actually are changing as humans. And that's a good. It's a good thing. But it is, we have to change our habits and our food to kind of match that. And why is it a secret? Like, why didn't we? You know, when you got a health class and it was like really awkward, you know,

when you're 10 years old? And like, everybody laughed, but at least you started the conversation. What if we had like a class that was like, hey, this is what's happening to your body. Like, you should probably eat this. You should probably like change this or you could probably do this. These are some options. Just like start the conversation, but there's nothing. And even in the medical literature, there's nothing.

Our menopause books don't have a section on nutrition lifestyle. So it's like I felt like there was a big hole in helping women in this phase of life in that way. Because I think most of us are at home. We're not at the doctor's office. We want to know, like, what are we supposed to be doing from day to night to optimize ourselves, our brain, our health, or, like, and it's not the same as men. Yeah. And it's not the same as when you were 20.

That's exactly. That is true, right? Like, everything does change decade by decade, I feel. And what you need today is not what you need when I was 25. When you're, by the way, when you're 25, anything can kind of go. Anything can go. Anything can go. Yes.

You get away murder. Yeah. And, like, your cortisol, like, is like, buffering, whether, you know, we were saying like, you can party all night and then, you know, go to work the next day and you're fine and then do it again that night. And your body is like fine. But you try to do that in your 40s and you're like, like down for the count or you get sick. Well, you know, when you said to me outside was really interesting because I was actually telling, I was just to kind of like fill you guys in behind the scenes. Well, you know, in front now. But, you know,

I got my blood work back and I was telling Amy that I was, I was, I was, the people were shocked and I was shocked that my physical stress test was so high, like so high, which is not a good thing. Like the stress in my body is very, very high or my physical stress. But my resilience is what saves me because I was so high on the resilience. Yeah. That it's basically my personality that's pushing through it. But I'm really at burnout, right? And then I was, you were saying to me, you asked me a question, you're like, at night,

how do you sleep? And I said that I wake up in the middle of the night. Yeah. I follow sleep okay. Yes. But then every night around 4.30 or 5 o'clock, like clockwork, I like wake up panic. Like, you know, like that's kind of like how a baby does when they're like small. And you said it's like because the cortisol. Can you talk about that? That's normal you're saying? So everyone gets a little bump of their cortisol at night. But what I see in, and I said, high functioning girl boss women.

Well, thank you. Yeah. Is that they're doing all the things. And then they're. wake up in the middle of the night because their cortisol bump is high enough that it wakes them up and almost like in a panic because it's a stress hormone and it's thinking like you're like, oh my God, am I dying? Right. It's like a really, it's like a whole, it's scary. Yes. And so what that signals to you is that you have a lot of stress in your life, which you could have

said that, but you have to do a better job managing that stress because what happens is as we get older, as we move through the hormonal continuum, our ability to buffer the cortisol goes down. And so the same things that didn't stress you out in your 20s or even early 30s start to really stress you out. So the same kind of, you know, those workouts where it's like high intensity training, whatever, you could, you know, maybe in your 20s, I know I did those all the time like every day without any recovery and it was fine. Whereas when I started in my late 30s, and early 40s, they started to notice, like, I was, like, not getting results from that. I was actually feeling like I was, like, gaining midsection fat.

I was, like, feeling tired. And it's because they raise your cortisol so high. They make you crave, like, a lot of food. Yes. And then you're, like, counteracting the calories that you just burned, right? So it's almost like this cortisol cycle that's happening. So we really need to learn how to recover a little bit better. So more nature time, more sunlight, more sleep, more things that bring you joy because that

counteracts the stress. And that's literally what perimenopause really, to me, is it's not the sex hormones, really. For me, it's like we're moving through a hormonal continuum that's changing our brain, our body, and we need to just learn to adapt to it. It's a great time. Like, you see all the CEOs and people living the peak of their lives in their 40s, 50s and 60s, right? So it's not that it's the end.

It's just that we have to learn to manage it. Like if you're this successful and this happy and this like fit, you can kind of go to that next level if you understand what's happening. So doing more recovery. Like for you, that might look like, you know, any version of. Don't say yoga, please. Don't say yoga or meditation. Don't say either one or I'm going to be showing you the door.

No, you need moving things because you have that personality of like you need to be moving meditation. So it's like anything that, I would say anything that collapses time for you. Like, is there, your daughter does dance. So I'm sure she's like my daughter. My daughter goes to dance rehearsal for four or five hours. And she's like, oh, it's like, it just passed by like this. Like, because you're doing something you really love. And that buffers your cortisol so well. So like, what is it that you really love? I started something called paddle. Have you heard of paddle? Yes. I love it. Okay. It's very, very fun. And it's, you know, it's, I'm terrible at it. So I'm not like, it's not like rigorous or anything, but I move.

Yes. And so I like it. But I was going to say something, I was very interesting that you said that's so true, that what I've noticed in my more middle, middle age is that these high intensity workouts actually work against me. Yes. Because of that exact thing. I end up eating 10 times the amount of food I would have otherwise ate because it makes me

so hungry. And like, I'm also like more like tired of fatigue the next day. But like not like I just feel, I don't feel energetic. I feel more like like kind of like just sluggish. That's exactly what happens because it riles up your cortisol. Yep. And that cortisol makes you want to eat because you need quick sugar when your cortisol's high. Exactly.

So you feel like having the quick, quick sugary thing. And then you're tired because that cortisol being so high for so long. It's like your body thought you were being chased by like a tiger for hours. You know, and so you're, like, fatigued. And so what I realized is taking away some of that stress and really going to the edges. So the edges meaning really short bursts and then lots of, like, low level activity, whatever you love, like, hiking, walking, you know, things that aren't like, you know. Strenuous. Yeah, something you love to do.

Because, like, because you also, the managing of the appetite is a massive, massive one, right? Yeah. Because, like, you will gain a lot of belly fat. I've noticed because of the fact that you are spiking that cortisol so high. So somebody told me this, and this is, like, very inappropriate, but I was like, this is so true. They were, like, go to a marathon and, like, watch a marathon. Yeah. And watch the people who are winning the marathon.

