The Livy Method Podcast - Let's Talk Hormones and Weight Loss Part 2 with Dr. Olinca Trejo - Spring/Summer 2024

Episode Date: June 6, 2024

In this Guest Expert segment, recorded on June 6, 2024, Gina talks hormones (specifically menopause) and weight loss with Dr. Olinca Trejo. Dr. Olinca is a licensed, board-certified Naturopathic Doctor in the province of Ontario. She also holds an honours degree in Kinesiology and has achieved her certification and internship in bioidentical hormone replacement therapy (BHRT).You can find the full video hosted at:https://www.facebook.com/groups/livymethodspringsummer2024Topics covered:Perimenopause, menopause, and postmenopause defined. The Menstrual Cycle explained. Estrogen, testosterone, and progesterone: their place in the orchestra of hormones. Signs and symptoms of the perimenopause transition. Weight Changes as #1 clinical presentation for perimenopausal women. What is it about perimenopause that leads to weight gain? The state of our body before we start the transition impacts our experience of it. Loss of muscle mass - a negative influence on health as we age. "You want to be strong, not thin!" Estrogen and the "menopause belly." Fibre is your friend - how The Livy Method helps you address the transitions you are going through. Supplements for perimenopause depend on many factors. Factors for losing weight when in perimenopause and postmenopause. Postmenopause - The fix is the same! Protein: Important for muscle mass, brain, and bone health. Aging without estrogen: how exercise can support overall health and well-being. Resiliency reduction: a pressure cooker of changes in the brain. "No. Not today. You should have picked a better hormone day!" Gimme the test! The importance of collaborating with your health care providers and follow-ups. Educating ourselves: learning about our body and the perimenopause transition. Gimme the drugs! The use of antidepressants and menopause hormone therapy. Hormone replacement therapy - a classic study discussed and implications for treatment. Is it too late to start menopause hormone therapy? Gimme the cream! Estrogen cream for vaginal health and support. Yes, you can thrive! The Livy Method can help you be the healthiest version of you at any life stage. Ask Dr. Olinca Anything - a series is in the works to dig deeper. More info will come! Thin is not a measure of your health - the scale is always just a tool! You can find Dr. Olinca at [e-mail] learn more about The Livy Method, visit www.ginalivy.com. Hosted on Acast. See acast.com/privacy for more information.

I'm Gina Livy and welcome to the Livy Method podcast. This is where you'll have access to all of the live streams from my 91 day weight loss program. With a combination of daily lives, guest expert interviews and member stories, there is something new almost every day. Miss the morning live? Want to re-listen to one of our amazing guest experts? Well, this is the place. This podcast is hosted on Acast, but it's available on all podcast platforms, including the one you're listening to right now, Spotify, Apple,

and Amazon Music. You're going to have this ability to now reframe. Allow yourself time throughout the day to stress the fuck out. The thoughts and the feelings and the behavior cycle can start changing. Menopause, perimenopause, big, huge, massive conversations taking place right now. We obviously specialize in weight loss. We want to have this conversation specifically geared to people trying to lose weight. I don't even know where to start with this, although I know we kind of started in our part one of this series just a couple of days ago. If you want to check that out, it's available now over on our podcast, The Living Method. If you're in the Facebook support group, it is also stored in

the guides. Welcome Dr. Alinka Trejo. How are you? I am so excited. This is my favorite conversation that we have. So buckle up people because it's going to be amazing. Me too. And I'm trying to be calm about it because you know, I love going down the rabbit holes of this conversation. Okay, first I want to start with, so there's perimenopause, which under my understanding starts around, you know, age 35. I may be incorrect about that. And then there's up until menopause. Now, menopause under my understanding is when you haven't had a period for a whole year and that's like you're in

menopause, but then there's like post menopause. So should, should we define them first before we get started? Absolutely. Okay. So menopause is a single day in your life. It is defined by one year of periods that signifies that your ovaries have sailed off into the sunset and they have died. And so before that one day, you're actually impairing menopause, which actually can last anywhere between seven to 10 years before that last menstrual period. And after that day, you're actually in post-menopause. Yeah. Because everyone's like, I'm in menopause. I'm like, menopause is like literally just one day after that year that you've missed your period. And then you're in post. Cause then people are always like, well, what about me? I'm post-menopausal. How does this fit? Like, what's the discussion there for me? So, okay. I think that's so important even just to be able

to have the conversation or understand the conversation that's happening a hundred percent okay so where do we start early signs and symptoms of perimenopause yeah so you know why don't we start with just like the basic um I guess like physiology of a human or a female's actually cycle so that people understand actually then what happens in perimenopause, I guess. And I'll just make it super simple. When you hit puberty, what will happen is actually, you know, you were born with all of the eggs that you're going to ovulate, right, for the rest of your life, which is about anywhere between one to 2 million eggs at birth. And what happens is that your brain loves estrogen and your brain is constantly just

like searching for estrogen in your bloodstream. And when that actually gets really low, it sends a signal actually to a center in your pituitary that says like, Hey, our estrogen is really low. Like, can we get some eggs in here? I think that we can get pregnant. And so then there's a signal actually that comes to your ovaries. And there's a bunch of little follicles that run this race to be like, I want to be the one. No, I want to be the one. No, I want to be the one. And so there's actually thousands of follicles that your body recruits in order to try to ovulate, right? And so it's actually that ovulation that increases that estrogen because, you know, as the follicle is growing, you're producing more

and more and more and more and more and more estrogen. And when there's that one or maybe two eggs that are ready, they get triggered and they get released. All of the other thousands that were, you know, in the race as well, they all shrivel up and die. And then as it gets released, the little casing that the egg comes in is called the corpus luteum, starts producing progesterone. And that actually signals the second phase of your cycle right which is the luteal phase if you do not uh conceive so if that egg does not see a sperm within 24 to 48 hours of being ovulated and the your brain is like well then maybe this time and then the lining actually and all your hormones kind of drop because we're like okay well better luck next week

and so then the the estrogen drops your progesterone drops and all your hormones kind of drop because we're like, okay, well better luck next week. And so then the, the, the estrogen drops, your progesterone drops. And again, your brain is like, I don't like these like low levels of estrogen. And then the cycle starts again, right? But it's, it's very predictable. It's usually within 28 to let's say 32 H days. And there's that consistency, right? That goes up and down and up and down and up and down. And so then if we talk about numbers, right, that we're talking about eggs, if we start with one to

