The Menstruality Podcast - How to Feel Better in Perimenopause (Lara Briden)

Episode Date: January 27, 2022

A major transition happens in our bodies in the years that lead up to menopause, a kind of ‘second puberty’. Many people are left wondering if they’re going crazy as they experience a vast range of physical and neurological symptoms which can seem to come out of nowhere; including anxiety, depression, irregular or heavier cycles, heart palpitations, insomnia, night sweats, hot flushes, migraines, and breast pain. Today the “Period Revolutionary” Lara Briden joins us to demystify perimenopause. Lara is a naturopathic doctor and the author of The Hormone Repair Manual, Every Woman's Guide to Healthy Hormones After 40, a practical guide to navigating the change of perimenopause and relieve symptoms with natural treatments such as diet, nutritional supplements, and bioidentical hormone therapy.We explore:The four phases of perimenopause and how to navigate them, including the ‘waiting room’ where your periods are very irregular, but you haven’t yet reached the 12 month point which defines the beginning of menopause. The science behind this life transition and the hormonal events that can drive symptoms like irregular / heavier cycles, sleep disturbance and hot flushes. The rescue prescription for peri-menopause and how it can help you to look after your whole being, and especially your brain and nervous system - Lara assures us that there is always a way to feel better. ---Registration is open for our 2022 Wild Power Immersion is now open. You can join here: https://www.wildpower.online. ---The Menstruality Podcast is hosted by Red School. We love hearing from you. To contact us, email [e-mail]---Social media:Red School: @red.school (https://www.instagram.com/red.school)Lara Briden: @larabriden (https://www.instagram.com/larabriden)

Welcome to the Menstruality Podcast, where we share inspiring conversations about the power of menstrual cycle awareness and conscious menopause. This podcast is brought to you by Red School, where we're training the menstruality leaders of the future. I'm your host, Sophie Jane Hardy, and I'll be joined often by Red School's founders, Alexandra and Sharni, as well as an inspiring group of pioneers, activists, changemakers and creatives to explore how you can unashamedly claim the power of the menstrual cycle to activate your unique form of leadership for yourself, your community and the world. Hi, welcome back to the Menstruality Podcast. We're back to our normal rhythm now after our wild power retreat. Thank you so much for joining us today. Today we're talking with the period revolutionary, Lara Bryden, who's joining us to demystify the major transition that happens in

our bodies in the years that lead up to menopause. Many people are left wondering if they're going crazy as they experience symptoms which can seem to come out of nowhere including anxiety, depression, irregular cycles, insomnia, night sweats, the list goes on. Lara is a naturopathic doctor and the author of the Hormone Repair Manual, Every Woman's Guide to Healthy Hormones After 40. Today we're exploring the four phases of perimenopause and how to navigate them, the science behind this life transition and the hormonal events that can drive the symptoms and importantly Lara's rescue prescription for perimenopause and how it can help you to look after your brain and your nervous system and the beautiful thing is Lara assures us that there is always a way to feel better.

Lara Bryden, welcome to the Menstruality Podcast. We are so, so grateful to have you here educating and guiding around perimenopause. Thank you so much for being here with us. Thanks for having me, Sophie. I'm looking forward to this. We will dive in the way we always do with this podcast, which is with a cycle check-in. And I was listening to your interview with Nicole Jardim on the period party and you were talking about how at that point which I think was in it was earlier this year you were still in the waiting room as you call it yeah get into later the different phases of perimenopause so I am wondering where you're at with your cycle and how you're doing today. Yes, I'm still in the waiting room, but I'm about to graduate to menopause, I believe,

in that my last period, which was a very scanty little bleed I had in January last year. So as you know, menopause officially begins when you're 12 months past that final period. So I'm getting there. Yeah, about to achieve menopause or graduate to menopause. I love that term graduate to menopause. And how, you know, are you experiencing your cyclicity? Are you connecting to the moon? How is that for you in this phase of your life? I would say I'm, I'm appreciating the more steady state of, you know, of the post menstrual years. We do, as you probably know, I mean, estrogen does go up and down, even, after periods stop so it's certainly common that women

notice some cyclicity cyclicity and as you say some women choose to create that by tracking the moon i'm not doing that i'm just um enjoying my diurnal rhythms and yeah just being quite stable i think there is this kind of cheeky freedom that comes once you get into these post-reproductive years which of course we can talk about today yes to cheeky freedom I feel like there is a general rewriting going on around the whole story of menopause which can't come soon enough and is is excellent I love that addition to it cheeky freedom yeah so I think it was earlier this year in February that you published the hormone repair manual yeah yes and it's a practical guide to feeling better

in your 40s and your 50s and beyond exploring how to navigate the change of perimenopause and to relieve the symptoms with natural treatments I'd love to hear what inspired you to write the hormone repair manual? What was it that called you to bring this to the world? Yeah, that's a good question. Well, as you know, it's my second book. So my first book, Period Repair Manual was a deep dive into menstruation. And then, and that book contained a chapter on perimenopause. But as I just worked with my patients and interacted with my readers around the world, I realized there was this gap about knowledge in our 40s. Like more precisely, there seemed to be this misunderstanding and not just amongst women but doctors as well that menopause is something that happens in our 50s that it's sort of way off in the future for