They're very, like, slank, like, very lanky and thin and whatever. But then watch, like, the very end of the marathon when people are, like, maybe first-timers or maybe, like, people who are just working on it. And they don't always look fit. They often are, like, people who do marathons for the first time tell me all the time that, like, I gained weight or I feel injured, you know? By the way, I talk about this all the time. Like, if you look at, I mean, watch me get, like, completely.

Like, I can't, let them come. Let the comments come. If you see people who are marathon runners, they don't look fit. Yeah. I never, I don't want a marathon body. Yeah. I want someone who's like a sprinter body. Yeah.

A sprinter body or someone who's like really toned and tight. because they're not doing those 20 hours of like, of running. Yes. But, but, but, but I find that running in general just breaks down your lean muscle mass so, so much. And long, long endurance races is not going to get you there. Like, you need to do strength training. That's right. I always say to get that kind of body composition.

Yeah. So I actually, okay, so I did a framework for women. Tell me what you think of this. Okay. Okay. Four, three, two, one. Yeah. So women in middle age.

I saw it's great. Yeah. So it's like 30 and above, really, you know, when you're 35 and above, people, what I would consider perimenopause, premenopause, four days of that activity that you love. The one that, like, the paddle that you love, the hiking, the walks, the thing that like the time passes, or you could do when you're 80 or you can do when you're 30, you know. So four days a week of movement, just whatever you love. Three days a week of weight training. Because that's essential, you know, we lose, you know, three to eight percent of muscle mass every decade. And then for women, we go up to like one percent a year

if we're not doing anything. So we got to counteract that. So three days a week. And that can be at least three days a week. That's what the data shows. Like you can do two days, but that's really rare. It's more three to build. And then two days of hot therapy. And that's because I feel like the data on hot versus cold, the hot therapy data is so much better. And it, for For women especially, like if you're someone who wants to boost your hormones, you are someone who wants to work on, like, brain health. And it doesn't have to be sitting in a sauna. It could be like moving in a sauna. You know, he did Pilates, whatever.

He did a workout. And then the one is a sprint every single week, meaning that most people after the, like after high school have never sprinted. Like they've never run to their maximal capacity. Yeah. But if you're actually trying to. our muscle, our heart is a muscle, and if you're trying to keep it strong, you need to exercise that muscle. And if you're always working at low level, and, you know, to be honest, weight training, sometimes it can get your heart rate up, but not to the, like, not to the max.

No, it can't. I mean, not for me anyway. Maybe some people. Yeah. If you're not taking glutathione, you're missing out of one of the most critical foundations for your health. Your body is dealing with toxins every single day. Pollution, chemicals, plastics, processed food, alcohol, stress, bad sleep. It's not a question if you're exposed. It's how much. That's where glutathione comes in. It's often called the master antioxidant, and for good reason.

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support, start here. Go to rownutrition.com and try rose liposomal glutathione. Use code gen 20 for 20% off sitewide. That's Roe Nutrition, R-H-O-N-U-T-R-N-U-N-R-I-T-I-O-N.com and use code Gen 20. So my question to you is this with your 4-3-2-1 framework. So of those four, for the the four movement days, how long? For the three strength training, how long? Yeah. Give me the time frame. Give me the duration of each. So 30 minutes for everything minimum, okay? Okay. And the sprint doesn't have to be 30 minutes. You can't do a sprint, sprint workout. But you go one minute on. You know the Norwegian four by four? Oh my God. I haven't heard that for so long. I have, remind me what it is. Okay. So I do, I remember. It's a sprint workout. Yeah. So basically there was a

study where they took people who were sedentary. Like literally in midlife were sedentary. And that means that they didn't ever go to the gym, but they did, they consider themselves like light movement, that kind of sedentary. Okay. And then they put them on a two-year exercise program. Okay. And they started with just walking, like really easy cardio, then they added weight training and all that stuff. And then the one year, six-month mark, they added sprint training and they added the Norwegian 4x4 once a week. And they tested their heart function at the end of it. And they compared it to the beginning. And their hearts looked 20 years younger. Really? By adding that one sprint workout, like in addition to the regular working out. But adding just that one sprint. And that was a

Norwegian 4x4. So if you wanted to like copy the study and do it exactly. Yeah. But it's really hard to do the Norwegian 4x4. Maybe for you, not for you, but for most people. So I would say most people have to start with just like sprinting for the first time in their life, you know, and like for 30 seconds and like getting their heart rate to 85% of their max and then, you know, work up. So Norwegian 4x4 is four minutes of working at 85% heart rate and then taking a break. Wow. So a four minute sprint. Like a four minute kind of like high intensity. Maybe it's like a biking or running or no break. No break for four minutes. Yeah. Do you remember Tabada? Isn't that like, well, that's 20 and 10, but that's for a four minute or eight minute. I can't remember. Yeah. There's so many versions of that. They just ended up picking that one, which I think is like the hardest one ever. Oh my God. Four minute sprint is very, very hard. And then you take a break and you rest and then you do it again. And you do at four times four by four. It's like a really hard. But you, if you think about it, 85% of your heart rate. No, it's great. Of your max heart rate is different for everyone. Right. So, but that would also spike your cortisone. But it's short. Four minutes times. It's. It's. It's. It's. It's. It's. It's. It's. It's. It's. It's. It's. It's. It's

And four is still 16. It's a lot. For them, it was like, you know, they did that once a week. So I, I'm all for high intensity once a week or even twice or three times. As long as you're taking lots of recovery days. Right. So the rest of the days are not that difficult. So that doing that one day is probably way better than doing every, every day at moderate to intense.

That's right. So when you go to those workout, like the very popular, you know, chains. Like an orange theory or a bookberry's bookup. You're like not really getting up to 85, but you're not like you're raising your cortisol. So like you're getting to like 70. Yes. And so you're just always going to be like kind of like kind of exhausted. Yeah, you're not on the edges.