2 million and we're recruiting thousands of them, by the age of about 30, you've lost about 90% of them. By the age of about 40, you've lost about 97% of them. And then things are getting tricky, right? Because now your body is trying like it's sensing that you're like uh-uh there's like not as much reserve and things are getting a little bit a little bit less um controlled and a little bit less consistent and it's this loss of consistency that actually ends up causing havoc in your body because what will happen is that your brain starts signaling this like low estrogen and it tells the pituitary like, what the hell, man? Like I told you to produce estrogen and the

pituitary is like, I don't know. I don't know what you want to do. Like I told the ovary. And so then there's this haphazard release of hormones where your ovary is trying to ovulate, but it's running out of eggs because now we're at a thousand eggs left over. Right. And so then it literally, your estrogen can go up and down and up and down and up and down and up and down. And often we don't actually have eggs that we ovulate every cycle, which then means that we don't have that steady, nice release of hormones at any point in our cycle. Okay. This is really important because what is really happening is your body is trying really hard to keep you fertile and for you to essentially have eggs to procreate. Like this isn't your body trying to screw you over,

work against you. It is like, okay, based on our conversation a couple of days ago, part one, hormones are chemical messengers in your body, right? Telling your body what to do. So you have these eggs, it's time to release and fertilize and your body thinks like, this is what you want to do. So when that isn't happening, as ideally as it had been happening, your body tries to compensate or figure out a way to keep you as fertile as long as possible. Correct? Absolutely. And the problem is that your ovary honestly just doesn't have like the eggs anymore, right? Once you start getting into perimenopause and it's not like your hormones are your friends and they want, everything wants stability. We talked about the hypothalamus, like really loves everything

consistent and stable. And so you can imagine that this haphazard release of hormones creates havoc in every single one of your systems because every single organ in your body has hormone receptors from your heart to your joints, to your bone, every single organ. And so in this transition, when you're starting to get these like up sent down some estrogen and up and down the estrogen, it can feel like you're going crazy because it feels like everything is off and you can't put your finger on it. And the challenge I think that we've run into perimenopause as well is that there are cycles that we can test you for your hormones. Cause you, you know, it's very common. You go to a doctor and you're like, honestly, I think it's my hormones and you go and get for blood

work. And if I catch you on a cycle that your ovary was like, Oh my God, we found an egg. Look at this. This is amazing. She's going to release it. And like, we're going to make a baby. I can actually test your hormones and they look like you're 30 years old because you found that one egg that got ovulated. Right. But if I had tested you two cycles after that, when your ovary was like more eggs, more eggs, more eggs, it can actually look like you're postmenopausal. And so I think that the hard thing about this conversation has been that we used to define perimenopause as there's changes in your cycle that happens, right? Whether your cycle starts getting longer, so they get fewer and fewer,

like, you know, fewer and fewer in a year, it starts getting shorter, the bleeding, like, changes, like something starts changing about your cycle. But that doesn't have to be the case. And now we're putting more funding and more understanding into it. We know that we're like, oh, we might have gotten it wrong for a little bit. Okay. So someone in the group the other day was just like, well, I'm old. I don't menstruate anymore. Like, is this hormone conversation even relevant to me? So there's over 50 different hormones in your body that are moving around around messaging, this is what we're supposed to do, or whatever. Are we really just talking to here that are fucking with everybody else,

like estrogen and progesterone? Is that the two that are causing the problems? You say hormones are like an orchestra. And, you know, if one of the, you know, instruments is, or, or, or part of the band is like going crazy singing its own tune. Is it, are we just talking two here? We're mostly honestly talking about three. We're talking about estrogen and there's, there's about five different types of estrogen, but estrogen, progesterone and testosterone. But the problem is that estrogen, for example, that deficiency because of that orchestra, right? We actually know that in the perimenopausal transition, I'm going to loop it back to our conversation on Tuesday, that those changes in estrogen will impact things like your dopamine, your serotonin, your ghrelin. Actually, we have really good evidence that says like those ups and downs

of estrogen increase your ghrelin. And so that's actually part of the reason as to why your appetite increases in perimenopause. Right. So yes, they're the ones that kind of like with a cortisol, you know, with the plates, like they're, they're the cowbell and they're the trombone and they're the ones that start going crazy and they, they create havoc with everything else. And so it is those three that are driving this, but it's causing a cascade of problems with everybody else. Yeah, I think that's really important because, you know, all the people who are in perimenopause, menopause, postmenopause, they're waiting for the answer that was really covered in the conversation we already had when we talked about stress hormones, you know, cortisol and insulin and

your hunger hormones, the leptin and the ghrelin and how, you know, cortisol and insulin and your hunger hormones, the leptin and the ghrelin and how, you know, lack, if you're stressed out and it can affect your sleep, if it affects your sleep, you don't get to get sleep, it affects your hunger hormones. And again, this is why the Libby method, you know, I preface this whole conversation by saying you're already doing so much to, for a lack of a better word, I don't like to say balance your hormones because they're not really ever in balance. They're always in flux, but to address your hormones, especially because you're like, well, how do I lose weight? How am I going to lose weight? So you're probably waiting for do HRT, do this, do that. But there's so much you can do because these three hormones

are affecting all of your other hormones. So it's not just a matter of just addressing those three. It's addressing all the other ones that have gone wonky because of those three. Correct? Is that a good way to say that? I couldn't have said it better myself. Okay. Yeah.

Okay. All right. So should we go to signs and symptoms? Because I hear people are talking about their flow, heavy flow, light flow, painful flow, missed the flow. Like what are, in your opinion, what are the signs? Because a big conversation that's having right now is anxiety, the mental part of it. We think, oh, it's just, you know, missing your period and having some hot flashes, but it's so much more than that. It is. So statistically speaking, about 90% of us are

going to have some sort of bleeding change, whether it's the frequency, the intensity, the like clotting, the pain, something is going to happen to 90% of us. About 85% of us are going to experience vasomotor symptoms, which are going to be hot flashes and night sweats. But I will tell you clinically, and every clinician will tell you probably that usually what we start seeing before we even start seeing the bleeding changes and the hot flashes and the night sweats are going to be things like changes in mood. And that actually happens because estrogen loves and brings almost into your brain, serotonin, dopamine, and norepinephrine, right?

And so when you have this haphazard release of hormones, what will happen is that, again, your serotonin is going to be all over the place. Your dopamine is going to be all over the place and your norepinephrine is going to be all over the place, which is actually where the mood changes come in. We actually know that women through this transition are about 50% more likely to develop some sort of mood disorder. And the use of SSRIs actually doubles across this transition as a result of it, right? Now the conversation is different of being like, do we try SSRIs? Because honestly,

we should probably be having a conversation about menopause hormone therapy instead but I'll leave that there um with the dopamine component we talked about this on Tuesday right that this is also why in this transition we experience like a lot more cravings we experience like this feeling like I just you know that you get addicted to social media you're scrolling a little bit more you want like the sugar and you want the fats and you want all of those things. Right. Because your brain has, again, this like inconsistent release of hormones. Why you also lose a lot of your focus in your cognitive function, because in your prefrontal cortex, which we talked about on Tuesday, there's a bunch of hormone receptors that then, especially for like norepinephrine to be honest and like serotonin

you can't focus like you have this like brain fog you you if you haven't had a diagnosis of adhd um you actually are significantly more likely to be diagnosed in this transition because of the cognitive impact that happens um another one that we see very often actually is fatigue right and we see the low mood and the low motivation as a result of it. But 90% of the time, honestly, what we see in our office is weight changes. Yes. Like we and it is the I am doing everything I'm supposed to be doing and everything that I've done before. And I just like my my close fit different, even if the scale says that I'm the same weight, my body is changing and I don't understand why.

That's typically what I see in that like seven to 10 year window before we even get into the bleeding changes and the vasomotor symptoms. Now there's, you know, there's the like joint pain and the, the, uh, tinnitus and the vertigo and all of the other ones that we can spend the entire day talking about. But I would say that those are typically the other ones that we can spend the entire day talking about. But I would say that those are typically the top ones that I see in my practice for sure. Okay. Let's focus in then. Why the weight gain? Why? Because I think it's important to understand why so that you understand what you are currently doing by following the program to address it.