some women when in reality as we'll talk about perimenopause which is the anywhere between 2 to 12 years leading up to the final period is for most women, the time of symptoms, if they're going to be symptoms. So not all women experience symptoms, but I would say what the research shows is if they're going to be symptoms and often they're neurological, they are more likely to occur in this lead up to menopause. And because most, many women don't understand that, or there hasn't been a discussion of perimenopause, they're left thinking, wondering what the heck is wrong with them. And just, you know, going down all other sorts of rabbit holes looking for the solution. And yet there's this, I would say quite major transition happening that I wanted to shine a light on. So that was the origin of

hormone repair manual. It's for women in their forties. And I do use the word perimenopause somewhere on the cover, but it's not in the title of the book, mainly because I just wanted women to know that this is for them. If you're 35 plus, this book is for you. Alexandra and Sharni refer to the time running up to menopause as the quickening. They've found a different phrase. I think, again, to include more and to invite more people in because people see the word menopause and they go, oh, no, not for me. Yeah, not until I'm in my 50s. Yeah.

Yeah. When we have people writing to us all the time at Red School saying, you know until I'm in my 50s yeah yeah when we have people writing to us all the time at red school saying you know I'm experiencing hot flushes migraines sleep challenges anxiety and depression you've you also speak about the breast pain and the how cycles can get heavier or irregular heart palpitations like there's so much going on in this second puberty I think is another term I've heard you use yes perimenopause could could you help us to understand that the core sort of physiological changes that are going on that create so much of these symptoms yeah well in the earliest phases of a normal perimenopause, which

in some women can start as early as our late thirties, the first hormonal event to happen is the quiet exiting of progesterone. Not entirely. does vary but we do we start to have shorter luteal phases which i think your listeners will know what that means we start to have some more cycles when we don't ovulate so that means that wonderful calming period, lightning migraine, preventing hormone progesterone is quietly dropping away. And we can do things to try to improve our progesterone through the years, but it is to a large degree, an inevitable part of this process. It's, it's, it's the follicles becoming less active, less vital as we move towards the natural transition of menopause. So the fact that losing progesterone is such a big part, especially in the early phases of perimenopause,

has also been potentially a missed part of the conversation. Like we hear a lot about estrogen and estrogen is doing things too through these years, but the losing progesterone is a, is a big part of it. So that's, um, I do talk about in that book and I'll talk about it in my book. And of course, as you say, the book is a lot about natural treatments. I also do talk about the value of different kinds of hormone therapy particularly for some women the value of supplementing progesterone real progesterone not progestins not the pill but real progesterone in cases where the symptoms are strong yeah that was new to me when i started researching you that

it's actually a huge cause of these changes is the losing progesterone. Yeah. I think there's a lot of misinformation out there or just misunderstanding about what's actually going on in our bodies at this phase. Yes. So Professor Gerilyn Pryor, who I think you've asked, you know, I talk about her in my book. She's a close colleague of mine. She's a reproductive endocrinologist. She a scientist she runs something called the center for menstruation and ovulation research she and she's published multiple papers on progesterone she is been a cheerleader for progesterone for decades and so a lot of what i talk about in the book including some of the protocols are from her and I just think her work has been so valuable for women and I'd like I'd always want to see her work better known so I always try to find an opportunity to

mention it but that's that's where a lot of the my discussion of progesterone comes from and I might just say something about just to reiterate the difference between progesterone and progestins, the contraceptive drugs, progestins. And that has been a big part of the confusion over the past several decades is that the word progesterone has been used interchangeably to also describe progestins. And that is not accurate scientifically you know progesterone is distinct from those drugs and progesterone itself the progesterone we make or the progesterone we can in some cases take has benefits particularly for mood and sleep and

migraine prevention that progestins don't have. In fact, the progestins are often the opposite and can contribute to anxiety. So I'm saying all of this just to shine a light on, you know, a potential treatment that women might not have been aware of that can be a lifesaver. Thank you. I'm excited to look at the ways we can, what we can do to feel better later on in the conversation. I'm really excited about that. Before we do, I think it would be great if we could walk through the way you've described the four phases of perimenopause there's a couple of fantastic instagram posts on your feed that i'll link to in the show notes that map out these four phases and it starts with the very early perimenopause i think which is around two to five years yes so and again some of this is coming from professor geraldine prior so the the phases of the menopause transition, and we'll talk them through, have been in

existence, have been talked about for a while, but Professor Pryor is who added the very early perimenopause. And again, she calls it the very early perimenopause, but that's of a normal perimenopause. There is also, of course, a situation of early menopause, which is a different topic, which we won't, I think, cover today. But we're talking about women who are undergoing a normal transition. Very early perimenopause is when symptoms begin, but cycles are still regular. The bleeds are regular. But for anyone tracking their cycles with cervical fluid or temperatures, what you'll see is what I mentioned earlier is the shortening luteal phases, the less robust luteal phase, sometimes an ovulatory cycles and symptoms are beginning. So the symptoms