Like we want to be on the edges. Right. So then and then if you do want to do a place like that, I often will go for that one day, the sprint day because when I'm on the treadmill or whatever at Lange theory, you can kind of like push yourself to that 85%. as much as you can. Like, I don't expect, I don't even think that most people can get themselves to 85% of their heart rate for like four minutes straight for that many times. I think it's something you work up to. So I usually do like 30 second sprints, then you walk for a minute and then you do

another 30 second sprint and then you do it eight. Have you ever heard of crazy eight? Yes. Yeah, that's like what I do. You do it. You do it. You know all these like different. I mean, it's like, I dabble. In your spare time. Yeah, exactly. I think, I think, I think that part, because I know that you're so into that, into the fitness world, that's why I wanted to share that with you. Because I think for the woman who is going into this next phase of their life that wants to optimize, it's not about doing more. It's really about recovering better. Yeah. Say that again, because for the cheap seats behind you, because I think that is so true. It's hard, though, right? Because if you've, you know, like, I think people get really stuck, I'm talking for a friend.

And doing, you know, with things like worked for you so well for so long, it's really hard to change that mindset and like, and do something different, right? Yes. Even though all the numbers and all the, all the evidence is pointing to that, right? It's so true. Doing more is not doing you any favors. It's not about doing more. Yeah.

You know, doing recovering better. So like that's hard for people like you and me. Very. Because we grew up our culture, our society. Everyone around us was like, do more, do more, you know, and get smaller. You know, like that was like the messaging that we were getting. And like, you know, like intense, intensity, intensity. Yes.

And to get stronger and to recover, it feels like so anti. Yeah. It seems like there's like it seems a very, it's like it's so opposite. Yes. And so that for you, like someone who has a lot of cortisol like, you know, spikes, especially when they're, it's like your life is spiking your cortisol. Your food is spiking the cortisol. Your alcohol is spiking your cortisol. Your caffeine is spiking the cortisol.

And then your workouts are spiking the cortisol. There's a lot of cortisol spiking. So if you actually put it all together, you're like, wow, your body is like amazing that it can even handle all that. 100%. What's the difference between cortisol and your adrenal? That's, it's all part of the same cycle. So adrenaline comes from your adrenals. And so when you wake up in the morning, if you're a,

cortisol is working, your adrenaline is high. And that's why you feel awake. That's what wakes you up, actually, in the morning. How do you know if you have adrenal fatigue? So adrenal fatigue is actually a misnomer. Because your adrenals are working fine. It's not, they're not fatigued. It's just that you're in this constant state of high cortisol. So like, if you ask an endocrinologist, they'd be like, oh, cringe when you say adrenal fatigue, because that's not really what happens. It's just cortisol dysregulation. Like what we're It's like you're keeping, you're never in the parasympathetic mode. You're always having your nervous system and your hormones in the mode that they have to focus only on survival.

And you need the mode of you're safe and I'm ready to digest. I'm ready to critically think. That's not going to happen if you're always in that sympathetic mode. So you have to learn. So sympathetic is talking about your nervous system being activated. So when your cortisol is high, it activates your nervous system. And so, you know, you feel like on edge when your cortisol is high. Yes, yes, yes. Like you're like irritable and like on edge because that's riling up your nervous system to be like ready to go as if there's danger around. And so one of the reasons you wake up in the middle of the night is like to look for danger. And that's why you're thinking about like, oh shit, I forgot to do that thing. I like all the danger things that your body feels as dangerous, they all come to you at that time. Did I lock the. the door. Did I unplug that thing? Did I send that email? Did I, you know, that's what you're thinking about. Yeah. Because your cortisol was like, hey, hey, we're in danger. Remember all the dangerous things like that. Like, they're not life-threatening literally, but like our mind thinks that they're life-threatening. Yeah. And you think about all of them.

And the hundred percent. I totally agree. This makes perfect sense. So what are like some things, like some, what are some habits that people do that are actually aging them that they don't even, they're not even aware of? Okay, so you said the first one that you don't do is alcohol. Alcohol, yeah. I don't know. I used to have a whoop. Do you have, or not wear it. I wear this. I used to wear the whooped and the oar ring and all the things. Now I'm not wearing them. Yeah. So I think it was really nice for me though because I would say, oh my God, my HRV is like so low today. I don't know what I did. And it was like, it was like in passing I would have a drink at dinner. Like, you know, just like nothing. And then it was like every time I noticed my HRV, so that's, like a measure of your nervous system, you know, how tightly wound your nervous system. Yeah, exactly. Mine's very tightly wet. Yeah. So my HRV would drop every time I would drink. So it's like even like you're having one or two every night. Yeah. So now we know that that's even one or two every night is not good for our, it ages us basically in every single way. So the first, the one thing people, the first thing that people are doing that's aging them is alcohol. Yes. Number one. thing that they should cut. Number one thing that you is aging use alcohol. I agree. By the way,

that's why I hate to say, look at J-Lo, right? Yeah. She hasn't had that, she hasn't drink at all. Yes. She's like 12. No, 100%. And she says that's why she doesn't drink because she doesn't want to eat. 100%. Yeah. I'm like, I'll afford this. Is that why you stopped? No, no, I'm lucky because the one thing I never, ever, ever liked was alcohol. I never liked the taste of alcohol. I never drink in high school, college, whatever. I hate the taste of it. So I got lucky on that one. That's amazing.

Yeah. Yeah. But I like chocolate cake and french fries. Okay, so that's number two. Oh, yeah. Number two is ultra-processed foods, like especially high sugar foods. Yeah. Because what they do, the other thing that happens as we age is that our ability to process

sugar, like so our insulin resistance goes up. So our, before you could eat something very sugary and your body, quickly absorbs it into itself. And so that's why it's good to walk around after a meal because you want to quickly absorb all that sugar. But when... I want to ask you about that after. Remind me. Yeah. So when we start to lose estrogen, we also lose a little bit of our ability to absorb that sugar. So it kind of sticks around a little bit longer. And so that... Oh, really? So wait, say that again. Yeah. So as we lose estrogen, that's when sugar kind of sticks on our body longer. Yes. So our cells ability, like, so our cell's ability, like, so our cells,

becomes a little more resistant to sugar. To sugar, right, to taking it in. As are estrogen drops. Yes. So you'll see a lot of people, including myself, their hemoglobin A1C, like a marker of your blood sugar, will start to rise during that time. That's like a marker of perimenopause. It's like people who have a diabetes history, like my family, everybody has diabetes.