And then what more you can do so why the weight gain huh why well this is where things get interesting okay so there are a couple of things that happen in tandem at this time right there is a the fact that we're aging um and outside of the menopausal transition you know if i was to uh even like do this with animals and, you know, take out, take, take menopause out of the equation. We actually know that we probably gain about one to three pounds per year in like midlife. Right. Because your metabolism will start slowing down naturally by about five to 10 percent every decade after you turn 40. And that's both for men and for women, because men also start losing testosterone actually after the age of 40 at about one to 2% per year, which is actually where they get their metabolism from. And so we're aging. Can I just say for a second, a big part of that though,

is because people are like, Oh, my, my, I'm just going to get, you know, just going to get fatter as I age. A big part of that is because you tend not to be as active. A big part of that is, especially for people who've done diets, you know, years of dieting that their body has just learned to store and slow down on top of that. Right. So I don't want to take away here is like, Oh, well, you're just going to gain weight year over year over year. And that's just going to be how it is when like, that's doesn't have to be how it is. So no, I just want to say, no, no, no, no. This is why you're here so that we can fix that part of it. Um, and then the second part that happens is that then we start getting this haphazard, uh, hormones, like hormone production, right? Through your cycle and how

that's going to impact you is twofold. One, it's going to impact the way that you feel, right? So what will happen is that your sleep gets disrupted. We actually know that about 40 to 60 percent of women going through this transition will develop insomnia. And about 42 percent of them will experience chronic insomnia when they reach postmenopause. Right. We know that women are about 2.5 to 3.5 times more likely to develop sleep apnea. And if you haven't listened to our sleep conversation, you have to go back and listen to that because we actually know that that on its own will have its own independent impact on your hormones, right? On your cortisol, which we've talked about, on your insulin, which we've talked about. And so that on its own is going to predispose you to gain the fat, right? When you don't feel well, you don't move. And we have data

that says women in premenopause walk about 3000 to 5000 steps less. Well, I think, you know, my view of this has always been, it's not necessarily the change or the transition that our bodies are going through. It's the state in which we start this transition and where we are at in our lives and what are we doing while we're going through the transition. High stress, lack of sleep, long periods of time without eating, starving, depriving. I think more than ever, this is a big conversation because more than ever, we are more stressed than ever. We have something going on all the time. You know, we, we talk about self care and self love and all this stuff because we, we weren't, or we don't continue to take care of ourselves in the way that we did maybe when we were younger,

we were more active. We had more, you know, obviously people get jobs and families and there's, we have to take care of our parents. You're not me yet, mom. I don't take care of you yet, mom. Still taking care of me. But would you say that's fair to say? Like if people reflect back on their weight journey and all the stress that they've been in their life, is that where they'd be able to say, okay, my body's a little broken down going into this transition, which is probably why I'm having a harder time managing it. How you show up in perimenopause to an extent will help, will help guide the severity of your symptoms in this transition. Okay. What can, for our younger listeners,

what can our younger listeners do to prepare themselves for this transition better? Ooh, this is a lot of question. Honestly, listen, and we're going to get into all of this a little bit later when we talk about exercise and muscle mass. But I think that if what you want to remember about estrogen is that estrogen is one of the most potent anti-inflammatory anything in your body. And in this transition, you're going to lose all of that benefit, right? And so the number one thing that is going to impact your inflammation at any point in your life is going to be your diet.

That's going to be the number one thing. And so choosing whole foods that are also going to help balance your leptin, your ghrelin, your dopamine, all of the things that we talked about on Tuesday. Right. So living the living lifestyle that no, honestly, but that is actually what you want to focus on. The other thing we're going to talk about this next in the body composition. Right. I think that for all of our lives, we've seen thinness as a social currency. And we have exercised to be thin. We have eaten to be thin. We have lived our lives with a sole goal of being thin because that traumatized your body through all of the yo-yo dieting, having absolutely no muscle mass because you gave that all up.

And when you understand that your muscle mass is where most of your metabolism is coming from, right? That is the most metabolically active tissue at rest. And up until like the age of 30, you are able to build and build and build. And you in your 30s, you peak your muscle mass. And then after that, all of us, all of us start losing a little bit of muscle mass as we age. And so then the problem is that in that four to I'm going to say like four to seven year window that straddle that last menstrual period. So that, that one day of menopause, for whatever reason, your muscle mass or the muscle loss actually declines really, really, really quickly. Because estrogen is also best friends with growth hormone, right? And so it just takes it with it.

And growth hormone is actually the one that helps us build the muscle mass. And so the most important thing outside of your diet that you can do to fight this is actually fight that muscle loss that's happening to everybody so that when you show up in perimenopause, your baseline muscle mass is significantly higher. So it doesn't matter what people tell you about being thin, you want to be strong. You don't want to be thin, you want to be strong. And so this is actually why I always talk about your method saying like, this is about fat loss. It's not, which is going to be to an extent weight loss. Right. But like, if I could go back to, I think you read a question on Tuesday about a lady that said like,

what if the number of the scale causes me stress and I can't necessarily move. Right. I think, I can't remember what it was, but it was, and I, yeah. And if I could go back to that, I would say to you, like, it honestly is not about the number. It's about like how all of the other things that you're doing in order to go through this transition smoothly, because when you're 80 years old, you're not going to look back on this stuff and be like, oh, God, I am so glad I've been into those like two pants, you know, size two pants. And you give up all your muscle mass in order to get there. Yeah. As soon as I asked you that question, I was like, Oh, they just need to do the living method. Right. But really this is where the living method, you could do the living method just to,

to, to get healthy. Right. Um, it's, it's interesting because, you know, I, I, I believe you do not have to exercise in order to lose weight. I mean, I've never met anyone who needed to exercise. You definitely have to be active. You have to move your body, but I've really come to respect resistance training. I've been a personal trainer since I was 14 years old and I'm 51 now. I've come to really respect the importance of, um, increasing your, and maintaining your muscle mass, especially in menopause. Yeah, I think it's one of the most effective and important things to do if your weight is an issue if you're carrying it in that midsection specifically, because that that decrease in muscle mass as you get older and when

you diet. So as we talked about in our previous conversation, when you're dieting, the body learns to store that fat and will not give you access to it. And as you get older, you're losing that muscle mass if you're not working on maintaining your muscle mass. By dieting, you are basically eaten away at your muscle mass. So when you go through this transition, that is where you see the menopause. That's where menopause belly comes from. Essentially. Yeah. Cause I mean, from a, from a physiological standpoint, estrogen, estrogen doesn't cause weight gain. What estrogen does, if you think about puberty, estrogen just guides fat where it's supposed to go,

right? So estrogen will actually guide your fat to that gluteal femoral area, you know, your hip, your butt, your thighs, which is anti-inflammatory. And so when you actually start getting this haphazard release of estrogen, right, that's going to one, expedite the rate at which you're losing muscle mass, but two, you lose that protective mechanism of estrogen that is supposed to be guiding that fat away from your belly and into that gluteal femoral area, right? What's going to happen then is that all of your fat is going to go to your belly. And, you know, what is specific to menopause and the weight gain is actually, it's more metabolic than it is actually, it's weight gain on the scale, is that we tend to increase our visceral fat, which is the

inflammatory part of the fat. And there's a 15% increase in visceral fat in women. We go from about 8% visceral fat in our 30s to about 23% of visceral fat without any changes in lifestyle, diet, exercise, and anything else. So huge. If you are listening to this, rewind it and listen to it 10 times over. When your body is storing that glycogen, it stores it in your liver, in your muscle, and in your fat. If you do not have your muscle, it will go to your fat. And that visceral fat that you're talking about, you cannot exercise and diet that off. That's not how that's done. It's completely different than the way your body stores fat and different types of fat in your body. So that visceral fat is different. You're not going to diet that menopause belly off. This is where you have to manage your stress and your sleep.