we've alluded to would be mostly neurological. So increased risk of anxiety, depression, potentially insomnia, that kind of waking in the night with heart pounding, potentially night sweats, especially premenstrually, increased frequency of migraines, a risk for fibromyalgia, you know, sort of put that in there. A lot of that fibromyalgia risk may come from sleep disturbance and then um of course for some women heavier periods as a direct result of the lower progesterone increased period pain breast pain and there can be some degree of weight gain even at that early stage so a big part of what's been in the early phase is the dropping away of progesterone. But also this is also when we start to see something very interesting happening to estrogen, which is that it's going up and down as it always does through menstrual cycles, but

it's the amplitude has increased. So you can have spikes of up to three times more estrogen than earlier in one's menstruation life. So estrogen is always on a roller coaster. That's its normal pattern. But now we start to get these very steep ups and downs. And as you can imagine, that does not feel great for some women. I mean, estrogen going up in some women spiking high can, well, it can, it's directly quite stimulating for mood. Um, but it also in some women can, um,

interact with the immune system in a way that it stimulates mast cells and histamine and that can create a whole set of symptoms perimenopausal allergies hives migraines just nasal congestion and just general and sort of an agitated mood this is histamine is a both an immune um communicator and also a neurotransmitter. So histamine is quite stimulating to the brain and doesn't feel good when it's in excess, which is why, and I'll just, I know we're getting to treatment later, but I'll just point out that antihistamines can actually be quite helpful for the parent, this or especially these high estrogen phases of perimenopause, both for sleep

and potentially for some of the mood symptoms and then when estrogen is going down the roller coaster that estrogen withdrawal because estrogen is addictive even on a sort of month-to-month basis we go through a little withdrawal that can trigger migraines that can trigger more sort of dark moods as estrogen plummets down. And also that's where the night sweats come in. So, and again, I know we're going to get to treatment, but I'll just say one of the strategies is to try to, to reduce the amplitude of those ups and downs, just to try to stabilize it closer to what we're we were used to and then yeah so that's okay so that's the we're on the phases so phase one is the very early phase this is when yes for two three years when cycles at least the bleeds are still regular but we're getting this combination

of low progesterone and high fluctuating estrogen, potentially coupled with a histamine or mast cell or sort of inflammatory reaction to that. And then, and I just, before, before we go on to the next phase, can I ask, because a lot of people write to us and say, am I in perimenopause or am I, you know, X, Y, Z, am I, am I depressed? Am I, you know, do I have a migraine problem? Or is this actually perimenopause? And I guess that's quite a foggy question without necessarily a clear answer, is it? Yeah, an assessment is by context and symptoms. So listeners are not going to be happy to hear that there's no definitive blood test for perimenopause, it would be so great if there was, but there's no way. In fact, if you do blood tests,

especially for ovarian hormones, or the doctor will say everything's normal. So I mean, of course, if symptoms have if there are symptoms, it's important to rule out other causes. So the doctor should look at obviously thyroid would be a underactive thyroid or any kind of thyroid disease would be a something that could also account for these symptoms that should be looked at. But then once some of the, and maybe vitamin B12 deficiency, some of the things I talk about in the book, but then once those things have been ruled out and you're left with a mid cycle or sorry, a midlife woman with symptoms arising and potentially evidence of that reduced luteal phase perimenopause picture, then the diagnosis of exclusion is this is perimenopause. And that's one of the reasons I think that this is so often missed is there's just not a nice tidy way to diagnose that. And

you're right about the mood symptoms. So it's quite a good deal of overlap. So if there's always going to be some background, potentially stressors in a woman's life, or maybe, you know, background vulnerability to mood problems, but it all just gets dialed up with perimenopause. So I've talked about how the high fluctuating estrogen is quite bad for mood, partly because of the histamine response followed by the estrogen withdrawal. Losing progesterone is quite bad for mood because progesterone normally has a beneficial stabilizing effect on the stress response system or the, what we call the adrenal HPA axis. So losing that can be quite destabilizing. And so I guess what I'm saying is, yeah, if the diagnosis is then anxiety or

insomnia or depression, these changes of perimenopause can be contributing to that. And at the same time, a way to improve those symptoms without having to take antidepressants, for example, makes me sad when my patients come to me and they've been having these symptoms in their 40s and they've been given antidepressants when in not that antidepressant medication is bad but in through my lens more targeted treatment for perimenopause would have been is more effective and often is more effective they can make that change onto perimenopause treatment brilliant yeah i think there's also a section in your book which is how to speak to your doctor I think which must be so helpful because I know so many

women and people with periods go to the doctor and they don't quite have the language for what they're experiencing and they bring you know whatever they can you know I'm feeling this I'm experiencing that and then the doctor can take them in any manner of directions that might not be exactly what they need so that section in the book feels vital in terms of getting the diagnoses and the treatments and the access to resources that we need. Yeah they're very popular sections so there's multiple ones throughout the book like for each depending on the symptom. And it's a lot of it's about speaking the language of the doctor and trying to stay on the same page. I just find that's obviously so important because the doctor wants to help you and you want to be helped and you just, you need to have a common language. And so for example, like in some of the those sections i use more precise language like