You'll see like now you're starting to see. Even people who look healthy, your sugars are climbing up. And so the same, it's aging you because when that sugar kind of sticks around in your bloodstream, it is a very, like your body's doing everything it can to bring that in. That sugar that's there is aging you by the minute, you know, so every. Really? And so that's why things like eating fruit instead of having a sugary thing is much better because it's slowing. Like when you have fiber with your sugar, it's slowly absorbed, right?

But have a dried fruit. Dry fruit is not as great because you're getting the sugar in concentrated form. Yeah. And so you're getting that spike that you don't want. And for, you know, for people who are really, really healthy, people are like, why would you care about blood sugar spikes? And you don't necessarily, but when you're getting to, when you're like over the age of 40, your ability to like process sugar changes. And so especially if you have a family history of anything, heart disease, diabetes,

you really want to be kind of minimizing those spikes. And so that's why it's really important to eat fiber because, like, kind of blunt the sugar response, but all processed foods, like, devoid of fiber, right? So if you're eating ultra-processed food, you're automatically eating a super low fiber, high-sugar or high, you know, processed, whatever, diet, that's the number two. Sugar, okay. And liquid sugar is the worst. So liquid sugar, so alcohol, liquid sugar, obviously, that's bad, but like frapuccino's and, da-da-da, like all the-d-diver. They never drink your calories.

Yes. That's why, by the way, I'm not a big smoothie person. Yes. Because like the amount of calories that people are like piling on stuff and they're thinking they're doing themselves a service. And it's not as satisfying. I'm starving. And after I have like, first of all, it takes you three seconds to drink it. I'm a volume eater. I like to have big volume because I feel like it's a whole, like a whole thing. Yes. Same. Like a, what do you call it? Like it's like a whole event when I eat. And you, and when you chew something and chew and all that. You get the signals to your brain that you're eating and that you have food in your system. And when you have a smoothie,

four seconds, it's like a finish. And I'm like, okay, now where's my meal? And then I just had a thousand calories. Yeah. So the sugary, these ultra-processed sugary foods is like the number thing you can do. And I don't mean like take it all out. Like if you're like eating a piece of fruit, I mean, okay, so for dried fruit, fruits out of everything, dates are the best. Yeah. I love mango. Dates are low. I see me. Mangles are amazing. I don't never ever, ever vilify fruit. Like these people who are like don't eat fruit. Like it's insane. It's insane. Like, what do you mean don't eat fruit? Like, they have all these vital, they have all these nutritional value beyond just the sugar content. Exactly. And the fiber when it's fresh fruit. So you're saying then I can eat my mango? You can eat your mango. But, you know, obviously.

The dried mango? Not the dried mango and not the mango flavored, like, like, drink or whatever. No, no, no, no. But the minimizing sugar spikes also, you can have, there's tricks to do that. So, like, if you're eating a dessert, like, if you eat something with fiber with it, it'll slow it down. So like don't, you know, eat your dessert after you've already had your meal so you're not, like, spiking your blood. It's much worse if you're eating it, like, on the go when you haven't eaten anything. Does that mean then you shouldn't, like, if you eat fruit by itself, there's a lot of people who, like, eat fruit first thing in the morning and nothing else? Yeah. Doesn't that just spike your blood sugar then?

Well, fruit, depending on the fruit, has a ton of fiber. Yeah. And so, like, raspberries have eight grams of fiber, which is insane. It's like a huge chunk of your food. fiber for the day, you just get from... The raspberries. A raspberries. So that is amazing and it's not very high in sugar.

So berries are incredible because they actually give you all of the polyphenols and the fiber without actually giving you that blood sugar spike and tastes really good. Yeah. I'm talking about like the straight up, you know, candy bar from your local, it's like a devoid of fiber and it... Like sugar, like junk food sugar. Like saying like, oh, hungry for Snickers. What was us saying?

Like, you know, like, you have this. Yeah, I know what you're talking about. Yeah. Because you would eat it because you're really hungry at like three o'clock. But that's like the worst thing you can do because it's like spiking your blood sugar. It's ultra processed. And, you know, as we get, if we're talking about aging, that's like literally aging you. So that's.

Can I ask you a question? What about this? Because this is what I do sometimes. And I like, so because I get super, I want that sugar craving, I'll have like an ice coffee with, like a little bit of like sugar-free vanilla in there. Yeah. Around three o'clock. Yeah.

I love that. Yeah. I do that too. You do? Yeah. It just like kind of takes the edge off. Exactly. And other thing you can do that I've been. Well, I mean, if you're not sensitive, people.

I'm not cancer. I can have like, I can have a vat of caffeine. Yeah. You're so lucky. That's a genetic thing. Oh, really? Okay. Some of us don't have that.

So we can, we can't have a caffeine in a little bit of, although I did. One of the tricks I have, there's two tricks I have. So one is when you're having something, So say you have a yogurt perfe and you want to have something sweet like crumble, cookie or something on top of it. So you're having like your Greek yogurt, the protein, and then maybe some berries in it. You get your fiber and then you're getting your treat. Like it's there. It's just paired with a bunch of things that can like escort it into your body in the right way.

Right. So the protein and the everything. Fiber. Fibre blunts your sugar. I like that. Yeah. So that's a trick. And then the other trick, which is something I've used for years, is it. If you really want your process knack or like there's something you really want, put it in a really small bowl and then walk away from the kitchen.

Like go to your patio, go to the farthest place that you would go and like bring a glass of water and like just have it. Because if you're standing in front of an open bag or box, that's like the worst thing you could ever do. And but if you give your, it's not about deprivation. Like if you're like, I really just want like one cookie and like, you know, whatever, a couple of chips. You put it in a little bowl. You walk away. Bring your water with you. And then you're not.

It's like really, it's much less likely that you'll just, it takes a lot less willpower to just be like, okay, I'm done for it now, you know. So wait, so you're saying put it into the bowl and then leave. And then leave the kitchen, close, close the thing. Oh, so don't eat it there. Yeah. Take it with you. Yes.