And yes, move your body, eat those whole foods. That is where the living method comes in. That's where the living method comes in. This is why weight loss for a lot of people is so much more than what you are eating and when, you know, and we have actually data that says that women that are consuming minimum 25 grams of fiber and i think up to i think they max out at like 30 i can say 35 or like 37 or 37 grams sorry women that consume more fiber and not from supplements from whole foods right because a bunch of stuff that gary with them like a lot of anti-inflammatory things. Women that consume more fiber tend to have less visceral fat, even in this transition, right? And so it's actually that estrogen loss,

because if you go back and listen to our conversation from Tuesday, and we talk about, you know, the belly fat and all of these things, but it's that estrogen loss and that increase in fat that will increase your risk for developing metabolic syndrome, cardiovascular disease, insulin resistance, all that stuff. And so up until, you know, that menopausal transition, estrogen actually protected our hearts. And then when you lose that estrogen, your risk of cardiovascular disease actually age matches that of men's. Whereas before that transition was about half. Just wild. Fiber, I've been saying lately,

is like definitely an underrated conversation. The reason why I'm not too concerned about having it is I know if you are following the Livi method and you're eating your veggies and your fruits and your whole foods and your grains, you are getting that fiber in your diet. Okay. And this is why it has to be a lifestyle right so it's like this is actually why it's not that like i just do this once and then

like we move on and i fit into my uh you know size two jeans and this is why this is like a lifestyle because it is so important to never give up on these basics that we're teaching you. Okay. Can you, uh, someone was asking, can you increase your estrogen? Is there a way to increase your hormones or you have what you have? You get what you get? Like hormones? Like, yeah. So, I mean, honestly, it depends as to where you are in that spectrum of, you know, I guess like your fertility window, I guess. Because if you've reached like the perimenopausal supplements work on the premise that we can still get your ovaries to produce stuff on their own right because i even though there's a little bit of phytoestrogens from food like soy and strawberries and like all of these things

um they work on the premise that like i can get your ovary to be like come on you guys like give me one more push. And there are things that do that for sure, but they don't work consistently, I will say. And sometimes they they stop working, right? Because then your ovary is like, we tired, man, like, we just can't do this. And I think that you also again, this is such a big conversation, because your estrogen, for sure, in this transition is the main driver. But before this, your estrogen also gets impacted by a number of things, right? Like your cycle gets impacted by your thyroid, by your cortisol, by your sleep, by all of these things. And so it's hard for me to say like yes or no because it's such a big conversation.

And yes, directly and indirectly, but it depends on the timing and what we're trying to achieve with it for sure. Okay. It's about being as healthy as you possibly can be at any given time. Really. And, and you, it's really just kind of prolonging the inevitable because eventually you're not going to have that estrogen anymore. Yeah. And you know what I, when I always say like how you show up in this transition is going to dictate the rest of your life, I really mean it. Like we're going to live a third of our lives in postmenopause, right? And so how you show up in this, because now you just don't have the protection of estrogen

and what you've done up until now and what you decide to do with this time is legitimately going to dictate your health span, not your lifespan, but your health span. And so this is actually why things like sleep and diet and all the bases that we sound like a broken record, but like why, if you were able to get away with murder in your twenties and you were like not sleeping, you're partying and like all the alcohol, they're like, Oh my God, amazing. I was like scrolling through. You can't get away with it anymore. You just can't because physiologically you don't have the anti-inflammatory benefit of all of these hormones. Okay. I want to talk about testing. I want to talk about medications,

but first I want to say, how would you answer? Okay. Gina, I want to do your program, but I have hormone issues. How am I going to lose weight? Like, what is your, what's your response? People want to know, tell, okay, great. Dr. Alinka, I'm listening to you guys. Hear me. How do I lose weight? My answer in my clinic is like, follow the living method and come back in three months. So I, I mean, but let's say it out loud. Let's, let's say it out loud. Following the living method, follow, but let's break it down. Let's say it out loud. I think we need to say it out loud. Let's say it out loud i mean the visceral fats right that we're talking about the metabolic risk is going to help with a lot of the hunger hormones and satiety hormones that we talked about on tuesday it's going to help your microbiome because we actually

know that in this perimenopausal transition there are changes in the diversity of your microbiome that happens which is wild and like our microbiome women, it is a lot more diverse than men's. The moment that you hit this transition, it actually loses the diversity and you end up with a similar microbiome. That's like not as diverse as a man, right? That is from like diet alone. You're taking out like a bunch of the processed foods and the sugar and a lot of the gunk that we actually know is the worst for your ovaries. It's inflammatory. And legitimately, we have data on this. Women who eat an anti-inflammatory, and I'm going to quote Mediterranean diet because this is what the living method is. It's like lots of color, whole foods, nuts and seeds, fish, oils, all of these things, right? So they tend to actually

go through the menopausal transition about a year later, which actually means that the anti-inflammatory component of your diet is, is preserving your ovarian function and the quality and the number of your ovaries to an extent for about a year. Okay. I just got sidetracked by a conversation. I think, um, Kim, who's listening, like we talked about perimenopause is the stage up to menopause. Menopause is one day after you've missed that cycle. The rest is post. So if you are carrying excess weight because you are in post menopause, the fix is the same. Is it not? Yeah. Yeah. We're going to get into medications you can take and drugs you can take but the fix is

the same i think it's so important because the postmenopause are always like well what about us and what do we do and it's like it's the it's the same for everybody because your hormones y'all are all fucked up and we got to address those right and your body's broken down you have the same loss of muscle mass right like you don't it's not it's not like you're in a special category same thing with the perimenopause and the menopause and the you know we're all in our different camps it's all the same fucking thing is it not yeah and i mean it's all the same principles right the the yeah the principles for diet are going to be the same regardless as to whether you are showing up

into perimenopause you are in perimenopause or you're in postmenopause right because like we you just slept through that day of menopause the next thing is it's going to be sleep like i mean go back and listen to our conversation about sleep but sleep on its own and i i just talked about that uh a little bit earlier in postmenop specifically, because we're talking about postmenopause. I want to bring them into the conversation. About 42 percent of women. In postmenopause suffer from chronic insomnia, so you got to fix your sleep because like outside of estrogen, that's impacting your insulin, your cortisol, your ghrelin, your leptin, your dopamine, your everything else, right? So it's not that like, just because you don't have estrogen, it's like, Oh, well, the principles of sleep hygiene don't apply to me. No, no, no, no, no,

you become more sensitive to the to, you know, the loss of sleep, your sleep becomes lighter, you know, you it becomes the architecture becomes a little bit more broken up and you spend less time in that deeper sort of sleep. And so if nothing else, you actually should be working harder at a lot of the lifestyle stuff that you and I talk about because you lost the protection of those hormones. And so all of the things that you were able to get away with, including alcohol, you probably can't because if you, in postmenopause, right? If you choose to drink alcohol right before bed, you probably can't because if you impose menopause, right? Like if you choose to drink alcohol right before bed, you're choosing not to sleep. Yeah, truly.