anovulatory cycles or you know is this perimenopause or should my thyroid be ruled out and avoid if possible phrases like for example estrogen dominance which i you're some of your listeners may be familiar with that term it's it's accurate but it is sometimes not as precise as some of the other ways of talking about it if that makes sense helpful it really does it's so helpful so the phases should we yes let's keep going yeah let's get to this essentially four phases and then menopause so phase one we've been talking about is mainly based on symptoms and then phase two is when you do start to see some variation in the cycle length and, and that's counting from day one of the bleed to day one of the bleed. It can start to

wobble by more than seven days variation cycle to cycle. So you might have in general office, sorry, just to interrupt myself with perimenopause is often a shortening of the cycle. That's the normal trend. So you might go from used to, you might be used to having a 30 day cycle, and now you're down to a 26 day cycle, maybe in that early phase of perimenopause, that's just really to do with the higher levels of a pituitary hormone called FSH, which is shortening the follicular phase. And then into this phase two of perimenopause, then you might start varying between, you know, a 24 day cycle and then a 35 day cycle, and then, you know, sort of bouncing around and that you might stay there for a few years. And also the same pattern of shorter luteal phases, maybe no luteal phases.

So that's phase two. And estrogen is still quite high and fluctuating at that time. And then phase three is when the variation is blows out to way more, like you might go have a 60 day cycle or more, you know, not have not have a period for a few months, and then get another one. And phase three is associated with more extended times of lower estrogen. Although estrogen still does spike up quite high around the time of a cycle or an ovulation, if you manage to ovulate at that time. And so the symptom picture is a little different. There might be more, you might start to see more, more pronounced, pronounced for example night sweats or hot flushes from the estrogen withdrawal and that's when when estrogen is lower for more extended periods of time that's when we do start to see more weight gain this is where

with with the drop in estrogen we we do get a shift to what's called insulin resistance or prediabetes. Estrogen through our reproductive years protects us to some extent from insulin resistance or prediabetes or that apple-shaped weight gain or weight gain around the middle. And then with lower estrogen and at the same time, sort of a shining through of more testosterone, all of that contributes to weight gain around the middle. And women notice that, of course, we do get this thickening of the waist, which is, I would say, unavoidable to some extent. You know, I really don't, I don't myself, I'm not fighting it. You know, obviously I'm trying to stay healthy and maintain muscle mass. We could talk about that in terms of treatment section but like i talk say in the book like it's i've got better things to do than you know fight to maintain

the hourglass figure of my 20s like you know that's just not i guess i'm just putting that out there that a thickening around the waist is to some extent a normal part of this process and then so that's phase three we're still having the occasional period. And then phase four, as we said, right at the beginning, which is where I'm at in and probably at the end of that is the waiting room. So this is where you think you've had what might be your final period and you're waiting, waiting, seeing if you achieve the 12 months, and then you get another period. And so that the waiting has to start all over again at that point so phase four usually although phase four in theory is actually only

12 months it in practice lengthens out to two or three years as well and then once you pass that 12 months with no period then you as i said you graduate to menopause, then you're in what Professor Pryor calls the life phase that begins 12 months after your final period. And that life phase, you know, fingers crossed is going to be 20 or 30. Or maybe if we're very lucky 40 years, you know, it's a big chunk of our life. So we're entering an important time in our life. If you'd like to explore how the wisdom within the different phases of your menstrual cycle can support you through all of life's transitions, including perimenopause or the quickening, as Red School's co-founders Alexander and Sharni call it, we invite you to visit wildpower.online where you can find out more

about our 2022 Wild Power Immersion. This is a six-week live online program guided by Alexander and Sharni to reclaim the magic of the menstrual cycle by awakening the power of your inner seasons. We start on February the 7th. We can't wait to get started. We'd love to have you with us. You can find out more at wildpower.online. That's wildpower.online.

I really love the term, the waiting that analogy is really beautiful you know having having been in the waiting room for a while yourself and obviously having worked with so many women and people with periods who have been in the waiting room it must be a huge stretch psychologically to go from this very regular for those who have regular cycles yeah regular like ebb and flow of the cycle to you know just not knowing if you're going to have a cycle in 30 days 60 days 90 days can you offer some you know some of your own experience or what you share with the people you work with about how to how to cope with the with life in the waiting room yeah well like I said I have personally found it quite stable no I mean in a little bit we can talk about my sort of this return to girlhood this

sort of emotional aspect of it which I did not quite expect but just to answer your question about the uncertainty of your bleed about I'd say about one in three to one in two women have quite heavy periods during perimenopause, especially those final, like the final hurrah of the periods can be flooding sometimes. So there's an added stress if you're waiting for a period, which could be a period where you bleed through your clothes, right? Like there's's definitely I personally did not have that experience because my periods just got lighter and lighter which is another way it can go but I'll just say yeah for women who are nervous about that that's when you start to you know get women sort of needing to you know seek medical intervention to try to avoid these really crazy difficult periods um and it's also just a practical thing of you have to keep period