And that's your treat. That's right. Because you're not like, you're saying you're not likely to come back to the kitchen. So you're less, you're less like. I'll go back 50 times. And that's your dopamine powder. So like put it back in the freezer, put it back in the, you know, put back. the things in the, yeah, like close it up. Yeah, and then go out, go somewhere where you feel really

less stressed or... Well, have you ever not ever not, like, the big joke of the world or the times is like, you know, when you have like a big cake and people like, oh, I'll just have a sliver and then they put the rest in the fridge. But the person just keeps up going back to this, they go back, though, the whole cake is open. Yes, and then they... Did you see that one where they like threw the cake in the garbage? Yes, and then they ate the garbage. By the way, that would be me. I hate to say it, but like, so I don't know if that last trick would work for me, because I would, I start to obsess about something. I'm like, well, I might as just go and have a nut.

I already had it. So I'd rather just have more now. And like you get into that crazy loop of like eating, because you already like did the damage, you're going to continue doing the damage. So the same, they actually want. So, I mean, I don't want to say like, oh, this whole evil conspiracy theory about processed,

ultra-process foods. But the companies are looking to like create foods that make you do that, that make you want to come back and like, You can't stop thinking about it. 100%. So if there are foods like that, that's like a sign you need to cut it out. It's like drugs. Yeah, don't even bring it into the house.

Yes. It's triggering your dopamine pathway. Our dopamine pathway is so strong that you will get up out of bed into your car and go across town for something that stimulates that dopamine. 100%. That's what's so dangerous about these things. Yes. And so I feel like, okay, so ultra-processed foods. I would put sugar, let's put sugary and fried like all in one category.

Yeah, processed food. Yeah, also processed food. And then number three, sedentary. We are meant to be moving. Like our bodies, we are genetically and evolutionarily programmed to be moving, like humans, not moving things. And I think that we're not programmed to be sitting for eight hours a day. And when we do that, our body doesn't function as well.

And that really, really accelerates aging over time. So it doesn't show up when you're young, but over time, it actually does age you a lot. I agree. And four. And number four is stress, which we kind of talked about. I mean, stress should be number one, probably. Is there ways that people, like, maybe are stressed and they don't even know their stress? Or, like, does everyone just know when they're stressed? Well, did you know that you were stressed? Yeah. But I didn't know. But I didn't know I was that stressed. And the other test that they showed that you can do is that how your body manages stress. Did you know about this test? Which, what's it called? I don't know what it's called, but they basically said again, like, I have a lot of stress. but my body's good at like, like, of like deflecting the stress. It's a, it's a very good thing to be able to be resilient to stress, but I honestly believe

that a lot of us are holding stress. Like, okay, I'll give you an example, neck pain. People who have like a lot of like shoulder neck stiffness or pain, sleep issues, like you said, waking up in the middle of the night, palpitations or feeling like nervous about things. like shouldn't be like, you know, anxiety provoking is like another sign that your, you know, cortisol system is really activated. Yeah. Cravings, sugar cravings, because if you think about it, if your body's preparing for to run away from like an animal, it needs quick energy. And so you're going to be craving sugar. And so a lot of people, as soon as they bring down that stress, like the sugar cravings

really subside, which is a huge thing that helps their life, you know? So I feel like stress is one of those things that ages you without you even really knowing that it's aging you. And it's, I mean, if you really want to know, we know evidence of this, it's like you look at people who have been through wars or really like stressful time, famines and wars, and you see how fast they age. Yeah. Look at the presidents. Like not this one, but you remember like most other presidents. Yes. When you start. When they start, firstly when they finish, they look like they're like 30 years older. You know, their hair is gray now. It's like it's really unbelievable. So if you think about it...

This is the only president who looks younger now than he did before. Totally. You know, which is a whole other story. That's hilarious. That's exactly right. So if we're talking about like aging per se, that stress will age you more than anything. The president example was so perfect. And like people that have gone through like really difficult, like, you know, come from a war-torn country.

Yeah, totally. They often are, have like a lot of signs of physical aging. That doesn't mean that you can't do anything about it. It just means that the stress that... that you experienced is aging. You wore, you know, all this things. Kids, by the way. Kids, yes.

I'm not even kidding. If you look at a woman who's 40 years old with kids versus a woman who's 40 without kids, without a doubt, the woman who's 40 with kids looks older. A hundred percent. Because of the stress of like taking care of other humans and like the time restraint you have on your life. And like your whole life is different, right? Like it's super stressful. Yes. You know, like the women who are for you without kids, like they don't really have a care in the world, right?

That's right. They can just have to take care of themselves. It's much easier. Well, I mean, I agree with you because kids are very stressful. Kids are super stressful. I'm super stressed out all the time. Like my friends who are my age, they look like they're 32, you know, who don't have kids. You know, the ones who already have kids.

And they often have like other life stressors, but it's just different. Well, different. But what I'm saying is like, I'm joking. Yeah, yeah, yeah. No, I know. But like they have, there's so many. other life stressors that don't age you like having kids ages. Right.

I'm saying. Like, it's true, though. Like, when you have, like, to, like, just, and it's also not necessarily, like, bad stressors, but it's, like, having to deal with other people's calendars and schedules and driving and feeding them and move. You don't have as much time. You don't have enough downtime. Yeah.

So you don't have any downtime. Yeah. So you don't have that ability. You're worried about them more than you worry about yourself. Well, that's right. So, like, that stresses you. Yes. And actually that ages you, I should say. That does age you. Right. It does age you. I'm just being real. Yeah. You know, so that's another one. Number five is like the most kids.

No, sure. Well, it's true. Yeah. Good and bad. Good and bad. Yeah. Number five is maybe definitely should be number one in terms of like, you know, like the ability to age you. This one is like the most important. Can you guess? Smoking? Oh, well, smoking I would put in that drinking category, but yeah. Okay. Why in the drinking category? I guess it's a toxin you're bringing in each box. Okay, number five. What's the, um, hmm. I know you know it, but. I probably do. But now, okay, we talked about sugar. We talked about alcohol. Uh, we talked about junk food, processed food, stress hormones. Not sleeping enough. Oh my God. Of course. Yes, like that's the number one. Oh my gosh.