Yeah. I want to just take it back. So far you've covered diet and sleep. So you talked about whole foods with the diet, but what about protein? Because I mean, with the program, people are getting enough protein on the diet when they talk about protein and menopause or it's so, it's so complicated because they use that catch all menopause for everything. You're either in those, all those different camps. So then they use menopause, which is like one day. So what about protein? Now you have to understand that when people talk about making sure you're getting enough, I think they're basing that on most people are doing a diet, trying to lose weight, eating less, exercising more, and not paying attention to protein on the Libby method.

People are paying attention to protein, but how important is protein in your diet when it comes to your hormones? Oh, I mean, when it comes to your health in general, right? Like the, the, the one, if we go back to the conversation of like what it is that you can do to show up in perimenopause and we're talking about muscle mass, your muscle mass is going to depend obviously on like the load that you're putting on your muscles, the resistance, obviously, but also how much protein you're eating and making sure that you're eating adequate amounts of protein. The other part of protein that people forget about is that protein is just as important, if not more for your bone health than calcium is. Okay. And so in, you know, what you need to like, for me, and any patient that's listening knows this, my greatest fear in life outside of spiders is osteoporosis because about 50% of us will have a fracture before we die. But the mortality, like the one year mortality rate, if you have surgery for that is 30%. The one year mortality, if you don't have surgery, it's about 79%. And if you survive it with, you know, the surgery and all of that stuff,

most of us end up with chronic disabilities, right? And the thing is, is that osteoporosis and a lot of things that we're talking about post-menopause, because we're trying to bring these girls in the conversation of being like, does this apply to me? Osteoporosis is preventable for most of us. And so adding in that protein, yes, it's important for your muscle mass. Yes, it's important for your brain. Yes, it's important for your muscle mass yes it's important for your brain yes it's important for your energy but girl it is super important for your bones so is post-menopause a conversation about is it more aging like do you know what i mean like perimenopause is transitioning. Is postmenopause the conversation? Because I'm thinking about all the conversations we need to have with hormones,

we need to talk, we need to address the males, right? We need to, they need to understand what's going on with their hormones as well. But what about, what about aging? Like, is postmenopause more of an aging conversation when it comes to weight? Like, is that a different conversation? Um, I mean, it is a conversation about aging because it's happening to all of us, but it's also aging without estrogen, right? I mean, honestly, your endocrine system, especially your ovaries age about twice as fast as anything else in your body. Even, even from an aging, like vanity standpoint, because like, who, who doesn't get interested in that? Like in those five years in that, like the five years that straddled that last menstrual period, you lose about 30% of your collagen. Yeah. And it just has to do with that. Exactly.

A hundred percent. That's actually what we're trying to do. And that also for your bone health, but it's, um, and so it is the aging that happens significantly faster, I would say, because of that loss of estrogen. Okay. And so, and we don't have testosterone, right? To like, like the testosterone that like the 60 year old males have to protect us against a bunch of things. Um, and, and the other thing that I would say, I mean, that we go back to is like exercise, making sure, I mean, that we go back to is like exercise, making sure I mean, movement is super important, even if it's like exercise snacks that I always talk about them. We're like, you know, you're doing little bouts of movement through the day.

And you're right, like exercise, actually, when you look at the data, exercise is better for maintenance and for health span than it actually is just for weight loss. And the exercise that we talk about in weight loss, and we have talked about in the weight loss industry up until right now, it's been like cardio, cardio, cardio, cardio, cardio, cardio, cardio. And guess what? A lot of the times, especially in combination with dieting, that eats away your muscle mass.

And it's actually been shown to increase a hundred percent. It actually increases your subcutaneous fat. If you don't like feed your your body properly right so the resistance training the movement adding in you know uh mobility and balance exercises to make sure that you live a healthy life without a fracture like all of these conversations are actually so important so so important okay so did a diet. We did sleep. We've done exercise, especially resistance training. What else? Yeah. Um, stress. Yeah. Stress is a huge one, but I'm like, well, I'm looking at the time being like, okay, how long do you have? Um, yeah. Yeah. Anything else

that you might factor in? Cause I do want to get into testing and what to do. Yeah. So listen, when you lose the estrogen in your brain, that ends up taking away a bunch of your neurotransmitters, right? There is going to be changes that happen in your mood and your memory and like pretty much every organ. If you come into my office and you're like this, this, I had an asthma flare up and I've never had asthma before. I'd be like, it's probably the estrogen going crazy. I've had the estrogen going crazy. But with your brain, what we see is that it's not just that you're more prone to things like anxiety, depression, irritability, cognitive decline, brain fog, all of these things. We're talking about the transition, right?

Because it's that your brain likes things steady. And at the beginning of this transition, when all of your neurotransmitters and your estrogens, your brain also feels like that, which is actually why you feel the way that you feel through perimenopause. But the one thing that actually happens to all of us, even if you don't experience the mood changes, is that we lose a lot of the resiliency that we had before. Yes. And we just it's almost like you're in this pressure cooker, right? And you and I talk about the pressure, the stress sandwich all the time, right? You're getting stressed from above, from your parents that are aging,

stressed from below because your kids are like growing up. And to be honest, this is supposed to be like the best time in your life. Like in your career, probably you've like achieved greatness. Like you, the kids are like leaving the home. So you're like going to start Like you, the kids are like leaving the home. So you're like

going to start redating yourself and maybe your partner. Like there's so many things that would be beautiful with this transition, but most of us feel like shit. And we, and then what happens in this pressure cooker, right. That you have is that like, if you start the day being like, I'm going to kill somebody because I don't have enough serotonin in my brain. And you're like, no, it's okay. Like it's just your hormones, just your hormones. And as the day goes on, you literally get to the end of the day and you're like, I swear to God,