products in your bag at all times and sort of be alert for when you're going to yeah when your neck's going to bleed um yeah i hope that answers the question in terms of the psych, like the actual sort of emotion yet, there would not be that. There's usually no ovulation at all in these final phases, there's a bleed, there's a anovulatory kind of breakthrough bleed coming through once in a while, that's usually what it is, although you might get the the ovulation or estrogen, you know, kicks back in and you're moving towards another period, you'll get quite a dramatic change in symptoms. Like you might go from having night sweats and being sort of insomnia and kind of more depressed to being suddenly, oh, the hot flushes or the night sweats are gone and a bit of euphoria. And then into that, you know, more anxiety pictures. So this is, I talk about in my book, just be alert, just know that estrogen is fluctuating between at times very low and spiking back up to high and just understanding that that's what's happening.

And, you know, be able to interpret your experience through that lens, knowing it's not going to last. It's just, you know, some final instability. instability yeah that is immensely helpful to have the kind of roadmap that you've laid out in this book to be able to at least understand or to normalize what's happening or validate yeah all the different symptoms that you might be experiencing although it doesn't make them go away I think it can take away from that feeling of am I just going crazy here because why are all these things happening to me and no one's talking about this you know I'm so pleased and so grateful that you're bringing your work through so that people can feel more validated in this yeah validated and also I would argue most there's always a way to feel better like there's always a way to feel better but what

you've just said there am I going crazy it's a common experience of perimenopause, unfortunately, especially, and it's, yeah, that feeling of am I going crazy is because it seems to come out of nowhere. It seems to be unconnected. You know, these are, we will have gone through our life, sort of having a sense of what makes us feel a certain way and what we can expect. And then suddenly we're just getting symptoms that seem to come out of nowhere and that's yeah I think that's that's potentially one of the most destabilizing parts of it so yes so I hope conversations like this and my book and all the other books that are out there about perimenopause can help to normalize this and help women not feel like they're going crazy make them real make you

realize that you're not alone yes let's and let's also talk about how we can feel better yes exactly no this is we're talking multiple years potentially of challenging symptoms you know how can we how can we manage these health challenges yeah let's go there like what can we manage these health challenges? Yeah, let's go there. What can we do to feel better? Okay, well, let's talk about the neurological symptoms first, I guess. The sleep disturbance, potentially the migraines, the mood.

I have what I call the rescue prescription for perimenopause and it's sort of three, three tiers of treatment and levels of treatment that are you, you know, you could basically start with level one for a few weeks. If, if that, that often doesn't, that's often enough for about 50% of women. And then if not, then you can sort of move to level two and that's the way I lay it out. But level one is what I call the basic action plan for brain recalibration brain. I talk about brain rewiring in this book because this process of losing first progesterone and then this crazy ups and downs of estrogen, and then eventually losing estrogen, this all your, the brain literally has to rewire itself and learn to do things differently. So you can help it in that process by just looking after your brain and nervous system. And so some of that becomes very basic things, but I'll start with the no

alcohol because I know that's painful to hear, but I will just say for what it's worth, I find that is actually often one of the single most important lifestyle changes to begin with to as a you know to start with I start with usually the no alcohol and a magnesium supplement those two things because the magnesium also helps to reduce the craving for alcohol and I just I partly mentioned the alcohol because I see a lot on social media sort of messaging around using wine to get through perimenopause and I would say that's not the way that's exactly what I was thinking I was thinking so many people go well the end of a long day of not only managing all the responsibilities of my life but also all these changes that are happening crack open the bottle of wine relief yeah it's not the way

I'm sorry to be the bearer of bad news but it it's, and I've always been, you know, I've always been, I would have a few drinks in a week, you know, you know, even occasionally I still do have a beer here and there, but just for myself through, this is through the, my experience for myself and also for all my patients, it's really consistent. If you can stop alcohol, you will stop waking up in a sweat in the night. And so often when I'm sitting there, I'm like, this glass of wine looks delicious. And I would love to have this. But then

I know I'm going to wake up all sweaty at three in the morning, it's just not worth it. You know, you start to sleep, he starts to become so precious in these years, you're like, all these things I need to do to sleep, and then I'll feel so much better. So and the other thing to say about alcohol for what it's worth, and I just think this is an important piece of information. Alcohol increases the risk of breast cancer, um, quite substantially. I mean, the risk of breast cancer is always relatively low, but moderate alcohol intake, even, you know, five to say eight drinks in a week increases the risk of breast cancer more than estrogen therapy does. So just to put it in perspective, right. Cause