Of course. Duh. I should have been looking at your friend. She was probably, she was like, pictionary. Like she's doing like that. Damn. No, I literally think that Of course sleep. Yeah, like if there's one thing that you could do to anti-age yourself is like start getting more sleep. Like more than you think. I think women tend to feel like they are lazy if they're sleeping like eight hours or whatever. Whatever it requires you feel refreshed. Yes. It feels indulgent. It feels like. Totally.

And it feels like that's one thing that's actually different between the genders. Men tend to need less sleep than women. And I don't know if most people like don't allow themselves as much sleep. But really you should sleep without an alarm and see how much sleep you actually need. And that's when you're not sleep deprived. And then that's kind of your baseline of sleep that you need for recovery. And like when we're talking about working on stress and working on like, like, Part of, like you said, it's really hard for you to meditate, just, like, sleep a little bit longer.

That's, like, the perfect way to bring down your chest. I know. That's so true. But I'm not a great, like, also your body has, like, an algorithm. Yes. Right? Like, I'm so used to sleeping, like, five and a half, six hours now. That's my baseline, even though I'm tired all the time.

Yeah. Like, I think that, like, my internal anxiety won't allow me to even stay asleep. Yeah. No, so that's what you have to work on. So one of the things I did, I was the same way as you. I used to be like, I would like, I felt tired, but I would just have an alarm all the time to like wake up. Yeah. Like, yeah.

So one of the things I started doing is like really getting a lot more sunlight first thing in the morning, like within an hour of waking up. That is going to reset your circadian rhythm so that your body knows now, okay, and about, you know, 12 hours from now, I'm going to start really releasing Molotone. Like, it rewires your brain. So if you're someone who, like, goes through different time zone, like, your travel. You're trying to rewire your sleep schedule. Getting a lot of concentrated light, natural light into your eyes. So not behind sunglasses, not behind a window, but actually direct. It goes straight from your retina to your brain to your super kiosmic nucleus and like rewires everything.

It's like one of the best ways to get better sleep and more sleep. And then the second thing I would say is the data shows that sleeping at the same time and waking up at the same time every single day, even as much as you can. even on weekends within 30 minutes, can really improve the quality of your sleep that you're getting. So even if you're getting less the quality, the restoration that you get from it is better. Yeah, I try to do that anyway. Also, like you said, I feel like I'm a creature of habit. Yes. So, like, going to bed around the same time.

Yes. But now because of this waking up in the middle of the night, that's the problem. I can't fall back asleep. Yes. So now you're awake at 5 o'clock in the morning. That's right. And I'm like, oh, my God. And then it takes you a couple hours to actually like get your stuff.

into a place where you can like function. Yeah, that's exactly right. So you want to, for you, I would say work on all the things. You need a cortisol reset. There's a cortisol reset in there. I know. There's work on all the things to decrease cortisol. I, that's like, I would say, like that's like the number one thing that I see women struggling with as we're moving through, like, the hormonal continuum is having trouble figuring out how to like recover, not giving. We don't giving enough permission and enough time to actually have recovery. So recovery doesn't always just mean like cold pungent sauna. It means also like sleep and it also means nature and also means like turning down the volume on the training if it's like draining you, you know, that kind of stuff.

So right. So recovery is not just about like these modalities of like the sauna and the cold plunge. The red light and the, you know, it's also about like eating to support your gut bacteria because your gut bacteria actually is your own, makes your own ibuprofen. So like our own stress-reducing anti-inflammatory compounds that we create in our body is created by gut bacteria. And so like we can do things by eating food to support that that will stimulate.

So it's like they create these things called short chain fatty acids and they work like natural ibuprofen, calm down the cortisol, calm down the inflammation, go all over our body. Like who doesn't want their own? like bottle of ibuprofen inside, right? Like, well, that's the thing. But you have to build it. But how do you do that? Like, I think right now, everyone talks about gut health, right? Yes. But everyone says, oh, I have leaky gut. I have this, I have that. But it is, like,

the gut really is like the brain of your body, right? It's not the brain, it's the gut. Yeah. But if so many people have gut issues, like, isn't that kind of, like, what are the, what are the some key factors that people can even know? And is that, is that also interfering with maybe the symptoms of perimenopause and menopause? I actually think that if you fix your gut, you'll fix your hormones. Really? How? Tell me how? Because our gut is constantly talking to our brain, our hormones, our immune system. And when you need more estrogen, there's like actually gut bacteria, we call it astrobalome, like a bunch of bacteria that like put estrogen back into your system. They take out estrogen from your system. They're like modulating your hormones.

and the gut bacteria are like literally like the captains in charge. Like they're the walkie talking your brain. They're walkie talking the rest of your body to do what they. Send more hormone this way to send more hormone. So if you really want to like get your hormones in check and balance, like you need more of that gut bacteria because the modern world, the way we live, it strips down our gut bacteria to like 50% of what we actually need we're supposed to have. And so we're working with like less than we started with. And then as we move

through perimenopause, our estrogen levels go down or gut bacteria die. Some of them are dependent on hormones like estrogen. And so we need to do stuff to work extra hard to keep these gut bacteria alive and healthy so they can signal to all the places in our body. So like your hormones, a lot of people will tell me as soon as I change my diet, all of a sudden those symptoms that I thought I had because I was getting older went away. Really? So how would you do that though? Give me an example. Okay. So that 30-33 that I kind of developed. So that the second, so it's 30 grams of protein in the morning, 30 grams of fiber throughout the day, and three servings of probiotic foods. So three fermented foods a day. If you start with the fermented foods, which every culture you used to

eat fermented foods, now nobody eats fermented foods. It's like, you know, less than, I mean, 95% of the population don't even eat enough fiber, and they're definitely not eating enough fermented food. Fermented food is the one thing we know that can add bacteria. So, like, increase the bacteria in our gut and also lowers the inflammation. So it's the one thing that we know in diet through all the studies. If you want to lower inflammation and your stress levels in your body through food, you want to be eating more fermented food. Yeah. Fermented food is a very, very popular now, I feel. It's getting more popular. It's, it's, like, is that like sauerkraut? Yes. Yes. It's sourcrap, kimchi, but it's also like yogurt and probiotic cut of cheese and...