I'm going to slash somebody's tires. Because you just lose your ability to cope with stress is so impacted by this haphazard release of neurotransmitters as a result of the crazy hormonal part that's happening in the back. Now your brain to an extent gets used to this after you hit that menopause. But during that time, legitimately, there's like even MRIs that show that your perimenopausal brain does not take up as much energy as it did before. And so stress is important to stress management,

because you just don't have the tools i mean you have the tools but sometimes you don't even know how to access them because of where you're at yeah because so our stress levels are through the roof and yet we're less resilient to our stress i thought this was like pandemic related for me it probably was because i used to be like a so easy going la la la chill person and now i like was like rager I was like anxiety stress raging and though this is where I'm wondering if like this is where exercise is important getting sleep is important and meditation is important and calming down your vagus nerve is important how many strong microbiome is important I've been doing those things today I was driving my kid to

school and I was going around a recycling truck. And this guy could see like I was like around and they just speeds up and sits in front of me. And I was like, get out of the way. I just was like, nah, I'll be here all day. And I gave him this look of like, honey. And he just looked at me and then he like backed up. I'm like, that's right. I didn't even look at him. I'm just like, no, just not today. Not today. Not today. Yeah. I should have made

the different estrogen day. Yeah. Okay. So testing it's been my, I'm it's my understanding that there isn't really testing because your hormones are always such in flux. It depends on what time of day that you are testing. You have to get tested again and again. I'm sure there is a very thorough process that you can go. Then they can put you on something and then you have to see if that works and then they have to change it to something else. So it's, it's not an easy fix to go to your doctor and be like, test me a hormones, test me, give me something. What can we do? What should we be asking for? Is there like saliva test, pee test, poo test? I don't, whatever kind of give me the test. What can we do? Um, yes, there, there there's blood work there's urine and there's

saliva tests right uh none of them are great in this transition none of them because your hormones like i said to you before one cycle because all of your your hormones really need to be tested either on day three of your cycle or about seven days after you ovulate assuming that you ovulate and so you can see the problem with both of those, because if on day three, your brain is like more hormones, all of the hormones that we actually test for diagnostic criteria. And I'm going to put that in air quotes, which are actually the ones that are trying to stimulate your ovary, right?

The main one is called follicle stimulating hormone, which actually comes from your endometriosis to try and stimulate your follicle and recruit more follicles. And so when it's really high, it means that you're running out of follicles to recruit because you're running out of eggs. The problem is that in one cycle that can look like it's like 75 and we're like, oh, God, yeah. I mean, it's like three days for menopause and then you can come back the next cycle and it's like six. And we're like oh do you want do you so do you do you still want to have a baby because like you could if you wanted to and so it that the the blood work is actually really hard because you can't keep going back

to the lab i mean you could i guess uh going back every cycle and just average it out but it doesn't really mean anything outside of like yeah your hormones changing. And then there's a urine test that you can do for sure. That's called the Dutch test, which is the dried urine hormone test. Again, like if you catch it on a good cycle, it might be amazing and look like you're fertile. If you catch in a bad cycle, it might look like you're the Sahara desert and you run dry. It's the same thing with saliva. I mean, the only thing about the saliva and the urine test that it's good for in this time of your life would be to get to test your cortisol, right? And kind of figure out what's happening with your adrenals and your

stress response and all of that stuff. So that's what the, because blood work is not a great measurement for that because obviously, I mean, it's as easy as when you go to the lab, usually you see a sharp object and you're like, ah, and your cortisol increases. So it is not a great measurement for that because obviously, I mean, it's as easy as when you go to the lab, usually you see a sharp object and you're like, ah, and your cortisol increases. So it's not a really good measurement. And so this is the hardest thing about perimenopause that the diagnosis is not made because of a test. It's actually made through like having a really great conversation with your clinician. This is why we're having this conversation. This is why this is so important. It's why you go to your doctor and you think, I hope my hormones are off. They're like, nope, your blood work is fine, but I've got this and I'm that. And they're like, here's some antidepressants. This is your fix.

This will help you sleep. This will help your stress. This is why so many of us are prescribed antidepressants. And this is also why the suffering is really in perimenopause. Like that is where we need the help in perimenopause. Yeah, we're like, well, you're not in menopause yet, because you haven't missed your period for a whole year. So come back to me tick tock after you've missed 12 periods. So this is this is why I'm having this conversation why we are having this conversation because this is about you being informed and being able to go to your doctor and being like, no, I got this is happening. This is happening that. And when they say, well, you need to eat better and lose weight.

This is what I am eating. This is what I am doing. Well, you maybe need to take some supplements. These are the supplements that I am taking. This is why. Oh, my God. The living method is so empowering. And that's why I'm so excited to have this conversation because for so long, it's like, well, I have hormone

issues. Can I lose weight? I'm in menopause. Can I lose weight? Right? Like, yes, you can. It's just not an easy fix, but the living method is how you address and then go to your doctors, have these informed conversations because this is like, it is crazy pants. So many of us are going through this. And yet in order to find something to help us, it takes forever. Got to do that test. You're fine. This test. I'm not fine. This test. I'm not, something is going on. Take an antidepressant and not to say those help. So can we talk about, can we talk about now, let's say you figure it out, either through tests, your doctor, you know, you got it. What do we do about it? Because there is

a place for antidepressants. Yes. Yeah. Okay. So I, and you know, to add to your conversation, I do think that it's actually really tough, even sometimes for clinicians, because if we go back to the fact that this, like this menopause for women can can vary from 45 to say 55 right the median age in Canada is about say like 51 52 if you're like okay a Caucasian female and so if we go back to the fact that these symptoms can show up starting 10 years before your last menstrual period that could be at 35 you're going into your doctor's office and be like I know know something's off. And your doctor being like, well, you have little kids and like you're aging and you're really stressed. And like, you feel totally gaslighted. Right. And you're like, I know my body and something is off. And you're like, no, your periods are still regular.

Like, like nothing's changing. And so I actually think that this is why these conversations are so important because, and you, why tracking and really doing like when, you know, you fix your diet, you do all of your sleep and you're doing all these things that you're like, nah, there's still something off, right? That you can actually go into somebody's office and be like, no, I know it's my hormones and go to a clinician that obviously specializes in this and understands the conversation. But anyways, let's go back to SSRIs. No, I just, I just want to stop there because it has been a lot of women's experience that they

are blown off, right? It just, this is what happens. Come back to me later. I also don't want to disrespect doctors either. I want to make that very clear. And that's not what we're doing because you're actually married to one. I am. But if you can imagine, you're like my hormones, fix it, give me something. And your doctor is like, well, all of this, like this is so much. And that's why it's our part to educate ourselves so that when we're going in there, we know how to have the conversation. It is such a huge conversation. They would literally have to sit there and explain all of this to you to help you understand. Right. So, yeah. And you know, in my husband's defense and in, I mean, my best friend's a medical doctor. Like I, I love them. I appreciate them so much. This isn't training that they actually get in medicine, right? Like we, we talk about menopause

as just being like, and then we lose your period and then they shrivel up and die the ovaries. And then we move on. Like the die the ovaries. And then we move on. Like the conversation actually about even menopause hormone therapy has honestly just gained a little bit of momentum since probably like 2020 or so I would say that Suzanne Summers was like the first person that was like, F this, I'm not gonna feel like this. And like, here's what I'm doing. But up until then, because of the WHO, like legitimately doctors weren't even interested in learning about it. And so even I have, I have a really good friend of mine who's an OBGYN and she's like, honestly, we didn't get any training on menopause hormone therapy. Hopefully that's changing now because, you know, there's a this like mishmash of that in combination with the fact that like women haven't been studied properly. Right. Even blood pressure medication, like all of the things that we put women on, they've been studied on men.