we have this, and we can talk about estrogen therapy a little bit. I mean, I'm quite, I'm an agnostic, you know, quite neutral, like estrogen therapy can be quite helpful. So I'm acknowledge all of that. A lot of my patients use it. Not everyone needs it. So I think it's not a one size fits all, but just to put it in perspective, it's something we have feared for a couple of decades and yet big picture, even moderate wine consumption is more dangerous from a breast cancer perspective so yeah that's motivating yeah it is and it's also just kind of clarifying it's it's not it's not your friend it's really not good for the brain or sleep or anything or hormone balance i mean alcohol not to spend too much time on this, but it alcohol impairs the body's clearance of estrogen. So estrogen is already spiking up to three times

normal and alcohol increases that and alcohol causes the histamine and a mast cell response. So it's, it's not friendly to the body. And so, and to the perimenopause body and brain specifically. So that's number that, so that's part of the brain rewiring basic action plan. The other, I mentioned a magnesium supplement. I usually give magnesium glycinate combined with the amino acid taurine. Those two things are very stabilizing for the nervous system. They both help to support GABA, which is our calming neurotransmitter that the neurotransmitter that progesterone normally supports. And as I just said, we're losing progesterone. So we're losing GABA stimulation

in the brain every month. So any other way we can improve GABA will help the situation. Magnesium is one of the best ways to do that. And then the next part of the basic action plan, and this is just so obvious but moving the body makes a huge difference especially i would say getting outside moving the body outside getting some of that outdoor light building muscle can help to well feel better building muscle is good for the brain it's good for you know movement is good for sleep and all of that obviously can help to mitigate this shift to insulin resistance or weight gain around the middle. Do you recommend strength training then, Laura?

I do. Working with weights. I mean, the funny thing is, full disclosure. Yes, I do. I recommend it in the book. I think the research around that is super solid. I don't personally do it yet because I enjoy other things. So I always feel like I need to sort of disclose that, but I think it's great. I think what I have done looking at all that

research and around weight training is modifying my yoga practice to include more planks and, you know, squats and lunges and just focusing on building muscle using my own body weight. So that's the direction i've gone with it you could do that with pilates i mean but yes for people who strength training is very good for the brain and very good for metabolism and i would say my patients who do it consistently have fewer perimetopause symptoms than other patients so yes to that um how how often a week are we talking in terms of i think it's just you know even just a couple times a week can make a big difference so yeah whatever you have time the great thing about strength training is potentially it's quite efficient

i mean you get in there and you you know do some lifts and it's you get a lot a lot done for not that much time so yeah yeah i mean I'm sure there you could probably have guests that know a bit more about strength training than I do given that I don't I would feel so sheepish about that but I know I love walking and yoga and I'm just like I need and you are doing it because you're using your own body weight which is absolutely a part of it I just know for myself personally one of the one of the blessings of infertility because I was trying to conceive for four and a half years one of the blessings was it made me try everything and in the run-up to my IVF process which was wonderfully successful with my

my little one who we heard crying earlier yes I did I did everything to get as fit as I possibly could and I started doing HIIT workouts with weights and I have never felt better than in those you know in that six months where I was um eating a really like anti-inflammatory diet no alcohol no sugar um doing the the HIIT workout the weight training I felt incredible you know in my mind in my in my body yeah so I'm this is inspiring me this conversation to get back on it. Yeah, absolutely. Yeah. It's, it's just a win-win. It's very good for the body. Absolutely. Great. So, so the basic action plan so far is we've had the magnesium, the getting outside and the weight and the strength training and taking out alcohol. Yes. And also

just scheduling time for rest. So that is sometimes I realize as I'm saying it, that is sometimes easier said than done. I understand that people have busy lives. They often have a lot of responsibilities, especially at this age, because there could be, you know, children and also aging parents and a career and it's a lot. And I understand that, but I just, I guess the argument I try to make in the book is if there was ever a time to slow down, it's now because not only will that help symptoms, but also it will help to shepherd or escort or support the brain through this transition time, which will pay dividends in the future in terms of a healthy brain and, you know, reduce mood symptoms going forward. And also, and I explained this in the book, looking after the brain during the menopause transition will help to reduce the long-term risk of dementia. And that is the research around that is a little

frightening, but also empowering because it means we can do something about it. And some of the research suggests that actually some of the, some types of dementia begin with menopause as in, you know, the, the, the brain's potentially starts going down a bad pathway if it hasn't been given the support that it needs. So there are lots of ways to support the brain. And I dedicate sections in the book to that, but a big part of it is the basic action plan for the brain, as we've been talking about, including scheduling time for rest, which will help sleep. I thought interesting. Yeah. I mean, one thing about sleep is we always were so focused on what we can do to sleep, but actually a big part of what we can do to sleep for sleep is to

reduce, calm our nervous system during the day so that it's better prepared for sleep when we get to the night. So that's just, I think an important takeaway. Excellent. Schedule time for rest. One of the things you speak about is how perimenopause can actually be a tipping point for long-term health. You know, you just referred to it with dementia. Does that happen with other areas of health? Yeah, that'd be cardiovascular health as well. I would say that potentially could be inflammatory or immune conditions. It's a, it's a tipping point. Perimenopause is a tipping point because it's a recalibration of metabolism of the nervous system of the immune system there. It's a known our women's forties is a known risk time for the onset of autoimmune disease or the flaring of autoimmune disease, including autoimmune thyroid. So another just tipping point just

is postpartum. So any kind of major hormonal shift change in a person's life can potentially be a danger window for the onset of certain conditions so that's yeah and the research around that is quite strong so I talk a little bit about that in the book and just talk about it then perimenopause as a window of opportunity for both feeling better and reducing long-term risk of disease. So we've talked about the, my, what I call the rescue prescription. So this is three levels. We've talked about the, you know, the basic action plan, which is what anyone can do. And I'd say is for about at least 50% of women is all they need.