Oh, I can have you... Oh, yeah, yogurt. Yeah. And, you know... So I should be eating way more of that stuff. Yes. So that can help kind of calm down the inflammation in your body and in your brain. So, like, that's a great way to manage that gut brain connection and get that stress down

and also help your hormones. And then the fiber is food for the gut bacteria. So imagine, like, you're supposed to have an Amazon jungle in there because it's literally like that trillions, trillions with the tea bacteria that live in there. We have just like the same amount of bacteria in our body that we have our own cells. So like there's a trillion of them. They are starving because all they can eat is certain foods like fibers, one of their main sources of food. And when you're eating an ultra-process diet, which most of us are, you're not feeding your bacteria, anything. They're starving. They're dying. Wow. Yeah. So then what do you

think of having, okay, so if it's fermented foods and everything that you just said, yeah, can that, can, you're going to say probably not, but if we eat better and then we are taking care of our gut, would that make us not have to take hormone therapy? So, so I will say this, when you're in perimenopause and starting to get the symptoms, this will probably, this can often be enough. Yes. Because you can just say like, hey, I don't feel myself. My gut's not, You know, my brain fog is a little high. Like, I'm not. So it's a band-aid.

It's a, no, it's a foundation. A foundation, meaning that you can't stop doing it even as you get older. That's true. Okay, fine, you're right. You're building a foundation. You're building a foundation. A lot of us never had that foundation. Like, I was in medical school and trained, like, I studied nutrition and we did not learn this.

That's why I think it's so important to have the book like this for me. Because I'm like, we didn't even learn this. How are people supposed to know this? I always found that very interesting, that doctors never get trained in nutrition at all. No. Ever. And the thing is, the shocking, shocking thing is that not only do we not get trained on nutrition, we really don't get trained on women at all.

Like women were excluded from. Right, because they're training, it's all usually based on men, correct? Yes. All the research, all the medical studies, everything was based on men. So not only do we not have enough nutrition knowledge, we really don't have any nutrition knowledge for women. And so all the stuff that I'm saying, for a lot of people, they're hearing it for the first time. I know. Isn't that crazy? It's so crazy. So I looked at the textbooks for menopause, for a perimenopause, like, where is the information about like, hey, we need more protein because

we want to build the muscle. We're losing muscle. We need fiber. The studies are there, but we don't have any instruction around it. So that's really why I felt like I needed to talk about it. to talk about it. What about, so let's talk about HRT because we're here anyway. Yeah. Yeah. Yeah. Yeah. Like, so what's your take on it? Okay. My take on HRT is that we're in a very unique situation in our world right now where we live well past menopause and we want to thrive well past menopause. So imagine right there's every animal in the animal kingdom, if an organ dies in your body, you die. Like you can't live with like something that's, not functional in there. Right. It's like, it's very critical. And so for us to be living 30, 40 years

past an organ kind of invaluting and not functioning properly is incredible, right? So we're in a very unique situation in history. Like we are living longer. We want to do things longer. And so I think that hormone therapy has a role, especially if you're someone who has osteoporosis, if you're someone who has major hot flashes or night sweats because we know both of those things can be solved, like literally solved by hormones. There are conditions that cannot yet be solved by hormone therapy. So osteoporosis can be, hot flashes, night sweats can be, and then vaginal symptoms, like dryness and discomfort can be.

Those things you can actually reverse completely. Hormone therapy. Slam dunk. What we don't have data yet on, clarity, weight loss, brain fog, gut issues. So all of this foundational stuff is still what we need to do for that. Wow. I didn't realize that. Yeah. It's not a magic pill for everything. It's not a magic pill for weight loss or for brain fog or for heart health even. Or for heart health. So that's, that's very interesting because I think that what the, I guess what people are just, are just,

they just assume really, the assumption is that it's kind of the panacea for every symptom. Well, in their defense, like, I think there's a lot of confusion, right? So if you're like, yes, it's good for this, but we're not sure about this. I think it's more like, hey, you should talk about this with your doctor. It's a good option. But like the nuance, I think is really important. Well, life is about nuance. Yeah.

Nothing is black and white. Yeah. Like, why? Like, if you're taking it for weight loss, like, that is not the right reason to be on hormone therapy. And same thing with, like, dementia and heart. There's a lot of, like, new studies like that are like, we have. have estrogen receptors in our brain. That's amazing, but the data is not strong enough. There's

not good data to say, like, you can reverse brain issues or you can prevent dementia or you can prevent heart disease. So what we're saying is like, yes, there's estrogen receptors everywhere in our body and there's some potential there, but we're not there yet. Interesting. So it's not like a panacea. It's not like a cure-all. And I think that I'm super excited. Like I'm really happy for people that are like embracing it more. But I think we need to talk that, talk about that other side. Like it's not like you're just going to take it in your life automatically. It's like shiny rainbows and butterflies and you just not, don't have to do anything else anymore.

Well, that's the thing. Well, and also they say if you don't, if you take it too late. Yes. Then you don't get any of the effects. So no. So kind of like this fear based like, oh shit. If you miss the boat. Yeah.

If I miss that boat. So do I have to start taking it now if I, if I don't want to like basically. shrivel up and die in 10 years. No, I think that's exactly right. The thing about taking it late, though, is more about the breast cancer risk. So when you looked back at that study where they saw a link with breast cancer, it was, there's a couple of reasons that came out. One was people taking it very late, like 10 years postmenopause in their 60s if you're taking

it. Because you already got used to kind of like not having the hormones and then you're adding hormones. It kind of like seems to be linked with hydrates. cancer. And then, you know, that's kind of the reason that even now, if you've kind of gone 10 years postmenopause, that's a conversation that you have to have with your doctor because a lot of times that's like an increased risk. Why? We don't know. We think that maybe your body got used to functioning without hormones then. Oh, so then you kind of like introduce hormones again and you're

kind of puts into overdrive. Exactly. And then the old hormone therapy also used like synthetic progesterone. But if you're not using synthetic, you're using bio, what you? Yeah, the, the, micronized, yeah, progesterone. That still can have the same effect you're saying. Well, so that, if you started really late. Yeah, late. I'm saying, like, if you're saying 10 years late, because your body's not accustomed to them at all. And the thing is, like, the studies are still evolving and still, we're still trying to figure out, like, okay, what is the right combo, what, how many years? So it's not something that's like a slam-down. I said, for those three conditions that I said to you, osteoporosis for vaginal symptoms and for hot flashes and night sweats,

it's actually, there's good data to be like, yeah, the risks outweigh the benefits in most cases. But most people are doing it. Benefits outweigh the risk in most cases. Most people, I would say, are doing it for the other reasons. Yes. It's become really in vogue to be like, oh, I'm like, like, it's almost like how people take peptides and testosterone.