Well, look at the diet industry. We're just starting to figure that out. I mean, not me personally. I figured it out a long time ago, but the diet industry is to figure itself out. OK, but we can go back to antidepressants if you want. Sorry. I kept interrupting. So let's do antidepressants. Let's do, I do want to leave a little bit of room. I know we don't have a lot of time for people like hysterectomies and whatnot. What's happening there. Does that factor into this conversation with, you know, hormone replacement as well? So what do we do? So there's a lot we can do with supplements, your microbiome, your CoQ10s, you're getting sure, getting, making sure you're getting enough magnesium and omega-3

and vitamin D, and there's adaptogens that you can take when you are stressed. Like, so I don't necessarily want to go down the rabbit hole of those. Cause we've already talked about those, especially with inflammation, with low estrogen causes inflammation that fits into the conversation, the estrogen conversation with Dr. Paul that we had on four reasons why your weight might be in which inflammation. Let's talk drugs. Give me drugs. Drugs. Okay. Give me drugs. Make me feel better. Okay. So let's start with SSRIs. So the research has actually shown that if women are given menopause hormone therapy, when they're perimenopausal, it can actually reduce the incidence of clinical depression developing.

Right. That's one. Two is there's a study actually that just came out recently because you have to know that up until about recently, we didn't really give hormones. And like our hands were a little bit tight unless women had hot flashes. Even if we knew your mood is like crap, you're fatigued, you're asleep, all of these things, it was like, no, she doesn't have hot flashes. We don't use menopause hormone therapy. You must use something else, which is actually why SSRIs were used.

And SSRIs also can actually help women, specific SSRIs can help women control hot flashes independently. And they have been used for a long time for women who are not candidates for menopause hormone therapy. I just want to make that clear. And they're great. So we'll leave that there. But there was a study that actually came out that said that if you have a new onset major depressive episode, or your depression was controlled, and all of a sudden, you woke up

one day in perimenopause, and you're like, this is not good, I don't feel well. Instead of actually starting somebody on SSRIs, we should actually consider menopause hormone therapy because it's not that their serotonin is a problem. It's actually that the estrogen is a problem, right? And so many women who even start menopause hormone therapy, and they've been incorrectly given antidepressants in the past, they actually find that their depressive symptoms get better on the right dose and type of menopause hormone therapy. Um, to the extent that a lot of them end up reducing or stop taking their antidepressants if guided by your clinician, please. Because I,

I think that you and I have had this conversation too. We believe that SSRIs and antidepressants are like floaties and sometimes you need floaties because we don't want you to drink. I want to say that for a second. Cause so many people it's like this, they don't want to take antidepressants. It's like you were in the water drowning and there is someone there trying to teach you how to swim. Like you're drowning. They can't teach, you can't learn to swim while you are drowning. And antidepressants is like like someone has thrown you a life raft and then you can hang on and then you're like okay now that i'm not drowning i can learn to swim so i have mad respect for medical intervention in the same with the ozempic you know i think there is medical intervention is

just we are so blessed to be able to have it in our lives but there is more than there is more you can do beyond and i think sometimes we feel like that's a blanket. And to your point, maybe it should be HRT first, then adding in, we are afraid of HRT because of a conversation that happened like in the eighties, seventies. No, it was, it was actually the nins, but it got published in 2002. I know. I know. Honestly, you guys, you have to join our summer program because honestly, this conversation, we could talk about this for five hours. But the summary of really, truly this like awful research study that we've now since like eaten all our words. It was called the Women's health initiative or the whi and to make a really quick summary of it it was there was uh the reason why we started this is because we were

like oh my gosh like we think that menopause hormone therapy decreased the risk of cardiovascular disease and the argument has always been like well yeah but like the women that are getting um more menopause hormone therapy are usually caian, you know, higher socioeconomic status women. So like, let's actually study. And so they take, I think it was 11. I can't remember, but it's like 1000s of women, right? And they put them into two groups, the average age of women that were put into this research study was 62. We just talked about how the average age for menopause is 51 to 52, right? So I want you to remember. And so there's two groups.

There's two groups in like the, I guess, control groups that are not necessarily getting the intervention, right? So the one group ended up having an oral estrogen that does not really exist anymore. That was made from horse's urine, a progesterone. And the other group did not have a uterus because just so that we can backtrack, that was made from horse's urine, a progesterone. And the other group did not have a uterus because just so that we can backtrack, the reason why we give progesterone is to protect the uterus, right? Because estrogen actually thickens the lining. Estrogen is magical, but it thickens the lining.

And so if you don't have a uterus, we don't have to worry about that. So the other group that did not have a uterus and they had a hysterectomy, they only got estrogen. And so they hold this conference like in the state before even like the data is published literally like i think it was like halfway through the study summit and like we just wanted to let you know that uh hormone replacement therapy or menopause replacement therapy causes breast cancer and people went wild but to put this into context right the risk actually went in the end, that was in the estrogen and progesterone group. In the estrogen and progesterone group,

there was an increase of one person with diagnosed with breast cancer for every 1000 people. So our baseline risk is actually four people per 1000. And it went from four people per thousand to five people per thousand, which you have to know that the actual absolute increase of that is less than 1%. Right. And in the breast cancer, in the breast cancer, sorry, in the group that only got estrogen, there was a decrease in the risk of breast cancer, the rates of breast cancer, right? And so everybody panics. Women who up on that point, because we used to give like menopause hormone therapy,

like candy before then, everybody stopped. And like thousands of women, right? Like ended up suffering through menopause because their clinicians were like, no, it causes breast cancer, no, it causes breast cancer. And then we actually went back and looked at the data in, I think it was 2020. And we were like, Oh, and so what happened is in what we learned for the WHI is a few things is that menopause hormone therapy, it started properly, right? So usually it's within that 10 year window before like 60, usually, but 10 years before that, or after that last menstrual period, they, the benefits of starting HRT actually outweigh the risks of it. Right. And so we actually know that menopause hormone therapy or hormone replacement therapy, women who receive

that have actually lower risk of colon cancer. We know that if you started between 50 to 59, there's a 50% risk reduction of cardiovascular disease, death from cardiovascular disease, and all-cause mortality. And it is way better at protecting than it is at treating. There's also a, it's almost like it buys you a little bit of insurance for your bones, right? Because it's going to decrease the risk of osteoporosis. If started properly, it decreases the risk of dementia also, right? Because of the cognitive piece, like for your brain.