And then the next two levels are potentially coming in with herbal medicines and or hormone therapy in some form, either progesterone alone, which I talk about a lot in the book or progesterone plus estrogen eventually would be kind of the third tier. And the idea is you keep all the basic action plan in place. You don't stop it. Like you don't stop magnesium when you start progesterone, you do both. If that makes sense. Absolutely. So, so this is so empowering and I can't wait to be, to share this with our community because there are going to be so many people who listen to it and go, right, there are things that I can do.

Cause a lot of people I think jump straight to the hormone treatment because that's what's available and it's really important and really necessary for some people but it's wonderful to know that there are many actions that that can be taken before that and that they work for for up to half the people is really really good news you also speak about the evolutionary advantage of menopause it came up in your conversation with Nicole Jardim and I'd love to hear you speak about that like how do you see that the evolutionary advantage of menopause yes so this um this is coming out of the research and a lot of it's for me came out of a book that I read that I quote in my own book a couple of times the book is called the slow moon climbs by Susan Matter and she's a historian which the book

is a lot about prehistory as well and she weaves together all these different lines of evidence including modern day the very few people on the world in the world who are still hunter-gatherer lifestyle and their experience, which I'll just say they experience menopause, of course, you know, period stop it around 45, 50, but they don't see it as a bad thing at all. They don't experience symptoms. The fact that we experience symptoms in our modern environment is, and this is, I found this quite profound that a longer human lifespan. So a longer lifespan for homo sapiens evolved or was selected for because of positive selection pressure on a post, a female post-reproductive phase, like extended phase, a couple of decades, two to three decades of life continuing past ovarian function. And

the way that would work is that, that women in their fifties, 60s, and potentially even beyond are so beneficial to their family group that they're significantly improving the survival of their genes in their descendants, basically. That's called the grandmother hypothesis. But this idea, this way of looking at it, that a longer human lifespan may have evolved because of menopause, because of menopausal women, and that therefore men get to live longer too, because women in their 50s and 60s have been traditionally so beneficial. so I see a lot of things through that lens and when I read that research I just felt so different in myself it's such a different way of seeing it knowing that we've evolved to do this rather than this my very existence post you know in menopause is just an accident of living too long that is that is not what the research suggests. Like if we have this, it is true that human lifespan, or sorry, human life expectancy on average used to be shorter. A lot of that was because of childhood mortality and young, you know, early death from

all various causes. But what they're also what the research shows now is the human lifespan, biological lifespan has probably not changed in hundreds of thousands of years so the human frame like the human body has has for a long time had the capacity to live to 70 or 80 and so if that's true and if some of this other you know evidence is true then yes you know it's very normal potentially beneficial thing to have these decades of life after you stop reproducing and we're one of the only species of mammals who do it actually which is just also so amazing it's us it's orcas it's pilot whales and that's about it like even the our closest relatives the great apes um keep reproducing close to when they their life ends so it's i think it's

fascinating i mean obviously i'm very passionate about this side of things it's it really from almost from a spiritual perspective it really has helped me to think about it this way i love this i love the name for it the grandmother hypothesis yeah it really ties in beautifully with something that alexandra and sharni teach on our menopause courses sorry i'm just having a total brain fog hang on it's i used to have such a synergistic brain until like a child yeah postpartum breastfeeding yeah yeah you could explain why I'm sure yeah but hang on I'll get there I'll get there on our menopause course yes they teach that the phase of life that women and people who've had periods are entering into and menopause is a phase where our leadership can

thrive where we can step into a new kind of authority and be of service in new ways you know find our way of being of service and then bring it through which really you know is this an evolutionary thing yeah and it you know what it physiologically bubbles up I have no other way to describe it like you do get I do get this feeling of I talk about in the book kind of being a force for good and just having things to contribute. And I just want to clarify this grandmother hypothesis, because I've had some feedback from readers who sort of feel excluded if they're not literally grandmothers. I think I'm not a grandmother. I had no biological children, so no prospect of being an actual grandmother, but that doesn't come into it.