That was my next question. Well, testosterone is one of the things. They put you on estrogen and testosterone. There are people out there, again, like all they're doing, they're showing you, their estrogen patch and their testosterone. I'm like, lady, put it away. I don't need to see anymore. But that's what's happening.

It's become like a badge of honor, you know. It is. I just don't, like, so it's not something that you feel is necessarily like a. It's not a slam dunk. It's not a slam dunk. I think it's a good, I think the reason why people are kind of going overboard on the other direction started out in a good, with good intentions. Yes, like, hey.

The path, the path, what, the road to good intentions or the, whatever, the path. That's right. The path to good intention. That study was so flawed. You know, the women's health initiative was so flawed. Everyone's so scared. And so trying to, like, turn the tide on that. Right.

So we're kind of like, the pendulum has swung so far the other way now. That's right. That everyone thinks that they need to start at 40. At 40. Exactly. Or just be on it, just in case. Because exactly, just in case. Exactly.

And I actually say in the book, I really say, like, I actually, looked into it. Like I was like, okay, what are the pros and cons for me right now? Are you doing them? No. Okay, so you're a doctor and you're a real doctor, a double-certified doctor. What kind of doctor, by the way? Oh, so I did internal medicine. So that's like general medicine, and then I did immunology. So you're like legit doctor, doctor, and you're not on them. Yeah, because I think it's a conversation that you have to think about the pros and cons. Like, I think if I, once I have hot flashes, if I do, great, I'll do it. Once I have osteoporosis, I hope, like, knock on what, like, I would do it, you know, like, vaginal symptoms that are, like, very out of the

order, like, I'm feeling discomfort or dryness, and, like, a vaginal estrogen is perfect for that. So I would totally do that. Like, I'm not against it. But I, when I was talking about it with my friend who was, we were just saying, okay, so the indications, I don't have any of the indications. Can I really uplift, like, my habits, my diet, my lifestyle, my, and really get myself to a place where I feel good? Yeah, I've done it and I think I'm getting to that place. like if someone just asks you like do you need hormones and like the answer is not always yes. Yeah. I mean, I'm not taking anything.

Yeah. And people are always shocked. They're like, you're not taking anything. I'm like, I'm not taking anything. Yeah. And it's great. I mean, and the thing is, if you need it, you should take it. Well, that's the thing. I'm not, I would take it. Like, that's why I'm asking you these questions.

I'm like, listen, I'm more than okay. I'm happy to take it if I actually need it. Yes. But like, I've always had this like this idea in my head. that I don't need it yet. So why would I do it? Just because everybody else is like, I'm not a believer in that. If you're cycling, if you have periods.

Yeah, I do. Then you're, you know, you're obviously your ovulation, that you're having ovarian function. Right too much information for everyone. They're like, oh God, it's like a medical consultation here. But like, and also the progesterone, a lot of people, though, I would say, the one caveat I will say is like a lot of people, maybe you too, including myself, the early signs of parimenopause, is sleep disturbances. And so one of the things that is kind of aggravating your sleep issues is your lack of hormones, including progesterone. So having progesterone here and there,

especially around certain times of your cycle, could help. So I would do that, consider that if you want. So for example, right before our period, our hormone levels dropped like to, like, you know, really, really low levels. And so that's why you feel a lot of, like, that low energy and a lot of people have sleep issues. issues right before their period. And so that is a sign that your progesterone is really low. Progesterone is like our sleepy anti-anxiety hormone. And so that can be used kind of as needed for people and you can even cycle on and off of it. And that can help with just like the symptoms that are starting. But you don't have to be on the patch and you don't have to be in a combo.

You don't have to be on the testosterone. Like that's kind of like maybe like a first step for people if they want to try it. And then the estrogen, really, you know you're in menopause when your periods are really irregular and you're skipping periods or you're going a full, when you go a full year without having periods, that's what's considered. That's what you know. Yeah. Well, all right, lady.

I think I have enough information here. I mean, is there anything else I need to add here before I go watch my daughter do her dance recital? I know. You need to go watch your daughter do her dance recital. I do. I think you need to just like every woman. probably listening to this or most women listening to this, you need to give yourself permission

to recover and get that cortisol down. Maybe go, do you know, like, when you go on vacation and how you sleep so well? No. You don't sleep well on vacation. Vacation? Oh, stress. Yeah, I don't know. I'm teasing.

Yeah. Yes. I know I'm supposed to be sleeping well on vacation, all these things. So, like, give your body a little vacation from everything you're doing. And even though, like, and a vacation doesn't mean you're lying on the couch. It just means that, hey, I'm not. I'm not going to like over-caffinate. You don't drink.

So like you're someone who's drinking, like, you might want to cut out, cut down the alcohol. Maybe you really concentrate on getting more protein and fiber and fermented foods to calm yourself. Maybe you allow yourself, you know, figure out how to take that little nap or add 20 minutes to your sleep schedule, however you can fit it in in the week. You can't really sleep more than 20 minutes at a time extra. So like if you wanted to try to sleep a little extra, it would be like 15 to 20 minutes more than what you do. and that's how you kind of like retrain your body. What you should give yourself permission is like to recover. So give yourself a cortisol reset for three to five days and really get that cortisol under control.

That's going to change your life. My God. Okay, I'm going to try that. Okay, Dr. Shah, where else do people fall? Okay, first of the book again is called hormone havoc. Where people can find you on Instagram. You're like very, very popular. Totally very active on social.

It's at Dr. Amy Shaw on Instagram and TikTok and then it's amy-mdwellness.com. I love it. Well, thank you for being here. Thanks for having me. That was fun. I was so fun. Thank you. Thank you. Bye-bye.