And believe it or not, in that group, the other thing that we learned is that women that eat more protein are less frail, which is huge, right? And so this research study now has shown us that it's like, oh no, menopause hormone replacement therapy is like amazing. It just has to be started properly. And we want to start it before there's that disease that's already developed because it's way better at preventing than it is at treating. Now it's not for everybody,

but I think that everybody deserves an educated conversation with their clinician, because this is not just about disease prevention, but it's about quality of life. Yeah. So yeah, I want to, um, I want to talk about what happens. So first of all, if you take something that makes you feel better, you are more likely to exercise, to get better sleep, to eat better too. So it's going to have a big, massive trickle down effect. What if you miss that? Is hormone replacement therapy good when you hit menopause and post-menopause? Is it too late? Oh, great question. I'm on like my third period missed if this keeps going

should i just be like oh fuck it i can survive the next like you know eight months nine months i'm good like by the time i'm diagnosed i just like fuck it i'll be fine once i've got one menopause i hit the menopause day which i'm gonna have a party by the way i'm having a fucking party for my menopause day i'm coming yeah do Yeah. Do I just say, fuck it and I hold off? It's going to get better because we hear it does get better. Or is there any, is there any drugs we can take

as when we're in it? Not the period. We're in the pause. Yeah. We're in the pause. The countdown is on, bitches. What can we do? So listen,

we, I have, I have patients on like menopause hormone therapy in their 40s um because and they haven't and they still have somewhat regular cycles but we know what about 50s yeah 60s yeah oh my gosh 70s what are we doing honest it's such a uh case by case for sure conversation that you can have i will probably die with like an estrogen crane like attached to me um you know they bury me it would be like that and it's like my grandma's jewelry that i hold on to um because i honestly hook me up sister yeah no honestly it's like just like in anything. So listen, I, I, I believe that estrogen

is like the key to, uh, aging gracefully and longevity. I truly, truly do. I think that the way at which your body ages, when you lose that estrogen protection and all of the disease risks that come along with it for me are um i even with it like one percent increase of breast cancer i always talk to my patients about this like you have a higher risk of actually dying from cardiovascular disease than you do from breast cancer right first of all and your risk for breast cancer is actually higher if you smoke, if you drink alcohol, if you're sedentary or if you carry a lot of visceral fat. And so the conversation for me, it's like, you know, if you are a candidate for it, for me, often it's a no brainer. Now, it's a difficult conversation because I think that, you know, symptomatically it's amazing for the hot flashes and the night sweats and the vaginal dryness and all of these things, right. But there's also the disease prevention part of it,

right, which is like the cardiovascular disease, the Alzheimer's disease, like the Alzheimer's risk, sorry, like your bone health, like your mood, your sleep, your vagina, because the only tissue that does not ever get used to you not having estrogen is going to be your vagina it will just keep on getting drier and more brittle and less elastic as you age right it's honestly it is like the sahara doesn't it is just you know it's no it's true it's true give me the. I want to save my vagina. I don't want a brittle, crusty vagina as I get older. Okay. I want it fully working.

I want it like. I want you to like, it's just, it's the same thing for your bones, right? And this transition would lose weight. Same thing for your bones. It's like 12% of your bone mass. I mean, look at these risks. Like I'm an osteoporotic fracture, like waiting to happen. And so for me, it's like, it's, that's what I'm thinking about. I'm thinking about the

quality of my life for the next 30 years of my life. Like, I'm not just thinking about the hot flashes of the night. So I was like, I mean, I could get rid of those with like sage if I wanted to and phytoestrogens or whatever. It's about the quality of your life as you age is so that you can thrive and not just survive. If it's something that is adequate for you after you've discussed it with your doctor because while i'm a doctor i am a doctor i am not your doctor um i always say that but it's uh it you just i think that for so and you and i have had this conversation i think the last time but i think that for for so long women uh were just forgotten in medicine and it was just this like i think that menopause was seen as this. And it was just this like, I think that menopause was seen as this thing

that it was just like normal and you had to suffer through. And it was just like part of aging. And it doesn't have to be like that. You don't have to live like the next 30 years of your life just like feeling like, well, this is just it because I'm post-menopause. Like you don't.

And it's not just about menopause hormone therapy, right? Like this isn't it. Like, it's just, this is actually what you're doing and why we want you to change your sleep and your exercise and your movement and your like boundaries with people around you and all of these things, because honestly, like you don't like, you can thrive. Like this is, this is quite possibly the best third of your life if you let it be and you work at it. Yes. So we all want to wake up, look good, feel, feel our best, live our longest, healthiest, happiest life. So this was a really big conversation. Okay. So we could continue this and sit here all day, go down the rabbit hole, all the natural options, the HRT, we can go into like bioidentical, we can go there. The takeaway from here. And the reason I like to stay in my lane with these conversations is to let you know, when it comes to your weights, this program, what you are doing while following

the living method is going to get you there, but it is so much more than what you are eating. And when it really is understanding what's going in, going on so much more than what you are eating and when it really is understanding what's going on in your body and how you are feeling and how you can best support your body. This program is it. This is probably the most comprehensive, effective program on the market, not just for weight loss, but for helping you be the healthiest version of you, regardless of where you are in any of the pauses situation. So this is really about just informing you this conversation, Dr. Link and I, we're going to, we're working on a six week, four weeks, six week, we're not really sure hormone series,

where we can actually get into it properly. There's only so much time that we have here in the group, but Dr. Link is going to be back. So we'll let you know about what's going on with that group. If you want to join that, we're going to in the group, but Dr. Alinka is going to be back. So we'll let you know about what's going on with that group. If you want to join that, uh, we're going to in the summertime, sometime we're just talking about it because obviously we need to have it and we would let just, it's really self-serving. It's going to be so fun to talk about. Um, but you're going to come back. So there's a lot of unanswered questions. I see you, I see your questions that you, you've been posting on the posters. This was a very concentrated conversation. So she's going to come back and we're going to do an ask Dr. Alinka anything. So I'm going to

compile the questions you have already asked on the posters in the Facebook support group. We will do a new poster for ask her anything in regards to, um, hormones. We're going to have her back and she can answer all of those, including for all the males in the group too. Because I think that males have had a lot of studies done. I'm not sure like hormones, they talk much about hormones. Men don't even have hormones as far as we're concerned. They're not even on this planet. Men are just shells.

And that is not true. That is not true. You got hormones too. We love you. Yes. You have estrogen too, actually. Yeah. We're going to break that down. There was not true. You got hormones too. We love you. Yes. You have estrogen too, actually. Yeah. We're going to break that down. There was a lot.

There was PCOS. There was like hysterectomies. There was like, there was aging. There was so much going on. So I think we might've broken the record for the longest conversation in 21 groups today. So you guys, remember when I said like, I always say this, like, do you want a Mexican minute or like a real minute? When I'm like, I'll just summarize it I said really quickly, but here's like,

all of our real diarrhea. Oh my God. And I feel like, do you feel like we're just getting into this? I feel like we're not even like scratching the surface. Listen, I could talk about, we could do just a live on, um, like menopause and mood and menopause and osteoporosis. Like we, we, everything that we talked about, even exercise can be its own hour and a half. Like this is so complex, but what we're trying to teach you here is like, this isn't like this conversation is so big and you're not here just to be thin, like this is thin is not a measurement of your health. We are trying to teach you that, like how you feel in the morning, like how, you know, how you show up at like the gym, how, like how you live your life is way more important

that the number of the scale, the scale is just a tool, just a tool. Yeah. And finally, and forever is more than just reaching your goal weight. It's like, it's looking your best. It's feeling your best. It's having a positive mindset. It's feeling strong. It's feeling grounded. It's feeling whole. It's feeling connected. It's feeling in tune. It's feeling empowered. That's what this conversation is about. Dr. Alinka Trejo. I love you. I adore you. I love our conversation. Me too. I wish I could stay all day. Anyway, you can reach out to Dr. Alinka at info at dralinka.com. We're going to continue this

conversation. She will be back and we will let you guys know more information on our hormone series that we are just starting to plan in the summertime. Have an amazing day, everyone. Dr. Thank you. Thanks for everyone joining us live. We'll see you next time. Bye. Thanks for having me.