That doesn't matter. Like it's still, we descended from grandmothers and we are still stepping into that role. And that can, that may or may not involve looking after children. I mean, that could be involved. Leadership in the community can just take so many forms and it can even just be, you know, creativity or just, you you know spending time in nature or just you know there's just so many different ways to embody that energy this really thrills me because obviously as we know we live in this world where women beyond 50 often feel invisible

because they're actively being excluded from all kinds of areas of life when what Alexandra Shani is saying what you're saying maybe what menopause is saying is we are needed more than ever now in our world you know we our world is turned upside down in so many ways and perhaps it's exactly the kind of wisdom that can come through a menopausal woman that can help to bring the kind of balance that we need back. Exactly. And in my book, I talk about the invisibility, freedom, two sides of the same coin. So I address that invisibility a little bit. A lot of that's about invisibility to men, which when you actually get here is totally fine. Like it's actually, you know, it's like no one misses that really like you know it's sort of this secret it's a little bit of a I don't know I don't want to overstate it but it is this

kind of like secret club kind of feeling like oh actually I dreaded this so much being invisible and now there's this freedom element to it which um yeah you have to almost live to believe you have to sort of get here to but it also is nice for young women to know that there's something to look forward to I guess I also want to say that but in some ways I remember my menopausal patients kind of talking about some of this and and me not you know 20 years ago when I'm 30 and trying to treat them me not really understanding what they meant to get here but yeah it's um there's a there's a good side to the invisibility too i think and and certainly we're not we're quietly getting a lot of stuff

done which yes have done for millennia yeah yes just in closing i'd love to just loop back to something that you mentioned about this evolutionary mismatch you know there's yes so much going on in our world that our our bodies sort of physiologically find hard to to work with how how can we manage some of that I mean I imagine a lot of the rescue prescription can help yeah so a lot of it too is about just realizing it's not your fault like you know we live so when I talk I talk about a modern environment a modern food environment as well like the modern you know alcohol environment and environmental toxins and we're in this soup of nutrients and lack of nutrients and toxins and that our ancient physiology never would have had to deal with so that, I'm arguing that what's creating a lot of the symptoms.

And also it's a different life history too. I think traditionally women would have not potentially gone through the same kind of perimenopause. They would have probably had their final baby at 42 or 43 and then breastfed for a few years and then just quietly slipped into no periods. You know, it would have been a different process, But how do we combat that is with, yes, a lot of the basic action plan, just eating whole foods, getting outside, moving the body, you know, realistically avoiding toxins as much as we can. Some of it is outside of our control. Like one of the examples I give in the book is there's

some research to suggest that what's called a body burden of lead throughout our decades, because, you know, when I was a child, there was leaded petroleum. And so we, you know, we had toxin exposures throughout our life that are potentially affecting us now that we have to just mitigate with, you treatments and feel better but um some of it is within our control so some of it's out of our control and some of it is about yeah just doing the simple things like choosing whole foods and getting outside most of the time I keep coming back to those things but they're very effective yeah and conversations like this are very inspiring in terms of actually prioritizing it because they're simple and they're effective, but often can get put down to the

bottom of the to-do list in the busy foray of life. So I really appreciate you, you know, inviting all of us listening to bring them to prioritize ourselves and prioritize that these simple acts of self-care, because it sounds like they can be some of the most important things to help to navigate this wild ride that is perimenopause absolutely yeah is there um one thing that you would love to share to people who are listening who are in the middle of some of what we've been talking about yeah is there one sort of golden nugget that you'd like to share in closing? Yeah, it's nice. Well, I'll just say two things. I'll just say two things and end with the golden nugget. But the next thing I'll just say again is, is it, it is okay to take hormone therapy if that's going to make you feel better and that's something you

want to do. So I just want to remove some of the stigma or shame around that. I talk a lot, quite a lot about hormone therapy in the book. I don't think we, from an evolutionary perspective, I don't think we need it because I don't think menopause is a state of estrogen deficiency, not, not like that narrative, but at the same time, hormones can help to hormone therapy can help to mitigate some of this evolutionary mismatch that we've been talking about, but the golden nugget is trust your body. Female physiology is not as mysterious or complicated as we've been led to believe your body knows what it's doing. It has a plan. Menopause is normal. We evolved to do it. And also perimenopausal symptoms, if they exist, are almost always temporary. So there is going to be another side, You're going to come out the other side of this. Thank you, Laura. Thank you so much. Thank you for writing this book. We're

going to link to it in the show notes for everyone that wants to go and find it, the hormone repair manual. And thank you for demystifying this phase of life for validating, for honoring us. I deeply appreciate your work and thank you for being with us today. Thank you so much for having me, Sophie. It was lovely to talk to you. Thank you for joining us today. If you are loving this podcast, please subscribe and leave us a review on Apple Podcasts. It really helps other people to find us. And if you're in perimenopause at the moment and you'd like to learn more about how to channel the wisdom of your cycle to support you through this time, or if you're in another phase of your cycling years and you want to reclaim the magic of your cycle, come on over to wildpower.online to explore our upcoming Wild Power Immersion.

And perhaps you joined us for the Wild Power Online Retreat and you are feeling inspired to make this your year of menstrual cycle awareness. And if so, our Wild Power Immersion is the perfect way to take your practice deeper by understanding the sacred tasks of each inner season, each phase of your cycle, and how they can help you to receive and to channel the full force of your cyclical intelligence. You can explore the program at wildpower.online.

Okay, that's it for this week. I hope to see you next time. And until then, keep living life according to your own brilliant rhythm.